I’m positioned behind a counter facing displays of featured titles. As luck would have it, they’re promoting local female memoirists. I get to stare at the covers of Girl, Interrupted and Prozac Nation while Dan, the young man assigned to train me, looks on exasperated as my fingers can’t pick out the proper codes.
“Have you ever used a cash register before?” he asks. Well, yes. But never in the second week of being put on an antipsychotic medication. Every time I mess up, trainer boy has to call a manager, who takes forever to arrive and then grumbles as she reverses my mistake by entering the secret manager code. I look at the clock and realize only a half hour has passed. It’s 9:30 a.m. and I don’t get a break until 11. I’m boxed in between the other two registers, where seasoned clerks madly bag books, and the line of customers grows by the minute. I have never seen the Harvard Coop this crowded, and I’ve been visiting Harvard Square going on two decades.
“What’s your problem?” Dan asks, as I once again enter the wrong code. There are, of course, many ways to answer that question, but I know exactly what’s wrong. I’m starting to have an anxiety attack. And I can’t do a thing about it. I note all of the signs emerging: sweating, chest pains, blurred vision, my fingers shaking and refusing to do what they’re told. The line of customers snakes into the travel section in the rear of the store. At that moment, my trainer decides it’s time for his cigarette break.
“You’ll be fine,” he says with a smirk—obviously a sadist. I look at the register and my hands seem miles away. The girl standing in front of me with a tall stack of books looks sixteen. Indeed, the whole place swarms with young, well-groomed Harvard students, emptying the stores shelves like waves of locusts. In the background, the words “freshman orientation” float by.
The urge to flee enters my brain like a crack hit. I blink twice, then dart behind the registers, clutching my backpack in my hands and ducking like I’m avoiding gunfire. Coming around the corner, I almost collide with the lady from the information desk. She is old and wears orthopedic shoes and overly bright lipstick.
“I quit,” I say.
“Do you work here?” she rasps.
I run through the doors and into the crowds thronging the sidewalk on Massachusetts Avenue. I imagine a security guard chasing after me, demanding I return the name tag, but that’s silly. No one from the store will even call me. I take the bus back to my apartment and spend the rest of the day in my room with the shades drawn and a cold washcloth on my forehead. My heart won’t stop racing.
I know my mother will be upset. “Couldn’t you have at least tried to stay for the day?” she’ll ask, the disappointment dripping from her voice like acid. When I finally leave the bed, I’m planning on taking a bath, but once I’m in the bathroom my hands go automatically to the cabinet and fish out a couple of new disposable razors. I dislodge the blades and set up my supplies: paper towels for blotting, alcohol for disinfecting, bandages. I’m not cutting to prove anything, but this one session doesn’t seem like a private matter. Every time I draw the blade over my skin, I think of how the marks will horrify others. Subtlety no longer matters. I target my upper arm and carve circlets—blood bangles—around and around: ten, fifteen, until my bicep wears a raw band of red incisions half its length. I’m breathless from the effort, dizzy too. And all I can think is Fuck you. Fuck you for making me jump back in and telling me I could land on my feet. Fuck you for all your fucking help.
My mother insists we go out for dinner the next night, since she’ll go back to teaching full-time in a few days. When I was younger, I often hid my cuts, or if she did see them, nothing was said. I’m sure she assumed it was the psychiatrist’s job to talk with me. And I know that, both then and now, my pain triggers something unbearable in her, as does the sight of my wounds. It’s a strange and impenetrable situation: My family’s response to my recurring crises is to minimize (It’s just depression… Just go to a meeting… You don’t really have a mental illness…). Yet at the same time, when faced with the blood or the hospitals, they become so troubled that they distance themselves even more. Recently my grandparents sent me a heart-shaped locket with their pictures in it. I haven’t talked to them in months, but my mother must have told them something. The locket is their way of expressing that they know I’m in trouble and they love me, but in my mind, it simply reaffirms that, while I have family, I don’t have their support. A picture of love is not the same thing as being present and walking through this with me.
I decide not to cover the fresh cuts. Like clockwork, when my mother sees my arm, she cries. But something has changed, because she doesn’t turn away.
“I’m not leaving you alone tonight,” she insists after dinner. She doesn’t realize that almost every night is like this. At the table, she’d given me one last present from Bali, a necklace with a stone Buddha set in silver. I put it on, and the Buddha rests on the middle of my chest, over my heart, sitting peacefully in his cross-legged posture. I don’t know much about Buddhism, only that Dr. Linehan’s dialectical behavior therapy is partially based on it. For now, I just know that the Buddha looks so calm and collected, so obviously unruffled by anxiety attacks and self-hatred, that it can’t hurt to absorb a little of his peace.
“I want you to hold the Buddha whenever you start to feel upset,” my mother says as we climb into my bed. “I want you to believe in your own goodness.” I wrap one hand around the necklace and drape the other over my mother. Hanging nearby is the gold locket with my grandparents’ faces inside. For the first time, I wonder: How much of what I feel as neglect has been fueled by the force of my constant need? How much can any person hold another who is perpetually falling? Yet my mother is here now, and insists on watching over me tonight—and gives me a Buddha that grows warm against my heart.
I wish this could be enough, but it isn’t. It’s a raindrop that falls on land barren from decades of drought. In a day, the private school job completely absorbs my mother. Her role is to take care of other children, and I am not a child anymore. I remember Dr. Zanarini’s article on borderline pain, how we feel misunderstood and think that no one cares about us and that we are bad…damaged children, shunned by the world (Zanarini et al. 1998). How much of this is feeling I have right now is fueled by a belief, and how much is reality? And if, as DBT maintains, there can be a dialectic of opposites, is it possible for both to be true?
All I do now is wait for my appointment with the potential new therapist in Cambridge. When I get to the point where I want to start chopping fingers off, I go to NA meetings, where I meet up with Brian, the poet, and his wife, Maureen. My reliance on them is an uncomplicated version of what I had with Bennet and Alexis: a couple who have room in their lives for a third wheel, only Brian and Maureen are married and in their fifties. When I tell them I’m mired in mental illness, they nod and list all of the medications they’re currently on. Maureen insists I call her if I ever need help, but I can’t imagine putting the weight of this nightmare on her.
Lately I’ve been fantasizing about carbon monoxide poisoning. Pills seem too uncertain now, and I’m not very good at swallowing them. My car’s exhaust, on the other hand, is rich in poison. In fact, it’s in such bad shape that I can practically kill myself just by driving with the windows rolled up. I mull over the benefits of carbon monoxide poisoning until my suicide seems dreamy, almost romantic. I’ll have a last meal, park at the edge of a field, watch the sunset, listen to Nine Inch Nails’ magnificent double CD The Fragile, and slip out of my body as I drink in the fumes. All I need is a hose.
While I continue to wait for my intake appointment for the new DBT program, the night arrives when I cross from fantasy into action. Relief is all I want—that, and a long hose. It turns out that Sunday night isn’t the best time to find an open hardware store. The only place open is Petco. There must be rubber hoses in the fish section, so I wander among the blue tanks and supply displays. I find bags of pebbles, miniature castles, fish food and turtle food, glass tank
s, and aerators, and, finally, plastic tubes. But they’re only about two feet long and no bigger around than my index finger. There’s no way I can run the exhaust from my tailpipe into my window for this plan. I’d have to lie on a lawn chair under the bumper to suck the exhaust.
It’s amazing how powerful vanity can be, because the image of me found dead under my car with black soot in my mouth is enough to dissuade me. I return to my room, feeling the way I sometimes do when I go shopping for a pair of shoes and come back empty-handed. Now there’s some distance between me and the urge again, enough that I have the presence of mind to call the hospital and pack my bags. Like always, they’ll ask if I’m a danger to myself or others, if I want to die and if I have a plan. The plan is very important. Then they’ll ask for a suicide history, but they don’t seem to be interested in all those times when a person has been on that edge for hours, days, or weeks; they only want to know about actual attempts. Apparently getting that close and then backing away doesn’t count. But from my side, it’s like racing toward a brick wall in a car and then swerving at the last minute. Afterward there’s adrenaline and relief, but no way to get out of the car, and the compulsion to careen toward the wall comes again and again.
