Monday, May 14, 2012

BPD Intensity: Stacy Pershall Turns Up the Volume

Recently, I invited author Stacy Pershall to engage in a "diablog" with me on the aesthetics and politics of borderline personality disorder. I was curious to talk borderline to borderline about the writing process. 

MLJ: I'm sitting here with your beautiful paperback edition of Loud in the House of Myself: Memoir of a Strange Girl, thinking about your exploration of borderline personality disorder, a disorder characterized by excess, the too-muchness of emotion, the too-muchness of a personality that is loud, strange, uncomfortable to have, and often uncomfortable to be around. The question came up for me, in writing my own borderline personality disorder memoir, of how to convey the experience of this condition without alienating my readers. I remember one editor at Random House telling my former agent that she felt sympathetic to my story at first (in an early draft) but soon became frustrated and eventually just felt like she wanted to be away from 'me' (or at least the persona of me in the book). A couple of more friendly early readers translated that comment for me, urging me to figure out how to give the reader enough of the environment inside my head to get them interested but not so much that they felt overwhelmed by full immersion in the (or 'my') borderline personality experience. So, very early in the writing process, I was already thinking about how 'loud' to be in my memoir, how to write about the too-muchness of borderline personality disorder without making the book feel like too much to bear for the general reader. How much to show, what to reveal - it took a long time to adjust those levels in my own manuscript.

I have always admired authors of literary nonfiction who were willing to reveal more than is usually considered 'polite' or appropriate, feminist authors who are willing to put themselves in unflattering lights in order to explore some under-attended part of human experience. There is a book on feminist performance art called The Explicit Body in Performance, by Rebecca Schneider, where she theorizes a similar theme in more visual art forms, looking at the work of Carolee Schneeman and other artists who put their bodies into the performance in unexpected ways to jar the viewer into some new understanding of their subject matter. I think about this idea of 'the explicit body in performance' when the question comes up, as it often does at readings from Girl in Need of a Tourniquet, about how I felt about revealing such private things about myself (obsessions, indiscretions, etc.) in such a public forum. There is a reason why I include scenes and details that might strike people as too embarrassing to share, and the reason has to do with conveying the process of how I came to understand that something was psychologically wrong with me. It is not about exhibitionism, which is something I think non-borderline readers might assume, but rather about the creative benefits of borderline disinhibition.

All of this was on my mind as I read your book and encountered images of your self punishments (eating from a bowl in your room, sitting in a closet writing degrading words on yourself, and so on). I was especially interested in the last section of the book and really saw myself in the brief anorexia narrative, especially in your choice of not presenting the eating disorder as a big catastrophe but rather just another form of BPD, but I also liked the willingness to reveal the total catastrophe of the suicide attempt on camera and to permit the excess of BPD emotions to show.

My main question to you has to do with these choices: What was your process of deciding what to share, what not to share, and what tone to use when narrating your symptoms? Did you ever worry about being 'too' loud in the house of yourself?

SP: I have an MFA in electronic art with an emphasis in installation and performance, and I love that book by Rebecca Schneider!  I had it on my shelf in my studio, and while I was working on my thesis I went back to it many times.  I definitely consider all my work, writing included, as a tribute to the female performance artists who came before me - Karen Finley, Marina Abromovich, Tracey Emin, Laurie Anderson. Tracey Emin in particular. The piece I'm thinking of is the one where she set up a tent in the gallery and painted the names of all her lovers all over the inside. She also painted things they'd said to her, one of which was 'psycho slut.'  
Another artist whose work I love is Pipilotti Rist. She made a video where she's skipping down the street swinging a giant flower by its stem. It's lit very dreamily, in slow motion, and she's wearing a frilly dress. She turns the corner onto a sidewalk next to a line of cars, and she swings the flower into the windshield and shatters it. Then she goes down the street shattering the windshields of the rest of the cars. I think both of these pieces are so transgressive, because they're women willing to express the worst about themselves.  
They're revealing the two most shameful states of BPD: obsessive love and rage. Not that I am in any way pathologizing the artists or the art, of course.  These are also the states people are most afraid of and threatened by in women. So when choosing how much of myself to reveal in my book, it was always all or nothing.  LITHOM may be (though I certainly hope it isn't) the only book I ever publish, so I was going to get it all in lest I never get another chance.  And everything's relative when you've tried to kill yourself on the internet.  I finally had a chance to tell my side of the story and let other strange girls realize they weren't alone, so I went balls to the wall.
You have to. BPD is a crisis.
Especially in small towns where there's no DBT or decent pharmacologist for miles. People are dying. Teenagers are killing themselves and each other, and I'm up against assault weapons and pro-ana websites and cutting communities on LJ where they compare pictures of themselves slashed and bleeding, so I have to be equally loud. Kids nowadays have no escape from their bullies; the bullies can come into their bedrooms through their phones and Facebook and email. They're in the tent with Tracey Emin, in their most private and intimate space, with the words 'psycho slut' written on the walls. They're in the closet with me covering their skin with Sharpies.
I was incredibly fortunate to have agents who were completely behind me and encouraged me every step of the way to write this book in my voice and my intensity. The first was Katie Boyle at Veritas. She signed me in '04 after reading a manic, scattered, angry version, and told me I had to get the meanness out.  The anger was fine, but I was being mean, and I had to write that draft and get it out of my system. Then I took a memoir workshop with Mindy Lewis, the author of Life Inside, and I started to turn myself into a sympathetic character. That took two more years and about three more drafts. I wrote my book seven times from start to finish, with only very small sections carried over. 
Katie had to take time off for health reasons in '06, and she gave me permission to find another agent. We have remained great friends and still talk every few days, but I think at that point she was exhausted with me. We'd been through fire together. I'd bled all over her and completely invaded her boundaries. Halfway through our time together, I overdosed, ended up in the hospital for the last time and then finally started DBT. She saw me at my most out-of-control, but she never stopped believing in the book. My second agent was Penn Whaling. She and her boss Ann Rittenberg have been full-on gung-ho supportive of me since day one, and they're delightful, intelligent women who are passionate about making good books. I've been on my best behavior with them and have been respectful of their boundaries, because I lucked out when I found them and I don't want to fuck it up. Same with my editor, who is very no-nonsense and would not for one second put up with my psychic bleeding. She made me scream into my pillow many times, but I by god kept my screams contained to my pillow and did the work she asked for, because being published by Norton is a tremendous honor and I don't want to fuck that up either. And thank god I found all of them during and after DBT, because that is the one and only way I had the non-fucking-it-up skills. 

