I recognize the conference room as the place where, when I was 14, I met with my mother and the social worker for the last time. My father had gone away to live in Egypt. My mother was wearing a kerchief around her head and a heavy bronze Star of David wedged between the hills of her breasts. Years later, seeing the mountains of Jerusalem, cupping the scathing sand of the desert, hearing the primitive wails of the Hasids who mourned the Temple's destruction, I would think of my mother's burning body, a pain T could never comprehend.

This is the conference room where she, unstable, prone to manic highs and depressive lows, shot through with a perpetual anxiety that made her hands shake, this is the same conference room where she told me she was giving me over to the care of the state, giving me up to become a foster child."I can't handle you anymore," she'd said to me, spit at me. "l no longer want you with me."

I bow my head in deference to something I cannot name, and enter the room. Things are screaming inside me and my eyes feel hot. Nancy introduces me all around and I take a seat, pull out a notebook, try to act as calm and composed as possible. "The patient Ms. Cogswell," the bearded psychiatrist begins, "is not able to make good use of the hospital. She's an extreme borderline, wreaking havoc on the unit. We suspect her of some factitious posturing as well." He pauses, looks at me, clears his throat. I smile back at him but my mouth feels uncoordinated, tightness at its corners. I won't cry, won't cry, even though in the one-way mirror, in the crisscrossing of the creamy branches beyond the ward's windows, I see my mother again, her face coming to me clearly, her eyes haunted with loneliness and rage. I feel her fingers at my breasts and flinch.

"We think," a social worker named Miss Norton continues, "that we'll be discharging her in a matter of days, as soon as we get her stabilized on some meds. We take it you'll be picking up her case on an outpatient basis. Any ideas of how you'll work with her?"

I nod, pretend to make some notes on the pad. As my voice rises through my throat, I'm surprised at how smooth it sounds, a sleek bolt of silk. "Lots of limits," I say. "We know borderlines do well with lots of limits. This is the only context in which a workable transference can begin."

The bearded doctor nods. In the tree, my mother tongues her teeth and wind lifts her lovely skirt, embroidered with fragile flowers. And then she is not my mother anymore, but a little girl whose legs are white, a single ruby scar on scrubbed knee. And while part of me sits in the conference room, part of me flies out to meet this girl, to touch the sore spot, fondling it with my fingers.

For I have learned how to soothe the hot spots, how to salve the soreness on my skin. I can do it so no one notices, can do it while I teach a class if I need to, or lead a seminar on psycho-diagnosis. I can do it while I talk to you in the evenest of tones. "Shhhh," I whisper to the hurting part, hidden here. You can call her borderline -- call me borderline -- or multiple, or heaped with post-traumatic stress -- but strip away the language and you find something simple. You find me, part healthy as a horse and part still suffering, as are we all. What sets me apart from Kayla or Linda or my other patients like George, Marie, Pepsi -- what sets me apart from these "sick" ones is simply a learned ability to manage the blades of deep pain with a little bit of dexterity. Mental health doesn't mean making the pains go away. I don't believe they ever go away. I do believe that nearly every person sitting at this oval table now has the same warped impulses, the same scarlet id, as the wobbliest of borderlines, the most florid of psychotics. Only the muscles to hold things in check -- to channel and funnel -- are stronger. I have not healed so much as learned to sit still and wait while pain does its dancing work, trying not to panic or twist in ways that make the blades tear deeper, finally infecting the wounds.

Still, I wonder. Why -- how -- have I managed to learn these things while others have not? Why have I managed somehow to leave behind at least for now what looks like wreckage, and shape something solid from my life? My prognosis, after all, was very poor. In idle moments, I still slide my fingers under the sleeves of my shirt and trace the raised white nubs of scars that track my arms from years and years of cutting. How did I learn to stop cutting and collapsing, and can I somehow transmit this ability to others? I don't know. It's a core question for me in my work. I believe my strength has something to do with memory, with that concept of fluid time. For while I recall with clarity the terror of abuse, I also recall the green and lovely dream of childhood, the moist membrane of a leaf against my nose, the toads that peed a golden pool in the palm of my hand. Pleasures, pleasures, the recollections of which have injected me with a firm and unshakable faith. I believe Dostoyevsky when he wrote, "If man has one good memory to go by, that may be enough to save him." I have gone by memory.

And other things too. Anthony Julio wrote in his landmark study, The Invulnerable Child, that some children manage to avoid or grow out of traumatic pasts when there is the presence in their lives of at least one stable adult -- an aunt, a neighbor, a teacher. I had the extreme good fortune to be placed in a foster home where I stayed for four years, until I turned 18, where I was lovingly cared about and believed in. Even when my behavior was so bad I cut myself in their kitchen with the steak knife, or when, out of rage, I swallowed all the Excedrin in their medicine cabinet and had to go back to the unit, my foster parents continued to believe in my abilities to grow, and showed this belief by accepting me after each hospital discharge as their foster child still. That steady acceptance must have had an impact, teaching me slowly over the years how to see something salvageable in myself. Bless those people, for they are a part of my faith's firmness. Bless the stories my foster mother read to me, the stories of mine she later listened to, her thin blond hair hanging down in a single sheet. The house, old and shingled, with niches and culverts I loved to crawl in, where the rain pinged on a leaky roof and out in the puddled yard a beautiful German shepherd, who licked my face and offered me his paw, barked and played in the water. Bless the night there, the hallway light they left on for me, burning a soft yellow wedge that I turned into a wing, a woman, an entire army of angels who, I learned to imagine, knew just how to sing me to sleep.