Girl In Need of a Tourniquet is not as well-known as Girl, Interrupted and Prozac Nation, which is a shame, because it certainly deserves more credit and attention than it currently receives. Written in non-linear, experimental style, the book is divided into nine chapters with copious quotations, allusions, and paragraph breaks. Johnson is a Director of the Center for Women’s and Gender Studies at the University of South Carolina Upstate where she teaches. Johnson’s literary background explains the literariness of the memoir and its unapologetically ‘hysterical’ (in the Cixousian sense) provocations, which while fascinating and exciting for researchers, may be understandably off-putting for readers looking for useful information about BPD. It is not an easy read, not only because of its bold literary style and language but also because of the stories it tells are brutal and gut-wrenching. She is blunt and frank about her affairs including with married colleagues of both sexes and a student. She is open about the mental illnesses and sexualities of her mother and sisters as well as her own. Her journey to BPD is intimately connected to her relationship with her lesbian identity and for me this personal growth is what makes this memoir so interesting.
As a note of warning, the book is full of references to self-harm, sex, and substance abuse, which may be triggering for sensitive readers or those with experiences of trauma. I won’t quote any of the triggering parts in this post, but I will inevitably refer to them because they are such a large part of Johnson’s life.
Living BPD, Writing BPD
Besides the graphic illustration of a human heart pierced by an arrow, what perhaps struck me the most when I first got hold of the book was the fact that it is called a memoir of a borderline personality, as if her personality was separate from and larger than herself. In the first chapter, Johnson confessed that while writing the memoir over five years, she was undergoing significant changes in her interpersonal relationships as well, and her resistance to those changes was reflected in the difficulties of writing the book.
My resistance limited the memoir to mirror rather than lamp. I produced many versions of the same story – each one warped by defensiveness, wrapped in arrogance, worn thin ny neurosis, and situated in the unpredictable ground of a volatile ego – and played musical chairs with its meaning. (21)
Johnson wanted the book to be illuminating and expressive of herself as an author rather than a reflection of what happened in her life. Illness memoirs are almost always written with the intention to be read by other patients, and as a form of protest for raising awareness; Johnson’s memoir feels more like a diary written for herself. In its unreserved candidness she spills sexual confessions and secrets, the reader is left in an uncertain position as voyeur/confidant, half overhearing and half eavesdropping, not quite understanding but too invested to turn away. Johnson does self-censor, and there is a sense that she doesn’t trust her readers in the way she substitutes references to other tragic events and stories of other women (like Princess Diana) for personal history. At the same time, as readers we are also weary about the extent to which we can take her words at face value. The quotations, arbitrary typesetting of block paragraphs on the page, sudden allusions to other stories, are disguises that distract and mislead us from details in her life.
The eldest of three daughters born to an addict, Johnson’s early life was fraught with emotional abuse and trauma. She suffered a lot of gaslighting and psychological cruelty from her mother who made her believe she was despicable. Yet in many ways she grew up to be like her mother in many ways. She learns her mother’s bad habits, from the anti-social behaviour, promiscuity, to the drug abuse, and is desperate to win her approval despite the abuse. Her unstable childhood makes her insecure and unable to maintain healthy relationships with others. She chooses to live with her father, leaving behind her two sisters with her mother.
She first learns about BPD through the university counselling office where she was then working as an English tutor, when a student who came to see one of the graduate-student counsellors was sent away from the office because she was a known ‘borderline’. She then read an article from Time magazine which listed the nine diagnostic criteria and she realised that she met all of them. She is finally formally diagnosed by her therapist.
“I make up for being borderline by reading fat books with hard words. I want to understand everything about borderline personality disorder. I want to be the best borderline personality ever. I want to be AMAZING.” (144)
Like for many women living with BPD, the moment of diagnosis is both revelatory and daunting. On the one hand the label gives Johnson something to ‘explain’ to other people, and a useful framework for reading herself. On the other hand, the self-stigma that comes with BPD as ‘bunny-boiler’ and ‘stalker’ makes it equally for her to accept herself, let alone other people. Her coping mechanism is to intellectualise, and she draws on the language of BPD to communicate her experiences to herself. ‘Dysregulation’ and ‘invalidating environment’ comforting words to her because they express her terrible experience in a non-feeling way. Yet it is also partly this nonchalance with which she delivers her writing that makes the book deeply unsettling to read.
