Real Therapy Is Hell -- But Worth It

I know I posted you the other day about leaving "all" the options open, that recovery is possible. And I still believe that it is -- in fact, I know that it is. It is, however, hard as hell. Absolutely hard as hell. Going to a therapist isn't enough. Unless someone is *very* committed to change, it could be costly (both financially and emotionally) and raise hopes for nothing. There is no way on earth that anything can be left "off the table" in seeking therapy to recover from something like BP. I mean absolutely anything.

The therapist I had was a very compassionate, patient guy. Exceptionally competent. Profoundly wise. Believed in me when I didn't believe in myself. And absolutely refused to leave stones unturned -- he could tell if I was holding something back or if I was being full of shit, and he called me on it, every single time. But, I was *open* to the process. I wanted to change. I did love my husband and didn't want to hurt him -- even though I did so many times. I, at the proverbial "end of my rope" had reached the point of desperation where I figured that if things didn't change -- I didn't want to be alive anymore.

So what did I have to lose by being open, and what did I have to gain by hiding stuff. Growing up in a pretty dysfunctional household with parents who had extremely negative views towards the mental health profession in general, I had this very distorted notion of what therapy was, what it would be like. My father used to always say that a person who was desperate enough to have to pay someone to talk to was pathetic indeed -- and I, for many years bought his view that therapists were no more than "mercenary friends." People that turned on the meter, sat back, nodded and "hmmm"-Ed for an hour, and basically spouted out nice little affirmations to let a patient know that whatever the problem, it was someone else's fault. The diametric opposite to the dark confessional I knew growing up Catholic.

Surprise, surprise, surprise! Sometimes after therapy sessions I scratched my head at how I could be paying big bucks (that I didn't really have) for someone to tell me everything I didn't want to hear. Far from being appeased, I walked out of there so pissed sometimes I could spit! During my first hospitalization, I had taken one of those fill-in-the-circles psychological profile tests. Little did I know the results would be handed to me at the end of my first official therapy session (right after I was released from the hospital.) Somehow, the little dots I colored led to this portrait of a raging woman with suicidal tendencies, manipulative, often seductive, selfish, at times socio-pathological, et al et al et al. My God, I thought, this is supposed to be me!

Did I sit there and calmly accept it? Think again. I was en route to my car on the lot, stopped by a pay phone and gave the good doctor a call... and a piece of my mind. "You rotten BASTARD", I cried through my tears, "What kind of bullshit is this? Did you read this crap? Manipulative, socio-pathological, selfish, raging -- fuck you, you asshole! Let me tell you a little bit about yourself, you son of a bitch!" Waiting, of course, for him to relent. Waiting for him to either be so intimidated by my rage and the fear of what I would do that he would somehow soften the blow or put a "spin" on the results. Waiting for him to start saying "nice" things about me to counterbalance the test results and make me feel better. Waiting for him to do what I know I could have gotten my husband to do. (And, as a matter of fact, when I arrived home, I got my husband to join on my side against this horrible "injustice.")

But my psychiatrist did nothing of the kind. As a matter of fact, he wasn't up for a discussion over the phone and would have it. All he said was "We can discuss it at your next session. "There won't BE another session, you sonuvabitch! I'm not gonna PAY to take these insults. What the fuck do you know, about ANYTHING? You're just a damned shrink -- you don't even have a real job. Screw you -- that was my last session. I'm quitting!

Well, a few hours later, I called back, talked to his secretary and verified that I *would* have a session the next week. (Dr. T hadn't canceled it anyway...) The man could lay the cards on the table. There wasn't a thing that I could do to make him paint a pretty portrait, to airbrush reality. He was patient, gentle and kind -- but he could draw the line. And, over the course of four years, we talked about absolutely everything -- things from my childhood, sex issues, self-destruction, inner emotions I was dreadfully ashamed to have. It was absolute hell. I ended up in the hospital twice more. Tried to starve myself, drove my car into every barricade on the parking lot, breaking every single one of them in half. Left unbelievably vile notes on the windshield of his car -- with threats and epithets and profanities. Left pictures of my children tucked under his windshield wiper along with a note that he had pushed me too far and if these kids ended up orphans, it would be his fault. Told him I'd report him to the psychiatric board and the hospital (of which he was psychiatric medical director) and accuse him of sexual abuse and make the charge STICK, going on the stand and lying without flinching an eyelash to watch him go down the river. (Charges, of course, that would be fully unwarranted -- he never so much as even shook my hand or hugged me -- he was a strict limits, no contact guy).

Dr. T never quit and never backed down, no matter what kind of shit I tried to pull. Then again, neither did I. Until, slowly over time -- LOTS of time, LOTS of sessions, tens of thousands of dollars later -- I didn't feel as compelled to do these things. I was willing to look at a lot more without resisting it. And slowly, I worked my way to recovery. Slowly, painfully, turbulently.

