Friday 22 July 2011

Book Review: The Buddha & The Borderline

The Buddha & The Borderline

By Kiera van Gelder

Reviewed by Margarita Tartakovsky, M.S.

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The Buddha & The Borderline, by writer, artist and advocate Kiera Van Gelder, exposes a regularly hushed-up topic: borderline personality disorder (BPD). BPD is shrouded in stigma. There’s little information about the disorder and, while effective treatments exist — namely dialectical behavior therapy — it can be tough to find a mental health professional who’s educated and experienced in administering them.

If you’re someone with BPD or a loved one of someone with BPD, you probably already know this. The devastation this disorder causes is immense but the misunderstanding and lack of treatment may be just as heavy. With The Buddha & The Borderline, I believe that you’ll find relief, reputable information and hope. It’s far from an easy read. But it’s real, authentic and truly valuable.

In this memoir, Van Gelder documents her diagnosis, treatment and recovery from BPD. She begins the book when she’s 30 years old, when she’s already attempted several times to take her own life, gone through a handful of hospitalizations, been diagnosed with depression, anxiety and post-traumatic stress disorder and recovered from alcohol and drug addiction. She is in the arms of yet another boyfriend, attaching herself to him in such a way that she loses herself completely. (She writes later in the book: “If Taylor were gone, it would be like pulling the plug in a basin that holds all the shapeless, turbulent liquid of my life. I would drain away.”) This is a pattern: With every boyfriend, her identity, her musical tastes, how she dresses, what she believes tend to change. Yet she doesn’t know why. After each relationship ends, she starts searching for another savior. 

Van Gelder desperately wants to find out what is wrong because as she writes, “…despite being clean and sober for almost a decade, I’m still a mess.” For almost two decades, she’s been in therapy. She has tried various types of treatments, medications and 12-step programs, but yet nothing seems to be working. 

When she’s finally diagnosed at a local hospital, Van Gelder witnesses firsthand the stigma, shame, myths, insurance woes and unavailability of treatment. Yet even as she’s struggling with out-of-control symptoms and suicidal urges and grappling with such a stigmatized diagnosis, Van Gelder continues fighting. Her initial motivator? Rage. She writes:
Ultimately rage, not hope, hurls me into recovery when I finally understand that it’s not simply my illness, but incompetence and avoidance from the mental health system that has created my ‘incurable and hopeless’ condition.
This book is a must-read for several reasons. One of the main reasons is that Van Gelder demystifies BPD, clearly defining the symptoms both from a scientific level and a personal one. She writes about deeply intimate slices from her life so readers receive an inside look into what it’s like to have BPD. This is very uncommon, as BPD is largely marred in mystery in our society. The public gets very little solid information about what this disorder really looks like. 

Van Gelder also addresses her loved one’s denials of her diagnosis — also common. In the beginning, her mom repeatedly questions her being “mentally ill.” In a therapy session with her mother, Van Gelder says:
But why can’t you take my mental illness seriously? I feel like I’ve been set up, over and over. Like I’m a cripple without a wheelchair, and everyone keeps signing me up for marathons, then shaming me for not winning the race.
She also faces similar frustrations as she tries to share information about BPD with her grandparents:
Indeed, I discover that the less I say, the happier everyone seems to be with me. I sometimes wonder if I wouldn’t have been better off as a paraplegic or afflicted by some tragic form of cancer.
Secondly, she demystifies dialectical behavior therapy (DBT) — a treatment developed by Marsha Linehan, Ph.D., which has scores of research studies to back up its effectiveness — and informs the reader in great detail about this treatment. So while this is a memoir, it also serves as a valuable teaching tool. Loved ones and individuals with BPD will benefit from learning about their options and the nitty-gritty of DBT, which like BPD itself, many people have no clue about. Therapists and graduate students also will learn a lot.

Relying on research studies and books on DBT, Van Gelder quotes Dr. Linehan (and other experts) and describes the theories, goals and techniques of the treatment in layman’s terms throughout the book. As she gives readers the theory behind each step, she illustrates this in relation to herself and her therapy.

For instance, DBT focuses on the concept of dialectics, which on a practical level is, according to Van Gelder, “…what happens when opposites combine to create something new…On a deeper level, dialectics is a viewpoint that recognizes reality and human behavior as fundamentally relational.”

Throughout the book, Van Gelder tries to reconcile the opposing parts of herself. Can she really resist something and long for it at the same time? Can she be healthy in some ways but still lack a secure sense of self? 

Interestingly, the book, too, mirrors this dialectical nature. It’s painful, frustrating and potentially triggering while being uplifting, soothing and hopeful.

In the last part of the book, Van Gelder discovers Buddhism and explores how it applies to BPD and her life (dialectical behavior therapy is actually based on Buddhist philosophies). Just as she does throughout the book, in the end, she provides several profound insights. 

In addition to the perceptive content, Van Gelder’s writing is beautiful and heartbreaking. Van Gelder is a gifted and eloquent writer, and readers will instantly get pulled into her story. 

As mentioned briefly above, parts of the book may be triggering to some readers. Van Gelder writes poignantly and often in-depth about painful experiences, including her cutting, suicidal urges and sexual abuse. So while this level of detail may be necessary for readers to gain a better grasp of BPD’s desperation, confusion and grief, it can have a negative effect on someone who’s vulnerable. 

As much as this book is about seeking the correct diagnosis and the struggles of recovery, The Buddha & The Borderline is also about Van Gelder’s journey to find herself and lead a life worth living — the ultimate goal of DBT. Even though this is a memoir, it’ll no doubt echo the stories of other sufferers and help readers better understand BPD and its treatment. 

The Buddha and the Borderline: My Recovery from Borderline Personality Disorder Through Dialectical Behavioral Therapy, Buddhism and Online Dating
By Kiera van Gelder
New Harbinger Publications: August 2010
Paperback, 246 pages
$17.95