Radical Acceptance

Radical acceptance, as used in DBT (dialectical behaviour therapy), means that you accept something completely, without judging it. I am finding it difficult to radically accept the fact that I have borderline personality disorder (BPD). My reaction to this diagnosis resembles my four-year-old daughter’s reaction when confronted with something she really dislikes: “No! No, no, no, no, no, no, no!” accompanied by stamping feet and clenched fists.

This is emotion mind, and emotion mind does not want to bear this burden and wear this diagnosis. Rational mind says “Hey, it’s just a name for a collection of symptoms that you’ve had for a really long time. Nothing’s changed—you are still you.” But emotion mind doesn’t want to listen.

And what’s on the dialectic between emotion mind and rational mind? Wise mind. Buddhists might call this the Middle Way. Wise mind tells me that the stigma, both internal and external, is greater for BPD than for depression and anxiety. It also tells me that the name is not the thing and the illness is not the person. I know this.

Borderline personality disorder is so called because its suffers are “on the borderline” of psychosis. Many professionals and sufferers are pushing for a name change. The biggest name in the field, Marsha Linehan (developer of DBT) prefers emotional regulation disorder. Other suggestions include impulse disorder, interpersonal regulatory disorder, and extended post-traumatic stress disorder or post-traumatic personality disorganisation.

In some ways, it would be better to be psychotic. I mean, when you have schizophrenia, you really believe the aliens are trying to get you. People with BPD are fully aware that their emotions and behaviour are inappropriate. They simply cannot do anything about it. To me, it feels like being in the back seat of a car and my emotions are doing the driving. I see the cliff up ahead, but I am powerless to change course or do anything to prevent going off of it. And so I do. Over and over again. I believe this powerlessness is what leads many people with BPD to suicide.

BPD explains a lot. Persistent and pervasive feelings of emptiness, the outbursts of rage and anger for no reason. The inability to settle down with one career, one occupation because of “impaired ego integration—a diffuse and internally contradictory concept of self.” I would resist the diagnosis more if I didn’t recognize aspects of myself all over almost every description of BPD that I read.

I don’t know what this means for my future. I fear the implications. But I also know that I’m on the right track: the “homework” my therapist gave me for the next two weeks is two-fold.

  • Practice mindfulness of thoughts for 5 minutes each day. E.g. sit.
  • Practice awareness of judgments. Be aware of when I am engaging in judging and let go of any judging that is not useful and beneficial.

The cure for BPD is practice. Two thoughts arise:

  1. My instincts led me to the right place when I went to live at the monastery.
  2. Profound gratitude to all the mental health professionals who have dedicated their efforts to helping people with this disorder. Marsha Linehan in particular who made the connection between mindfulness and BPD which has turned out to be one of the most helpful therapies ever.

Studying dialectical behaviour therapy is like applying Zen practice to my mental health disorder. From past experience, I know this is going to help. I just need to let go of judging myself and practice my life, this life, mental illness and all.