BPD or umempathetic psyhology?

Yesterday I was given a psychiatric evaluation and what I think is a misdiagnosis of borderline personality disorder. I am currently seeking out information about it – especially from people with BPD rather than clinicians who haven’t experienced it, but have outside observations. In this exploration, I am noticing the answers I gave to the evaluation that would have steered her in this direction, as well as making sense of some things that she said which seemed strange in the moment, and now I see why.

I think that some of the answers I gave could simply be interpreted in different ways, and without time to speak in detail (the entire relationship was 2 hours, and we will never meet again), once she got the idea of BPD, I think that bias led her towards the conclusion. Some of these answers were around …feeling chronically-misunderstood. The psychiatrist told me at the end that this was a common experience in BPD, but after a small bit of exploration, I think that this is more of a feeling of being emotionally misunderstood, when what I meant was what I think is the autistic experience of saying words that I think are very clear in meaning, and not being understood or believed. The belief part is about people not thinking that my affect matches my words. The understood part is like my actual words or thoughts don;t make sense to neurotypical people sometimes.

Then there were questions that I said I do experience something, but in retrospect, I may have been either interpreting the question differently, or trying to be fair by saying, “sure,” when I meant no…this is a weird motivation. Less about people-pleasing as it might sound, but from a place of fearing my own bias, and leaning the other way thinking that I could correct for it. A lot of them were wildly compound questions wherein the two or three parts didn’t even seem related and I was supposed to answer them all in one answer?

Upon reading the findings back to me, she said some things that surprised me, and I don’t know where she got them. For example, she asked me nothing about my relationships outside of family, but she told me that I indicated that I have problems with boundaries and relationships. Not only do I think that this is the opposite of my relationship experiences, but I asked several people if I display these traits, and they were pretty starkly in opposition. I don’t know how she came to think that, but I get told that I am really good with boundaries – particularly if they are explicitly-communicated and not just me guessing. I believe that she mentioned mood swings, which i don’t have. I do experience intense emotion, but it is not swinging around wildly. A mood usually lasts most of the day, with mild changes in response to stimuli. I often feel intensely sad, and so I nurture the joy and love – I romanticise them and hype them up so that I can enjoy more of my life. She also mentioned emptiness, which might be my fault, in misinterpreting a question to mean depressive emptiness, not a lack of self.

There is another tremendous weight on this assessment, which comes down to the cyclic pattern of mistrust between doctors and patients. I have had way more experiences of being disbelieved and dismissed as “fine” by medical professionals than of helpful ones…particularly harmful to me in the realm of mental health. In particular, last year I was searching for mental health supports because I was finally ready to try an SSRI for my 30-year-long depression, and that led me into seeing whether I could get any therapy options or other supports. I had a pile of appointments and referrals – usually they were suggested to me when I simply asked for my SSRI prescription to be renewed (not at my request), and I would temporarily get my hopes up that maybe there IS help after all, only to have them dashed when after asking me a bunch of invasive questions without warmup, they would drop me off a cliff, saying that I was clearly fine, and they couldn’t take me on, leaving me in the wreckage of the hope I had been building. So, after that stretch, I have felt like I had to get really pushy in my self-advocacy AND not give an inch on the severity of my existential agony, my burnout, my ability to cope forever and ever…etc. This is the cycle – because I have been disbelieved and dismissed so many times, I have to almost inflate my symptoms – I must relentlessly insist that things are horrible, and not admit that I also experience joy and fun and peace…because those are all results of my coping, and a lifetime of being denied help, and they are tactics that I have taught myself and cultivated…but they don’t mean that the other side is less present. And I won’t have my survivability conflated with wellness. I have just learned to allow both things to exist at once. So, because of being dismissed, I feel that I shouldn’t acknowledge my coping (because they see coping as a solution, when it is meant to be a temporary bridge to a solution!) and all of the work I have done on my own…so, technically, I feel dishonest, and there is the cycle – they don’t believe me, so I become dishonest in order to be taken seriously, and if they sense that I am being dishonest, they are affirmed in being suspicious of what patients say! And so, my personality is not represented in these one-time meetings, and I come across as a very stern and difficult and miserable person, simply because if I even admit that one thing is ok, everything else will be erased. I hate all of it.

Writing a blog post debunking my own challenging diagnosis does seem like a very defensive and unstable thing to do, but nobody reads this blog, so i am just processing my thoughts for myself here…somehow it works better for me than writing in a notebook.

reflections on growing up with the ADHD i didn’t know i had

They say that girls are underdiagnosed with ADHD because of socialized behaviours masking the symptoms and innate behaviours, and I definitely think I fit into that demographic. Anyone who knew me as a child seems surprised that I have ADHD because I was so reserved, tidy, bookish, careful, and fearful. On the surface, I appeared to do well in school, but the truth is that I was faking it, which was pretty easy, as long as I could control my attitude towards the teacher and material (The classes I did poorly in were the ones where the teacher didn’t like me, or i couldn’t mask my contempt for them). I definitely had other reasons to make myself quiet and invisible, but thinking about it now, I can see a lot more of what was going on in terms of learning, school, and behaviour.

