Get Me Out of Here (13 page)

It was 2
A.M.
again. I hadn't fallen asleep, this time awash in guilt. I had been so caught up in my own little world that I had completely turned my back on my family. I had to see them. I had to see them now. I got up out of bed and went to the nurses' station.

The drill sergeant again. I approached her anyway.

“I need to go home.”

“It's two in the morning, Rachel. Please go back to bed,” she said flippantly, not bothering to look up from her
Cosmopolitan
.

“Didn't you hear me? I said, I need to go home.”

She glanced up, irritated. “I don't have release orders for you. And I'm not about to get them at this time of the morning.”

“Call Dr. Padgett then.”

“He's not going to release you at two in the morning. As a matter of fact, if you keep trying to pull stunts like this, he might not release you for a long time.”

Funny, the first two times I'd been in the ward such words would have been music to my ears. I'd feared release then, a return to the adult life of responsibility. I had wanted to remain a child of sorts, dependent forever. This time, however, the words were a warning. If I didn't straighten my act up and display some self-control to Dr. Padgett, he wouldn't release me. Now, I
wanted
to be released. I wasn't thinking as a child; I was thinking as a mother.

Within a week I was released and back home. There would be plenty more fantasies about being an inpatient. Many times I would long to be back in the safe shelter of the hospital. But my third hospital stay was destined to be my last. It had taken three trips, but finally I had opened myself up to the intensity of my emotions and had actually gained something in my stay—not weight, but insight and the drive to keep moving with the journey to get better.

“You're way too sweet and you've got too beautiful of a family to be stuck in a place like this.”

Maybe, just possibly, Alice had been right.

I'd never placed much stock in the theory that dreams were anything but random entertainment. A jumbled mix of details and snippets of words, sights, and sounds. Meaningless. A horror film or fantasy of the mind that ended with the light of consciousness. Exit the theater, and it's over.

But the nightmares in the hospital didn't end with the credits rolling down the screen. They seized me long after I woke up, haunting me. I could not ignore these messages, and they would not stop until I faced them. My subconscious mind demanded to be heard.

Most of my therapy sessions during my hospital stay and its immediate aftermath were devoted to the feelings these dreams brought about. What was the message? Substance or symbolism? Truth or fiction? Or both?

What could the events have been? What did the flashing lights and my angry and hysterical family mean? Guilt? Retribution? For what? Why were the two little woodenlike figures apart from everyone? Was it abuse? Had things gotten so bad that someone summoned the fire department?

In a family that valued secrecy above all else, even within itself, the details of my early childhood were sketchy. My parents seldom spoke about that era of our family's life, although they spoke freely about later years. Was it just coincidence, or were they withholding dark secrets?

I only knew that it was a particularly stressful time for my parents. My father had been working eighty-hour weeks to get his business off the ground, and my arrival (the fifth child in the family) was unplanned. Worse, I was a girl.

I knew that during my infancy my mother was sick a lot. Psychosomatic illnesses always gripped her in times of great stress. I knew that she had always been a stay-at-home mom, but for some reason, even though all of my older siblings were already in school, they hired a nanny to take care of me for a few years. Why?

The EEGs and MRI and CT scans had all shown that I had some type of lesion and scar tissue on the left side of my brain. We never reached any conclusions. But now I found myself wondering why it was there. Was it an aberration? A fall on the playground? Or was it the legacy of abuse?

These were horrible questions. The possibility of abuse existed, but the only people who would know whether or not it had occurred were my parents. And I knew I could never be certain of their answers even if I directly confronted them. If the speculation were false, they would justifiably deny it. But if it were true, they would also deny it. There was no way I would ever know. Just pondering the reality of that dream was a serious accusation.

After discovering many real memories of my childhood, those I knew had occurred, I was beginning to feel furious toward my parents. The embittered rage of the betrayed. Yet I could not bring myself to condemn them based upon sketchy dreams without firm evidence, evidence I would never have.

Dr. Padgett did not say much at this time. He was cautious not to lead me either way—symbolic dream or memory. As much as I relied upon him now, even a few words could have tilted the balance. Instead he focused on the one thing he believed was real in the dream—the feeling memories. He had always been convinced that, in whatever form it may have taken, my early childhood had been far more abusive than I had imagined. Determining the specifics, he said, was not as important as coming to grips with fact that I was abused, and, above all, feeling the emotions that came with that revelation.

Eating came very hard. But Dr. Padgett did not bring it up, even though I had not gained back a single ounce. He strongly believed that if I could face these fears, eventually the need to be anorexic would dissipate.

For me it was no longer an issue of anorexic body distortion. It was the horror of these feelings, the recognition of a sickening reality so revolting that I lingered on the edge of vomiting.

