TAHOE/TRUCKEE, Calif. — EDITOR’S NOTE: May is National Mental Health Month. As her contribution to de-stigmitizing mental illness and mental health challenges, Kimball C. Pier has shared a very personal story about her experience with Borderline Personality Disorder and depression. Dr. Pier is the founder of Sierra Agape Center in Truckee and with her husband Jon, founded the teen yoga program in local schools. She has spent 20 years as a psychotherapist practicing mainly in community-based mental health. An avid athlete, she was a professional distance runner for over 20 years. She has transitioned to competitive endurance cycling, trail running and is devoted to yoga and meditation. For her, healing is a daily practice.

“Dasoham” translated from Sanskrit means “Servant, I am.” I did not come to my work as a psychotherapist 20 years ago to “help” people.

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I felt a heart-centered calling to connect with people through hearing their stories and with the clear intention to share my own stories in a way that would open people into loving themselves, which is the nucleus of my work.

“Self-hatred reopens the original wound and makes me its slave — I’d rather be a servant of peace and love.”
Kimball Pier

In first asking, “How will my story benefit the listener?” I humbly offer the invitation to find the commons we share at a soul level. I am going to step out from behind myself and share a story with that very intention. It is one I have never shared publicly.

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DISORDERS OF PERSONALITY

In my profession, there is a nosology specifically for mental illness called the “Diagnostic and Statistical Manual of Mental Disorders” (DSM). There is a section called, “Disorders of Personality” grouped into types or clusters according to the features of each so-called disorder (I’m a little allergic to that term). As a psychology student at the University of Washington back in 1992, I became familiar with the DSM and looked to see if I matched criteria for any of the disorders.

As many students do, I worried I might find myself. At that time, Dr. Marsha Linehan, a psychologist in the UW’s psychology department was doing ground-breaking research into the origins and treatment of Borderline Personality Disorder. When I looked at its features, I was heartbroken and terrified. I saw my past self and some of my present self in that disorder’s criteria.

UH OH, IS THAT ME?

Frantic efforts to avoid real or imagined abandonment. Check. The trauma of being left behind and the subsequent stories of being easy to discard or dispose of have stayed with me since my first experience at age 2. (My mother traveled to Europe for six weeks at a time leaving me with nannies who were physically abusive. When I was 8, she developed a chronic illness which required almost constant hospitalization. I lived with constant fear that she would die. After my father left, I was her sole caregiver. She attempted suicide several times and succeeded several days after my 16th birthday).

A pattern of unstable and intense personal relationships. Mostly check. I found tons of unavailable men upon whom I projected my starvation for love. They usually ran as fast as they could in the opposite direction, thereby reinforcing my belief that I was not worthy of love. My extremes manifested in being Super-Girlfriend: I’ll do anything and everything better than any girlfriend you’ve ever had, to weeping, sobbing, heart-broken fixated weirdo who drove by his house every five minutes and wrote 70-page letters about what a terrible person he was for not loving me anymore. Wore all my friends out…

Identity disturbance: markedly and persistently unstable self-image or sense of self. Check. When a therapist told me to “focus on myself” or “learn to love myself,” I had no flaming idea what they were talking about and stopped going to therapy. It was only important the man of the moment loved me.

Recurrent suicidal behavior, gestures or threats. Nope. I just felt like dying. Definitely thought about suicide a lot.

Affective instability due to marked reactivity of mood — intense episodic depression, irritability or anxiety. Check, check and check. I’ve had a life-long relationship with intense episodes of severe depression, unrecognized as such until I had severe panic attacks in 1991 and couldn’t leave the house.

Chronic feelings of emptiness. Check. I couldn’t even fathom the idea of being of value or worth in my teens and early 20s.

Impulsivity in at least two areas that are potentially self-damaging.Check. In my teens and early 20s, my impulsive behaviors included addiction to starvation, my way of combating self-loathing; spending, abusive relationships, cocaine use and an attachment to alcohol. Over the past 30 years, those behaviors have been understood, tamed and healed, but the shadow is always there. Always. For me, healing is a daily practice of self-compassion and awareness; soothing the parts of me that remember past trauma and react to it almost automatically.

Inappropriate or intense anger or difficulty controlling anger. Check. My fear of being left behind or abandoned would often manifest as rage. Like an abused dog, I often reacted by lashing out.

Transient stress related paranoid ideation or severe dissociative symptoms. Mmmm … check. As a young woman, I panicked when my boyfriend left even for a few days. If he didn’t call every night, I called the sheriff to go check on him and make sure he wasn’t dead. I thought my behavior was reasonable.

‘Healer, HEAL THYSELF’

When I became a therapist, the prevailing attitude was (and still is) to label women like me, “A Borderline,” often in a sneering, belittling way. Those who struggle with the above described behaviors are mostly women with histories of trauma as children and teens.

Judith Herman, M.D., a renowned researcher and author on trauma and its effects writes, “This term (Borderline) is frequently used within the mental health profession as little more than a sophisticated insult. Patients, usually women who receive these diagnoses, evoke unusually intense reactions in caregivers. They are frequently accused of manipulation or malingering. They are often the subject of partisan controversy. Sometimes they are frankly hated.” (“Trauma and Recovery,” p.123)

I haunted self-help aisles of book stores reading about abandonment, trauma and all the rudimentary survival skills children develop in order to cope with abuse and trauma — sexual, physical and emotional abuse, neglect, exposure to violence, frequent and sudden changes in the family due to poverty, drug abuse and/or mental illness, death, chronic illness — the list goes on. I found patient therapists who would be the surrogate parents I needed.

I was so full of shame about my feelings and behavior that I felt certain even they would abandon me. The thoughts and behaviors described above create chaos in women’s lives, but they can and do improve with the right combinations of love, therapeutic intervention, spiritual practices, support — and medication when it’s necessary.

To be pejorative in labeling in women (or men) who struggle with this formidable foe would be to despise myself. I’ve already spent enough time doing that, thank you very much.

It doesn’t work.

Self-hatred reopens the original wound and makes me its slave — I’d rather be a servant of peace and love. I would rather we see ourselves in one another and love all of it, not just the pretty stuff.

Loving the “not beautiful” is where the true love waits.

With devoted practice and attention to embracing all of ourselves, (which for me has included a devotion to connecting with nature, trail running, cycling, yoga and meditation), our gifts so often overshadowed by labels and assumptions surrounding mental illness can then be manifested and shared.

Please read Marsha Linehan’s story of her own struggle with mental illness by following this link: http://www.nytimes.com/2011/06/23/health/23lives.html?pagewanted=all&_r=0.

Elyn Saks, a successful attorney, shares her story of living with schizophrenia here: http://www.ted.com/talks/elyn_saks_seeing_mental_illness.

Kimball C. Pier, Ph.D. LMFT is a depth psychologist and a marriage and family therapist in Truckee. As the founder of Sierra Agape Center, she promotes mental, physical and spiritual well-being by offering clients opportunities to learn practices for sustaining overall well-being. Sierra Agape and its partners offer affordable psychotherapy, meditation training, massage, nutrition coaching and yoga therapy. Visit http://www.sierraagape.org for more information.