When I Had to 'Take My Armor Off' to Help a Patient With Borderline Personality Disorder
My patient is sitting in front of me with a concerned look of his face.
“What’s going on in your mind?” I ask.
“Look at you. You’ve got it all together. You’re married, have kids, have a job… I want those things, but I’m not focused enough. One day I work for something, then the next day my goal will be completely different.”
He is older than me and we met each other at a job training a long time ago before I was a psychologist. Now he’s in front of me and while he’s lamenting the “wasted years,” he’s also viewing me as a person who — to put it quite bluntly – has her shit together.
You don’t even know, I think to myself. I studied two years of computer science, one of graphic design, finally finished psychology and then worked three years in neuropsychology, four in human resources and now clinical psychology. The reason: borderline personality disorder (BPD), same as him.
“I’m tired of this,” he continues. “I feel like a failure. I haven’t accomplished anything. I don’t like how my life turned out.”
While it’s true he isn’t happy with his life right now, he’s working to accomplish the things he wants to accomplish. He’s still not there, but at least he’s on track. However, this state is more than that. It’s the characteristic period of hopelessness that we BPD warriors go through.
If we look at the cycle of BPD, there’s usually an intense motivation (“World, get ready for me”) that lasts a couple of days, then the sudden and sharp decrease of motivation (“What the hell was I thinking? I can’t accomplish this”) and finally the depressive phase (“I hate my life, I’m not good enough for anything.”) He is in this last phase right now. He’s living in the darkness, the rage, the disappointment and the suicidal thoughts. I know them well.
So I try to show him the bigger picture, explaining the stage of the cycle his illness is taking him through. I tell him the goal of therapy is to have these cycles be more manageable and less significant in his life. I tell him this period will be over soon, this part of the cycle repeats sometimes and that we’ve only been in therapy for two months.
He acknowledges what I’ve said but then replies, “It’s easy for you to say because you don’t know what it’s like.”
Oh, but I do.
“You don’t know what it’s like to be so desperate to stop the voices in your brain that you will try anything.”
The small scars on my arms prove you wrong.
“It’s exhausting, I can’t live like this. Who can ever be happy this way?”
It’s hard, but it’s not impossible. You can have a life worth living.
He’s going through one of the most difficult emotions a human being can experience: Hopelessness. Hopelessness is a thick fog that permeates everything it touches. It suffocates, poisons and steals the worth of everything. He needs hope.
So I do it.
I take my armor off and become completely vulnerable and exposed.
“I know you feel lonely and feel like no one understands you. Not even me. How would I know, right? I know that you feel like a failure because you have dreams you haven’t accomplished while everyone else seems to be on track with their own dreams. I know you feel like you are a burden to those who surround you and you constantly feel guilty for that. I know that you get to the point where you hate yourself for not being stronger, smarter, braver and more focused. I know because that person is me. I don’t know it out of a text book, I know it because I’ve lived it.
And you know what else I know? I know there is hope and help. Never in a million years would I have thought I’d be able to sit here in front of you or my other patients. I didn’t believe I’d be able to have a family and yet I have a wonderful husband and two sons. I’m going to be completely honest with you. You can feel better and have a good life. I’m not necessarily saying you will be ‘cured,’ but I am saying you can manage your symptoms if you know yourself and learn how to deal with unwanted situations. But in order to do that, we need to work on it. Trust me, I’ll do everything I can to help you get better, but we need to establish that I do know what I’m talking about and it does apply to you. I can help you help yourself. Please let me.”
His eyes filled with tears as he nodded. Several months later, he confided in me that this was a turning point for him, not only regarding my knowledge as a therapist, but in giving him hope that those of us with BPD really do have hope.
I always thought I had to show strength in order to help others, but this experience taught me that in some cases you simply need empathy and humanity. There is strength in vulnerability.
Goodbye superwoman, hello flawed me.
If you or someone you know needs help, visit our suicide prevention resources page.
If you need support right now, call the Suicide Prevention Lifeline at 1-800-273-8255.
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