Let My Journey with BPD Be Your Guide (Not Your Blueprint)

I stopped counting inpatient psychiatric hospitalizations at 20. I don’t think I went 25, but I’m not sure. My first admission was in 1987 for anorexia, and my last was in 2014, following a suicide attempt.

I’ve come to appreciate the quality of the treatment I received and the opportunities afforded me, rather than focusing on a number. I consistently reflect on the extraordinary people who I’ve had the privilege and pleasure of knowing, both clinicians and fellow patients. There are individuals from both groups who remain in my life today, in various capacities.

My gratitude is ever present that I managed to emerge alive and content, with a life worth living.

The Beginnings

Diagnosed in the mid-to-late 1980s, when I was in my late 20s with anorexia, major depressive disorder and borderline personality disorder (BPD), it was a different world in psychiatry then. Managed care hadn’t yet determined the parameters of treatment and there was no Internet to research my diagnoses.

After being diagnosed with BPD following my second suicide attempt, I was transferred from the psychiatric unit at a Manhattan hospital to a hospital in the suburbs that had a long-term unit dedicated to treating individuals diagnosed with BPD. This unit was groundbreaking in that it had a new therapy called dialectical behavior therapy (DBT).

Despite the stigma that BPD carried in 1990, the staff on this unit wanted to work with us and were excited by the prospect of a community where the patients were immersed in DBT. I stayed on the unit for 10 months, until my insurance balked at paying for additional time. I was discharged to a DBT day program run by the hospital that was also for patients with BPD. I stayed for 18 months.

After leaving the hospital, I lived at a 24/7 supervised residence for three years. My counselor there had been a patient on the hospital’s long-term BPD unit for two years. She was studying to be a nurse at the time, and she became one of my early role models for recovery.

The Psychiatrist Who Changed My Life

In 2005, I abruptly quit taking all my meds. My group therapist referred me to Dr. Lev, a psychiatrist who specialized in a different type of treatment for BPD – TFP or transference-focused psychotherapy. The premise of TFP is that the relationship, or transference, between the therapist and the client holds up a mirror for all the other relationships in the client’s life.

Sessions with Dr. Lev left me in tears, and I relied on DBT skills to keep me from drowning in self-destructive behaviors. In the years spent working with her, I was able to explore feelings about issues I’d never revealed to anyone.

Gradually, I trusted her implicitly and believed her when she told me she could take whatever I threw at her. Over time, I understood she would not reject or abandon me.

Regardless of the modality utilized in therapy, research over the past 50 years has demonstrated that one factor, more than any other, is associated with successful treatment: the quality of the relationship between the therapist and the patient.

Each time Dr. Lev and I trudged forward into unknown territory, zigzagging ahead and often falling back, our bond became stronger. I don’t believe it was until about a year into our work together that she grasped how desperately ill I was. I was chronically suicidal, laying out detailed, creative plans. I lied about my anorexic behaviors. I diluted the efficacy of my lithium by purging with diuretics. I fired her. Twice.

Yet, she stuck with me, and for that I remain grateful.

Learning to Care for Myself

I never thought I’d be able to function in the world without relying on a therapist to talk with each week. At the end of 2015, I told Dr. Lev I wanted to spend the next year without therapy. We mutually agreed a year was appropriate. In our sessions, I was answering my own questions, with scant guidance from Dr. Lev. I’d gained insight into what my danger zones were and learned to spot the warning signs before self-destructing. What gave me the confidence to take a leap of faith in myself was that Dr. Lev told me her door would remain open.

In an eight-page letter I wrote to her, presented at our last session in December 2016, I wrote about the joy I was feeling, a word I’d never dared to think would enter my lexicon.

In 2017, I returned for several “booster” sessions. Then in May 2018, I suffered a stroke and predictably a post-stroke depression. When I was discharged from the rehabilitation facility, I resumed therapy with Dr. Lev to process what had happened. I recovered physically, but there were some residual cognitive deficits. I needed to work with her to accept I’d never recover my “old brain.”

I never married or had children, but my life is rich with relationships with family and friends from different aspects of my life. I’m fortunate to have found pursuits that excite me and fuel passions within, such as writing and realizing my potential as a growing entrepreneur.

In May 2019, one year after my stroke and five years after my last psychiatric hospitalization, I rescued a three-year-old lab-terrier mix from a kill shelter. Shelby and I were destined to be together. She can’t be an emotional support animal as she has a fear of being abandoned, and I have to assume she was abused — something I can both understand and relate to. Instead, I’m her emotional support person, and I can be responsible for her because I’ve learned how to care of myself.

Andrea Rosenhaft is a licensed clinical social worker in the New York City area. She is recovered from anorexia, major depression and borderline personality disorder (BPD). Andrea writes on the topic of mental health and recovery. She is the founder of the mental health advocacy and awareness organization, BWellBStrong, which focuses its efforts on BPD, eating disorders and major depressive disorder.