The difference between my young Borderline self and my older, somewhat wiser Borderline self is that I may still have the same intense feelings of rage, paranoia and injustice, but I now sit in those feelings and try to discover what they mean to me and channel them into a different, more positive direction. Instead of hating civilisation and its discontents I embrace the suffering, look inward and transform it into a learning opportunity for personal and spiritual growth. Part of that was learning to love what I already had instead of seeking out what didn’t belong to me and never would. The Buddha said, “Suffering is inevitable.” And it is – sometimes. It is what we do with that suffering that counts. I had to learn to lie down beside the Borderline bull, embracing her lacerating horns at a level we were both comfortable with.
After fifty years of eating disorders, lap bands, a small bowel obstruction, kidney cancer, malnutrition, metabolic syndrome and diabetes type 2, I was further diagnosed with a lump on my ovaries in August 2012. So I went to see my disease-free, de-toxed, slim, fit, healthy, yoga-inspired, meditative, free-range, organic, body-centred clinical psychologist who advised to me to do what she had been advising me to do for the past 17 years. Look after myself, be kind to myself, be gentle with myself and start to eat and exercise accordingly. What would you know about life? I thought, as I threw my last sugar binge in her outdoor bin before taking off on holiday with my husband.
Bali for me is usually one long, eating/drinking self-indulgent binge punctuated with cheap shopping sprees in and around Kuta – buying clothes I never wear and items I would sneer at back in Australia. This time we stayed at Lovina Beach and Ubud and I made the epiphanous decision to eat organic vegetarian, drink detox blends and spend as much time as possible being mindful at the Yoga Barn. I also relished the idea of torturing myself by hiking 500m almost vertically down (and back …
Borderline Personality Disorder is not just about mental illness and emotional distress, it is also about social skills (or lack of them), empathy, manners, conflict resolution and self-care. Most children learn these vital social skills early on at pre and primary school where they observe other children’s behaviour, learn a “theory of mind” or how other children think and feel (mentalising) and experience compassion and empathy for others. These things come naturally to them.
But some children, through no fault of their own, are unable to learn and remain totally clueless about how to survive socially in the playground. These are the kids who suffer social neglect, rejection and abandonment. These are the children who need a step by step guide or a “recipe” on how to learn empathy, how to be a team player, how to get on with other children, negotiation skills, conflict resolution, the rough and tumble of give and take and sharing toys with grace and dignity.
These kids need to learn that when this happens, this is the correct response. I was not one of those naturally cluey children; I lived in social Siberia most of my school life and became a library refugee.
Here are five survival techniques desperately needed when suffering from BPD:
There is a saying in a self-help group I used to be in back in the eighties. When a “normal” person gets a flat tire, they call the Automobile Association. When someone with (what’s now known as BPD) gets a flat tire, they call the suicide hotline. There’s an awful lot of truth in that.
My goal recently has been to respond rather than react to what I perceive are excruciatingly provocative circumstances and situations. I want to think and act with grace and dignity, to deep breathe, turn around, walk away, move on, learn the lesson and get a life. This attitude has, in the past, kept me in relationships, out of the law courts, out of jail, out of psychiatric hospitals, in employment and in therapy (or life coaching as we are now doing).
No longer is my therapist my nurturing supporter, smothering me endlessly with loving/kindness, reassurances of never abandoning me and justifying my bad behaviour and lack of social skills as a result of my environment. We have a more pragmatic egalitarian relationship where I feel mentored, rather than mental.
Learning how to accept criticism graciously is a form of art, but for me it is a work of art in progress. This is because I was diagnosed with borderline personality disorder and part of that syndrome is being unable to tolerate critical comments, no matter how well-meaning.
So what happens when I get criticized? No matter how mindful my brain wants to be, my body has an anaphylactic reaction. I feel as though someone has thrown acid in my face. I feel my body disintegrating and my internal organs shutting down and psychological and physical death is imminent. Does that sound familiar to you?
This isn’t planned, this isn’t about me being a Drama Queen or a Princess with a slipped tiara; it’s about staying alive. I go into survival mode where I have to sit in a chair, breathe deeply, count my fingers and toes and make sure that I am all here. I have to detoxify my body before I can even start to work out cognitively what was said, why it was said and what the ramifications of the criticism were.
It used to be that if I ever ran into my therapist at a café, at the airport, in a restaurant, or walking down the street, I would have to walk out, catch a different plane, leave my meal or cross the street and get hit by a bus. She once said to me that I would have moved on when I could pass her in public, either wave or not wave, and my care factor would not be there.
