DX – Old and New

A highly stylized mask is shown against a black background. The eyes are empty.

When telling a story, it’s always good to start at the beginning, right? But figuring out where the beginning is… is not always so easy.

My BPD journey presumably began in my teens, but my school and home life in my teens was so disrupted that it’s basically impossible to tease out what was caused by external issues and what was going on inside me. I was bullied for most of my time in school, right through high school. My parents’ marriage was falling apart, my academic performance was the bane of my school counselors, etc. etc. Certainly, there was no one paying enough attention to me to get a diagnosis then, even if there had been any money for therapy. But remember, back in the 1970s, therapy was often considered to be something only rich neurotics got. Kids in working class families only encountered psychologists or psychiatrists if they really, really went off the rails.

I imagine a handful of readers reacting with a bit of shock or disbelief at the last part of the previous sentence; “what? you were a kid in the 70s???” Yup. I’m an older guy. I think that a lot of people associate BPD with teens or 20-somethings, but it doesn’t just disappear when you hit your 30th or 40th birthday. It also isn’t a ‘new’ disorder, although it may seem like something that didn’t exist earlier, because it’s a relatively new diagnosis in the literature, from what I’ve gathered in my reading. Apparently, the term ‘borderline’ goes back to the 30s or 40s, but the description wasn’t firmed up until the early 80s (leave me a comment if I’ve gotten this wrong; I’ll fix it if you can show me an authoritative source).

I’ll get back to telling my story, though. In the late ’70s I flunked out of high school and decided to go into the Navy, as my dad had. I pictured myself traveling the world, having adventures. I certainly didn’t expect to end up stationed 80 miles from home, with no chance of travel.

Then the nightmares started.

A year after I arrived on my ship, I was under evaluation by the base psychiatrist, and after running me through an extensive battery of tests and several hours of in-person analysis, he diagnosed me with Borderline Personality Disorder.

This was many years before the internet was a thing (at least for anyone outside of a few universities), so I couldn’t do much research on it. I seem to remember him giving me a sort of summary of the condition, and it was pretty scary. He recommended that I be discharged from the Navy, though, which sounded really good to me by then, so I didn’t ask many questions. By the early spring of the following year, I was out on my own, scrabbling for a living, dead broke and with no education and no real job skills.

With all of my attention on surviving, I basically forgot about the Navy psych’s diagnosis. But that doesn’t mean that BPD wasn’t part of my life. The next three decades consisted of my crashing in and out of friendships and leaving broken relationships and failed jobs and hurt feelings and dark days (and dark weeks and months) in my wake. I finally started to get myself under control somewhere in my late 40s.

I won’t go into the details now, ’cause they don’t really matter for the point of this post, but looking back at my life through the lens of a BPD diagnosis really brings into focus the problems I experienced. If you read this short article about ‘quiet’ BPD, you’ll have some idea of what I was dealing with.

So now we fast-forward from the last year of the 1970s (when I was in the tender care of the Navy psychiatrist) to the summer of 2018, with my wife in the hospital and my stress level somewhere in the low stratosphere. My wife and I are really fortunate to have good medical coverage these days, and one of the benefits was that she was assigned a ‘care coordinator,’ someone who helped me track down physical therapists and home aides and other care that my wife needed. One day, she said to me “So, how are you doing? Being the primary caregiver for an ill person can be really stressful. Do you need any support?” I tried to brush it off. My focus for months had been on my wife’s care, and I hadn’t really paid any attention to my internal state. She suggested that it might be a good idea to talk to someone. I let her send me a list of therapists in my area, but I never looked at the list once it arrived in my mailbox. If you, dear imaginary reader, have any mental health issues as well, you’re likely saying ‘ah, that sounds like denial.’ I’m not going to argue with you. It was.

Another month went by, and I was talking with the coordinator again, and she asked me if I’d looked at the list of therapists. When she asked me again, it kind of dawned on me that I really was very stressed and experiencing a lot of anxiety, so I asked her to send me the list again.

This time, when the list of nearby therapists arrived, I took a look at it, and after another few days of waffling, I decided to make the call. I chose the nearest person and phoned her up. She (I’ll call her ‘Cyrene’) told me that she was willing to take on new patients, and we set a start date in mid September. I was very lucky; Cyrene and I hit it off right away, and I quickly realized that I really, really needed to talk to someone. Talking to her also felt a lot safer than blurting out stuff to random friends.

I threw myself into my therapy, basically holding nothing back. In an early session, Cyrene asked me if I’d ever been in therapy previously, and I mentioned the interaction with the Navy doctor that ended with my early release from military service. “BPD?” she mused. “You certainly don’t present that way!” and I agreed. We shrugged off the earlier diagnosis as a blip and kept talking. And talking. And talking. I’m pretty sure I’ve never talked that much to anyone in that short a period in my life.

Weekly, for four months, I talked my head off. I even got concerned (more on this theme later) that I was just indulging myself by paying someone to listen to me blab about myself. For someone with (possibly) a touch of narcissism, what an indulgence that is! When I asked Cyrene about that, she replied “well, do you feel better?” Me: “yes.” Cyrene: “then let’s keep going and see where we end up*.”

In mid December, we realized that we each had a number of holiday events coming up which would disrupt our therapy schedule around the end of the year, so this would be our last session until the new year. As our hour wound down, Cyrene asked me if it would be okay if she read something to me. I agreed, and she went and got a book, opened it to a bookmarked section, and started reading a list of symptoms. After a few items, she paused and said “according to the DSM-5, if you match five of these nine symptoms, you can be diagnosed as having the condition.” As I remember it, up to that point she still hadn’t mentioned what the condition was. As she read the list, I started checking off each one on my fingers. When she finished, I’d checked eight of the nine symptoms. That’s when she said it… “Borderline Personality Disorder.” Yep, it was the same diagnosis that the psychiatrist in the Navy had made. Cyrene said something like “you are doing really well for someone with this diagnosis. I have to assume that you’ve come up with some really good pragmatic coping skills.”

After I caught my breath (I was really excited at having a name to put on everything that had been causing me trouble my entire life), I said “So, this is really interesting, but I know that people are not their labels. If this is just a label, it’s not very valuable; does this give us any tools we can use to move forward?” Cyrene said yes, that it very likely would give us tools to use. And then the hour was done, and I was driving home with my head swirling with ideas, shock, excitement, and confusion. In the last three weeks I’ve done a ton of reading, spent time on Reddit BPD subs, started a Twitter account, and started this blog. My sessions with Cyrene start again later this week, and I’m looking forward to seeing where all this takes me.

I have a feeling you’ll be seeing more posts from me, as I work through all of this new information and these new perspectives on my past and my future.

*I’m not great at remembering conversations, and I’m not claiming every conversation I transcribe here has anything more than a passing friendship with what was actually said, but I believe the gist of each paraphrased conversation is essentially correct. In any case, my intent is never to deceive my reader, nor myself.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.