DBT and Me

“He who makes a beast of himself gets rid of the pain of being a man” – Samuel Johnson, 1809

Next to falling down a rabbit-hole, there isn’t much else that quite compares to being mentally ill; least not for me. I won’t give you a huge backstory about the suicide attempts and the self-harm and the countless nights alone, sobbing, and trembling like a dandelion in a hurricane. That kind of thing is readily available in anecdote after anecdote: just contact your nearest Borderline Personality Disorder sufferer. No; you don’t need to get the whole picture painted for you in glorious technicolour by me. The dawn is drizzling its grey light into the room I’m sitting in right now anyway. No colour today by the look of it in here – or in me. But that’s normal, eh. That’s the default setting. Ghosting your way through life, drifting along from people to people and finding out – if you get lucky – that the problem was never them, it was you. Familiar old emptiness. Friend to no-one, except us: the BPD diagnosed, fully paid up members of the ‘Society of the Inner Void’.

I got diagnosed about ten years ago. And back then the first choice for any Psychiatrist with a full caseload and a bulging morning clinic was always medication. The stronger the better. Sure, I’d been the recipient of ‘warm tea and sympathy’ counselling, and I’d even had a year (extended from six months because I either wouldn’t speak, or spent my sessions engaging in a war of attrition with the therapist) of Psychotherapy. But none of the stuff worked any better than the constant reminder from friends and family that I had ‘changed for the worse’. Eventually, the friends I’d grown up with trickled away down the BPD drain along with a marriage and a career. No, to quote a really bad song, the ‘Drugs DIDN’T work’. Nothing did.

But these things have a funny way of coming to a head, or some sort of messy conclusion, I’ve found. After a decade of complete misery I fell, by default, into the auspices of a different Mental Health Trust – here’s a top tip for changing the treatment lottery: move. So I had yet another assessment by yet another Psychiatrist. Don’t they ever trust each other’s previous diagnosis or simply read casenotes? Shit, you’d have to lever mine into a consultation room with a crane. But this time was different. Something was on offer that I’d never heard of before: Dialectical Behavioural Therapy (DBT).

I looked up DBT and tried to avoid all the bullshit on the internet, and the sob stories (like this one), and get right to the nut of the thing. Some weird American had invented a system of pseudo-Buddhism crossed with Cognitive Behavioural Therapy to treat BPD. On paper it looked a disaster waiting to happen to anyone with BPD and ten minutes to kill (no pun intended) in a room with someone encouraging them to imagine rocks falling through water in a lake. But what else did I have? Not friends, that was for sure. And not any decent way of getting through life without thinking far too much about hurting the worst monster on earth – myself. Nah…not this time. If DBT was really the evaluated, blue-ribbon treatment for BPD then I owed it to all the people I ever hurt to try and stay alive and make amends for all the shit I’d put them through. I signed up – this time not in blood – with mixed hopes.

That was an entire module ago – DBT is run in ‘Modules’. I’ve been on the programme for about four or five months (if you include the pre-treatment psychotherapy). DBT crashed into me like a lifetime smashing through every part of my brain at once, in a good way… Nothing could really prepare me for what it feels like to begin to understand exactly how screwed up I am; and that takes a lot of getting over sometimes, believe me. But I’m starting to change. And that’s, ultimately, all I wanted. Yeah, yeah, early days and all that, but I can’t believe I suffered for all this time when there was something out there that could have improved the last twenty years of my life. Instead, I moped around in a prescribed chemical fog, or blasted through life on the back of a mentally ill missile. A beast of a man in every sense.

I’m not sitting here trying to kid you that Nirvana for BPD nutters is really a DBT programme and lots of professionally guided introspection, but I sure as hell wish I’d known a little of what I know now when the symptoms of BPD started to chuck my life down the toilet and reach for the flush. I’ve still got over a year of DBT left. Six months ago I would never have thought I’d stay on something so intense and long-winded, but I can’t see me leaving. I’ve made friends with people on the course (least I like to think I have) and it is the single most positive experience I’ve had in treatment/life, full stop.

The quote at the top of this article is one that I used to think summed up how I felt about life; like an inevitable outcome of a predictable curse. It meant a lot to me. You could even say it was my motto. But for the last couple of months I’ve begun to think those words might not apply any more. I’m not sure what they’ll be replaced with, or even if they’ll be replaced at all, but something is changing, somewhere, for the better. I can’t give more praise than that, or express a greater sense of hope.

The Piano Teacher

The flowers were wrapped in a piece of white tissue paper my mother had been saving for an occasion, probably nothing like this one. I needed both hands to hold the bouquet. The door opened. The little old lady stood there smiling. ‘Hello, young man. Come in.’ The smell of lavender oozed out of her house.

