My light-bulb moment for the month

It is May. I have survived my first term back at school and it has been very challenging, but in a good way. I thought that once I would be back at school undertaking a counseling course, I would have plenty of material to write about on here. Instead I find myself reluctant to share my experiences as I feel I am not where I am “supposed” to be. I am not doing as well as I think I should be doing.

And for the life of me, I could not figure out why. I was in a really good space by the middle of 2010. I had decided to stop trying for a baby for now. I signed up for my counseling course and passed the admission’s interview. I got a job working with children in an after school care program. Yet I have regressed so much over the last few months.

I know part of it was due to Jay being very sick and having to cancel most of our sessions between September 2010 and February 2011. I might have seen him a total of five times during those six months. But since February we have been having our normal two sessions a week, so why am I still so all over the place? I am so clingy one moment and so withdrawn the next. Therapy is beginning to feel like a waste of time. Ever since I was first forced into this minefield of mental health treatment I seem to make progress only to lose it again after a few months. Perhaps I am meant to stay insane.

Jay has also noticed that I seem to be doing therapy halfheartedly. He calls it me “not showing up” for our sessions, in the sense that I am there but not really willing to engage in deeper level stuff. He has been trying to get me to have a think about wanting to do therapy for me, not for him, not for my family, but doing it because I want to. Otherwise it will never work.

He asked me to have a think about this and email him my thoughts. An extract from that email (edited only to hide identifying details or leave out irrelevant stuff):

“[…] I was thinking about how you said I should want to do the work for me, not for you, not for other people, but for me. And how I just don't seem to want to. I can work on stopping self-harm, because I don't want to get thrown out of my course, I don't want the parents of the kids I look after to find out, and because I know it is expected of me. But really, if I had a choice, I'd like to have that option available to me. I don't mind self-harming every once in a while.

And I was thinking about how for most of my life I have looked to other people for cues on how to behave, what expectations to meet, what not to do. Even now, I will sit in the lunchroom at school and watch other people make small talk and laugh at jokes, and I’ll make mental notes on how to behave. How to engage in small-talk, when to laugh at jokes that I just don't find funny.

[…]

It sometimes seems like I don't really have that sense of self. I am always looking up to other people to see what they expect of me and how I should behave. I do therapy the way I think you want me to. I am a wife to my husband, always trying to please him and anticipate his needs, and forever assuming that every unhappiness in him is caused by me […].

Am I doing therapy for me? I don't know. I want to stop self-harming because it is expected of me. I want to stop acting out coz I risk hurting those I care about. I want to "get better" so everyone gets off my back. But do I want it for me? In an ideal world where no-one would care whether I was sane or crazy, I'd probably prefer to stay crazy.

The only time where I kind of felt like I was doing it for me was when we were trying for a baby. […] But it seems Mother Nature has already figured out I'd be the crappiest mum ever, so then what's the point.

I know you've often said I have to do the work because I want to do it for me. And I just don't think there's a "me" underneath all this. Of course there's a G.I. that experiences awful feelings and she hates feeling like that. But even that can feel like something "foreign" sometimes, that has to be gotten rid of, by either self-harming or acting out in other ways. And then she's back to feeling like this shell of a person. I imagine my body almost to be like a shell. And there's this huge emptiness inside. No organs or bones or anything. Just emptiness. So I go from person to person trying to fill that up. And I know there's certain ways in which I should behave to get the love and care that I seem to forever lack. So I do all the right things, behave in all the right ways, and most of the time that means someone will look after me or love me or care for me or laugh with me. So I can kind of "do the work" to get my needs met. But if there had been easier ways to fill up my empty shell, I sure would have grabbed a hold of them. So in a way I don't feel like I am doing all this work for me. I am doing it because that is how I get other people to respond to me and give me what I want. But it's not how I would prefer to behave.”

As I wrote this to him I felt utter hopelessness. Why, after all these years of treatment, am I still not “better”?

