Borderlines?

The followup was this: I was there again, and he admitted that’s what he thought of me. In some ways, he was really immature about it. For example: instead of just telling me when asked  what I thought he thinks, he threw it back at me, “What do you think I think?” and I said borderline, and he assented. But then after that he kept trying to argue, “You said it, not me.” And refused to tell me why because “it would be harmful to me” and he knows best and all that.

I can’t really have therapy from someone who takes a patronizing attitude to me, who isn’t honest, and fully admits it. I think this is a fair enough request. I told him also that I hope never to be that kind of doctor where I know better than other people what is better for them and stuff.

It really stings right now, but I think in the long term I will be better off. I went to him because he sort of gave me hope that I could stop wrecking my writing career. I didn’t want personality analysis. But he isn’t willing to do any kind of therapy that treats a simple problem.

I guessed that if it made me feel really sad (though, to be fair, I was before I went in there too) to be treated like that, there is some truth to it. And that I hope he realizes that he did harm to a patient, and maybe thinks twice next time – which I guess is kind of manipulative and borderliny too.

Jake pointed out to me that from the moment he says that, it CAUSES the borderline type behavior. I learned an important lesson from that. The moment he said it, I lost all control of my anger. But that doesn’t, in and of itself, make me borderline. I learned about how expectations as a doctor actually end up dragging people into roles. I now wonder, some of the patients who have been angry with me, who I assumed had their own issues – maybe I somehow expected them to be angry and caused it? I learned from this, and that isn’t all bad.

And I hope I never ever start seeing people as “borderlines.”  I’ll have a shitload more money. Back to my old technique of buying myself something equal in value to the cost of a session when I feel horrible.

I just need to get back to my life. No more introspection and thinking about myself. It’s funny, since I decided to quit, I immediately went back to enjoying aviation magazines, my partner, and even being a doctor. This is why I hate psychotherapy – it makes you focus on yourself, when what really makes people better is to enjoy and find interest in the world around them: the people, the beauty, even the tragedy. And just ignore the crazy feelings until your life is full of other things.

Of course, being obsessive, as I also am, I went and immediately sat down to read everything ever written, ever, about borderline personality, from the newest “part of the bipolar spectrum” research to the ancient “caused by the fetal conflict between the nurturing womb which later becomes the rejecting womb” psychoanalytic shit.

After about an hour, I had calmed down a lot. It became immediately clear that I’m not. I don’t have the sine qua non features. The impulsivity and mood swings, sure. But identity problems? Nope. I know who I am, and I haven’t changed, well, ever. I don’t have stormy relationships, and I don’t have the panic at abandonment. I don’t split or have any of those other defenses. I don’t have a problem with ambiguity. Even during my rage at the shrink, I didn’t think I hate him. And before that, I definitely didn’t idolize him either.

And most of all, in my gut, I didn’t feel it any more than you feel a vague sense of relatedness when you read about any personality disorder.

When I first was brave enough to read about cyclothymia, light bipolar, it was like getting kicked in the stomach. Repeatedly. The immediate recognition that there had been no mistake, that this was my life in clinical terms. It still can do that to me. Borderline – I read for two hours with interest, then with relief. Three days into the reading, I got bored.

The other thing that pisses me off is the way the term is tossed around to generally mean a young woman who is angry, who turns on a therapist, or both. I mean, I realized that if I were a patient of mine, and had to hand myself off to another doc, and give a one-sentence description, I’d probably use that word. A glimpse into the medical subculture.

So – I am both relieved, and frustrated. Return to the shrink, realizing that he is using shorthand when saying that? I wish I were religious, or lived in a different century, where psychiatry wasn’t the only game in town…

On further reflection and the rest of the story

Today in the light of day, I still had the kick in the nuts feeling about it. But I made an appointment to go back…and just chill out. And explain why I feel so fucking betrayed. I did realize that part of it is just like what my father used to do to me. He would, for example, be fine one minute and then you trust him and open up, but then what you say comes around to bite you in the ass, which is probably why I am so fucking closed off to begin with.

