Borderline Personality Disorder and How Hospitals Justify Torture

New art is at bottom, way below.

Okay, first of all, below is much more like the checklist that I brought to Dr Mary B O’Malley, and we debated it line by line. Which I will do again, revealing her “proof” of my postiive diagnosis, just to show you how tortuous was her forcing me onto that Procrustean bed of such an absurd diagnosis. If she didn’t have to chop off my feet to make me fit, she would have had to stretch me on the rack to lengthen me! But read below and after I will give you a taste of her “reasoning” as well as the story about what happened subsequently. As my dear friend Tim says, “it ain’t pretty…” The checklist so to speak is in the second paragraph.

From BPDresourcecenter.org

“The essential feature of Borderline Personality Disorder is a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity that begins by early adulthood and is present in a variety of contexts. Individuals with Borderline Personality Disorder make frantic efforts to avoid real or imagined abandonment (Criterion 1). The perception of impending separation or rejection, or the loss of external structure, can lead to profound changes in self-image, affect, cognition, and behavior. These individuals are very sensitive to environmental circumstances. They experience intense abandonment fears and inappropriate anger even when faced with a realistic time-limited separation or when there are unavoidable changes in plans (e.g., sudden despair in reaction to a clinician’s announcing the end of the hour; panic or fury when someone important to them is just a few minutes late or must cancel an appointment). They may believe that this “abandonment” implies they are “bad.” These abandonment fears are related to an intolerance of being alone and a need to have other people with them. Their frantic efforts to avoid abandonment may include impulsive actions such as self-mutilating or suicidal behaviors, which are described separately in Criterion 5.

BPD is manifested by a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  1. Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in (5).
  2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. This is called “splitting.”
  3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
  4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in (5).
  5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
  6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
  7. Chronic feelings of emptiness.
  8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
  9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

You got it? Okay, so as I understand it, I am supposed to #1, primarily and first of all, to FEAR ABANDONMENT and try by hook or by crook to avoid it. Everything I do is supposed to be aimed at not letting people abandon me or to mitigate the chances of it happening or of my feeling the pain of it, right?  That’s what Dr Mary Burroughs O’Malley tried to get me to believe was true about me when she pointed out that I actually cried, omg, when my friend of 25 years was dying…that I “feared abandonment”. ( Yeah, you better believe I am stating her name right out loud, and Dr Amy Taylor at Donelly 2 South at Hartford Hospital’s Institute of Living as well, as she is the latest in a long list of deliberate torturers…)

Holy shit, you fucker, you dare to tell me that my shedding tears at the thought of losing a longtime friend, a friend who was my surrogate mother when my own parents were not in the picture for 30 years, is a symptom of a a personality disorder? You miserable little piece of pond scum…But you did. You insisted that my tears of simple grief were fears of abandonment.

Never the less, that was not proof of anything, because it never showed that I ever in any fashion behaved in such a fashion as to “avoid real or imagined abandonment.” And you know why you could not adduce any proof of that, Dr O? Because you could not find any. There was none. I simply never tried to avoid abandonment. I was abandoned, yes, by my father, one, for 35 years, but I never protested or tried by any extraordinary means, except letters, to ask for him to come back…And I was abandoned by unprofessional psychiatrists…But I took that in stride, frankly. Since I recognized that if they behaved that way then I would not want to be their patients any longer in any event.

Did I ever try to keep a session going longer than the set time? Never. I was punctual about getting up, immediately at the end of the “hour” and you know it. It would have horrified me to overstay into someone else’s hour! And I feel like such a burden on the world that the notion of overstaying or needing anyone simply horrifies me completely. So why would I want to keep anyone, or place any unnecessary demands on anyone? YOU were the one with the short temper and the curt voice…You were the one who would tell me to call you on your cell phone and then be unpredictable about it. YOU were the one who would tell me I had an appointment and then sometimes not even be there when I came…and I took it in stride.