Jay had a very different perspective. He found it enlightening to read about how I view myself as this empty shell without a real sense of self. He explained that children form that sense of self during their first few years by having their caregivers respond to them attentively and by reflecting to the child what they are feeling. An angry, young toddler, does not know they are angry. An adult has to tell them “I can see you are very angry right now”, before they learn to connect the upset that they are experiencing to being angry. They also need adults to teach them that these feelings are temporary and that the upset they are experiencing will eventually subside. Jay explained that this did not happen during my early years and he was struck by how I described this emptiness inside me now. He believes that during our fourth year of therapy (2010) I slowly trusted him with more and more of the disintegrated parts that make up me. And by him kind of “holding” all those parts and integrating them little by little, I was slowly creating that sense of self, which is often much harder to do as an adult, than had it gone right the first time around when I was younger. Nevertheless, we were making progress. But then he got sick, and this process got interrupted. Even though most of me says “oh well, I dealt with it, no big deal”, it most probably scared the hell out of the younger part of me. And that is why it seems we are back at square one. Unconsciously I have decided not to bring my vulnerability to Jay as he has proven to be unreliable. And that is probably also why I feel so “all over the place” at the moment.

It was such a relief to hear him explain my craziness like this. It was my light-bulb moment for the month. He gave a name to all these things that I had been experiencing and that had been making me feel like I was destined to stay crazy forever. But in fact I had been making good progress and had he not fallen ill, I would probably still be doing really well right now. But the disruption to our sessions caused my “holding environment” to fall apart and in doing so, it disintegrated that fragile sense of self I was developing.

So that now leaves the hard work of me slowly allowing myself to bring my vulnerability into the therapy room, rather than to withdraw and/or act out. Easier said than done, but I do really believe that understanding is the first step toward becoming a whole person again. (Or perhaps to becoming a whole person, full stop, as it seems it was never really there to begin with, for me.)

This week is the first time in months I felt like there might just be some hope for me. To be continued…

Thank you for reading.

Yours truly,

G.I.

The Makings of a Borderliner

I have to admit I do not consider myself a regular borderliner. I do not know whether there is any truth to this or whether this is simply grandiosity on my side. When I read forums and message boards aimed at people with BPD I am disgusted by all the self pity and unaccountability. People blaming their BPD for them cheating on their spouses. Posting messages to the tune of “I went ballistic last night and I could see I was hurting my partner, but I just could not stop. That darn borderline.”

Of course I have those impulses. If things do not go my way, my first instinct is to stomp my feet, to throw things around the room and to hurtle insults at my husband, until he concedes and does as I say, if only to keep the peace. But, I choose not to act on that. I choose to talk to my husband and tell him I feel like throwing a tantrum. I choose to go out and take my car for a spin. I choose to ring Jay and tell him I feel like acting out. Anything, as long as it helps me get through the next few hours.

This has taken a lot of practice and a lot of hours spent in therapy. But I pride myself on having put so much effort into changing those behaviors that were problematic in my marriage. My husband and I are coming up to our three year anniversary and I cannot even remember the last time I threw a full scale tantrum. There is still some sulking every now and then. Still some extreme clinginess when I am sad or scared. But these emotions are so much easier to work with.

I have often wondered what “made” me borderline. Because I think we can all agree that borderliners are not born. I have yet to meet a borderliner that has had a carefree, stable, loving childhood free from any trauma, abuse and/or neglect.

When I started nannying and looking after babies and toddlers I was surprised by how similar my responses were to theirs. I often think that I am so good with children, not because of my nurturing and caring personality, but because I am so similar to them in my thinking and acting. I have their constant need for reassurance, for touch, for acknowledgment. When I get anxious I get the compulsive need to see and touch/cuddle my husband every few minutes, much like a toddler experimenting with her autonomy. Wanting to explore the world, yet needing to know her caregiver is still there. When I have had a rough day, I await the return of my husband anxiously, and need to be close to him for a good one to two hours, meaning literally being within a 2-3 meter proximity of him. I had previously attributed these things to just being part of my craziness, but noticed that these behaviors were very similar to the behaviors displayed by the 8 month old baby and the 26 month old toddler I was looking after.

This made me wonder, if rather than being crazy, there was a part of me that had not properly grown up yet.

