Buddha and the Borderline

by Kiera Van Gelder

  I went into the bathroom and got one of Bennet’s disposable razors. I hadn’t cut myself in years, even through all of the turmoil with Bennet, but this sudden encounter with myself felt intolerable. Seeing all the scars on the others’ arms in group tipped me back into the realm of possibility. And then impulse took over. The blade drew a slim, beaded thread of blood along my arm, and another. And perhaps not surprisingly, I grew more mindful as the slow rhythm of bloodletting rinsed me with clarity. It wasn’t dramatic; it was familiar and reassuring. I was all business, making sure not to press too deep. I etched the lines in orderly rows, and after I was done, I swiped with alcohol, blotted the skin, and applied gauze. When Bennet and Alexis returned late that night, I was in much better shape—and wearing a long-sleeved shirt to bed.

  “The exercise didn’t go too well,” I report to the group when it’s my turn. “I tried to be mindful of my emotions, but I got overwhelmed.”

  There are some nods. “Sometimes it’s too difficult to be mindful,” a beautiful, gaunt girl sighs, “when it gets to be so much.”

  The others in the group agree. To be mindful of overwhelming pain seems all but impossible.

  “That’s why you’re here,” Molly says. “Mindfulness isn’t supposed to be torture. It’s a tool. When you’re aware of something, you have the ability to work with it. That’s why learning about states of mind is important. You can say to yourself, when you get into a lather, ‘Oh, look, I’m in emotion mind.’ You can learn to control your attention and skillfully choose what action to take.” She thinks for a minute, then turns to me. “I suspect that while you were trying to practice being mindful, you were actually judging and reacting to your emotions.”

  DBT describes people as having essentially three states of mind: emotion mind, reason mind, and wise mind. The handout Molly gives us shows a picture of two overlapping circles. One circle represents reason mind. The other circle represents emotion mind. And in the space where reason and emotion mix is wise mind. In discussing the different states of mind, it’s easy to understand that reason mind is all about logic, while emotion mind is all about emotions, but wise mind seems beyond my grasp. It’s described as the integration of the two other states of mind. Sometimes it’s also called wisdom mind or wise knowing, but whatever you call it, Molly says it’s that part of yourself that’s intuitive and yet also based on direct experience.

  “Is it like déjà vu?” the boy asks.

  “Think of it more like a well or fountain inside of you. It’s always there, but because you’re been fixated on emotion or reason, it’s hard to access it. When you bring all ways of knowing together, wise mind emerges.”

  I know there’s something more to my mind and reality than whatever I think and feel in the moment, but so far my only proof of it has been out-of-body experiences while I was on drugs. My state of mind at those times definitely wasn’t wise.

  I think the hardest aspect of understanding wise mind is believing that something exists within me that’s actually reliable. Where inside me is this wisdom? How do I access this calm, intuitive, go-with-the-flow awareness?

  Back at Bennet and Alexis’s, I try to do the breathing exercise where you watch your thoughts and emotions and simply label them: “thought…,” “emotion…” I don’t find wise mind, but once again I discover how intensely painful it is to just be with myself. As I try to sit, an image from an old Life magazine takes hold. It’s a Tibetan monk, sitting in his robes, on fire. I remember reading that the monk set himself ablaze to protest China’s occupation of Tibet. I know that my feeling of being burned alive is much less noble, and completely invisible, but that’s how I feel, sitting with myself: on fire. Dr. Linehan uses a similar image. She says that people with BPD are like emotional burn victims: We’ve lost all of our protective skin (Linehan 1993a). I wonder if wise mind can give me protection from that. I wish it were like a Magic 8 Ball. Just shake your head and an answer will appear. I wish there were a wise mind drug. DBT says that’s inside me, even now. And that is the hardest thing to believe.

