2 Mindful Therapy Techniques Healed My BPD

When I first became depressed, all had been well. I was an anxious, screen-addicted 16 year-old, but I was well-liked by my teachers and classmates and my parents believed my future was bright. The metastasizing bleakness I felt within was unreasonable and inexplicable, except I seemed to know, “You are a very, very bad person, and you will never be happy.” Or, at least that’s what I told myself.

Initially a mindfulness skeptic

In a matter of weeks, I wanted to die. I began visiting the school social worker, who was a sweet Italian-Canadian lady named Anita. Anita strongly believed in the healing power of mindful breathing, which she taught in a sparsely attended meditation club during lunch breaks.

I let my mind wander aimlessly during those sessions, believing that mindfulness was simultaneously too hard for me to practice and too simple to be effective. How could paying attention to my breath possibly have any meaningful effect on the unprovoked and agonizing emotional pain that was suddenly tearing my life to shreds?

I was a mindfulness skeptic right out of the gate, and while Anita helped and inspired me in many ways, in my head I thought little of her passion for mindfulness. Little did I know that years down the line, mindfulness would be my salvation.

Antipsychotics, ECT and BPD

By the time I was 17 years old, I’d started taking antipsychotics and was undergoing electroconvulsive therapy (ECT), commonly known as electroshock therapy—a therapy that was as intensive as I believed my depression would require. The riskier and more burdensome the treatment was, the more hopeful I’d feel that it would help me.

Over the next four years of lingering unproductively in university, I underwent lots of ECT and went through many courses of therapy, all while riding the medication carousel and trying to find something that helped. At some point I was diagnosed with borderline personality disorder (BPD), which is characterized by intense mood swings, self-destructive behaviour and unstable relationships.

Drinking, smoking, self-harm, bad relationships, hospitalizations and starving myself were my extracurricular activities in those years. There were wholesome periods, too, during which a treatment would work for a time and I’d get in the habit of meditating daily. I found much of what I read about Buddhist philosophy to be evidently true, but I struggled to integrate mindfulness into life outside meditation, and after six months or so I’d relapse and be in that dark hole again.

My first full-time job

After six tumultuous years, I was finally finding my way in life at my first full-time job as a telefundraiser. The medication I was taking had been working for me, and in a bizarre twist of fate, I proved to be a prodigious fundraiser. The employee turnover rate was indicative of the difficulty of the job, because in nine months, I was the most senior fundraiser there.

Having the job was a fortuitous self-esteem boost, and by the time I was once again senselessly plunged into depression, I believed from the bottom of my heart—for the first time in my life—that life was worth living. Though I’d relapsed into self-harm and was experiencing wicked mood swings, my job proved to me my own value and my co-workers had become some of my best friends.

Thus, my attitude was firm and hopeful when I got the call that I was at the top of the waiting list for the six-month dialectical behavioural therapy (DBT) program at an Ontario (Canada) hospital’s borderline personality disorder clinic. I’d been on the waiting list for three years and the timing of that call was impeccable; the thread of my sanity was rapidly unravelling once again, and I was more motivated than ever to see myself get through the ordeal.

More about DBT

For those unfamiliar, DBT was created by a Buddhist psychiatrist named Marsha Linehan as a way to treat BPD, which is more of a complex trauma response that can be healed with therapy than an illness to be treated by medication.

Dr. Linehan suffered from borderline personality disorder herself and found relief in her Buddhist practice. Therefore, she adapted various aspects of Buddhist philosophy into teachable skills to improve patients’ emotion regulation, distress tolerance and interpersonal effectiveness, with mindfulness being the foundational skill upon which all others are built. This therapy has proven to be immensely effective for BPD, among other disorders, allowing many patients to achieve full remission.

Incorporating mindful journaling

Throwing myself into therapy wholeheartedly, I began “studying” DBT at work. I memorized DBT skills by writing and rewriting sections of Dr. Linehan’s DBT manual in a notebook while I was dialling phone numbers. This was interspersed with obsessive journaling about my present experience, which was my way of cultivating mindfulness within myself and remembering to practice DBT skills as the need arose.

This constant journaling proved to be incredibly helpful, especially as I gave myself many guidelines to keep my observations constructive and truthful to reality, rather than being driven by my emotional inclinations. A journal can become a miserable echo chamber for false beliefs, and while the opportunity to vent can be useful to some, it doesn’t fit in with the non-judgmentally aware spirit of mindfulness.

This practice of constructive, mindful journaling was transformative. Slowly, I learned to identify and describe my emotions rather than being consumed by the agony of it all, and for the first time, I noticed the physical sensations that accompanied them. For instance, a hollow feeling in my chest occurred when I felt alienated, dissociated and empty, which was a phenomenon I could previously only describe as “feeling weird” (to the chagrin of my psychiatrist).

I began to notice that painful feelings end naturally, often without intervention. In the past, I’d been so quick to try to make them go away by whatever destructive means necessary. I discovered that emotions want to be acknowledged and investigated, not decimated. Emotions are a message from your body, and whether or not they’re helpful, repression will only make them come back more loudly than before.

I also began to notice certain patterns arising repeatedly, and as I defused those emotional bombs, they became less impactful. For example, I often had the delusion that my co-workers secretly hated me. As I fact-checked beliefs like that and recorded observable proof that they weren’t true, I stopped feeling pulled into those thoughts when I noticed them.

This obsessive journaling also gave me the chance to actively use therapy skills and practice mindfulness as situations called for these techniques. So often in the past, therapy skills had been learned and practiced, but only in therapy sessions. Journaling kept me present and kept the skills close at hand. Over my six months at the clinic, filling up notebook after notebook, I began to integrate DBT skills into my life and using them became automatic.

Practicing Tara Brach’s “RAIN” meditation method while listening to the song “Echoes” by Pink Floyd, rather than self-harming, became my go-to reaction to an intense mood swing. Delusional beliefs and chronic feelings of emptiness stopped arising. Slowly, I was being freed. I could feel it.

Graduation and full remission

When I graduated from the DBT program at the end of 2023, my therapist administered the borderline personality disorder assessment questionnaire for the second time, to measure my symptomatic improvement. My symptoms had been reduced from severe to subclinical levels, meaning that I no longer met the diagnostic criteria for BPD. I had achieved full remission.

I haven’t attended therapy or been prescribed antipsychotics in the years since, though I still take an antidepressant and see a psychiatrist every four months. For a time, intensive interventions like electroconvulsive therapy helped me when I needed them, but mindfulness helped me exponentially more (and still does).

I don’t journal much these days, but I’m a member of a Theravada Buddhist Sangha with whom I meditate daily, and the group is my supreme support system when it comes to living a mindful, ethical life.

If I could go back in time and tell my 16-year old self about the role mindfulness would play in her life 10 years down the line, she would think I’d gone mad. In the words of the Venerable Ajahn Sumedho, a Buddhist monk, “some people make themselves into such complicated personalities.” That complicated teenager I was wouldn’t have believed that something as simple (and difficult!) as mindfulness could disentangle the mental knots I’d tied myself up in.

Anita knew her stuff all along. If she or any other social workers read this piece, keep teaching mindfulness to teenagers! Those wiser than I was will give it a chance, and those who aren’t might come around someday. Thank you for planting the seeds that ended up bearing fruit so far in the future. Thank you for caring.

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