I finished studying for the day. However, I still feel energized and wish I could keep studying. It’s not the first time this happens. I think it’s the stress of knowing Step 1 is closer each day.

So I was thinking about this thing recently… Well, no, really I’ve been thinking about it for a long time now, since I got the borderline personality disorder diagnosis and began therapy. Therapy has really helped me notice all the BPD behaviors that I have. First it was realizing that I had issues with abandonment. Then it was realizing that cutting and self-harm goes beyond being just “right or wrong”. And, finally, it took me a while to admit to myself that I split other people (and myself) into black and white, good and bad, positive and negative. And many more.

Specifically, it’s the splitting what I was thinking about. Splitting and it’s effect on countertransference. For those who don’t know what countertransference is I’ll paraphrase one of my handy Step 1 books: First Aid. It’s basically, the feelings a doctor projects onto a patient. These feelings arise from the patient reminding the doctor of a “formative or other important person” in their life. So, for example, if the patient reminds me of my father, then I’ll relive those feelings and project them onto the patient.

Simple enough. (sarcasm)

So, I was thinking about how having BPD could affect how I experience countertransference as a future doctor. (I’m a very insecure person, I think about every teeny detail all the time, so please bear with me.)

Having a BPD label has made me question whether I’ll be a good doctor. I’m not, by any means, insinuating that those of us with mental illness are flawed. Not at all. Never. What I mean is, that I worry all the time about how having this illness will affect how I treat my future patients. Sure, it has helped me be 120% more empathic, and that’s a beautiful experience!

But what if I were to encounter a person who reminds me of, say, my sister? Or my mother? Or of my ex? Would I split that person into black and white? Would I not recognize the evident countertransference and end up seeing the person as all negative or all positive? And how would that affect how I treat that person? Would I unconsciously favor other patients over others just because they are all good or all bad?

I think it’s valid that I question myself these things. I want to be the best doctor that I possibly could! BUT, and this is a big but, I have to learn to trump my irrational-BPD-side. I can’t let unconscious feelings slip through and split patients. I have to recognize the countertransference and work on it, not let it blind me.

Which is where therapy comes into play. Of course.

And I’m sure all of this begs the question of whether I’m OK with having doctors with mental illness treating patients. Of course I’m OK with it. Just because some people are doctors doesn’t mean they can’t get sick. Plus, I’ll be one of them.

And I think having a mental illness will make me one damn good doctor, thankyouverymuch.

  1. Hi again, it's legitimate to question how our conditions will interact with patients. It shouldn't limit us though, we just have to figure out each step one by one…You are definitely on the right path!
    All the best with the Step 1 studying 🙂


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