End of days


What I alluded to in earlier posts and  didn’t know until some weeks ago  is that I have this new sword of Asclepius hanging over my head. And part of the reason –aside from my usual tendency towards verbosity- of the long build-up to this bit is that it I feel a huge discomfort sharing this information. I have no handle on it.

My more constructive coping mechanisms –like my sense of perspective and humour- fail me completely, and the only one that is on high alert and fully active is the one that screans at me to RUN. Every neuron in my body is firing warnings that I “need to step away from the PC, sir, and lie down on the ground. Right. Now”.

My head is pounding.
My mind is telling me I need to do laundry, washing up, mop the floor, mend the roof, peel the coffee beans and paint the cat as a matter of the highest priority.

But in the words of the late, great Magnus Magnusson: “I’ve started so I’ll finish”.

I’m going to try and be brief here, for a couple of reasons.

  • It really fucking hurts and I fear I may lose my nerve if I dwell too long.
  • As I said: I have nothing yet. No insights or out-of-the box vision.
  • Without the required medical skills or knowledge, I do not feel all that comfortable drawing my own conclusions or going too in-depth.

Brazil: visions of the futureSo the diagnosis of a truly horrendous battery of psychological tests came back with the following:
The SCID-5  is a semi-structured interview technique to diagnose DSM personality disorders.
DSM-5 is the fifth update to the Diagnostic and Statistical Manual of Mental Disorders, the authoritative mental disorders guide and diagnostic tool.

Will The Defendant Please Rise?

The diagnosis that was returned was that I scored (and for once that is not a good thing) on borderline , narcissistic and dramatic/histrionic personality disorder scales.

“That sounds fairly horrific, Mister H.!”, I hear you ask. “What does it all mean?”
Well, basically these are the general recognisable traits connected to each disorder:
Borderline: excessive fear of abandonment; suicidal tendencies
— Myeah. Hard to deny. OK.
Narcissistic: inflated sense of self-importance (even when there’s no evidence to support that) and have a great need for admiration.
— Ahem. Yes. Well. Let’s quickly move on.
Histrionic: needs to be centre of attention; tends towards self-dramatisation
How DARE you, Sir? Melodramatic? MOI? I know NOT of what you SPEAK! Assuredly, NOT I!)

However, not to panic. Just yet.
None of these scores even came close to the “cut-off” of a proper personality disorder. So these are “merely” character traits (or weaknesses, if you will), more or less under control, although potentially adding to the disruption in a perfect constellation of negative circumstances.

Where I scored significantly though was on the scale of the Compulsive Personality Disorder: a preoccupation with details at the cost of an actual goal; a need for perfectionism that interferes with actually being able to achieve results; a serious problem with delegation of responsibilities and a strong tendency to be directive.

Meh. Sounds about right: so I strive for perfection, because, you know, I am pretty goddamn awesome, and all I need is for the peoples of the world is to acknowledge my obvious, shining  brilliance (and if they won’t, I’ll happily guide them to that insight).

So far so good?
Well, hang on.

Now all of this is embedded in a defective personality structure.
Interpretation and diagnosis of these and other test results yield a certain profile.
Without getting too technical that profile indicates that my coping mechanisms are… I think the technical phrase is “fucked up”.
Let me explain.


Imagine that a normal, adult coping mechanism is a kind of balloon. It gets filled (“inflated”) by learning the proper way to deal with situations throughout your life. If catastrophe strikes the balloon absorbs the impact, and while it may (temporarily) twist, bend or reshape under the pressure, it will revert to its original shape (or a similar workable one) over time.

Now imagine my balloon.
Apparently it is full of holes. Completely perforated.

And here’s me, working like crazy to keep it inflated by blowing air into it continuously. Obviously that’s fairly exhausting, but you know, it works just fine in normal circumstances.

Now imagine catastrophe striking.
A death, a relationship failing, losing a job. Pretty high stress level events even in normal circumstances.
My balloon cannot absorb the blow. It bursts. It is shredded in the wink of an eye.
From one moment to the next I am utterly naked, unprotected, in a state of utter panic and incomprehension. I have nothing to bring to bear to deal with it. To help protect me.

And this is the thing that propels me into the most self-destructive, hateful, self-loathing, deep black depression: as far as my mind and every single psychological mechanism I have gathered in my life is concerned I am utterly alone and vulnerable.
Yes. I may be a mental giant.
But apparently I am an emotional baby.

Well fuckin’ dada..I mean hurrah.

This particular defective personality structure is called a Borderline Personality Organisation.
Please don’t get hung up on the name.
I cannot emphasise this enough: I do NOT suffer from Borderline personality disorder.  It is the personality structure/organisation that is doing me in.
Yeah? We good? Good.

A Treatment Of Human Nature

This is where therapy comes in.
I mentioned this before: the psychiatrist (well, actually the intern to the assistant to the psychiatrist. They’re really busy people over there) told me that this is now very treatable by a technique called ‘schema therapy’.

In brief:
1.  Schema therapy endeavours first to find the base reason for certain behavioural and thought patterns.
Then analyse the coping styles and “mind states” that have developed as an effect of these patterns.
Then it attempts and readjust those, based on whatever the patient’s basic emotional needs were found in that first phase to not have been met.

So yeah, there’s a clear element of cognitive therapy in there (which helps changing response and behaviour by changing thought).
— This costs – I can tell you from experience- a ton of energy and time.
And then there’s an element of classic psychoanalysis, in that you get to revisit all the things your parents did or omitted (and, if you’re lucky, get to blame them for it! Woohoo!)
— Which normally takes many, many years.

It’s confirmed by professionals and literature alike: it’s a process of years.
Which I suggested before is something I would certainly have taken on twenty years, and maybe ten years ago. But now? Start again? On an even harder and longer path? Pffff…

And then of course, just when you think you now at least know these murky waters you swim in… oops.


Upon re-reading the diagnoses yesterday I found some references to something else that wasn’t touched upon during the three (!)  review sessions we have had since. Which methinks  would warrant some discussion, not to mention a few well-chosen harsh words, next time.

The text actually a few times refers to a Narcissistic Personality Organisation.

I have had a day to read up on that, and it is in many ways not markedly different from the Borderline Personality Organisation.
But every text agrees on the same very markedly different and crushing distinction (and I am translating and paraphrasing several treatises I found on this in Dutch):

Treating people <like this> is a very long and arduous affair because their defence mechanisms are so deeply ingrained and part of their personality that they cannot find, see or accept them, leave alone any help in changing them. Treatment is very difficult and takes a very long time. It is extremely hard to reach patients like this, and they are not open to change.

Wake up and smell the coffin.

It is interesting, sobering, humbling and a little saddening  to see that in a very few short weeks I have gone from at least the pretence of knowing everything to merely one absolute certainty.

I know nothing. I am from Barcelona


Next post: I’ll finally get to the suicide bits! I have been dying to do that!

  • Song for the day: