Borderline Crazy

I have had a hard, crappy semester in general, and the last few weeks have been tremendously difficult for me. Stuff that’s just happened to occur at work and clinicals triggered me big time, and I had flashbacks for about a week and then subsided into my current sad state. I started wondering if I can really be in the profession I’ve chosen and fell into a state of hideous self-doubt.

Eventually I spoke to my clinical instructor (who observed me falling apart in a conference room one day), attempting to maintain a reasonable balance between providing enough information and overdisclosing (does anyone else have problems with this???). She knows that I’m a recovering alcoholic, and I added that I had some other “personal issues” that were causing me to have some real difficulties and left it at that. I just asked for her opinions and guidance about how health care professionals handle this problem. I was sure I wasn’t the first one to experience a group of patients that just set me off, but I also felt I should just be able to handle it superbly out of the gate.

This lady was very kind, as she always is, and reassured me that indeed I am not the first health care professional to experience difficult reactions to some patients. Most importantly, she told me emphatically that this has not affected my practice at all. Indeed she said she felt that my past was a great benefit to my patients and that she could easily observe I had great empathy that patients responded extremely well to.

So that crisis was not actually a crisis at all. I needed that feedback. I was sure that I was falling down on the job and everyone knew I was in extremis; it was really good to learn that this was just a case once again of my not accurately perceiving my own self. Maybe someday that little voice that says, “You can’t do this” and all that other shit it says will be silenced. Right now I still confuse that voice with my own self. Sigh.

Perhaps I am experiencing difficulties because I am so close to achieving a very important goal. I have wanted to be a nurse since I was 8 years old, and my mom told me I didn’t want to be one. She ridiculed me and said I wanted to be a doctor. I ended up doing something completely different and then made the leap to abandon my first career. Those of you who are COBs know what it’s like to move against the tide of BPD programming; the last few years have just been…argh. But it turns out that I’m a damn good nurse, and the cognitive dissonance is problematic. How fucked up is this? Normal people are all, “Yay, I’m good at my chosen profession!” Not I. I’m overcome with dread and sadness about potential success.

At least I can spot all of this and take reasonable steps to handle it. I also realize I’m not that different from everyone else from school. The difference is that I take responsibility for my professional reactions to those I am supposed to be helping whereas some other students simply refuse to acknowledge how they are reacting and behaving—IMHO. I’m very grateful for the kindness of this one instructor. She does not know my story at all (only that there IS a story), so she is not kind out of pity. She is kind to everyone and is a good role model for me. I need those…

Happy mother’s day to those of you who are mothers! For the COBs…did this day suck or what? I just had to post. I was at work all day, and family members visited all day with flowers and stuff for the female patients. Most said, “So, what did you do for YOUR mother today?” Sigh.

I guess the day actually wasn’t too bad…just sad. I wish I had the flowery kind of relationship with my mom, but I don’t. Bah.

BTW the Borderline Kids forum is off the ground, so don’t forget that it’s there. There is some good discussion going on there.

Argh. I have nearly fully convinced myself that if I compose an e-mail that says “Happy birthday! How are things?” (her birthday was recent, and I felt like a turd for not sending her a card or acknowledging it in any way), my mother will write back something along the lines of “Things are great! I’ve been patiently waiting and hoping I would hear from you so that we can patch things up.”

I went so far as to comb through my deleted e-mails, where my carefully crafted filters would dump her e-mail unread so that I wouldn’t see it. I felt crestfallen when there were no e-mails! How pathetic is that…

Yet also, last night the dog barked late because of a scuffle outside, and, half-asleep, I thought automatically, “Of course, she’s on the porch with a gun.” This is not the thought of someone who should be expecting a rational response to communication attempts.

Those near and dear to me are becoming alarmed, and I know they are right: the burner is still hot and will burn me badly if I lay my hand on it to check. The same thing happens every time. Some part of me must badly need nurturing, support, or approval, and I suppose it would be better to nurture myself or seek out some other way to meet those needs. I will keep slapping away my own fingers when they pose above the keyboard to dash off an e-mail.

I know. It sounds crazy, doesn’t it? But it’s true. I realize I simply miss the idea of a mom, because it would be completely insane to miss the dread and fear and low self-esteem and the feeling that I must question reality. What I miss is the idea that I could call up a mom and get some feather-smoothing and some back-patting. Some normal conversation about our lives and some mother-daughter bonding. Perhaps it has been long enough that I have forgotten how bad things get and how quickly they get that way. How could I forget that the last time I tried to “mend fences” with her I got e-mail flames and such? When I ponder the situation I realize anew that I literally cannot do anything different or more to fix the situation. I have been over it millions of times and always land at the same point: I can’t have any contact with her.

