I Hate You, Don’t Leave Me: Two Tales of Borderline Personality Disorder
August 10, 2007
I’ve got a borderline personality disorder (BPD) two-fer to share with you today. Both articles, from Psychology Today, look at BPD from a different perspective. I’ve always been fascinated with borderline personality disorder. On one hand it is one of the most esoteric diagnoses in the mental health profession. On the other hand, it’s one of the most damaging and traumatic - for both the person living with the disorder and those around him or her.
As a little precursor to the stories, here is the “official” diagnostic criteria for BPD as stated in the Diagnostic and Statistical Manual of Mental Disorders (the book of criteria mental health practitioners use to make psychological diagnoses):
A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
- frantic efforts to avoid real or imagined abandonment.
Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.- a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
- identity disturbance: markedly and persistently unstable self-image or sense of self
- impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, Substance Abuse, reckless driving, binge eating).
Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.- recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
- affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
- chronic feelings of emptiness
- inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
- transient, stress-related paranoid ideation or severe dissociative symptoms
See why I call it an “esoteric” diagnosis? A lot of psychological diagnoses are subjective - and BPD more so that some others. BPD is much more common in women than men (although my time spent at the hospital leads me to believe this trend in diagnosis is changing).
I can also tell you from my time at the hospital that patients living with borderline personality disorder are some of the hardest to help. Unlike some conditions that can be stabilized with medication and treated therapeutically thereafter, BPD is an ingrained way of thinking that medication has little effect on. The very nature of the condition often leads to a self-fulfilling cycle of behaviors that make it very difficult to shake.
But I digress… on to the two stories.
The first looks at ways to deal with a borderline parent. Because those living with BPD are so “high maintenance” at times, a borderline parent can often make children feel like they are actually raising the parent - instead of the other way around. As the story points out, a borderline parent will often inadvertently make children feel like an extension of themselves. They expect their children to meet their needs and share their emotional instability.
One of the parts of this article that was most interesting to me was Christine Lawson’s take on borderline mothers. In her book Understanding the Borderline Mother, Lawsom makes the case for dividing a mother with BPD into 4 distinct personalities: the Queen (controlling), the Witch (sadistic), the Hermit (fearful, reclusive), and the Waif (helpless). That’s an awesome analysis that really does fit the dramatic changes that one can witness in someone living with BPD.
Imagine living with a parent who wore all of those masks? Having dealt with BPD firsthand at the hospital I can only begin to imagine growing up with such radical changes in persona. Unfortunately, I’ve also seen the affects of a childhood wrought with borderline. Many times children - especially females - will develop borderline tendencies themselves. We saw many mother-daughter combos at the hospital.
The second story is just that: a story. It’s the tale of a medical student who falls for and marries a patient with a borderline personality disorder. His thinking was that his unconditional love would be enough to overcome the BPD. But sadly it was not.
I’ll let you read the story yourself (and if you’re remotely curious about BPD I honestly suggest you do). It illustrates some excellent real life examples of the ways that BPD can wreck even a loving relationship. Ultimately the BPD usually prevails. Again, this leads to a self-fulfilling cycle: the person living with borderline feels empty, unloved, and useless… they find someone and attach themselves quickly… their smothering need for attention drives the other person away… and feelings of emptiness return.
Like I said, I’ve always been fascinated with borderline personality disorder. But I’m also torn about it. Sometimes I don’t think it’s really a mental “disorder”. In many ways it’s just a personality type. All of the personality “disorders” are, I suppose… but they’re types we’ve labeled as maladaptive. “Disorder” also suggests some kind of sickness or illness. And I’m not sure that fits BPD.
After looking over all of this information, what do you think? Is borderline personality disorder an “illness”? Is it just a maladaptive way of thinking? Should it, as a colleague once suggested, be called “selfish personality disorder” instead?
Posted in In the News, Psychology
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- The Emotional Roller Coaster
- Scientists Successfully Reverse Autistic Disorder in Mice
- Don’t Lie to me Argentina (or anyone else, for that matter)
August 10th, 2007 at 11:53 pm
BPD is an illness. I have it. I have been able to work hard at over comming some aspects of it, such as black and white thinking. I am able to function if my enviroment is supportive. At times I have what I call episodes and I can feel the difference in my body and mind, I can almost feel a shift so to speak right before it happens. Then I have no control over the BPD, it takes hold and all the work I have done to over come it goes out the window. I believe it is neorological and triggered by emotions, similar to how lights can trigger epilepsy. I am not a doctor or researcher though so this is based on what I have read and my own experience.
