Tag Archives: BPD

GISHability

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For #gish item #158 and #disabilitypride we were asked to make a portrait of a disabled person out of something representing their contributions. 

I made this piece in honor of Marsha Linehan, the woman who has saved my life and many others with her creation of Dialectical Behavioral Therapy as a method to treat Borderline Personality Disorder, a disorder that she shares with her patients. It is made with quotes from her textbook and DBT skills. 

When it comes to explaining art, especially if it is fairly plain, you always get the question “how do you know when it’s done?” 

Of course, it’s never done. No such thing. 

But this comes from a basic flaw in understanding the artistic process. 

Artists just fix the most wrong thing they can currently see. Then the next most wrong thing they see after that. So it’s an easy assumption to make that by improving the amount and type of flaws an artist can see, they would improve substantially.

 But it’s not as if the painting has a certain number of flaws and after each one, check mark that part is done. Because every line and color that gets adjusted changes how the eye perceives. And the more flaws that you are attempting to rework at the same time, the more likely you are to become demotivated and just give up. 

This is a perfect metaphor for the process of growth through DBT. Thesis and antithesis reaching synthesis. Followed by re-evaluation. Then do it again. You continue to fix the most wrong thing that you can see. Until… when?

Until the risk of exceeding the limit of your skills is greater than the reward of the fix you are trying to make. “If I push this further am I gonna ruin it?” 

This is likely what people find most frustrating about the first line traditional therapies. The skill gap. Your ability to see flaws will improve before your ability to handle them does. 

This is the opposite in DBT.

Your ability to see flaws and cognitive distortions improves as you begin using skills and gaining experience with them. It is only then then you begin making the connections as to the true sources and solutions of your behaviors.

Those connections may have only traumatized you if you were still functioning at the same level as before. 

You need practice walking up to the line and knowing whether you can take another step or not and you cannot learn that academically. 

You’re gonna ruin a lot of work. Eventually you tune in your sensitivity and awareness so you can spend more time in the safe zone of fixing things before you reach the limit of your skills. That’s when you can actually begin the real and profound work safely and know that wherever you end up going with it, you have the capability and control over what’s directly in front of you to be able to handle. 

I had stopped making art for 10 years after a cruel drawing professor in college. I also was institutionalized 22 times during that decade. That part was more about identity. It was play that developed the confidence and learning that results in me now being introduced as an artist, and as the person that I’m actually comfortable living as day to day. 

Practicing non-judgmentally which gives you the time and experience to develop your own meaningful conclusions, and improving your eye but not practicing systematically, will both allow you to improve. One has gotten you into a productive practice, though, and established a baseline, and done so without relying on installing a harsher critic. 

I lived it before I became it.

And it is only now that I feel safe enough to go deeper.

But it is with a better understanding

And a better mindset.

And now… no one can take it away from me.

See I once thought that the goal was to get good at something. 

Now I realize you only need to be good enough to fix your mistakes to be quite dangerous.

And you’re already ahead of everyone that’s not even trying. 

But is this piece done? 

Not if Marsha Linehan says it isn’t. 

I’ll be fixing it up digitally to give away as a downloadable if she gives permission. 

Frack

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A man
once told me
the inside
of my skull
was like
a funhouse
filled with mirrors
so the
slightest
little laser
impulse
of emotion
would
bounce around
and
I r fractured
u refracted
split like concrete
served like pie
little slices
teeny splices
page at a time
all stories are lies

23 Pills and a Biweekly Injection*

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That’s what it takes to keep me in operating condition.

Not particularly fantastic operating condition, either.

I creak, I groan, I piss and moan.

But I’m still alive.

And these *very expensive* pills are to blame for that. They can be a bit of a curse. It’s obnoxious to go pick them up all the time, my insurance doesn’t allow the pharmacy’s prescription syncing service because they hate progress or something. It takes me about an hour and a half for me to watch a comedy special and prepare the next three weeks of pill cases. It’d take less time if I were singularly focused, yes, but I’d also get so angry that I’d probably start chucking pills at passing cars. Truly though, cars don’t pass by my apartment often enough to let out that rage so I might feebly try to anger-juggle the bottles or some shit like that.

