Case Study M - Part 2

The Symptoms and the Diagnosis

There were plenty of frogs, patiently waiting, taking whatever came along — sometimes a fly, sometimes little Princess M.

Conspicuous Behaviors

Does it seem extraordinary to you?

Let us continue.

In the evenings, she likes to have a few glasses of Prosecco, sometimes a bottle, sometimes 1.5-2, depending on her mood and the events of the day or the relationship. She likes to go out, she eats very little (if anything at all), works like someone possessed, and has a great many doctor’s appointments (3-4 per week), naturally with different doctors. She always had some kind of complaint. M. had something different every day. One could wake up in the morning and ask, “What does M. have again today, where does it hurt?”

She is very impatient and can barely or not at all tolerate inner tension. She is very easily offended, which she expresses in extremely exaggerated ways. At first glance, she appears rather introverted. Looking more closely, she seems extroverted. Yet she is neither one alone. Wherever she goes, she always has a water bottle with her. Sometimes her pupils were large, then again very small. Opening her refrigerator, one found nothing to eat — a piece of cheese and a few chocolate bars — but wine or Prosecco.

What was striking was that M. never had money, although she earned very well. What on earth was she doing with it?

The Diaries

Her diaries read like roller coasters full of pain toward herself and her life, full of idealization for whoever was currently the object of her affection, and suicidal thoughts that surfaced again and again — described in detail when she did not feel loved.

Is it becoming extraordinary, or is that just your impression?

Relationship Patterns

In relationships, she immediately speaks of absolute, undying love, mystical connection, and very quickly offers sexuality — or rather, before the relationship even begins. She makes future plans and verbalizes them (this after just a few hours or days). She is a person with an overwhelming need for acceptance, warmth, security, sexuality (which goes in every direction), respect, understanding, and being the center of attention.

Again and again she is deeply in love, yet the relationships seem very changeable and not lasting, like her nature. She has many failed relationships behind her, which she typically ended herself. What was striking was how she portrayed the relationships and why she ended them. Thus one felt pity for the princess who was only searching for the frog prince. If someone had ended the relationship, she would do everything to reverse this — and then leave.

What was striking was that M. had great difficulty being alone, as each failed relationship was immediately followed by the next, or one already existed. Or these brief periods “of being alone” — which amounted to days, at most a few weeks — were bridged with very short-term affairs.

Esotericism and Rituals

She calls premium-rate numbers to have cards read or horoscopes told. She frequently visits a card reader and naturally lays cards herself. Naturally, she is not a person but a reincarnated witch — a white witch, of course. Should she move again — which happened 8 times in the last 12 years — the corners of the new apartment are thrown with sand and clapped out, naturally accompanied by the appropriate witch dance.

It is becoming more unusual? One could actually say “quite unhinged.”

The Diagnosis

Yes, you are thinking correctly. M. suffers from borderline disorder (extremely pronounced), accompanied by anorexia and hypochondria. This is a cascade disorder (multi-comorbidity). The underlying condition is borderline disorder, with anorexia and hypochondria layered on top. The anorexia and hypochondria are here a part of the borderline disorder.

At first glance, one only recognizes the anorexia; at second glance, the hypochondria; and only upon very close examination, the borderline disorder.

Back to the Introduction Case Study M - Introduction

Part 3: The Childhood The development of the disorder in early childhood