  5

  Saviors

  Social Security officially deems me disabled, so now I get a big fat monthly check for five hundred dollars. This means I can at least pay my rent in Waltham and some of the outstanding utility bills my housemates have been shoving under my door for the past couple of months. I’m still avoiding staying there, but the house is just two miles away from the hospital where I have the DBT group, so I try to stay at least one night a week. My nights at “home” feel like I’m huddling under a tarp in the arctic. My room is warm enough; it’s the isolation that freezes and paralyzes me. I’ve never understood why I freak out like this, but now I know it’s a borderline symptom: intolerance of aloneness and a pervasive sense of emptiness. So the first night I stay at home, I try to practice mindfulness as I sit in my room. A leaden and pulsing sensation in my chest gets heavier with each breath until it’s too heavy to carry. Once again, I don’t know how to manage it.

  I tell myself, Just observe—observe and describe. I notice that I feel horrible. I feel hopeless. I don’t expect that it’s really going to help, but watching the feeling and naming it does put a little cushion between me and the pain. I also notice my intolerance of it, how the desire to escape this feeling sweeps over me like a wave. Someone in the group mentioned “urge surfing,” a DBT technique for learning how to ride out each feeling and impulse rather than habitually escaping it though various modes of self-destruction. Over the past decade, I’ve somehow learned how to apply this approach to drugs, but in 12-step recovery this involves believing you’re powerless and asking for help. DBT is completely different. It doesn’t maintain that we are powerless. On the contrary, it sees the other side of acceptance as the ability to change, and it focuses on developing the skills to do just that.

  We spend two weeks on mindfulness and, indeed, the next module we enter is focused on change—the other part of the dialectic. It’s called interpersonal effectiveness, and it’s about learning how to ask for and get what you want in a relationship. There are numerous complicated worksheets and exercises, and the module is quite long. Molly warns us that we could spend at least two months on it, maybe more. I’m immediately put off and wish that if we were going to spend two months on anything, it would be distress tolerance. That’s the DBT module about how to deal with the feeling of being burned alive. And that’s where I’m at right now. Besides, nothing is going to change the situation with Bennet. I’d need explosives to separate him from that apartment and Alexis.

  In interpersonal effectiveness, we read a handout of bulleted items about the importance of attending to relationships: Don’t let hurts and problems build up. Use relationship skills to head off problems. End hopeless relationships. Resolve conflicts before they get overwhelming (Linehan 1993).

  Molly moves to the whiteboard to drum up some participation on the topic of balancing priorities versus demands, but my eyes keep returning to one previous bullet point: “End hopeless relationships.”

  I raise my hand. “How do know if you’re in a hopeless relationship?”

  “We’re actually on a different section now,” Molly says, though not unkindly.

  “But if you’re in a fucked situation with someone, it doesn’t make sense to do all this other stuff, like negotiate.”

  “That’s true, but it’s wise not to make any quick decisions about relationships.” She turns back to the group. “How many people here have left relationships prematurely?” All hands fly up, my own included. Molly certainly has a point. As a creature of blind impulse, I can just as easily flee from a relationship as I can get lost in one. I definitely need to learn how to negotiate rather than cutting and running when trouble develops. However, I’m beginning to understand that I also stay in relationships that are beyond negotiation, that I stay trapped and hopeless, because I’m too afraid to be on my own—because there’s nothing else in my life to hold on to.

  The BPD diagnosis might
be a taboo subject in the group, but my mind goes to it automatically whenever I think about how I’ve been clinging to Bennet all these months, despite how sick the situation is making me. I will suffer almost anything to avoid the “chronic feelings of emptiness” that BPD involves. It drags me in like a black hole as soon as I’m severed from an important relationship.

  I remember that even when I was just five or six years old, I didn’t want to close my eyes at night because the dark inside my head would expand like the space of a starless night and I’d be left alone in it. It’s like that familiar scene from movies about space travel, where an astronaut is cut loose from the spaceship and spins away, helplessly cast into the empty void of space. That’s what being alone feels like. If I break up with Bennet, I’ll be floating again. I don’t know which is worse, the pain of presence or the pain of absence.

  Although Molly cautions us not to act on impulse, reading that line about hopeless relationships sparks a dead circuit in my mind and there’s a sudden recognition—a deep, decisive knowing—that I have to free myself from Bennet and Alexis if I want to get better. Is this wise mind? Other’s might say it’s simply common sense. Maybe, for me, there’s no difference.