One day I came perilously close to doing so right on Dr. Padgett's office floor. I was writhing, gagging, the bile rising in my throat as I battled the demons of these feeling memories. I shook and shuddered—every part of my body somehow in motion. I grabbed and twisted my hair and bit my fingers in wild kinetic motion. I was crazed, trying somehow to expel these feelings.

“Sit with them,” Dr. Padgett would say calmly but firmly. “Sit with the feelings. Don't act them out. Don't run away. Feel them. You can do it, Rachel. Sit still and put these feelings into words or tears. Share them with me. They're only feelings. No one can hurt you now. I'm right here with you.”

Words often eluded me, and I could only manage to howl in pain—the bloodcurdling cries of an infant that jolt the mother, wherever she is, to run to her child's aid. No magic words exist to soothe these cries, and Dr. Padgett didn't try.

Instead he sat.

He listened.

He was present and unconditionally accepting. From behind the blank screen I could see the pain in his eyes as he witnessed my suffering. It was a pain he did not try to hide and one I don't think he could have hidden even if he had wanted to. These feelings transcended words and analysis. They simply needed to be felt. And Dr. Padgett simply needed to be there with me, feeling the pain of a parent watching a child suffer and knowing that only time will make it pass.

We would wind up these sessions of raw, primal emotion—unvested with words because the feelings were so early in origin—by gently bringing me back to adulthood.

After one particularly intense session, he chose to unveil pieces of himself. He had two grown children, a boy and a girl. He would tell me stories of his own experiences with these children. His little girl would crawl away, scrambling across the floor giggling as he attempted to change her diaper, him laughing too. He would tiptoe into their bedrooms at night, stand next to the crib, peek in, and watch them in grateful wonder. He would hold his little girl through her tears, his own heart breaking, wishing her pain away, but careful not to let her see too much of this pain because she needed him to be strong. He loved, cherished, and saw the beauty and the miracle in his daughter as much as he did in his son.

As I emerged from the memories, still in muffled tears, exhausted, he would tell me that this was the childhood I always deserved. While we could not rewrite the past, he could meet my need for unconditional love and acceptance. It could never be a substitute. It could not erase the past. But it could help me become whole in the present.

I listened and fantasized about what life would have been like with Dr. Padgett as my father. They were comforting thoughts, but painful as well. The only way I could conjure them up was to plunge deeply into the depths of vulnerability I felt as a young child. As much as he took pains to remind me that I could never be a child again, I fervently wished I could. The distinction between fantasy and reality was one I desperately didn't want to make.

I was back home unpacking my suitcase from the hospital when I noticed a pink sheet of paper. It was a form with the hospital logo titled “Patient Treatment Plan.” Several signatures ran along the bottom, including those of Dr. Padgett, a nurse I assumed to be drill sergeant, and my own. I didn't quite recall signing it, but then again, I'd signed lots of paperwork during my stay. Before tossing it in the trash, I wondered, what had I signed?

It contained a lot of jargon about suicidal ideation. A stress scale, whatever that was, showed overwhelming anxiety. I recognized Dr. Padgett's handwriting in the section marked “physician.” He had printed the diagnosis, however.
Anorexia nervosa
. No surprise there.

But there was a second diagnosis this time.
Borderline personality disorder
.

Borderline personality disorder! What in the hell was that? I'd never in my life heard of that term. But it sounded sick, twisted, and demented—crazy. Dr. Padgett had mentioned a number of psychiatric terms in the course of therapy but had never mentioned this one. Yet here it was in his own handwriting. How could I have signed that paper without noticing?

I quit unpacking and headed straight for the public library and the microfiche kiosk. Under the category “Subject—Borderline Personality Disorder,” three books were listed, and one caught my eye immediately:
I Hate You, Don't Leave Me
.

Those were the words Dr. Padgett had used to describe the alternating love and hate of my black-and-white relationships. It wasn't just a phrase he had coined but the title of a book—a book that was entirely devoted to a diagnosis the doctor had, for some reason, failed to tell me.
Why hadn't he told me?

I drove to the bookstore with the library computer printout in my hand.
I Hate You, Don't Leave Me: Understanding the Borderline Personality
by Jerold J. Kreisman, M.D., and Hal Straus. I found the blue paperback on the psychology shelf and spent the rest of the evening and the next morning devouring it.

It was compelling reading, a comprehensive portrait of severe mental illness—one that could cause damaging consequences, not only to the ones suffering from it, but also to their loved ones.

“Borderlines,” as they were called, had an overwhelming inclination toward self-destruction. Ten percent of borderlines committed suicide; even more engaged in dangerous, impulsively self-destructive behavior. Chemical addictions and abuse marked the disorder, as well as reckless driving and eating disorders.

