NAMI Book Review

The following is a review by Kathleen Vogtle, Communications Coordinator at the National Alliance for Mental Illness (NAMI):

Remnants of a Life on Paper: A Mother and Daughter’s Struggle with Borderline Personality Disorder

Mental illness is like a ripple on a pond.

The waves are most well-defined and cause the greatest disturbance near their origin, rocking family and friends the hardest even as they maintain a tight cluster around their loved one. As the ripple widens and spreads outward, the waves soften, yet still leave a distinct impression on an untold number of people. The displacement of the water also draws unknown and unpredictable elements to the surface, which may then influence the direction, spread or even the longevity of the ripple.

Bea Tusiani felt this ripple effect first hand when her daughter, Pamela, was diagnosed with borderline personality disorder (BPD). Remnants of a Life on Paper: A Mother and Daughter’s Struggle with Borderline Personality Disorder is a moving, impactful account of their family’s journey through symptoms, medication, healthcare issues, government agencies and lawsuits, and in-so-doing, urges others to reach out and seek help.

Remnants of a Life on Paper immediately draws the reader in through its structure. Each of the 12 chapters begins with a series of question-and-answer sessions that took place between Ed Davis, a lawyer, and Pamela’s mother and father, Bea and Michael. These excerpts provide not only a lead-in to each chapter, but also how Bea and Michael’s perceived their daughter’s thoughts and actions at the time and the understanding they gained after the fact.

The content of each chapter is presented in a unique way, with excerpts from Pamela’s diaries—her artwork, poetry and inner musings—alternating with her mother’s recollection and viewpoint on the same events. Both accounts are incredibly moving and insightful, offering a rare understanding of BPD.

Pamela’s diary entries very clearly illustrate her periods of depressed mood, irritability, anxiety and impulsiveness, all of which present a real face to typical BPD. For example, in December 1999, she writes:

December 4, 1999

DO NOT GET HIGH EVER AGAIN! I am an idiot! I must be insane! I hate myself for everything! I am not normal. I go from fine to freak-out.

December 5, 1999

I feel stupid for how I acted last night. I should not doubt my drug problem. I want to be in control of my life.

December 29, 1999

I feel crappy. Called everyone I know…. I am in a cold sweat. Should I go out to some bar tonight? No! I know that drill…but still….I don’t want to sleep or watch TV, I want some human contact.

I bought a damn outfit for New Year’s Eve and don’t have anyone to look good for. No chance of love.

Bea’s accounts are rife with a mother’s worry, her attempts to live her own life whilst caring for and worrying about Pamela, the hope as her daughter seems to improve, and the disappointment, frustration and helplessness as she slides back down again.

The reader hopes and grieves with them both.

Remnants of a Life on Paper not only recounts the relationship between mother and daughter, it also offers their differing perspectives on her treatment. The most notable instance of this occurs upon Pamela’s dual diagnosis and the family’s subsequent discussion of possible treatment facilities. Her strong desire to attend Road to Recovery, a dual diagnosis facility in Malibu, Calif. was met with uncertainty from her parents, as neither they nor any of Pamela’s psychiatrists had heard of it.

“It amazes me,” Bea recalls of Pamela’s insistence, “how, in such a short time, my daughter transitions from being withdrawn and dependent to someone in control and decisive.” But their eventual decision to allow Pamela to enter Road to Recovery ultimately proves to have tragic consequences.

Remnants of a Life on Paper is a gripping reminder of how deeply mental illness affects millions of people around the world. As Pamela writes, “There I stood, in a hole, deep in the ground. Did I dig it or just get in? Did I fall into it? Did someone else dig it and throw me in?” In the aftermath of their experience, Bea echoes her daughter in saying, “The hole Pamela wrote about is still there, but through the telling of valiant struggle, she has extended a hand to help others climb out.”

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