MLJI'm so impressed that you wrote the manuscript seven times, and that you deliberately worked to get the meanness out of it. I think mine remains sort of mean, and a lot of the meanness is directed at myself, like I went so far in the opposite direction from my original work of explaining my good intentions that I ended up draining them from the book, focusing so much on resisting self-deception that I produced another self-deception, one where I was only ever wrong and bad. An example would be the line where I describe comforting my youngest sister and then immediately undercut it by saying we were 'two losers clutching each other in the dark, calling it a hug.' But the truth is, it was a hug, and I was comforting her, and myself. Somehow I couldn't leave the good intentions in the book, like I didn't want to get caught thinking too much of myself, so I rushed to say the negative thing lest anyone think I didn't see its possibility (I struggle with that in everyday life even now). I would love to hear more about the workshop with Mindy Lewis. How do you go about turning oneself into a sympathetic character?  

SP: I think the question of how to make yourself a sympathetic character in memoir is such an important one. I'm thinking of Elizabeth Wurtzel's books, Prozac Nation and More, Now, Again, and how much flak she's taken for the fact that people don't like her as a character. I have to admit I was one of those people because she was writing from a place of unappreciated privilege and because she disses body modification even though she has tattoos and piercings, although I absolutely give her props for being willing to come out about her mental illness at a time before mental health memoirs became popular.  
One of the ways I made myself a sympathetic character, one of the ways I differentiated my book from others in the genre, is that I wrote about what it's like to have the odds stacked against you as far as class, educational opportunity, and wealth. I wrote about the struggle of dealing with the health care system when you're broke and uninsured. Other broke, uninsured people were looking for themselves in a memoir, so that's the book I wrote. That's the story I have to tell.
However, if there's one thing I've realized in the year and a half since LITHOM was published, it's that books are mirrors. There are always going to be people who hold your book in their hands but make up their own narrative as they read your words. Because many of our readers are struggling with emotional issues they may not be ready to face, they'll project onto you things they don't like about themselves. One reader wrote a review of my book saying that it was interesting to read the story of a woman with bipolar disorder who was more manic than depressed. I think I make it very clear in the book that I struggled with depression long before I struggled with mania, and to a much greater extent. I also clarify that I doubted the bipolar diagnosis (I have since dismissed it entirely) once I was diagnosed borderline. But that woman may well have been bipolar and had more manic episodes than depressive, and if that's what she needed to get out of my book to help or comfort herself, so be it.  
I've also been taken to task for being dismissive of the South, for thinking I was too good for the place I came from. I don't think that at all, but I pull no punches about what it felt like to be bullied by Christians because I didn't believe in God, or by cheerleaders and jocks because I was smart and dressed like David Bowie.  I talked about the pain of longing for more educational opportunities than my hometown could offer. That was my experience of that place, and it would have been disingenuous to say I was happy there. If that's not the reader's experience, fine. But my book's not for her, it's for kids who want to hurt or kill themselves because they're atheists queer hyperintelligent isolated in places like that. A gay boy who's now being bullied at my old high school wrote and told me I gave him hope. When I hear from those kids, it makes all the criticism completely irrelevant. One of the things DBT helped me come to terms with is that not everyone's going to like me, and that's fine 
Also, it's really important to think of yourself as a character, instead of an angry ball of pain out for vengeance. I wrote about myself as a strange little kid, which is a character readers tend to love, from Scout in To Kill a Mockingbird, to Frankie in The Member of the Wedding, to Matilda in Matilda. We relate to those characters because everyone knows, to some extent, what it's like to feel that others don't understand you. Whether you're the artsy kid who feels too ugly to fit in with the cheerleaders or the cheerleader who feels too pretty to be taken seriously, we all know about being misunderstood. Finding the universal truths is how you make yourself relatable to the reader. As William Faulkner said in his Nobel acceptance speech, what makes a good story, a sympathetic character, is 'the problems of the human heart in conflict with itself . . . Only that is worth writing about, worth the agony and the sweat.' The story he must tell is one of 'the old verities of the heart, the universal truths . . . love and honor and pity and pride and compassion and sacrifice.' Those are the things we all feel. How to feel those things fully and unashamedly, those are the questions all readers want answered. It is our job, our responsibility as writers, to give them that.