August 13th, 2007 at 11:33 am
I think it really just depends on the person and how serious THEY think it is.
Like, for instance, I have ADD. Not a big deal to me. BUT..there are tons of our clients where I work who have AD/HD as their primary diagnosis. Yes, technically it’s a “learning disability” but I don’t take it that seriously…well…seriously enough to where I get provided services for it. But to some people it is a big deal. In fact, I can think of one person in particular who I think would do anything in their power to not get it under control, because I feel like they want to have an excuse for acting a certain way or not doing things the way they ought to be done.
I have no doubt that a lot of the people who have BPD have a hard time managing it…but bottom line is they are aware of what is going on, and they have the power to control themselves…especially if it is a part of their personality. I just think there are a lot of people who like to use it as an excuse for their actions and/or “self harm.”
October 5th, 2007 at 11:56 pm
Doesn’t the latest brain research show succinct neurotransmitter and brain area malfunctions with serotonin, dopamine, and the limbic system being affected alluding strongly to a genetic predisposition? This is discussed in a very lay person friendly manner in “Stop walking on eggshells: The Workbook.” If this is indeed the case, then this is a genetic brain disorder at it’s core, then seemingly triggered and/or magnified by external risk factors, i.e., abuse, sexual abuse.
Having just been suddenly abandoned by a diagnosed BPD on the eve of our engagement following the most distressing, perplexing, and damaging 4 months of my life, I can tell you that this is an insidious disease that destroys the lives of both the BPD sufferer and their loved ones.
Reading the above workbook has been one of the few things that has helped me cope with this experience and I recommend it highly to non-BPD’s. My love was a wonderful and amazing woman outside of her BPD and we have both been robbed by this heinous destroyer. I am pledging a portion of my remaining life to contributing to finding a solution to this dark madness.
October 10th, 2007 at 11:08 am
I don’t buy the genetic or physiological explanation for BPD. Not one bit. Brain chemistry is not a one-way street. Sure, variations in brain chemistry are the root of some maladaptive cognitive and behavioral patterns. But that very same brain chemistry is also affected by the way we process and react to the world around us. It’s a “chicken or the egg” scenario.
Do genetic and physiological factors lead to chemical imbalances in the brain… or do we cause those chemical imbalances with maladaptive ways of thinking?
While I’ve never been in a relationship with someone who had BPD, I have worked with dozens of borderline personality disordered patients at the psychiatric hospital - both men and women. I can only imagine what your relationship was like. And I think most people suffering from BPD are great people. But, as you said, the illness itself can destroy even the perfect relationship.
My experience leads me to think of BPD as more of a learned way of dealing with the world. Children of borderline parents are more likely to develop BPD themselves… but this doesn’t automatically suggest a genetic component. The environments we grow up in exert enormous influence on the way we develop and learn to process the world. Borderline parents are going to pass along those maladaptive ways of dealing with the world not through biology… but by example.
Coupled with the fact that many BPD behaviors are self-fulfilling and often reinforced by enabling from those around the borderline’d individual - and you’ve got the making of a highly ingrained, continually reinforced way thinking and behaving. That makes “breaking the BPD cycle” extremely difficult. For many BPD sufferers, it’s the only way they know how to live!
But that’s just my two cents. Our experiences with BPD are vastly different so it’s no wonder that we approach the subject from different perspectives. Thanks for sharing yours with me and good luck with your continued research into the condition! The more folks that get involved in finding ways to approach borderline personality disorder, the better.
Thanks again!
