Toxicology

August 3, 2012

I messaged A.F., Monkey Man’s step-sister, on Facebook yesterday. We’d been having a nice little chat back and forth. And I thought of what my new therapist Brunet Young said–about preparing to call Monkey Man’s step-mom who hadn’t called me back like she’d promised.

Well, I went ahead and asked A.F. on the last email if she’d heard anything about the toxicology reports. This was her reply:

Evidently cocaine and codeine don’t mix. Drugs are bad mmmkay? I guess he woulda stuck around longer if he wouldn’t of been so hard on his beautiful little body. Damnit.

I need a hug and kiss, thank you!

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Well, I got the answer I wanted. Damn it Monkey Man, I thought you’d quit that shit! Liar!

Ooooh, ok. ok. ok. Today is one of my swim days.

Breaaaaathe.

Ooooh there goes the trembling and the tears.

I need a nap.

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Her red hair was suddenly blue, blue like a blueberry muffin on top of her scalp. I wanted to cup her and gulp it, gulp those mountain blueberry swirls, gulp her like the muffin she is. I wanted to eat her out completely. The coffee was hot, hot like me. I took a sip.

I waited for something but the silence was warm; it was a fine and kind kind. It was fine. Silence can be kind and fine with her in the air–she makes the silent air kind and fine I find. Yes. Kind and fine are the words for her.

“I like my coffee black,” I said, “Black and bitter like my heart. I do like it dark though, dark like my thoughts, dark like you,” I smiled.

She smiled, such a wide delectable, lickable smile, “Tu es stupide! Mais, oui, je aussi aime du café noir. La vie, c’est comme la merde, n’est-ce pas?” She understands my sarcasm and has nothing but quips and smiles about it, no scoffing from her. She knows I’m just bullshitting because I’m nervous yet calm. No, I’m anxious. Anxious for her, for longings past and longings to come.

“Oui, un mangez et fait chier et baiser et mourir. Pur merde!” I sipped my black, cold coffee. How did it get cold so soon? I’m still hot!

And I gazed waiting for her to purr some more. I wondered why does everything I love run behind the fridge only to come back out from there to nibble–bite after little bite–tearing at me slowly until I become gangrenous? Is that why I feel like a zombie?

Green, I am. Black, I love.

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Note: Native French speakers, apologies for my terrible three-and-a-half semesters college-battered French.

*minor trigger warning. mention of the death of sometimes-lover/mostly best friend aka Monkey Man L, other general depressive shit and brief mention of self-harm*

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Dear Dotty’s Words of Wisdom: Grieving for the Mentals Can Be Worse  

Dear Dotty was right. There’s something I knew but hadn’t been giving much attention to, not enough attention to at least. A trigger. A trigger beyond triggers, a stressor beyond stressors has set all of me bouncing more and more off the walls, down the corridor, down he street, like a rubber ball down a seemingly endless cobbled stone road. It’s the loss of Monkey Man L.

Yes Dear Dotty, thank you dear. Much of what I’m going through is grief. But how much of it adds to the mental mix dear lovely lady? That’s what I wanna know.

Today marks the second month of his death. JUST TWO MONTHS AGO! ONLY two months ago! Actually, we don’t even know if he died that day or two days before. It doesn’t fuckin’ matter. All I know is that on March 22, I got the horrible call.  What is up with people dying at twenty-seven? Fuck, I’m about to be twenty-seven.

Sigh. I don’t even know if he died by his own hands or if his body just gave out from the combination of his past self-abuses and his present condition as well as the Osteogenesis Imperfecta (OI). His spine was compressing his chest, he’d become a chain smoker, etc.

All I know is that I’d seen him a week before. And a few days after, when I saw the Rapper K, I talked to him on the phone. And that was the last conversation we had. He didn’t pick up my other calls that weekend. I only got a measly text message in reply, saying, “I just want to be left alone right now sweety”. So that’s what I did. I left him alone. And that was the last time I talked to him. The day I’d seen him that week before, he looked terrible.

In the post I wrote about him after the funeral, I mentioned doing my best not to let myself fall into guilt. Well, sometimes that guilt tries to come up and take over.

He was found in his apartment sitting on the couch as if he were watching T.V. That’s all I know. And I keep thinking I could’ve been there; I SHOULD’VE been there. And I know this has me bouncing more that I would have been.

Then there’s the added factor that I was ALREADY falling, spiraling into a deep depression–I don’t even like using that word, “depression”–but that’s what we’ll call it and that’s how I was before his death. Depressed. And now what?

February was hell, then March came with the news. “He’s gone”.

This. THIS is one reason why I’ve been so much more mental than my usual mental. That, and in terms of this week, it could be the hormones added to the mix. I think this week I’m having the PMSS. That extra S was put there on purpose. It’s what I call the Premenstrual Suicidal Syndrome. It’s when my suicidals get more intense just before the cycle. I know the APA has a name for it, it’s premenstrual dysphoric disorder but fuck their labels and their making everything a disorder.

I’m just bouncing too much. Off the charts…

Looking back on that trigger my brother’s girlfriend set off when she innocently mentioned Vicodin, I realize it was actually a double trigger, no a triple trigger. One, it reminded me of what I’d done to myself the Sunday before last–or was it Monday?–anyhow, it reminded me of the incident. Two, it reminded me of my own problems with painkillers in the past. Three, it reminded me of Monkey Man L and his addiction. And that, THAT was the ultimate trigger because I was fucked for the rest of the night (it wasn’t the good fucked, nope).

No one prepares you for what you’ll feel when you loose someone you cared for so much. No one. We were co-dependent. We had an intense, tumultuous relationship. No one prepares you for grief just like no one prepares you for the feeling you’ll get when you become a parent. Sure there are books out there on parenting and on grief (what a lovely combo no?) but they don’t actually TEACH you how to FEEL about being a parent or how to FEEL  about a LOVED ONE when that loved one is no longer there to say anything back.

