“Remnants of a Life on Paper”: Borderline Personality Disorder

There I stood, in a hole, deep in the ground. Did I dig it or just get in? Did I fall into it? Did someone else dig it and throw me in? Pamela Tusiani, Remnants of a Life On Paper: A Mother and Daughter’s Struggle With Borderline Personality Disorder

In the memoir Remnants of a Life on Paper: A Mother and Daughter’s Struggle with Borderline Personality Disorder (2013), authors Bea Tusiani, Pamela Tusiani, and Paula Tusiani-Eng describe Pamela’s struggles with this psychiatric illness, often considered one of the hardest to treat successfully. Pamela’s “remnants” in question are from her journals and visual art, culled posthumously.

Pamela was diagnosed at the age of 20 with severe depression and wound up having multiple hospitalizations and 12 ECT treatments. Although Pamela had been excelling in college, she had to leave there because of her difficulties.

According to Dr. Lloyd Sederer, The Huffington Post, it was after all the above occurred that Pamela finally received the more accurate diagnosis of BPD. “She was often suicidal, took overdoses of pills and cut herself frequently and deeply. After five months and five hospitalizations she seemed to be doing worse, not better.”

Next up was 19 months at an expensive residential facility in New England—and when this program wasn’t enough, a program in California, Road to Recovery. “Pamela’s course at Road to Recovery was labile,” states Sederer, “with times of sobriety and rebuilding her life and times of falling into states of impulsivity and self-abuse. She developed seizures, which proved to be ‘psychogenic,’ meaning that it was her psychology, not her neurology that produced them. Such is the power of the mind.”

Medications were never helpful enough and often harmful. Eventually Pamela’s prescriber agreed to try a drug called Parnate, something her mom had read could be useful with the type of “atypical depression” that’s often linked with borderline personality disorder.

Sederer: “Pamela was well into her journey of recovery when a series of treatment program and medical errors conspired to kill her. The awful irony was that she did not take her life, but irresponsible, stigmatizing and poor residential and medical care did.”

An example of one such error involved Pamela having severe side effects to the Parnate, which unfortunately was misdiagnosed—in all probability because she was viewed as a “mental patient.” Some of the other experiences mentioned in the book similarly seem representative of mental health stigma affecting not only the patient but also the parents.

Kirkus Reviews weighs in on what readers glean from the back and forth between Bea’s information and the viewpoints of her daughter:

The contrasts are often dramatic, as mother and daughter pull together, apart and back together in a painful dance that hurtles toward a tragic conclusion. Tusiani enumerates the unique difficulties of dealing with a mentally ill family member, from finding Pamela bleeding from a self-inflicted wound—she had a proclivity for cutting her arms and legs so she could ‘feel something’—to learning that Pamela, either through maliciousness or delusion, falsely accused her father of raping her. The unpredictable is always around the corner.

From Sederer’s concluding remarks:

…(N)o parent, no mother, should see a child die. And to lose a child who may have recovered is all the more agonizing. Bea Tusiani only tells us at the end of the book that she is a writer — though it is plain enough how powerful a writer she is as she lets the story, the events she chronicles, show us so much about her daughter, her family, and our flawed mental health and medical systems. What is also so inspiring about the book Bea Tusiani has given us, which is why I found hope (reason to believe), is how she gives us a front-row seat, so we witness the courage, love, determination and stamina of the Tusiani family. I am sure that Pamela would be proud to see how her pain, spirit and resilience — and that of her loved ones — have been so sensitively and cogently captured in these ‘remnants …on paper.’

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