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Is 'Dr. Sanity' an undiagnosed BPD? *Triggers*

Posted by Quintal on September 3, 2007, at 4:34:48

I'm sorry if others find this triggering, but I feel I must share... I did a Google search on BPD this morning, and I came across this webpage.


Way back when I was just beginning to practice psychiatry, I had a young woman patient (17 years old) whose name was Chris. She was one of those extremely difficult patients who we suspected of having a Borderline personality disorder (BPD) (you really can't diagnose personality disorders before the age of 18 or so)--and if she didn't have BPD, she was well on her way to developing it. She used illegal drugs and claimed they "helped" her; she was impulsive and histrionic; she cut herself frequently; made suicide attempts regularly; and was so desperate for attention and love that she would lie, cheat, and do anything for to get it. She and I had a particularly difficult session one day; and that night I happened to be on call in the emergency room. I was awakened at 2:00 am by a call from a "friend" of Chris, who informed me that Chris's body had just been recovered from the ocean, where she had gone and killed herself because she was so angry at me.

I was devastated. I remember sobbing for some time after I hung up; overwhelmed with remorse and convinced that I had chosen the wrong career. Her death was all my fault and in my sorrow I considered leaving psychiatry, since I obviously was no good at it. I thought about what a sad, wasted life Chris had lived. If only I had paid more attention to her; listened more to her pain and not expected her to control her behavior. For three hours I was in a state of abject misery and hopelessness. I would have done ANYTHING to change the fact that she was dead.

At 6:00 am the page operator put through another call to me--from Chris.

"Oh, " she told me nonchalantly, "the body they found on the beach wasn't mine"; her "friend made a mistake"; "sorry about that" and "could I see you a day early next week?"

It was then I remembered that she had been angry at me because I was planning on going on vacation next week and had told only been able to schedule her for the week after.

It was amazing how quickly my remorse turned to anger. Not for a minute did I believe that this had all been a tragic misunderstanding. No, I had been incredibly, unmistakably HAD. My emotions had been played as if they were a song composed by my patient on an instrument of her choosing. My clinical supervisor laughed (laughed!) when I told him the story, and pointed out to me that this is what it felt like to be well and truly manipulated by a pro.

And it almost worked. Hadn't I thought to myself that I would do anything to have prevented what I had thought happened?

Such behavior, he went on, was pretty typical of the Borderline patient--so, why was I shocked at what had been done to me?

Indeed. Certain behaviors are predictable, though normal people can have a hard time wrapping their minds around the whys and wherefores. The "root cause" was not my going on vacation (if you go down that route, you might as well say that the root cause was my very existence as a separate person from Chris).


.......what is even more stunning is that these people continue to distort and lie about everything the President has said about the war.

And, of course, it is particularly stunning how many are salivating at the prospect of America suffering a humiliating defeat at the hands of the terrorists. Like the borderline patient above, they will distort and filter everything that is said through their own agenda, which has nothing to do with defeating terrorists, and everything to do with defeating the "real enemies of civilization" -- the evil Bush Administration and fascist/imperialist/corporate America.

The patient I described above was a borderline personality. As an ideology, socialism and its various offshoots are, at best, borderline and at their worse, sociopathic and utterly malignant to a healthy human society.

There is no magic cure for this type of psychopathology. All the treatments that exist take years--and even then there is no guarantee of success. As the old adage goes, the patient really has got to want to change and have a better life. I see no evidence that the leftover adherents of socialism desire anything but continued power over others and an easy route to make themselves feel good about their lives.

An individual with this pathology can do a lot of damage within his or her own little world; so just imagine the unbelievable havoc that a dysfunctional ideology can do.

I felt very hurt and angry, and puzzled at some of her comments. To me, they showed the typical black-and-white thinking typically shown by people suffering from BPD. I'm guessing that her inner schema goes something like this:

"I got f*cked over by someone with BPD, therefore all people with BPD are bad. I hate socialists, therefore all socialists are bad people. All bad people have BPD, therefore all socialists must have BPD".

What I find scary is that this woman is a *practicing psychiatrist*. Good God!, I always suspected this type of stigma and irrational hatred existed in the psychiatric community, but it's still shocking to see it all laid bare like this. I'm still shaking.





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