Content Warnings: themes of suicide, self-harm, and sexual assault
Park Center reeked of a combination of antiseptic and mildew—two scents that, in theory, should not be capable of mixing. One is quite literally intended to eradicate the other. Yet, like many of the individuals who came to the facility, the odor absolutely existed despite its own contradictions. It greeted me harshly as I walked through the squeaky automatic doors.
The woman at the check-in desk was nice enough. She smiled at me kindly as I approached, but something about it didn’t quite reach her eyes. Still, she thanked me for completing the online paperwork instead of making us both sit through the twenty minutes it would take to fill out a physical copy. Then after clicking her mouse a few times, she gestured for me to sign the touchpad on my side of the plexiglass divider. I couldn’t help but wonder if the barrier between us was a remnant of the global pandemic or a means of physical protection from other patients who came here. Either way, the result was the same: a clear separation of the employees and the sick.
After completing my sign-in, the nice, protected receptionist instructed me to take a seat and wait for the psychiatrist to come get me. I found a spot on one of the half-plush, half-wood chairs that they always have in waiting rooms, trying my best to ignore that one of the armrests was splattered with something sticky. As soon as I sat down, I began picking at my already-raw cuticles. The anxious habit had gotten so bad in recent years that I started carrying a variety of colorful Band-Aids in my purse. My favorites were the galaxy print.
As I maimed my poor fingers, I began mentally reviewing the diagnostic criteria they would be looking for during my evaluation:
Frantic efforts to avoid real or imagined abandonment. Unfortunately, a weekly, if not daily, occurrence.
A pattern of unstable and intense personal relationships characterized by alternating between extremes of idealization and devaluation. I assumed five counted as a pattern.
Affective instability due to a marked reactivity of mood. Without a doubt.
Inappropriate, intense anger or difficulty controlling anger. I tried not to think of the time I threw my phone at the wall when my ex-boyfriend got cast in a play and I didn’t. Or the time I had grabbed my sister by the shirt and thrown her on the ground for relentlessly taunting me. Or the time I hit my steering wheel so hard during an argument that my hand hurt for days after.
Before I could get through the remaining five criteria, a middle-aged man with glasses appeared in my peripheral vision, clipboard in hand.
“Makayla Edwards?”
I took a deep breath and stood up, once again carefully avoiding the armrest. He walked me down an off-white hallway with a moderately stained beige carpet, the slightly flickering fluorescents making the whole scene look like something out of a psychological thriller. It made my stomach hurt, but not enough to turn around. I followed him to his office at the end of the hall.
Sean the Psychiatrist was the exact type of unremarkable that made me believe he was built for a place like Park Center. He wore a pin-striped dress shirt paired with a plain tie and slacks that could be described as “sensible” at best and “frumpy” at worst.
He was of average height and build, with an average receding hairline. Even the way he talked was average—not animated, not monotone, just talking. This is to say that Sean seemed entirely fit for a job where the main objective was to focus his energy on another person. He seemed to know how to pick words carefully, poking around someone’s cowebbed mind for any jagged edges or unexpected obstructions. He also kept the surrounding area clean of his own individualism to ward off both attachment and distraction, maintaining an office with little to no knick-knacks and exactly one picture of his children on his desk.
After settling into his standard-issue office chair, Sean the Psychiatrist made sure to get all the typical evaluation info before jumping in. I gave him my name, birth year, some brief medical background, etc. Then, he got into the real questions.
What is your relationship with your family like?
Do you ever have emotional outbursts?
Have you ever considered suicide?
I had rehearsed the answers over and over again in my head in the past few weeks to ensure clarity, but sitting in that cold office, it all went out the window. By the time I got to talking about my parents’ divorce, I was stumbling over my words entirely. Even more so when I told him about my difficult relationship with my mother and her suicide attempt my senior year of high school. It all came out, messy and unrehearsed and honest. It was like all of these feelings that have been swelling behind my sternum for years were unraveling all over his plain desk, and every time I thought I was done, more spilled out.
