Work stress as trigger for learned BPD reactions?

[Our abuse recovery guide]

I've been dealing with a work situation this week that has really gotten to me, in a way that I think is probably out of proportion to what's actually going on, and I suspect this has to do with me growing up with a uBPD mother. I'm very curious if anyone else has experienced something similar.

I'm a physician, and I'm employed by a larger private practice, where some physicians are partners (so they're more leadership/management), but I am not. Last week, I had a day where I was totally over-scheduled and it was super hectic. I was working with a brand new nurse, and at some point during the day when we were running very behind, I was a bit short with her and very direct in what I needed her to do to keep things running as efficiently as possible. I wasn't rude to her, but I think she was more stressed out than I realized, and she must've taken it very personally. At the end of the day I did thank her for all of her help, acknowledged that it had been a tough, crazy day, and told her that she had done great.

Fast forward to yesterday, and one of the senior partners (not the "head boss", but the guy right under him) tells me that he and the big boss want to have lunch with me on Wednesday to discuss what happened on Friday. Apparently the nurse complained about me to her supervisor. I'm not sure exactly what she said, but this senior partner just kept saying that even on crazy days, he wants to be sure that the nurses feel they can always come to the doctor with questions and concerns. I assume the concern is that I wasn't nice enough and that I didn't seem approachable.

This is all triggering a lot of emotions for me. I feel pressed from all sides and a bit trapped. I have little to no control over my schedule, and I'm frustrated that these over-scheduled days are just constantly happening. I feel like I'm expected to be efficient, see more patients than is reasonable, stay on time, keep patients happy, be 100% friendly and hand-holding to the nurses, keep up on all of my admin work and documentation, not get burnt out, AND do it all with a smile. I'm angry and also feeling guilty and ashamed (without reason, I think). I feel very unstable and threatened, like suddenly my whole life isn't secure and like I can't trust anything.

I think this is triggering things in me that come from always feeling like I'm not enough, and like my value and worth as a human being is always under question. And that if people look closely enough, they'll see through the facade I've put up of being on par with everyone else (basically feelings of imposter syndrome). I'm sure a lot this comes from the chronic verbal abuse and hypercriticism I've always gotten from my uBDP mother.

Anyway, the last 24 hours have been very anxiety-producing and stressful for me. Last night I broke down sobbing in my apartment about it. It doesn't help that just last week, I spoke with my mother and she went into a rage and just emotionally battered me on the phone for 45 minutes. Now I'm feeling attacked on all sides. My supportive, understanding, and kind boyfriend is also overseas for 2.5 weeks, so I'm feeling pretty alone. I did call my sister last night for support, which helped, but I'm still perseverating on this and can't stop thinking about it.

Does anyone else feel this way in response to work situations in particular? Like they have an almost PTSD-like reaction to any kind of reprimand or criticism from authority, especially in a workplace setting?

Any insight would be much appreciated! I'm not sure how to approach this meeting on Wednesday either. My overwhelming instinct is defensiveness. But the other part of me thinks maybe acknowledging that I was short with the nurse and stating that I'll work on it might be better? I also intend to bring up the scheduling stressors that contribute too.

[zemara]

I've been dealing with a work situation this week that has really gotten to me, in a way that I think is probably out of proportion to what's actually going on, and I suspect this has to do with me growing up with a uBPD mother. I'm very curious if anyone else has experienced something similar.

I'm a physician, and I'm employed by a larger private practice, where some physicians are partners (so they're more leadership/management), but I am not. Last week, I had a day where I was totally over-scheduled and it was super hectic. I was working with a brand new nurse, and at some point during the day when we were running very behind, I was a bit short with her and very direct in what I needed her to do to keep things running as efficiently as possible. I wasn't rude to her, but I think she was more stressed out than I realized, and she must've taken it very personally. At the end of the day I did thank her for all of her help, acknowledged that it had been a tough, crazy day, and told her that she had done great.

Fast forward to yesterday, and one of the senior partners (not the "head boss", but the guy right under him) tells me that he and the big boss want to have lunch with me on Wednesday to discuss what happened on Friday. Apparently the nurse complained about me to her supervisor. I'm not sure exactly what she said, but this senior partner just kept saying that even on crazy days, he wants to be sure that the nurses feel they can always come to the doctor with questions and concerns. I assume the concern is that I wasn't nice enough and that I didn't seem approachable.

This is all triggering a lot of emotions for me. I feel pressed from all sides and a bit trapped. I have little to no control over my schedule, and I'm frustrated that these over-scheduled days are just constantly happening. I feel like I'm expected to be efficient, see more patients than is reasonable, stay on time, keep patients happy, be 100% friendly and hand-holding to the nurses, keep up on all of my admin work and documentation, not get burnt out, AND do it all with a smile. I'm angry and also feeling guilty and ashamed (without reason, I think). I feel very unstable and threatened, like suddenly my whole life isn't secure and like I can't trust anything.

