My name is…
September was Suicide Awareness and Prevention Month What if I told you that 1.3 million people in the UK alone exist in a world of pain where they consider suicide nearly every moment of the day; in-fact suicide is a fairystory that they tell themselves while others consider it a nightmare. That there are over 1.3 million people in the UK alone that walk the streets with the equivalent to untreated 3rd degree burns on every part of their body. That their soul is literally on fire. That they struggle to breathe, to think, to sleep, to eat, to drink.
My name is Pixie, Pip, Pippa, Pippy, Kitty…I go by many names. And then there is my secret one that I reserve for the “bad” bits. The negative, intrusive, impulsive, restrictive and tiring bits. It’s not another personality, she is me just…at my most extreme. Itis unrecognisable as me, entirely pro-social when socializing; completely anti-social when pissed off. Itis stronger than I will ever be alone, It is faster than I could ever be without it and it is part of who I am. This is the name I give to my Borderline Personality Disorder. You can meet her later.
Also called Emotionally Unstable Personality Disorder (EUPD), it is a mental health diagnosis that causes a variety of highly disturbing psychological and physiological symtoms for the individual.
Mainly due to the high level of stigma that pervades the disorder throughout the psychology community, those with BPD, people like myself, are side-lined when it comes to treatment; a combination of a long line of subjective and non-corporeal symptoms that mainly describe how the behaviour is viewed rather than what a patient is actually experiencing. And psychiatrists feigning ignorance because it’s “just annoying” because “everyone has a personality”. And so a stigma prevails. I invite you to look at Quora.
Can a person with borderline personality disorder (emotionally unstable personality disorder) feel empathy?
Can unconditional love treat borderline personality disorder?
Does a person with BPD truly love anyone, or is it just idealization?
The most common answer to that last one is depressing and severely isolating.
https://www.quora.com/Does-a-person-with-BPD-truly-love-anyone-or-is-it-just-idealization
Basically the answer seems to be a unanimous “no”. We are hard, cold, unfeeling and deliberately manipulative; soulless, heartless mynah birds of emotion; the cookoo of the proverbial psych-nest.
I was one of those rare cases to be diagnosed when I was on the cusp of adolecensce after a series of highly percular behaviours for my age.
Severe moodswings, self-harming, hypersexualization, insomnia, depression, hyperactivity, drug abuse (yes it was only Ventolin for my asthma but it made my head go buzzy if I took enough puffs) dissociation that began at the age of 7 and proceeded to worsen until I was 10.
And that was when the bulimia started.
This is all rather doom and gloom. Take a deep breath; we’re just getting started.
I’m not going to pretend that it isn’t. Lord forbid that helps no one. Early diagnosis was a little redundant in 1998 as the baby-boomer nation was all work and all play so I don’t really blame my parents for not getting me help sooner. I’ve long since forgiven my parents for the part they played in aiding the grip of Borderline Personality Disorder on my life. Not to mention that these behaviours were marked as “attention seeking” and “manipulative”. Now we know that the earlier the intervention, the more therapy succeeds.
But as it was for me , my adolescence was ridden with self-harming, promiscuity, and substance abuse…including my first overdose…and then my second.
My moods were absolutely out of control; I could be happy then miserable then angry then screaming blue murder to near catatonic.
Aside from their marriage crumbling around the family, coupled with some serious disfunctional parenting, I don’t think my parents had a single clue of how to deal with me. And my poor siblings must have been just as clueless as they certainly weren’t expressing themselves in the same way.
When I was first diagnosed in the early 90's, Marsha M. Linehan’s DBT was still in it’s infancy with regards to being rolled out as a standard treatment for Borderline Personality Disorder, gaining traction as the leading method of treatment; studies were already showing how it made a profound positive impact on the behaviours of those with BPD.
Alas, at the same time, doctors were beginning to become frustrated with the whiney threats of proverbial adult babies crying wolf about feelings that they simply couldn’t handle like “a normal person”.
I was one of those people. Stigmatized due to a highly emotively described disorder.
It presented similarities to the cruel egocentricity and void in self-esteem of a narcissist, coupled with the unbridled rage of a psychopath.
I honestly thought that everyone felt this way and was just afraid to talk about it. I was afraid to talk about it. I was afraid to talk about being in constant emotional pain that could manifest as physical. I was afraid that I was losing hours of my day to dissociation, I was afraid that I had some strange longing to slow the world down by causing my body pain; by casually committing suicide. And so I thought others were doing the same; they were just better at handling it than I was.