I used to swallow pills one at a time.
A few overdose attempts and having a regimen like this managed to train me out of that.

I also used to swallow Cheerios like pills when I was a kid. I’m not exactly sure why I felt I needed the practice, but I can’t argue with the results. I’m a real pro.

My psychiatrist appointment yesterday brought up my starting Testosterone. It all had happened so quickly, that he hadn’t even been informed yet. He was definitely surprised, but also said, “well maybe we’ve hit a root issue here and once you’re further along, we can start to back you off on stuff again.” That’d be nice. Maybe regular human doses and such!

A few months ago I weaned off Abilify because of drowsiness and weight. It went fine for awhile, then I tanked. So we are trying its new big brother, Rexulti, which is more potent so you take a lower dose and get less side effects. It’s also retails at around $1,100.

Yeah, I want off meds. It sucks that I have to take them. However, I have confronted the fact that I do not have a normal brain. I will never be able to be free of them and have a decent quality of life.

I doubt I’d be able to go off them for 6 months and physically survive, actually.

So, 23 pills and a biweekly injection.

I continue into the fray. I depend on them. They are my sword and shield in a harsh forest full of monsters.

When it comes to advocacy and stigma, I won’t say “I am medicated, hear me roar!” I don’t think we need more associations of crazy.

I might say “I am medicated, watch me manage!”

 

 

 

 

 

*Some are supplements, and none are fun.

Why I’ve Just Begun Being A ‘Good’ Mentally Ill Person

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You know when you learn about something for the first time, and then suddenly it keeps popping up everywhere(that’s called the Baader-Meinhof Phenomenon, by the way, and I bet you’ll hear that somewhere else soon)… That’s been happening with the writer Sam Dylan Finch for me. He represents a slice of who I crave to become. He is the beautiful butterfly of a feminist, transgender, and mental illness advocate and writer. I am barely building the chrysalis where I will liquify into the goop of my potential.

When this article popped up on my Facebook feed today, I took notice. I read it. I re-read it. I went to work in a residential psychiatric facility. I had Kool Aid thrown on my new shirt. I kept someone from harming themselves but not from destroying their wooden bed frame. I guided a woman to the floor and used my hand to prevent her from hitting her head as she had a seizure. I came back home. I read it again. I starting writing this. I read it again.

I see myself in it. Then I look, and I see myself in it again. I look a little deeper, and there I am. I’m existing at all different levels in this piece, just as I’ve related to the mental health system at all different levels.

 
As a child

The first time I said I wanted to kill myself, I was on the playground. It was second grade. The recess monitor abruptly replied “No you don’t” and I continued to hang between the bars, imagining a vast expanse between me and the ground. I doubt she told anyone. I suppose if she had, there might have been some earlier intervention, and my life might have gone a little differently.

My parents didn’t really “believe” in mental illness. They saw me struggle. They saw me come home crying. They saw me gain weight. They prayed. They kept their distance, because I was pushing them away and they thought it was the right thing to do.

I wasn’t quite right, socially. I wouldn’t get diagnosed with Asperger’s until I was 19, but all the signs were there. However, I made good grades. I excelled in every subject I touched, except PE, where I was clumsy, apathetic, and unpopular. But when is came to Science or English I basked in the attention of teachers and other authority figures. These were the only people I could seem to talk to. My peers were just out of reach of my awkward rumblings. Somehow I was okay with that for awhile. Increasingly, I isolated. Increasingly, I became more and more difficult to reach out to.

This is how I slipped through the cracks.

 
As a patient

The seeds of potential in me had long been choked out by thorny tendrils of mental illness and substance abuse by the time my grandfather died. I had dropped out of engineering school and semi-flunked out of community college. I was living with my sister, drinking heavily and pretending that it was okay.

The years of 2012 to 2015 remain fuzzy to me. It’s hard to clarify timelines, or which hospitalization happened in what order. I went to treatment centers somewhere between eight and a dozen times, I believe. Some were partial programs, where I learned coping skills during day classes and then drank at night. Some were full hospitalizations, with varying levels of functioning. Once I was in the ICU for three days, knocked out following a suicide attempt. I had Electro Convulsive Therapy, also colloquially referred to as shock treatment(this is part of why by brain is so scrambled).

