amanda@rethinkbpd.com

When Your Therapist Coaches You Through Crises

When Your Therapist Coaches You Through Crises

The falling snow gently dusted the road before me. The air was crisp and with each breath a small puff of fog appeared. As I put one foot in front of the other, the snow crunched below. I was reluctant to go for a jog, not because of the bitter cold or the slippery road but because I was in no mood to live. You see, death invaded my brain once again. For the past few days the only thing I could think of was how and when and what excuse I’ll give once I’m gone. It wasn’t a good sign. I texted my therapist not because I wanted help, not because I wanted to live, but because I needed someone to know how much I’m suffering. Before I could take any step forward, I needed a witness.

Hi. Having suicidal thoughts throughout the day. Didn’t want to bother you but it’s increasing in intensity. I’m tired of fighting this.


She’s heard this many times before. It was nothing new. But she took it all seriously. It was part of dialectical behavior therapy that separated it from other therapies I tried. The premise is that you reach out before you do anything harmful to yourself. Your therapist then elicits your “wise mind” and coaches you on skills you’ve rehearsed long before you ever found yourself in such predicament. We go over our checklist.

Sleep? Eating? Meds? Mindfulness? Exercise?

I’ve been a compliant patient and tried everything except exercise. When I feel this bad, getting my heart rate up is the last thing I want to do. I just want the world to disappear and let me disappear with it. The harsh voices bubble up. They do their best to convince me to die. I listen intently.

My therapist asks me again the next day.

Have you called your psychiatrist? Have you had good sleep? Have you moved your body around yet? Do you need help in terms of coaching in any of these?

I was digging in my heels. I didn’t want to feel better. Willful, is what they call it. I was tired of going through this. I was tired of all the work I had to do to get myself feeling slightly better than before. I didn’t think it was worth the effort. I told her I was fine and didn’t need her help. But she was encouraging nonetheless. She continued to offer suggestions in ways to get through this. Again she mentioned exercise.

And that’s when I reluctantly put on my running gear, laced up my shoes and stepped out into the cold. One foot in front of the other. It was hard and hurt on an emotional level. The run was working the side of me that my brain was working against. I wasn’t ready to let go of death. With each step, however, its grip slowly loosened and by the midpoint of my run, only one thing was on my mind. Only one thing kept repeating in my head, minute after minute.

I must keep going. I must keep going. 

Today I kept on going. Not because it was the right thing to do or because I found my life meaningful. I kept on going because I put one foot in front of the other. What helped me the most is that my therapist witnessed it all — the suffering, the willfulness, the reluctance and eventual transformation — I knew I wasn’t alone in my journey.

2 Comment(s)
  • Thebiggreg Posted February 29, 2016 7:04 pm

    I to am a complicated patient and I think I am burning my therapist out. Of course that might just be my over reaction to a preconceived notion from a couple of statements she made in our last session together. Just in case I am going to my other therapist to discuss it all with her. Really the hole damn thing is just too much to even think about sometimes!! Just this weekend I felt like getting drunk and jumping off a bridge. But I didn’t act on them, just road the wave of thoughts and emotions. Maybe someday this will all make sense?

  • Musha108 Posted July 25, 2016 12:27 pm

    Im a 48 y/o male with BPD, and no one, and i mean no one could ever imagine what its like! Im also a Buddhist teacher and have no problems understanding the teachings of “no-self” i believe that people with BPD face death every day! The death of the idea of who we are. Oh, how i long to be one of those lucky souls who do not have to deal with that hell everyday! To just wake up and go through your day facing the world instead of facing the emptiness within every second of every day! How wonderful… Nothing that i do for myself matters! Because no matter what i do for “myself” vanishes along with any meaning that came with it. I help people deal with mid life crisis, and can only say that having PBD is like living with a mid life crisis every day of my life. I am tired most of the time!

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