MLJ: I posted a question in my last blog entry: What is blocking the thought of borderline pride? What is your reaction to the idea of BPD pride?
SP: I don't know that I'm proud to have BPD; it's just a thing that is. I do, because of my own experience of it, think it's an illness, and it's caused way too much pain and trauma in my life and those who love(d) me to consider it an asset. Now that I've learned to manage it, I appreciate the intensity of my ability to love and feel joy, and I am thankful for the traits that so often go along with BPD, namely creativity and wit. But I don't think I have those traits because of BPD, I think I have them alongside BPD. In other words, this mental illness does not give me the things I like about myself. Instead, they run concurrent, and I struggle to harness them because of the guilt and shame I feel about things I've done in the past. There will always be that little voice telling me I don't deserve success, that I instead deserve to spend my life punishing myself and denying myself happiness because of my previous terrible behavior. That's the central struggle of my life. There is always a mourning for the time I wasted being sick and a jealousy of the people who got treatment earlier than I did and therefore had those years. I compare myself unfavorably to others who spent that time achieving things, and, at 41, feel that I am very much behind. If there's something I'm proud of, it's that I'm still alive despite this, and that I found the self-awareness and humility to get through DBT because I so desperately wanted to live instead of die.

MLJ: Pride in still being alive. I like it. So what's next for you as a writer? I believe I heard you say you're working on a new book. And what else are you up to these days? 

SP: Oh god, the new book! I'm fighting my way through a serious bout of writer's block. (Does any writer actually like writing?) It's a Southern Gothic novel set in 1980s Arkansas. It's about ghosts, the Cold War, numbers stations, analog technology, and Chernobyl.  The brilliant Lance Vaughan, whose blog, Kindertrauma, you should read (but only when you have a million hours to spare), is illustrating it with his gorgeous, creepy paintings. There are lots of footnotes, mostly about horror movies. It was inspired by the three best books I read last year: Iodine, by Haven Kimmel, Cruddy, by Lynda Barry, and House of Leaves, by Mark Z. Danielewski. Took me three tries over 10 years to get through the last one, but it was worth the frustration. As for what else I'm up to, I recently moved from NYC to DC, where people talk about their security clearance at dinner parties. It's pretty weird the first time someone casually mentions that they work for the CIA. I work as a speaker for the Active Minds speakers' bureau, educating folks about BPD, suicide prevention, bullying, and the difference between body modification and self-injury (in other words, climbing up on my soapbox for money, which, booyah.) As I write this, I'm on the Metro on my way home from teaching my first writing class to high school students as an instructor for Writopia Lab, my other (awesome) job. When I'm not writing, teaching, dancing, reading about nuclear holocaust, or proselytizing about DBT, I'm working my way through every Tim Minchin video on YouTube. He's my non-Stewart Copeland imaginary boyfriend. (Laurie Anderson and Annie Lennox continue fighting to be my girlfriend. Oh, the drama.)

Sunday, May 6, 2012

The Unthinkable Thought of Borderline Pride

Neurodiversity logo
As I said on Facebook earlier today, I am still sorting through the idea of BPD pride and recognizing BPD as a form of neurodiversity. 

This is not to say I'm overlooking the negative sides of the disorder, but that I see value in shifting the paradigm from an illness model to a disability model, and then using the path established by disability studies to make our assets and surpluses as visible as our impairments and deficits. 

It is a complex balance to strike because I don't want to underemphasize the fact of psychological suffering in the lives of borderlines, and sometimes I find it useful to describe BPD as a kind of chronic illness, so there is no one single way to conceptualize the condition that works for all purposes and in all contexts. I'm less interested in proposing borderline pride as the new or best or right way of looking at BPD and more interested in noticing how difficult it is to form a thought about "borderline pride," how unthinkable it is under the existing conditions of knowledge about BPD. 

When something seems to be unthinkable, according to feminist epistemologists like Nancy Tuana, it is sometimes because there are biased forms of knowledge that get in the way of the blocked thought. 