I started writing about my experiences not long ago, transcribing hospital records and frenzied scribbles in notebooks that are entirely free from metal binding or staples. I found statements from the psychiatrist in one of the partial programs I did. He said “I do not know how much she will get out of our program as it is impossible for her to think with any kind of speed.” This was a kick to the gut, which, coincidentally, also happened during my shift at work. I have never once been accused of being slow, it’s nearly universal that people who interact with me will make some off hand comment about how I seem smart within minutes of meeting me. It hurt to read. At that time, I was assessed with a GAF, or Global Assessment of Functioning, of 40. The scale goes to 100, for reference.

I have been a “bad” mentally ill person. Bruises from fighting against the restraints(I have no memory of this.) Someone trying to drag a necessary response out of me, but I was too busy staring at a crayon with tears running down my cheeks. Not waking up for any reason but to go to the bathroom, for days. Not remembering who or where I am. Being awakened for a blood pressure check to the croons of “well you’re just wrapped up like a burrito!” which became decidedly less charmed when we both(!) realized I was actually naked in my blanket burrito.

Then there’s the egotistical nature of depression. I was quoted in one of my charts as saying that I was the worst person in the world. God, how arrogant. But to truly believe, right down to the base of you, that that is true, is absolutely wrecking. It reflects in everything about you. You don’t care about a damn thing. Eating, showering, moving, taking meds, appointments. You have to be pried out of wherever you are in order to be forced to do anything. And there’s 25 other people on the unit in various stages of recovery that need to be handled too. And guess what? Staff would do a phenomenal damn job. And I’d still be back in three months again.

I have also been the “good” mentally ill person. I was grinned at and asked what I’m doing for the next art competition by about 5 staff during one stay. I always made sure to give them a baffled look and respond “The 16 hour days from the LAST one landed me back HERE again, what makes you think I wanna do more giant art?!?!” I’ve been the bright, relatable, engaged one, who will hold a conversation while meticulously coloring. I’ve been asked what hair color I’m gonna do next, and quipped about how I hope they don’t get to see it. I’ve made a girl nod sheepishly when I asked if she was pregnant the last time I was there.

There was a point where I was a revolving door patient, but I was liked. I was cared about. They prescribed the name brand stuff and made sure to give me a stack of samples on my way out the door. They signed special notes in the cards that we all got with our Christmas bags. They tell me to come back and visit sometime when I’m NOT suicidal. Give them an update. Maybe someday I will.

 
As a provider

Things have changed a bit lately, and I’ve turned the corner well enough to be able to actually work in the mental health field as a care provider, and that provides a different perspective.

One, you have to consider your safety at all times. Allowing your preconceived notions about who might be a “good” patient to lower your guard just means that you will be attacked. Yay, you didn’t suspect it! That probably means your injuries are worse.

 

Two, your patients crave connection, and the staff will most likely try to connect to the ones they relate to most. This means the “mostly normal” one who has a substance abuse problem is going to get better treatment than the person with schizophrenia. This is an unfortunate reality of bias. I try to compensate for it every day, but it’s something that workers need to be actively conscious of.

Three, the mental health field is othering as all get out. I have Borderline Personality Disorder. Every-Single-Training that I went through specifically called out people like me. There were multiple instances of failure to use person-first language, “You might be dealing with schizophrenics or borderlines.” This occurred in the class that brought up using person-first language. Even in Van Safety, the watered down two hour driver’s ed class, “One in four people have experienced a mental illness, there’s seven of you in here, I bet at least one of you has anxiety or something, raise your hands.”

The “Trauma Informed Care” training referred to individuals with trauma as “broken” and says that we are to be there for them while they put themselves back together. THIS IS THE APPROVED CURRICULUM OF TRAUMA. INFORMED. CARE. Broken. Seriously. I was mildly uncomfortably during most of the training, but he had provided coloring sheets so I was keeping pretty chill. Some people were stepping out because the videos were triggering. But the second he said that, my brain went on a loop. Broken, broken, broken. I scribbled it all over my carefully and brightly colored paper. I went up to him afterward and expressed my concerns. He diplomatically explained that this is how traumatized individuals are to be viewed through this approved and regulated curriculum which cannot be changed.

