Diagnosis and a donut

Someone once told me that the traits we dislike most in others are those that we hate or fear in ourselves.  Ouch.  I think they are right though.  There aren’t many people I don’t like, but I’ve met a few in the mental health system, and I suspect they are the ones with diagnoses closest to my own.  Don’t worry, so far I’ve managed to not mention this observation during group therapy.  Anyway, the point is, that getting a diagnosis of BPD is a bit like that – a painful mirror to look into.

The thing I should talk about most is the thing I want to talk about the least.  It is painful.  Humiliating.  Pathetic.  Criterion number one for BPD: A pathological fear of abandonment.  Of all the criteria, this is the one I associate with most strongly and that has the biggest effect on my life.  I never knew it was a ‘thing’ until the day I received my diagnosis.  I remember the day clearly.  I was allowed out of residential care (still on my list of things to write about, I promise) to visit the psychiatrist. It was a beautiful spring day -warm and bright. Sunlight streamed in through the window of the psychiatrist’s office, so that I could see the motes of dust hanging in the air.  I didn’t realise that in the next hour a lot of things I thought I knew were going to be swept away from me.  An hour somehow doesn’t seem enough to tell someone they have a mental illness they never suspected, then spit them back out into the world. The psychiatrist informed me, without a great deal of pre-amble (although she was very kind), that having read my case notes, she was pretty sure I had BPD.  I had never heard of BPD.  I always thought I had depression, maybe a touch of Asperger’s.  I told her that.  “Yes”, she said, “don’t feel bad, even professionals commonly misdiagnose BPD as Asperger’s, especially in women.”  Then she read me the list of criteria and I knew she was right.  How did I mark such a great epiphany?  I went for coffee and a donut.

Later on, I started to wonder, why is Borderline Personality Disorder called Borderline Personality Disorder? Where the hell is the Borderline? So, on the off-chance you are also wondering – It is a term coined many years ago to describe the idea that people with this diagnosis are on the cusp between neurosis (you’re nuts and you know it) and psychosis (you’re nuts and you don’t know it).  People with BPD display characteristics of both.  For example a person with BPD may experience anxiety and poor anger management, but also hallucinations and delusions.  Anyway, some people then decided that this term was outmoded and (apparently) offensive, so they decided to come up with a new term.  So now I have Emotionally Unstable Personality Disorder.  I’ll give a fiver to anyone who can provide a convincing explanation as to how that is less offensive.  I’d rather live on the Borderline, thanks.  At least that has mystery.

People have often asked me how I felt about receiving a diagnosis.  It is a mixed blessing.  On the one hand, it makes some sense of the things I am experiencing and gives an explanation of my feelings and behaviours.  On the other hand, it is definitely not a cool mental illness. It is not a club I want to belong to (can you imagine what the AGM would be like?!).  My diagnosis does not offer much in the way of hope. I am what is known in the business as a ‘heart sink patient’.  Medical professionals see me and think that I will be difficult – difficult to interact with, difficult to deal with, difficult or impossible to cure.

Here is a quote:

“The borderline patient is a therapist’s nightmare….because borderlines never really get better.  The best you can do is help them coast, without getting sucked into their pathology…They’re the chronically depressed, the determinedly addicted, the compulsively divorced, living from one emotional disaster to the next….And they end up taking vacations in psychiatric wards and prison cells, emerge looking good, raising everybody’s hopes.  Until the next letdown, real or imagined, the next excursion into self-damage.  What they don’t do is change.” (Kellerman, 1989, pp. 113-114)

Okay, I’m being negative.  Attitudes have changed.  BPD is no longer considered to be untreatable.  This makes a huge difference to how people like me are dealt with by the mental health services and for that I am truly grateful.

I think about that quote a lot.  I have it as a photograph on my phone and carry it around with me.  I’m not sure why.  Sometimes it feels like a stick to beat myself with.  I am truly screwed.  A disaster.  A hopeless cause.  Other days it inspires me.  I am not addicted.  I don’t have a criminal record.  I’ve never divorced (although I’ve never married either!).  But most of the time, it makes me want to find the person who wrote and tell them to go fuck themselves.  Because I am going to get better.  Just you wait and see…..

P.S. The more observant amongst you will have noticed that I have completely managed to sidetrack and not talk about fear of abandonment. Well spotted, award yourself a sticky star, and tough luck – I’m writing this blog, not you, so you’ll just have to wait!

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