My soul continues to reject the idea, however. At the very voicing of that statement a little part inside me begins to mutter and fidget, so I have not truly accepted it and continue to hold out hope–for what I’m not quite sure. Even if, miraculously, she underwent treatment and became able to be involved in casual interactions without completely destroying the situation, it seems our relationship has become so broken that it would be too little too late. And, of course, I have no evidence or hope that she is doing that (my evidence is that she is sitting at home bitterly comforting herself that it is I who am insane and have a diagnosis of BPD). I can’t blame her, in some ways. I did choose to seek treatment and stop the course I was on, and it has been excruciating. Bucking cognitive dissonance and confronting your demons is one of the most difficult things humans can do. Still, I hold out futile hope that she will choose for the sake of her daughter to do just that. It’s stupid. She hates me now.

Why can’t I give this up? I have a flat learning curve. I honestly get to the point sometimes where I am CONVINCED that I can just pick up the phone and call her and we will clear up these “misunderstandings” and everything will be OK. Thank goodness I have just enough of a memory of past attempts at that to hold me back.

I heard this at a meeting and thought it applies so brilliantly to so many of us COBs: “the tree remembers, but the ax forgets.” So true.

I woke up to this charming bit of bullshit.

Am I to assume this person is a therapist and feels that this comment is appropriate and somehow legitimate? I wasn’t mad before, but now my buttons have been very effectively pushed. I have spent the last few days reinventing that old wheel about my mother (you all know that wheel: “maybe if I call her up, she won’t be awful to me, and we can talk, and everything might be worked out somehow…”). It’s so PAINFUL to go through this. Part of that pain is that I know she probably doesn’t understand why I can’t be around her, although I still think she has to know on some level at least. But I know what it feels like to be told to stay out of someone’s life, and it is completely awful. I know it has to be worse when it is your child. I hate causing that. I have done everything I possibly can to “mend fences” with her. Look at the post “West” commented on to see what the results were. Why the HELL would I put myself back in a position that would elicit that letter (the one West comments on)? Do you know what caused that, West? It was me, trying to have a normal relationship with my mother.

I have had ENOUGH of people deciding I deserve to suffer the rest of my life because my parent cannot have a single interaction with me without being abusive. ENOUGH. It’s got nothing to do with empathy. It’s to do with self-preservation.

So screw you and your ilk, West. This here, West, is good old-fashioned anger caused by your judgmental bullshit, which I have seen before from others and will no longer accept. You are an incompetent professional if you have such uninformed opinions and feel compelled to voice them. You should not be treating patients. Your anger statement is less than a brilliant observation given that I say I’m filled with rage all the time, and your “lack of empathy” comment is totally out of line. I WISH I had no empathy. If I were a borderline with no empathy, I wouldn’t tie myself in knots every day, agonizing over the situation and dreading what happens next. If I were you I would stay the hell away from vulnerable patients. I’ve seen the kind of damage ignorant therapists like you can do. And don’t come back to my blog unless you want an education. You’re not welcome here. This is a supportive environment. If readers want damaging, incompetent, judgmental crap from the mental health system, we can get that everywhere else.

I am gloomy. Last night I was reading a book, and in it the character spends a lot of time in libraries on account of kids can hide in libraries without anyone finding it strange. I didn’t do that, but pondering it brought one of those sensory flashbacks thundering around me. I used to go to the public library during the summers because where my dad lives you can walk to places. I used reading and imagination as escapist activities when I was a kid. I read book after book. I remembered the sounds and smells of that library in a not-good way. For some reason, it brought back to me how desperate and confusing my life felt back then. I have no idea why the library symbolizes this to me right now. Perhaps it was just the fact that the memory took me back to my 8-year-old self, and that is a very unpleasant place to be.

It’s astonishing how exact and complete my memories are once I have them. Most of the time I might as well have not had a childhood. I have almost no recollection of it. But now I recall as if I’m there in that library the feeling of air-conditioning hitting my sweaty kid body. I can hear the creak of the floorboards under the worn carpet and smell the old-book moldy-carpet odor of the building. I can smell the dusty paper smell of the cards in the card catalog and see the bright signs tacked up in the children’s area. I can feel the dread and fear that went with me everywhere, so constant that I didn’t even know it was there (the old “how do fish know they’re in water” thing).

