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Ticking off the pros

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She was really going off on the nurses, and they couldn’t get control of her. It can get scary for a psych nurse when a patient goes there… probably because they believe Torrey. I’ve never found the mentally ill to be any scarier than anyone else, so I guess I have an advantage. I got there within a minute of the call. All they wanted was for her to go be quiet in her room for a few minutes.

The patient, a textbook Borderline, was throwing a first-class tantrum. Keep in mind that a lot of therapists refuse to work with people who have her problem, and that most of the ones who will work with them don’t have much success. The great skill of Borderline Personality Disorder is Jerking People Around; they do it better than absolutely anybody.

One of the things a Borderline will do is, they’ll place you into one of two categories. You’re an angel or a demon. You can jump immediately from one category to the other, depending on whether or not you’re doing what the patient wants you to do. If you care at all, even a little, about the relationship, they will quickly condition you. It’s either amazing or sad to watch.

Nurses are taught to maintain a “professional distance” with patients. That tends to work with most, but the Borderlines will scream, “You don’t even care about me! You’re supposed to be nurses! Nurses are supposed to care about people!” (Yes, I learned a lot about double-binds from these situations.)

Personally, I think the key is that I care more about my opinion of myself than I care about anyone else’s opinion of me. Like me? Great! Don’t like me? That’s still OK. I like me.

I walked over to the ranting patient and asked her what was going on. After she got a sentence out, I shifted my stance to mirror hers. Then I started to nod in time with the rhythm of her ranting. Once in a while, I’d feed back to her a word or two. One of the nurses stood nearby. I usually appreciate that. This time, though, the nurse picked up on something the patient said and tried to respond.

The next thing that happened caught me off guard. The patient wheeled on the nurse and shouted, Excuse me! I’m having a conversation with this man!” The nurse blushed a dark maroon, apologized, and walked away. To my credit, I suppressed my smile before the patient turned back to me. (Well, it was funny.)

After a minute or so more, I said to her, “OK. Head on back to your room and wait there for a bit. I’ll talk to the nurses and get their side of the story.”

She thanked me and went to do what the staff wanted her to do all along.

Written by Michael DeBusk

September 16th, 2008 at 2:06 am

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