Even though the words Borderline Personality Disorder appeared on my file at such a young age, I remained under the radar. Home life was strenuous and very secretive so any form of therapy was nearly impossible to maintain long-term. And we kept moving house, country, school, locality. Luckily I maintained the same doctor from the age of 7 onward, when I turned 11, I started anorexia binge/purge subtype- and high school. These are linked intrinsically as it was the high school that first identified a serious problem.
From my eating to my mood swings to my near catatonia in some classes, my guidance teacher spent more time talking with my parents about how to help me than she did teaching her subject, which was English.
Ironically it was also my writing that caught her attention and not in a “New York Best Seller” sort of way. In the “Mr and Mrs Cooper, your child keeps drawing pictures in their book of herself with pins in her eyes” sort of way.
I was describing emotions and feelings, situations and experiences that she felt were inappropriate for someone my age. Love, abandonment, death, missing children, self-harm, suicide, the holocaust…and all in graphic detail…again…at the age of 11. And quite brazenly. I recall an enthusiastic motivational speaker coming to school to clue us in about Mental Health saying “1 in 3 of you will be considering suicide.” I squeezed my friends hand extra hard as he counted me as the 2 that wouldn’t out of 3. And then he ran through a mindfullness exercise, told us to tell a teacher when we felt like that and that was that.
After so long I honestly thought that this was just going to be my norm. I was one of the 3 of many threes! And so I thought nothing of mentioning blithely that I had unbuckled my seatbelt, and opened the cardoor while going high speed on the dual-carriage way. At 12, my self-harm had reached a state that the GP recommended councilling after the school warned my parents it needed to be attended to. With my mother insisting that I was simply replicating behaviour I had seen on Hollyoaks, we walked into Marcella’s office. My parents crisply dressed and beautifully presented, myself sullen and quiet. And in the space of a few moments I knew that the cards weren’t dealt in my favour. I was never going to be alone with this woman, never going to be able to tell her about my father’s explosive and violent temper, my mother’s turning the blind eye, obsession with her image/weight (though I always thought her beautiful) and childish whims, my sister responding with bullying me, and my brother responding with night terrors.
Most importantly, I was talked about as though I was not there, and using those words again “attention seeking” “manipulative” “common”. Not a single mention of the physical anguish I was experiencing. We walked out, and I never saw her again.
It wasn’t until my first overdose at 14 that I learned that what I was experiencing by accident…by curiosity…because I’m just far too inquisitive? I looked at my chart at the end of the bed.
What I had always experienced could possibly be boiled down to 3 little letters and a question mark, sitting for 2 years on my medical record: BPD(?).
It wasn’t the most spectacular overdose…and certainly not an effective “suicide attempt”. I took 8 paracetamol and casually told my parents that I just wanted the world to slow down so I could feel I was going at the same pace, holding out the packet like an empty chocolate wrapper for the bin. What I recall was their anger. That I was going to be taught a lesson for this. That it was a nuisance.
Of course, this likely was not the case. But I am not speaking for my parents. I am speaking from a disordered mind.
I was marched to the hospital. Ten hours in a&e, one bottle of activated charcoal and a black poop later, we were out the door with a recommendation that I saw a psychiatrist…I was dropped off once to speak with him. I barely remember the conversation past him mentioning BPD. I do recall my mother saying I could get the bus to see him after school…and so I never saw him again either. I was 14. Come on!?
At 18 with my father’s temper at its peak following a diagnosis of MS, my brother in hospital with 3rd degree burns up his arm, my mother with her head in the clouds, my sister having finally made her escape to university and splitting her time living with her boyfriend, my ability to keep it together was wearing disastrously thin. Then, one night, my stereotypical dick teen boyfriend decided that fingering another girl at university 300 miles away after texting me “we need a break” was absolutely the proper way to behave; I snapped.
Properly and loudly at first, screaming into a pillow and scratching at my arms and pulling out my hair.
I cried until I was sick, I remember the feeling of my brain being on fire, my body on fire, my soul. I called anyone begging them to help me, to make the pain stop. I couldn’t live this way. I couldn’t. It had to stop.
No. I did not want to die, but this pain in my head that no one could see had to end. At the house of two of my best friends at the time; I chased two boxes of paracetamol, a box of ibruprofen, a tub of asprin with half a bottle of vodka. Cried a little more. Put my fingers down my throat once by order of a very good family friend on the phone, threw up some dregs of the pills that I had made sure to chew on the way down and then passed out.
I woke up, threw up and called the ambulance myself. My grandmother was the first one there. My father had me sectioned. One friend visited. My boyfriend was now my ex. I vowed, from that point, that overdose was never going to be the way out again…and that was not true; I did came pretty close a number of times until I was 23.