Clearly Dr. Padgett had been telling the truth when he said that therapy was a matter of life and death. Not only was borderline personality disorder (BPD) serious, but, according to the authors, also exceptionally difficult to treat.

Borderlines were disproportionately represented in the psychiatric inpatient population and were prone to a host of other mental illness episodes as well: major depression, chemical dependency, and anorexia, to name a few. Often the best that could be hoped for was to treat these episodes as they occurred and to possibly control some of the BPD-related behavior such as explosive rages, damaging manipulation, and compulsive acts of self-destruction. Controlled but not cured.

The prognosis was bleak, and a significant number of borderlines were destined to lead lives of turbulence. Lifetimes spent in and out of psychiatric wards, prisons, and institutions. Significant recovery from the illness was rare and almost always meant several years of intensive psychotherapy.

This couldn't be me, could it? There must be some mistake
. To discover this answer for myself, I closely reviewed the criteria for BPD in the American Psychiatric Association's
Diagnostic and Statistical Manual of Mental Disorders (DSM)
, the thick book psychiatrists used to determine a mental illness diagnosis.

Diagnostic criteria for Borderline Personality Disorder: A pervasive pattern of instability of mood, interpersonal relationships, and self-image, beginning by early adulthood and present in a variety of contexts, as indicated by at least five of the following:

(1) A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of overidealization and devaluation
. The black-and-white thinking, the good guy/bad guy phenomenon Dr. Padgett had pointed out. A definite yes.

(2) Impulsiveness in at least two areas that are potentially damaging, e.g., spending, sex, substance abuse, shoplifting, reckless driving, binge eating. (Do not include suicidal or self-mutilating behavior covered in [5])
.Promiscuous sex with more partners than I could either count or remember until Tim came along. Heavy drinking and illegal drug use that had slowed with the births of Jeffrey and Melissa but were still present. Midnight runs would probably meet this criterion. Certainly anorexia would. Dr. Padgett was always bringing up my out-of-control behavior. This one was a yes too.

(3) Affective instability: marked shifts from baseline mood to depression, irritability, or anxiety, usually lasting a few hours and only rarely more than a few days
. Another definite yes.

(4) Inappropriate, intense anger or lack of control of anger, e.g., frequent displays of temper, constant anger, recurrent physical fights
. I had struggled my entire life to keep this one under control, trying to heed Sister Luisa's warning from years ago about the damaging power of words. However, outbursts against Tim had been increasing, and my explosive temper with Jeffrey had driven me to seek help in the first place. Dr. Padgett, who loosened my defenses and thus my reins on my emotions, had witnessed such intense and inappropriate anger countless times. I had to admit this was a definite yes too.

(5) Recurrent suicidal threats, gestures, or self-mutilating behavior
. The suicidal ideation and threats were so frequent they had prompted Dr. Padgett to threaten to commit me. The two runs to the West Side, before and during my first hospitalization, fit this criterion. I wasn't sure whether anorexia fit into this category or not. I'd never made a bona fide suicide attempt, never swallowed pills or put a gun to my head, but I'd thought about it plenty and talked about it frequently. I surmised this was a yes as well.

(6) Marked and persistent identity disturbance manifested by uncertainty about at least two of the following: self-image, sexual orientation, long-term goals or career choice, types of friends desired, preferred values
. Clearly I hated myself, although on occasion I could be prone to delusions of grandeur followed by crushing lows. Now coping with the concept of fragmenting (conflicting selves), my self-image was definitely a serious problem. In the area of heterosexual versus homosexual orientation, I hadn't had self-doubt, but I had very serious difficulties accepting my gender. Long-term goals were nearly impossible for me to contemplate, much less to hold, even briefly. This also had to be a yes.

(7) Chronic feelings of emptiness and boredom
. I made frenzied attempts to stay busy as hell to escape them, which never seemed to work for long. This point was a no-brainer yes, something I'd known about myself long before I ever entered therapy.

(8) Frantic efforts to avoid real or imagined abandonment. (Do not include suicidal or self-mutilating behavior covered in [5])
. The tough, I-don't-give-a-shit part of me resisted identifying with this one, loathing the concept of dependency. But Dr. Padgett had specifically pointed out the abandonment fears on several occasions. I had to give this one a yes, although I preferred to think of it as a qualified yes.

The question now was about my prognosis. I had already been a psychiatric inpatient three times in less than a year and was going to three therapy sessions a week. Was this something I could expect for the rest of my life?

