Borderline Personality Disorder. This diagnosis scares the best of mental health professionals. Imagine how it scares the people living with it.

MY BEGINNING
Emotional invalidation, verbal abuse, neglect. If these three responses to the needs of one’s child can spur a mental illness, then this is how mine was spurred.

My parents loved us, my sister and me. My parents did not know how to raise us, my sister and me. What memories I have of my childhood are few. A fog encases over my recollections of my past, of my upbringing, that protects me from the loneliness, shame, isolation, from the causes that left me, so young and vulnerable, feeling as distant from myself as I did from those around me. It is far easier to forget than to carry images of one’s parents that elicit intense anger, regret, and violation. What I do know, my parents did not value me. They did not value my judgments. They did not value my feelings. They did not value me.

I was oversensitive, responding readily to stimuli that would bypass most children. I was angry, rebellious and stubborn. These qualities were not handled well by my family. Already questioning my own perceptions of myself and my world when I was very young, I was easily influenced by my parents’ understanding of my experience. They would take my feelings and turn them around, discard them, criticize them, ignore them. As our world, my sisters and mine, revolved around my parents, their interests, their needs, their desires, I was learning that the dynamic of my family was as dysfunctional as I was inconsequential.

My father loved me. Of this I am sure. My father did not like me. Of this I am sure. His tolerance of my highly reactive interaction with life was minimal. My behavior sparked an anger in my father that he found difficult to express in a socially acceptable way. He chose, through his own history of abuse, to sling words at me that were as harsh and painful as daggers penetrating my core. These words became violations of my being and of my sense of safety. “Why did we get stuck with a kid like you? You are a rotten child. Why can’t you be more like your sister? Keep it up and I’m going to smash your head up against the wall.” In time, my belief was why would anyone want to be stuck with someone like me, friends, teachers, my family. The rotten child he accused me of being became the rotten core that ultimately defined my existence. Why can’t you be more like your sister fueled my thirst to be more like just about anyone but me, since there was no real me. The threat of pain, of having my head smashed up against the wall, became a love of physical injury as a release for the emotional turbulence that was my inner experience.

The security I lacked in my interactions with my father was just as lacking in my interactions with my mother. Though her love for her children was evident, it was spurred by her own internal need for connection, not ours. She rarely, if ever, played with us, read to us, enjoyed us. We were given attention on her terms, when she needed some loving. The kisses and hugs she lavished us with, though suffocating, were the only attention we got.

When my mother was angry she deprived us of this attention. Withdrawal of love. That was her technique. That was her form of discipline. During her anger, she would not talk with us, kiss us, love us until we were ready to apologize. This worked out for my sister, as she was willing to express her remorse. Unfortunately for me, I hated to apologize.

My mother was also unreliable. That is how I saw her. When my sister, four years my senior, decided it was time for me to go to bed, as my mother was busily immersed in her projects, she would lead me off and tuck me in. My mother would call out, “I will be up in five minutes to kiss you goodnight.” To kiss you. To kiss me. With patience, the warmth of my blanket protecting me as I would pull it up to my neck as fear of aloneness encapsulated my world, I would wait. I would wait for those five minutes, which turned to ten, twenty, fifty, sleep, sleep, sleep.

My parents’ world was filled with museums, the orchestra, summers in Europe. Mine and my sister’s world was filled with museums, the orchestra, summers in Europe. We were two young children living a lonely existence in a grown up world. It was rare, if ever, that my parents did things their children wanted to do. My parents’ form of neglect was not in depriving us of food and clothing, of this we had plenty. Their form of neglect was in depriving us of them and of knowing who they were. It was in depriving us of ourselves and knowing who we were. I grew up questioning my likes and dislikes, my wants and my needs, my feelings and my desires. With parents so distant from their children’s emotional world, their internal life, I too became distant from my own emotional world, my internal life.

The last slight that I discovered was my father’s infidelity. A handsome successful man, he was admired by many women. This admiration, hard to resist for my father, enticed him and excited, and so began his adultery. And so began his adultery that lasted from my early childhood through my late adolescence. And so began his adultery that added a tone of secrecy to our already dysfunctional family. And so began his adultery.

Now, as I look back on my family it elicits feelings of dark loneliness, isolation and pain. During my childhood, a period of vulnerability and learning, I realize that the most important people in my life were unavailable – my parents.

MY ILLNESS
Suffering from a mental illness is frightening, consuming, debilitating, stigmatizing, and more, much more. I know, because I was once frightened, consumed, debilitated, stigmatized and more, much more. There is one disorder, however, that is the epitome of stigma. I happen to be one of the people to whom the label was attached.

