Where My Patience Ends.

As a psych tech in an ED, I see it all. From suicidal patients, homicidal patients, psychotic patients, repeated visits from patients with substance abuse-crying for help with detox, kids and teens with autism or other major mental disorders.

I’ve had patients spit at me, hit me, say they don’t trust me because I’m a “fucking white woman,” patients hallucinating to the point that they believe I’m not real, or start telling me that I have an evil witch inside of me-start whispering the witches name and telling them to get out of me, patients threatening me…you name it…there’s a good chance I’ve seen it.

I had a secretary walk up to me the other day and tell me that there is a special place in Heaven for me because of the patience I have with dealing with these patients.

Let me tell you about my patience…I have very little patience in my personal life…but when it comes to work-somehow-I have the most patience I could ever hope for. I don’t understand where my patience and my calm spirit suddenly comes from, but there it is. Thank God for it…I guess it was my upbringing…I think God placed this calm spirit within me from such a young age, and because of growing up with a mother with serious mental health problems, I learned how to tap into that. God only knows how.

However…there is one line, when crossed, that my patience runs out.

I can smell borderline personality disorder from a mile away…and thank GOD those people usually come in at the very end of my shifts because my patience is so thin with those patients. I’m not proud to say that, but that’s a weakness of mine. Not necessarily all of them, but the ones who come in faking a disorder that they do not have, which is very characteristic of people with that disorder. For instance, one day a girl came in the ED for “psychosis.” When I went to assess her, she told me this dramatic story about the woman who claimed to be her mother actually having stole her from the 1900s and was mind-controlling her and raping her…she kept calling me sweetie (even though she was almost 10 years younger than me) and telling me she was actually older than me. She would suddenly fix her eyes, shake her head and say, “I’m sorry, I was just lost in my head for 6 years…” To most people, she seems delusional, right? A bit on the psychotic side…When I walked out of the room and talked to the nurses, I said, “she’s lying. she’s faking this.” The nurses just looked at me like I just wasn’t having compassion and didn’t know what I was talking about. I talked to the patient some more and asked her if she had ever been diagnosed with anything and she said “depression…and…schizophrenia…no, I don’t have schizophrenia! I don’t…no, I do…and it’s okay…I can admit that.” She kept crying for a few minutes and saying “I’m sorry! I’m being mean and crazy, aren’t I?” I told her she had only been there for 20 minutes at one point and that number stayed in her mind-she brought up 20 minutes later-applying it to her story…copying me…typical of people with borderline…they latch on to someone and try to be like them. Psychotic people don’t make sense…they don’t have stories like that…they don’t repeat numbers and remember things you say and apply them to their story…they don’t make that much sense.

When her mother finally showed up, I spoke with her in private to get some more information and that’s when she told-she has borderline personality disorder…ah, and there it is.

She was pretending to have schizophrenia.

I asked her mother how long this had been going on and it started 3 days before…which was Christmas Eve. Did she not get the attention she wanted for Christmas? Whatever it is what that this off…she chose it…she picked a disorder that she thought she could exhibit the symptoms of.

Finally, the nurses understood and saw that I actually knew what I was talking about.

I didn’t go back to see the patient…it was shift change and though I would be there for 30 minutes more, I informed my coworker of what was going on with the patient and let him handle it…my patience was gone. She was sitting in one of only 3 rooms in our pod-faking like she had an illness that other people truly have. She was wasting time-hurting her family without giving a second thought-frightening other patients…for what? attention?

I know that borderline personality disorder is also a real thing that causes people to act this way. Though she does make these choices-she also has a disorder that causes her to have this almost uncontrollable need to make these choices. I know that. I understand that is real. But for some reason…this is my weakness. It actually makes me angry.

Pretty sure I do actually know why, though. My mother had a “best friend” when I was a kid who faked like she had dissociative identity disorder like my mom did…she exhibited symptoms, even though she couldn’t quite keep up at times. She saw several therapists who ended up diagnosing her with borderline. She ended up hurting my mom and just being horrible to all of us. There was also a girl that lived with my family for a bit and I loved her like a little sister and treated her like one/took care of her as if she was…then she turned on me and my family…she started lying and making up all kinds of things and she hurt me so bad…idk for sure if she has borderline or not…she was diagnosed with bipolar, but psychiatrists try to not diagnose an underage person with bpd. Idk…she may not have it, but the things she did seemed oddly familiar. I was best friends with this guy in undergrad who was diagnosed with bipolar…he was a wonderfully broken person. I loved him. One day he murdered another student in the dorms we shared. He, too, exhibited signs of bpd. I guess, my patience is thin with people with bpd because people with bpd have always broken my heart.

Hit me. Spit at me. Cuss me out and call me names. Whatever. But don’t lie to me. 

This is where my patience ends…unfortunately. 

*Side note: I know not everyone with this disorder may be like those I have encountered, and though I have a difficult time with this, I am trying to remember that this is a real thing that they don’t necessarily control. I’m just being transparent and sharing my weakness. People give me credit for being so patient…but I don’t deserve that credit because everyone has that line…everyone has some trigger that makes them feel/think in a way that they may not be proud of. So…if you’re reading this and you have bpd…or you love someone with bpd…know that I understand. My heart still loves that guy who was my best friend…my heart still loves that girl who was my little sister. I still talk to them. I’m a work in progress. We all are. 

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4 thoughts on “Where My Patience Ends.

  1. I’m a psych nurse working in an acute admission ward so I completely understand what you mean. Individuals who have symptoms of borderline personality are generally the most difficult to work with, mostly because generic psychiatry is not able to address their needs effectively. Certainly as inpatients, their risks often increase dramatically. We all have our strengths and weaknesses, we all have our Achilles Heel. But by being aware of it we are in a better position to not let it interfere with the care we give.

    Liked by 1 person

      1. No, never boring! You might find it interesting to look up the psychodynamics involved with caring for someone with borderline issues e.g. abandonment and dependency. It’s still difficult but more understandable!

        Liked by 1 person

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