World War III

After my rather unfortunate experiences at high school, followed by some minimum wage factory work, I decided it was time to exercise the old brain. Last July I signed up for a Certificate in Social Services, which should eventually lead me into a Diploma in Counselling.

Cliché, I know. The patient wanting to become the helper. I have no intention though, of working with people “like me”. I’d love to become a child psychotherapist one day, and work with young kids with behavioral problems. This interest has sprung forth from my part-time work as an after-school care nanny. But that is a blog for another time.

On my very first day at school, I was grouped together with 24 other students. We were all doing the certificate in hopes of either gaining entry into a Social Work qualification or a Counselling qualification. So these were all people wanting to “help” people. I could already see which of them were a walking God-complex in the making. Those that talk about the mentally ill as “them”. Then there was the group of people that just didn’t know what to do with their lives, and this certificate was a short-term commitment, so not too much of a risk. There were those that were well into their adulthood and had decided to make a 180 degree career change. And then there was me. A bit of an outsider. Wearing long sleeves to hide my disturbing personality, and trying my hardest just to blend in.

On these first days they always try to make the group “bond” with exercises that force us to “meaningfully” interact. The exercise we got stuck with was called the “Bomb Shelter Exercise”. The gist of the exercise was this:

World War III is raging all around you. Nuclear bombs are detonated left, right and center. You are a high official and are safely tucked away in a bomb shelter along with other important people (your group members). A group of 10 survivors knocks on your door. They all want to take refuge in your shelter. The problem is, there is only enough space, food and water for another 6 people. These 10 people leave it up to you, the high officials, to decide who these 6 will be. So in your groups you must decide which 6 people you will take on, and which 4 you will basically leave to die. Keeping in mind that these 6 people might be the ones that have to repopulate the whole earth.

This is all you know of the 10 people waiting impatiently outside your shelter:

* 16-year-old pregnant girl, low IQ

* 75-year-old clergyman

* 28-year-old ex-policeperson. Kicked out of police force for aggressive behavior. Not willing to give up their gun

* 42-year-old female physician, can no longer have children

* 36-year-old violinist, served 8 months in jail for drug related charges

* 38-year-old prostitute, has been retired for five years.

* 22-year old black militant

* 25-year old lawyer, married, refuses to be separated from his wife.

* 26-year old wife of lawyer, spent last 10 months in a mental hospital, heavily sedated, refuses to separate from her husband

* 52-year old architect

So the whole point of this exercise was to show us how we stereotype. How everyone would probably think that the militant was a man, the violinist was a woman, etc.

But something far more interesting emerged. For me it was obvious we would at least take on the pregnant girl, the doctor, and the young couple that seems very committed to each other and are young enough to still have tons of kids. But I was very alone in that opinion. My group was very opposed to taking on the “loony”. “She’s fresh from the loony bin, probably psychotic, she might kill us all.” “Yeah, she’s too much of a liability.” “What if she gets aggressive?” “If she is sedated she probably came from the isolation cell.”

I was taken aback by how much opposition arose from the simple fact that this woman has spent 10 months in a mental hospital. People end up there for numerous reasons. And if you take a closer look, most of them are not aggressive and won’t be psychotic. But I was soon outvoted by all my group members and just like that, the lawyer and the loony died during World War III.

When we came back into the classroom, every group got to read out whom they had decided to let into their shelter. I was gobsmacked to find out every single group had voted lawyer and loony out. They were letting a young couple that obviously love each other very much, die, because they were scared the wife might go bananas. When this was discussed everyone was very much in agreement she was just too much of a risk.

As a borderliner undercover, I felt very uneasy. I should have said something, but didn’t, not wanting to give away my cover. I am ashamed to say that the prejudices my classmates were holding up of people like me, were the same prejudices that stopped me from speaking up about how ridiculous it is that this class full of social science students is scared of people suffering from a mental illness. I was scared that, like the lawyer’s wife, I too would be shunned and left to die.

In that classroom was the next generation of mental health professionals. And they had already bagged, labeled and thrown out our future loonies.

