In this blog, I am including an exercise from a Borderline Personality Workbook that I have completed on the stages of change in relation to my BPD. I am typing up the exercise because I want to show progress of where I am in my rehabilitation, and I think it gives honest insight into my journey of continued treatment.
Thank you for taking the time to read my responses. If you haven’t read my other blog entries you may want to start from the beginning, they help give a deeper context to the answers I have provided here. It is not possible to show ongoing growth and treatment through a single entry, and I have been detailing my failures and journey in rehabilitation over the last couple months.
The Borderline Personality Disorder Workbook; Daniel J. Fox, Ph.D., (Page 49-59.)
Chapter 6: Where you are in the process of change
The Stages of Change: The change process is unique for each of us in many ways, but it also follows a series of somewhat universal stages, including precontemplation, contemplation, preparation, action, maintenance and relapse. The process of change is scary for many people, and you’re probably comfortable with your BPD, to a degree. BPD can seem like an old pillow, but one with thorns; you’ve had it so long that you're comfortable with it even though it hurts you. The pain you know probably feels safer than the comfort and safety you don’t know yet.
Stages of Change Evaluation:
For each statement below, write a checkmark in the column (true or false) that reflects how you feel today. There are no right or wrong answers. Please answer all questions to the best of your ability.
I have issues in my life that I need to work on (T)
I am making changes in my life (T)
I don't see any problems in my life right now (F)
I know I need better resources to help me stop myself from going back to my old unhealthy behaviors (T)
I am ready to do things differently (T)
I need help to continue to do things differently (T)
Everyone else is the problem, not me (F)
I am working to prevent myself from relapsing into my old, unhealthy behaviors. (T)
I think it’s time to do things differently (T)
There’s really nothing I need to change about me or how I’m living my life (F)
I would like to learn more about how my life would change if I did things differently (T)
Anyone can talk about change, but I am doing it (T)
I’m not sure what will cause me to fall back into my old, unhealthy behaviors. (F)
I'm not sure I am ready to do different things (F)
I am working to overcome obstacles in order to change my life. (T)
I’m ready to put things in place to make a change (T)
I am aware of and encourage my new healthy behaviors and seek support when necessary (T)
I had some success doing things differently but I fell back into my old ways of doing things (F)
Now score yourself. True answers are 1 point and false answers are 0 points. Write the points for each statement in the scoring sheet below. For example, to determine your precontemplation score you’d total the points for questions 3, 7, and 10.
Question 3: (0)
Question 7: (0)
Question 10: (0)
Question 1: (1)
Question 9: (1)
Question 14: (0)
Question 5: (1)
Question 11: (1)
Question 16: (1)
Question 2: (1)
Question 12: (1)
Question 15: (1)
Question 6: (1)
Question 8: (1)
Question 17: (1)
Question 4: (1)
Question 13: (0)
Question 18: (0)
Precontemplation: At this stage you’re not considering changing anytime soon. You’re unaware that a problem exists, but family, friends, coworkers are aware that there’s a problem. If you seek help at this stage in the process, it’s due to pressure from others.
If you rated this stage of change the highest, what thoughts and feelings do you have about changing?
This was my lowest rating currently, but where I was most of my life up until January 2020 before I was diagnosed and started treatment.
I was scared to seem imperfect and like a bad person in the public eye, and had deep seated behaviors that were harmful to myself and others. I had made a routine out of leaving existing relationships in an unhealthy way, and being abusive to those around me.
For example, throughout my life I used problematic language that people labeled me for. (I explain this in depth in my August 31st blog in which I discuss my struggles with verbal abuse, if you haven't checked it out you can read it here.)
When I was criticized publicly, it created this sense of pressure for me that felt like,
“Okay. People don’t like me, so I need to do and say the right thing so people will forgive me.”
I felt pressured to make apologies that I felt like I didn’t need to make because I didn’t feel like I was in the wrong and didn’t think the language was a big deal.
I lacked education on it, and even when the world was full of resources to utilize, I still didn’t.
That coupled with problematic language humor I had behind closed doors mixed with my struggles with verbal abuse was a constant state of toxicity that I projected onto others.
