When Connor very kindly asked me to contribute to his excellent blog from the perspective of someone living with BPD (Borderline Personality Disorder) I think he was preparing himself for a metaphorical kicking. ‘I’m getting a bit hot under the collar over the survivor movement’s constant haranguing of the mental health professions’ he told me, as if he could almost feel me winding myself to vent my spleen.
I want to say ‘it ain’t so’ but that would be telling an untruth. The two sides of the equation – let’s call them ‘the professional’ and ‘the patient’ – ought to be travelling in the same direction, should, really, be striving for the same goal but I would suggest that isn’t always the case.
Why? Surely ‘the professional’ works with ‘the patient’ and in her/his interest? To answer that question I would like to describe, in sometimes quite graphic detail, the ‘realities’ of living with BPD and its various relatives (amongst others Narcissistic Personality Disorder, Paranoid Personality Disorder). Forget, for a few minutes, any textbook or clinical definitions, put any preconceptions to on side and try to see how from my perspective.
Let me begin by stating the bleeding obvious. There is no typical BPD ‘sufferer’ and maybe the condition lends itself to a greater variety of manifestations than other, similar, maladies. There is no one-size-fits-all and therein, I think, lies the first of the problems I would argue that the mental health profession – not necessarily the practitioners but the managers and commissioners, still believe in a universal panacea.
That stipulation – not necessarily the practitioners but the managers and commissioners – will become a recurring theme.
Some of the clichés are true enough. The underlying theme is one of instability and insecurity, in every aspect of life: emotional, professional, financial. But ‘instability’ is a pejorative term; in the mindset of the mental health professional it’s symptom of BPD that really must be cured and I think that’s something we need to address.
More of that anon. I haven’t yet mentioned the almost fanatical devotion to extremes. Everything is black or white; there can be nothing inbetween. Grey represents tedium and orthodoxy, the mediocre and the banal; characteristics that should not just be avoided but sought out and destroyed at all costs. I once had a psychotherapist who tried to persuade me that the grey was, in fact, in silver. I was lost in a haze of antidepressants at the time and she very nearly fooled me.
Very nearly, but not quite because deep down inside, you see, I don’t want to be ‘cured’. I’ve become so viscerally hostile to anything that might be construed as conformity or compromise that it might appear, to the neutral and/or relatively rational observer, that I seek out adversity even in places where it doesn’t really exist. For example, writing this essay – some would call it a rant – I soon realised that I wanted the reader to either love me or hate me; the last thing I desire is pity because pity is the preserve of the weak and the wretched. I don’t so self-pity, I don’t do misery; I only do self-destruct.
And that’s the Narcissistic aspect of BPD. I’m so often overcome with loathing for my fellow human beings that I could easily be mistaken for a misanthrope. Yet when I love someone I love them with a passion that soon veers into self-destruct. I rarely vent my anger on others; hatred – and violence – always turns in on itself.
BPD has led in more directions than there are points on the compass. On the negative side it fuelled a latent gender dysphoria which ended up in gender reassignment surgery (in tabloid talk that’s a sex-change). It’s brought me to the verge of alcoholism and anorexia and encourage – yes, encouraged – me not only to self-harm but to revel in it; for several years gin and a sharp blade were my constant and sometimes exclusive bedfellows and I would literally spend hours gazing lovingly at the rows of knives on display in my local supermarkets. I tread a thin line between wealth and destitution; I’m perennially in debt because I don’t understand money in the same way as many of you do. If it’s there, I spend it; if it’s not, I borrow or blag and something always comes up in the end.
You can see how it can lead to a precarious existence. One more than one occasion BPD compelled me to quit my job, my home and my family to seek refuge on the other side of the world but guess what? Those bastard little demons saw it coming; they packed their bags and followed me; they turned up in El Salvador 48 hours later on my hotel doorstep.
You don’t believe me? Ask the duty manager; he’s the one who talked me down. And he didn’t laugh when I told him that although I hated those bastard little demons I couldn’t live without them. If there’s one phrase that defines the nature of my BPD it’s my relationship with those bastard little demons; I’m drawn to that which ought to repel me. Like a moth to a flame.
Finally it drove me to two overdoses, the latter of which was, I concede, pretty damned stupid and could well have proved fatal. But I survived. And you know what I’m going to say next, don’t you?
I don’t regret any of it.
Because, ridiculous as it might seem, there are positives and even if they appear to you to be vastly outweighed by the negatives, and if you were to offer me a pill or a course of therapy that put everything on an even keel I’d tell you where to stick it. What you call normality I call subservience; what you call instability I call a voyage of self-exploration. You’ll note how everything revolves around the self; the ego is the sun around which the rest of humanity must revolve. There are those who know me who would speak of my gregarious, outgoing personality – and that’s the key word, isn’t it? Personality. They would describe me as generous of spirit, intelligent, quirky and good company but they would be describing the ‘good’ Siân; some of them have known me long enough to come across the ‘bad’ Siân but she keeps herself to herself; locked away in her own little world.
The ‘bad’ Siân, of course, is the Siân the mental health professionals want to treat. They’d like to eradicate her from the face of the earth. Trouble is, more often than not I prefer the ‘bad’ to the ‘good’ and I don’t want to be rid of either.
Still with me? Well done! Now, with Connor’s permission I shall, in the second and concluding part of this polemic I shall endeavour to find some common ground on which mental health professional and service users might meet and smoke the pipe of peace.
It’s not going to be easy!
Siân is author of The Society of Sin, a Victorian Goth-erotic fiction inspired by her Dorset connections, and is currently in the process of publishing her autobiographical novel Death by Eyeliner. You can find out more about her here.