What is blocking the thought of borderline pride? 

What might the phrase mean? Is it pride-in-being-borderline? Is it pride-despite-being-borderline? How might we distinguish it from BPD grandiosity? Or BPD complacency? Does BPD pride make sense in the way that autism pride or Deaf pride does? Or is it nonsensical in the way that cancer pride might be? (As soon as I wrote that sentence, I googled  "cancer pride" and discovered the Bald Is Beautiful campaign.) 

Bald Is Beautiful T-Shirt

If cancer pride exists, it is even more difficult for me to understand why BPD pride is so unthinkable. Still, cancer pride and BPD pride tend toward a focus on pride-in-recovery or pride-in-survival, unlike autism pride and mad pride which foreground pride-in-alterity. 

I would like to see a form of BPD pride based in the disavowal of stigma. The fact that BPD pride is difficult to think - that it feels, in fact, unthinkable - is an index of the depth of the stigma, and therefore a marker of the necessity of BPD pride. One message of BPD pride might be, "I have it, I am not ashamed of myself for having it, and I feel compassion for and community with others who also self-identify as borderlines." BPD pride might say, "It is normal to experience pain, suffering, illness, and setbacks. It is not a sign of monstrosity. It is not a sign of being a failed human being." 

Rainbow colored balloons tied to
bronze statue of a woman dancing.
Spartanburg Gay Pride Parade 2011
(Photo Caption: Charles Reback)
In the world of queer theory, the pride/shame binary has been rejected, a fact that is unfamiliar to the general public, which is still entangled in fights against gay rights (see the current fight in North Carolina around amendment one) and fights for gay visibility (various towns continue to inaugurate gay pride parades, as my own town, Spartanburg, did three years ago in 2009). In the context of sexuality, what lies beyond the pride/shame binary is a more complex look at difference (can we handle the fact that people are radically different from each other?) and sameness (can we handle the fact that people are far more similar to each other than our categorical thought processes tend to reveal?). In the context of disability, those same questions about permission for radical difference and recognition of unmarked similarities apply. 

I think BPD pride is a thought worth thinking. 

I also think it is not the desired endpoint of the conversation.

Tuesday, March 6, 2012

Borderline Voices Project

I continue to be fascinated by the proliferation of memoirs, scholarly texts, and cultural projects dedicated to reoriented the public understanding of autism. And also, I'm a little bit envious, to be honest. Where, I wonder, is the borderline personality pride movement? Where is our creative intervention in the public understanding of BPD? What would a Borderline Voices Project look or sound like? Is it possible to take pride in oneself 'as a borderline,' in the way that Donna describes her pride in herself as a person on the autism spectrumI spend so much time reflecting on what I don't like about my borderline-ness, alternating with fears that borderline personality disorder doesn't really exist, or shouldn't really exist, that it has begun to feel like I'm having a borderline reaction to my borderline personality, with a heavy emphasis on devaluation. 

I'd like to put the shame and the anxiety on the backburner for a while and redirect my own focus to (1) exploring the positive side of being borderline, and (2) promoting recognition that 'borderline' is as true and real, yet also as historically situated and socially constructed, as autism is. (See "Autism as Culture" by Joseph N. Straus in The Disability Studies Reader on this point about autism as socially constructed.) I'm going out on a limb to say borderline personality warrants equal attention to these other, more positive ways of representing the benign neurodiversity of borderline personality

Toward that end, I'd love to hear from the borderlines on the question of borderline pride and borderline realness. Let's get this Borderline Voices Project started. Post your responses, send video blogs, or what-have-you. 

What do you like about being borderline? 

What are your positive borderline traits? 

What is there to say about borderline personality besides the fact that it hurts? 

Is crip pride applicable to BPD? 

I did a brief internet search and turned up one tumblr post on fuck yeah mad pride that sounded promising, but here's how it begins: "living with borderline personality is the most awful thing I have to deal with." Hmm. Truly, there must be more to the story of borderline personality disorder. It can't all be reduced to the genre of horror. 

Sunday, April 3, 2011

Jane Sutures It Up; or, Can You Have a Personality Disorder and Be a Feminist Too?

A reader recently wrote to me in a mixture of admiration and distress over her experience of relating strongly to my first book, Jane Sexes It Up: True Confessions of Feminist Desire, and again to my most recent one, Girl in Need of a Tourniquet.  She loved the bold feminist protest of Jane and the raw psychological wounds of Girl.  In a voice not unlike my own as I sorted through the conflicting and confusing evidence of my relationship history in the memoir, she wrote to ask, What does this mean?  Which one is true?  Who was good?  Because I found her inquiry so challenging, I wrote back to ask if I could take some time to think it over and answer her on the blog.  

She said yes, so here goes.