I am therefore gloomy. I’m not a big fan of revisiting my childhood. Even memories that seem happy on the face of them end up sucking because I was so SAD all the time. And filled with dread. Flashbacks just really suck. There’s no way around them. Now I have to spend all day and maybe longer finding my way back to the present and processing whatever bubbles up. It’s really too bad I don’t drink, because this would be the perfect weekend to hole up and get quietly unconscious. Too bad I’ve already had my lifetime quota of alcohol!

Readers, I write as a conquering hero. All I conquered was an ongoing fear, but you probably understand that this can be quite a victory. For a long time I have been afraid that if confronted with a person who acts like my mother at work I would be unable to be a competent professional. I had visions of crumpling into a ball, bursting into tears, getting crazy mad and screaming, shaking uncontrollably and having a panic attack, or any combination of the above, any of which would result in disciplinary action up to and including getting fired. Now, I have PATIENTS who are awful to me every time I go to work. It’s rare that someone doesn’t yell at me or take a swing at me once every few shifts. But it doesn’t bother me because these folks have dementia or some other good reason for their behavior: that’s why they’re IN the hospital.

But. This time it wasn’t a patient; it was a family member. She read the borderline book (one of the docs actually said, “We’re dealing with some, ah, significant pathology here”) chapter and verse. I walked in to the room and into a surprise attack (of course). This woman did the screaming thing (I thought idly, “THESE windows won’t break, at least, because they’re shatterproof glass”) and had the annihilating look on her face. I think you can diagnose borderline witches by this particular screaming rage thing. Once you’ve seen it you just can’t mistake it. Veins stood out on her forehead and neck. She waved folders and forms in my face. Spit flew out of her mouth. She was mad because the hospitalist wasn’t listening to her, so there wasn’t fuck-all I could do about it. She was also mad about the ineptitude of the social work department and case management, none of which I could do fuck-all about it. Yet somehow I was supposed to jump to it and fix all of this now. NOW! NOW!

I hovered above myself and thought, “This lady is in a borderline rage. I think she’s going to hit me.” [I backed WAY up. As the weekend wore on, I began to *hope* she would hit me, because I would have broken a speed record dialing the cops to file an assault and battery charge on her.] What stuns me is that I behaved exactly the way I should have. I inventoried my posture and unwound my arms and unrounded my shoulders. I responded to nothing until she ran out of steam. Then I said, calmly, “I’m going to leave now to see what can be done about this.” And left. Happily, the entire floor had heard her screaming, so social work was there lurking outside the door (the same social worker who committed me 10 years ago…I’m not making this up).

This lady screamed every time I had to walk in the room all weekend, which was at least once an hour. My heart bled for the patient, whose words were taken away from her. Everything she said, this family member said, “She doesn’t mean that” or “That’s not what she said.” She took away the patient’s hearing aid and then said the patient couldn’t hear us (shocker there). This patient was very agitated, and the woman screamed at us for causing it; no one dared to point out that the patient was fine when there was an absence of screaming in the room. We too were agitated! She invented medical problems that were not in the chart or known to anyone and screamed at us for being stupid and doing things that could hurt the patient. She screamed that all four bed rails weren’t up (this is against state law; it’s a restraint). She just screamed. Period. Everyone was shaking and felt vomitose all weekend. A colleague in the room to help me move the patient got so mad she said, “I’m going to hit this woman.” Me: “Just leave. Go.” She left. We charted and charted, because I have little doubt that we’re going to get sued. My favorite part was when she screamed, “[The patient] hasn’t been turned all day. I have it on tape!” I hope she WAS taping everything, because it will show that we did everything by the book and gave her family member excellent care, but this just caused me to sigh and shake my head. The woman was totally nuts.

The point is that over two brutal back-to-back shifts (our unit is completely full; everyone is hideously sick with the flu/pneumonia; one of my patients died on my first shift), I never once lost it with this woman. There was not a single chink in my professional competence. Not ONE. I spoke calmly to her at all times. I did not argue with her. I brought her coffee, for god’s sake (and then realized I shoulda made it decaf! Haw haw!). When I got too mad, I said, calmly, “OK, I’m going to leave right now.” And left. I’m blown away by myself. Seriously. Never in a million years would I have thought I could possibly handle this. It is literally the worst situation I could have projected for myself at work, had I done any projecting, and I behaved beautifully. I don’t even think I got any more upset than everyone else. We were ALL shaken and upset. People GET shaken and upset because we are working our asses off to provide excellent care to too many patients with too few nurses, and to be treated like that leaves a very bad taste in our mouths. But I didn’t have an extra “oh-fuck-I’m-having-a-borderline-flashback” reaction. I dare to hope that a normal future awaits me.

