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Every day is a struggle: the battle in my mind between wanting to die to end the pain, and trying to survive to overcome the trauma of the past and live a decent life. In an instant, emotions can go from one extreme to another and it can take a very, very long time for the intense distress to come back down to the normal emotional baseline. It’s all about tolerating the distress – how can one who has never learned to self-soothe know how to tolerate extreme distress without behaving in extreme ways? Well, that is where the therapy and professional help comes in, but for now I am going to take you through a day in the life of someone with BPD. I think in black and white. All or nothing. One extreme to another. I find it difficult to name emotions – they just come up and in a very intense way to the point where I cannot cope and want to harm myself to relieve the intensity. For instance, I hadn’t heard from a very close friend who is usually quite reliable and contacts me nearly all the time. But when I didn’t hear from him I began to catastrophise and my fear of rejection and abandonment surfaced. My efforts to deal with this were very self-destructive and my thought pattern was extremely black and white. I harmed myself, because the beliefs that I had growing up in an abusive household all came back to me with this trigger: I believed I was worthless and unlovable. With these core beliefs at the forefront of my mind I began to spiral. I was in extreme pain (feeling this as though I was the hurt child but only now in an adult’s body). My inability to cope with such distress caused me to have a dissociative episode which manifests in different ways. In this instance, I dissociated and harmed myself and then collapsed afterwards. I have been told by medical professionals that dissociative episodes are the minds way of trying to cope with such intense stress and pain. When I came around from my episode I had to call an ambulance to get medical attention for what had happened to my body and to also speak to someone from the mental health team. So that meant a trip up to the A&E department, which in itself is distressing and anxiety-inducing. I was then upset that I had once again needed an ambulance and was drawing attention to myself when I don’t want to be noticed or known for these kinds of things because of the stigma attached to mental health issues. The self-blame and hatred started to rise within me as I was in the ambulance, and by the time I had got to the hospital I decided I didn’t want to live anymore because I hate myself for being like this and I feel trapped in my own black and white thinking and intense, unbearable emotions. My experience in A&E really shocked and hurt me. The person who caused this was the head of the department, as I later found out. I had dissociated in the hospital. My distress manifested in a way where my body just cut out like a car engine. I dropped to the ground. The staff accused me of throwing myself on purpose for attention. I felt helpless and had to defend myself…however, things got worse. I couldn’t handle this extra distress, I threw my handbag against the wall in anger and ran out of the hospital…but I dissociated again and whacked my head off the concrete at the A&E entrance. Unfortunately, the staff took me back in and I met with this doctor who sat in front of me and said: ‘’You have severe behavioural issues – who do you think you are throwing stuff in my department? You have to grow up and get help”. That triggered me more and I ran out and got a taxi to my friend’s house, where I cried and cried in despair. People perceive BPD as a behavioural issue – someone who is acting childishly, as well as an attention seeker. These perceptions are incorrect and cause the person with BPD to feel misunderstood and to blame for their problems. This just perpetuates the suffering and problems! Usually, BPD is a response to trauma, therefore the person has been through something frightening and painful. If someone comes along and tells them to ‘grow up’ that just dismisses them and the severity of what happened to them. I can’t highlight enough that people should educate themselves on BPD and how the distress manifests for the person diagnosed. This is what happens when people do not take the time to understand what is causing the behaviour. It can lead to a person being so distressed that they feel there is no way out. This shouldn’t be happening.  Attitudes must change. A dissociative episode, self-harm, collapsing and a trip to A&E leading to me feeling suicidal all triggered by the intense emotion from the fear of rejection of not hearing from a friend – who later called me and said he was busy with family matters. That

Rita Brophy

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