Merri Lisa,
Congratulations on your great new book! I finished it a few days ago, and I wanted to write and say how much it moved me. The huge life changes that you’ve gone through were obviously shattering, yet they gave you such amazing insights. The suffering you describe was tough to experience vicariously, but your strength and bravery that were ultimately conveyed were inspiring.

You have no idea how many people I convinced to read JSIU after I discovered it in 2003. It sparked many intense and fruitful dialogues with my feminist- and non-feminist-identifying girlfriends, and even my boyfriend.
As I just said, I absolutely loved Girl, but it seemed like it was written by a totally different person. My friends and I responded deeply to Jane (all the essays, but especially the ones you wrote) because its ambivalence about men, gender roles, and feminism reflected our inner tensions and doubts. We identified completely with your searching for a different kind of heterosexuality. Your book embraced both the dangerous, unruly rawness of desire and the essential truths of feminism.
So I guess I’m left with the question of what you see when you look back at your earlier work. Is there something other than pathology to be salvaged in Jane? When you think back on how you captured contemporary girls’ dissatisfaction so poignantly, do you see anything more than just symptoms of borderline personality disorder and/or repressed lesbianism?
[Then I wrote to ask for more details on the comparison . . . ]
The differences I see in the two books have everything to do (I assume) with the changes that have happened in your life in the past five or so years. Three big ones: the BPD diagnosis, coming to terms with lesbianism/coming out, and getting married. Girl is about these circumstances, the revelations they brought, and how you still struggle with those revelations. To me, it reads like a chronicle of your 30s, while JSIU was a chronicle of your 20s.
I'm wondering about how you connect these two chronicles. Is the sole connection a therapeutic narrative that finds in Jane a repository of symptoms of BPD? Should young women who see themselves in your Jane essays get therapy, stat? :)
Again, thank you for ALL of your beautiful books. Thank you for struggling through the trauma to reach healing expression.

Amanda's questions zero in on precisely the most complex philosophical work in front of me these days as a self-identified queer crip academic feminist person-with-borderline-personality-disorder.  

  • How to write about female psychosocial disorders without reinforcing sexist stereotypes of women as inherently crazy, irrational, excessive, and generally off our rockers.
  • How to make nuanced distinctions between the feminist protest of asymmetrical and otherwise unsatisfying hetero-relationships and borderline styles of reaction to distress, which are markedly disproportionate and self-defeating.  
One might say of the borderline personality what Melanie Klein (via Joan Lachkar) says of the patient in a paranoid-schizoid position: 

She stands up for herself in bizarre and inappropriate ways.

Such concerns will be at the center of the scholarly monograph I have begun to imagine, where I will theorize in more detail the movement between shoring up identity categories while simultaneously calling them into question, staging an encounter with stigma in order to loosen its hold on the category of borderline personality, and negotiating between the perspectives of feminist critique and those of 'crip' critique to expose a gap between them that resembles the gap Cheshire Calhoun reveals between 'feminist' and 'lesbian' viewpoints on matters of sexuality.

The decision to write Girl in Need of a Tourniquet was prompted, in a way, by my realization that the bad feelings described in "Fuck You and Your Untouchable Face: Third Wave Feminism and the Problem of Romance" (chapter 1 in Jane Sexes It Up) were coming up in similar ways in my lesbian affair, a realization that definitely made me question my insights in JSIU for a while.  (Maybe the problem wasn't the guy.  Maybe it was me.  Why did I always take the faucet end of the tub after all?  My capacity for self-subordination outstretched the influence of male-dominant couplehood dynamics.)  Gender roles were no longer the obvious culprit, so I dove into the wreck of my personal psychology, family history, and ungrieved losses, leaving feminism behind for the time being.  

Yet I always conceived of this memoir as a form of feminist social commentary.  

In preparation for writing the book, I took a course taught by Deborah Siegel and sponsored by the National Women's Studies Association on how to write book proposals for trade publishers called Making It Pop, a course with the explicit aim of educating academic feminists on the practical skills of reaching a wider audience rather than restricting our conversations to the smallish world of academic journals.  In short, the feminist cultural work of the book as I imagined it had to do with countering misogynistic and mentally ableist portrayals of the borderline personality woman as 'psycho girlfriend,' a la Fatal Attraction, Play Misty for Me, and, for a more lighthearted demonization, My Super Ex-Girlfriend.  I even shopped the book to agents and publishers under the title Psycho Girlfriend Apologia for a few months.  I hoped to contribute a humanizing portrait of borderline personality disorder as a mishmash of trauma reenactment, attachment disorder, and emotional dysregulation, and to suggest that what appears irrational in her behavior has a persuasive logic to it, the flawless logic of the neurotic to borrow a phrase from Karen Horney, which is perfectly pieced together but rooted in paranoid delusions and ego fragmentation.  

After spending the requisite period of time worrying that the new book reveals the old book as precisely such a delusion, the fog of self-doubt lifted, and I saw a very different relationship between the two.  

