This is a psychology book that reads like a novel and a fairly raunchy
novel at that! ‘Anthony Walker’ is a pseudonym for a real-life psychiatrist who
as a final year medical student fell in love with a young lady who had been
admitted to hospital after an overdose. She turned out to have Borderline
Personality Disorder. However, she was so beautiful, so alive and so entrancing
that their relationship developed and they eventually got married. The marriage
was fairly short-lived as he could not satisfy her insatiable demands for
constant attention, her bouts of violence, her threats, her suicide attempts,
etc. and they were finally divorced. This book is the story of their relationship
from the very first meeting after her admission to hospital until their final
meeting after their divorce.

The term ‘Borderline Personality Disorder’ is a somewhat unsatisfactory
label for a group of symptoms which the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental
Disorders lists as fear of abandonment, unstable relationships, fluctuating
self-image, self-destructive impulsiveness, recurring threats of or actual
attempts at suicide or self-mutilation, short-term mood swings, chronic
feelings of emptiness, inability to control anger and some degree of paranoia.
Not all sufferers have all the symptoms but a diagnosis of BPD requires at
least five. Sufferers tend to be mainly women (about 75%) and the disorder seems
to have some biological basis as it is five times more common if one has a
first-degree biological relation who has the disorder. However, there also
appear to be environmental/social triggers such as early abandonment leading to
an attachment failure, constant put-downs during childhood, parental
inconsistency, parental incest, parental brutality, physical and especially
sexual abuse. Drug regimes and some forms of psychotherapy most notably
Dialectical Behavioral Therapy work best in combination and the prognosis is
positive as the symptoms become less severe as the sufferer reaches middle age.

Michelle, the pseudonym by which the young lady is known, has all the
above symptoms to some degree at some time or another. At her best she is as
alive and as vibrant as any human being can be but her abrupt mood swings,
violent anger and constant need for attention make her a draining companion and
the worst possible wife for a young doctor working long hours and being on call
for much of the rest of the time. The author blames himself for his own
shortcomings but the reader will undoubtedly refrain from judging him harshly
as none of the rest of us could have done any better.

The book is not long, 168 pages plus some appendices, but it is a
rollercoaster of a story and is difficult to put down once one has started to
read it. This reviewer found it very moving, often disturbing and once, very
near the end, extremely saddening. The portraits of the doctor’s and Michelle’s
families are hilarious and worthy of the true novelist. Who are the intended
readers of the book? Like so many popular psychology books, this one would be
of enormous help to relatives and friends of people diagnosed with the
particular illness, in this case BPD, as it would give them some insight into
what drives BPD sufferers. Living with such a person must be extremely
difficult and this book would reassure them that their predicament is far from
unique.

© 2005 Kevin M. Purday

Kevin M. Purday is
Head of the Cambridge International High School in Jordan and recently
completed the Philosophy & Ethics of Mental Health course in the Philosophy
Dept. at the University of Warwick.

Categories: Personality, Memoirs