When I was sixteen years old I was diagnosed with borderline personality disorder.

There are nine criteria for the disorder. They are as follows:

1. Frantic efforts to avoid real or imagined abandonment.
   
2. Patterns of unstable and intense interpersonal relationships, fluctuating between idealization and devaluation.
   
3. Unstable self image or lack of identity.
   
4. Impulsivity in at least two areas that are potentially hurtful (i.e. reckless driving, substance abuse, gambling, binge eating and other eating disorders, promiscuous sex).
   
5. Recurrent suicidal or self-mutilating behaviors.
   
6. Intense feelings that fluctuate, lasting a few hours to a few days.
   
7. Chronic feelings of emptiness.
   
8. Inappropriate intense anger or difficulty controlling anger.
   
9. Stress related paranoid feelings or severe dissociation (i.e. feeling outside of ones body or the experience of memory loss for stressful events).

I met all nine.

Life for me was a desolate island crawling with terrifying feelings of aloneness, lack of connection, fears of abandonment, shame. I carried these feelings within an unskilled mind, not knowing how best to rid myself of them, or at least how to deal with them effectively. Not knowing how best to shake their ever present gnawing upon my very soul, I carried these feelings with me, and they sucked me in and ate me alive.

When I was a kid I had a very hard time connecting to my peers. I did not know how to relate to them. I did not know how to be playful. I did not know how to be talkative. I did not know how to be natural. I did not know how to be. And they knew it.

I have a memory. I am in the second grade. There is a girl named Carrie. She is blond, blue eyed, pretty, popular. I am standing, alone, next to my desk when Carrie runs past me and she grabs my shirt. She was not being malicious, she was not teasing, of this I was aware. How to respond, of this I was not aware. I began searching, searching my mind for a time when I saw other children in similar situations. I searched, hoping to find a clue on how I was to respond. I searched, and I found. Relief. I realized that I was supposed to chase Carrie and as I turned I saw her running across the classroom. I began to run after her. Carrie was laughing. I began to laugh. Carrie was having fun. I was trying to have fun. I was unable to have fun. I still had another image, an important one, which I needed to find in my mind. I searched again, hoping to uncover a clue on what I was to do once I caught up to Carrie. I searched and I searched, but I did not find. I could not get an image of what other children did once they caught up to the person they were chasing. I could not get an image. Fear riddling my body, holding me captive, I caught up to Carrie. The fear ran down my arm, across my hand, through my fingers. The fear came out as I grabbed Carrie, hard, unknowing, lost, confused. I grabbed Carrie, my fingers, my fear, my shame, digging into her skin. I hurt her. I do not recall the teacher seeing this. I do not recall getting into trouble for this. What I do recall is that the other kids saw it. What I do recall is that Carrie saw it. Carrie felt it. What I do recall, the shame, I felt shame. Needless to say, I was not easily accepted by my peers.

On occasion, I was able to infiltrate the peer culture and be a part of the group. When I did, I was extremely clingy. Another fear, aloneness. I was terrified to be by myself. I was afraid, in the sixth and seventh grades, to walk to school by myself in broad daylight. I was afraid, in the sixth and seventh grades, to play alone in my own back yard in broad daylight. I was terrified to be alone. My rationalization, dogs, stray dogs. I was afraid that I might be attacked by a stray dog. This was an irrational fear. I had never been attacked by a stray dog. I had never been attacked by a dog, period. This fear, however, made more sense to me than a dread of aloneness. To wrap one’s head around that kind of dependency was not something that I was consciously willing to do. To be afraid of dogs, this was socially acceptable. I always had to plan to be with someone. This became very suffocating to my friends. They would reject me.

My difficulty relating was not exclusively centered on my peers. It was directed at me as well. The manifestation? A lack of identity. I had virtually no sense of being, of who I was, of what I believed in, of where I belonged, if I belonged. I was empty and alone, externally as well as internally. I compensated. I reached for an identity wherever I could find one and it was never my own. I borrowed from others. I borrowed their likes. I borrowed their dislikes. I borrowed their philosophies. I borrowed their beliefs. I borrowed their gestures. I borrowed their nuances. I borrowed to such a degree that I became them. I was not myself, because I had no self. I became them. The people I became did not want to share. They did not want me to take their identity away from them. They owned it. They fought me. They rejected me.

This lack of an identity, the missing of a soul, left me with an emptiness that was hollow, cold, frightening, incomplete. I liken this barrenness to a peanut shell with no nuts inside. The outer shell is extremely fragile, extremely easily crushed. It is the inside, the peanuts, which give it its substance, its value. Without the peanuts inside, you throw the shell away. My fear, without the substance of being human, my friends would find this empty shell of a person worthless, useless, and they would throw me away. Once again, I had to compensate, like a person without sight has an intensity of hearing, I had to compensate with an intensity of personality. To do so, I made up stories. I made up stories to appear more exciting, more alive, to my friends. In time, as my stories grew more extravagant to keep up with my growing need to fill the emptiness, like an alcoholics growing need to fill his addiction, my friends realized that I was indeed just making up stories. My friends realized that I was lying. Trust was broken. They would reject me.

My pain was extreme. My behavior reflected it. A mirror portraying the horrors that lay within me, my behaviors reflected it. Self-destruction, self-mutilation, suicidal ideation. These were slowly evolving into my skills to deal with a life that I did not know how to manage.

I had a game. I called it TP. That stood for ‘taking pills.’ I would rummage, like a hungry child left homeless and alone searching for food, I would rummage through my parents medicine chest. An excitement would come over me. I would open the pill boxes and I would ingest. I do not know what my intent was. I do not think I was trying to kill myself because I never took enough pills, three or four at a time. I do not think I was trying to get high because I did not know about that at the time. I was eight years old when I played this game.

Nine years old. Hating my body. Hating my appearance. Hating myself. I decided I did not like my two front teeth. Screwdriver and hammer in hand, I looked in the mirror. Destroy. I wanted to destroy what lay before me. I put the screwdriver to my tooth. I hit with the hammer. I told my mother that I had broken my tooth by falling.

At eleven years old my mind shifted. I realized that life was an option. I realized we all had a choice. I stood at my parents’ bedroom window and contemplated that choice. I wondered, could I jump, should I jump, what would happen if I jumped? I chose not to jump, but this was the first point in my life that it became a choice, a conscious one.

Not liking to be alone, my self destruction, at times, employed the aid of others, getting into the occasional fight. It employed the aid of others, unknowing of their role, of how I would instigate it. I remember my one experience with overnight summer camp. I behaved in a way that one would expect from an eleven year old spiraling down the path toward mental illness. Among my peculiar behaviors was one that got me the physical pain I was looking for. I tormented and teased one of the camp counselors to the point that he snapped. He, the son of the Episcopalian minister who ran the camp, snapped. I remember lying there doing nothing as this eighteen year old boy beat up on this eleven year old girl. I lay there and did nothing because I wanted him to aid in my self destruction, and he did.

Seventh grade and impulsivity. It was in the seventh grade that I could no longer resist my impulses. I began to shoplift. If I could see it, it would be mine. Drug stores, gift shops, anyplace that had something ripe for the taking, I would take it. I could not resist. I was impulsive.

The summer between seventh and eighth grade. My fear - abandonment. My father took his family and we moved. We moved from one part of the country to another. Abandoned by my city, abandoned by my community. In abandonment, we moved. I do not know if it was the move or if it was because I was entering that ever so fragile stage – adolescence. But my anger spewed. Before this it was directed towards my family and me. Now, it spewed. It began to seep out and spread. I continued to get into the occasional fight. I did not, however, instigate them. I responded impulsively to any slight, real or perceived. Art class. I am leaning over my work, drawing. A girl. She walks behind me. She whispers. I did not hear what she said, but I was sure it was unkind. I snapped. I jumped up. I grabbed her. I pinned her by the neck on the desk. My anger seeped to areas other than my family and me.

My difficulty was not restricted to my peers. The adults in my life, my teachers, were a source of conflict for me as well. I was desperate for attention. I was desperate to be noticed. The only kind of attention I knew how to get, the only kind of attention that I wanted, was negative, and I got it. Reprimanded frequently, and angrily, I got it.

There was one teacher, however, that I had a particular bond with. Mr. Carlson. He was my eighth grade history teacher. I would talk with him frequently. I loved Mr. Carlson. He was the best. He was the only teacher, no, the only adult, who understood me. The only one. I loved him!

Ninth grade. Whom did they give this very troubled young girl for history? They gave the only teacher who could handle her. The only teacher who could reach her. Mr. Carlson. In the ninth grade, I hated Mr. Carlson! He did not get me. I demanded that I be switched to the other history class. They denied my request and I never spoke to Mr. Carlson again.

