Dr Chugh asked me what was going on in my head, and I told him how I was feeling. ‘I’m constantly depressed, and I always feel this void,’ I said. ‘There is this surmountable emptiness that follows me around like a shadow. I am never happy and sometimes I have an overwhelming urge to end it all. I feel tremendous guilt for having let my father down, and I feel that he is very disappointed in me. I can’t sleep, and I suffer from anxiety almost every day. I feel as if I’m in this deep dark black hole and I’m being sucked into it even further and further. I have trouble with my mother and our fights always get out of hand. I am angry with my parents for not understanding me, but at the same time, I feel guilty, knowing that they suffer because of me. I see no hope or future for myself, and to counter these feelings, I party and drink a lot, all to numb the pain that I constantly feel. I feel emptiness and pain all day long, and live like that. I come home after partying and sleep the whole day. Then I get dressed in the night and go out to party again. I do this just to disguise the fact that I feel like a complete failure. My insides want nothing more than to feel some sort of normalcy, and then there is this matter of the book which has hurt me so much. I am severely dysfunctional, or so I am told.’
Dr Chugh listened patiently and assured me that things would get better, that I was taking the first step already. ‘I will have a word with your parents,’ he said. ‘I want you to come in for a session with Purnima every week. She will be your counsellor.’ He prescribed some medication for me, and explained that he thought it best I took it under the supervision of my parents. I asked him what it was for, and he said that it would help with my anxiety and elevate my mood. It would also help me sleep. He did not tell me the name of the medication, or what my problem really was, but I did not expect him to diagnose my issues in a single session.
On the way out, I scheduled my next appointment with Purnima. The fact that Dr Chugh did not want to hospitalise me right away, unlike the doctor in Mumbai, endeared him to me.
It was only after a few months of therapy that I started becoming comfortable with Purnima. At first, I missed a lot of sessions and I was irregular, probably too lazy to go. But after regular dosage of medication and the fact that Purnima was very nice, I became consistent with therapy. The medicines helped me sleep, and I slowly began to ease up. Purnima did not preach; in fact, she understood me well. My erratic thoughts were rationalised and given a sense of logic when I spoke to her. After every session, Purnima would report back to Dr Chugh, whom I affectionately began calling Doc. I would meet Doc as and when required.
Though I was getting better, I had a long way to go to become stable. Although on the surface I began to see a ray of hope, my turmoil within began expressing itself in different ways. I still behaved in a weird way. I discussed so many things with Purnima, telling her about all my problems. I described how empty and troubled I felt when I fought with my friends or family. My emotions refused to stay under control, and I was unfair to myself in so many situations. I relied on the men in my life to give me happiness; it had been Hafez and Gill before, and now it was Pink. I told her that meeting Pink made me content, but otherwise I was dull and dysfunctional to the point where I couldn’t bring myself to even want to do anything with my life. The only other time I roused myself was when I had to go to a party, where I would drown my destitution in alcohol, attempting to fill the vacuum embedded in me.
I gave Ria’s book to Purnima, thinking we could discuss it and the pain it had caused me. But she wanted me to move on from the book. ‘The book has garnered no attention and it is vital for you to stop thinking about it. You should bury it and focus on yourself,’ she said with deep concern. She let me work out my feelings regarding everything in my life: All the fights, the rejections, and the sorrows. ‘Everything is okay,’ she would tell me. ‘We can handle it.’
Slowly, we worked through the pile of guilt I had built up. I told her how I felt to have left my education half way and never gotten back to it, thus destroying my father’s dream. I told her that I had been admitted to the University of Liverpool, which has an excellent archaeology programme, and even rented an apartment there. But my unwillingness to leave and change my life all over again had held me back. I told her I had sacrificed my education for men, and I could not forgive myself for that. I was haunted by my past, by the things I had done. My emotional intensity had scared people, even driving away my friends when I acted possessive of them. My aggression alarmed people, and kept them at an arm’s distance, even when I needed them most. I was labelled as ‘trouble’ and ‘drama queen’. ‘You can really change that, as I don’t believe in labels. All you have to do is concentrate on yourself, work on the intensity of your feelings, and love yourself,’ Purnima would reiterate these points in each session.
She would counsel me and tell me to forget about my past, saying that it was okay to make mistakes. They were behind me now. She asked me to focus on myself and slowly make an effort to better my present. She would encourage me to do something simply for my own sake. ‘When you focus on yourself, you will begin to love yourself,’ she said. I had joined an NGO that helped protect the environment, a cause that was really dear to me, but I had left it in between, midway through my work. ‘Why can’t I finish the tasks I take up?’ I asked her. ‘Why do I leave everything unfinished, incomplete?’ She pointed out that focusing on myself was the priority. Once I had learned to forgive myself and love myself, I would regain my ability to keep my attention on other things. I worried about superficial things as well; I was alarmed that I had gained so much weight recently. Purnima told me to relax about that, and to exercise as much as I could. ‘Don’t stress too much; every problem has a solution and we will solve out your issues, slowly and steadily,’ she said.
Months of therapy turned into years, and two years later, I felt much better and I moved on with my life. I forgot about the book and even managed to improve my temperament. In those two years of therapy, all I did was vent out and try to make some sort of semblance of myself. Purnima made me identify my dangerous patterns and we were examining my life in detail. She helped me to cope with my demons—those twisted, toxic, manic creatures that constantly gnawed at my wounds. However, there was still so much work to be done. I was at the bottom of a mountain trying to take baby steps and work my way up. But Purnima and Doc never gave up on me. For her part, she reiterated, again and again, that she saw a lot of potential in me and the reason why I was always frustrated and depressed was because I was letting that potential go to waste. ‘Why do I hate myself so much, while I have so much love to give to others?’ I asked. Her response was gentle. ‘I have gotten to know you well in the course of our sessions, and you are a kind, compassionate person. You love other people with honesty and all your soul. The trouble is that people don’t understand you and the intensity of your emotions might scare people away. That’s what happened with Hafez and Gill. You need to focus on yourself and your needs.’ Her objective was to instill in me a healthy view of myself, and make me take strategically placed steps towards gaining focus and building a routine. Like while playing a game of chess, the objective is not to avoid checkmate but to intelligently manoeuver your way to say ‘check’ and ‘mate’ to your opponent or enemy. In my case, that cunning rival was my own self, my tricky mind—I had no focus. I was so blinded by my deranged mind that I was disconnected from reality. I was a twenty-seven-year-old single girl, who hated herself and her life. I could see no future for myself, and was always unhappy. I drank too much at social events and made a complete fool of myself. Even my friends were wary of taking me places because of my uncontrollable drinking, and we would have huge fights about it. And without an independent income, I was forced to rely on my parents. In my opinion, I was a complete maniac, and someone who had no self-love or self-esteem.
Purnima tried to make me see my positive attributes in each session, and after my sessions with her, I did feel better. I loved therapy and was almost addicted to my time with Purnim
a. She helped me regulate my intense emotions in every sphere of life, whether it was the relationship I had with my mother or my friends. The one aspect of it she never had to regulate, or help me deal with, was Pink. In fact, she often said, ‘Somehow, only Pink and I are impervious to your high intensity.’
I spoke to her about my excessive need to please people, born of a fear of rejection. She told me that I had to be assertive, that I could not be a pushover. She advised me to go easy on the drinking. By this time, Uncle had hired a driver for me, on Doc’s suggestion. Uncle remained much more patient with me than my own mother.
I was even put on anti-alcohol medication which inhibits the enzyme acetaldehyde dehydrogenase, which breaks down alcohol in the body. If you drink alcohol after taking it, you have an immediate reaction which includes flushing of the cheeks, abnormally high heartbeat, nausea and profuse vomiting, and in extreme cases, death. In my case, I was so psyched out about the medicine that I did not drink while on it. I hated the side effects of the medications I was on, but I had so much respect and love for Doc that I always heeded his advice.