I find it hard to consider this possibility as it automatically makes me feel ungrateful towards my parents. As if I would be blaming them for my acting out. It was always easier to say “that is just GI, she is crazy like that.”

But over the past year Jay and I have looked into my early childhood experiences. It has been scary, as well as kind of liberating.

Treatment for Borderline Personality Disorder consists mostly of Linehan Therapy, Cognitive Behavioral Therapy (CBT) and Dialectal Behavioral Therapy (DBT). These therapies are centered around identifying irrational thoughts and dysfunctional behavior patterns. Recognizing that rather than these feelings, thoughts and urges coming “from nowhere” (as it always felt like to me) there is a chain of thoughts, feelings and events that precipitates the urge to act out. Once you can identify these links, therapy tries to teach you to intervene earlier on in the chain rather than later. In DBT they also teach you self-soothing techniques, distress tolerance strategies and emotion regulation.

These therapies go hand in hand with endless forms to fill out, analyses to write out whenever you have engaged in self-destructive behavior, diary cards to complete at the end of every day, etc. All the rules, forms and homework made me feel very controlled and in turn made me rebel. Jay can bear testament to me dragging my feet at every step, until we finally decided (after two years of fruitless DBT) that this was not working for me.

I do not think DBT and CBT do not work. I think they definitely have their place in the treatment of BPD, however, I think they are over-prescribed, and that not everyone fits these therapy models. I learned all the skills, all the strategies, and I knew exactly what to do when I felt like acting out. But this was not enough for me. I did not just want an action plan for the times I felt like hurting myself, I wanted the urges to go away completely. After three or four years of feeling like hurting myself more often than not, I felt very discouraged with DBT. If this was what my life was going to amount to, wanting to hurt myself most days, and then spending all of my energy trying to postpone that moment until it would eventually go away, only to have to repeat the whole process the very next day, then I would rather be a chronic self-harmer.

I can see how CBT and DBT can work for some people, but I wanted, I needed, to know why I was feeling these things. Why did I react so strongly to rejection and abandonment? Why could someone cancelling a meeting with me, send me into suicidal despair? Why did I rarely yell or express anger, but instead felt like tearing myself apart, wanting to feel the pain soar across my skin? Why did I sulk, much like a toddler, even though I was now a grown twenty-something year old woman?

I needed to know why. I did not need to know what to do once the feeling was there, I needed to know how it got there in the first place.

So over the last year or so, Jay and I have been looking at my early childhood.

I was a baby born six weeks early. I then spent the first two weeks of my life in an incubator, after which my mum signed me out of hospital against doctors’ recommendation. She was tired of driving up and down between home and the hospital (this was before mums were allowed to stay overnight if their baby was in hospital). I was home for four weeks, after which I was put in daycare, full-time. When I turned four, I started primary school. I was dropped off with a babysitter in the morning, who fed me breakfast and got me ready for school, picked me up again at the end of the day and looked after me until my mum picked me up around 6pm. I do not have very fond memories of this babysitter, nor are they overly negative. Over the next few years my younger sister and I went through a dozen or so babysitters, until, at eight years old, my parents deemed me old enough to walk myself home after school, let myself in, fix myself a snack and entertain myself until my dad came home around 6pm.

Do I remember this time as particularly lonely or scary? In short, no. I remember being proud that I was considered mature enough to have my own house-key. Could it be interpreted as neglect? Perhaps. But again, I want to stress this was not something I experienced as frightening or lonely.

It did mean that throughout my early childhood, I possibly could have suffered an attachment disorder, where I never properly bonded with one primary caregiver. I am all for daycare, but I consider a six week old baby too young to go into daycare for 50hours a week. I also don’t know how daycares were run in the eighties, but the daycare that I volunteered for three years ago, had one adult looking after six babies. No matter how loving and caring you are, the reality of looking after six babies is that, for most of the day, you are meeting their basic needs. You are changing nappies, preparing bottles, feeding, burping, putting to bed, and that leaves very little time for one-on-one bonding.