Though most people carried negativity for me, I did find a group of friends. I found a group that had as hard of a time fitting in as I did. Outcasts, together, we were unified. We were drug users. We were one. Eighth grade, they were my friends in the eighth grade. By the beginning of ninth grade things began to change. My perception began to change. I was becoming gripped by an illness. I was starting to get paranoid. I started to think they were talking about me behind my back. I started to think that everyone was talking about me behind my back. I started to think that they hated me. I started to think that everyone hated me. My paranoia extended out of my friendships and into the car pulled up next to me at a red light. I would think the occupants, if they were laughing and talking, were laughing and talking about me. I was paranoid. My friends started to treat me differently. My relationship with them became very stormy and we would fight a lot. No matter how they treated me though, or how I perceived them to be treating me, I was not going to leave them. I was not going to be alone. I loved them some of the time. I hated them some of the time. I needed them all of the time. I cut myself for the first time in the ninth grade, while in a drunken stupor, Vodka, glass to flesh.

Tenth grade was a short experience for me at my local high school. While reminiscing recently about my past with my parents, my mother told me that she and my father were called in to my school. They were told, “We are going to expel your daughter. She is extremely disruptive in class. She makes faces at the teachers, she calls them names, she refuses to do any of the work. We can’t keep her here unless you get her help.” I have no memory of these behaviors. On the schools suggestion, my mother brought me to three different therapists, all of whom refused to treat me by the second or third visit, a common response to people with BPD. I have no memory of the short time I spent at my high school, except for one. It was on the brink of expulsion that I overdosed on twelve sleeping in the lobby of my high school. This is what brought me treatment, a treatment that haunts my dreams today, but may have played a part in giving me a tomorrow.

MY TREATMENT
There is a new concept in mental health today. As the medical model starts to reshape itself, to lend itself to new ideas, a conception is born – the recovery model. People with severe mental illness are finding hope, and they are overcoming. Since the late 1980s and early 1990s, this notion has been blossoming, as have the people afflicted.

When I think about my journey towards recovery, I am always trying to make an effort to come to terms with it, with the illness, with fact that it happened to me, me. As I reflect on this, I have to ask myself two questions. What hurt me? What helped me? When I ask myself these questions I am torn. I am torn because the answer to both is the same – treatment.

I was put in a private psychiatric hospital after overdosing on twelve sleeping pills in the lobby of my high school. I remember that day. My parents had already been forewarned of my impending expulsion. The basis for my expulsion? I was very inappropriate in school. I would make faces at the teachers, curse, disrupt the class, refuse to do any of the work. They had been asked to seek treatment for me. I was declining on a slope that had started when I was very, very young, as far back as second grade and earlier. I was declining, so my mother brought me to three different therapists in the hopes of keeping her daughter both in school and on the socially acceptable side of reality. The three therapists, noting me to be a very difficult and angry adolescent, all refused to treat me by the second or third visit. They denied me, a young girl of sixteen, the treatment, the expertise they held, that could have potentially saved me from what the next four years were going to bring. They denied me. It is like a cardiologist saying, “Your heart condition is too complicated; I won’t treat it.” Your mental illness is too difficult, you have borderline personality disorder; I won’t treat you. It was just before getting expelled that I overdosed on twelve sleeping pills in the lobby of my high school. Suicide had become my only option. This option brought me treatment.

When I was first hospitalized I was in for one year. Then I was out. Then I was in for three months. Out. In for six months. Out. In for one month. Out. In for one year. Out. How many times in between? I do not remember. There is a lot I do not remember because dissociation, the ability to lose memory for stressful events, is a criterion for the diagnosis and the cause of many lost moments in my life.

When I was not in the hospital I was put in a special school. It was a privately run, two room school on the grounds of the local state hospital. There were twelve kids. There were four teachers. It was a place for adolescents so severely emotionally damaged that there was little hope for them to complete a standard high school curriculum. It was a place for adolescents so severely emotionally damaged that there was little hope for them to ever enter college. It was a place for adolescents so severely emotionally damaged that there was little hope for them. My life had been diminished to control, and it was not my own. What I am about to share with you were my high school years. What I am about to share with you were my early young adult years.

When I was first put into the hospital I was petrified. I was put on the adult unit because there was no room on the adolescent unit. The adult unit was an open unit. That means the doors to the outside were not locked. People, when they earned the privilege, could sign out and walk the grounds independently. The nurse’s station was right by the door, so those who were not trusted or who had not earned the privilege of independence could be seen trying to get out the door and intercepted. I was not to be trusted. They were so wary of me, so distrustful, that they put me in the back of the unit, where they could close it off from the rest of the building with two big brown doors, and created a locked one. They locked me in. I was in despair. I was incarcerated. Control.