Having arrived for session two hours early the next day, I strolled the grounds of the hospital and surrounding neighborhood, listening to the melancholy strains of Supertramp, trying to make sense of my most recent discovery. Granted, I'd always known I was different, messed up in many ways. But seriously mentally ill? The thought was overwhelming. I had to see Dr. Padgett right away. I couldn't bear waiting another minute.

By the time the session began, my uncertainty and confusion had turned into rage. I immediately walked to my chair, intentionally leaning forward and tightly folding my arms. It was confrontation time. I didn't need any time to collect my thoughts. I started in right away.

“You lied to me! I can't believe you lied to me!”

“Lied?” Dr. Padgett had the innocent look of one who sincerely had no idea what I was talking about.

“You know what I was doing until four in the morning? Do you? I was reading
I Hate You, Don't Leave Me
. It's not just a phrase some shrink coined, you liar. It's a book—about a diagnosis you didn't have the balls to tell me about.”

He nodded. Now he knew exactly what I was addressing.

“Borderline personality disorder,” he said.

“Yes, borderline personality disorder. I'm sick as hell. I'm a fucking mental case, demented. I'll probably be in and out of this goddamned hospital for the rest of my life. Sitting in here for 120 bucks a throw, ad infinitum. And you were gonna keep it from me, weren't you, you asshole? Just keep on sucking the cash from the little fuck-up until you retire.”

“I didn't lie,” he said, as calm as I was agitated. “The diagnosis was on the treatment plan, very openly. You read it; you signed it. I haven't lied to you about anything.”

I rolled my eyes, tapped a drum roll on the table, and began to swivel the chair back and forth. I wanted to strangle him. I wanted to run. Goddamnit. I wanted to run and never stop.

“Bullshit! This is all bullshit. I signed so much crap in the hospital, filled out so many forms. Who reads it all anyway? A bunch of bureaucratic, psychobabble paperwork bullshit. You're a chicken shit; that's what you are, a spineless chicken shit. From that very first session when you didn't have the balls to give me the test results to my face, just tossed me some goddamned written report on my way out the door. And now I've got some psycho, demented mental illness. I despise you. I wish I never ever met you.”

By now the drum roll had reached peak intensity, the chair not only swiveling, but rocking wildly back and forth, my feet tapping the floor, body shaking, ready to explode.

“Rachel, you're an adult. You're not crazy, and you can control your body motion. Stop with the tapping, stop with the feet and the chair, calm down, and listen.”

Without raising his voice in the slightest, he had delivered his command with clear authority. Still seething, I stopped moving.

“First of all, you know the rules here. We can't work on your intense feelings when you physically act them out. We need to use words.”

“Okay then. Fuck you!”

“That's not what I'm talking about, and you know it. Cussing me out is just another way of acting out. It doesn't tell me what you feel or why you're feeling it.”

That one took me aback. It was the first time he had censored my speech and called it “acting out.” I felt the cold slap of having stepped over the line. I could feel my face flush, and I was silent.

“Are you listening now? Are you ready to look at this issue now? Is the adult in control?”

I nodded.

“Okay.” Even the blank screen couldn't hide his irritation, but under the circumstances he was containing it quite well. “I wasn't trying to hide any diagnosis from you. It was on the treatment plan that you signed; that's not hiding it. We've been dealing with a lot of important issues right now. The diagnosis is an issue in itself, but I don't think it's as relevant as others we've been discussing.”

“You don't think borderline personality disorder is relevant? Look … How can I say this? I'm really trying to control myself here. I was up until four in the morning reading this book about what seems to be a very serious illness. I meet the criteria. I've gotta say I can't see a whole helluva difference between having BPD and being just a manipulative asshole. Can you really blame me for freaking out?”

“It's a very broad and general diagnostic category, maybe too general, in my opinion. BPD encompasses all kinds of people with all varieties of behavior. It doesn't define you.”

“So you're saying I don't really have it? That it really isn't that bad? Maybe mine is a milder case?”

“No, I'm not saying that. You meet the criteria, and you are in a very serious situation.”

“So I
am
sick.”

“Yes, you are sick. I've never said anything to contradict that. I've always said therapy was a life-and-death matter for you. But you aren't a lousy person, Rachel. At your core you are a good person who's been through an awful lot.”

Touchy-feely affirmations. I knew that argument; everyone is good at the core. The eloquent defense lawyer paints the tear-jerking portrait of the neglected, abused “kid of the streets.” The lawyer plays on sympathies, tugs on heartstrings, and twists everything around so that somehow the rapist or murderer becomes the victim. Perhaps the lawyer's story of neglect and abuse is true. Sad, perhaps. But to me, it never cut it as an excuse. The dead person is the victim, and the murderer is the murderer.