That is what you're looking at when it comes to true recovery and healing. That's the kind of process it takes. It's brutal and ugly and it ain't particularly easy on the significant either. When I left a session in that kind of rage, that rage stayed with me when I got home. But I was committed to being honest and candid, I was committed to sticking with it, I was committed to changing and getting better. I missed only one session in 4.5 years -- when I was running a 102 degree fever. My therapist had that same kind of commitment. As did my husband. It took every single one of us, the support of friends, and the kind eyes of a God I always doubted but now know to be a reality. If a borderline isn't willing to tell the full truth, isn't fully and 100% committed to the process, there's no way its going to work. No way. It's too hard. Just way too hard.

If the BP is only amenable to therapy as a means to appease someone else -- that isn't enough. It *has* to be self-motivated, it simply has to. It will take everything the BP has within them to withstand it. And I mean everything. If the BP is "shopping" psychiatrists or therapists to find a good rapport, qualifications -- in other words, for the right reasons -- fine. But if they start to "shop" them to shop around for the answers they want to hear, the answers they are willing to accept, the topics they are willing to discuss - forget it. The only effective therapists, I am convinced, are the guys who are willing to lay it on the line come hell or high water. Period.

I can see why a lot of borderlines hightail it out at the first signs of a therapist who isn't willing to bend -- one reads of BP's who go through 3, 4, sometimes a dozen therapists over time. It's no coincidence. BP's that do that are running. . . from the truth. Just like BP's that exit a relationship or marriage simply to enter another one, and perhaps another and another are doing the same thing. Running. Running doesn't help a thing, it only hurts. It buys time. But progress isn't made. The "flight" instinct is strong. The BP diagnosis is UGLY. Plain, flat-out UGLY. It's horrifying to read about. It's even more horrifying to look at the words and descriptions and realize that the BP they're talking about is YOU--I can't begin to tell you how horrible it is.

It's natural that, confronted with such things, any person is going to react pretty strongly -- and, in the case of a BP, there's plenty of ways to react that are eminently explosive. The temptation to run is overwhelming. But, as long as someone keeps running away -- running away from therapists, from marriages, from anything that reminds them of the ugly truths she or he doesn't want to face -- absolutely nothing can be accomplished. Therapy, at least for me, was like sitting on a surgeon's table, knife cutting away -- and being forced to watch every painful moment of it. With no anesthesia -- medications, perhaps, to make it marginally tolerable -- but nothing to dull the painful emotions. It's incredibly painful, and yet, if one cannot feel one cannot heal. A 4+ year heart surgery, dosed with the pain-dulling equivalent of Tylenol.

And, unlike a physical surgery -- it isn't enough to sit back and let the doctor do the work. Amidst the pain and the horror and the ugly reality -- a person has to actively participate in the process. There's no road map, no idea of how long it will take. No clear notion of what recovery is, or when it's reached. It takes, as my therapist would always answer to my desperate questions, as long as it takes. I know I've rambled on here. I've spoken much on-line of hope, of recovery being possible, of miracles happening. But I don't want anyone for even a moment to think that, somehow, the process is simple, passive or predictable -- it's hell. Pure, unadulterated hell. There's no other way to put it -- it's an arduous years-long nightmare that, hopefully, will have a happy ending.

But there are no guarantees. I also speak a lot of the vast difference between intellectual comprehension of all the pathologies, all the symptoms, all the highly-defined terms and feeling. Because, in my day, I searched through every book I could find, versed myself so well in the terminology that my psychiatrist once commented I probably knew a lot more about BPD and all its clinical ramifications and definitions that a helluva lot of therapists treating them. I wanted to find some step-by-step way that I could intellectually conquer my illness. Thinking, for some reason, that if I were to know all there was about it, immerse myself in this knowledge, I could become "wise" enough to overcome it. Dr. T had a good answer for that, too. No dice.

There wasn't a way, no matter how knowledge I accumulated, no matter how much I could recite the Axis-DSM backwards and forwards, that an intellectual recovery could be had. Intellectualizing, he said flat out, was a defense. Like raging and cussing and crying and self-destruction were a defense. To avoid, to run from, the work I had to do, had no other choice but to do if I were ever going to have real change, real recovery -- which is to dive right into that pool of reality, feel that pain, sludge through the mud, feel the pain, go through the hell and face those emotions. To dive in, without looking back, without any guarantees or timetables, without any idea of what to expect -- to be willing to bear all of that pain on trust. On faith. And, at least in my case, there were few things on this earth harder than to trust. Ultimately, I did trust, and, fortunately, in my case, the trust turned out to be warranted.