Trauma happens. It can be small or big and it is unavoidable. And how we manage it is determined by the internal impulses stimulated by that trauma; fight, flight, freeze, faun. Someone catcalls: fight. Someone says they love me/hate me: Flight. Someone tries to physically harm me: Freeze. Someone succeeds in hurting me: Faun.
When I turned 22, I was the victim of a sexual assault. A year later, my anorexia had me at 7 stone and malnourished. My father had been to jail for fraud, and come out the other side wiser and tempered, my mother was ready to finally shed the dusty robe of compliance; they divorced and made to move on with their lives. I, on the other hand, could not. Too much had happened. And I was stagnant in life. On the surface, I had a boyfriend I loved who loved me, a job I was managing in retail but
…unfulfilled and far too ready to be abandoned, abused again. Far too ready for the pain to continue. I drank, I cried, I dissociated, my mood was unstable. Everything was superficial and non-commital. I simply couldn’t see the future.
This was when I was marched to the doctor for my eating disorder after being hospitalised due to dehydration, told I would be inpatient if I purged again and was put on the waiting list for psychotherapy due to the sexual assault.
When I met Sarah. Sarah was a psychotherapist in Fareham, Hampshire. And she was the first person in the medical profession whom acknowledged (and reminded me) that I had been displaying and managing a very serious mental health disorder for over a decade with no appropriate treatment what so ever. She gave me every reason it would have been ignored from neglectful parents to unwilling psychiatrists, from poor research to mental health stigma; I had fallen right through the net.
She reassured me that it was highly likely that doctors hadn’t chased my case when I didn’t turn up, even though I was a minor, due to the stigma surrounding BPD.
Untreatable, malingering, whiney adult-babies who simply refused to grow-up. Which she didn’t believe at all. She completely ignored the “major depression” and the “chronic fatigue syndrome” and the “malingering” and went straight for the jugular.
Though we focused on healing from the trauma of the sexual assault, she believed that resolving this key event through trauma therapy and DBT would enable me to look at my other traumas and process them in the same way. Mainly they would give me the skills to manage a disorder that, she assured me, had as much to do with my brain chemistry and brain development as it did my life experiences. She explained that medically, neurobiologically and psychologically, Borderline Personality Disorder is one of the most impactful mental health diagnosis, carrying highly destructive thought processes that drastically reduce and increase emotional brain function. And as we progressed through treatment I came to understand my brain structure more and more, where it had always been deficient and what had worsened and strengthened my ability to function with BPD.
After 16 weeks, I wasn’t cured but I certainly wasn’t a victim to the disorder anymore. I wasn’t going to go down without a fight. I began to be able to identify good days and bad days, positive coping mechanisms and negative. I had more energy, less panic. I wanted to plan for the future, build something for myself. I returned to university. I was little and a bit battered but still good. Still useful. And genuinely proud to be.
Sadly there will always be trauma…and it did find me in the form of my would-have-been Sister-in-law. It wasn’t so much an attack on me but her publicly airing my traumas to everyone drunkenly at a party. I received an from her apology but I found myself depressed. The physical impact was unbelievable. Some of my old habits resurfaced, drinking until blacking out. Panic attacks, catatonia, night terrors, and flashbacks of the sexual assault. But I knew this dance. The relationship didn’t survive, but I did. I went to the university councillor through my GP mentioning my disorder which had me seen faster.
Six short months after the relationship ended, I had graduated, my physical health was back on top form and I was working as a supply teacher across Hampshire, I was dating, I felt sexy, I felt free and I felt happy.
That was until we met Alex…Alex Agathocleaous hit me physically, emotionally and mentally like nothing I had experienced before. He pushed me past every BPD breaking point with threats of abandonment, actual abandonment, physical punishment, anger and aggression that I hadn’t experienced since I was very, very young. Too young to remember. But I will remember it now. Harriet made sure of that. Because one time Alex was aggressive, and we knew that from aggression we were a short step from violent… and Harriet blew up the world before Alex got there first.
Harriet is the name I now give my BPD at it’s most cognicent. She rammed our head into a wall, she tore up love notes, cut up a handmade scarf, smashed a mug, a glass, cut our arms, bit our limbs to bruise and bleed, she begged him to hit us again, she baited him to act on his threats, and then, when I still couldn’t leave him, she had us over the balcony. She was NOT going to go out by the hands of that man. No way.
We were going to scare him ridged so he would -never- touch us again or die at our own hand. He pulled us back.