Far from undermining the feminist analysis of hetero-patriarchal romantic narratives, power dynamics, and gender roles that appears in Jane Sexes It Up, I believe Girl in Need of a Tourniquet excavates the psychological dynamics that produced in me a hypersensitivity to the insults and injuries that come with the work of feeding egos and tending wounds, the emotional labor, that is, of hetero-romance.  

(Whenever I write or teach about hetero-romance, I find it necessary to pause and explain that I don't mean to suggest that same-sex relationships are blissful or free of conflict.  The point I'm making by identifying the subject of hetero-romance is not about drawing a contrast between straight and gay relationships, but rather it is a way to emphasize the social constructions of heterosexuality as a form of desire structured by the eroticization of gender inequalities.  Now back to our regularly scheduled programming.)

It is my borderline personality that made me feel the discomfort so acutely that I was moved to produce a critical anthology on sexual politics and third wave feminism.

It is my borderline personality that works like a forked branch vibrating over buried springs of fresh mountain water, leading me to wells of emotional intensity and, at times, emotional inequalities running beneath the surface of a relationship.  

This view of borderline personality as emotional giftedness works in important ways to balance the usual understanding of borderline personality as emotional dyslexia.  My therapist said many times that borderline personality comes with gifts as well as challenges, but the public sphere has rarely made space to address borderline gifts of creativity, perceptiveness, empathy, and expressiveness.

So, should fans of Jane Sexes It Up seek help immediately for borderline personality disorder?  Is there something besides pathology and closeted lesbian desire to be salvaged from Jane?  

To the first question, I guess it depends on what parts resonated with you.  If it was the longing for a more equitable sex life, then no.  If it was breaking your favorite wine glass in the sink during a fight, then maybe therapy would be worth a try.  (What needs fixing is not the anger but the management of anger.)

To the second question, I have to admit that when I reread my chapters in JSIU now with almost a decade since its publication, I draw little smiley faces in the margins next to the previously unrecognized traces of lesbian sexuality and borderline psychology in that narrative.  Those things are definitely there.  But I consider them the queercrip excess of Jane Sexes It Up, a bit of subject matter spilling over the top of its main ideas about queer feminist heterosexualities, not the 'true' or 'real' story beneath the false consciousness of feminist critique.  

Towards the end of chapter 1 in JSIU, I asked the question on so many undergraduate Women's Studies students' minds: Can I have a boyfriend and be a feminist too?  And I offered a tentative 'yes' to acknowledge the difficulty of reconciling feminist politics with hetero-desire while encouraging women to try to do so anyway.

Now a parallel concern is unfolding in reader and audience responses to Girl in Need of a Tourniquet:
  • Can I have a personality disorder and be a feminist too?
  • Can I admit to psychosocial disability and interrogate misogyny, able-ism, and medical authority at the same time?
  • Can I claim the label of borderline without signing away my rights to a feminist perspective on relationships that drive a girl crazy?
Again, I'm gonna say yes.  

Tentatively.  Critically.  Self-reflexively.  

The path is unclear, but I think I can get there from here.

Thanks for the great questions, Amanda!  

Tuesday, March 1, 2011

March Madness

A lot of questions have been coming my way about the problem of gender bias in borderline personality disorder diagnoses, and in honor of today's kick-off to Women's History Month, I offer this blog post not as a response but as an invitation to begin a collaborative inquiry.  Let's figure it out together.  Two components of gender bias stand out immediately: (1) the disproportionate diagnosis of women as borderlines, and (2) the overlap between borderline personality traits and traditionally 'feminine' traits.  A number of important feminists have worked on the question of how psychiatric labels have been used to subjugate women (Phyllis Chesler, Jane Ussher, Jean Baker Miller, to name three out of a throng of feminist scholars).  A smaller group of feminist disability theorists have pushed back against this feminist renunciation of psychiatric labels, advocating for the labels as 'enabling fictions' that provide us with a useful way of understanding and describing psychological distress, not to mention an avenue of access to social and medical support (mainly I'm thinking here of Andrea Nicki's article, "The Abused Mind," but there are others working along similar lines).  

In the specific context of borderline personality disorder, Dana Becker has advanced a strong feminist critique of BPD, a condition she says is "arguably the most pejorative diagnosis of our time," so I'm pasting a segment of her work below (pulled from the website for the Association for Women in Psychology).

Let the conversation begin!  

Is borderline personality disorder a big ol' sexist ruse?  Does it have any liberatory dimensions worth celebrating? 

Borderline Personality Disorder:  The Disparagement of Women through Diagnosis

Dana Becker, Ph.D.  Professor, Bryn Mawr Graduate School of Social Work and Social Research

Borderline Personality Disorder (BPD) is currently defined in the Diagnostic Statistical Manual of Mental Disorders as a persistent pattern of instability (both personal and interpersonal) and impulsivity. Its symptoms range from self-damaging and suicidal behavior to intense mood reactivity, feelings of emptiness, and problems controlling anger.  It entered the DSM in the 1980 edition and is currently the most frequently diagnosed personality disorder.

