Something to Remember

Borderline Personality Disorder:

DSMIV Criteria
1. Frantic efforts to avoid real or imagined abandonment.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization
and devaluation.
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.
5. Recurrent suicidal behavior, gestures, threats or self-injuring behavior such as cutting, interfering with the healing of scars
or picking at oneself.
6. Affective instability due to a marked reactivity of mood.
7. Chronic feelings of emptiness
8. Inappropriate anger or difficulty controlling anger.
9. Transient, stress-related paranoid ideation, delusions or severe dissociative symptoms.

I've been trying to write about her, but it's just too difficult. She's too vulnerable, too accusatory, and though I realize she may never read this, I still fear her turning against me. So I'll write about her boyfriend instead...although even this I do tentatively.

He's a 26 yo African-American man, appearing slightly older than his stated age with hair cut tight around the curves of his skull, wearing a black, ribbed, long-sleeved T-shirt over baggy jeans, and one small silver hoop earring on his right earlobe. I found him standing outside in the hallway of the emergency room after he had knocked on the door to the psychiatry office, saying that he was looking for a Dr. Du. He stood, shifting his weight from side to side with his hands in the pockets of his baggy jeans and reached out his right hand to shake mine. He made appropriate eye contact but shifted his gaze away from mine frequently as he spoke of the facts of his situation, as though my eyes were those very emotions that ought not be confronted at this moment of logistical urgency. His speech was polite but had a sense of urgency and his hands punctuated his sentences with masculine fairness . He spoke what I can only describe as the language of the "inner city," frequently ending his sentences with 'you know what I'm sayin?' As he went on, he spoke more and more rapidly, as though he was making his final plea to the jury. His thought process was linear, but he returned always to 'I just want her to get better,' and 'I just can't be with someone like that.' His thought content was predominated by her threats, her moodiness, her violence, her drinking, her lying, her insatiable need for attention, etc. His affect ranged from worried about her, to angry at her, to sad that it has been so hard. His eyes moistened as he heard my trite words, 'it must have been difficult.' I didn't ask him his mood, but I suspect he would have repeated, 'I just want her to get better, you know?' I could tell he had insight into the issues in his life and hers, but he hadn't heard the term "Borderline Personality," nor had he thought of her as fighting a difficult life-long "illness." To him, she was the firebrand, fragile-hearted, emotionally draining, but yet fascinatingly endearing love of his current life - and I can't deny the accuracy of his perception. He had good judgment to focus on his immediate purpose of finally curing her of her manipulative behavior that kept him holding her but hating her, by telling me anything and everything he could of the truth, knowing that she twists the truth and lies. But he was wrong to believe that by doing so and by being in a hospital, she would 'be cured' of her personality. And perhaps he was wrong to have stayed with her because she threatened to kill herself each time he tried to leave. But then again, perhaps he was really the one who saved her then and now.

In summary, this is a 26 year old man standing before me, his eyes moist with the tears of a trapped animal without a trap to blame. There was nothing that I could do but to feel his anguish and remember.