I think this is triggering things in me that come from always feeling like I'm not enough, and like my value and worth as a human being is always under question. And that if people look closely enough, they'll see through the facade I've put up of being on par with everyone else (basically feelings of imposter syndrome). I'm sure a lot this comes from the chronic verbal abuse and hypercriticism I've always gotten from my uBDP mother.

Anyway, the last 24 hours have been very anxiety-producing and stressful for me. Last night I broke down sobbing in my apartment about it. It doesn't help that just last week, I spoke with my mother and she went into a rage and just emotionally battered me on the phone for 45 minutes. Now I'm feeling attacked on all sides. My supportive, understanding, and kind boyfriend is also overseas for 2.5 weeks, so I'm feeling pretty alone. I did call my sister last night for support, which helped, but I'm still perseverating on this and can't stop thinking about it.

Does anyone else feel this way in response to work situations in particular? Like they have an almost PTSD-like reaction to any kind of reprimand or criticism from authority, especially in a workplace setting?

Any insight would be much appreciated! I'm not sure how to approach this meeting on Wednesday either. My overwhelming instinct is defensiveness. But the other part of me thinks maybe acknowledging that I was short with the nurse and stating that I'll work on it might be better? I also intend to bring up the scheduling stressors that contribute too.

[Harri]

Does anyone else feel this way in response to work situations in particular? Like they have an almost PTSD-like reaction to any kind of reprimand or criticism from authority, especially in a workplace setting?

Your reaction is very familiar to me.  I used to be that way a lot, taking things far more seriously and personally than was warranted.  It was a behavior of mine that was directly related to the way i was raised and the way I thought about criticism.  It needed to change though as it was affecting me like you (obsessive thoughts, anxiety, defensiveness, and in my case, being very argumentative).

Any insight would be much appreciated! I'm not sure how to approach this meeting on Wednesday either. My overwhelming instinct is defensiveness. But the other part of me thinks maybe acknowledging that I was short with the nurse and stating that I'll work on it might be better? I also intend to bring up the scheduling stressors that contribute too.

I think acknowledging that you were short with her is the right way to go.  Take their feedback as constructive and aimed at helping you, mentoring you in a way (I am assuming they will not be over the top with accusations and such).  It will be hard, but fight off the defensiveness even if they are less than tactful about it. 

I used a lot of self-talk to get me through times like you described.  Telling myself they mean no harm or insult, it is okay if I mess up on occasion but I still need to be accountable and use those times to learn.  I forced myself to change my thought patterns and see times like this as a positive thing, an opportunity to change some less than helpful reactions.

Not sure if that will help you or not.  What do you think?  Can you think of what would work for you?

BTW, I spent my career working in a very busy multi physician and provider office and experienced the same with my scheduling and was pulled in all directions.  It is a tough environment in which to work and very demanding.  I watched the more senior physicians take a mentoring role with some of us.  Not all of them did though..  Some were less kind and went about things differently.  It made it harder to learn to be different sometimes.  Anyway, I think I can relate to what you describe here.

[Turkish]

 I'd own what you need to own to make it through the meeting. It sounds like you don't have a close enough relationship with them to tell them what's going on, yes?

Nowhere near as stressful, but I work and worked for a large tech company, as recognizable as Intel (but not them). I spent way too much time on the boards here from work 2013-2015 and it resulted in my first bad review in 25 years since my first year in the industry.  It shocked me, but then not. It wasn't my boss, but his boss. Cue a reorg.

Two years ago, I went through more BPD stress with my mother after my ex.  I caught myself crying by myself in the chem lab. My supervisor was mad at my lack of productivity. I hated that I was at the place I'd been before after redeeming myself.  The old manager was his boss and kind of covered for me, encouraging grace, in a sense. I didn't feel as comfortable sharing with my new immediate boss, who's a workhorse. Again, we work on silicon, not people, and I know it's no where near the pressure you're under. 

Yet the first step for me was to forgive myself and give myself grace. That helped center me. 

But the other part of me thinks maybe acknowledging that I was short with the nurse and stating that I'll work on it might be better?

There's a problem/issue to solve here.  If you bring a solution-oriented mindset, it might help, so they don't have to do it (extra work for managers).

[Ramhorn]

I really empathize with your reaction to criticism, specifically within a professional context.  The defensive, almost indignant, reflex with a hard shame chaser. That’s my usual experience. I’ve gone through the entire process (inciting incident/situation, setting of meeting, and finally the meeting itself) a couple of times. It’s terrible, so I am sorry! 