Example: one time, right in junior year or so when people start getting college catalogs I ordered a bunch from all kinds of good art schools. So I sat with my father (sorry, hard to call him Dad or something, as I always call him by his rather distinctive first name) looking at them, one time, when he was nice and not crazy. A nice father-daughter moment.

Then, two nights later, he was beating the shit out of me because I had considered going to art school and not medical school. If that cannot make you crazy, then what can?

In short, it felt like the shrink did the exact same thing. I was honest, and it landed me a manic-depression diagnosis. More honesty – borderline.

After he said that, there was just no way I could even focus on anything else. I went home feeling horrible (managed to score 30 valium off him at least because he felt guilty).

But then I thought – say I quit therapy. What would happen? I’d have a lot more money, and stop thinking about how miserable and fucked up I am all the time. And guess what? That felt damn good. I told myself that that was it. I went to look at some travel magazines for the first time since I started going to the shrink. I looked at some aviation catalogs (another hobby).  And then my partner came home, and I had a nice evening where we enjoyed each other’s company, also for the first time since I’ve been to the shrink because I stopped thinking about how many bad things there are in our relationship. I had a good day at work even. Enjoyed just being with colleagues, patients. In short, I went back to feeling and functioning the way I did before therapy and the med horror.

So once again, why the fuck am I going to therapy? It is without doubt making me worse. First the manic depression thing, then this all.

I just don’t really believe in therapy. He once again wrangled me into going by sort of suggesting he could get me to stop sabotaging my writing career. Well, nothing like that came out of anything. He made the manic depression diagnosis which caused me an unending amount of grief to try to come to terms with…and now throws another, worse one at me, just as I get my feet back on the ground.

The thing is, personally, when not in shrink mode, I like the guy, so when he says, “You need therapy,” I really believe him. Even though the last time, four years ago, it was the exact same thing. And last time I absolutely promised, swore to myself not to fall for “therapy” again.

And it isn’t even the borderline thing. I am not stupid, I’m sure I have some borderline tendencies, maybe even a lot, and probably with how I’ve been medicated lately, you could make a good case for schizoid as well. The thing that bothers me is that, if he decided/knew I wasn’t manic depressive, and that the thought that I was was causing me great grief, why not, oh, say something about it? It’s the dishonesty that bothers me more than anything.

Another reason I have trouble opening up to him is that, god help me, I feel sorry for the guy, and it’s hard to throw my shit on him. He’s one of those depressive types too…and not always, but a lot of the time, he’s barely going through the motions. He has that stench of the misery of someone who went into a psychoanalytic institute and actually took all that shit seriously. I get the feeling that I want to just stop everything and say, “Oh honey, tell me what’s wrong.” Which is not surprising, given my job / personality / overdeveloped sense of empathy. But I can’t tell him that because he’d just blame transference or projection or some other bullshit. So I’ve been closing myself off to pretty much any of his wavelengths, otherwise I wouldn’t be able to dump all my shit on him.  And that can’t be a good relationship for a therapist.

And for my usual dose of irony: I went into his office totally suicidal that day, miserable, restless, thinking there is NO WAY I could come out feeling worse…

The whole reason I bothered to write this here is that, though this blog isn’t widely read, sometimes I write something and then get emails from a lot of people who, say, are diagnosed borderline who want to comment. Once, I wrote something about shrink troubles, and surprisingly, I got a deluge of emails from psychiatrists, telling me to speak up. So I’m putting this out there, asking for advice. Worth trying to salvage something here, or not? Should I say that his burnout has made me hold back, or is that just going to kick me in the ass? Anyone? Comments or email – either would be appreciated. I go back Thursday, but can move that if I’m still undecided. I wasn’t going to go back at all yesterday, now, not sure. Thought there might be something worth saving or at least trying to close out politely.

Psychiatry claims another victim

…or Dona Juana falls for it again.

I have been having a really horrible week. So horrible, in fact, that almost every night on call I get to a point where it is difficult to avoid thinking about suicide seriously…climbing up to the top of a tall building and jumping. I have been inconsolable. I haven’t really been able to talk about this to anyone. Just…all I can think of is the relief I could have from being me.