What is to become of the next generation of borderliners when tomorrow’s mental health professionals have already written them off?

Thank you for reading.

Yours truly,

GI

My Jay

Jay is my shrink.

I have to admit, he is ok as far as therapists go. He doesn’t seem to suffer as much from the God-complex as most shrinks do. It is a disorder very prominent in medical and psychiatric practitioners, which causes the sufferer to believe he or she is inherently superior to most other people. Not unlike people suffering from Narcissistic Personality Disorder, these practitioners believe they are “special” and unique, and that they can only be understood by other “special” people, namely, other shrinks and docs.

Although Jay has his moments where I can feel him slipping into his God-mode, he is usually able to maintain a fairly equal relationship with me, which is quite refreshing after my last dozen or so shrinks.

We met at a seminar.

Jay is a self-proclaimed expert when it comes to patients with BPD and self-harm behavior. I had never met any professional that has a good understanding of what it feels like to be a cutter, so I was going along for the ride. One thing I love (and that I get away with, since any obnoxious, provoking or society-deemed-unacceptable behavior is subscribed to me being a borderliner, and therefore I “can’t help myself”) is putting mental health professionals on the spot. Outsmarting them. Beating them at their own game.

As soon as I walked into the room, I took one look at him and I knew he was no match for me. He looked late thirties, blonde, and, well, tiny. Like too many thought-provoking questions might just blow him over. He didn’t smile. In fact, he had an air of arrogance about him. I thought, “Here we go. A therapist with a dozen or so degrees, masters and what not, thinks he is going to teach us, the layman, about his area of expertise”. I was wearing a sleeveless top. On purpose. To expose what he would surely recognize as my borderline acting out.

But as he started talking, I was genuinely surprised. He kind of did know what he was talking about, although it was still from a “I am the therapist and I am discussing a patient” point of view. But he wasn’t as patronizing and belittling when it came to discussing borderliners as most shrinks are.

Since I was getting bored with my then-therapist (we must have had over eight sessions, so time to move on), I stayed back after the seminar, and chatted with Jay. We made an agreement to catch up after the Christmas holidays, somewhere in February 2007.

And that was how it was settled.

For two whole years I have allowed him to have a look into my head on a weekly basis, and we are about to start our third year. Before Jay, my longest therapeutic relationship had been about six months, and it ended horribly with both the therapist and I unable to let go of each other. So after that had ended I had resolved to never let myself get that attached to a shrink ever again.

I do not know what changed. I guess in my file it would say that I am getting better, although I don’t see being a borderliner as an illness, and therefore feel no need to recover from it.

The reason I am writing about Jay is that he is on holiday for six weeks. I see him twice a week, so that adds up to twelve sessions he is making me miss.

The borderliner in me knows exactly what to do.

I refuse to have any contact with him at all. I will not write him and I will not accept any post cards from him. I will not make use of any crisis numbers and I refuse to do any kind of therapeutic work during his break (such as keeping track of “my emotions”). If I want to make him feel the full brunt of my wrath, I will make sure that I end the last session before his break, prematurely. I will be silent for the first half of the session, which will be followed by a full-scale tantrum, after which I will walk out. This should have him worried about my mental stability while he is sipping cocktails on some tropical beach. During his break I will indulge in any form of self-destruction I please. When he comes back I will give him a detailed report on how much, how often, and how badly I hurt myself, after which I will say I don’t feel like talking about it. I will then spend about three or four sessions in silence, making him work for his money. By this time he should feel inadequate, incompetent and defeated. Self-doubt is slowly creeping into his thoughts about whether he handled saying goodbye to me for six weeks right, and he is starting to get desperate. All the while, I will be enjoying watching him try and try again, and fail miserably every time.

Yet it seems I can’t do this to him anymore (I have done this to him numerous times over the last two years). Nobody has ever stuck by me for this long, so he deserves a little credit for that.