I know what this stage feels like, because at that point in time in my life I felt like I had to be perfect so people would like me, and that was it. It was a very shallow type of change. It was the type of change that I was hoping would just make people stop posting about me.
It was a toxic quality of having to control everything because having control made me feel safe in my chest. At that time, I didn’t care about changing my core beliefs and mental health, I cared about saying what people wanted to hear. It’s embarrassing looking back on, and it makes me feel manipulative and ashamed. But it’s important for me to reflect on it to keep me from being that person again.
What are you uncertain about when you think about changing?
I felt uncertain about my future. This was something I struggled with at the start of my treatment. I had an obsession with looking like a good person, and craving social acceptance that was dishonest and narcissistic. It was because I felt like I needed all control over everyone's opinions of me to feel like I was accepted and “safe” in my chest. I was afraid if people knew about my struggles that I would be isolated and people would not want anything to do with me. After being cancelled, and losing all control of that, it was hard on me.
When it happened I took my entire bottle of Xanax, prescription medication, destroyed my apartment, and drove my car into oncoming traffic in a suicide attempt. I was then hospitalized for the overdose and sent to a facility involuntarily, and that’s where/when my treatment began.
It was the lowest moment, but also the start of the transition I needed into receiving treatment to live a healthy life. Something that was hard was when I got out of my facility and had started my treatment, people started texting me saying there were documents and videos being made about me, and that loss of control was and is still the hardest thing I have ever experienced. I struggled badly with the idea of my worth being determined by things people have said about me online, and that feeling of rejection that I feared so badly.
I struggle particularly badly with the idea of not being able to have people see the good parts of me. But I understand it is entertaining to display and discuss the bad parts of people and their failures. I also understand the collective healing and closure it gives for people, which I think is a good thing and am happy people were able to have.
It’s hard because social media is something I don’t use because of the toxic traits it brings out of me, but I don’t know how to show people I am a person who is capable of good and living a stable healthy life with stable healthy relationships. Ultimately, I learned that I couldn’t and it didn’t matter how much control I wanted to have over the situation, I never was going to be able to control it. Accepting that was hard and letting those feelings go is still hard, but those feelings of control were toxic and I projected anger and pain through them frequently.
The term “cancelled” scared me because I felt like I wasn’t a season of a TV show, but a real person who thinks deeply about the world and reflects on my failures. I have a life to live filled with hopes and dreams, and love to give to my family and those around me. I was scared I would never get to live those things if I wasn't accepted. In reflection, it was the best thing that could have happened to me, because giving up that control has allowed me to begin to live my life as a person with a deeper understanding of my failures, and led to the meaningful continued treatment I am in.
In a lot of ways I am thankful for it, because I have been given an opportunity to take my personal struggles and discuss them openly. But I struggle still with the uncertainty of if people will accept me. I think I will always struggle with that.
I regret not being accountable and receiving help earlier and had been in rehabilitation earlier because I hate the person I was, and I feel like it wasn’t me, but it was. I feel awful, embarrassed, small and wrong, and I want to be someone who can change the course their life was on. I think the embarrassment and shame are good for me though. There’s something that forces growth when you can’t hide the things you regret. It’s like being open all the time 24/7 and it’s all I think about.
So I feel embarrassed and ashamed 24/7. I can feel the way it changed my core energy, in a grounding way. It has helped me review how I think, what I say, every interaction I have, every conversation I have because I am scared of it. I am scared of being judged, and I think that having fear motivates me.
It’s helped correct my behaviors, and I am thankful for that. Because once I started treatment I couldn’t believe how uneducated, emotionally disturbed, misogynistic, and problematic my humor and day to day language was. It was disgusting and terrible, and I struggled with being that type of person. I am really ashamed of it, but am happy to have been able to deal with these issues directly. I want my family to be proud of me and I want to be a good person. I am thankful for the education I have had and for having a support system who has helped me understand maintaining healthy relationships, and respect for people.
What would it take to make you start thinking about addressing and changing your problem?
It took being hospitalized involuntarily, because I only received help after I was in a mental health facility and didn’t know when I was leaving. (This is discussed more in my August 31st entry here). I wouldn’t have ever really committed to getting help if I wasn’t in an environment where it was required 24/7 to start that routine. It was the lowest point in my life, but also the best thing that could have happened to me. For a person like me, with my BPD/BP the amount of pride/ego I had, it took the most extreme solution to solve an extreme problem.