I wonder what happened to the version of me that was okay. But I know. Therapy happened.

Now, today I had to see the shrink again. I mentioned that I hadn’t been feeling well, that it had been difficult for me lately. I did not go into detail about the chronic suicidal thoughts and so on. Figured it would come up if it would. I went into the appointment knowing that I am in desperate need of some kind of relief, comfort – maybe a med change, definitely a little support…and also knowing well that I wouldn’t find it there.

Finally, I just asked rather simply, “What the hell is wrong with me? That I have everything and can’t just live.” I also may have mentioned how it seemed like being in therapy – again, his idea, not mine – seemed to just be making things worse. That instead of living my good moments and enjoying them, I was stuck on monitoring my feelings all the time, noticing pathology everywhere.

His answer to what was wrong with me: “I don’t think anymore that you have bipolar. It’s a personality disorder.”

This came out of nowhere, though I guess deep down I knew somewhere not to trust him. This is after letting me spend over a year mourning the fact that I had been diagnosed with bipolar disorder, taking that to heart, coming to see myself as broken and learning to live with that. All, of course, on the basis of his diagnosis.

I didn’t think it would be possible to go into that appointment and come out feeling even worse than I already did. But he did.

I just feel sick and betrayed. Someone who encouraged me to trust and trust – despite my better instincts – encouraged me to do talk therapy, despite the fact that it only caused me harm in the past, was so dishonest with me, never would have even told me unless I pushed for an answer, and even then couldn’t be honest enough to name the name.

The most horrible part: his solution was to increase the frequency of therapy.

No, wait, that’s not the most horrible part. The most horrible part is that I was reasonably happy with my life until I went back to him in late winter. Now, thanks to all this therapy, I’m back on the same med cocktail I was to start with after losing months of my life to the misery of many unsuccessful med changes, and am an absolute fucking mess.

So when they ask how therapy is harmful, here is my story. I feel okay, and that gets me a bipolar diagnosis. I spend a long time in mourning, trying to come to terms with that. It hurt. Then the so-called helper decided it wasn’t even a right diagnosis and actually did not even intend to tell me that.

I am out several thousand dollars, at least six months of needless suffering, and once again, cheated by psychiatry.

This wouldn’t be so bad if I hadn’t been through the same thing four years ago, promised myself to never, ever go back to therapy, for these exact reasons, and then walking into it again. Six more months of wasted time, wasted money (money is a big worry for me), and most of all, personal hurt and dashed hopes. I can certify that I came out of therapy worse than I went in.

For a while, when I quit last time, part of what I promised myself was that if I felt the urge again to go back to any kind of therapy, to immediately go out and spend the cost of a session on something that would give me pleasure. It made me feel infinitely better than therapy ever did.

So now, after another painful and expensive lesson, I am back to where I was four years ago, with additional hurt, in a fairly severe crisis with nowhere to turn, and with no med doc to fix this shit. And a new, deep wound to add to it all.

I probably should go out right now and buy myself something nice with the value of a session. But I’m too fucking tired, too fucking full of wishing for death, for relief. Of course, now I can’t even kill myself, because that would just be some crazy borderline manipulation.

God, I promised myself then never to do this to myself again. Back then, I said to myself, this is it. No more therapy. No more money and time and hope in a dead-end. No more subjecting myself to the judgment of some of the most fucked-up people on the planet. No more looking for relief, for humanity, for help, where there is none to be found. I swore to myself deeply then to never go back.

I guess with time, the reasons I was so adamant got blurry. I managed to forget. Managed to buy into all that crap about how people in that profession really care, are committed to service. Are sensitive. Are empathetic. May even care about patients.

So now, I am out a drug provider. And I am, if anything, worse off than I was this morning with no hope in sight.

I’ll probably call Jake. Just to get reassurance that I’m not personality disordered, a touch of real life, real people. The things that psychiatrists shy away from more than anything.

