Spiegel im Spiegel

Wednesday is the final group therapy meeting of my Dialectic Behavioural Therapy (DBT). It has been a 52 week course of intensive introspection and skill building. Others may arrive bearing wrapped gifts or cupcakes, I want to bring something much more reflective of my experience.

It is by chance that just a few days ago I heard a radio performance of Spiegel im Spiegel by Arvo Pärt. On this very first hearing I was taken aback by how similar this piece made me feel to how I felt whilst practising DBT mindfulness skills. It was immediately clear that I should perform this piece for my therapists and fellow group therapy members.

Spiegel im Spiegel is so named because of the infinite repetitions occurring when one places a mirror in a mirror, or Spiegel im Spiegel. These repetitions can be heard in the arpeggios performed by the piano over which the cello line plays repeated F major scales, the scales create long beautiful soothing melodies. Naturally, these melodies are essentially scales in contrary motion, a musical term meaning ‘mirrored’. As the piece continues they lengthen and lengthen. I understand this to symbolise the ever increasing images of the mirrors’ reflections. Pärt has cleverly created tension and release by choosing to commence or end the scales on notes other than the traditional tonic or 'do'. The cello melody commences on the supertonic ('re'), the second note of the scale,  this gives me the impression that the piece had started before the musicians had even arrived. Perhaps the composer wants to remind us that we exist in a tiny moment within an infinity?

This is precisely what I have done for the last twelve months. I have looked at myself in the mirror, again and again. I have become aware, through repetitive mindfulness activities, of every thought, physical sensation, emotion or urge. When the reflection within the reflection is examined and understood, the cause behind these thoughts, physical sensations, emotions and urges becomes clear, it's cathartic. With complete acceptance and/or willingness to change, I have been able to calm and validate myself. I have been able to see how normal it has been of me to do what I did in those challenging circumstances. Alas, my experience has been of much repetition. In these reflections I found beautiful soothing. One of the distress tolerance skills is to self soothe through the five senses. I use my ears to be soothed by music, my eyes to see the beautiful patterns the music makes on the page, I can smell the old aged wood of my cello and the rosin or tree sap on my bow. I feel the wood on my skin as the instrument vibrates with the resonance of sound. The dissonance and harmony comprise two opposing forces which can be simultaneously true, this is the dialectic. It's what suffering Borderline Personality Disorder is. It's wanting to live and die in the same moment; it's hating something because you love it so much; it's many strange things which I have learnt to radically accept.

F major is a beautiful choice of key. Before the common practise of equally tempering tuning in the late eighteenth century, key signatures would arouse desired emotions in the souls of audiences. So for the lessor musical scholars in my audience, what I am saying is that the note a composer chooses as his 'home' note can affect the emotion one feels in the music; depending of course how the musician chooses to tune his instrument. Temperament (are you seeing the emotional connection?) is a frightfully complicated mathematical phenomenon. Go and chat to Pythagorus, he can explain it so much better than I. F major is a key which evokes a pastoral setting, it places me in a forrest or upon a rolling hill. Mother nature is my God, it is the glory of natural instinct which tells a flower when to bloom or an animal to migrate. This for me is evidence enough of God's existence. My earlier religious experiences taught me to despise the word 'God', so mother nature she is for me. I guess this is all a long winded way to explain how F major places me in the midst of my higher power, in her greatest cathedral.

Learning to play Spiegel im Spiegel has required much skill in emotional regulation, the third of the quartet of skill groups one learns in DBT. Yet another dialectic, to remain detached from the emotion of the music in which I wish to swim. Maintenance of my rational brain, is a requisite of expert cello execution. In DBT language 'wise mind' is a place where the perfect balance of emotion and rational mind exist. This is where I must remain to affect the emotions of the listeners, yet maintain a high level of technical prowess.

I greatly hope this performance of Spiegel im Spiegel will bring great comfort, encourage further soul searching and celebrate the end of a truly remarkable year of therapy. Thank you Marsha Linehan, creator of Dialectical Behaviour Therapy.

I won't do it.

Currently at work, I am dealing with a client who is demonstrating really destructive behaviour. It's very self sabotaging, abusive and rude. I identify with it all. In fact I laugh because I've done exactly the same thing. This client is getting so much support from the government with doctors, social workers, cleaners etc etc. but the woman is just refusing to do anything and is being abusive to those trying to help her.

My heart goes out to the client because I can see how much pain she is in, and those trying to help her are getting really worn out and are therefore increasing the invalidation and causing her more grief. As a peer support worker, how do I get her from, 'I won't do it' to 'I want to do it'? We have to get the client to a place of really wanting to get on the recovery journey. I remember being there myself, I was in so much pain that I couldn’t do, feel or think anything. So anyone saying, ‘come on Kate, you need to do this’….I’d tell them to f*%# off because I felt like they had no idea how hard/impossible it would have been for me to do 'that', they just didn’t understand and they must have thought I was being silly and should just get over myself (after all that’s what I believe my mother has been telling me for forty five years). The only way for the pain to have stopped would have been to exit this world. My poor client is saying I'll have blood on my hands if she is successful in this. From my experience I do know however she is safe. 

In the end I had no help whatsoever, my friends were fed up with me, I was fed up with my family and I had ‘sacked’ any doctors/social workers trying to help. Typical Borderline behaviour. Perhaps my friends weren't fed up with me, but I believed they were, I didn't want that they would have to 'suffer' me anymore so I isolated myself.

Realising that I couldn’t seem to exit this world (after five attempts), meant that I would have to find a way to make life bearable. It was the first time I had reached the 'I want to do it' step. The first thing was that I had to find a way not to loose my house. I luckily found a job in which I used my experience as a mental health patient. I was a ‘peer support worker’, ‘peer’ meaning I also was a mental health ‘consumer’, a consumer of mental health services. I used my ‘lived experience’ to help others cope and recover. This was a great foundation to my recovery. I was a useful member of the community, the increased amount of time I spent with other consumers, helped me to feel less lonely and that my feelings and pain were valid. I felt so good about myself sharing my coping strategies to help others and I wasn’t going to lose my house. I was alone, but I had a great team and clients at work. My new employer was supportive enough to keep me afloat, not much more.

Finally the 18 month wait was over and I started DBT (Diabolical Behaviour Treatment…..ha ha only joking, Dialectic Behaviour Treatment). I think it was that first day in which I met my DBT individual therapist when I got to the ‘how do I do it' step. I had found someone who said, 'come on Kate, this is how you do it'. This person (Dr Fabbo), who was telling me what to do, did know how much pain I was in, did understand what I could and couldn’t do, was prepared to tolerate me when I tell her to f *^% off. God had given me the right help. This was my big opportunity. I felt confident that these clinicians were not ‘one of them’ (mental health clinicians). Well they weren’t ‘one of us’ (mental health consumers) but they were a ‘one of them’ who know precisely how it was to be ‘one of us’. We became, 'we are one'. 

The first day I went to group therapy I was terrified. I hid my face and cried the whole way through it. I just knew that I couldn’t leave that room, this was 'how to do it'. My commitment to changing and beginning to live a life that was bearable depended on it. The odd thing was that the other participants and clinicians in the room did nothing about my sobbing. It was awesome. They didn’t embarrass me by saying anything, making a fuss of me or giving me sympathy. Their silence was pure empathy and understanding. It was although my behaviour was totally normal. I felt totally safe and validated. So throughout the morning my crying changed from fear tears to soothing and relief tears.

My journey to recovery had begun.