Book summary “Get Me Out of Here”: summary

Introduction

You might find yourself trapped in a relentless cycle of emotional agony, sudden rages, and deep feelings of worthlessness. Borderline personality disorder tears apart your sense of identity and damages every relationship you try to build. Rachel Reiland offers a raw look into this private hell through her personal descent into psychiatric crisis and her arduous climb toward recovery.

A harrowing, intimate account of recovery from borderline personality disorder, proving that intensive psychotherapy and unconditional support can transform a shattered life.

The book details this transformation across six distinct stages of psychiatric care and personal reckoning. You will see how emergency hospitalization gives way to psychoanalytic treatment, how childhood trauma emerges from behind an airbrushed facade, and how intense transference brings about lasting emotional resilience.

• How do you survive the acute terror of a borderline crisis?
• What happens during years of intensive psychoanalysis?
• Can you heal the wounded inner child and achieve true emotional stability?

1. Crisis and Hospitalization

Severe emotional invalidation and domestic overwhelm culminate in a suicidal crisis, forcing an entry into the psychiatric unit and the beginning of intensive treatment.

Escalating Symptoms

Childhood origins leave you with chronic shame and feelings of being fundamentally defective. Authoritarian environments punish emotional expression and create a lifelong cycle of self-loathing.

In kindergarten, Rachel dumped brown paint on another girl's drawing after experiencing intense jealousy and rage. Harsh condemnation from her teacher and nuns followed that outburst.

Domestic isolation, financial stress, and childcare responsibilities trigger overwhelming emotional paralysis and explosive rage. Routine household management becomes an insurmountable trigger. You alternate between intense dependency on your partner and furious impulses to push them away.

Rachel trapped Tim at work with frantic phone calls complaining about their unfinished house and finances. She screamed and ran away barefoot into the dark streets, spending two hours wandering and running westward to the city projects.

Unchecked psychological deterioration eventually breaches the protective barrier you maintain for your children. Outbursts are directed at the most vulnerable.

Overwhelmed by her toddler Jeffrey trying to climb onto her lap, Rachel snapped and severely spanked him. She saw the same look of horrified betrayal she remembered from her own youth.

A suicidal crisis point serves as the ultimate threshold where you finally relinquish complete self-reliance and accept professional intervention.

• Call a family crisis hotline when overwhelmed by suicidal ideation.
• Refuse to be left completely alone by negotiating safety terms with a crisis counselor.
• Arrange temporary childcare with a trusted person.
• Meet with a local pastor or clergy member to facilitate professional medical intervention.

After calling a church-sponsored family crisis hotline and speaking to a counselor for over an hour and a half, Rachel agreed to contact a local pastor who ultimately escorted her to the hospital emergency room.

The Inpatient Unit

The reality of a psychiatric inpatient unit contrasts sharply with stereotypical expectations. Social smoking lounges mix with strict, authoritative nursing control on the stress unit.

Patients in the regular psych ward socialize freely in jeans and sweatshirts. Night shifts bring strict nurses who enforce bedtimes and control access. Medication carts dispense anti-anxiety and sleeping pills reminiscent of mind control.

Rachel observed laughing coeds rushing to the evening medication cart at ten o'clock. Later she clashed with a heavyset night nurse with a pageboy haircut who acted like a drill sergeant in white. Midnight brought a new shift that enforced bedtime. At two o'clock in the morning, Rachel woke up in acute panic and decided to escape.

2. Entering Psychoanalytic Psychotherapy

Establishing a therapeutic alliance with a skilled psychiatrist creates the foundation for long-term psychoanalytic healing despite intense behavioral outbursts.

The Therapeutic Alliance

An effective psychiatrist can bypass your aggressive, defensive facade through empathetic listening and articulate deep-seated emotional truths. Instead of engaging in a power struggle or asking standard clinical questions, a skilled psychiatrist sits in total silence, listening without judgment. This non-defensive posture coaxes out an unfiltered emotional diatribe and allows the therapist to accurately mirror back your core internal conflicts, such as self-hatred and gender resentment.

