My Dark Secret

I have a dark secret to reveal. I secretly enjoy the challenges a borderline personality disordered (BPD) patient can bring.

The trick is to find something within that BPD person that I like. Sometimes, this can be hard, but usually, even BPD folks have something that I admire. Then, be super consistent in your interactions. When you are always the same, they know what to expect, and having such firm boundaries give them a new experience and therefore, potentially gaining insight into their own interactions in the 'real world.' Also, chant to yourself, "Nothing personal, it is just business."

As a resident, I actually had this therapy patient with a diagnosis of BPD, whom I saw twice a week for a good part of her treatment. I really liked her, and actually, really wanted her to like me. (The power of projective identification.) I always wished I had her eye for fashion, for beauty, for style.

Interestingly, I have bumped into her twice as a resident. Once, I saw her as I was leaving a brunch spot with Hubby and Aidan, I whispered to Hubby, "Patient alert, quick, cross the street." Don't worry, no HIPPA laws were broken, since it was totally crowded with about a hundred people out there. The other time, I was with Aidan (on his first birthday!) and we were strolling around the same neighborhood, when Aidan needed a diaper change. We ducked into the Apple Store, and there she was, waiting at the Genius Bar. We made eye contact, she smiled, I smiled.

The following session, nothing was spoken about this.

I managed to maneuver her thought onto transference issues, and explored what she thought about how therapy was going. Anyway, after a long time, we eventually talked about this incident. Get this: She had no recollection.

Psychodynamically, I thought she suppressed it. (Or am I narcissist for thinking that I was SO important that she had to suppress it?!)

Anyway, after becoming an attending, she came back to my service. And so far, I haven't run into her anywhere, although I know all the places she goes to. Secretly, I am looking forward to running into her.

Life wouldn't be as interesting if there weren't so many personality disordered people. I love my job.