I was a high achiever all throughout primary school, middle school and junior high school. I scored top marks in most subjects, but rather than thriving on this success, my sense of self was tied up in my achievements. Therefore, a slightly less than perfect mark could shatter my self-esteem so completely, as I felt it rendered me a complete failure as a person.

Babies need to be able to form trust in their primary caregiver that their wants and needs will be met, that their distress will be comforted, and their pains will be soothed. Only by forming that trusting relationship, does the toddler learn to trust in herself. I cannot help think that this step was somehow missed in my development, as my sense of self has been very shaky ever since I can remember.

Of course there were other factors that added to this as well. I choose not to go into detail about that out of respect for my parents, as I believe they did the best they could with what they had.

But the realization that there was not something bad or crazy inside of me marked a turning point for me in therapy. Rather than literally wanting to cut and bleed the crazy badness out of me, I was able to feel compassion for the toddler I had once been. When I felt sad and was scared that the feeling would consume me, I was able to recognize that the part of me that thinks the sadness will never end, is a very young part. And that the adult inside me knows the sadness will go away eventually, and I will not fall apart or disintegrate because of it.
I think this was a vital step for me that was missed during my years of DBT and CBT. With all their forms and steps and techniques, nobody had ever sat down with me to look at why I constantly felt like hurting myself. Why were these urges there in the first place?

This is not to say that my urges to act out disappeared overnight. It is still hard sometimes and it still takes a lot of effort to resist the urge to hurt myself. But rather than it feeling like a never-ending battle, it feels like I am slowly allowing the young part of me to grow up and integrate with the rest of me. I can envision a time where I will be self-harm free. And most importantly, I can be gentle with myself. It is much easier to put effort into looking after myself, if I know it is merely the young part of me that needs nurturing, rather than putting effort into not hurting myself day after day after day without end in sight.

And over these last few weeks I have had to soothe that younger part of me a lot. Jay has had to cancel quite a few sessions over the last month or so due to illness, and I notice that a part of me feels like she’s falling apart. She’s scared Jay will never return, and that like many other people in her past, he will simply walk out of her life and vanish. This in turn makes me want to act out. (The borderliner in me is screaming “I will leave you before you leave me. You hurt me by cancelling sessions, so I will hurt you by hurting myself.”) But I’m trying hard to comfort the little girl inside me, and to keep myself from acting out. Instead I try to look after myself, I am enjoying my new job as an after school care supervisor, and I am hoping with all my might that Jay will have been restored to full health next week.

Thank you for reading.

Yours truly,

GI

Little Loons

I recently found a semi love letter when cleaning out my cupboards. Two pieces of cardboard, folded in half:


DONT SHOW ANY STAFF OR DONT READ

[On the inside of the first piece of cardboard:]

Dear Grasefuly Insane,

Sorry if ive might of freaked you out a bit but I really like you. I know that I might of been a bit worried about u, but only cause I really like you. And how you said your mum said you're not worth it, well if I were your family/father I would be so proud of you for attempting to try and help yourself. But im not the father so I can just think about you & me. I really like you and think your sexy, cool, intelegent and so COOL

P.S.
Write back, put it in my door tonight.

Like/love u

DONT SHOW ANYONE


[On the second piece of cardboard:]


SORRY WRITTEN IN DARK PEN BUT MEANINGS ARE THERE

DONT SHOW ANYONE

WILL YOU GO OUT WITH ME

O YES O NO


It was sent by a hormonal 14 year old boy, Noah, second door across the hall from me. Both of us were prisoners of Little Loons. As our county's hospital only had an adult acute psychiatric ward, the local Child & Adolescent Mental Health Service preferred not to put their youngsters there. So if at all possible, we were sent to Little Loons, a kind of safe house for the more disturbed among us.

From the outside, Little Loons looked like a normal house, in a normal street. Its only give-away being the many cars that constantly drove in and out as staff members changed shifts, children were driven to their therapy appointments and parents arrived to see their sons and daughters. It catered to a maximum of five children at any one time and they made sure children with similar diagnostics were never housed together. (Druggie + anorexic = okay. Self-harmer + self harmer = not so okay.)

