Visions Journal, 2011, 7(1), p. 11
My first introduction to borderline personality disorder (BPD) occurred when I was 22 years old in 1998. It came via a nurse clinician at a hospital emergency department. She'd seen me several times over the course of a few weeks when I was in crisis. She suggested to me that I had some symptoms of BPD and that I might want to do something to prevent developing the disorder. What she thought I could do, I have no idea. She did suggest that I read the book I Hate You, Don't Leave Me. I read the book and didn't relate to it at all. There were a lot of anecdotes in the book about people with BPD directing their intense anger at others, and I have never been like that. If anything, I tend to suppress my anger and direct it toward myself.
Nine years ago at age 26, I was formally diagnosed as having the disorder during an assessment at Vancouver General Hospital Outpatient Psychiatry Program. Since that diagnosis, I have seen more therapists than I can even count. Not because I don't want to be successful in therapy . . . quite the opposite. It's just that what helps me is a delicate balance of caring and boundaries, and it can be hard to find both. When I do find something that works, I stick with it for a long time.
I can clearly see that some things have shifted in my life over the course of being in group dialectical behaviour therapy (DBT) for nine years. I haven’t attempted suicide since starting DBT. I've learned a whole new skill set for managing emotions and tolerating distress. I’m more consistent in attending classes and volunteer work regularly, no matter how I'm feeling.
Yet I sometimes I feel like I'm in the movie Groundhog Day, where Bill Murray keeps living the same day over and over. I seem to be repeating the same themes. It's frustrating to be an intelligent person, and to sometimes even know the "right answer," but not be able to shift yourself out of certain states.
I still self-harm regularly, even though this is something I'm trying to eliminate from my life. I do self-harm less severely and less often, but change in this area seems to come with a lot of setbacks. While self-harm has a lot of negative consequences in the long term, it is hard to resist the immediate relief it provides when I'm faced with overwhelming emotions.
Another ongoing struggle for me is that my boundaries seem really fragile. At times, I feel like my sense of self is shattered and bits of me are lying everywhere. This is a very vulnerable and threatening feeling. Boundaries are what keep you intact as a person. They let you know where you end and others begin. Having a sense of boundaries helps you know you are in control of your own behaviour. Losing those boundaries can feel like you are flowing everywhere, like spilled milk.
When I lose my boundaries, I so want someone else to be able to understand how I feel and help me put all the pieces back together. But it also feels threatening for anyone else to come too close to me. I tend to dissociate a lot during these times, which is like spacing out and not really feeling like you're inside your body.
While others can support me in re-establishing boundaries, it seems like it has to be an inside job. I need to regain the sense of control over my own behaviour. Grounding myself and being connected with my body is important. I need to be able to define what is safe for me. It can be a long process, over the course of weeks.
When my sense of self is unstable, it helps when people in my life are clear about their boundaries with me and keep them consistent. I feel more in control of my own behaviour when I know what others expect from me. For example, knowing that my therapy session will end at the same time every week is important because then I know I can't do things to try and extend it. It may be hard for me in the moment when people set those boundaries, but it is better in the long term. Having a consistent routine in my life also gives me the feeling that life is predictable and helps me feel more secure.
Another recurring theme to do with BPD is referred to in the Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic criteria as, "chronic feelings of emptiness."1 I think saying it that way makes it sound so benign. The actual experience is a lot more raw. It's an intense kind of longing . . . as if someone you really love has died and you want them back terribly.
Even though I have created a support network for myself, sometimes I still struggle with a colossal sense of aloneness. It comes like a tidal wave and sweeps away all memory of connections to people. I may have seen someone an hour ago, but I can't remember how it felt to be with them. This is a feeling that often leads to self-harm. Not so much the actual feeling, but the wish to avoid it or make it go away. Sometimes I self-harm to try and bring people closer so I won't feel so empty.
The best ways I've found to deal with this feeling are to allow it, validate how I feel, cry and reach out to people when I can. Validation means telling myself that it makes sense to feel this way and that I have a valid reason for the emotion. It takes a lot of courage to experience such intense emptiness. But feeling things deeply also means I am capable of having really meaningful connections with people. I wouldn’t change that for anything.
About the author
Lisa Marie is recovering from BPD. She has her bachelor’s degree in psychology from Simon Fraser University. She has been an Information & Referral Volunteer with Vancouver Coastal Health for the past four years and a Consumer Contractor with the Walking to Wellness program at Midtown Mental Health Team
American Psychiatric Association. (2000). Diagnostic and statistical manual for mental disorders (4th ed., text revision). Washington, DC: Author.