And oh how we both hated him for it. Of course, there was a short break, and then the relationship continued. He made me promise that it wouldn’t happen again…and so I promised while he promised nothing. I refused to allow Harriet her outward violence while he continued his. And so she took it upon herself to make me pay attention. Dissociating and finding myself at the top of buildings. Strange bruises I couldn’t explain. Writing, writing, writing until our hands were sore. Alcohol, talking with strangers, and tears.
I talk about my BPD as though it is an entirely different personality. But she isn’t. I knew why I was doing the things I was doing. I knew fully understood the danger I was in. At times words would come out of my mouth, true words, about what was happening behind closed doors. I would remember them though Alex would rather I forgot. And Alex took advantage of my disorder; blamed Harriet. Harriet who had always been there. Harriet who had been managed for 5 years prior to his arrival.
After the relationship ended, it took a further 18 months before I understood fully that I had been abused. Again. If you’re looking for the money-shot of BPD, abuse is your trigger.
But it was through the trauma of Alex that I learnt something very important about my BPD, about Harriet. I had cursed her existence for so long. I had ignored her, berated her, silenced her and been so ashamed of her. She is a part of me. Disordered or defunct my personality may be, but she knows how to scare like no-body, she knows the stories of our life that captivate and horrify, she is stronger than I think I am, has a sharp tongue and sharper wit, she learns fast, she is inexhaustible and alert, she is highly intuitive. She can utilise our empathy to solve the problems of others, right wrongs, stir up emotion when it is needed to fight the good fight, to finish the essay, to get you to work. Treating her as my enemy served to hurt us both, embracing her, taking time to process with her, giving her a moment to breathe and explain what she thinks; we are learning to live with each other again. And given that life is long, more trauma is inevitable,
but I would rather walk with her as an ally, now, than suffer at her hands for ignoring her.
Treatment works. Empirical evidence shows that DBT therapies profoundly lessen the impact of Borderline Personality Disorder. It combines the talking elements of Cognitive Behavioural Therapy with the Radical Acceptance of reality in Trauma Therapies, encouraging the strengthening of neurosynapses and control of seratonin response and dopamine release; something that recent neurological studys show that the BPD brain naturally struggles to do due to hereditary malformations in the amydala and hippocampus.
When given the time and focus required by the patient, it does work. And yet only 450 facilities across the UK are able to provide this valuable service to any and all that require it. Your average psychology degree narrowly touches on Dialectic Behavioural Therapy as a method of treatment; an extention of Cognitive Behaviour Therapy which is studied at length; provided across the NHS.
Borderline Personality Disorder/Emotionally Unstable Personality Disorder still remains one of the most dangerous and highly stigmatized Mental Health Issues in the profession with psychiatrists refuting its existence, and untreated individuals carrying a 80% chance of attempting suicide in their lifetime. 10% will actually attempt. 7% will sadly succeed.
And the assumption that individuals simply “grow out of it with time” in dangerous. People with EUPD/BPD do not grow out of it; the brain grows around it.
But with DBT, an individual with Borderline Personality Disorder will see dramatic decreases in their harmful behaviours, an increase in stress tolerance for the neurobiological impact of emotions and a decrease in the resulting self-harm, a vast reduction in suicide attempts and suicidal ideation, improvement in mood stability, decrease in dissociation. Some can even achieve near full mastery of their disorder.
If that is not a reason to destigmatise a mental health disorder both publicly, and in the medical profession I don’t know what is. I am one of the youngest people to have received this diagnosis. At 32, I now have the ability to share this story coherantly and confidently. It doesn’t make me special. That is a worrying fact.
Diagnosis of BPD is on the rise; how many have suffered longer and harder without even a name for those emotional third-degree burns the ravage the body, whether the emotion is good or bad?!
Life is unbearable when you remain untreated for so long; for yourself and those around you. The longer it is left, the more likely an individual will never achieve full-remission as the brain can be stubborn when it reaches a certain age. My hippocampus and amygdala just ain’t as flexible as they used to be!
But I can still learn; Harriet can still learn. And, from what we know now about this disorder and how it can be diagnosed and treated, there is no excuse not to teach the skills required.
If the facilities were readily available, people could be diagnosed earlier, supported quicker (including friends, partners and family), suffer less, live longer, live happier.
Please check out my instragram for more information on how I live my life:
https://www.instagram.com/the.borderline.kitty/
Look here for the #dbt4all campaign, striving to make DBT readily available across the NHS:
https://www.instagram.com/dbtforallcampaign/
Some of the studies mentioned above can be found here, but I invite you to look for more (there are many) and fight the stigma against BPD beside us:
