Buddha and the Borderline

by Kiera Van Gelder

  The next week, Molly asks how the meeting went. I shake my head and tell her I don’t think he’s interested. But I still have that feeling like on the days after a tepid date—I can’t help but wait for another call. On a date, I can usually give a blow job to keep a guy interested. What would be the equivalent offering for the most famous clinician of BPD?

  The heavy wooden door across the hall remains closed, and I’m not invited back again. Later that spring, as I sit in the waiting area before DBT, unshowered, in my pajamas, and engrossed in a People magazine, Dr. M walks through. I look up and smile hopefully. His eyes pass over me and the others, and then return to me for a second, quizzically. He knows me from somewhere, but it seems he can’t place it. He smiles and nods, and goes back into his room.

  Though I rarely believe in myself, I’ve always believed in saviors. Perhaps that’s why I haven’t given up and am always reshaping myself into an ideal image for my chosen savior. When my mother sent me to a born-again Christian Bible camp at age eleven, I changed my name to Kiki, developed a Southern accent and took Jesus Christ as my lord in the span of three days. Even then, I’d do about anything to guarantee eternal love from a man—even if he was bleeding and hanging from a cross. We sat on benches around a wooden table with our Good News Bibles those summer afternoons, and at the end of the study group, we prayed to be saved. I’d sit, head bowed, and try to take this man Jesus into my heart, hoping, begging, that his ministrations would purify me and set the world straight, the same way I’d later get on my knees in front of other men, for other reasons, or sit in therapy rooms and 12-step meetings naming my demons and confessing my latest sins.

  The world is full of saviors, both professed and unwitting. But so far, no one has saved me, and I continue to feel like I cannot help myself. Now only one person other than my father regularly checks in on me: Raymond. Raymond has actually been hovering in the background for ten years. He’s my mother’s ex-boyfriend, and unlike my father and stepfather, Raymond has never been kicked to the curb, had his face cut out of family photographs, or forced my mother into changing the locks. He’s the handsome prince my grandparents undoubtedly prayed my mother would find before she lost her virginity. Unluckily for all of us, by the time my mother and Raymond met and fell in love, the obstinacy and ingrained habits of middle age made it all but impossible for them to merge their lives. Plus, Raymond has deep-seated commitment issues, which is too bad, because he’s the first man my mother loved who was truly a responsible and successful adult. He has an Ivy League doctorate, his own company, no issues with his mother, and the kind of heart that is able to feel other people’s pain without getting overwhelmed or turning away.

  For me, this means that he has never disappeared from my life. Over the past decade, Raymond has kept a calm eye on me without interfering, but now with my mother out of the country, he checks in on me periodically. Since I quit the addiction education job, I’ve been downplaying my struggles and trying my hardest to put on a strong front, because our relationship has never included bailouts. But by the beginning of spring, Raymond is worried. I haven’t contacted him in months. He tracks me down and takes me out to dinner.

  I love dinners with Raymond. I can order filet mignon, prime rib, or anything on the menu. I point to the most expensive, finest cuts of beef and he just says, “Go to town, kid.” Now he wants to know what’s really going on, so while I stuff my mouth with bloody beef and tear into the basket of fresh rolls, I try to explain the process of my latest disintegration, from quitting the job to going on psychiatric disability to getting a new diagnosis, doing another kind of therapy, and trying different medications.

  Raymond looks more than a bit alarmed. “Are you getting the best treatment?” I tell him that I don’t know what the best treatment is, that I’ve never met anyone who’s “recovered” from BPD, but that the seeming authorities say the therapy I’m doing now will help. By the time the crème brûlée and cappuccino arrive, Raymond’s brow is deeply creased and he shakes his head a lot. As an economist, his job is to analyze and calculate, and from where he stands things aren’t looking too good for me. He asks if my mother knows what’s going on, and I admit that I haven’t told her everything because it will only upset her. When he asks about my dad, I say, “He thinks I need to go to more meetings.”