Shrinks are always trying to sell you this idea, that the perfect revenge for therapeutic abandonment is showing your therapist you don’t need him at all, by spending breaks completely self-harm free. They try to make you feel as if that would be the worst thing you could do to them, because it would show them you don’t need them.

Every borderliner knows this is crap.

They want you not to hurt yourself, and they’ll try to achieve it by any means possible. Real revenge is ending up in hospital while your shrink is away, or the ultimate, killing yourself.

I know all this, but despite that, I am into the third week of his leave, and I haven’t done a single self-destructive thing yet. I have thought about it. Fantasized about it. Maybe I should cut myself twelve times, once for every session he missed. Or maybe once for the first session, then twice for the second session, three cuts for the third session, etc. Or I could cut it back to six times (no pun intended), once for every week he missed.

But there is something stopping me, and I haven’t quite figured out what. Some days I swing back and forth between hating him and missing him.

I think one of the hardest emotions to feel is sadness. I have tried everything over the years to numb feeling sad. I hang on to anger, because if you are angry you don’t have to feel sad. Sadness is such a passive emotion, it kind of just washes over you to a point where I sometimes feel it will consume me. Anger, on the other hand, is very active, you are in control. To avoid feeling sad, I have also hurt myself so I could get high on my natural opiates, which pretty much block out anything I was feeling before that. I have tried my hand at drugs, party pills, and concocting dangerous cocktails consisting of tranquillizers, sleep meds, painkillers, and whatever else was in my cupboard. All this in an effort to avoid feeling the one emotion that scares me. Sadness.

I don’t know what it is about being sad that I hate. It seems like such a weak emotion. You are all over the place, it is icky with all the crying and tears, and it shows how vulnerable you are. And when you are vulnerable, people can take advantage of you. Perhaps it is that fear that makes me scared of being sad. The feeling that people will take advantage of me once they see me at my weakest.

In the two years I have known Jay, I have tried so hard not to ever cry during our sessions. Sometimes I make him leave the room and wait in the waiting room, so I can compose myself. Even though I know he knows I have been crying, I can at least hang on to the fact he didn’t actually see me crying.

And even now, in the comfort of my own home, I find myself fighting to hang on to anger instead of allowing myself to say “I miss Jay and I look forward to seeing him again in a few weeks”.

So I still haven’t got that one quite figured out yet. To be angry or sad. To be emotional or depressed. To act or to experience.

Thank you for reading.

Yours truly,

GI

Who am I?

If you would look at my high school record, it would say I have been stood down twice for a whole week. The first time for having formed a “destructive friendship” with a girl who, like me, was a self-harmer. It will not mention that I was introduced to this girl by my guidance counselor with the words: “I have another girl here that cuts, maybe you two could be friends and help each other”. It will not mention our counselor facilitated our introduction and it will also not mention he knew both of us were not “in-recovery”, whatever that means.

I could have seen this train-wreck coming from miles ahead, but my “counselor” (who was merely a social studies teacher, doing a little bit of psychological experimenting on the side) was genuinely disappointed when he found out we were indulging in our self-destructiveness, rather than being the textbook 12 step recovering addicts he had hoped us to be.

The second time I was stood down was for having a crafts’ knife on me. Everyone was allowed to have those at school, except for me, since I had a history of self-harm. The thing is, no-one told me this, or I would have hidden it better. So after having been back at school for just one week, they sent me home again. I thought detention would have been more appropriate, but welcomed the holiday nonetheless.

On the last page of my school record it will say I dropped out, and left school voluntarily. The truth is I was given the choice between being expelled for setting a bad example at school (and thereby making university entrance nearly impossible) or signing myself out. I chose the latter.

I was the typical borderliner-in-the-making.

If you would look at my medical records from the various public mental health services I was sent to, it would make interesting reading. It seems every shrink had his favorite flavor of the month when it came to diagnosing. It started with “Generalized Anxiety Disorder”. Then came the all-encompassing “Major Depressive Disorder”. To see if I was psychotic as well, I was put on a course of anti-psychotics. If they made me “better” then clearly I was psychotic, but to no avail, I was still the same obnoxious, defiant, manipulative, almost-old-enough-to-warrant-the-dreaded-borderline-label GI. And then when I did reach the age, a big fat “BPD” (Borderline Personality Disorder) was stamped across my file, relieving every mental health worker from having to try to help me. After all, BPD is incurable.