Contemplation: At this stage you’re aware that problems exist but remain uncertain if you want to change or what’s involved with changing. You may be weighing your options: should you stay where you are or invest effort into doing things differently.
Do you see benefits for staying where you are with the problems and issues you have related to BPD? What are the benefits?
As I described above, that feeling of loss of public image coupled with my BPD made my day to day life unbearable for the first year I started getting help.
I would go manic sitting around thinking about people making fun of me and spreading rumors about me and getting joy out of making posts and videos shaming me and it consumed me.
I was in a place where I didn’t know how to continue to have a voice for myself, and I thought that having a voice meant I was in need of making YouTube videos and having social media. Which is a trap I think people with struggles in the public eye fall into. I don’t think making a video saying you are working on yourself does much to document growth or show commitment to change.
If you apologize immediately when you are called out publicly, you haven’t focused on the issues presented at all. It goes back to the precontemplation stage of wanting people to know you are “sorry” because they want you to be, but you haven’t had time to educate yourself on what you feel “sorry” for, why you should feel that way, the consequences of your actions, and to start treatment for those things. I felt in my heart that I wasn’t the person I had been determined to be online, and I didn’t know how to express myself. But I didn’t need to be expressing myself publicly, it wasn’t appropriate.
At first, I wanted to hide, and made the decision I would never do music again because there was a sort of freeing notion in the ‘Okay, it’s finally over. I can start living my life now” but the feelings I had didn’t leave, and I didn’t feel as though I was free, I felt worse and worse. I told my Therapist and Rabbi that I wanted to go back to school to do some kind of job out of the public and they told me they didn’t see that for me.
They told me that my skill of using my voice and words was something that I needed to continue to do despite my failures, because they have helped and continue to help people with similar issues. I agree with them to an extent, but I think using my voice comes in the form of songs, not on social media platforms.
My BPD makes me extremely paranoid, and I haven’t been able to hold a job or stay in school because I get worried people don’t like me and I won’t be able to succeed and I struggle with replaying every interaction to make sure I am someone people accept. It is still that craving for acceptance and being perfect, and worrying when people don’t accept me, I am unable to handle it appropriately.
Emily has been there as a support system and has shown me consistent love, acceptance, and encouragement to do what I love, which is writing McCafferty songs. Working with a team I was able to create a way of doing music healthily and discussing my treatment through my website. It has allowed me to show my growth and be at peace with things. I think documenting my treatment allows for people to make a decision on if they accept me or not, and if I am really just the things people say about me. But the importance of it is it allows me to express myself for my own self worth. People can rightfully dislike me, and I accept that, but the process of expressing my struggles openly gives me a feeling of closure, and accepting myself. I am past the point of wanting people to like me, and projecting that frustration into anger. I want to accept myself, and writing is my way of trying to do that. It feels like a weight lifted off my chest when I can type out my feelings.
I have had a lot of failures in my life, but my journey isn’t over. It’s weird, but staying where I was and being inactive after being diagnosed felt just as unhealthy as being active on social media before being diagnosed. It was that same BPD feeling of replaying things in my head and festering, and becoming manic. A lot of the time it was worse because I didn’t know exactly what people were saying and that loss of control was hard to sit with. I accepted not having that control, and realized that even without it I could still be someone who is allowed to exist and create. And I love to create. Writing music gives me so much joy, and is a constant I have always had.
What might you gain by changing your negative beliefs, behaviors, and patterns?
By changing my negative beliefs, behaviors and patterns, I am able to start living my life as someone who might be able to gain healthy relationships built upon respect and be someone that is capable of being stable. I want to have normal stable relationships and make friends and be someone that people like to be around. Not online, but in my personal day-to-day life. I want to be a happy person, and I hope changing those things will help me find happiness.
Preparation: In this stage you’re testing the waters of change. You’ve committed to doing things differently and are getting ready to challenge your BPD symptoms and address issues.
What areas of your BPD do you want to be sure to address and overcome?
