Repetitive behaviors

[Jaquta]

Hi
I have a tendency to repeat certain behaviors.  This can be extremely time-consuming and is enormously stressful (and embarrassing, and distressing, etc).  The behaviors can cause bleeding, pain, infection and tardiness, etc.
Worse than the behaviors are thoughts that repeat themselves.  There is a desperate need to continue behaviors until I have counted the right number or completed specific alphabetical sequences or it feels right.

I have previously been diagnosed with severe depression, anxiety (GAD, NOS) and bpd.

I have emotional difficulties regarding medication and I am generally non-compliant.

Over 12 months ago I was prescribed 30 mg of Buspirone but discontinued it due to debilitating fatigue.
I did decrease the dose but then it was said to be sub-clinical.

I'm not sure what my question is.
Treatment for this behavior??  A possible time-frame?  Is it treatable?

I have been in therapy but are not currently.  My previous T left the mhs last September.
I was told that one way to reduce the behavior was to do mindless activities mindfully.  I think the behavior did decrease (I'm not sure why exactly: taking medication, mindfulness strategies, decreasing asthma medication and caffeine, ...??)

Is the anxiety causing this behavior the same as that for the pd?
My understanding is that part of that anxiety is created by un-integrated splits.

I am tired of this behavior affecting and dictating my life.  I have been having strong suicidal thoughts and urges but they are possibly the cumulative affect of severe stress and other issues.

J

[Ted A Grossbart, Ph.D.]

I think your issues are all treatable but it takes the right therapist and the ability to keep at it for a long time.  Books, forums, and other adjuncts can be very helpful, but ultimately it is long term therapy that will be key.

I would not suggest provoking a crisis as a way to get a system to respond.  Your GP sounds like an important part of your support team.  It is very fair to leave a therapist or system that is not helping--although that can be difficult to evaluate in the heat of the moment.

I'm glad to hear the new therapy is happening.  Expect crises, but take them if possible as the beginning of productive therapy not the end of it.

tg

[Jaquta]

Thanks for your responses.

With regards to the parent/ picking issue, perhaps it is both.  Perhaps that is also symbolic of the invalidating environment.  I was referring to my father and I.

Not knowing what to discuss, or at times not being able to discuss, do seem representative of fear.  My fear is of being judged or more specifically being exposed.  My fear would then be about my vulnerabilities and insecurities.  Which could come back to issues about identity.

I'll respect your, and others, space and let you answer the questions.

Self-disclosure issues do seem complex, especially when one is impulsive and lacks boundaries.  Perhaps it comes back to trusting people and their integrity.
Abandonment/ engulfment??
I am very sensitive about my repetitive behavior (ocd) and also about skin issues.
I am wanting to run.  Not because I don't want to confront them but because I am sensitive, fearful and ashamed.  Perhaps I am frightened because I have mentioned them to you.  Perhaps I am waiting to be reprimanded and thought badly of.  Maybe subconsciously I am wanting to leave the bad here with you.  Perhaps it is because talking about them makes them feel real.  Perhaps what I am afraid of is what the behavior is defending.
I actually thought I had a way in to discuss some of these issues with my GP.  Last week he said 10% of his workload is performing skin cancer surgeries.  Maybe next week?  Would the grossbart.com site give him an overview without me needing to explain?  So, I'm avoiding.

I thought that self-help books or clinical texts might help me.  I'm very shut-down on reading at the moment though.  I bought a copy of Dr Gould's, Shrink Yourself: Break free from emotional eating forever, but I haven't been able to read it.
The psychology adviser, who will become my new T next week, gave me a book on sleep to read.  I have also had limited luck there, although for different reasons.

I have trouble carrying through with most interventions.

I have been trying to take more responsibility for my parents farm (while they are finishing their house) but it has been stressful.  Almost too stressful.
I am extremely stressed and feel burnt out.

Forums have been my main support and I do feel like I've had some pretty big break throughs on them.  I feel Dr Gould (expert on the mh and emotional eating forums) has been very supportive (and patient).
Even talking to you, I feel I've learned a lot about myself.  
I expect I would be lost without these inputs.