So how do I avoid either the impending feeling of doom and chaos or the sheer guilty pleasure and excitement of seeing my therapist outside of therapy for free? I have had a mixed reaction on the handful of occasions I have seen her or her car out in the wide, wide world.
I thought it was safe to let you know how I was doing. I thought it was safe to email you about what my thoughts were regarding brief psychosis –v- depression (which is something I have finally made sense of and wanted your opinion on because I trusted you). I told you what my current working life was like and I felt as though I got a rubber stamp response because nothing in your email referred specifically to what I had actually said or achieved.
In therapy once, you asked me to always let you know how I was doing because you didn’t want me to move on and disappear out of your therapy life. You also once told me you loved me and trusted me deeply and that you would never abandon me.
With those bold statements comes a considerable amount of post-therapy responsibility to clients, even to the most adjusted but vulnerable client who has left your therapy and your rooms. With that comes a duty of care to accept that sometimes the client who wants to move on feels much dissonance, ambivalence and an overwhelmingly disproportionate sense of obligation and responsibility to her former therapist to keep her informed lest she feels abandoned by her.
It occurred to me the other day that I had not thought about myself in terms of excessive guilt, shame and disgust for many months. This coincided around about the time I started my new job working with self-actualised people in the mental health field and making long overdue decisions about what sort of people I surrounded myself with in my private life.
I never seemed to have the discriminatory powers to know who was good for me, who was not good for me and who was perfectly evil in my life. I also put strict boundaries around certain family members. There are people in my life determined to make me feel shame and guilt because that is what they do best.
I was in session last week with my emotionally and socially intelligent therapist learning important role-modelling and personal negotiation skills when my mobile phone started to ring. I swore loudly, threw my arms in the air, jumped up, and raced out the door and into the courtyard. I was expecting a phone call to tell me whether or not I had a much-wanted part-time job.
Only for me it wasn’t someone giving me potential employment – it was a life or death experience. If I got the job I would be ecstatic and if I didn’t get the job I was going to throw myself under a train. One would make me feel very important and the other would annihilate me. If I didn’t get the job, I would just keep walking to my car, without explanation because the alternative was to tell my beloved therapist I had failed – yet again. I just could not face that. Ever.
Not that I overreact or anything.
I’ve often wondered what being a therapist and giving therapy feels like? What does it feel like to be on the other side of the couch, the so-called mentally healthy side, slowly building up that all-important trust, respect and safety, dispensing wisdom, experiencing and sharing flashes of insight, feeling the poignant pangs of empathy and for some, being able to conjure up that third person, the second client in the room – the inner child, the little girl/boy who so desperately needs a voice to be heard after being silenced many decades before?
Transference can be the duct tape that binds the psychotherapy universe together.
One of the interpretations of my mostly positive, idealizing transference was to use my therapist as a role model. This is similar to Social Learning Theory where people can learn new behavior through reinforcement, punishment and observational learning and are then more likely to model, imitate, and adopt the behavior themselves. This occurs through four stages; close contact, imitation of superiors, understanding of concepts and role model behaviour.
Albert Bandura, expanding on this theory, studied patterns of behaviour associated with aggression by conducting the Bobo doll experiment in 1961. Seventy-two 3-6 year olds were divided into two groups. Two thirds were placed in a room with an adult and Bobo the doll where the adult hit and kicked the doll and the other third was placed in a control group. In a nutshell, Bandura found that the children exposed to the aggressive model were more likely to act out in physically aggressive ways than those who were not exposed to the aggressive model.
So if in therapy I am exposed to someone who deals with life by displaying good manners and an unruffled aura in a situation where appalling manners and a decidedly undignified process of behaviour is apparent; then by the wisdom of social learning theory, good role model behaviour by my therapist will begat new thought processes, schemas, beliefs and behavioural patterns by me, the emotionally-dysregulated client. A classic case of monkey see, monkey do.
For me, mirroring this process was at first largely unconscious in the real world until I related the stories in therapy and realised I had well and truly kept my wits and composure about me. Similar situations would then compound on themselves. As well my therapist would tell me personal stories of adverse situations where clarity and coolheadedness were required. In a similar situation where I would explode, burn my bridges and later have serious regrets, she would be able to stay calm, centred and (most importantly) in control – move on, regret nothing and remain the person she always was.
When I deliberately started to imitate her behaviour, after a …