This was not my idea of “(mis)adventures of a mentally unstable” mouse. When I started this blog, I had meant to write about my past misadventures not my present ones. But life has a funny way of throwing more at you. They say things come in threes and they did. First, my face and the Bell’s Palsy; then, my arm, and lastly, my L.

Threes. One. Two. THREE. I wonder if there’s some sort of cosmic thing in that or if we’re just trying to make sense of what seems so incomprehensible.

Then after Dear Dotty reminded me, I began to think about mental illness and grief–there’s another set of words I don’t like to use “mental illness”. I think my dislike for the term has something to do with my Christian Science upbringing, though I suspect it’s much more complex than that.

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But is it really much more difficult for a mental? This grief thing. I mean, can it send an already distraught person over the edge? Of course it can! If it can send a non-mental over the edge, then fuck… Then again, I think what makes the most difference in grief is the nature of the loss. I had such a turbulent relationship with him and I know this will make my grief more complicated. Also, the the fact that he died so tragically at such a young age complicates the grieving process further. The nature of this grief is inherently complicated.

After the incident last week or the week before last or god knows when (I forget), I talked to the New Male Therapist-Who-Is-Really-a-She and told her what had happened, the freaky dream about him, the thoughts, the pills, more or less descriptively than here. I find it easier to write feelings out than to talk about them. My writing is stronger than my verbal communication. Maybe that’s what makes me a “poet”, ha, then again, maybe that’s just what makes me become more mental. Anyway, I told her, strangely enough, that the week before last, I’d began obssessing about my hearing loss again–something I hadn’t done in months.

“Could it be I’m combining my griefs?” I asked her.

“Yeah, possibly,” she replied.

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Stages of Grief

According to the Kübler-Ross model, there are five stages to grief . They are:

  1. Denial (a funny one that denial)
  2. Anger (my best friend who’s no good for me… Actually, that’s not entirely true. In small doses, anger is motivating. Anger is part of our innate autonomic response to danger. It tells us a lot about our experience.)
  3. Bargaining
  4. Depression (oh look another friend)
  5. Acceptance (when? six months from now? a year? years? a lifetime?)
Yesterday, after a family friend was over, I found myself crying in the bathtub again. Why does washing dishes and showering go so well with crying? Anyway, I found myself BARGAINING. Of all the stages, that’s the one I said I wouldn’t get into. Silly me, saying what my brain will or won’t do. It wills itself sometimes.

I was there crying, “Dear god, I’ll take his place. No, wait, I’ll take the six fractures he had after that accident last year. I’ll take more. Fuck, fractures are nothing, I’ll take as many as it takes. Just bring him back!”

These stages aren’t quite lined out in chronological order. I mean, mainly they are, but you can experience them simultenously or even switch from one to another and then back again. I found I’ve just gone all over the place. It’s my style of doing things.

But I’m too lazy to go all out and write about these stages. Besides, this post is getting long and I’m opting for non-monumentally long posts at the moment.

So here’s a great little post by Sailor Carrie titled “The Five Stages of Grief”.

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Emotional Instability, Repression and Acceptance in the “Borderline” Mind

Another dear fellow blogger’s recent comment brought something else to mind. Well, two things: 1. I have no close friends or FEEL like I have no close friends and, 2. I don’t know how to open up to people which is why I feel like I don’t have close friends.

Isn’t it funny that I find it easier to run a knife down my thigh than to tell my dad “I’m upset”? Or that I find it easier to pop a dozen pills than to call a friend and say, “I need someone to talk to”?

Yeah, quite funny P.

The support network we mentals generally need but often neglect or just plain don’t have, that’s what came to mind. We often lack support strategies or non-destructive exit-strategies, coping mechanisms, distress tolerance, or call it what you will.

If I didn’t have maladaptive coping mechanisms and maladaptive friendship patterns, I wouldn’t have been in therapy in the first place. That’s what the therapist was for–for DBT, CBT and retraining on how I can reach out to people more effectively.

In responce to said fellow blogger’s comment, I said, ” I have trouble with communication”. I was a communications major; another funny thing P. But that’s what’s at the core here. Fellow blogger suggested friends, which is great, but I have trouble with friends. Aren’t people too busy to talk to nowadays anyway?

Getting myself to actually TALK to friends was something I was working out in therapy before Young Therapist had to leave. See, I said in my comment, “a ‘healthy’ coping mechanism someone without a dysfunction might have is to run to a friend in time of deep distress. I do the opposite. I run into a hole and throw on a cover and don’t let anyone in, which only makes it worse in the end. Despite knowing this, I find it EXTREMELY DIFFICULT to just reach out and say ‘I’m desperate…'”

A therapist can do something a friend can’t but a friend can do something a therapist can never do–be a fountain of mutual support. That is, if you have a good friend and therapist to begin with.

Why do I have such a terrible difficulty reaching out to people? Why can’t I express negative emotions besides anger?

Here I am, deeply in need, needing to confide in a friend all the while feeling completely unable to. Sadly, I can’t think of but one friend I’m comfortable talking about this “suicidal” stuff with and she’s pretty mental, so I can only let her have so much. She’s the BPD friend I mentioned in earlier posts, the one who I keep at close distance. Besides her, there was L and well, fuck, he’s gone! ha. He’s the reason I started this post.

Not being able to talk to people about my emotions, or just not reaching out and having enough social interaction to begin with is what the Young Therapist was trying to get me through; it’s what we were working on, finding solutions for. Sure, I can talk to people at parties or in social situations. I seem “normal” (whatever that’s supposed to mean) but really, I’m not. I’m constantly thinking, “Oh my god, I wanna get out of here, I wanna get out of here,” and if I’m not thinking that, I’m thinking something else that’s pretty similar to that.

