Borderline personality disorder accounts for almost 25 percent of psychiatric hospitalizations in this country. Lost in the Mirror takes readers behind the erratic behavior of this puzzling disorder, examining its underlying causes and revealing the unimaginable pain and fear beneath its surface.
Coming of age in the days of the Beatles, John F Kennedy, and Martin Luther King, a youthful sense of purity and immortality collided with a growing awareness that life can turn in the instant it takes for a bullet to leave a gun's muzzle and extinguish something cherished and good. An awareness that trauma shatters spirits as well as bodies led to a quest to help make sense of tragedy and to weave trauma and loss into an ever strengthening fabric of identity.
Nearly four decades as a psychiatrist has brought reminder after reminder of life's uncertainty and provided countless opportunities to bear witness to others' pain and to the remarkable capacity of the human spirit to emerge renewed from unfathomable misery. Out of this experience came a special interest in helping those least able to sustain the buffeting to recover their resilience, and a related interest in understanding how we remember and how the narrative of memory influences present day emotion.
My understanding of Borderline Personality Disorder grew out of my early experience as an inpatient psychiatrist working with those who had reached particularly desperate crossroads in their lives. LOST IN THE MIRROR: AN INSIDE LOOK AT BORDERLINE PERSONALITY DISORDER was written to provide these sufferers a model of what was happening to them that could help them find their way from chaos to serenity.
Accompanying others as they journeyed through their personal histories made clear to me that the retrieval and remodeling of memories made objective accounts of the past impossible and that the narratives that resulted must be taken as stories designed to make sense of experience. Each time a story is told, it changes a bit. And as the narrative is filtered through the therapeutic relationship, there are opportunities to mold it in ways that can heal. The ability of a therapist to influence how experience is remembered can be powerful and carries with it considerable responsibility to do no harm.
CAROUSEL MUSIC integrated my understanding of the complexities of remembering within the context of the narrative of therapy. While framed as an entertaining novel, it is also designed as a guide for therapists and patients to understanding the ambiguity of the personal narrative and finding ways to validate its essential elements. And it provides a balanced account of the controversy surrounding the validity of recovered memories that prevailed toward the close of the last century.
Now retired after 36 years as a trainee, teacher, and clinician in psychiatry, my attention turns to aging and mortality. Passing the Beatles' apocryphal 64, the beginning of the last chapter of life, brings with it the full realization of no longer being among the youngest adults on the planet and certainly not immortal. Bringing meaning to this stage of life is a different kind of challenge that can be particularly sweet if met successfully.
Aging also brings me back to musing about how memory works. Because of the span of our experience, the changes that have occurred in the narrative of our lives from the repeated retrieval of memories, and the changes that evolve in the capacity of our brains to process knowledge as we age, the lens through which we perceive our histories becomes clouded much as the lenses within our eyes. Some of us experience more clouding than others and we have not yet found the neurological equivalent of cataract surgery that can restore the clarity and color to our thoughts.
These concerns have fueled an interest in understanding the state of research in Alzheimer's and other neurodegenerative diseases and seeking ways to facilitate the prevention and cures of these diseases. They have also piqued my interest in exploring new themes in my writing as I take up pen again after a long intermission in my creative process.