Breaking the Silence



Bridgeport Mental Hospital



Dr Benjamin Drake, Clinical Psychologist at the Bridgeport Mental Hospital, pauses outside the bolted steel door and studies his new State-assigned patient’s case file for a moment before entering.  30-year old female, classic symptoms of borderline personality disorder – the splitting between idealizing and demonizing others, mood disturbances, self-harm and if left untreated - suicide attempts – the last attempt almost a successful one. 

He spent the last three weeks trying to get through to Annabella without any significant progress.  It was frustrating to him. 

It’s his off day today, but Benjamin is adamant to gain Annabella’s trust – he will do whatever it takes. 

Benjamin places the file on the coffee table stationed outside the door, turns the lock and walks in.

He sits down on the vacant chair opposite his patient placing his hands in his lap – palms facing down – just like hers. 

Individuals with BPD can be very sensitive to the way others treat them, reacting strongly to perceived criticism or hurtfulness – a careful approach is warranted and no matter how frustrating, he will just have to wait until she is ready to talk to him. 

Her face is pale-white and she has green eyes, like emeralds.  She looks defeated.  Sitting there she seems vulnerable and broken –

She doesn’t move – just continues staring out the window as if she is the only person in the room.  He continues to study her. 

She appears calm, no sign of anxiety or paranoia but her dissociative state is a psychological disorder frequently linked to severely traumatic childhood experiences – usually the root cause of borderline personality.

“Good afternoon Annabella.” He breaks the silence.  

Studies show that patients can be hyper-alert to signs of rejection or not being valued.  They tend to view the world generally as dangerous and malevolent, and tend to view themselves as powerless, vulnerable, unacceptable and unsure in self-identity.

Benjamin notices her hands stir slightly. 

Her case file indicates her mother passed away in her senior year.  There is no mention in the file about a father.  Deceased maybe?  Estranged? 

Her mother suddenly became very ill after Annabella’s 16^th birthday and deteriorated to such an extent that she was bed-ridden until she passed away in Annabella’s senior year.  The file mentions no other relatives.    

“Annabella, tell me about your mother.”  A patient’s childhood is always a good place to start. 

She slowly turns her head and when her eyes met his, Benjamin sees a sadness in them that makes him feel he as if he would never be cheerful again.

And then she speaks …