Around 2012, I started to have twelve-hour-long headaches. I had erratic eating habits; I drank coffee all day and smoked, only eating at night. I began suffering from chronic diarrhea and blamed it on the medication. The only thing I was happy about was that, thanks to the diarrhea, I had lost some weight. ‘How shallow have you become!’ a voice in my head would tell me. Doc advised my parents to have me checked by a gastroenterologist and get an MRI done to investigate the cause of the headaches. The MRI came out fine, but I fought with the neurologist when he told me he could do nothing about the headaches except prescribe a painkiller. He told me the headaches were caused by severe stress and overthinking. I was on so much medication already that I decided I would rather tolerate the pain of the headaches than take another pill.
Obviously, I could not function because of the headaches and it was difficult for me to do anything. Because of the therapy and efforts of Doc, Purnima and my parents, I was slowly showing improvement and I wanted to invest in myself, do something useful. I still went to parties at times, but I was much more stable than before. I began to see a whole new dimension in life, a dimension I had earlier missed because of my imbalanced party days. I wanted to read books, learn more about the world, I wanted my intellect to grow and I wanted to start a business. But I could not do anything because of the never ending headaches which occurred daily.
However, I would bring negative attention to myself by acting out, whether it was at parties or restaurants or other public places. I did not know how to behave like a normal person, or at least what others perceive as normal. My mother would constantly remind me that I embarrassed her, and that was why she did not want to go out with me. That would just add fuel to the roller-coaster relationship we shared, and I would quarrel with her again. I went from place to place, wondering what was wrong with me. I would cry all the time and I wanted answers. Finally, I confronted Dr Chugh. I asked him point blank as to what was wrong with me? What was the mental ailment I suffered from? His answer was vague. I knew it was part of his strategy to not let me know, to spare me from stigma, but I persisted. Finally, he gave in and said to me calmly: ‘You suffer from Borderline Personality Disorder (BPD).’
Chapter 18
AN INVISIBLE ILLNESS
BORDERLINE PERSONALITY DISORDER
Constant Emptiness, forever mourning loss, fearing
Abandonment, unbearable Rejection . . .
Our Emotions are always Magnified,
Harming ourselves and others, our Impulses have sharp claws,
Obsession becomes our Tangle, Regret for us is Mangled
We end up Hating ourselves,
we are deeply Misunderstood creatures
These are some of the salient features . . .
these are the Borderline Flaws.
I had heard them mention BPD a few times, but I always assumed it to stand for Bipolar Disorder; that would explain my horrible mood swings and outbursts of temper. I asked Doc what I could do to combat this disease, and he said, ‘You have come far through regular therapy, but you need to make more of an effort; I see that you are consistent with therapy, but you need to show this consistency in other aspects of your life, consistency is everything.’ He said and went on to draw a cross on a piece of paper to illustrate his points. ‘The four empty sections of this cross represent your life. Let us try and fill these sections. One represents your social life, which is comprised of the partying you do. The other three sections in your life are empty. One is related to your career, goals and work, which you are trying to build. One is for the activities you do, taking care of your health, being with family, exercising, doing yoga or whatever suits you. The last one is open to you; you can fill it with anything you desire, other than the previous three.’
I wondered, was the emptiness I always felt a result of not doing anything? My mind was not occupied by work; I had no family life; I was not taking care of a husband and children; nor did I have a household to run.