For two hours straight, I rambled to Sean the Psychiatrist about everything from my ex-boyfriend who used to pressure me into sex to my inability to control my anger toward people. He interrupted intermittently with guiding questions but mostly spent the time silently scribbling notes, his face plastered with a rehearsed apathetic expression. At the end of the session, he explained that I had met at least five of the diagnostic criteria. In fact, he said, I had met nearly all of them.
* * *
People aren’t born with a personality disorder. Just like any other identity or trait, it develops over time. For instance, it can start when a little girl watches her parents get divorced at age five. She quickly looks for what she can control. She looks for ways to not be a problem, ways to be an “easy child.” She is sensitive, so she still cries about small things, but when Mom yells at her to stop, she does. When the girl gets angry, she keeps her mouth shut to her parents and takes it out on her little sister—the only other person she has power over. The girl is on time for school every day, and she is a pleasure to have in class (even if she talks a little too much). She gets straight A’s on every single report card, so nobody has to worry about how she is doing academically. When her parents say they are proud, she smiles. She always wants to make them proud. And she still has big feelings but nobody to tell them to, so she screams into her pillow and hits her head trying to make them go away. She throws things but only in the privacy of her own room. She does it as quietly as possible, always.
Then, when she gets a little older, the girl attaches to people quickly. She desperately looks for safe places to fall apart. She gets too close to people too fast, and they end up leaving. Every time. Then one boy doesn’t. One boy stays. He tells her he understands. She believes him.
The boy is nice to her for a little while until one day he isn’t. And she sobs, and he sobs, and he promises to be better. He isn’t better. This happens again and again.
Then the boy wants to have sex. The girl doesn’t. But the girl doesn’t want to lose the boy, so they have sex anyway. When she says she doesn’t feel like having sex, he gets mad and then pressures her into it anyway, so eventually she learns to stay quiet. Then after a few years, when she can’t take it anymore, she stops loving him overnight. The girl leaves. But only because there is someone close enough to run to. Only because she is sure she won’t be alone. She never wants to be alone again. No, she wants to be loved. The girl wants to be loved so badly that she will mangle herself to do it. Again and again and again.
* * *
I read somewhere that seventy percent of people diagnosed with Borderline Personality Disorder will attempt suicide in their lifetime. That meant that, theoretically speaking, out of the eight total people in the dialectical behavioral therapy group that Sean the Psychiatrist had placed me in, nearly six either already had attempted or were going to eventually. I personally had never actually attempted, in part because of my mother’s failed overdose, which meant that only one other person in the room was “safe,” and my money was on the older man in the blue shirt at the far end of the table. (This wager hinged solely on the fact that he was the only one who actually looked me in the eye during introductions. He even smiled.)
The curriculum was cyclical, looping every six months, the group therapy leader explained. This meant that everyone in the group was at a different point in the process, some having been there for only a few weeks, and others nearing their completion within the next few sessions.
Having patients across such a wide range of progress was strange to me. I had assumed it would be a scaffolded program, building skills off of base concepts and working our way toward more difficult scenarios. But as I leafed through the packet I had been given—they ran out of actual workbooks—I discovered that all the lessons were just variations of the same thing: “mindfulness.” That isn’t to say that mindfulness isn’t a useful skill. It absolutely can be. I just found it hard to believe that group thought experiments of “how to be mindful of other people’s feelings during a conflict” and ten-minute YouTube meditation videos were going to solve my deeply rooted abandonment issues and rage.
Still, every week, I filled out the homework and did the activities, even the ones I thought were stupid. And every week, I felt unchanged. By the end of the first month, the eighty-minute drive to Fort Wayne started to feel like an utter waste of time. I wasn’t getting better. In fact, the stress from constantly driving back and forth was quite possibly making my mental state worse.