The primary characteristic of any personality disorder is said to be its stability over time, but as described in the current DSM-IV-TR, BPD is characterized by instability—of identity, of mood, of behavior — and there are well over 100 ways to combine its symptoms that qualify a person for the BPD diagnosis. Given the diversity of its symptomatic picture, many, even in the psychiatric profession, have had difficulty conceiving of BPD as a single disorder. According to the DSM-IV-TR, about 75% of people diagnosed with Borderline Personality Disorder are women.  This was not always the case.  BPD criteria have been altered appreciably over the past fifty years to include more and more symptoms related to emotion, accounting at least in part for the sex bias inherent in the diagnosis.  Many researchers have challenged the validity of BPD, some concluding that BPD has become a catch-all label given to people, especially women, who experience acute sadness, emptiness, and emotional reactivity (particularly in the form of rage). The BPD diagnosis overlaps with other diagnoses such as Histrionic and Dependent Personality Disorders, which have been assailed for pathologizing behavior (e.g., dependency, seductiveness) that many women have been socialized to exhibit. 

Some women who have been diagnosed with BPD have histories of psychological maltreatment, neglect, and/or childhood sexual or physical abuse, and they may have difficulty expressing anger “appropriately.”  The ways in which “borderline” women express their pain has occasioned a vast clinical literature on how to treat “borderlines” and how to manage the strong emotions they may arouse in their therapists.  So-called borderline women are often described as angry and manipulative, when in fact they often act out because they do not trust that others will meet their needs if they express them straightforwardly.

The BPD diagnosis has been used in court to institutionalize and/or medicate women involuntarily, deny them custody of their children, and have their parental rights terminated.  Women diagnosed as having BPD have also frequently been discredited as witnesses in court cases involving rape or sexual abuse. 

Categorizing a particular set of disparate symptoms we now call “borderline” as a personality disorder encourages clinicians to focus on a particular style of coping learned under adverse circumstances rather than on the forms of abuse and emotional invalidation that originally made that style of coping necessary.  The association between women and what is arguably the most pejorative diagnosis of our time can create fear and avoidance, if not frank hostility, on the part of students of psychotherapy and practicing professionals toward a population of extremely vulnerable women.

Becker, D.  (1997).  Through the looking glass:  Women and borderline personality
disorder.  Boulder:  Westview Press.

________.  (2000).  When she was bad: Borderline personality disorder  in a
posttraumatic age.  American Journal of Orthopsychiatry, 70 (4), 422-432.

________.  (2001).  Diagnosis of psychological disorders:  DSM and gender. 

In J. Worrell (Ed.), The encyclopedia of gender, Vol. 1 (pp. 333-343).  San Diego: 
Academic Press. 

Becker, D., & Lamb, S.  (1994).  Sex bias in the diagnosis of borderline personality

disorder and posttraumatic stress disorder.  Professional Psychology:  Research and
Practice, 25,  55-61.

Brown, L. S. & Ballou, M.  (1994).  Personality and psychopathology.  New York:  Guilford.

Herman, J. L., Perry, J. C., van der Kolk, B. A.  (1989).  Childhood trauma in borderline personality disorder.  American Journal of Psychiatry, 146 (4), 460-465.

Nurnberg, H. G., Raskin, M., Levine, P. E., Pollack, S., Siegel, O., & Prince, R.  (1991).  The comorbidity of borderline personality disorder and other DSM-III-R Axis II personality disorders.  American Journal of Psychiatry, 148 (10), 1371-1377.

Ogata, S. N., Silk, K. R., Goodrich, S., Lohr, N. E., Westen, D., & Hill, E. M.  (1990). Childhood sexual and physical abuse in adult patients with borderline personality disorder.  American Journal of Psychiatry, 147 (8), 1008-1013.

Shaw, C., & Proctor, G.  (2005).  Women at the margins:  A critique of the diagnosis of borderline personality disorder.  Feminism & Psychology, 15 (4), 483-490.

Saturday, February 19, 2011

5 Things Not to Do When Someone Is Angry With You

Anger is scary.  I react to it like I'm a little kid and the world is ending.  It says 'grrr' and I turn to run away.  I want to learn to react like a grown up, with some grace and stability. 

Some segments below have been tailored from the original source to directly address PWBs (people with borderline personalities).

  1. Do not keep pushing and prodding for explanations or for conversation in general.
  2. Do not overcompensate.  Going to desperate lengths to fix the problem comes across as phony and makes the person more angry.
  3. Do not beat yourself up.  Tearing yourself apart will not improve the situation.  Resolve to yourself to make a change.
  4. Do not turn the situation around and get angry at them.  Resist the urge to make them the problem.
  5. Do not try to get revenge.  [I find this one confusing, like, what on earth kind of revenge would one take on someone for being angry, but 4 out of 5 helpful tips is not bad.]