Thanks for listening, whoever is out there. And if you learn one thing from me, it’s this: don’t go to a fucking shrink. And if you do, never trust one.

Article Link

Take a look here:

http://www.medscape.com/viewprogram/14636_pnt

I wasn’t expecting anything new in this article that came in my email updates, but it was worth reading because it made me laugh out loud. About halfway through, he describes the life of someone as full of “intermittent and recurrent chaos.”

Holy fucking hell. That is just hilarious. And I guess maybe if that had been a criterion, I could have been diagnosed a lot sooner.

It’s all coming back to me now

It is so strange how you can be okay for a while, enjoy life, live normally, and then, just when you breathe, overnight it all comes back. You’re crazy again, hurt again, suicidal again.

I must admit, even though I went back to an old, previously successful drug routine, I haven’t really stabilized out. How do I know this? Because when I am really stable, I don’t think about my mood every day, every hour, every minute. When I fully recover from a mood episode, I am horrified at myself, the monster that took over my body for a while. I think back to my meticulous suicide plans and all of the details and it is as frightening to me as if I had planned a murder. And how I acted. The shame, so much shame. Worse than being drunk in front of everyone, but similar in tone.

I didn’t get that far this time. I still don’t feel the horror. I still don’t really want my life back.

I am doing well at my new job. I am one-upping people with much more clinical experience than I have, in fields that are their specialties, not mine. I have made obscure diagnoses before anyone else raised the possibility, and been right on things when every expert thinks I’m wrong. I am again the shiningflamingscorching star I was apparently meant to be. It all comes so naturally. Other people are knocking themselves out to do half as well as I do.

And the big secret: I don’t really want it. That’s how the universe gets you.

It is strange and ironic and sad that in the cutthroat arena so many people would kill to do what I do, for the sprezzatura with which I do it, to be me. And all of this, all of it, all that I can do and all that I did do and all that I do means nothing to me.

I am not yet 30 years old. I am relatively at the start of my career, one that apparently, despite anything I do, has the auspices of being a brilliant career.

And yet, last night, awake and pacing and storming at 4 AM, hating everyone and everything and impatient and restless and full of animal fury, I couldn’t help thinking that it isn’t good for someone to be like me. I mean, it’s good for the world and the patients and the hospital and whatever. But for the person, to do it all and see it all so young, to be unstoppable, without struggle, to be where nothing impresses me at all, to have everything so easy and nothing to look forward to or work toward…to be empty and bored already. I would trade it all for a little happiness. Not big happiness, just the ordinary happiness that ordinary people have. Picnics without rain. Seeing kids playing and not seeing the years of tragedy that await them.

A few rough days and nights, a heat wave, exhaustion, the mood swings again, and I am back to wishing I weren’t alive. Moreover, I’m so restless and so very fucking angry that I can’t help thinking about jumping off buildings, a giant fuck you to the universe, for giving me everything except the ability to live with it. And for some quiet. To know that I will never, ever, have to do anything I don’t want to do again.

When every moment of every hour of every day consists of something you don’t want to do, and everything you see in the possible next ten years is more of the same, the relief inherent in this idea is considerable.

I lost my temper today. The reason was, at least on the surface, justifiable.
More work for me due to someone else’s doing less work. Unfortunately, I ended up taking it out on the messenger. And having to do more work for all these women who are pregnant and men whose wives are pregnant. I am considering starting to tell everyone that I am pregnant. It seems to be an all-purpose, unquestionable excuse for anything. But I’d never really be pregnant because I couldn’t possibly bring a child into the world.

People always ask me why, seem to think this is strange. Don’t they see? I don’t even want to be alive. It’s sort of like when people admire me. (No, I don’t think they like me much, but a lot of them in medicine admire me.) I mean, they see some stuff and think they’d like to be like me. No one ever seems to notice that I don’t even want to be like me.

This is self-indulgent and rambling, which I guess is fair enough, considering it’s the internet. Time for a fucking med change, methinks.

But before I get myself drugged into mediocrity, one question: why the fuck can’t I just get a little euphoric mania for once?