I was trying so hard to be careful and hide or mask my ADHD behaviours because of shame. The anxiety over that was trumping the ADHD, in a way, at least in terms of priority. Managing anxiety is about immediate survival, and managing ADHD is more about learning ways to thrive in a long-term sense in a world not built for your brain. I was predominantly anxious, but probably because I was dealing with all of the struggle of not understanding things, not absorbing information, having a different learning style, feeling energetically out-of-control and knowing I was too much, and forcing myself to be very quiet because of it, etc., and thinking that I had to solve all of these problems alone, all whilst not letting anyone see how stupid I actually was. People have called me smart my whole life (1), which actually gave me a lot of shame, because it made me feel weird about how much I have struggled with concepts and don’t understand things, and made me feel like I was hiding it, even though it was only people calling me something I was not that made it seem like I was hiding it…as though I was ‘passing’, which was not through my own efforts, but in the end it has the effect of having to hold up the assumption made by others.

And forcing myself to be methodical, clean, careful, etc., was not just giving me anxiety, it was keeping me from finding ways to thrive with my kind of brain, because without knowing it, I was pretending to have the kind of brain it seemed like I was supposed to: i was leading an undercover life. It was suppressing my natural personality, humour, and other traits, and it was isolating me with all of these secrets and fears.

As I grew into my adulthood, even before knowing I had ADHD, I started to let go of that control, when I didn’t have to account to an abusive parent, and school, and to notice and accept how disorganized I was…how clumsy and loud and in-the-moment, unable to measure time, but able to let go of small things going wrong and immediately reroute and move on, etc., and eventually the chronic anxiety went away, and I learned ways to use and like, or accept those traits, or at least laugh at them when they are disruptive or annoying, instead of hiding or fighting them. I still get situationally anxious sometimes, but that seems very appropriate to me.

Sort of a side-note is that as a child, I was afraid to be too much: too loud, too extreme, too needy, because I was sure I was going to be beaten (I never was beaten, and my parent only used violence a few times, but I lived in a house where the threat of power-based violence was always hanging like a dirty smoke). So, stifling behaviours and symptoms was about more than not wanting to seem stupid: it felt like a survival tactic.

Now that I am 40, i am only now wondering what might have been different if I were diagnosed as a child. I feel that learning to find ways around everything that seemed impossible is a major contributor to being an adult who can’t get work that pays enough to do anything but get by…I had to choose the things that felt accessible to me, because most things seem impossible and foreign. This may have shaped my economic status as much as growing up in poverty did, in terms of access to education and opportunities.

Footnote (1): I don’t believe that intelligence is measurable, because it involves infinite variables: we are all intelligent in so many different ways from one another, and are each an intelligence-star made of thousands of intersecting rays…and furthermore, I think that when adults tell children that they are smart, they are typically seeing something in said child which they identify to be like themselves, and that is actually what they are praising: “you are smart, because you are like me!”

My Face

I have always called my face my superpower – it keeps people away from me. It’s not something I developed consciously, but likely over time, throughout my development as a human. It is, most essentially, uninviting.

I don’t want strangers to feel safe talking to me, because so often, if they do, it is I who ends up feeling unsafe, or disrespected, or like I have been forcibly made to be a prop to someone else’s agenda. I have been told by strangers that I’m a freak, that I should smile, and most unbelievably, that I’m ugly…many times. I can’t even imagine possessing a mindset in which I would consider approaching a stranger completely unprovoked to tell them that I thought they were ugly. It is truly astounding behaviour.

And so I have cultivated a face which does not invite approach or comment because the very reason I look different to people who want to comment on the way I look is that I don’t care what they think; I don’t like the way they dress either, and I don’t have any interest in them.

And in case you are wondering, yes: it does also often keep away people whom I want around, and I don’t love that…it feels like an injustice that in order to protect oneself from unwanted attention and even violence, one may feel they have to isolate themself…”themself” being me.

In addition to not wanting to be insulted, I don’t generally want much attention. As far back as I can remember, I just wish to be invisible until I am in a voluntary conversation with a person whom I actually want to talk with. I don’t want people to start conversations with me by asking me personal questions…by the by, you may have noticed that I likely start conversations either by supplying a relatively neutral anecdote, or by talking about myself, and this is because I am treating you the way I would like to be treated, and I don’t want to put you on the spot. This includes “how are you doing?” which I find incredibly invasive, since we are expected to never be anything but well, and even if a person is interested in hearing how you may not be well, you yourself may not be in a place where you want to talk about how you are not doing well. And now I have illustrated why my face is helpful with acquaintances, as well as strangers.

Finally, I know that I also developed this face as a protection from an abusive parent, who would try to read my face for clues to manipulate and exploit, and to see that they had made some progress with their attempts to control through fear, so before I can even really remember clearly, I was teaching my face to be a mask that hid my fear and hurt, and did not allow my mind to be read.

i only want to lay in bed all day and listen to podcasts….but first I have to think of a bunch of stuff i should be doing so that i can not do them whilst lazing…otherwise, it doesn’t feel as rebelliously enjoyable.

Epitaph

I’m gonna need a two-sided tombstone, because I can’t decide between these two epitaphs:

1. Were she man or machine? We hardly knew…
2. Fuck this shit, just let me put my dick inside.∞∞

Slow Like That

Sometimes I get really drunk and when I send my friends home, I make them promise they will call to let me know they got home safe…and then I completely forget about them – startled and wondering why my phone is ringing at 4:30am.

The Sound

discussing childhood perceptions:

“I definitely prayed for a sword – like to jesus.”
–jh