I was 18 when I was offered (forcibly made) a stay in there. I was quite ready to leave this life for the next and in trying to prevent this, my parents had become exhausted from monitoring me 24/7. As this was an acute admission, they only had a bed available for the next three days. Being the borderliner I am, I was furious for being locked up. As soon as I got out I tried, quite dramatically, to jump off a bridge. Very Hollywood-like. Three passersby saw me and called the police. After a bit of a chase (note to self: you cannot outrun a police car) I was grabbed by a police woman and taken into "protective custody". This remains my one and only trip in the back of a police car.

Needless to say, the very next day I was back at Little Loons.

My stay came complete with supervised showers, the handing in of all my belts, shoe laces and earrings, as well as the 15 min checks at night, where you are told to go to sleep and then get woken up by a night staff member entering your room every 15 minutes to make sure you are asleep.

When I was at Little Loons, Noah quickly formed a crush on me. I was flattered, but told him I was not his type. He assured me I was, as probably anything with two tits and an ass would be. Apart from sliding notes under my door, which staff had strictly forbidden him, he made sure we had our daily dose of in-house entertainment by pulling pranks on the poor students that had to take us out during the day.

During my stay I befriended Hot Girl. She was 16, anorexic and had the most gorgeous body. I could see why she might object to having to gain weight. Hot Girl had been admitted to Little Loons on and off for two years now, she told me. Every time she was below her minimum weight she was sent here to fatten up (there were no eating disorder clinics in our part of the country). As soon as her weight was back up she got released, only to be readmitted a few months later when she had lost all the weight.

Hot Girl was slightly wary of me until she learned I was 18 and could buy cigarettes and alcohol. I was soon regarded as "cool". As the only two girl inmates, we gravitated towards each other and quickly worked out a system where she would throw the biggest tantrum at dinner about not being hungry so I could self-harm in peace and quiet. And in return I would show staff one of my hidden razorblades and then refuse to hand it over if Hot Girl wanted to give in to her bulimic tendencies in the bathroom.

When checking in to Little Loons they searched my bags for razor blades and forbidden items (like knives, lighters, alcohol and cigarettes, but also things like spray on deodorants and perfumes, go figure). I had hidden razorblades in CD cases between the pages of the lyrics booklet, in between the double lining of my panties (obviously not the ones I was wearing) and in the battery compartment of my cell phone.

I took great pleasure in hurting myself at night, proudly showing the morning staff my handiwork, and then sit back and watch them turn my room upside down, while I had to wait in the living room...with my blades securely taped to the soles of my feet.

To pass time, Hot Girl and I would hold competitions to see which one of us could rack up the most incident reports in any one day. I think our record was four. In hindsight I can see we were a pain in the butt, yet I remember my time at Little Loons as "fun" mostly. A place where I could act out my craziness without repercussions. Where I could be angry and sad without feeling guilty towards my family that they had to endure yet another one of my tantrums.

At Little Loons we had two night shift guys. Creepy and Sleepy. They rotated on a weekly basis, so that one week we'd have Creepy supervise us from 10.30PM until 7AM, and the following week we'd have Sleepy to keep us company at night. Sleepy was by far our favorite. He was supposed to stay awake all night, but consistently fell asleep in front of the television between 2AM and 3AM. This was about the time I'd get out of bed, have a rummage through the kitchen, self-harm for a little while and have a cuddle with Puss-Puss the housecat, before returning to my room. Creepy was harder to trick, and neither I nor Hot Girl liked being around him.

During the day the house was staffed with two people at any one time, one male and one female. Sometimes these were qualified social workers, most of the time, though, they were third year psychology students. The latter were my favorite as they were more gullible. Quite idealistic still, and therefore more prone to believing you when telling them you would just like to take an unsupervised shower and you promise you will not get up to no good.

After three weeks I was sent home again, with the threat of a planned longer stay so my shrink could work more intensely with me. As my family and I moved three days after my release, this never happened.

The lessons I learned at Little Loons?

Blue-top milk contains more calories than orange-top milk. And no matter how hard an anorexic patient will try to convince the staff that orange-top milk contains extra vitamins, they will still make you drink blue-top milk.