I guarantee you, every time I had a concern in one of these classes, I brought it up the the trainer afterwards. I can also guarantee you that I was not the first to notice or be made uncomfortable. I was probably not the first to complain either. There are systemic mindset issues in the field of mental health. Fortunately, the type of people drawn towards that kind of work are usually compassionate and often touched by mental illness in their own life somewhere, so they make efforts to improve. Awareness is where it starts though.

Okay, what was it, four? This is tough work. You will be kicked, punched, spat at, and insulted on a regular basis. Anyone that doesn’t do this is a welcome respite.

So yes, being able to function as a somewhat “basic human” can make you a “good” mentally ill person.

The thing is, high functioning, low functioning, a number on a GAF scale, these are indicators of illness, of danger. If you have a GAF of 20(which you do, if you are clearly suicidal) you are Stage 4, man. Appropriate interventions are planned and made to save your damn life.

That guy screaming for help? He could have established attention seeking behaviors.

You never really know.

I’m very much afraid.

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There are plans in place to move to Arizona next year. I was going to do it secretly. I was going to cut ties with everyone I knew back home, but for a select few. I was going to start over. I was going to give up on people that I’ve known for ages, on the chance that they will reject me. That’s borderline personality talking, if you’ve ever heard it whisper.

There are plans in place for me to get bariatric surgery. In a couple months, my body will begin to change rapidly. I was going to start hormones then. I was going to try to be sly.

The truth of the matter is that I will be rejected by some. I will be found out. And this is not the authentic way to live my life. I will regret it.

So I’m going to make the brave choice.

I’m going to choose the words that will baffle, will hurt, will likely come back around to show me pain in the face of a deeply conservative community.

I am not what I was made to be.

I am transgender.

I have had these feelings for a long, long time. Not feelings, really. Knowledge. A soul scab that never quite heals right ’cause it keeps getting torn.

I push it away. Again. And again. And again.

“It’s not natural. I’m just a tomboy. There’s not enough women in manufacturing, you might be an oddball but you’re an important one.”

“They’ll hate you forever.”

“They’ll think their kid is gonna go to hell.”

Probably a dozen psychiatric hospitalizations. Maybe half that many semi-serious suicide attempts(I say semi about the results, not the intent).

I’m on about $1600 dollars worth of medications each month and I still can’t work through the anxiety of going to a goddamn second-run theater.

I was already in hell. I’ve been there a long time. I was in second grade the first time I told someone I wanted to kill myself and I didn’t get any kind of therapy or medication until I was 19.

This is the chokehold, the silencing factor, that a belief system can have.

Maybe I won’t be accepted.

But the time has come.

And I’ll run it if I have to. To Arizona or anywhere else.

But today I declare my journey.

Today I take the first step.

 

 

 

 

 

Please consider donating to the costs of transition here:

https://www.gofundme.com/lets-just-get-rid-of-those

Here you are…

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That story you’ve been waiting for, the one I hinted at before! I know the two people in Russia that have looked at this blog must have just been on the edge of their seats.

Here it is: Youtube Story Time!

Sorry you have to put up with my human form being in there.

Astral projection is harder than they make it out to be.

What is this?

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Blog number 5? Damn you WordPress.

Like I really needed five distinct blogs to catalog all the nothing I do.

In any case, it’s time for a whole new identity. I’m reinventing myself!

I don’t think I invented my last self, but whatevs.

A part of me is lurking in the back of my head, telling me to make a sperm joke. That part of me is skeeving the rest of me out. Another part of me is calling for me to build a wall between that part of me and the rest of me.

Diplomacy is hard, y’all.

I’ve been struggling lately. There have been a few dreams about gender transition that have really shaken me. I’ve always had the thought. For as long as I can remember. I’m also hyper aware of how much easier my life would have been had I been born a boy. How much more natural it would have felt. How much better I would have fit in. Maybe I wouldn’t have all the mental health struggles that I do. I don’t know.

I don’t really wanna play those games. It only leads to pain.