I just can’t think of a friend I can confide in and that just made me very sad to think about, realizing how lonely I’ve let myself become. I’m glad I live with my parents and little Luna is the best, but I’m becoming uh oh, here it goes, “empty”?

B., a friend from college came by last week. I wasn’t able to make it to his graduation so he stopped by. How nice of him, right?  And I wasn’t able to tell him about L because he came by with his mother who just came in from AUSTRALIA(!) and well, I was being a good host. I was meeting his mother for the first time so telling him was out of the question.

Eloise, who lives in Florida, was the only person I’d told but well, she lives in Florida. She called me last week and I haven’t been able to muster the courage to call her back. Yes, it actually takes some courage from me to call people! Even the close friends like Eloise (oh wait, I do have a close friend)! Because calling people gives me anxiety!

Maribel also knows. I told her only because she’d called me to tell me her mom died and she needed someone to talk to. Funny, I can be the support but not reach out and ask for it.

It would be nice if L and I had mutual friends because then I’d be able to call them up and say, “Hey man, yeah, you miss him too?” But we didn’t have any mutual friends. Not one.

Only A.F., his stepsister, but she lives all the way up in New York City and even so, she hasn’t called me again after I called her and we had our last talk a month ago. She’s probably really busy with her little three-year-old and the baby.

I can’t even talk to my brother about most of this. I mean, sure my brother’s been kinder to me. He’s a sweetheart. But we are just beginning to rebuild the bridge I’d burned between us last year. See, six months ago, my brother and I were not in speaking terms.

“I’m not talking to your fuckin’ crazy ass again! Don’t contact me, just don’t!” he’d said.

Yeah. I’d pushed him away again.

I know telling him some of this might even make our rekindling stronger, but then I get discouraged. Every time I try to bring up the BPD diagnosis, he seems a bit aloof like he’s not really listening (of course, that could just be my misinterpretation). I haven’t even been able to muster the guts to show him that Five Faces of Borderline video I posted, which I think he’d find funny. I just, ugggh. I mean, I listened to him rant about his OCD. Why is it so difficult for me to simply do this?

Emotional Acceptance

I started looking up information about BPD and the inability to express certain emotions. I found these really good, really simple and straightforward  links:

How Accepting Emotions Can Improve Your Emotional Health (from about.com)

Defining Invalidation as a risk factor for developing BPD 

Post Traumatic Stress, BPD and Suppressing Emotions (from about.com)

A common string I’ve found connecting a lot of this BPD literature is the notion of invalidation. Invalidating environments is a hallmark for BPD.

See, I always assumed invalidation equated to neglect. But “I WAS NEVER NEGLECTED” I’d say to myself. Yet I realize invalidation can come in so many flavors. For L, it WAS CLASSICAL neglect. His mother would get high and leave him on the toilet for hours. She’d forget to feed him. Yeah. My parents ALWAYS made sure to feed me. When my mother couldn’t, my grandmother would. Even at our hardest times, when my dad was getting bread baskets from a local church, I WAS ALWAYS fed. Well fed!

So what flavors did my invalidation come in then? I wonder. My parents never outright said, “Don’t express yourself P! Don’t talk about your emotions P! We don’t wanna hear you crying P! None of that in this house P.” No, not at all.

Then I begin to think, of course! My invalidation is definitely there. I can see it. I can see it in my Christian Science years. I can see it in my mom running away when I screamed in agony in the hospital beds. I can see it before then. I can see it in a very subtle way. Invalidation for me was not overt.

I’ll give you an example. By the time I became a toddler, I stopped crying when I’d break a bone. I mean shit, after you’ve had your fiftieth fracture well before your fifth birthday, you just don’t cry about that shit anymore–unless it’s a femur, because femur fractures FUCKIN HURT LIKE HELL!

So my parents interpreted my not crying about fractures as: “This here is a brave one! Much braver than her wimpy brother! She doesn’t cry about ANYTHING.”

And I interpreted that as: “I have to be the brave one. Be BRAVE P! BEING BRAVE IS ALL YOU CAN BE. Braver than my cry-baby hermanito! I cannot let people discover that I DO cry. I cannot let people see me cry or else they’ll see I’m a faker! And no one likes a faker! I’m a mean challenger!” I think that’s more or less how I started to develop my calloused sense of self.

Then there was my mom’s bullying. “And blah blah blah smack, blah blah, BLAH BLAH BLAH, smack smack SMACK, SMAAAACK.” You just can’t let a bully see you cry. That would only give them power over you and you wouldn’t want that.

Just yesterday my dad asked me, “Have you been crying?”

“Yes, but sometimes I cry you know,” I replied trying to be assertive of my discovery.

And he replied with something about him not being able to withstand my crying because it tore him up inside.He didn’t say this in a way to hurt me. He said this as his way of expressing his OWN hurt, sure and his love. It was a bit selfish though. It’s maladaptive but he doesn’t know better. It works for him. He was hurting when he saw my swollen eyes.

I realize that now. He just doesn’t know how or understand how someone like me can twist those words up; how someone like me can distort them so. He doesn’t know how to effectively express his hurt while acknowledging and validating my hurt and my need to let it out.

That’s my flavor of invalidation. The child me, years back, would’ve seen this as, “Oh no! I must NEVER ever let him see me upset again or cry in front of him because it will DESTROY him! TEAR HIM UP INSIDE! And I don’t want to destroy dear daddy. No, I cannot kill my papi.”

