I really reccomend that you get hold of a copy of this:

http://www.amazon.com/exec/obidos/AS...893218-2730266

Doesn't matter what your diagnosis is, I think it could really help you with respect to the way you see yourself and your behaviour. I know that it really helped me immensely, and I really can't reccomend the book enough.

See...

She talks about how the kinds of behaviours that you describe most often result from people not having recieved adequate care earlier in life. Normally (or perhaps ideally) our parents care for us. They mirror our emotional responses. They notice when we are upset and soothe us. They teach us how to regulate our distress and they teach us appropriate ways of eliciting care from others and through their care we internalise that and we start to provide it for ourselves. And in this way... You get an adult who is secure in their place in the world. But when people don't receive adequate care then they need to up the ante on the distress in order to obtain appropriate care from others. This could be unconscious or it could be conscious, it doesn't really matter. The point is that some kids are taught that the only way they will be able to get the caring they need is if they present with severe distress, or if they 'play the victim'. Some people never had appropriate and consistent care when they were kids and so they never learned how to internalise those emotion regulation and self soothing skills. Sometimes our parents don't have those skills so it isn't so surprising that they couldn't teach them to us. Some kids are abused too and kids who have trauma need more soothing and help regulating their emotions and validation of their emotions than kids who don't.

So... The upshot for Linehan is that those kinds of behaviours are understandable responses to past experiences. She allows a role for genetics with respect to some people having higher levels of emotional arousal and slower return to emotional baseline as well, but I guess that for her the focus is on the experiences.

If a therapist sees those kinds of behaviours as understandable responses to experiences then they are less likely to 'blame the victim'.

But another thing that can happen... It can be really very hard to find a therapist with good boundaries and good awareness and insight into what is going on for them. Sometimes therapists burn themselves out because they work so hard at changing the person because they can't bear to see them distressed. They just want to make the pain stop and go away and so they work to change change change the person. Which is commendable, of course. But sometimes the message that the client can take from that is 'I am unacceptable as I am. I have to change in order to be a worthy, worthwhile human being'. And that can lead to despondancy and depression and a lot of beating up on oneself and ultimately... Failure to change. And it isn't that the person doesn't want the distress to stop. Sometimes it is about... The genuine (and legitimate) need to grieve in a healing way. It is just that one doesn't know how to get the healing side of that happening... Sometimes... It is okay to feel distressed. And to be able to sit with that without trying to change it. Trying to change it all the time can be experienced as really very invalidating. Like one isn't allowed to experience negative emotions. Like one isn't allowed to grieve. And of course that isn't the message that the therapist is attempting to convey, but it can be the message that is taken nevertheless.

It is the therapists job to have good boundaries. To have boundaries that are good enough so that they don't burn out. That can be a jolly hard ask, but that is the therapists job. If that doesn't happen then the therapists job should be to refer the client on to someone else. Preferably someone else who has a better ability to tolerate distress themselves so they can teach the client how to tolerate distress too. How to tolerate the moment without trying to change things all the time. You can't change the past. One can avoid it and distract oneself and focus on other things... But change change change can be an avoidance strategy. And overfocus on change can have the counter-productive result of... More distress.

> I am too needy, and keep wanting more, and eventually people start to see through it and feel taken advantage of, and then they hate me and never want to have anything to do with me again.

See that is a therapist having bad boundaries issue. Don't get me wrong, they might have better boundaries with other clients but their boundaries with you weren't good enough. They chose to focus on changing you for what they thought was the better and they tried and they tried and they tried and that was their decision. When their strategy didn't work for them (and they got burned out) they blamed you. They need to take responsibility for that.

Another factor... Is that their focusing on changing you all the time... Lets see if I can describe. Lets say I'm feeling really upset about something or other. The therapist attempts to alleviate my distress (to change it) by minimising whatever it was that I was upset about. I feel invalidated. I escalate... I tell the story again probably endorsing about every cognitive distortion in the book attempting to get some validation for my feeling. The therapist tries to alleviate my distress (to change it) by drawing my attention to my cognitive distortions. I feel really disconnected and pissed off. Therapist concludes by blaming me for not trying to help myself / for not wanting to change / for not changing.

I wanted some validation. Is that really too much to ask? For some therapists... Yes.

Lets back up and do that with some validation. Lets say I'm feeling really upset about something or other. Therapist says something along the lines of 'it sounds like you are having a hard time of it at the moment' or something like that. I can talk about the hard time and about how upset I feel. Validation... Eventually... I have had enough of feeling upset. I want to change it. I figure out what the upset was really about. Usually something different, or maybe there was a trigger in the situation that got me thinking on something else... And whatever it was that was the real trigger... Well, my distress is an understandable response in light of that.

See there are always two things we can do. We can accept x just as it is or we can try and change x. And that means that we always have a choice. Sometimes distress needs to be felt. I personally think that what is so wonderful about the acceptance and the validation is that... I never got that as a kid. My t was very accepting and validating. I would initiate change 'please can you help me figure out how to change that'. (Not so with self harm and suicide but with respect to emotions and stuff). I internalised a lot of the validating and soothing and accepting things she said to me. She gave me some of those experiences that I missed out on as a kid. But I internalised them from her. I'm not anywhere near as hard on myself as I used to be. I still have a long way to go, though.

Sounds like your t has burned out.

> that concept that you can accept yourself where you are and still have need of change is a really hard one for me.

I think the notion is that you are okay just as you are right now. In every moment... You are acceptable and worthy and a decent human being just as you are in the moment right now. You don't HAVE to change anything. You are doing just fine.

Dwell on that...

It can be the case (at the very same time as you acknowledge that the above is true) that there are things that you would like to do differently. Both can be true at the very same time.

It takes the pressure off change. Removes the brick wall. And the acceptance... Can inspire one to take that step across into new ways of doing things... Carrot instead of the stick.

It is hard...

Reading Linehan really helped me, but having a therapist who actually understood the balancing acceptance with change thing (and who - perhaps as a result - had really very good boundaries with me so that i felt cared for and she didn't feel burned out) well... It was that latter that was life changing.

That being said I've seen DBT therapists who didn't get this at all. The self psychology stuff was interesting to me because the empathetic stance sounded so similar to the acceptance strategy... There are therapists out there who can do this. In my experience, they are rare, however.

> I think that it is more important to work my way through the pattern I am stuck in and find a better outcome. If I started over, it would probably take another couple of years for the pattern to repeat again, and they may or may not recognize it or know what to do with it.

What I'm concerned about is that it sounds like your therapist is burned out already. She is blaming you. Since you blame yourself already it is familiar turf for you. You probably don't think you deserve anything different. I'm not sure that she is able to produce a different ending for you because she is burned out already. I think the different ending will have to come from a different beginning of a therapist having better boundaries right from the start and their being able to tolerate your distress okay so that you can see that you can too. Some things... No amount of academic learning can get into you... One needs to experience validation and acceptance and caring in order to really come to believe that one is worthy of such things.

I said to my t once 'I'm scared that you will burn out with me'. She winked at me and said 'You aren't THAT bad'. I miss her so much. So much. I'm hoping that my new t is going to pull through for me. It is looking promising thus far.

I really think... You deserve better.

I really do.