  “And your grandparents?” I look away. When I say the words “addiction” or “mental illness,” they either leave the room or change the subject.

  Raymond continues to shake his head and asks what he can do to help. I admit I don’t know. I thought getting the right diagnosis would finally turn things around, and that going into DBT would put me on the right path. We’re now in our third month of interpersonal effectiveness, and it’s driving everyone crazy. Already two members have dropped out, complaining they were stuck in the fourth circle of Linehanian hell. I have no clue what to do next. Neither, it seems, does anyone else. I’ve run out of saviors.

  6

  Full Circle

  During the spring, I spend most of my time in my room, sleeping and reading. My bed is the ultimate refuge, though I do try to make forays into the other parts of the house, where the two women I live with putter around. Marcy, a nester and a pack rat, works temp jobs and continues to nurse a broken engagement from four years ago. The minute she gets home, she changes into fuzzy slippers, makes tea, and watches TV in her room. My other roommate, Patty, is a high-energy saleswoman, cranked up on caffeine and with a sex drive that rivals my own in the best of times. One night I wander into the kitchen to make tea and discover her having sex on our kitchen table. It’s only 9:30—not exactly the most appropriate time to be having a kitchen tryst, especially with everyone home. Public sex doesn’t especially freak me out, but doing it on my kitchen table does. After all, I eat granola there every morning. I know I’ll have to confront her on it, despite how much I hate conflict. As it happens, in group we’re still in the interpersonal effectiveness skills module, so I try to make it into a homework assignment. I plan the whole thing out, and the next time I see her in the kitchen, I use DBT skills to explain how her behavior is affecting me and request that she keep her sexual life in her bedroom.

  Patty throws down the dish towel and turns to me. “You have a problem with me being sexual?! It’s not my problem that you’re sexually repressed.”

  “Excuse me?”

  “And it’s my house too.”

  “I am not sexually repressed,” I huff.

  “Yeah, whatever.” Patty sits down at the (recently sterilized) kitchen table, crosses her long legs, folds her arms, and stares me down.

  I turn to the fridge and don’t say anything. My heart palpitates and races as I hunt through the fridge, looking for something to pull out so I can leave the room. When I turn around and meet Patty’s eyes boring into me, I have conflicting urges to punch her and to run from the room crying. And in the back of my mind, perhaps I’m jealous—jealous that she’s still such a “bad girl” and that she’s getting away with it, being all saucy and bringing lovers home. In comparison, I’m like a stripped storefront mannequin, living a denuded replica of human life.

  Patty and I stop speaking to each other, and from that point forward, home doesn’t feel safe. I listen for noises before I venture down from my second-floor room. I stockpile crackers and juice boxes in my room, and my ears prick up at the slightest noise, hypervigilant for any sign of her. I share in DBT group that my exercise in making a request didn’t work so well.

  “Obviously she’s a bitch,” one of the girls says. Molly nods. There’s a caveat to all techniques for being effective: Sometimes the environment refuses to change, no matter how skillfully you ask. In this case, it’s the “bitch factor.” If that’s not in Dr. Linehan’s skills training manual, it should be.

  In early summer, Raymond sends me a package. It’s a fancy new cell phone with a note: “Keep in touch, kid.” He says not to worry about the bill. I program his number into it, along with Anna’s a
nd my father’s, and I carry the phone with me in a little black pouch clipped to my waist like I’m a doctor on call. When I go out to the supermarket and can’t breathe from the anxiety, sometimes I open it up and pretend to listen to messages or call the operator just to ask for the time.

  But it feels like time is standing still. Why is it that the more pain you feel, the slower the seconds tick by? My father calls one night when I’m literally in a stupor of despair. I can barely talk, and he accuses me of abusing my medication. “I’m not taking any more than usual,” I sob. He doesn’t understand. He tells me to go to a meeting and to remember that I’m in recovery.