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I’ve been thinking about texting Warrior D. She’s a friend who also just graduated. Just got her masters in Social Work. She’s someone I’ve been getting kinda close to in the last year or so. Oh yeah, she’s the other person I told. She’s great at listening. Trouble is, I tried to get her to meet up with me after L’s death and she got back to me but didn’t follow through with plans. I understand she was in the middle of her end of semester mayhem but it hurt me to wait, expecting to talk and go for tea and then not. So now I’m hesitant. This is why I feel I do need therapy still. Young Therapist would help me find ways to deal with this situation and call Warrior D. Truth is, I said in my last post that I’ve gotten along all these years before without a therapist. But come to think of it, I JUST BARELY got by.

I might’ve/might end up like L if I would’ve kept getting by the way I was.

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addendum: I went swimming yesterday evening at my mom’s friend’s gym and it was awesome! Took pictures of the cold, cold water.

As many of you may already know, I have brittle bones disease which is scientifically called Osteogenesis Imperfecta (OI). As a result, I’ve broken roughly 100 bones in my life, stopped counting after 70. I was born, or rather already had 17 fractures before leaving the womb.

Infants with type II OI, the most severe type, generally die from a collapsed lung, pneumonia or heart complications because the rib cage is so frail. Some die during birth or are stillborn with disconnected spinal and cranial bones.

I have type III, so I’m a little stronger than those with type II and fortunately, I can walk short distances while holding on to things. I mainly use a wheelchair, however, I do have a walker and would like to get crutches. Type I is the most common and also the least severe (I know, it’s funny how these are all out of order, you’d think type I would be the most severe).

Anyway, if you’ve been following my blog, you’ll remember that I wrote a post titled “Hooray, Phuckin A It’s Rare Disease Day!” and well, this is my promise of updating on the “awareness day” for OI. See, I do keep my promises! Some at least.

Now, I’m not going to place any links or any such things on here because chances are you won’t click (no offense) and I understand and don’t blame you because considering how many good blogs are out there, how crazy and fast paced life is, there’s just not enough time to read up on these things, especially some depressing disease. Who wants to know about diseases? They’re fuckin’ depressing man!

Really though, it’s not that bad. (HAAA, yeah, sure P). No, it’s not. I mean it’s not lethal like cancer or anything… wait… type II… nevermind. The case is, I’m going to keep my OI brothers and sisters in mind today.

As of today I’m also going to make a commitment to write more about chronic illness/disease and its relationship to mental illness (though I don’t like to use the term “mental illness” much). Anyway, there is a huge comorbidity there folks. For example, it’s no surprise major depressive disorders (MDD) are more common in a sample population of people with a chronic illness than in an otherwise “healthy” population. This to me, shows a high relationship with the psychosocial aspect of mental health.

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So here’s to the little OI kids with little mangled bones all around the world! Keep on truckin’ little ones! Keep on! Keep on!

Wishbone Day is May 6th. It is held internationally in various cities to raise awareness and funds for Osteogenesis Imperfecta.
for more info visit http://www.wishboneday.com or
http://www.oif.org/site/PageServer

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addendum: Yous guys ever heard of the film Unbreakable directed by M. Night Shyamalan? Well, this Shyamalan guy is one I can’t seem to figure out. He’ll do one good film and then two terrible ones. I’m not going to say Unbreakable is TERRIBLE because I’ve never actually seen it and therefore, it would be very unfair of me to say anything. What I CAN say is that M. Night Shyamalan’s The Happening was a fuckin’ complete waste, bloody rubbish (ya’ll Brits have been rubbing off on me, I swear).

So, back to Unbreakable. (I swear I’m going to make a really good point here if I don’t forget.)

In Unbreakable, the fabulous actor Samuel L. Jackson plays a character–or was it Bruce Willis’ character–whatever, one of the two played someone that had none other than OSTEOGENESIS IMPERFECTA (OI). And, though I’ve never seen the film, I know that at one point they mention he has THE WORST TYPE of OI! WORST TYPE? HAHA! OUTRAGEOUS! If you’ve read this far, you know what happens to most of those who have the “worst type”. I’m a “midget” people! How can one of these two, muscular to built and tall to average-height men have it worse than me? I don’t even have “the worst” type to begin with!

And how do I know this? Because my dear deceased L told me this, and I believed him because he was a movie addict; when he wasn’t poppin pain pill after pain pill, drinking like a sailor and flipping out, he was flippin HBO channels. Also, he had type III OI like I do.

This just goes to show you guys that “REALITY” (whatever that may be) and FILM/TV are FAR FAR APART. And this is coming from someone who ADORES FILM, who DREAMS of MAKING FILMS ONE DAY!

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Speaking of Samuel L. Jackson… My next post will be “P’s First Film Review: THE AVENGERS, a Character Study On the Hulk’s Raging Borderline Personality Disorder” (yes, I am now CONVINCED Sir Bruce Banner aka Hulk is borderline and I can say this without offending because I’m officially certified borderline myself and yes, I’ll take the label and milk it for what it’s worth for now).

Yep, I just got back from seeing The Avengers and did not have a panic attack!

Thanks for reading!

*mouse nibbles*

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addendum 2: I just realized it’s MAY 5th today! Bahaha. NOT May 6th! Oh well, for you New Zealanders I’m not off at least, am I? It’s already May 6th there isn’t it?

I really do think I need to be hospitalized at this point.  NO NO NO P, you do NOT. You will NOT go to a county PSYCH WARD! Nevermind. Shhhht. You don’  heard nor read nothin’ alright. Alright? I’m out.

*le mouse sigh*

I’m on the border y’all.

Not only am literally on the border (Texas borderlands) but I’m also on the border mentally.

It’s “official”.

It’s set on paper with nice black ink–though not in stone or anything–but it was kept from me, KEPT FROM ME!

Kept from ME by my own therapist, my Young Therapist.