‘Mrs Taylor,’ began my mother, but the old lady cut her off before she could launch into things properly.

‘Come inside and we’ll have a sit down.’

I felt absolutely nothing.

The Island had the decaying, weather-beaten, mood of somewhere that used to be a place people came on holiday by horse and carriage. Sand blew across the roads nearest the beach. Beach huts lined up in rows along the shingle and the better parts of the areas well above the high tide mark. The two remaining ice cream parlours smelled of chips and mice.

In the height of the summer the beach got moderately full with people from Colchester. The sand filled with fag ends and ring-pulls. The place was failing, growing old. What little life was left belonged to either the wealthy, commuters, or a small community of fishermen. There was a Yacht Club, a summer Regatta, and the large properties which had landscaped gardens running down to the beach held lavish parties until the beginning of September and the arrival of the onshore wind. All of it was in the hands of the richer folks, who treated the place like a private fiefdom. I’d swum in enormously expensive private pools, sailed on racing yachts owned by millionaire sons of wealthy stockbrokers who’s oak paneled offices in Mayfair I’d seen and felt overwhelmed in. The Island was an ancient last vestige of some place it used to be for everyone, not just the money-men.

Mrs Taylor lived in a modest wooden house at the end of a small road leading directly onto the sand. The street was quiet. On still nights she would have been able to hear the music and laughter from the parties further along the shore.  Her house was painted green. Shiny green. It looked like a box of wax ready to melt in the August noon. The prissy rose garden was older than she was. She was grey-haired, small, plump. She’d led a life as a Teacher at a Public School, retiring to the coast when her husband had died. For the past two years she had been my piano teacher.

We lived around the corner. I’d walk round there with my sister once a week for our piano lessons. I hated the piano. I hated every aspect of it; the music stank, the exercises were tedious, and the future – my future – didn’t lay anywhere near a piano. Even aged 7 I’d worked that much out. Mrs Taylor, deep down, knew all of that too. But she kept on. She wouldn’t let me be. I’d boil and boil, keeping a lid on the rage, while she chastised me for some stupid mistake or other I was making on an instrument I didn’t want to learn, in a house full of the 1920s that I didn’t want to be in. The sun always shone into the room during lessons, which only made me think of everything I could have been doing that was good instead of sitting bolt upright on that stupid piano stool and playing ‘The happy chipmunk’ for the three millionth time. I swore I’d kick the first chipmunk I ever saw when I got older. But I never said a word of it to her; even as I laid on the flowery carpet for that mind-numbing half an hour of my sisters lesson and waited for my turn. But then, one afternoon in summer, my 7yr old emotional regulation failed. Looking back, I think it was the first time.

My sister’s lesson was underway, the mocking sunlight was blazing across the doilies and china, the sound of the badly played piano was screaming through my brain. ‘Mrs Taylor?’

‘Yes, dear.’

‘Can I go to the toilet please?’

‘Of course, dear. You know where it is.’ She smiled and pointed down the hallway. I walked to the toilet and stopped outside the door. The piano was twanging and plinking. That was it. I’d stop these fucking lessons, the sounds, the whole bastard lot of it. I crept past the toilet, the flowery carpet masking my little footsteps, to her kitchen. I had to do something. Something bad enough to stop the hate and the anger. She had a large pan of liquid simmering on the cooker. Wispy steam gently rose up in front of shelves, above where…. there were – oh yes!- jars of what looked like medicine.

I pulled over a chair, stood on it, reached up, grabbed two or three jars of powder and quickly tipped the lot into the soup simmering in the pan. I took a wooden spoon that was laying on the table next to the cooker and stirred. It would kill her for sure. No more piano then. She’d die quick, by the look of her. She was almost there anyway. This would be quick and painless. No more piano for me. Or her.

I went back to the toilet, flushed it, then went back in for my lesson. I played the chipmunk song for what I thought would be the last time. Played it note perfect too.

The phonecall came the next day. Mrs Taylor wasn’t dead. The salt, sugar, and flour I’d poured into her soup had ruined her dinner, but she was none the worse for it. Salt, sugar and flour… In my head I felt sure it was medicine, poison even. My mother was angry but she didn’t tell my father, thankfully.

So there we were, sitting in the room with the piano the next morning. ‘What do you say?!’ my mother prompted.

‘I’m sorry, Mrs Taylor.’

She smiled. ‘It’s ok, Benjamin.’

It wasn’t ok. I was going to feel obliged to play that fucking instrument until the world ended. But the old lady had let me off the hook. Why, I don’t know. I never asked her. The next week lessons continued as if nothing had happened. I started to improve my playing, so she told my mother. I despised very second.

A few months later my parents bought a piano… I felt even worse.