The truth of the matter is that I have pushed away these thoughts for the 27 years I’ve been on this planet, because of my upbringing. My parents, who are great people, are not great parents. At least not for me. Hyper Conservative Christian Evangelicals.

HCCE’s?

I can’t pronounce that. It’s like coughing up phlegm at the back of your throat.

I think I’ll tell a little story in a bit.

 

Because I’m Afraid

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Silence had broken out in The Garage, a workstation in a small town where nerds met weekly to plink away on projects and be nerdly in step together, never quite locking eyes in their imagined social landscape. This was actually almost inevitable, since my friend and her husband and I were the last ones left, and her husband was in another room, buzzing on circuits and code.
I finally decide to confront the feelings that have been choking me the past couple weeks.

 
“I don’t think it’s anxiety, but…”

 
This was in reference to a coworker of mine who had said “I don’t think it’s anxiety, I just have this sense of impending doom.”

 
That’s the goddamn definition of anxiety.

 
“I don’t think it’s anxiety, but I have this sinking feeling in my chest.”

 
“Is this a new feeling?”

 
Word vomit was my answer. “I don’t think it’s new in the sense that I’ve never felt it before but it’s new in the last couple weeks and I had been doing so well and I’m just concerned that I’m slipping backwards and what if…”

 
She interrupted. “Lock the door. Hide the key. Turn out the lights. Pretend you aren’t home.”

 
“Maybe it’s just loneliness?”

 
We ended up discussing this at length. How loneliness just is, how it shouldn’t bring such pain with it, how I need to learn to sit with loneliness, and historically have epically failed at doing so.

 
So really, at the root of it, what am I afraid of?

 
Because that’s the goddamn definition of anxiety.

 

On one layer of it, I am afraid to be alone.

 

But I’m also afraid to be with someone, afraid of the things that would come out, afraid of who I am when I’m also defined by someone else.

 

And along the way, I am afraid to put myself out there, to try with people.

 

Or, another example, I am afraid to fail artistically, so I take tricks and little advantages and cheats. I can’t get by without my reference photos and projectors and tracings. It makes the art more likely to be “successful” on the first crack, but I know my own limitations and weaknesses. I’ve guaranteed that I will never be able to view something as truly successful.

 

So, so, scared to succeed. That’s way worse. That’s why I self sabotage so expertly and so devoutly.
This is a tangent, but a relevant one. Dr. Bell looked at me one day and asked me what borderline personality was. I parroted back to him “It’s a personality disorder characterized by at least 5 of 9 traits, such as impulsivity, anger issues, lack of identity, suicidal tendencies, and a few others.”

 

His reply was “That’s just a list of symptoms. If I asked you to describe what diabetes was, you wouldn’t just say it makes you pee a lot.”

 

He went on. “Typically, in a borderline person’s life, someone was there that they looked up to, a person of authority, typically a parent, who would tell that person to do something but not how they wanted it done. And the child would try it their own way, because everyone’s got their own way, I’m a psychiatrist but my son’s an engineer, we have different ways, anyways, the child would try it and the parent would be upset that it wasn’t done perfectly in their image. The parent would say something like ‘No, you idiot, what’d you do it that way for?’ and that would be the smack. So the child tries again, and again, different ways, becoming a chameleon for what they think that person wants. Then they’ll grow up and do this for anyone important in their lives. That’s what they mean by lack of identity. ”

 

“But,” he continued, “these people, you are, very bright. And they’re afraid of failure, afraid of that smack, but they’re just as afraid of success. In fact, it seems like when things start going well for a borderline patient, like a good business deal, a graduation they’ll often self sabotage. Why do you think that is?”

 

This was hard for me. Precisely because it hit so close to home, and it felt like some real therapizing was about to happen. “Because…it’s easier…not having people expect anything of you?”

 

And there it was. It’s not just insecurities, worrying about what people thought of me, it was worrying about being a constructive member of society. About setting myself up to fail bigger down the road.

 

I’m afraid to have anyone rely on me.

 

Because I’m afraid I’ll let them down.

 

Because I’m afraid I’m not good enough.

 

Or simply not… enough.

 

Ultimately, I think that there’s something in me, that’s afraid to simply be. On a molecular level, I’m jittery.

 
I don’t think I’m alone in this.