I was wondering if stopping my weekly GP visits and interactions here would precipitate the crisis necessary for my mhs to become more involved.  I feel they should be doing more.  My GP feels they should be doing more as does my previous T who believes all I'm going through now is unnecessary.

Your last comment makes me feel a little anxious as I did continue to work and persevere with a T (the wife of the one I'm to see now) and it was extremely damaging.
Is it advisable to continue with a T or approach that has proved ineffective in the past?
What are your thoughts on when a system lacks the skill and experience to deal with a patient?  Is it fair to brush them aside?

From your experience, can much change for a person with a pd?  What can a person hope for or even expect?

Sorry for the long post.  I appreciate your time.  (And am in awe of speaking to professionals from such recognized institutions.)

J

[Ted A Grossbart, Ph.D.]

These are important questions.  The toughest situation is when people who are bright, thoughtful and troubled, clearly need therapy, but have had bad experiences with the mental health system that have left them unwilling to go back.

I'm happy to answer questions, but clearly you and others in your situation need more.  

I read people's other med help postings only to get an overview.  The question on when to disclose and when to protect is complex on the web as in life.  I don't think you have mentioned anything that should be cause for concern.  Feeling unsafe and the closeness-distance issues you describe are part of the problems you are grappling with.

I think the biggest question is what can you do for therapy or a more effective therapy substitute.  I suspect forums will provide some support but no real progress over time.  

I think what it will take is a person or system where you can get into some of your classic dilemmas and struggles but stick with it and keep working and working on it and keep the relationship intact.

Any ideas?

tg

[Jaquta]

I have a problem!  Well lots actually but they can be overlooked for a bit.
I first posted here because I felt uncontained.  Posting helps me to feel contained.
My concern is that I'm not backing off and are harassing people.  Harassing you.
I understand I am doing this because I have emotional needs, but ... it's frustrating.
Sometimes it feels extremely important for me to have contact and to feel connected.  Later, I feel like a complete idiot!

I'm not in therapy and therapy seems unlikely at this time.  How can I contain my behavior without making a nuisance of myself and feeling ashamed afterwards?

I do have a genuine interest in mh issues and do have issues with repetitive behavior.

Also, do you have any advice about self-disclosure?
I saw you mention you had read another member's profile.  It makes me feel a little uncomfortable thinking an expert may have read my profile, or worse yet, my posts.  It makes me feel a little self-conscious and a little (a lot) defensive.
I share quite a lot of personal stuff (thoughts, feelings, experiences, etc) on forums I visit regularly.  When I read the number of monthly visitors to this site I freak out a little.  What if someone I know is reading what I've written?  I like feeling like I can share and be honest about my feelings.  How much do you think a person needs to protect their identity here?  (This is perhaps even the first time that I have acknowledged having an identity.)
It's difficult trying to access support (and at times offer support) without revealing a small part of ourself.
I don't understand why I suddenly feel unsafe.  Perhaps I have regressed to splitting forums due to stress and lack of containment.

I feel like asking questions is using you/ taking advantage of you.
Why am I even doing this?

J

[Ted A Grossbart, Ph.D.]

It may be aspects of the child that the parent has trouble loving, accepting or valuing or frequently an aspect of the parent themselves that they can't accept when reflected in the child.

I think the book is well worth it.  It is a very intense but valuable read.

OCD is usually triggered by some emotional pressure but not necessarily trauma/abuse.

Not knowing what to discuss can come from many sources.  Everyone experiences it at some point.  My hunch is that for you it would more often be fear.  

I'm really not sure on policy on discussion between questioners on expert forums.  This is usual on the open forums, not the expert ones. Let's try  if you have a specific answer to a specific question chime in briefly.  For on-going dialog go to the public forums.  We'll see how that works.

tg

[Jaquta]

Also, not knowing what to discuss in therapy, is that due to lack of containment?
I was going to add some of my thoughts, feelings and experiences to volumes post but didn't know if that would be welcomed.  Is it OK to comment on someone else's post?

J