I want to address and overcome the anger and paranoia I have in relation to my manic highs. I have continued to grow in this area. Before I started treatment, when I was manic, I had a problem destroying walls and technology. I would get overwhelmed and kick/punch repeated holes in walls and I would smash technology. In 2019 I broke 5 televisions from punching holes in them. In 2020 I broke my laptop, and my home computer, computer monitor, and several of my dishes when I was manic and angry. I haven’t put a hole in anything or broken anything in over a year now and It feels weird writing like it's a good thing because it’s abnormal and abusive to break things, but it’s something I struggle with. It’s a pattern I had and one I have been able to break.
That doesn’t mean my anger has gone away though. I still have manic episodes of anger where I will want to break things and it takes the routines and behavior changes I have had to actively stay in control of myself. My medication helps a lot, and I have an appointment on the 26th with my psychiatrist to discuss a medication increase because I still feel like my manic episodes are intensive and take up most of my days.
This relates to the second area of my BPD I want to overcome which is the amount of time I spend manic high and low and how it changes on the flip of a switch.
For example, Emily and I were having a normal day and enjoying each other’s company while working in our office. We were about to transition to going to watch a movie, when I had this sudden manic low switch and I became overwhelmed with fear to the point where I was sitting face down at my desk crying. She is incredibly patient and eventually I am able to get myself together, but it takes an hour and it happens several times a day. Some days more than others, but I usually struggle that way at least once a day. I know the stress is really hard on her.
Sometimes she will cry because it gives her stress, and I apologize and comfort her and she tells me it's okay but it's hard on her and I feel selfish for it and like a bad partner.
I am always there for her because I love her more than I have ever loved anything, and I think about how if the roles were reversed I would reassure her and make her feel the way she does to me, which is safe and forward thinking.
I want to not feel that manic low. It feels like there is a hand that is always hovering above me and it takes grip of me and it won’t let go. I sometimes feel like I exit my body in the third-person and am trying to get myself to move and telling myself to get up, but I can’t. I used to think it was just a selfish choice, but I physically cannot move and I have been trying to figure out how to. This is an area I want to continue to work on because I want to give my partner the support and attention they give me.
Emily has taught me about healthy communication and I want her to feel like she has a partner who loves and supports her just like she does me. I live for her everyday and she has been there for me every step of the way through my treatment. There isn’t anyone else in the world like her, and I am incredibly blessed to have her in my life. I value and love her. She is my best friend, and a lot of the time I feel like we are the same person. It’s incredible having a best friend to spend everyday with and our inside jokes, and adventures make my heart feel full. I love the way she laughs and her intelligence, and her kindness.
She has taught me how to forgive and the importance of patience, and she demonstrates all those things to everyone around her. She is a blessing to everyone she meets, and I am lucky to be her cheerleader and watch her do amazing things. She is better than me at most games we play, and hates almost every movie we watch, just like I do. Waking up with her in my life is the most important thing to me, and I want to be a partner who makes her feel that way, and to deserve to have her. I love her so much.
Who can you consult for social support as you begin this journey of change?
My Rabbi is someone who I consult with daily. We have a good relationship and we meet often. I am thankful for her support.
Action: In this stage you’re engaged and ready to challenge, control, and defeat those negative beliefs, behaviors, and response patterns related to BPD. You’ll go through the workbook and use the skills you learn, incorporating them into your views of self and others and the situations you’re in. You’re committing time and effort to change and grow. At times during this process of change you may feel a sense of loss for the old negative beliefs, behaviors, and response patterns that you're leaving behind. Remember that this is a normal reaction, and you should continue to commit yourself to the process of defeating your BPD.
What can you do to empower yourself to get around barriers to your growth?
I think the biggest barrier to my growth was myself. So I had to get around myself in a sense. I was the person who was creating all of the issues in my life. It was my mouth, my behavior, and my mind creating the harm.
The worst thing for me was Nick Hartkop, because I was a toxic person and still have that toxicity in me. I talked with my therapist about how if I could go back in time and tell my younger self the biggest thing I needed to work on, it would be my mouth. My manner of speaking, my lack of respect, my verbal abuse, but I know if I told my younger self that they would have told me to go fuck myself.