  1. make a sincere apology
  2. give them space
  3. assure them you will be there when they are ready to work things out
  4. maintain emotional balance because falling apart is a flawed and unfair defense  (see previous post)
Specifically, this last one means you still have to eat, sleep, exercise, hydrate, go to work, and take care of any children or pets in your care, and, if possible, do extra little things to nurture yourself like bake cookies or go for a long walk and smell the warm spring air and accept a world where someone being mad at you can coincide with an unseasonably sunny Saturday in the impossible month of February.  

The world hasn't ended.

Watch Grey's.  Go to sleep.  Wake up tomorrow.  

Try again.

Pretty Little Defense Machine

One question that comes up repeatedly at public readings from Girl in Need of a Tourniquet goes something along the lines of 'how did you gain perspective on your own symptoms?'  They want to know how I am able to see through the haze of borderline cognition to see and accept my own complicity in the painful experiences I describe.  Most of the time the question makes me feel special, like I am a borderline savant who is gifted with insight into her own flawed perceptions, but the truth is that the insight comes from other people.  I see the emotions I'm experiencing as authentic reflected in their faces as false and strategic.  It has often been the case that I ran the other way when I saw this distorted reflection because I believed the person was seeing me the wrong way, and I wanted to hide to protect myself from the unfair picture.  

Occasionally I can admit that what they are seeing is accurate.  

Sadistic verbal attacks?  Yes, I've made a number of them.  

Wild swings from idealization to devaluation?  Definitely, over and over again. 

Paranoid misinterpretations of other people as hostile and out to get me?  Again, yes. 

Sudden frightening bursts of anger?  In the words of Natalie Portman, 'Don't test me when I'm crazy.'

The one saving grace in this awful picture is that once I see the behavior for what it is, I am generally able to change it.  I am holding on to this glimmer of hope today because I just saw a whole new set of personality disorder symptoms in myself, and they are not attractive and, more importantly, not functional.  Sometimes I wonder if maybe I made this whole  being borderline thing up.  Like maybe there's nothing wrong and I just went all Lauren Slater metaphorical on borderline personality disorder and used it as a narrative device to capture the feeling of being in extreme emotional pain, or worse, maybe I made it up as an excuse for bad behavior like one of my Feminist Disability Studies students said on Thursday about how people abuse diagnoses by using them to get away with things.  I said her comment was ableist.  I said those defenses are symptoms, too.  She looked frustrated.  I think maybe she wished I would hear what she was saying about the importance of accountability despite the diagnosis.

Just as I begin to wonder about whether my diagnosis is real (and just as I block a student from addressing crip accountability), the psychoanalytic karma fairy drops  a whole new load of 'behaviors' in front of me, and I realize something. You can call it being borderline or having a personality disorder or just being a bad person - who cares what anyone calls it, who cares where the line being normal bad person and abnormal bad person is when you hurt someone you love and then watch yourself like a character in a bad movie trying to get off scot-free instead of sticking around to deal with the pain and anger directed legitimately at you (at me) - it is not okay to hide out inside a false reality where you are  always seen as right and good, or, at worst, wrong but impaired.  

So anyway, long story short, I'm a defense machine, and I am pretty grossed out by my defenses right now, so in the interest of seeing them for what they are, and towards the end goal of us PWBs (people with borderline personalities) and people in general, really, being honest and accountable for our hurtful behaviors, here is the list I made today of my tactics for avoiding responsibility when I do something wrong:

  • crying when someone is mad at me so that they switch from anger to compassion
  • positioning myself as a martyr, encouraging them to take their best shot, like I am jesus savior good when I am really judas traitor bad, like I am somehow generously giving something up by facing my responsibility for their pain
  • describing myself as all bad (see above) so that others will rush in to say I'm not all bad
  • depriving myself of basic self-care (the long goodbye of the hunger strike, in Aimee Mann's words) as a kind of emotional threat so that my partner becomes afraid for my well-being and doesn't feel free to express anger
  • making it all about me, apologizing so that I can be forgiven, offering to do whatever they say so that I will be seen as compliant easy docile when I am really stubborn difficult recalcitrant, treating guilt like a hot potato I don't want to hold
  • lying (I won't pretty this one up with imagery)
  • writing a book or a blog post because I don't know how to be sorry in person
  • referencing a cool band or song in the title to cover up my emotional deficits with a veneer of hipness 

I kept my one-year-old niece last weekend, and I noticed she cried really intensely every time I told her no (like, no don't pull that drawer out, or no don't grab the dog's tail), and I sort of identified with her, thinking hey I don't like to be criticized either.  Crying is not simply the expression of pain and sadness.  Crying is a defense.  The thing is, she's one and I'm thirty-eight and acting like a baby.  Self-pity does not wear well at this age.  I'm still groping around for a model of what mature regret looks like, though.  

I'm hoping the people who follow this blog will explain it to me like I'm five.  

Draw me a picture.  I want to do better.