I’ll start with some encouragement; this meeting will be fine. It has been my experience that everything that I was anxious about beforehand was baseless.  Instead of feeling punitive, it felt supportive. Going into the meeting with humility while still asserting yourself when needed, is what I have found to work best. Listen to the lecture on how nurses need to be able to come to doctors. Half of it won’t even come close to what happened in your situation. They think they need to say it. None of that is personal. If they don’t understand someone making a mistake and the other person taking it personally, then that’s not on you. That is then their mistake. What happened in your situation sounds like a classic “conflict” that happens when people work together. Not to downplay what you’re feeling, moreover to normalize the situation as a whole. 

As it relates to your thought life, look into rumination. The way I understand it is; running through harmful situations in your head with the subconscious intention to protect yourself from the bigger harm coming in the future. Learning about this has helped me normalize the craziness that happens in my brain. I don’t want to project or diagnose. Especially because it looks like I’m the only one on this board that doesn’t have letters after my name. So... I have found for myself that this dance happens because my body and brain is prepping for my dad. Like ok, we messed up, I need to have my arguments in order and know why this is not my fault. I am trying to answer the question, how will I be able to mitigate the coming doom?  The problem is that I’m not dealing with my dad anymore. People in the real world, especially professional situations, would consider that behavior highly inappropriate. But my brain doesn’t care about the real world cause it’s programmed for toon town.

The best advice I can give is to be as mindful as possible. As crap comes into your brain, the more you can filter through reality, the better. Harri hits this with her self talk paragraph. I would also take care of yourself. Do something to counter the “not enough” feeling; do the thing that gives you life, that feeds you. I guess just make sure you’re intentionally loving yourself because your brain doesn’t sound like it’s doing a great job right now (silly face emoji).

I feel compelled to end with a summary, so I’m sorry in advance for the cliche. Everything you described in your reaction to this situation seems normal to me. Obviously not normal, but you know...  ok sorry. I’m sorry this happened, but you will be ok, even if that doesn’t even seem possible.  Even though the meeting may be difficult, when the dust settles, I would be surprised if things were any different than before. (Hopefully, the scheduling is different). I highly doubt your worth or value to your organization is in question, let alone your worth and value as a human. You don’t need to be perfect. And try to catch as many lies as you can before they slip into your mind.

You’re doing great. Even though the top of your tree is getting blown around, you’re not going to fall over. 

[LFCNZ]

Hi

I can really relate to your post.  I have identified that work or maybe just my current line of work is a real stressor for me, also have a BPD mother.

I work in IT, and the nature of IT is that you see problems you have never come across before frequently(even after 27 years in the field), but people generally expect you to fix them straight away and can be very demanding, IT systems down or not performing as expected means people not being productive!

When I cant fix something straight away or please, appease people, this seems to cause me loads of anxiety and stress, like I'm a failure etc..., and any criticism from my managers about my performance just sets me over the edge(why dont they come and do my job if its so easy  - )

I think someone that maybe had better coping skills would just not let it get to them, but for some reason I do.

Anyway, just thought I would let you know, you are not alone.

[zemara]

You all are absolutely amazing! Thank you so much for your thoughtful responses. It's so helpful, as always, to know that I'm not alone in these feelings and reactions.

It is okay if I mess up on occasion but I still need to be accountable and use those times to learn.

I LOVE this and will be continually reminding myself of it! I think I feel like it's not okay for me to mess up, and I'm definitely always worried about an overly punitive reaction.

Going into the meeting with humility while still asserting yourself when needed, is what I have found to work best.

This is excellent advice, too. I've always valued humility highly, but I can lose sight of that if I'm feeling at all attacked- which is not necessarily even happening, but a response I jump to emotionally. I like the idea of still asserting myself when needed, though. There are other factors at play, too.

I have found for myself that this dance happens because my body and brain is prepping for my dad. ... The problem is that I’m not dealing with my dad anymore.

I think this nails it on the head for me. I'm pretty sure that's exactly what's going on for me, too.

Even though the meeting may be difficult, when the dust settles, I would be surprised if things were any different than before. I highly doubt your worth or value to your organization is in question, let alone your worth and value as a human. You don’t need to be perfect. And try to catch as many lies as you can before they slip into your mind.

This is so helpful to remember, because I think I tend to catastrophize. But rationally, it makes sense that things really will most likely go right back to normal. I know I'm an asset to this group. I just have to watch the insidious thoughts that make me feel like I'm in danger of losing something (or everything). It's not real. Catching the lies is a great way of phrasing that.


Thank you all again! My meeting is in an hour or so. I feel much better going into it now. It's been a while since I've been on the message boards; what a great reminder of how amazing this place is.