Randi Kreger has brought the concerns of people who have a family member with borderline personality disorder (BPD) and narcissistic personality disorder (NPD) to an international forefront through her best-selling books, informative website, and popular online family support community Welcome to Oz.
"My Journey With Borderline Personality Disorder"
I discovered the joy of cutting by accident when I made my first suicide attempt. I fingered the cold steel of the razor blade and traced the delicate blue veins that ran down my forearm. Placing the sharp edge of the blade against my surprisingly resistant flesh, I pressed and hard and cut myself. My arm lurched back. Blood ran in tiny droplets down my arm.
I didn't go deep enough to need stitches, but I when I cut myself I entered another realm, one in which I felt nothing. Not the chaos of being thrown repeatedly against a cement wall, not the ache of emptiness that plagued my insides. Cutting became a ritual; my arm displayed the scars and I wore long sleeves everywhere.
A year later, on a humid summer morning before the sun rose, I padded to my kitchen (where I kept my meds) and swallowed sixty capsules of Prozac. I went to bed and waited to die. Nothing happened, so I went for my morning roller blade skate. If I'm not going to die, I thought, I might as well be thin.
At my hospital day program later that day, I finally told a friend what I had done. She related the incident to a staff member, who rushed me in a taxi to the emergency room. The doctors there committed me to a psychiatric unit. The physicians there diagnosed me with borderline personality disorder.
I had never heard of BPD. I wasn't aware of its negative connotations, of the alarms it set off throughout the psychiatric community. Not knowing that many mental health professionals outright refused to work with those of us diagnosed with this disorder, I remained blissfully ignorant during the initial stages of my illness.
I was transferred to a long-term BPD unit at a private psychiatric hospital. The unit specialized in treating its patients with what was then a relatively new treatment known as Dialectical Behavior Therapy (DBT). It was the start of a lengthy and arduous expedition that would persist for the next 21 years and has not yet ceased.
I used the psychiatric hospital a revolving door with more than 20 hospitalizations over the course of those years. I've attended day programs and partial hospitalization programs. I lived in a 24/7 supervised halfway house for three years. And all this time I've continued in individual therapy
My co-occurring disorders included major depression with psychotic features and anorexia, which complicated treatment. Starving. Cutting. I was trying to destroy myself any way I knew. I made a third suicide attempt — I crashed my car into a pole — and another lengthy hospitalization ensued. I lost a career that I had worked eight years to build, advancing from a secretary to a development manager, because my supervisors couldn't hold my position after two long hospitalizations.
DBT was the treatment I needed at that time. It provided me with basic tools so I was able to stay in the here-and-now and to stop the self-destructive behaviors. I learned consequential thinking and to think before I chose to act. I didn't just sit down, learn the four modules of DBT one time and master the skills. One can start using the skills such as Act Opposite and Self Soothe immediately. I sat through numerous tutorials of DBT and I'm still learning how to more effectively use the skills today. As my place in the world shifts, so does my perspective about how I use this exceptional treatment.
In 1998, eight years after swallowing the Prozac, I felt ready to attempt a significant challenge. I had been out of the halfway house for three years, living in my own apartment and I was bored working part-time for Barnes & Noble stocking shelves. I wanted to return to school, graduate school and obtain my master's degree in social work. I won't say I made it through unscathed; I graduated with a 4.0 GPA — but with a cost — I suffered a relapse of anorexia during the two-year program. My self-destructive and perfectionistic tendencies kicked in, and it cost me. The relapse wasn't serious enough for me to be hospitalized, but it made studying more difficult.
I broke down in 2005. Not piece by piece, but all at once. I had been working as a social worker at an agency near my home, and I had to be hospitalized for depression twice in quick succession. I lost that job.
Four more hospitalizations followed in the next eighteen months. I was intractably depressed and suicidal. A therapist I knew from an prior BPD day program referred me to a psychiatrist for a medication consultation because I was not thinking clearly, I had stopped all my meds.
"Dr. Adena" would become my psychiatrist and my therapist for the next eight years (we continue to work together today). She practices Transference Focused Psychotherapy, which is another treatment for BPD in which the emphasis is on the interaction between the therapist and the patient and how these patterns may provide clues to impaired relationships outside the therapeutic office.
Today I am thriving. In 2007, Dr. Adena said I no longer meet the criteria for BPD. The progress I've made has come with hard work. There have been major revelations and breakthroughs that have left me retching in the hall bathroom that Dr. Adena shares with her colleagues. I once spoke to her while standing in front of my hairdresser's salon with a black smock plastered to my body and my hair slicked back with dye, wailing in the salon. I thought, "I'm going crazy."
Each time I thought I was done with revelations and thought there could be no more, another one, even more difficult to handle, would come along and take me on a journey about myself, teaching me something that I didn't know. There were setbacks and relapses. But I no longer wanted to die. This was the process of therapy.
In 2007, I began to study memoir, writing about my experience with mental illness and publishing my essays in literary journals and anthologies. My writer identity has replaced my patient identity. A staff member at one of the hospitals once called me a "professional patient." That remark hurt and I have never forgotten it.
I began working part-time at an outpatient mental health clinic in 2008, and in 2009 the clinic hired me for a full-time job. Today, my position is split between clinical work and administrative work for the executive director. She singled me out because of my penchant for detail work. I have found my niche.
I have a small but close circle of family and friends and an active social live, something that I sorely lacked before. I used to be isolated, spending most of time with my mother in her home. She passed away 11 years ago from pancreatic cancer. My mother was diagnosed and given six months to live. As she was making her arrangements, she purchased her plot and bought a plot for me next to her. Two years ago a friend of hers told me that she lived in fear that I would kill myself. I like to think that she is looking down on me filled with joy and happy that her prediction didn't come true.
I have reclaimed my life. I am alive, grateful for each day. I wake up early because I am most productive in the mornings. I write before I head off to work, watching the oranges and yellows of the sunrise streak across the sky and welcome another day.
Links of Interest:
Dialectical Behavior Therapy: http://behavioraltech.org/resources/whatisdbt.cfm
Transference Focused Psychotherapy: http://www.borderlinedisorders.com/transference-focused-psychotherapy.php
National Education Alliance for Borderline Personality Disorder: www.borderlinepersonalitydisorder.com
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