Read an Excerpt
The World of the Borderline
"Everything looked and sounded unreal. Nothing was what it is. That's what I wantedto be alone with myself in another world where truth is untrue and life can hide from itself."
From A Long Day's Journey Into Night by Eugene O'Neill
Dr. White thought it would all be relatively straightforward. Over the five years he had been treating Jennifer, she had few medical problems. Her stomach complaints were probably due to gastritis, he thought, so he treated her with antacids. But when her stomach pains became more intense despite treatment and routine testing proved normal, Dr. White admitted Jennifer to the hospital.
After a thorough medical work-up, Dr. White inquired about stresses Jennifer might be experiencing at work and home. She readily acknowledged that her job as a personnel manager for a major corporation was very pressured, but as she put it, "Many people have pressure jobs." She also revealed that her home life was more hectic recently: She was trying to cope with her husband's busy legal practice while tending to the responsibilities of being a mother. But she doubted the connection of these factors to her stomach pains.
When Dr. White recommended that Jennifer seek psychiatric consultation, initially she resisted. It was only after her discomfort turned into stabs of pain that she reluctantly agreed to see the psychiatrist, Dr. Gray.
They met a few days later. Jennifer was an attractive blonde woman who appeared younger than her twentyeight years. She lay in bed in a hospital room that had been transformed from an anonymous cubicle into apersonalized lair. A stuffed animal sat next to her in bed and another lay on the night stand beside several pictures of her husband and son. Get-well cards were meticulously displayed in a line along the window sill, flanked by flower arrangements.
At first, Jennifer was very formal, answering all of Dr. Gray's questions with great seriousness. Then she joked about how her job was "driving me to see a shrink." The longer she talked, the sadder she looked. Her voice became less authoritative and more childlike.
She told him how a job promotion was exacting more demands duties about which she felt unsure. Her five-year-old son was starting school, which was proving to be a difficult separation for both of them. Conflicts with Allan, her husband, were increasing. She described rapid mood swings and trouble sleeping. Her appetite had steadily decreased and she was losing weight. Her concentration, energy, and sex drive had all diminished.
Dr. Gray recommended a trial of antidepressant medications, which improved her gastric symptoms and seemed to normalize her sleeping patterns. In a few days she was ready for discharge and agreed to continue outpatient therapy.
Over the following weeks, Jennifer talked more about her upbringing. Reared in a small town, she was the daughter of a prominent businessman and his socialite wife. Her father, an elder in the local church, demanded perfection from his daughter and her two older brothers, constantly reminding the children that the community scrutinized their behavior. Jennifer's grades, her behavior, even her thoughts were never quite good enough. She feared her father, yet constantly and unsuccessfully sought his approval. Her mother remained passive and detached. Her parents evaluated her friends, often deeming them unacceptable. As a result, she had few friends and even fewer dates.
Jennifer described her roller-coaster emotions, which seemed to have worsened when she started college. She began drinking for the first time, sometimes to excess.
Without warning, she would feel lonely and depressed and then high with happiness and love. On occasion, she would burst out in rage against her friends fits of anger that she had somehow managed to suppress as a child.
It was about this time that she also began to appreciate the attention of men, something she had previously always avoided. Though she enjoyed being desired, she always felt she was "fooling" or tricking them somehow. After she began dating a man, she would sabotage the relationship by stirring up conflict.
She met Allan as he was completing his law studies. He pursued her relentlessly and refused to be driven away when she tried to back off. He liked to choose her clothes and advise her on how to walk, how to talk, and how to eat nutritiously. He insisted she accompany him to the gym where he frequently worked out.
"Allan gave me an identity," she explained. He advised her on how to interact with other lawyers, when to be aggressive, when to be demure. She developed a cast of "repertoire players" whom she could call on stage on cue.
They married, at Allan's insistence, before the end of her junior year. She quit school and began working as a receptionist, but her employer recognized her intelligence and promoted her to more responsible jobs.
At home, however, things began to sour. Allan's career and his interest in body-building caused him to spend more time away from home, which Jennifer hated. Sometimes she would start fights just to keep him home a little longer. Occasionally she provoked him into hitting her. Afterward she would invite him to make love to her.
Jennifer had few friends. She devalued women as gossipy and uninteresting. She hoped that Scott's birth, coming two years after her marriage, would provide the comfort she lacked. She felt her son would always love her and always be there for her. But the demands of an infant were overwhelming, and after a while, Jennifer decided to return to work.
Despite frequent praise and successes at work, Jennifer continued to feel insecure, that she was "faking it." She became sexually involved with a co-worker, who was almost forty years her senior.
"Usually I'm okay," she told Dr. Gray. "But there's another side that takes over and controls me. I'm a good mother. But...