This third time, checking in isn’t so easy. I come with three bags in tow and the word “borderline” all over my records, and it’s obvious that the clinician doing the intake mistrusts my motives for coming back. When I say I’ve been suicidal for a lot of my life, he raises his eyebrows. “Maybe you should start learning how to live with it.”
“But I need to be safe. Right now!”
He keeps his eyes on the paperwork, and when he looks up at me, I sense anger, or maybe dislike, almost like a vapor coming from his eyes. Though it’s just a small hint, I feel rage bubbling up. I want him to see my scars. I want him to see me bleeding and smashing my head against the wall. I want him to know what it’s like being me.
This time I’m put in the “rapid recovery unit,” a place that’s about as antithetical to recovery, let alone a rapid one, as you can imagine. The door opens, and the first thing I hear is men bellowing—not shouting or screaming, but bellowing in another language. Several black men in white scrubs, obviously the overnight staff, argue over the TV station in the common room. Their voices send me into a panic, and I turn to the nurse who is gathering my bags for inspection.
“Can you call someone? Get me switched?” I plead. “Isn’t there a women’s unit or something?” She shakes her head and tells me nothing can be done. I feel like I’m going to throw up as the realization that I’m locked up—really locked up—hits. So far, hospitalizations have felt comforting. I’ve not wanted to leave. Now I’m trapped. In my room I start crying, then it turns into howling. I don’t care who hears me. If there’s any place where screaming and sobbing is typical, this is it. The person doing night checks wears stiletto heels, and every time she does rounds it sounds like small firecrackers being thrown down the hallway. I don’t sleep.
The “Rapid Recovery Unit,” or RRU, is really just a euphemism for a holding tank. I’m the only woman not in a chemical straightjacket from all the meds, and for the first time in my mental heath career, I’m an ethnic minority. The attending doctor is the same one associated with MAP, and he looks saddened to see me here, especially when I say I’m being held here against my will. “But you checked yourself in last night.”
“Not here!”
“You can’t leave until we figure out why you keep coming back.” He sits in a chair, looking dapper in his tailored suit, and I sit on my bed with a blanket wrapped around me, eyes swollen and throat sore. We review my current treatment: medication, 12-step meetings on occasion, the DBT group. He tells me that we can continue adjusting the medications, and that I can return to MAP until I’m in the new DBT program, but he wants to know what will give me hope again. It’s the first time anyone has asked me that.
“If I have hope, I’m only going to get crushed again,” I say tearfully.
“If you could have anything in the world, what would it be?” he asks.
“Love,” I say without a second’s hesitation. “But that’s the biggest setup of all.”
When I call my mom and tell her I’m back in the hospital, she exclaims, “What happened?!”
“Nothing happened. It was just another day.” I’m sure she won’t be able to visit, but she promises to come the next day. I ask her to bring me chocolate—and a file in a cake. She arrives the next day, bearing expensive dark chocolates, mango body lotion, and a book on van Gogh’s drawings. (“He had borderline!” I declare when I see it, and she sighs; not even high culture can escape my preoccupation with mental illness.)
“I want you to try to focus on other things,” my mom says, unpacking a sketchbook and some charcoals I mentioned I’d run out of. “This place depresses me,” she says, and asks what they’re doing for my treatment.
“Why don’t you talk to someone and find out?” I say.
“I just don’t understand why they’re not able to help,” she replies. “You’re on medication, right?”
I explain that meds don’t fix borderline, and that I’m going into a new DBT program with a new therapist soon.
“Good. I never liked Anna,” my mom says, “ever since the nipple ring incident.” Oh god. After I got my nipples pierced, I asked Anna if she thought it was appropriate to tell my mom about it. “What’s the worst that could happen?” Anna asked. That was admittedly a disastrous decision on both our parts. Some things you should never tell your mother.
I share the chocolates with the lunch crowd and give away the body lotion. In two days, I’m discharged back into MAP.
10
Chalice of the Hopeless
People want to know the exact moment or the circumstances of my turning point. Is there a bottom with BPD? Does something happen that changes everything? This will sound bizarre, but yes, I’ve figured out what did it: rage. Ultimately rage, not hope, hurls me into recovery when I finally understand that it’s not simply my illness, but incompetence and avoidance from the mental health system that has created my “incurable and hopeless” condition. And if there’s one thing that motivates me, it’s justified, self-righteous anger. The tipping point comes when I request my medical records from the hospital, both from my current stays and from back when I was seventeen, so I can discuss them at my upcoming intake interview for the new therapist and DBT program.
It only takes a week for the manila envelope to arrive from the hospital, filled with a small stack of intake and discharge summaries. The current records don’t surprise me, I practically could have written them myself. It’s the one from fourteen years ago that turns the tide, that makes me decide I am not going to let this illness or the negligence of others destroy me. Call it a variant of “Living well is the best revenge.” When I read the discharge summary from so many years ago, it plainly states that my Axis II diagnosis was borderline personality disorder—meaning that for years and years doctors knew and kept it a secret.
The room goes white when I read the words. Why didn’t they tell me? How could my psychiatrist allow me to leave a mental hospital without knowing the illness that was destroying me? I call my mother up.
“What did they tell you at the hospital in 1987? What did they say my problem was?”
“They told me you were depressed and using drugs.”
“No one said anything about BPD?”
“No one said much of anything, Kiera. It felt like they didn’t want me involved. And I was already overwhelmed.”
I don’t know who to believe. It seems just as likely that the doctors did tell my mother and she promptly forgot. Yet there’s no way I can blame her for not knowing. That summer before my eighteenth birthday was a nightmare. In those few months, my brother went into drug rehab, I was in the mental hospital, and my mother’s thyroid was diagnosed as malignant and needed immediate surgery. But I can blame the doctors, the hospitals, and the therapists, even if
their intentions might have been to “protect” me from the stigma of BPD. This could be considered black-and-white thinking, but given the treatment I’ve received for my BPD, this much is clear: The whole system is fucked. I’ve had the diagnosis for almost half my life and no one told me. Even after getting the diagnosis, in this past year not one professional has given me information about it outside of Dr. B’s original fifteen-minute discussion of my symptoms. Even my meeting with the famous BPD doctor didn’t touch on the subject. I’ve been on six different medications, and now I discover that the hospital’s “DBT program” is a sham, even as I’m still being told it’s the critical element to helping me get better.
We hear many stories of desperate parents who must fight with doctors to get proper mental health treatment for their children. Less frequently, but on occasion, we hear of people with mental illness who fight for treatment. But in 2001, no one with borderline is publicly demanding proper help and treatment. Here we are, immersed in a sea of shame and self-hatred beyond reason, and on top of that, our illness is considered too shameful to even admit to, and apparently no one else wants to deal with it. By now, after almost a year of supposed treatment for BPD, my symptoms of inappropriate anger, paranoia under stress, rapidly shifting emotions, and all of the core feelings of being neglected, alone, and helpless aren’t symptoms of the disease anymore; they’re a response to real conditions. I finally realize that a diagnosis of BPD will create a response in the mental health system (and others) that can actually trigger these so-called symptoms, locking you into the borderline criteria. The clinical term for this situation is “iatrogenic,” meaning a treatment that causes more illness.
This is what does it. This is my turning point. I’m so pissed off that I become determined to fight—for my survival, and for my borderline brothers and sisters. We do not deserve to be trapped in hell. It isn’t our fault.
Buddha and the Borderline Page 9