Guys I’m going to warn you. Before you go any further with this post, know this: I’m actually going to be serious for a moment and I’m going to be saying some things that are not easy for me to say. I’m going to say some things that may be triggering to some of you. AND, I’m going to be serious without cursing! (Yeah, I know!)

Here’s where I bore you to death or at least until you’re nearly as suicidal as me. *trigger warning*

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Let me explain, I suspected it ever since Young Therapist let it slip that her dissertation/PhD concentration is on Borderline Personality Disorder. In fact, I suspected it long before then. I suspected it nearly two years ago when I started with her and she gave me these handouts on dialectical behavioral therapy (DBT). When we began, I’d get packets–one after another. I’d get a new packet every week and now I have a damn book’s worth of packets in a folder. A chapter on mindfulness, a chapter on progressive muscle relaxation and diaphragmatic breathing, a chapter on DEAR MAN, another on Cognitive Restructuring of Mental Distortions and Distress Tolerance and the list goes on.

One day I asked Miss Young Therapist about this Dr. Marsha Linehan who was the author (you could read it on the fine print on the bottom of the handouts). Young therapist answered that Dr. Linehan was pretty much the mother of dialectical behavioral therapy (DBT) which is primarly used on borderline patients.

“But just because I’m giving you these packets P., doesn’t mean I’m saying you’re a borderline patient.”

That was, until I had my last session with her on Wednesday this week. The first half hour or so we did the usual, “How are you doing this week? Wha’ts going on? And this and that.”

I’d brought my “release of information” form signed for her so she could send my files to the new therapist I’ll be seeing at the community clinic. I was waiting for her to bring up the termination thing and sure enough she did.

“So, this is our last session,” she sighed, “is there anything you want to say?”

“Yep, it is.” I looked intently, sighed, then looked away towards my wheelchair where I’d placed my folder. “Oh, I brought the release form signed. I went to the clinic and found out the name of my new therapist and got the fax number and everything here for you.”

I pulled it out of the folder and handed it to her.

I went on and told her that I’d like a copy of the two reports she’ll be faxing in to them–the “Termination Summary” and “Intake Evaluation Report”–because since it’s a community hospital she can’t just send it directly to the therapist. And I added that since it would have to go through the medical records office which can take over a month, she might as well give me a copy of each just in case.

“Yes, of course, I’ll give you a copy when we head out.”

I wasn’t lying about the medical records office. They’re terrible! But, I did do something with double intention there. I wanted to get a hold of my records without being too obvious about it. I know right? Why couldn’t I just upright and tell her I wanted a copy? Why was I so nervous about that? It’s the dynamics I tell you, and my own anxiety and hesitance.

We went on to discuss what I’d benefited most from and she asked what I thought I’d become better at handling. I mentioned some of the mindfulness stuff and managing my anger. She said that I was one of the most “committed clients” she’d worked with as well as one of the clients with the most extreme life stressors. “You’ve had to deal with more than most people. And you’ve done extremely well considering that, I think,” she said.  She went on with the whole patting me on the back, flattering, and good job thing. I don’t doubt she was being honest though. She genuinely seemed pleased with my overall progress.

When we went out to the front desk and I paid her my dues, she wished me luck with the new therapist again and said bye. I thanked her and then just stared at her for a minute.

“Yes?” she asked looking confused.

“Um, aren’t you going to print out the Termination Record so I can have a copy?”

“Oh, oh, right.”

I don’t know why, maybe I’m just overly critical, but I once again felt she was holding back on me. She could’ve honestly forgotten but I don’t know.

Anyway, she printed it out and handed it to me and said, “If there’s anything you have questions about, about what’s on here, feel free to call me.” She gave me this look I can’t describe. It’s was a sort of apologetic look.

“Ok.” I looked at the paper and said, “This is just the termination summary, can I get the intake evaluation report as well?”

“Uh, mmm, I don’t know, I’ll really have to ask my supervisor about this P. Sorry.”

Again, I felt a little put off. But oh well, I figure I’ll call in a week and ask for her supervisor and try to get it directly from him.

*******

When I was in the car I began reading the termination summary, and read something that shocked me a bit it. At the end of the report, it read:

Diagnosis:
Axis I
296.32 Major Depressive Disorder, Recurrent, Moderate

Axis II
301.83 Borderline Personality Disorder

Axis III
Disease of the Musculoskeletal System and Connective Tissue: Osteogenesis [Imperfecta] <–She’d left out the imperfecta part.

Axis IV
Occupational problems
Economic problems
Problems with access to healthcare services

Axis V
GAF Current: 75
GAF Long Term: 55

What shocked me was the Borderline Personality Disorder diagnosis. But why? I had suspected it even though she never told me, ever, and even though I’m not big on holding to a diagnosis. What I mean is, I take a diagnosis with a grain of salt, a BIG grain of salt. They are merely there to draw a delineation the person’s major mental problems and a course of action.

BUT, then again, I contradict myself, because a part of me was and has been desperate, yearning even for some sort of label. With that I would have proof! I know, me wanting a label sounds shocking in and of itself! See I’d gotten a bipolar label after my monumental mental meltdown in 2008. That was the first time I’d seen a mental health professional in my life. And I got diagnosed only after the second session.

I’ll tell you though, getting something on paper felt like a relief then. It was a validation. I could no longer tell myself (even though I still do): “See P, you’re just making all this up. There’s nothing wrong with you. All of humanity is insane anyway! And you, you’re just weak! You’re just crying over nothing. Go on, cry like a baby over nothing. Always have! The baby you’ve always been. You can stop all this, you know? You’re just making it up anyway. They were right about you, your family and everyone! You and your antics and your dramatics. That’s all it is! There’s no such thing as mental illness girl! Yeah little, stupid, little selfish girl. You don’t need their help. You don’t deserve it either. Just straighten up and quit the crying! Quit it! Quit hitting your head against the wall and get that damn razor out of your hand!”