  Later that week, Bennet and I sit in front of the TV. He smells like linseed oil and sawdust, and he’s probably worried I’m going to drag him to bed for some predinner sex. We sit on the couch and stare at the TV for a while. And then I turn to him. “It’s over,” I say. “I can’t do this anymore.”

  Bennet stares at the news for another moment and then looks me. His eyes are baggy and tired. It occurs to me that I have no idea what his day was like, because I never asked.

  “I guess that makes sense.”

  There’s no anger, and no accusations from either of us. After all of the fights and drama, all the color and noise, with just the slightest tug on the electrical cord the whole screen goes blank and our story is over. And that’s it. I pack my bags and carry them to the door.

  “Are you going to be okay?” Bennet asks.

  Even though this is my decision and I know it’s right, I want to say, “No, I’m not alright. I’ll probably hit a tree going home, and it’ll be all your fault…”

  “I’ll be fine. Really,” I say, holding back the tears. Bennet insists on giving me a big hug, and then I drag my bags out into the almost-spring air and to my car. I want to be proud of myself and feel liberation, or at least release. Instead, panic and rage explode inside me as soon as I close the car door. I start screaming when I turn onto the highway toward Waltham. If passing drivers were to look, they’d glimpse a wild-haired woman-child at the wheel, swerving along her lane, mouth open, eyes like slits, her voice—and her life—trapped inside a vehicle careening toward destruction.

  The room I’m now living in full-time is in half of a faded duplex built in the 1950s on the edge of a less-than-savory section of the Charles River. I have the back bedroom, along with a narrow additional room that could be used as a large closet or an office, with a window facing the river. After I unpack my clothes, I sit on my futon on the floor. I regret my decision to break up with Bennet as soon as the room’s silence envelops me. I’ve tried to spruce the place up a bit on my occasional overnights, but it feels like I’m visiting the cast-off shell of a former life—and I didn’t really even live here for that life. I’m just sitting in a place I used to avoid. It’s still not mine, and I don’t know how to make it my own.

  I know I should reach out to someone at this point, rely on my supports, as they say. But my options are fairly limited. I consider calling my father. After years of fighting and being estranged, we’ve come to a reasonable truce, partially because we’re both recovering addicts. He’s been sober eleven years, and I’ve just passed my ninth. Although his support as a father was minimal, at least we now share some understanding about addiction. The disadvantage is that any problem or feeling I fob his way is met with 12-step speak. Whenever I’m in pain, falling apart, or in crisis, he gives me slogans: Easy does it. First things first. Keep it simple. Ask your higher power for help. Go to a meeting. If I were to call and tell him I’ve just split up with Bennet (read, yet another man), I doubt I’d get sympathy. He’d probably just suggest I do another moral inventory. Fuck moral inventories.

  Somewhere in the stack of postcards my mother has been sending throughout the year, I have a phone number for her in Ubud, Bali. Actually, it’s the number of a phone booth supervised by a man who takes messages and then forgets about them. Not having my own phone means I need a special card for international calls, which Social Security hasn’t factored into my living expenses. But even if I could get through to my mom, I couldn’t tell her the truth. If I told her the truth, it would upset her so much that she’d call me a moth later to tell me she hadn’t slept since our last conversation. My difficulties completely overwhelm her, and in the end, my pain seems to cause even more pain for her. And though I could call Anna, the eternal cheerleader, who is always encouraging, she has no game plan other than rereading Codependent No More.

  What solutions would DBT suggest? In group, we’re now in the middle of complicated worksheets about goals and priorities in interpersonal situations. I’ve been in the DBT group for over two months, and my interest and ability to focus on it are dwindling. The worksheets and ideas don’t make sense anymore. I know I need more help. In the couple of weeks following the breakup, I barely notice the approach of spring because most days I’m curled up in bed crying. I’ve been putting it off, but eventually I call Dr. B. We’ve met three times since he gave me the diagnosis, spending our allotted fifteen minutes going over the change from antidepressants to lithium. Each time, he’s asked if the DBT group is helping. I’ve said that in some ways I’m better, but in other ways I’m worse—that I mainly feel lost in it, and depressed. I’m getting terribly depressed. When I ask him about the BPD diagnosis, he’s vague and encourages me not to focus on it, saying that the most important thing to know is that I can get better; it just takes time.