During the time that I attended group therapy, one woman completed the program, one got re-hospitalized, and another man joined (this one slightly younger and much less smiley than “safe” blue-shirt man). Yet, not one of them seemed any happier or optimistic than they had been at my first meeting. To me, they all just looked tired.
I didn’t tell Sean the Psychiatrist or group-therapy-lady-whose-name-I-don’t-remember that I was quitting therapy. One day, I just didn’t show up, and that was that. Nobody called or messaged me on the client portal about missing group or if I was coming back. Nobody reached out to reschedule my appointment. Nobody even bothered to check if I had become part of the seventy percent.
After leaving Park Center, I swore off therapy for years. “It didn’t help,” I explained to my new boyfriend when he encouraged me to go back. “Anything that a therapist can tell me, I can just find on Google.”
At the time, it didn’t feel like a lie. Nothing I had learned from professionals extended beyond the many online articles I had read. And none of it, online or off, helped me hurt any less. It couldn’t take away the horrible ache in my chest or the throbbing in my head. This was just my life, and I had to deal with it. What I failed to recognize was that it was also deeply affecting the people around me. The people I loved. My dysregulated mental state was eating away at my relationships and I didn’t realize it until it was almost too late. I recall one phone call with my boyfriend that ended with me sobbing on the kitchen floor, snot and tears spilling from my face like a faucet. I could hear his tired voice on the end of the phone, begging me to take care of myself. To get help. That was when I decided to give therapy one more shot—if not for me, then for the people who loved me.
Which is how, three years after leaving Park Center, I found myself outside a tiny strip mall in Muncie, Indiana. It was nothing that would catch your eye on the morning drive to work. Nothing facility-like, I thought, which made sense considering that the practice only had three employees and one intern. I had received an email informing me that they hadn’t been able to replace the sign out front yet, but it should be done in the next few weeks. Soon, their dainty floral logo would overtake the fading (and misleading) “Allstate” one.
Walking through the front door, the first thing I noticed was a pink, glass candy bowl sitting on top of a mini fridge marked “Water—help yourself.” I also quickly realized that the small, foyer-like room didn’t smell clinical or out-of-date. In fact, it smelled like the cinnamon-apple candles my grandmother used to buy at Walmart. The scent flooded my chest with something warm and recognizable.
I glanced around the room a little more as I took a seat on the cheap (but unstained) loveseat and waited to be called back. My eyes caught on a bunch of self-care booklets and multipacks of stickers neatly lined up on the side table. There was care put into the setup of the room that felt unlike any other office I had been in before. I decided that even if this therapy thing didn’t pan out, the fact that this didn’t feel like the set of a Stanley Kubrick movie was a sign that there are safer places out there for people like me. Softer ones that smelled like autumn spices and compassion. After about two minutes, a blonde woman in her twenties came around the corner to greet me.
“Makayla?”
I nodded and followed her back to an office plastered in colorful (albeit slightly cheesy) inspirational posters. As I sat down on her sun-soaked sofa, she smiled at me again with a kindness that shaped her whole face, not just the corners of her lipglossed mouth. Then, for the first time in my life, a therapist said something to me that Google hadn’t.
“Oh my God, I love your rubber ducky earrings!”
It was such a silly, simple compliment. Not to mention, one that I had heard many times before. But this was different. Because for this woman to notice me and my rubber ducky earrings was to say, You are more than a diagnosis and treatment plan. It was to say, You are whimsical and unique and human.
It was to say, I see you.
“Thank you,” was all I could say back.
And for some reason, in that cinnamon-scented, warmly lit room, it felt like enough.
Makayla Edwards (she/her) is a creative nonfiction writer and poet from Indiana who centers her work around feminist issues and mental health. Her poetry has been published in Vast Chasm, Blood+Honey, and The Broken Plate. In her spare time, Makayla likes to read rom-coms and cuddle with her rambunctious Aussie-Collie mix, Jeff.
Substack: @makaylaedwards