The day had arrived; a bed was available on the adolescent unit. I did not want to go. I desperately wanted to go home, but if that was not an option, which it was not, I desperately wanted to stay on the adult unit. I felt safe with the adults. I was terrified to be with my peers. I was terrified of the rejection that I feared would inevitably present itself among kids my own age. I resisted. I lied on my bed, face down, and refused to go. The threat from the two staff members that came over to escort me to the unit, “Walk or we will put you in restraints and carry you over.” Control. I cooperated. That was pretty much the last time I would cooperate for four years.

While I was in the hospital, over time, I got used to it. More than used to it, I became very dependent on it. I became very dependent on the structure. I became very dependent on the control. I was sick, and I became sicker as I became more and more dependent. My dependency grew to such an extreme that I would dig my heals in and regress every time I thought I was going to get discharged, or abandoned, from the community I so greatly needed. I would do whatever it took to avoid real, or imagined, abandonment. I would threaten suicide, attempt it if I found the means, or self injure. To self injure I would find whatever sharp object I could and cut, over and over, I would cut my flesh until I bled. This was not a conscious, manipulative effort to seek attention. This was not thought out and planned. It was a response to intense fear and pain, desperate, overwhelming pain. It was a response to the overpowering dread that followed loss, rejection, abandonment. These self destructive behaviors actually relieved the pain within. They also kept me hospitalized.

I was an angry person. Deep down, full of rage. I did not know how to control my anger. I did not know how to control the rage, the frenzy that lurked inside of me like a tornado. The rage and fear, the irritation and depression, the negativity that spun and swooped, up and down, back and forth, like a million little atoms caught in a capsule, bouncing. I did not know how to control this. I did not have to know how to control this because the staff did it for me.

When I was a threat to myself, and I often was in an effort to tame the violent turbulence within me, I was put into seclusion. Seclusion was a room with white walls, a bed, an unbreakable window to the outside, a door with another window where they would watch you on the inside, and the brightest fluorescent light that still hurts my eyes to this day. They would put me in. They would lock me in. Since I was no longer cooperating, I would not walk down the hall and let the staff put me into this bright and terrifying room. Since I was no longer cooperating, they would have to carry me down kicking and screaming out of fear, anger and desperation. They would restrain me to the bed. There I would stay until the next morning. There I would stay until the next morning no matter how early they put me in the night before. Hours restrained to a bed. On one occasion, just one, it was days. To me, this was terrifying control. It was a treatment that has left me today having to deal with a new diagnosis – post traumatic stress disorder. To them, it was the only way to manage a young woman who was so full of pain, so sick, that her only way to deal with it was through suicidal behavior and self-mutilation. Things were different back then. They truly thought what they were doing was right. They truly thought what they were doing was helpful. They truly cared. I believe, they truly cared.

MY RECOVERY
Today, I share my story. I share my story of illness and recovery. As I do, encountering providers, parents, and people suffering, endlessly, with borderline personality disorder it makes me wonder what made my recovery possible. The answer – treatment.

What was it about the very treatment that haunts my thoughts and dreams today that could have played a part in saving me? What was it? What did that treatment give me? It gave me structure. It gave me discipline. These things I never had at home and I desperately needed them. It gave me security. It gave me community. It gave me a sense of belonging. These things I never had at home and I desperately wanted them. Security. Community. Belonging. It also gave me countless hours of intensive, mandatory therapy. Psychodrama, art therapy, group therapy, individual therapy with staff and my psychiatrist, school when I was an adolescent, career skills training when I was an adult, sports, which I hated, and trips, when I earned them. It kept me safe. It was a dark, dark place with people full of pain all around you all the time. I never noticed, because my pain overshadowed theirs, as theirs overshadowed mine. But, there was hope. There was security, community, belonging. People did recover. People did go home and stay home. When I went home and stayed home, four years after I overdosed on twelve sleeping pills in the lobby of my high school, I still had a lot to contend with. I was still suicidal. I was still using drugs. I was still depressed and fearful of just about everything life had to offer. I was still plagued by the traits of the highly stigmatized disorder with which I had been labeled. But, I was willing to try. For the first time in my life, I was willing to try.

How did I try? I got a job. Terrified and sick to the point of nausea, I got a job. I went. Day after day, I went. As I became more and more comfortable, my job gave me security, community, a sense of belonging. Security. Community. Belonging. Suddenly, I had too much to lose. I had to stay well enough to stay out of the hospital. I had too much to lose. I went to college. It took me seven years and just about as many majors, but I graduated Phi Beta Kappa with a degree in psychology. I got married. I have three beautiful daughters. My life continues to be filled with many internal struggles, including persistent traits of borderline personality disorder. But I am in recovery. I have reason and purpose. I have a life worth living. I have family and friends. I have security, community and a sense of belonging. Security. Community. Belonging. I have hope because I have too much to lose.