Having explored in (somewhat excessive) detail what being psychotic implies on a phenomenal and interpersonal level, I suppose I’d better start thinking about the way in which my borderline characteristics impact and have impacted my life. I’d already looked at some of these when I thought my diagnosis was veering towards narcissism, but considering anticipated, perceived, or imagined triggers from a new viewpoint has helped me better to understand my feelings and reactions. The cap fits better, so to say.
This new orientation corresponds to progress in the therapeutic treatment I’m receiving. Until recently, the major component of my treatment has been psychiatric, and has concerned finding the appropriate dosage of the meds I’m taking. This has been generally effective, despite a few major incidents that generally indicated a need to adjust medication. The meds are still essential to maintain stability, but I need now to engage with the psychological symptoms, identify them and the situations they provoke and are provoked by, and develop parallel nonmedical strategies to deal with them. This will be the main orientation for the psychotherapeutic sessions that are just starting.
The first and most damaging of these is rejection (I’ll deal with its bosom companion, abandonment, at a later date). Anticipated, perceived, or imagined rejection, and the accompanying feelings of alienation, worthlessness, and shame, is the primary cause of the vast majority of my rageful meltdowns. It’s also a major factor in my social isolation and in the breakdown of my romantic relationships.
While the rejection-rage relation is well-documented, my own reactions tend to follow the fault-lines inherent in my primary condition, and correspond largely to the grandiose and jealous aspects of the disorder.
I am, of course, the most intelligent and creative entity that has ever existed. Any failure to integrate and respond appropriately to my genius – by disagreeing with or criticising my point of view, by lacking appreciation of my aesthetic output, by neglecting to read my articles – will be perceived as a rejection of my very being. I’ll scrutinise all but the most glowing and admiring remarks for disinterest (lèse-majesté) or ridicule (sacrilege), and an ambiguous comment will lead me to a frenzy of rereading and overinterpretation. As I implied, my greatest fears are mockery and dismissiveness. My reaction to such perceived slights is anger, swiftly followed or accompanied by self-doubt and the feeling that I am, or am perceived as, a worthless narcissistic poseur. Experience, and my feelings of shame and self-doubt generally block me from achieving a state of rage, but I’ll become mistrustful and resentful and avoid further contact with the perpetrator, whether the slight was real or imaginary. This has been a major handicap in my professional and – unsurprisingly – academic life.
This is a matter of romantic or sexual rejection. Indeed – and from reading forums this seems pretty common, particularly among borderline men – my fear of rejection makes it almost impossible to instigate romantic or sexual activity. Most – almost all – of my relationships were initiated by my partner, and the few times I have tried to get things started I was either so nervous or unsubtly forthright that I fucked it up or so oblique that he/she had no idea what I was getting at. And, as with my grandiosity, rejection can be anticipated, perceived, or imagined – and the accompanying feelings are alienation, worthlessness, and shame. Such feelings persist or resurface even in established relationships – as I’ve said before, the first time we don’t have sex in a new relationship I immediately start believing ‘something is wrong’, and if we go without sex for a couple of days I begin to think it’s because he/she no longer desires me, or is comparing me unfavourably to other lovers real, potential, or imagined (hence the ‘jealousy’). Similar remarks apply to shows of affection. There’s frequently no actual cause for my sense of rejection, save my own brooding over what I imagine to be the case.
While nowadays I rarely get into a rage as an immediate reaction to perceived or imagined rejection, it definitely fuels the kind of obsessive, sulky behaviour and sullen jealousy that precedes or provokes explosions of rage, particularly when there is some real or implied criticism. If asked to explain what I feel I’m more often than not unable to, and this leads to long, rambling expositions in which my interlocutor becomes increasingly annoyed and I become increasingly frustrated. The expression of annoyance and/or frustration is what usually sparks the rage.
The fear of rejection and ridicule is also a strong influence on my general inability to form friendships or even handle the simplest social interaction (I have a nigh-on phobic fear of the telephone). About a week ago I had to go to the bank for an entirely routine transaction and I realised that my degree of nervousness and outright fear would have been more appropriate to a WWI soldier waiting in the trenches to go ‘over the top’. I was scared of making a fool of myself – or of being made a fool of – and of the resultant social censure. Similarly, I treat any friendly advance with suspicion, imagining that it is born of the intention to mock or humiliate.
This isn’t going to be one of my inanely upbeat “I’ve got this now, I’m going to lick it real soon” conclusions. I am getting better at handling real and – above all – imagined rejection, but so far it’s more a matter of understanding that I’m the problem and that I need help. At least it gives a clear direction for starting psychotherapy.