So you see, getting it in paper meant that I wasn’t just being dramatic as I’ve always been called. I’ve held my little BP label as a trophy even, in a sort of twisted way but I don’t think people can truly understand what I mean until they’ve been there in front of that psychiatrist or therapist looking like hell (oops, just a little curse).

Then, I didn’t stick around with that first psychiatrist in the spring of 2008.

“I hate them all! Nothing but drug dealers for the Big Pharma Co.s, nothing but pill pushers. They don’t care about you.” And then I caved and went back to another and then another and another all in the span of a year.

I eventually landed myself in one of the university psychiatrist’s hands by pleas and begging of my first therapist.

“Please go. Just try it,” she’d say.

So I went.

****

You? bipolar? I’m not sure. No se. Vamos a ver. I doubt it. But I’ll have to see more of you to be sure. Nos daremos cuenta con el tiempo,” he said.

He was an old Cuban man and I hated him the instant I saw him (not because he’s Cuban yall; I’m Colombian remember, so there’s a lot not to like there 😉 I kid). I just got a terrible vibe from him. I didn’t trust any psychiatrist then (am still hesitant) and I sure as hell didn’t trust some old mangy one covered in liver spots.

“I don’t think I’m going back there,” I told my first counselor/therapist, the one I was seeing at the university’s psychological services center (this is not the same place where Young Therapist works. Young therapist works at the College of Social Sciences in the Psychology  department).

“P. you really should go see a psychiatrist to help you stabilize those mood swings,” the counselor said. “Look if you don’t want to see that man, there’s this really good psychiatrist, just came back. She was going to retire but decided not to just yet.”

Needless to say she finally convinced me to go and I returned.

An awkward moment occurred when I went to see this new “good psychiatrist” and Dr. Cuban Liverspots said hi to me when he was marching with his coffee cup on the way to his office, right next to new “good psychiatrist’s”! Well, turns out this was the third or fourth psychiatrist (I honestly don’t remember how many I’d seen by then) and she said that I did not have bipolar (BP). But she didn’t say what it was that I did have. If it wasn’t BP, then what I wondered. I never asked though. I guess I can be passive in that sense. The only thing I knew, is when I went to the cash register to pay, the bill read, “Major Depressive Disorder” (MDD) and “Generalized Anxiety Disorder” (GAD).

At least I got my answer, I thought. That’s when the alphabet soup of my psychological disorders got spicy. I now had a gumbo soup of disorders.

Then this! This Borderline Personality Disorder. It sounds so macabre! So fantastical. So unreal. So STIGMATIZING! I’m sorry to break it to you guys, my dear BP internet buddies but my belief is that as stigmatizing as BP is (and it really is), the BPD label is ten times more. Why? I’ll explain in part two.

****

“What?! You got that borderline personality disorder!? What is that? Is that like when you have multiple personalities? OH MY GOD, you got multiple personalities P? You gonna go Dr. Jekyll and Mr Hyde on me P?”

“No! Come on! I don’t have multiple personality disorder, that’s not even called that by the way; it’s been updated by the APA. It’s now called dissociative identity disorder, Dee-Eye-Dee (DID). I’m just me, the one and only PAZ. I’m still the melancholically manic mouse, only now I fit the ICD and DSM and [insert random acronyms for other diagnostic manuals] criteria of a borderline meloncholically manic mouse. I’m a borderline melancholically manic mouse  is all. Maybe it’s because I grew up in a very unstable environment though my family was always tightly knitted and mostly very loving. Maybe it’s because I’ve had to deal with a lot of traumatic events, especially in my childhood so I’m somehow ’emotionally scarred’. Maybe I regress to childhood if you were to ask Freud, though the behavioralists wouldn’t agree. Maybe my brain does fire off too quickly, and if that’s the case, the pharmas are more than happy to hear. Maybe my limbic system has a malfunction and thus, my amygdala is hyperactive or hypersensitive; maybe it’s a genetic mutation like my malformed bones and that’s why I’m so quick to rage. Or maybe I was conditioned to rage by my mother’s rage and abuse. The behavioralists would agree with that one. Maybe I do have a shortage of dopamine, norepinephrine and serotonin or GABA or some other neurotransmitter. Maybe I don’t, but maybe I do, and maybe I have all of the above or none of the above. All I know is I have the emotional stability of a five year-old. I guess it fits my toddler height.”

Really, how do you explain all that? It just makes my alphabet/acronym soup spicier and more foreign than a crunchy Samosa plate served with dhaal soup.

Mmmm. Samosa.

********

Alright, some of you may know what this is already, this BPD and BP and Axis I and Axis II nonsense, but to those of you who don’t and are interested, let me explain what some of this is  (it’s a good thing I’m a nerd that’s into psychology and I have several books on it).

When I got home, you best believe I dug out those books from my book shelf.

First, the various “Axis” levels go like this:

Axis degrees are used as intersections of a person’s main mental problems in order to diagnose a mental disorder. Each Axis affects the overall diagnosis as each affects/intersects and correlates with the other.

Axis I: clinical disorders.    
Symptoms that cause distress or significantly impair societal or occupational functioning such as anxiety disorders, major depression, bipolar disorders, etc.

Axis II: personality disorders and mental retardation disorders. (now why’d they have to dump me in with the mental retardation folks? It’s just like they did when I was in PE class in middle school! P in PE with the retarded kids.)
Chronic and enduring problems that generally persist throughout life and impair interpersonal or occupational functioning.

Axis III: general medical condition.    
Physical disorders that may be relevant to understanding or treating a psychological disorder.