December 27th, 2007 at 7:34 pm
I thank “G” for his comments, for I was in a six year relationship with a BDP LCSW. She was the most wonderful woman imaginable for me at times and then the most destructive one imaginable too. I stayed in counseling for 2 years to keep my own sanity and it was until the divorce when the counselor told me what was going on. I my case she left me and went far enough away that I won’t have to worry about her calling me or coming back any time. I loved her like no other and yet could never really “have her”. When we were close as a couple it was AMAZING. When things went the other way, it was off the scale bad. I witnessed her breakdowns too of intense fear and trembling and I can cry today thinking about it. I never prayed so much nor wanted to help her but never could. I love her still but realized we were destroying one another’s heart and soul. It will take me years to get over this, even with counseling. Thanks for letter me post..it helps a lot
February 11th, 2008 at 8:27 pm
I have just ended a long term relationship with a Borderline (Borderline waif).
We got together when I was only 19 and she 21. Now I am 35. I was married to her for 15 years of and my life and it could not have been much more chaotic. It was a, “I love you” “I am so lucky to have you” “I could not live without you,” kind of relationship. On the flip side she could not help but to flirt in a very provocative manner with her co-workers,my friend and my family. It seemed that any man that was even a little bit attractive was fair game for her. I would always blame myself for this behavior. Sometimes I felt I was not doing something right or had short comings that I was not in touch with. This was very emotionally damaging to me and my sense of self worth. At other times she would convince me that I was paranoid and it was all in my head, again further making ,me doubt myself. I began to withdrawal and try to occupy her time with just the two of us. This was my way of keeping safe. I felt if I was to leave her unattended for any amount of time she would start to flirt or get into a sexual situation with someone. She also had an internet affair almost immediately upon getting a computer in 1997. There were countless attempts by her to have affairs with people she new and would quickly developed “crushes” on. It took maybe 8 years for her to finally admit she had these crushes and intended to have sex with these people. Her admission would always fall short of actually having sex. To this day I believe she cheated on my and I will never know with whom or where or how many times. This really bothers me not knowing if my friends were ever involved. She was often very seductive with her flirtatiousness and would find herself in very suspicious settings. This had a devastating effect on my self esteem and my relationships with family and friends. She was diagnosed to be Bi-Polar by some professionals and not by others. This was due in part to her BPD I am sure. It is quite hard to distinguish between the two at least most of the time since they can mimic each other in many ways. Even though we are now divorced (without children) she has found ways to suck me back in using sex and her “helpless child” routine that she play so well. She is a master manipulator for sure. I was able to get her into a Dialectical Behavior Therapy (DBT) program here in Portland. This came as some of the best advise ever giving to me by our marriage counselor. This is the only real hope for a truly BORDERLINE person. I new long ago that I needed out of this relationship, but at the time she was very depressed and she would likely have tried to commit suicide if I had left her at her worst. I decided to seek even more help for her to try to get her healthy enough to allow me to find some way out of this relationship. That is what lead me to marriage counseling and the DBT program for her. The DBT program is a very useful tool to help stabilize a borderline especially when you are trying to exit the situation. The outlook for people with BPD who choose to use DBT is much better than those who don’t. I realize now in hind site what I have been through and it makes me cry when I think about it. I have read many blogs on the internet from men who loved or still love a borderline and the pain and emotional abuse that came with it and it brings tears to my eyes. I can relate all to well with the shear pain they feel. I am not one to cry in general and this really gets it going. I have just contacted Portland DBT to find a support group for loved one of borderline people. I am currently waiting to hear back from them. I have found a resource on the internet that has helped me.
Here is a link to it. I hope it helps others as well! http://www.gettinbetter.com/borderline.html
February 20th, 2008 at 12:31 am
we are
HUMAN.
boderline personality…..what a hack.
each day is a choice, nothing more…or less.
PEACE.
March 14th, 2008 at 6:09 am
OMG
After looking over all of this information, what do you think? Is borderline personality disorder an “illness”? Is it just a maladaptive way of thinking? Should it, as a colleague once suggested, be called “selfish personality disorder” instead?
.. id hate to be your patient.. way to go.. saying that to ppl who doubt themselves!!
March 14th, 2008 at 12:09 pm
Hey now… don’t put words in my mouth. I never said I told people that or even that I believed it myself. I’m simply asking what other people think. As I said right about the part you quoted:
I don’t know exactly what to think about BPD… hence my asking for the opinions of others… to see what other people who’ve had experience with BPD think. The different perspectives I listed in that quote are just some of the things other folks have said.
Did you even read the rest of the post?