Johnson’s BPD diagnosis is revealed midway through the memoir and in the chapter ‘’Becoming a Borderline (Notes on a flawed diagnostic label)’ she uses the category to “diagnose” her sisters. Herself as ‘discourage borderline’, someone who cling and merge with partners to compensate for their own self-doubt and helplessness; Jessica as a ‘self-destructive borderline’ whose anger is turned inward and inflicted on the self under the mask of self-sacrifice; and Melissa as the ‘impulsive borderline’ who is capricious and seeks constant attention to satisfy a craving for stimulation and sense of security. These ‘diagnoses’ mimics the language and style of psychiatric diagnostic criteria and echoes the excerpt of the BPD diagnostic criteria and Theodore Millon’s schematic diagram of BPD earlier in the chapter. Though it is not revealed whether her sisters have received official diagnoses of BPD, this diagnostic exercise invites her sisters into her narrative as though they were her alter egos representing her other lives.
‘Sex with Lesbians is better’
More than her BPD diagnosis, the most important discovery Johnson makes about herself was her identity as a lesbian. Recognising and embracing her sexuality gives her the feeling of empowerment that BPD takes. As a borderline woman, she is a medical problem and psychiatric patient to be tamed and subdued; as a lesbian, her body is not a problem but a site of pleasure and she is the one in charge.
Both of Johnson’s sisters identify as lesbians and for a long time she herself identified as bisexual, fearing the associations and stigma that come with the label ‘lesbian’. Although she found herself sexually attracted to women, it was not until she had an affair with a female co-worker called Emily, that she begins to embrace ‘being a lesbian’. Her relationship with Emily, who is married and has a daughter, is tortuous. She carves Emily’s initials into her leg and drinks excessively. Johnson’s obsession over Emily consumes her and she falls apart after Emily leaves her. She then has a string of sexual affairs with other people, including a male colleague and a student, before she finally marries her partner, Stacey.
When she first has sex with Emily, she is amazed at the ease with which she was able to experience intense sexual pleasure and orgasm, something which she was previously unable to do with men or heterosexual women. She recalls how her past boyfriends pathologised her lack of sexual arousal and recommended medical intervention, but now she realises there wasn’t anything “wrong” with her except for the heterosexual cultural privileging of male sexual pleasure and suppression of her female desire (for pleasure and for women). Her sexual experiments with Emily rebel against patriarchal expectations of sex experiences and sex roles and it is through the thrill of discovering sex as an expression of power rather than of submission that she reclaims and proclaims her identity as a lesbian.
I am exploring the subtle power dynamics of being a FEMME TOP.
I run the fuck. (71)
Conclusion
Just as the book has no clear beginning, it has no definitive ending either. Towards the end of the book, Johnson is markedly less angry and more in control of her life than before, but she is by no means free from the pain. There is no happy ending to her book where she is cured of BPD and resolves all her problems. In fact, the book ends rather abruptly, with an announcement of Johnson’s marriage, Jessica’s (now called Jay) divorce, and Melissa’s cancer. The wedding doesn’t cure her of attachment disorders but as she cares for Jay after her separation, she finds the intimacy between the three of them somehow healing. The last sentence of the book reads:
“EACH OF US MAKES TENTATIVE STEPS TOWARDS WELLNESS.
I watch the light in the sky deepens from pink to plum and wait for a better season. (222)
As a reader, I admire the courage it took for Johnson to write this difficult memoir. As cathartic as writing can sometimes, having to recall and narrativize past trauma can itself be traumatising. It is a well-written memoir that, despite the pain and violence it depicts, is also poetic and subdued. For me, illness is necessarily a chaotic mess and I feel the book’s non-linear experimental form is Johnson’s way of conjuring up the complexity of her trauma and experiences. That said, I would have perhaps liked to know more about how she dealt with CBT and how she navigates her experiences of BPD. All in all, anyone interested in mental illness and want a literary read should definitely check it out.
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