I was able to get around myself because that version of myself was broken down. It was broken down by being diagnosed and starting treatment while hospitalized. If I hadn’t been hospitalized (And I was more than once. I still struggled once I was out the first time) I wouldn’t have stuck to treatment. If I wasn't cancelled, it wouldn’t have become my life. My treatment is my full-time job. It's what I do from the moment I wake up until I fall asleep, alongside writing. I am someone who struggles with BPD/BP and it takes all of my time to actively grow alongside it. I’m the type of person who if it hadn’t become my life, I never would have cared about it, because I didn’t take it seriously. But now it's what I live for everyday. I’m trying to figure this out one day at a time. Safely and meaningfully.
Maintenance: By this stage you’ve made the changes you need to make to develop adaptive and healthy response patterns, behaviors, thoughts, skills for self control. You’re committed to adaptive and healthy functioning.
What can you do to prevent yourself from sliding back into old beliefs, behaviors, and patterns?
I think the most important thing you can do to prevent yourself from sliding backwards, is to make the choice not to. Working on BPD/BP takes an active thinking process, which is much easier said than done. It’s easy for me to talk about my mental health like I am in control of it when I am in a safe environment, but what matters is the moments when I am manic. I had a manic episode recently where I was feeling angry, and it was one of the first times I was able to actively use my behavioral changes.
I am at a point now where I am able to have coherent thoughts when fuming and rationalization. Don’t break this, you’re going to regret it. Putting a hole in this does nothing to change your situation, Being angry right now isn’t going to make people accept you. You're only hurting yourself by doing this, when you come down you are going to regret saying/doing this.
These things may sound like normal thinking processes, but they took me a long time to start developing them. It’s embarrassing, but part of my illness. I am trying to now implement that on the other side of my mania which is my depressive lows. I struggle badly with being able to get myself out of my crying habits. It comes with an overwhelming urge to kill myself and make the thoughts go away. I have been struggling with not needing to go to the hospital and threatening self harm still.
When I am manic low I feel like my feet are nailed to the floor and I can’t move. It's something that I feel like has replaced the anger, and is an ongoing issue. It wastes a lot of my day and it wastes my partner's day and I am going to be asking about techniques to overcome this in my next session, which is tomorrow. Another thing that keeps me from sliding backwards is separating myself from things that brought toxicity out of me.
For me it was social media, touring, and pretty much any type of social interaction. And all of those things were my fault. I have problems communicating effectively, and it's something I have been working on since starting treatment. But the biggest difference is medication and therapy.
Without those things, I am right back where I was before I started. I think living privately helps me a lot. Giving up control of my social image and losing that toxic want for control was something that really has changed my life.
Relapse: A research study found that of those who relapse, 15 percent fall back to the precontemplation stage but 85 percent go back to the contemplation stage (Prochaska, Norcross, and DiClemente, 2013). What this means is that the majority of people who relapse into old negative beliefs, behaviors, and patterns, go back to thinking about changing and then reenter the change process. If you relapse while tackling your BPD, have faith that this is okay and expected. Eventually you’ll resume the process of change and can and will do things differently and better in the future.
What has helped you control your triggers and overcome barriers?
As described earlier, my ongoing therapy helps identify them and overcome barriers. My triggers come from being stuck on delusional thoughts and paranoia. I am still my worst enemy. I recognize thoughts that are unrealistic and behaviors that become routine from panicking around them. Whether it's crying at my desk for hours, or putting holes in walls, in my past it was verbal abuse and physical altercations when someone got in my face. I am able to realize now when I am manic and when I am low. I can understand the feeling of my brain shifting, and I can understand the anger, I know what's happening, and I know how to react to it. I am still learning everyday on how to manage it. I still feel like I have no idea what I am doing though. I still feel like I am not better because I still struggle with the anger and paranoia. I know it is normal to struggle with them, but I wish I didn’t. It is important to note that I answered number 4, I know I need better resources to help me stop myself from going back to my old unhealthy behaviors, as true earning me a point in relapse. I did this because it is important for me to always be receiving more resources and education related to not going back to the things that are unhealthy. If I felt as though I had everything figured out and a perfect system going, that is how you fall into not being active in monitoring your mental health. I will always be utilizing resources given to me throughout my treatment to have a deeper understanding of my triggers and unhealthy behaviors.