Axis IV: current psychosocial and environmental problems.    
Problems (such as interpersonal stressors and negative life events) that may affect the diagnosis, treatment, and prognosis of psychological disorders.

Axis V: global assessment functioning (GAF).
The individual’s overall level of functioning in social, occupational, and leisure activities. (Now I’m not going to go into detail with this one but if you want more info go here. You probably won’t though since no one clicks my links. hehe

****

Then there’s the Borderline (BPD) diagnosis. I had already known about BPD but again, I thought if anything I fit more into the BP criteria (tell me if this is getting confusing). I could just relate to those who have BP, who I’ve  talked to either face-to face or in online forums. The BPD people folks though, I said to myself, are said to be manipulative and I’m not manipulative, no, no I’m not. Am I? No. I’m not.

I’m not going to talk about the major depressive (MDD) diagnosis because that was a given for me.

So a very, very short description of Borderline Personality Disorder (BPD) is that it is essentially a disorder of extreme and pervasive emotional disregulation characterized by impulsivity and instability in moods, relationships and self-image. (Karen Huffman)

None of this is catch all, you see. We are still people with unique personalities and cultures, histories and separate though connecting lives. We’re individuals, even those like myself who now have had the personality disorder diagnosis slapped on.

****

I cried uncontrollably for about two hours Wednesday night. It could’ve been PMS and a thought about L. I don’t know why I didn’t get so worked up about the other diagnosis (Dx) in my past. Then it dawned on me the more I thought about it. Could it be that  it’s because I think it’s actually the most accurate Dx I’ve had to date? And then, could it be that this has made me subconsciously think about all of the things I’ve been through, all that I’ve done? All the extremes in my life? I mean, all the psychiatrists never saw me for who I was. They never saw me more than twenty minutes at most and once every month or two (again, at most).

Young Therapist did see me for who I was, at least partly. She saw me for an hour every week for almost a year, then every two weeks for another. And she had me do tests and talk about so many things which I never did with the others. Young Therapist actually saw me cry. I cry a river damn near ever day when I get depressed but I don’t cry in front of people! And Young Therapist saw me get shaky to the point of telling her I had to puke, to the point of having to put my arms down and sit on them. Young Therapist, if anyone, would know how to diagnose me. So maybe I cried because I got the sense that not only did I get diagnosed with a very severe, very misunderstood and stigmatized disorder (albeit relatively treatable), but I felt for the first time they got to the core of me. Maybe, I was also crying out of relief.

In order to qualify (ha,  “qualify” like a merit) as having BPD in America, you have to fit at least five of these within your problem scheme. Here are some of the criteria according to the damn (oops) DSM-IV:

  1. frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

Ok this one got me. I don’t think I make frantic efforts to avoid any kind of abandonment. Do I? No, you don’t P. But maybe I fear it so much I’m in denial? Maybe P, maybe. Or maybe this one just doesn’t pertain to me. Remember, it’s not a catch all.

  2. a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

Yes. Yes. Yes. That’s definitely me. Just this week I said, “Damn you WordPress. You suck! Why do I bother with you,” then, “Oh Dear WordPress. Don’t leave me. I love you. You’re the best. What would I do without you?”

  3. identity disturbance: markedly and persistently unstable self-image or sense of self.

Yes. Maybe. Yes. No. Maybe. I’m the best! I’m the worst! I’ll talk about this later. What do you mean by this anyway? Of course I have an identity! It’s not disturbed. Ok. Hmmm. Maybe. I don’t know. I change my mind about what I think about myself, what I want to do with my life and many people do that right? Yes P, but not at such extremes. I doubt what my strengths are. Am I good at writing? No! But I love writing. I’m good at it. Yes? Should I stick with editing video then? But I want to write documentaries and dramatic films. I like to draw too. Could I write comics? Who am I kidding, I’m not an artist. Should I be a therapist? Yes. Yes! I’m so wise, so loving. I want to embrace everyone. No! You’re a misanthropic nihilist. Nothing fits. Am I splitting? What about the web design thing you were trying to do, and what about the multimedia journalism masters at UT? What about the Latin American Studies masters you’d thought about too P? What about your music P? What about your photography P? And what about your poems P?

Yeah, I’ll have to get back to this one later.

  4. impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

Yes. I’m a highly reactive and highly impulsive person even though I tend to over-think things before I do them–so in that sense I’m not impulsive. I hesitate too much on doing them, say choosing a college degree or buying a flavor of yogurt or talking to someone I find attractive. My impulsivity in other aspects, however, has gotten me in trouble and put me in dangerous situations. I’ve done drugs. Many. I did cocaine with L. I was always a bummer, never a buyer. I bummed drugs off of people whenever they were offered, so I never considered myself a “real” user. I was a functioning alcoholic or as the AA people would say, I am an alcoholic in recovery.

I’ve also had phases in my life where I binge eat, particularly to deal with stress. People with BPD, especially young women tend also have a comorbid eating disorder, most notably bulimia nervosa. Though I’ve never been bulimic per se, I have always punished myself in some way or another after binging. My weight has also fluctuated drastically throughout my life. Right now I’m more on the healthy weight to slightly-underweight side.

Sex. That’s a difficult one. I was a shy, late bloomer, a wallflower. But I knew a lot about sex at a very young age. Growing up with an older brother and always hanging out with the guys, you find out about porn early on. Then I lost a close friend because of my impulsive sexual behavior. However, I’m still extremely shy, self-conscious and have issues about my body so I’ve turned down many sexual encounters due to the fact that I have terrible anxiety about it. I’m really short, have brittle bones (some of which are a bit disfigured), use a wheelchair and I always felt no one would find me attractive. I mean, really, who would find a girl in a wheelchair attractive, I’d tell myself. There are ignorant folks out there who still refuse to believe someone like me could have a thriving sexual life.

