ior. 6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). 7. Chronic feelings of emptiness. 8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights). 9. Transient, stress-related paranoid ideation or severe dissociative symptoms.Etiologically, Susanna fits Borderline Personality Disorder beautifully. She is a young adult of eighteen. Seventy-five percent of borderline patients are women. Susanna also fits many of these criterions. However, several of them were not seen out in the open. For example, she practiced “wrist-banging,” which corresponds with symptom number five as self-mutilating behavior. She would sit in her butterfly chair and bang her wrists on a sharp edge. She did this almost religiously every evening. For a while before she discovered wrist banging, she scratched her face. This proved to be too obvious, so she switched. Her pain brought comfort. “It was the only way I could get through to myself (“counteract feelings of ‘numbness’)(Kaysen, 1993, 153).” I think that self-mutilation and suicidal ideation and attempts go hand in hand. Susanna, before she was admitted to McLean, made a mild attempt at killing herself. She also said that she thought about suicide a lot. While she is lucky that she never made a fatal attempt, her ideation was still a large factor in her disorder and diagnosis.Chronic feelings of emptiness, criterion number seven, was a definite for Susanna. She felt that she was living her life based on her “incapacities.” Basically, she didn’t want to and felt she couldn’t do pretty much anything. She liked boys and poetry, nothing more. School was a waste of her time. She didn’t really have any friends. She didn’...
