I Hate You--Don't Leave Me - Jerold J. Kreisman [13]
“I was cutting myself and overdosing on tranquilizers, antidepressants, or whatever drug I happened to be on,” she recalls. “It had become almost a way of life.”
In her mid-twenties, she began to have auditory hallucinations and became severely paranoid. At this time she was hospitalized for the first time and diagnosed schizophrenic.
And still later in life, Carrie was hospitalized in a cardiac-care unit numerous times for severe chest pains, subsequently recognized to be anxiety related. She went through periods of binge eating and starvation fasting; over a period of several weeks, her weight would vary by as much as seventy pounds.
When she was thirty-two, she was brutally raped by a physician on the staff of the hospital in which she worked. Soon after, she returned to school and was drawn into a sexual relationship with one of her female professors. By the age of forty-two, her collection of medical files was filled with almost every diagnosis imaginable, including schizophrenia, depression, bipolar disorder, hypochondriasis, anxiety, anorexia nervosa, sexual dysfunction, and post-traumatic stress disorder.
Despite her mental and physical problems, Carrie was able to perform her work fairly well. Though she changed jobs frequently, she managed to complete a doctorate in social work. She was even able to teach for a while at a small women’s college.
Her personal relationships, however, were severely limited. “The only relationships I’ve had with men were ones in which I was sexually abused. A few men have wanted to marry me, but I have a big problem with getting close or being touched. I can’t tolerate it. It makes me want to run. I was engaged a couple of times, but had to break them off. It’s unrealistic of me to think I could be anybody’s wife.”
As for friends, she says, “I’m very self-absorbed. I say everything I think, feel, know, or don’t know. It’s so hard for me to get interested in other people.”
After more than twenty years of treatment, Carrie’s symptoms were finally recognized and diagnosed as BPD. Her dysfunction evolved from ingrained, enduring personality traits, more indicative of a personality or “trait” disorder than her previously diagnosed, transient “state” illnesses.
“The most difficult part of being a borderline personality has been the emptiness, the loneliness, and the intensity of feelings,” she says today. “The extreme behaviors keep me so confused. At times I don’t know what I’m feeling or who I am.”
A better understanding of Carrie’s illness has led to more consistent treatment. Medications have been useful for treating acute symptoms and providing the glue for maintaining a more coherent sense of self; at the same time, she has acknowledged the limitations of the medications.
Her psychiatrist, working with her other physicians, has helped her to understand the connection between her physical complaints and her anxiety and to avoid unnecessary medical tests, drugs, and surgeries. Psychotherapy has been geared for the “long haul,” focusing on her dependency and stabilization of her identity and relationships, rather than on an endless succession of acute emergencies.
Carrie, at forty-six, has had to learn that an entire set of previous behaviors are no longer acceptable. “I don’t have the option of cutting myself, or overdosing, or being hospitalized anymore. I vowed I would live in and deal with the real world, but I’ll tell you, it’s a frightening place. I’m not sure yet whether I can do it or whether I want to do it.”
Borderline: A Personality Disorder
Carrie’s journey through this maze of psychiatric and medical symptoms and diagnoses exemplifies the confusion and desperation experienced by individuals afflicted with mental illness and by those who minister to them. Though the specifics of Carrie’s case might be considered extreme by some, millions of women—and men—suffer similar problems with relationships, intimacy, depression, and drug abuse. Perhaps if she had been diagnosed