  Time. Now I leave a message on Dr. B’s answering machine, telling him that I’m so depressed I can barely move. I know it’s because of the lithium. I can barely lift my fingers to pick up the phone. In my message, I say, “Maybe it would be a good time to go back on an antidepressant.”

  Then, out of desperation, I call Bennet, weeping and asking if he might reconsider.

  “Do you want to be with me because you love me,” he asks, “or because you can’t stand being with yourself?”

  It’s the last time I call him.

  When I tell Dr B. that I feel like I’m falling through a giant hole and nothing’s ever going to catch me, he agrees that I need to get back onto the other meds.

  He asks how my individual therapy is going, and I explain that Anna isn’t interested in the BPD diagnosis or DBT. “You should have a DBT therapist,” Dr. B says. “Get a referral from Molly.”

  So at the next group, with a bit of Zoloft finally pumping through my brain, I ask Molly if she can refer me to someone trained in DBT. She shakes her head. “There’s not much available right now.”

  “Are there any therapists in the area trained in DBT?”

  “Unfortunately, no.”

  “What about a therapist who specializes in BPD?”

  We both glance across the hallway at the famous Dr. M’s office. It continues to upset me that I can’t get more support or information about BPD even as one of the high priests of the diagnosis does therapy across the hall. Knowing the location of his office also gives me a vague stalkerish feeling. What happens behind those doors? What kind of therapy does the man give to the borderlines? Do they get better? The women (and they are mostly women) waiting for appointments with him look as uniformly unhappy as we do, though they are, on the whole, very attractive; “refined” might be the better word. I suspect he takes only self-pay, as I’m sure insurance isn’t exactly generous when it comes to reimbursing famous doctors.

  “What about Dr. M?” I
venture. She looks at his office and scrunches her face up. “Well, maybe… Maybe I could get you an appointment for a chat.” She doesn’t sound hopeful.

  “A chat?” She makes it sound like sitting by a fireside with tea and scones.

  “He’s very busy. But he might be able to take you on—if it seems right.”

  Good enough, though it sounds more like a date than a consultation, this “chat.” What kind of borderline would tempt Dr. M into taking her on? The question intrigues me, and soon enough I’m studying the women outside his office with more than casual interest. These women are obviously sophisticated, probably rich, and clearly interesting to him. So I know exactly what I need to do, how to catch him: I need the perfect outfit. From what I’ve read of his case studies, Dr. M feels special sympathy for the waiflike girls who hurt themselves. I’m not a waif, but I know how to dress like one, how to smudge my eyelids with black liner and tousle my hair, making the curls fall over my eyes. When the day arrives, I dress in tailored clothes, and as I sit in the waiting room, I thumb through The Economist rather than the People magazine I’d normally snatch up. When Dr. M comes out to invite me in, I make sure I’m not slouching. It’s like auditioning for a boyfriend, a teacher, and a father all at once.

  The “interview/chat/date” lasts only ten or fifteen minutes. I explain that I have BPD, which I hope will entice him, but of course everyone he sees has BPD. I tell him I was at the hospital before, as an adolescent. Even so, Dr. M doesn’t seem to think of this as a clinical discussion. He asks about my career and interests. When I say I’m an artist and writer, this takes him on a tangent into twentieth-century literature, and before I know it, he’s giving me suggestions on good novels, shaking my hand, and showing me to the door. In my mind, a little voice is chanting, Help me, help me, help me. Should I show him the scars? Burst into tears? I wonder if I made a tactical error in telling him I had BPD. Now the mystery is gone. He can’t discover me; I’ve come to him already named, like a claimed continent. Perhaps the thrill for him is in planting his own flag?