Getting Night Shift Guy in trouble by telling the day shift you really did not mean to hurt yourself, that you even tried to talk to Night Shift Guy for support but he was asleep, is surprisingly satisfying.

I learned that cats like no other beings on earth, can make you feel at home in a strange bed.

The cactus plant in the kitchen windowsill is not all that well suited for self-harm purposes.

But most of all I learned that, despite my preconceived notions, it was nice and almost familiar to hang out with other people "like me". For once not having to feel like the odd one out.

Thank you for reading.

Yours truly,

GI

Today I cried

[...]I'm not crying
It's just been raining, on my face
And if you think you see some tear tracks down my cheeks
Please. Please, don't tell my mates
I'm not crying
No, I'm not crying
And if I am crying
It's not because of you [...]

"I'm not crying" by Flight Of The Conchords

Today felt like a significant day. After more than three years with Jay (and probably well over 200 sessions), I cried with him for the first time. I have struggled so hard to keep myself from losing it. To keep myself from falling apart. Yet today the little girl inside me curled up in the waiting room, with her Pooh Bear clutched close to her chest, barricading herself in the corner with two chairs, refusing to get up and enter the therapy room.

And I cried.

And cried.

And Jay bore with me.

He sat down on the remaining chair and respectfully allowed me my space by not looking directly at me and staying well away from my line of vision. We talked and we were quiet, and as the tears subsided I could feel myself slowly being reformed. I had dreaded this moment for months, years even, for fear of falling apart and not being put back together.

It is hard to explain the disintegration I so dread. A feeling unlike any other. As if someone picked up an eraser and started to slowly wipe me out of existence. They start at my feet, disconnecting me from the world around me. I can feel myself floating and I know that I have to stop them from erasing me entirely, for if I am erased completely I will never be able to come back. I will not be able to reform and people will never be able to connect to me again. From the time they have erased my feet, the anxiety mounts and starts to rapidly rise to an unmanageable level. I have to keep them from erasing me fully, thus panic starts setting in. I have to stop them, I need to stop them. I frantically search for my razorblades, my fingers trembling as I try to unwrap a fresh blade. I press it into my skin and drag the blade across. And only then, when I feel the sharp, stabbing pain and see the red crimson bubble up from my newly made incision, can I feel myself being put back together. I can feel my feet on the ground, I notice my surroundings, and the panic slowly subsides with every new cut.

For this reason I only ever cry when I am by myself (so I can self-harm to ground myself) or when my partner is home (so he can ground me). I do not allow other people to see me cry because I'm scared I won't be able to put myself back together in time. My partner knows how to contain me, knows when to let me throw things around the room, when to let me hit him, when to let me bang my head against the wall. And he also knows exactly when to hug me, when to wrap his arms around me so I can't move, how long to hold me for before he lets go, in short, how to put me back together.

Neither of these two options can be used when I'm with Jay. He obviously won't let me hurt myself and professional boundaries prevent him from holding me and hugging me. This is what I feared most. That if I would start to fall apart during a session, I would disappear, for Jay wouldn't be able to glue the pieces back together in time for me to leave in one piece.

And yet today, this is exactly what seems to have happened.

While I was waiting in his waiting room (and at times like these I count myself lucky Jay has a private practice at his house, so there is no-one else but me sitting there) I could feel myself starting to fall apart. I could feel the tears in my eyes, could feel my pulse rise and my breathing quicken. I tried hard to push back the tears, but today my body would not listen. I tried to hold my breath and tense every muscle in my body to keep the tears in, but today my tried and tested method failed me.

As the tears started falling, I could feel myself grow smaller. In wanting to protect the little me, I slid off my chair, onto the floor. Dragged the heater across from me, and barricaded myself behind two chairs and one coffee table, safely shielded from view, where my quiet sobs would neither be ridiculed, nor punished. And when Jay walked in to get me for my session, he just sat down and was gentle with the little girl sobbing on the floor and "held" her as much as he could, from one chair away.

Today, I cried.

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.