This is a big milestone for me. I shows me that I have really internalized a lot of the normalcy that I have been trying to “fake.” I am not doomed to reacting instead of acting and to suffering from panic attacks and terror when I encounter abusive people. There is hope!

Not really. That was a teaser. I just got some more hate mail (see here and here) from a person dubbed “epiphany.” So I guess I got TWO epiphanies! And this person wishes me his or her best, as well as offering a lot of advice, so I guess I should really count myself lucky.

After my initial eyeroll (two, after the second comment appeared), I decided that since epiphany took the time to leave these well-thought-out commentaries (despite, oddly, not being able to work up any interest in my blog), the least I could do was have a think on them.

Am I self-absorbed? Without a doubt. Most people are. Not losing sleep over that one. Epiphany, despite his/her amazing ability to size up my entire life and give amazing suggestions about life philosophies I’d do better adopting, can’t possibly know me well enough to make this call. It’s the suggestion that my BLOG is self-centered that is causing me to scratch my head. Should I be blogging about someone else’s life? Ought I, perhaps, to be having other people’s flashbacks? If not, I’m not sure how I can keep a blog about my life that isn’t self-centered. Like, keeping a blog about someone else’s life is psychotic or libelous, depending on how you look at it, eh? Epiphany, if you figure that one out, do let me know.

Am I attention-seeking? Hmmm…maybe. I don’t think so. If I were, I’d seek it from people who frickin’ knew who I WAS. Seriously. I don’t think epiphany really thought this one through. How can a person be attention seeking through an anonymous blog? The best part about this is that, after calling me an attention seeker, epiphany proceeds to state I won’t be getting any from her/him. While paying lots of attention by leaving two comments. Um, WTF?

So, epiphany, thanks for your really helpful advice to get tough and suck it up. It doesn’t matter that I wouldn’t have survived past the age of 4 without figuring that out on my own; I still appreciate your time and attention. Seriously. I really was taking my day too seriously until I got your e-mails.

Parting note to others who plan to NOT pander to my attention seeking by taking the time to send silly comments about how much you hate me and my blog: your browser has a “back” button, and as far as I know, it didn’t come with a quota; you can press it! Go on…just suck it up and leave. Ah, the miracle of other blogs that you actually like and of not being government mandated to read this one…there’s a little opportunity for gratitude for ya.

I have entered a twilight of mere survival. It’s not to be knocked when compared with other possible alternatives, many of which I have considered of late (one night, in a real fit of self-loathing and despair, I even went so far as to write a will and write out all of my account numbers, passwords, and so on). Still, it does get tiresome to just feel blah all the time. It’s actually a continuum between blah and “drop-dead exhausted.” I can’t tell whether I am situationally depressed because I’m tired and hate almost everything I’m doing in my life right now or whether I am tired and hate everything because I’m chemically depressed. I suppose it’s an age-old question. The only times I feel awake and cheerful are when I drag myself to the hospital and kick myself to a patient’s bedside. Once there I am transformed into a well-adjusted, cheerful human, and I’m not acting. It must be the magic of forced relief from introspection! Still, I do not look forward to working or doing clinical work for school, even though it seems obvious I would. I’m just very sick of myself. I’ve also been sick with the flu for a week now, as has everyone else I know. It casts a pall of gloom over everything. As usual I’m left wondering what part of this is normal and what part is “I’m nuts.”

I don’t feel nuts. I am taking a relatively adult stance and slogging through all of this, with brief forays into tantrums, sobbing, and desires for self-annihilation (hence the “relatively”). It’s all relative. I’m not drunk and cutting giant holes into myself to “make myself feel better,” so it seems incredibly mature to me.

I had a freaky dream involving my mom but immediately forgot it when I woke up. All I remember is thinking that looking into her eyes would freeze anyone’s bone marrow and then having a strong pull from my gut toward her. I don’t know what the feeling is; it’s probably empathy or pity or a combination. I get it with patients who are in serious circumstances and so on, and it evokes my “what can I do to help” reaction. I have also started wondering whether I slave away so dedicatedly to a (largely) elderly population to make up for my refusal to take care of my own mother—although it doesn’t feel like penance. Who can tell. I haven’t heard a peep from her in a really long time, and it makes me nervous. Mostly I’m just glad and hope I never do hear from her, but occasionally I think it may be better to have some kind of a handle on what she’s doing. Blah.