YOU abused me. And I took it in stride, as if I deserved it. And Felt that I did. Because you taught me that I did and I knew nothing better. You continued to treat me like an subhuman less- than-adult right up until the day I left you…

But let me go on to criterion number 2. Splitting. Extremes of Valuation and devaluation. I am on the fence about this, because I believe that NO BODY can tell me that we do not ALL do this to some extent when we get angry with a person. The point is to know how a person feels and thinks when she calms down. Knowing how a person acts and thinks in a hospital is NO WAY to judge how a personality is in “real life” and it is simply silly and Dangerous to judge on a legal medical record something a fundamental as a personality disorder by behavior seen in a hospital setting. MOST ESPECIALLY in someone being treated, as I always was, for a psychotic disorder. YOU KNEW This is frowned on. It is considered unethical and actually regarded as improper and impossible, to diagnosis a personality disorder in a person with an axis I diagnosis….SO WHY DID YOU DO IT? WHY????

I know why, because you were a coward and could not stand up to nurses that you wanted to have like you. You could not simply telll them to treat me decently and with respect and dignity,. to understand that I was not myself and that I was not in control of myself…NO instead you threw me to the wolves and colluded with them  in treating me as if I were wholly in control and able to make rational decisions about how I behaved, when you knew absolutely and without a doubt  that this was NEVER the case. You knew it, because we discussed it many times, and you knew me outside of the hospital to be an entirely different person.

I have one intense and upsetting relationship, with an intense and very possessive borderline friend, who I needed to get rid of then and for a long time. SHE is borderline, not me. ALL my other friends have been friends for a long time. MAny are long distance friends — so much for the fear of abandonment…I don’t care how far away they move. They are still my friends and we stay in touch!

Dr Mary B O’Malley didn’t want to discuss identity, she jumped on the criterion on impulsivity and actually seized on the one about, you got it, self-mutilation. She seemed gleeful as she pounced. Smiling. I looked at her. Shook my head, but said nothing. She knew perfectly well that I didn’t fit their clinical picture, not for BPD, since I only self mutilate because of command hallucinations and when psychotic, and never in order to compel others to do something…But she was so triumphant when she made her point that I understood who had the power of the pen and diagnosis and that she evidently had forgotten what she had told me back in 2003 (this was in 2006): ie that the staff had asked her to add to the schizophrenia diagnosis for their convenience, not because she had suggested it or even felt it was true.

Apparently cognitive dissonance, if I use the term correctly, her behaving towards me as if I had BPD, and restraining me and telling others that I had BPD, had so affected her that now she had to make her thoughts correspond with her actions…and she was doing so, and dotting even i and crossing every T in the effort. But that didn’t make it true, that never made it less of a lie. It simply made it crazy making and infuriating.

It was then that I realized, though it took me a few more years to do it, that I had to leave her. If I had this conversation with her in 2006 or 2007, we put together the poetry book in 2007 and it was published in 2009, by which time I was already gone from her practice, and she had left the area as well (the week after I announced that I was leaving her, she announced that she was leaving me….NOW WHO HAS ABANDONMENT ISSUES???)

The other “criteria” for BPD here I will ignore, as they fit PTSD acute, as well, and frankly are absurdly vague. Anyone who has been restrained repeatedly in the hospital and kept in seclusion for a good three weeks, can be excused for exhibiting erratic moods and behavior!

Anyhow, I want to continue with how Dr May B O’Malley’s change in my diagnosis in 2003 affected my treatment in other hospitals. (You can likely guess, but there are details I would like to share, with names and other identifying tidbits added) but it is late and I needs must do it another day. Thanks for your patience in listening to this. My heart is —- Hmmm. Thanks to Inderal, a beta blocker that I now take for migraine prevention, I think my heart is NOT racing, that the panic I feel is a subjective feeling not a true palpitating reality after all…Interesting!

Small Acrylic portrait of man, eating, 3" by 5"
Small Acrylic portrait of man, eating, 3″ by 5″

Acrylic, 3" by 5" (start of a painting,,, not certain where this is going...
Acrylic, 8″ by 5″ (start of a painting,,, not certain where this is going…

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