When Rachel meets Dr. Padgett in a small cubicle, she launches into a fierce anti-therapy rant, but his gentle and accurate reflection of her secret desire to be understood breaks down her defenses immediately.

Inpatient behavioral outbursts lead to strict disciplinary consequences, including physical restraint and transfer to intensive care units. When you fail to control aggressive impulses, such as running laps in hospital corridors or throwing objects at staff, the psychiatrist authorizes security intervention. Transfer to the intensive care unit involves strict monitoring, confiscation of shoelaces, lighters, and cigarettes, and placement alongside severely incapacitated patients.

After throwing her Walkman at the charge nurse's head and later slamming into walls during a midnight run, Rachel is subdued by bouncers and locked in the intensive care unit. A psychiatrist can legally commit you for ninety-six hours if you represent a threat to self or others.

Rules of Therapy

Psychoanalytic psychotherapy relies on strict procedural boundaries, free association, and long-term commitment to uncover buried childhood neuroses. The therapy demands regular multi-weekly sessions over one to five years or more. It uses free association and uncensored thoughts while the therapist acts as a blank screen, revealing no personal life details to facilitate transference and bring frozen feelings to the surface under adult rational understanding.

Rachel and Tim read the pamphlet provided by Dr. Padgett detailing the origins of emotional pain in childhood and the financial and time commitments required. Therapy sessions cost one hundred twenty dollars an hour. Most patients need therapy for one to three years, though psychoanalytic therapy sometimes requires five or more years.

• Attend sessions on a regular schedule of once, twice, or three times a week.
• Practice free association by sharing uncensored thoughts in a controlled setting.
• Rely on adult, rational understanding to make buried childhood fears manageable.

Encountering harsh clinical test summaries can trigger intense feelings of betrayal, anger, and rejection in psychiatric patients. Standardized multiple-choice psychological profiles generate clinical summaries filled with severe diagnostic labels. When you read these raw clinical assessments without prior preparation, you often feel character-assassinated and betrayed by the treatment team, leading to intense outbursts and threats to quit therapy.

Rachel reads a three-page report containing her psychological profile test results with terms like manipulative, seductive, histrionic, and sociopathological, causing her to scream at Dr. Padgett over the phone and quit therapy in a rage during a standard fifty-minute hour.

Intense emotional reliance on a therapist can create a cycle of furious rejection followed by sheepish submission. You may develop a rapid, addictive dependency on your psychiatrist when dealing with severe emotional vulnerabilities. When faced with perceived rejection or harsh clinical truths, you react with extreme rage and quit, only to be pulled back by your overwhelming need for soothing and validation, ultimately scheduling new appointments.

After screaming at Dr. Padgett over the phone and telling him to shove his therapy up his ass, Rachel spends the night in agony before sheepishly calling his office the next morning to secure her Thursday appointment at 3:00 P.M. for the start of psychoanalytic therapy in earnest.

3. Uncovering Childhood Trauma

Psychoanalytic techniques such as the couch and exploration of family dynamics uncover the deep roots of shame and the protective function of an airbrushed childhood.

Therapists provide unconditional acceptance to counter your deep-seated shame and fear of abandonment. Dr. Padgett reassures you that his commitment is absolute and that nothing you say or do will drive him away, establishing a secure base for therapy despite your skepticism.

When you apologize profusely for your violent outburst after seeing your psychological profile, Dr. Padgett responds gently, stating he will not abandon her and that she is the only one who can decide to leave therapy. Each single therapy session costs 120 dollars.

The Couch and Free Association

Using the psychoanalytic couch induces intense anxiety but helps bypass conscious resistance to access repressed early memories. Lying on the couch without eye contact isolates you and strips away defensive barriers, allowing deep-seated childhood trauma to surface through free association.

When you try the couch for the first time, you experience a surge of anxiety before regressing into a vivid memory of being six years old, terrified of the dark, needing the bathroom, and fearing her father's belt. Dr. Padgett asks you to sit up with ten minutes remaining in the session.

Family Dynamics and Imprinting

Children of abuse often construct an airbrushed, idealized version of their upbringing to protect themselves from a painful reality. You convinced yourself you had a fortunate, privileged childhood as the favored baby of the family, viewing your parents' strictness and volatility as justified and harmless to cope with your internal anguish.

You rationalized your father's use of the belt and your mother's hysterical fits by telling yourself your father was a successful businessman under high stress and your mother was merely weak and harmless.

Abuse paradoxically increases the bond and loyalty of children toward their abusive parents, similar to the phenomenon of imprinting. Dr. Padgett explains an experiment where ducklings pecked by an abusive mechanical mother followed her much more closely than ducklings raised by a normal mother, illustrating why abused children fiercely defend their parents.

Dr. Padgett tells you the duck-test story about scientists using a mechanical duck that pecked ducklings with a mechanical beak, revealing that the abused ducklings followed the closest.

One parent may act as a gatekeeper and manipulator, weaponizing the other parent's strictness to control children and secure attention. Your mother acted as a powerful matriarch who twisted children's words, feigned illnesses, and reported fictitious misbehavior to the workaholic father so he would administer punishment while she played the damsel in distress.

Your mother would collect grievances about the children throughout the day and present her own version of events to the father, quietly leaving the room as he pulled off his belt to discipline them.

A therapist must establish firm boundaries and threaten suspension to force an out-of-control patient into taking responsibility for their behavior. When your explosive behavior and constant emergency calls undermine therapy, the therapist must draw a hard line, refusing to enable destruction and demanding active, rational participation.

Four months elapsed since their first meeting when the decisive session occurred, lasting thirty minutes while therapy sessions happened three times a week. Dr. Padgett brings Tim into a session and warns you that if you cannot maintain a degree of rational reality, he will temporarily suspend therapy and risk committing you to a state hospital, while also limiting your emergency calls to once a week.

4. Confronting Borderline Pathology

Defenses and Dissociation

Intellectualizing and mastering psychological jargon can serve as a defense mechanism to avoid experiencing raw emotions. By intensely studying psychoanalytic books and becoming well-versed in terminology, you try to intellectually conquer your problems while maintaining emotional distance and hiding behind a sophisticated facade.

Intellectual mastery of psychological terms hides the raw emotions of the inner child.

Rachel stayed up until one or two in the morning reading psychoanalytic books and mastered terms like transference and projection to please Dr. Padgett. This defense leaves little room for actual healing.

Lacking a fully integrated personality leads to fragmentation or dissociation, where different aspects of the personality emerge depending on the situation. During times of intense emotional stress, alternative personae step in. An abusive, tough-acting persona fends off vulnerability, while a pleading, begging little girl persona asks for rescue.

Rachel experienced explosive rages and threatened violence against Dr. Padgett and her parents, followed by immediate terror and pleading for help.

Severe eating disorders can function as psychological defenses or alternative hiding places to avoid facing painful and frightening inner feelings. Dr. Padgett explains that the re-emergence of anorexia was not a separate illness, but another rock for the buried fears and irrational feelings of the inner child to hide under.

Rachel relapsed into anorexia, reaching a dangerous weight while lying to Tim and skipping meals as a penance, mirroring her 1978 adolescent anorexia. Her weight fell from an initial goal of 120 pounds down to a stagnated 110 pounds, finally reaching a dangerously low 103 pounds on her five-foot, six-inch frame.

The BPD Diagnosis

Discovering a formal psychiatric diagnosis through paperwork can bring shock, validation, and a deeper framework for understanding self-destructive behavior. Finding the diagnosis of borderline personality disorder on a hospital treatment plan leads you to research the condition and evaluate your life against official criteria.

A formal diagnosis provides a concrete framework to understand overwhelming emotional instability.

Rachel found a pink hospital form labeled Patient Treatment Plan with the diagnosis Borderline Personality Disorder and subsequently read Jerold J. Kreisman's book I Hate You, Don't Leave Me. The book noted that 10 percent of borderlines committed suicide.

Borderline personality disorder is characterized by a pervasive pattern of instability in mood, interpersonal relationships, and self-image. The diagnosis requires meeting at least five specific criteria from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM).

Rachel evaluated her own history against the DSM criteria:

• frantic efforts to avoid real or imagined abandonment;
• a pattern of unstable and intense interpersonal relationships;
• identity disturbance with markedly and persistently unstable self-image;
• impulsivity in areas that are potentially self-damaging;
• recurrent suicidal behavior, gestures, or threats;
• affective instability due to a marked reactivity of mood;
• chronic feelings of emptiness;
• inappropriate, intense anger or difficulty controlling anger;
• transient, stress-related paranoid ideation or severe dissociative symptoms.

5. Transference and the Inner Child

Intense acting out and attacks on the therapist reveal the desperate demands of the inner child who is trapped in black-and-white thinking.

Rachel hides a digital scale in the basement storage corner, sneaking down several times a day to check her weight. Despite the pain and expense of a three-week hospital stay to stop weight loss, she skips meals, triples workouts, and drops to 101 pounds, convincing herself that she must avoid becoming fat.

Rachel weighs herself in the basement, sees 101 pounds—a pound less than her discharge weight—and falls back into self-destructive thoughts while hiding the scale from her husband Tim and Dr. Padgett. This big rock of anorexia remains a sneaky, internal demon.

Acting Out in Therapy

Feeling abandoned by Dr. Padgett's refusal to offer comforting words during an emotional session, Rachel seeks revenge. She finds his car in the doctors' parking garage using his vanity license plate, places a hostile note under his windshield wiper, and adds an intimidating threat outside the folded paper.

Rachel tracks down Dr. Padgett's red Mazda with a sunroof and vanity plate JMP in the doctors' parking lot, slipping a note on the windshield and writing that she knows where he lives. The blank screen of psychoanalysis triggers extreme acting out.

Following a turbulent session where she withholds her feelings and feels pushed out, Rachel retreats to the attic, locking herself away and taping alarming notes around the house implying she possesses a loaded gun. This forces Tim to call Dr. Padgett under threat of police intervention, deeply traumatizing their young children.

Rachel hides in the attic while Tim reads her alarming notes and tries to break the door down, eventually leading to a phone call with Dr. Padgett where police intervention is threatened if she refuses to confirm her safety. Ten minutes is the deadline given by Dr. Padgett for Rachel to call him back or face the police.

The Inner Child

Dr. Padgett explains that a child's intense need for a parent is completely natural and does not work in reverse. Healthy parents do not exploit a child's vulnerability or abandon them when they throw temper tantrums or say hateful things out of temporary black-and-white thinking.

Dr. Padgett compares Rachel's violent emotional outbursts and declarations of hatred to a toddler throwing a tantrum over a crystal vase, which a loving parent handles without taking it personally or retaliating. Unprocessed childhood terror leaves adults trapped in the black-and-white emotional processing of a two-year-old, leading to dangerous forms of self-destruction.

Rachel realizes her violent mood swings and threats mirror the black-and-white thinking of her four-year-old son Jeffrey and toddler daughter Melissa when they experience a tantrum. Thirty years is Rachel's age and the duration she managed to survive before beginning therapy.

Dr. Padgett points out that even in an abusive childhood, Rachel subconsciously sought and stored tiny droplets of love from teachers, friends, or brief moments with parents, which ultimately kept her alive. Two-hundred-pound weight is a metaphor for the heavy emotional burden Rachel carried throughout her life.

To bypass Rachel's intellectual defenses and access her trapped childhood emotions, Dr. Padgett suggests play therapy. By interacting with her children's toys, Rachel physically enacts her hatred for girlhood and dolls by using boy toys to violently destroy female figures.

Rachel brings two garbage bags of her children's old toys—including a laser gun, G.I. Joes, and a ballerina doll—into Dr. Padgett's office, eventually smashing the ballerina against the wall. Two weeks is the duration of numb and unproductive sessions prior to introducing play therapy, and ten o'clock is the time at night when Rachel sneaked the bags of toys out to her car while Tim watched the news.

You can use these steps during play therapy:

• Pick up whichever toys you want to from the bag.
• Play with them as you wish.
• Say what's on your mind.

6. Graduating into Emotional Resilience

Through strict boundary setting, spiritual insights, financial accommodations, and a final no-contact termination period, complete recovery and long-term stability are achieved.

Thirty-one-year-old Rachel experiences true faith during a Sunday church service while staring at a sculpted crucifix. She confronts her resentment toward God and feels the profound comfort of knowing she was carried through her worst trials. You can explore spirituality by embracing an agnostic soloist identity or moving past performer's detachment and passion.

Spirituality and Forgiveness

Father Rick explains in the confessional that Jesus called wrongdoers ignorant rather than innocent. Forgiveness is a one-sided internal process that brings healing to the victim rather than absolving an unrepentant trespasser. Thirty-three-year-old Rachel discusses this moral dilemma for over 30 minutes in the confessional while still dealing with childhood trauma.

You can use these steps for forgiveness:

• Take care of yourself
• Forgive yourself first
• Spend time every day in prayer thinking about the discussion of forgiveness

As you gain emotional maturity during 1994, you stop acting as the compliant peacemaker during family gatherings. You set clear boundaries and refuse to participate in toxic games or family roles.

You can use these steps when confronting dysfunctional family dynamics:

• Tell critical family members directly what food offerings are available and let them bring their own if they are dissatisfied.
• Refuse to participate in toxic phone conversations or venting sessions about other family members.
• Express honest personal opinions instead of defaulting to a diplomatic litany of apologies.

Termination and Long-Term Stability

Dr. Padgett enforces a one-year no-contact period after termination to ensure that any return to therapy is driven by genuine unfinished business rather than separation anxiety. Rachel initially fights the one-year rule, calling it needlessly cruel, but eventually comes to understand that an emotional hypochondriac needs a hard time limit. September 12, 1995 is the final termination date circled in red on the calendar.

During their final reminiscences, Rachel reviews labels like manipulative, self-destructive, seductive, attention-seeking, and histrionic with Dr. Padgett. Four years is the duration of Rachel's transformative therapy process that uncovers her diamond core and helps her move beyond borderline personality disorder and the BPD diagnosis.

Looking back from the perspective of January 2004, Rachel reflects on eight and a half years of long-term stability post-therapy. Life continues to bring normal crises, but you can weather challenges independently and maintain lasting peace of mind.

10 Key Ideas

1. Severe emotional invalidation, domestic overwhelm, and childhood origins culminate in a suicidal crisis that forces an entry into the psychiatric unit and the beginning of intensive treatment.
2. Establishing a therapeutic alliance with a skilled psychiatrist creates the foundation for long-term psychoanalytic healing despite intense behavioral outbursts and strict procedural rules.
3. Psychoanalytic techniques such as the couch and the exploration of family dynamics uncover the deep roots of shame and the protective function of an airbrushed childhood.
4. Intellectualizing psychological jargon and experiencing fragmentation hide the raw emotions of the inner child while providing a concrete framework through a formal borderline personality disorder diagnosis.
5. Intense acting out and attacks on the therapist reveal the desperate demands of the inner child who is trapped in black-and-white thinking and regressive behaviors.
6. Dr. Padgett enforces firm boundaries and introduces play therapy with toys to help Rachel bypass intellectual defenses and access trapped childhood emotions.
7. Spiritual insights and confessional discussions about forgiveness allow thirty-one-year-old and thirty-three-year-old Rachel to embrace faith and stop acting as the compliant peacemaker during toxic family gatherings.
8. Dr. Padgett enforces a one-year no-contact termination period to ensure that any return to therapy is driven by genuine unfinished business rather than separation anxiety.
9. Four years of transformative therapy uncovers Rachel's diamond core and helps her move beyond borderline personality disorder and the BPD diagnosis.
10. Looking back from January 2004, Rachel reflects on eight and a half years of long-term stability post-therapy, proving that intensive psychotherapy and unconditional support can transform a shattered life.