  That word again, “recovery.” Its meaning is always related to progress: the journey from illness to wellness, from being incapacitated to being effective, reclaiming the parts of yourself buried under problems you’re finally overcoming. This word has been in heavy rotation in my vocabulary for so very long, with the basic assumption that when you hit bottom, you’ll finally admit to having a problem and ask for help. Sometimes people never bottom out—or at least don’t realize they’ve hit bottom. In AA and NA, I’ve seen some people lose everything in their lives and still not stop getting high. I’ve seen people die instead of getting better.

  But I know this isn’t the case with me; I’m a “help seeker.” Whenever I hit bottom, I look for some way out. And from reading the online BPD message boards, I know there are others like me: people with BPD who are desperate for help, who can’t find therapists, who join a DBT group and discover it’s like trying to hold back a tsunami with a beach umbrella. Yet even with my help-seeking nature, it’s all getting to be too much. For all my efforts, I feel worse than ever. If I posted on those online boards, I’d be the person with a screen name like “fuckitall.” Anna looks scared when I talk now. I’m scared too, because the part of me that wants to live is shrinking by the minute. I don’t want to try anymore.

  Keeping old meds is BPD insurance. Even in times when I’m not seriously suicidal, I hold on to big bottles of pills. They have incredible appeal. Candy-sized, the pills can be consumed instantly, and they’re also controllable, collectable, and not as messy or uncertain as other suicide techniques. For some people with BPD, the need to escape is so overwhelming and the pain so intolerable that no thinking or planning happens. They attempt suicide the way crack addicts do crack, habitually and impulsively, using death to alleviate the compulsion and pain. These attempts aren’t necessarily planned. And a lot of times, they’re instantly regretted. I have a less stereotypical relationship with suicide. I don’t attempt it often, and usually only after enduring a long string of incremental sufferings. Suicide is like a little cyanide capsule in my pocket, just in case the enemy comes too close—always there, but only to be used when facing seemingly insurmountable odds.

  My first suicide attempt was at age twelve, but already I’d been fantasizing about my death for over a year. The immediate reason I wanted to kill myself was that I’d lost my math notes for a test. This was no ordinary math test: A passing grade would grant me admission into one of the most elite and expensive private schools in the country—not because I’m a genius or because we had tons of money, but because my mother worked at the school as a teacher. Passing the entrance exam would mean a free education and the opportunity to become, like earlier graduates, a president or a millionaire.

  “Just get in,” my mother chanted. It was one of the reasons she took the job—that, and so we could live on a campus stuffed with delights beyond the scope of almost any other high school, from pool to theater to hockey rink to Gothic chapel built of stone. Everyone said that if I could get into this school, my life would be changed. And I did need a change. Already I’d been caught stealing, cheating, and lying by my family, and by a couple of teachers at my middle school. I didn’t know why I did those things; I just felt this immense pressure inside of me and a weight of misery that I couldn’t push away.

  When I discovered that my math notes were gone, I was sure I’d fail the test, which meant no private school, no golden future, and no escape from the relentless bullying of the local kids. So I took a pill bottle out of my mother’s bureau drawer, hidden under a stew of lace underwear and smelling of rose sachets, and swallowed the contents—a handful of chalky nibs that reminded me of miniature mints until they passed down my throat and I tasted their bitterness. I didn’t know what the pills were, and though I wondered if they were too old, I wasn’t particularly concerned with the bottle’s expiration date; the pills looked serious enough, and after all, they were hidden away. I felt like a failure—like I couldn’t do anything right—and these pills seemed to be the antidote

  The next morning, I discovered that I couldn’t even die right. In the morning I was still there, just with a buzz in my head. I got up, got dressed, and took the bus to school. The faces of the other kids in my seventh-grade history class were fuzzy and their voices echoed in my head. I had the urge to throw up all through math, the test blurry under my eyes. Claiming dizziness, I went to the nurse’s station, where I was allowed to lie down for the afternoon on a padded cot under an empty square of window. I didn’t tell anyone. I already knew I would try again.