Doc told me that Borderline Personality Disorder is a bunch of symptoms that become a part of the patient’s personality, the patterns becoming ingrained in them. He said it is not a hereditary disorder; however, I had a vulnerable DNA because of the history of mental illness in my family. My paternal aunt and uncle both were schizophrenic, and were severely mentally crippled. He said the disorder itself is caused by internal biological factors and external situations or traumatic experiences. He said for me the biggest trigger which set me off was the trauma caused by my father’s death. ‘You have been unstable, and you have shown all the patterns of a Borderline in your life. You have extreme intense emotions, unstable relationships, you have trouble controlling your anger, you behave in a manner which is consistent with a person who lacks a stable sense of self, your goals and your ideals shift from time to time, and you yourself repeat that you have constant anxiety and you always feel empty. Your relationships with men in the past have been obsessive and you have a severe tendency to self-destruct, which is why Purnima tries to instill in you a healthy self-image of yourself. She tries to counsel you to have focus and to invest in yourself, to have some sense of self love. Your emptiness makes you wallow in self-pity. You can do it, Amrita. You can beat this pervasive pattern of emotional upheaval. With the help of medication and therapy, I believe you can become a healthy, functional individual with a set path, a career and you can have rewarding relationships. You need to try harder. I am not going to give up on you.’
Doc always gave me a huge confidence boost. His presence alone made me feel safe, secure and positive. My relationship with him and Purnima was the most healthy relationship I had ever been in. I respected them both a lot.
I wanted to make my life better, so I wanted to get to know more about Borderline Personality Disorder. That night, I talked to Dad about it and he gave me an old definition: ‘People suffering from Borderline Personality Disorder oscillate between neurosis and psychosis,’ he said. ‘What exactly are neurosis and psychosis?’ I asked. In response, he asked me to do some research.
I did exactly what he suggested, and found out that neurosis refers to a mild mental disorder with symptoms like chronic stress, anxiety, anger, irritability, mental confusion, and depression. I realised I had constantly shown all these signs. Psychosis refers to any mental state that impairs thought. People have hallucinations, paranoia and show an overall change in personality. They get away from reality and can imagine things; they can distort routine conversations and situations; and they can perceive and visualise people, places and things into something different and bizarre which is completely dislocated from the reality that they are in. I remembered the days I couldn’t sleep and instead constantly thought about conspiracy theories and imagined things. That breakdown could easily be described as a psychotic phase in my life. Carl Jung had said that ‘a consistent sense of self is ego’, but I had a very variable sense of the self
. My perception of myself ping-ponged between being unworthy, burdensome, dysfunctional, or a good person who helps others and has a lot of empathy for those who suffer. And according to Jung, ‘neurotic people have an insatiable need for pills, alcohol and tobacco.’ I laughed and said, ‘Amen to that!’ I thought a lot and realised that I, at my best, was a neurotic and at my worst, a psychotic. And somewhere I was in between neurosis and psychosis; hence I was Borderline.
I went online and read up on some descriptions of borderline personality. I could relate to everything that was written, and I got more and more intrigued, so I went and looked at the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association. There are ten types of personality disorders and they are divided into clusters. Borderline Personality Disorder comes in cluster B—the dramatic, emotional and erratic group. The essential features of the disorder are instability of self image, instability in interpersonal relationships (which I exhibited with my family members, my friends, and my extremely dysfunctional relationships with Gill and Hafez, bordering on the obsessive), instability of mood, identity disturbance over friends, goals and work. These features, when they become a pattern and a pervasive one at that, they make up a disorder. Apart from these features, Borderline Personality Disorder has nine criteria, and one has to have at least five of the nine criteria to be diagnosed with the disorder. The nine criteria are:
1. Frantic efforts to avoid real or imagined abandonment: This symptom makes me crippled with anxiety, which is why I held on so tightly to my relationships with Hafez and Gill. I didn’t want them to abandon me, but even a child could tell that these two relationships were doomed; I tried everything in my power to sustain them. I did the same with my friends. When I behaved erratically with them or when I had unstable moods and took it out with them, I would think they are going to abandon me so I would frantically call them and go over to their house and apologise again and again in an effort to avoid abandonment. The real abandonment which was not anyone’s fault was the death of my father, and I still wasn’t completely over that incident. I was still in mourning.
Borderline Page 13
