I’ve been in a number of car crashes in my life, 2 which were severe and left me with chronic ailments – one involving the driver swerving to miss deer (chronic pain issues resulted) and the other involving a lady having a seizure and driving straight into me (requiring spine surgery and leaves me with occipital neuralgia and cervicogenic headaches). But as a result of Borderline Personality Disorder I have experienced many more emotional crashes – as damaging and irrevocable as the totaled cars I emerged from.
Today my car broke – the car my grandmother bequeathed me on her death bed and means more than I can state. It’s been my home for a while these last few months. It’s been a safe haven. It’s given me the ability to go to doctor appointments and get groceries. It saved me from the 100+ degree days waiting for the erratic buses in Austin. It gets me to therapy twice a week, the psychiatrist once a week, and the pharmacy far too often.
On today’s pharmacy trip, my car decided not to start. And though it wasn’t an actual car crash, you would have thought I’d been in one. I don’t know how to explain what such an emotional crash is like in the borderline mind. If you’ve been in an accident, you know the feeling of everything all the sudden being out of control, you’re trying to assess the situation but there’s too much information to take in all at once, you’re in pain and scared, and much like the time with the deer – the roads are dark, there is little help around, and you don’t know where you are. You know that you have to get out of the car and call the police or 911 or something. You know you have to make sure the other person is okay. You can operate in these tiny bits but you’re not really present as you. Your disconnected and in a different reality. Everything has sped up and slowed down at the same time. You’re wondering how did you get here and what will you do next. The brain is foggy and muscles are starting to get sore from the whiplash and the sirens of the police and lights of the tow truck bring you back to the present and the debris before you yet you still can’t completely process it all.
That’s how it happens for me. The car didn’t start. I can use my mindfulness skills and call the insurance company and get someone to come out and jump start me. I use those distress tolerance skills right up until the moment the guy tells me it’s not my battery but probably the starter and that we’ll have to tow it to a shop. Then the tears well, I start thinking I should commit suicide, and that it’s a shame my past attempts didn’t work. I think of how I’m a failure and how I have no money to fix this, let alone money to get from the place we tow the car to back to the motel. I have $10 to my name because I’m a failure and I had to spend my last money on groceries that are melting in the car and prescriptions that I don’t even really want. I’m a burden and a mess and life is too hard. Nothing makes rational sense anymore and I want to scream and cry and cut and fall apart.
I think they say it well in I Hate You, Don’t Leave Me:
Mood changes come swiftly, explosively, carrying the borderline from the heights of joy to the depths of depression. Filled with anger one hour, calm the next, he often has little inkling about why he was driven to such wrath.
And by another author:
The tiniest things can be landmines. Once I tried paying for my groceries with a type of credit card the store didn’t accept, and the cashier informed me in a tone of voice I heard as hostile. By the time I got to my car, I was in tears and ended up sobbing in my car for an hour before I drove home.
Emotion takes over and the rules of physics and logic don’t apply anymore. My mind has been hijacked (and there’s much neurobiological research to suggests that impairments in emotional processing in the amygdala and prefrontal cortex are the culprits).
After years of therapy, I can recognize in the moment that it is insane to be thinking that the starter in my car needing to be replaced should not result in me contemplating suicide. And yet… I can’t stop it. I would give anything to make it stop.
This is what distinguishes this disease from much less drastic forms of mental illness. Sometimes I’ll say that I’m crazy and people, meaning to be polite, say that “well, everyone is a little crazy.” And then I explain to them that most people don’t start contemplating suicide because no one in the mall could fix their watch. This time, instead of a watch, it was the car not starting.
Just like a car crash, once this emotional cascade has started, it’s out of control. I can do things to mitigate the damage – wear a seat belt, take defensive driving courses, don’t speed. However, a crash may still happen and it can be a minor dent or a tragedy. In my case, my seat belt is my friends – I am capable of sending frantic texts or tweets to reach out to someone to hold on to me. My defensive driving courses are my therapy – always trying to implement the DBT and CBT skills I know and add new ones that I continue to learn (currently through sensorimotor techniques). And my not speeding manifests as taking my meds, trying to get enough sleep, seeing doctors who will try to address chronic pain and other issues. All these together won’t stop the crashes though. They probably won’t stop me from thinking of suicide. Though they may provide a buffer from the impact.
The worst part is the knowing that I’m crashing. Like when the lady had the seizure and ran into me, there was less than a second that I saw her coming at me and I knew I couldn’t do anything – there was no way to avoid it. And as it happened, I knew that it was crazy but it was still happening and I couldn’t stop it. Unlike a physical crash though, the damage from a borderline crash is all in my mind – the shards of glass can’t be seen by anyone else but me. I can logically see that I’m okay and safe and the world is still spinning on its axis. While emotionally I’m reacting like that of a 3 year old. I feel untethered, unsafe, unable to act competently. It’s like some crazy form of locked-in syndrome where I can’t get the logical part of my brain to take over. I succumb to the emotions that engulf me like a sneaker wave – wondering if the whirlpool I’ve been sucked into will spit me back out or take me under completely.
I’ve had a rough week this last week but was getting through it as best I could. Then today the car failed and I crashed. I can honestly say that if I didn’t have someone to help me get an Uber from the garage and back to my cats, I probably would be in a hospital again. The crash was still damaging.
I won’t know until tomorrow what the outlook for the car is. I will have to cancel some doctors appointments until I know. My mind is already thinking the worst. It’s a 1998 Honda Accord, nothing fancy. Sturdy. I take good care of it. But it’s been my experience that when cars fail, they cost more to fix then they are worth. The emotional aftershocks of how to deal with this will probably be pretty hard to weather.
For now, I’m just trying to breathe, to listen to those who remind me that though I feel an incredible failure and beyond messed up, they still love me and will try to help me. And to try to find my way out of the wreckage of my mind.
 Kreisman, J. and Straus, H. (1991). I Hate You, Don’t Leave Me: Understanding the Borderline Personality.