It seems that once you have the borderline label, you have become this whole new species. The receptionist at the mental health service no longer looks at you with a smile, but instead looks right through you, telling you without words she thinks you’re a waste of resources. Psychologists are pulled from your case, because talking won’t help the incurable. No more weekly sessions, or therapies, just a once-every-three-months visit to a psychiatrist for meds that will keep you doped up enough to keep you from seriously harming yourself. If you complain you still feel like crap, your daily dose is upped or a new drug is added to your tropical cocktail of psychotropics. If you complain the meds are not working and you want to stop because they make you feel like a zombie, you’re defying authority, and illegible notes will be added to your file about how your BPD traits are getting worse.

Nobody told me I had BPD attached to my forehead, until I was about 20. It had been in my file since my teen years, but there was never a “hi, you have a borderline personality” until I went to see my current therapist, Jay. When I asked him whether he thought I was a borderliner or not, he gave the classic “Why is it important for you to know that?” “What significance does knowing have for you?” I have found out through years of being a patient, that this is therapist speak for “yes”.

Borderline Personality Disorder. It’s got its own little subheading in the DSM (Diagnostic and Statistical Manual of Mental Disorder), every shrink’s bible. Apparently there used to be only two types of personality disorders: Neurotic Personality Disorder and Psychotic Personality Disorder. But this left a whole cluster of crazy people without a label, even though they were clearly not as functional as those that call themselves normal. So all exhibited symptoms of this group of people came to be known as a Borderline Personality Disorder, not quite neurotic, not quite psychotic, but definitely insane. There are nine so-called symptoms, and if you tick at least five, consider yourself a winner.

Borderline Checklist

1. Frantic efforts to avoid real or imagined abandonment. [Not including suicidal or self-mutilating behavior covered in Criterion 5] It’s up to your shrink to decide what “frantic” is. No-one likes being abandoned. That’s how we’re programmed in my opinion.

2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. Sometimes we hate our partners, most of the time we love them. Where does a relationship become intense and unstable, and when are we just making our way through the world, trying to find our mate.

3. Identity disturbance: markedly and persistently unstable self-image or sense of self. Yeah, that was me. Once. Like about 99% of adolescents.

4. Impulsivity in at least two areas that are potentially self-damaging (e.g., promiscuous sex, eating disorders, binge eating, substance abuse, reckless driving). [Again, not including suicidal or self-mutilating behavior covered in Criterion 5] Show me a person who hasn’t indulged in any of those.

5. Recurrent suicidal behavior, gestures, threats, or self-mutilating behavior such as cutting, interfering with the healing of scars (excoriation) or picking at oneself. Ok, I guess this one applies to me. That’s one out of nine.

6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). I definitely struggle with this. Once a month. Every month.

7. Chronic feelings of emptiness, worthlessness. Don’t we all feel like this during certain periods of our life?

8. Inappropriate anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights). I guess I’m a little intense, although I wouldn’t say I have an anger problem, and I’ve definitely never been in a fistfight.

9. Transient, stress-related paranoid ideation, delusions or severe dissociative symptoms. I’m not even going to try to understand what that means.

Source: http://en.wikipedia.org/wiki/Borderline_personality_disorder

I find the BPD label highly useless. Most of these symptoms are exhibited by most people in some degree. It’s up to your doctor to decide whether you’re crazy enough to be awarded the honorary title of borderliner.

I have found life as a borderliner difficult when it comes to dealing with health professionals simply because of the stigma attached to it. But I wouldn’t trade it for anything. I reckon life is more intense, with higher highs and lower lows than most people experience life. My loving husband always jokes he’d be bored to death if he’d married a “normal” woman.

My name is Gracefully Insane and from time to time I’ll share my disordered thoughts here.