  On a logical level, I know that everyone feels pain. Everyone suffers. Is my pain really that much greater, or am I just weaker? Where is the line between normal and abnormal emotional suffering? I come across “The Pain of Being Borderline,” an article written by another famous BPD clinician, Dr. Zanarini. It says that in comparison to people with other personality disorders, borderlines experience greater levels of worthlessness, anger, abandonment, and hopelessness—that more than others, we feel like bad, damaged children, shunned by the world, and better off dead (Zanarini et al. 1998).

  This is my second encounter with the idea that our internal experience can be characterized by a defining emotion, not just “instability.” As Marsha Linehan says, we’re like emotional burn victims (1993a). Dr. Zanarini views this specific kind of pain as a characteristic of the disorder itself: borderline pain. We’re emotional epileptics, thrown from one fit of horrible suffering to another. Poisoned by what’s inside us, and vulnerable to anything outside us. I’ve spent my life chasing relief from this pain, only to find myself more deeply mired in it. How can it be that after all of this work, killing myself once again seems like the only option left?

  One afternoon in early summer, I pick up the phone and call Anna. I’m dizzy from spending too many minutes looking over the edge. It’s like I’m on a cliff and the smallest breath of wind might topple me over. I want to fall, and to release myself from this endless cycle of suffering, but I also resist it. Something in me still refuses to give in. I don’t understand this tenacity that duels with the death wish, but it’s still here, and it pushes my hand to the phone.

  “I’m in trouble. I need to see you,” I cry to Anna’s voice mail. She calls back and tells me to drive right over. Once I’m in her office, I say, “I can’t do this anymore.” I curl up in the chair, shaking, a continuous chant of no more, no more, no more in my head. For a moment, it looks like Anna’s going to give me a pep talk. But she doesn’t; she asks if I need to go to the hospital. I nod and sob. An hour later, I’m in an ambulance going to a psych ward. It’s been ten years since I’ve been an inpatient. Ten sober, “I’m in recovery, taking my meds, and seeing a therapist” years. And now I’m back at the hospital where I landed when I was seventeen, brought full circle to this place where my mother deposited me, a drug-addled teenage runaway, to put me into someone else’s care.

  7

  Short-Term Solutions

  During summer and early fall, I’m hospitalized three times. After the ambulance drops me off at the hospital’s evaluation center the first time, I’m placed in a ward called the short-term unit, aka the STU. It’s a stereotypically bland place with pale blue walls, anonymous doors, a glassed-in nurse’s station, and plastic couches. Three bored staff sit behind the glass with books and snack food. It takes ten hour
s of waiting for interviews and insurance clearance before I get a bed. By the time I pass through the doors, it’s 2 a.m. and the ward is hushed. A middle-aged man with a belt cinched under a thick wad of stomach welcomes me and offers a blue hospital johnny, a toothbrush, and toothpaste.

  I know that mental hospitals are supposed to be full of horrors, loss of human dignity, and bad starchy food, and that you shouldn’t feel such relief at having your freedom taken away, and yet… And yet when I climb into bed, the white hospital sheets feel as cool and fresh as peppermint. On some level, I am dangerous to myself. And yet…here I am not.

  “The goal here is stabilization,” says Dr. M, the attending psychiatrist, when we meet toward the end of my first full day. He looks over some papers and asks me how I’m feeling. I’ve spent one night in a private room and did nothing for most of the day except stare out the windows and eat snack food, yet I’m feeling better. The quiet containment, the fifteen-minute check-ins, my name written in red with little boxes next to the daily groups I should attend—all this keeps me away from the edge of the precipice. I’m still panicky and hopeless, but the realization that tonight I’ll be tucked into crisp white sheets and looked after with the sweep of a flashlight, over and over, keeps me feeling calm. I am no longer alone. I want to tell the doctor this, yet I worry I’ll be kicked out if I do. And I don’t know how I’ll feel once I leave. The idea of going back to Waltham and being cloistered in my room immediately fills me with dread. So I tell the doctor I feel horrible, and that I don’t know what to do.