Who would find a midgety, malformed mouse attractive? So when I found out that I was found attractive indeed, when I was put on the spot, I often backed away. I’m very impulsive sexually though so there’s a tug of war going on in my head. “I can’t but I want to so bad”. Once I get comfortable enough, I’m very impulsive with sex so much so that L and two male “friends” of mine who used to called me a nymph. That’s when the alcohol and drugs come in to play as well.

Oh, and I’m also bisexual, though I mainly just identify as queer and don’t tell people I am. I guess I’m still in the closet about it.

  5. recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

Triple yes. Though I’ve never really attempted and don’t think I make “gestures” of my suicidality to people. In fact, I try to hide it as much as possible. I don’t talk about my suicidal ideations or depression, the only exception being the therapist and even then I’m very vague about it.

As far as gestures… I don’t know. Maybe I make them and don’t realize it? There was, however, one time when I got in a huge fight with my brother not too long ago and I became a “maniac P., you’re acting like a manic! Chill! Chill! What are you…? Oh, f****, hi officer. No, no she’s alright. No, I don’t think I need to take her to the ER. She’s my sister. Yes. She just needs to sleep. I just need to get her to bed. No, I got it. Ok, yes, I’ll see if I take her to the nearest ER. I’m just getting to my apartment right around the corner. I will call them once I’m there, yes. Thank you.”

A cop had pulled us over because my brother wasn’t watching the road because he had to pull me back as I was trying to jump out of his car while screaming, “LET ME OUT”. Maybe that’s a suicidal gesture? I’m not sure. I don’t recall much of of it since I felt out of my body. I only remember sitting on the curb of some parking lot near his apartment complex that night crying and shaking uncontrollably and then, eventually, getting picked up by my dad who later said I couldn’t make a coherent sentence. Very impulsive indeed. Oh and that’s another thing with BPD. Borderlines supposedly have a tendency towards depersonalization  and derealization as well as transient psychotic or psychotic-like breaks under crisis situations, something I’m very familiar with.

Self-mutilation. Yes. I’ve never been much of a cutter, but when I have, it’s been extreme. I’m going to leave it at that. And I’d banged my head against walls ever since I was about ten or eleven or younger even. When I was in middle school, I got into the habit of scratching and slapping and punching myself and pulling bits of my hair. So triples yes on that one too. This is embarrassing guys.

  6. affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).

Yes, it’s one of the things that got me the initial Dx for bipolar. There’s something that should be said about this one though, because unlike the criteria, I usually don’t just have these episodes for only hours or days thought that is the case sometimes.

  7. chronic feelings of emptiness

Not as much as years back. It fluctuates for me. The way I see it: I fill up and then I drain, I fill up and then I drain.

  8. inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

Yes to the power of ten. I’m a recovering rageaholic too. When I was a kid, I threw a butter knife at my brother over a simple remark he’d made and smashed all the plates. It hit him in the forehead. Fortunately, it was only a butter knife and my weak hands couldn’t throw hard enough for a blunt force to seriously hurt him. And these types of violent outbursts were not at all uncommon for me. I have dozens of similar stories ranging as early as when I was four.

  9. transient, stress-related paranoid ideation or severe dissociative symptoms

Yes. People are after me. I make terrible, mean comments on WordPress and that makes everyone get offended and so on and so forth. I have dissociation episodes galore. Where am I? Are those shadows moving? Are they people? Am I there and not here. I’m outside of myself!

********

Ok, I’m going to leave it here for now, but I plan to write more about BPD, what I think of all of this and all of the psychological research I’ve read about it as well as the co-morbidity of BP and BPD.

Hey? 🙂 You there?

See, I bored you to death. 😦

*Le mouse sigh*

***********************************************************************

Resources

Handbook of Personality, Third Edition: Theory and Research edited by Oliver P. John, Richard W. Robins, and Lawrence A Pervin

Psychology In Action, 6th Edition by Karen Huffman

PsychCenteral

Mayo Clinic

National Education Alliance Borderline Personality Disorder (NEA BPD)

National Alliance on Mental Illness

National Institute of Mental Health

About.com, Borderline Personality Disorder Guide

Wikipedia, Borderline Personality Disorder

BPD Today – DSM-IV TR Diagnostic Criteria

NaPoWriMo Día 17: He

April 17, 2012

He

He, my muse.
I his.

His ease of inspiration
is thwarted by the need he feeds.

He, always
drunker than he lets on.

I will not.
I will not.

I, sallow,
now sail farther than my ship allows.

I am his muse he says,
his easel, his canvas, brush and paint.

HA! What will he do
when I’ve smeared off his page,

washed out, leaving it empty like
the glazed gaze washing over me now?

His embedded emerald eyes reveal
a touch of grey marble beneath,

a bit cracked like thunder
and clouded, darkened with the gods and demons.

All those deep pangs they release
on our frontal lobes when we elope.

I will no longer.
I will no longer.

I will not lie in
the blanket of his fever.

I alone hold enough fire to
light the darkest hour of night.

And damned be that evasive smile!
And damned be my indecision!

Voices echoed. Heidi calls again.
We, we, we, we, we. A screech!

Lost in his mental Minoan Crete.
He! He! Damned, depressed poet!

Glad to burn out his body
for a few years of continuous intensity.

I will not.
I will not.

He and his Dionysus
He and his courtesies

I must leave.
I will not. I will not.

I will not rot.

© PAZ

*****************************************************************************************

*********************************************************************************************************************

Is it cheating if I picked up and finished a poem I’d started and dropped two or more months ago?

BAGH. It’s all over the place.
Blegh, it still feels incomplete like it always will, like his fuckin’ life.

Today was a long day. Not bad, not good, just long.
*le sigh*

Buenas noches