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I was both encouraged and dismayed by Jane Brody’s article about Borderline Personality Disorder in the NY Times. Here is the text of the original:
June 16, 2009
Personal Health
An Emotional Hair Trigger, Often Misread
By JANE E. BRODY
In the popular 1999 movie “Girl, Interrupted,” Winona Ryder portrays a young woman who tries to commit suicide, then spends nearly a year in a psychiatric hospital with a diagnosis of borderline personality disorder.
The film, based on a 1993 memoir by Susanna Kaysen, was gripping. But experts say it oversimplified this common yet poorly understood mood disorder.
Georges Han, a recovered patient now studying at the University of Minnesota for a Ph.D. in psychology, describes borderline personality disorder as “a serious psychiatric disorder involving a pervasive sense of emptiness, impulsivity, difficulty with emotions, transient stress-induced psychosis and frequent suicidal thoughts or attempts.”
Moods can change quickly and unpredictably, behaviors can be impulsive (including abuse of alcohol or drugs, reckless driving, overspending or disordered eating), and relationships with others are often unstable. Many patients injure themselves and threaten or attempt suicide to relieve their emotional pain.
People with the disorder are said to have a thin emotional skin and often behave like 2-year-olds, throwing tantrums when some innocent word, gesture, facial expression or action by others sets off an emotional storm they cannot control. The attacks can be brutal, pushing away those they care most about. Then, when the storm subsides, they typically revert to being “sweet and wonderful,” as one family member put it.
In an effort to maintain calm, families often struggle to avoid situations that can set off another outburst. They walk on eggshells, a doomed effort because it is not possible to predict what will prompt an outburst. Living with a borderline person is like traversing a minefield; you never know when an explosion will occur.
A Misleading Label
The name of the disorder was coined in the 1930s, in a misleading reference to the border between neurosis and psychosis. Experts say it has nothing to do with either condition.
Rather, affected individuals seem to be born with a quick and unduly sensitive emotional trigger. The condition appears to have both genetic and environmental underpinnings. Brain studies have indicated that the emotional center of the nervous system — the amygdala — may be overly reactive, while the part that reins in emotional reactions may be underactive.
As children, people who will develop the disorder are often “hyperreactive, hypervigilant and supersensitive,” Valerie Porr, a therapist in New York, said in an interview. Typically they receive a host of misdiagnoses and treatments that are inappropriate and ineffective.
“Some children need more than others in learning to regulate their emotions,” said Marsha M. Linehan, a psychologist at the University of Washington who devised the leading treatment for borderline disorder.
“These kids require a lot of effort to keep themselves emotionally regulated,” Dr. Linehan said in an interview. “They do best with stability. If the family situation is chaotic or the family is very uptight, teaching children to grin and bear it, that tough kids don’t cry, these children will have a lot of trouble.”
Even in a normal family, such children need extra help. Dr. Linehan told of one mother who said: “I was an ordinary mother, and my child needed a special mother. I took training and became the special mother he needed.”
Borderline personality disorder afflicts about 2 percent of the general population, according to the Diagnostic and Statistical Manual, and it is twice as common as a much better-known disorder, schizophrenia. (Other studies suggest the prevalence is as high as 6 percent.) Many borderline patients hurt themselves, and 10 percent die by suicide.
Yet as common and serious a problem as it is, Dr. Linehan said that patients often have difficulty getting the help they need — partly because therapists tend to regard borderline patients as manipulative and demanding of an inordinate amount of time and attention.
Ms. Porr, a social worker who specializes in helping families of borderline patients, said therapists with traditional analytic training often provide ineffective treatment, then experience feelings of failure and frustration. Psychotherapeutic drugs have not been effective in controlling the disorder. As a result, 70 percent of these patients drop out of traditional treatments, Ms. Porr said.
Ms. Porr tries to help families learn to handle the problem and not make it worse. She said in an interview that families need to understand why borderline patients act and react the way they do, then respond in ways that validate the patients’ feelings and help them regain and maintain emotional control.
Treatments That Can Help
Experts say that even suicidal patients are unlikely to benefit from the kind of extended hospitalization depicted in “Girl, Interrupted.” More often, a few days in the hospital should be followed by psychotherapy directed at helping them learn to live more effectively with their cognitive misinterpretations and emotional instability.
Dr. Linehan practices dialectical behavior therapy, the only therapy that has been demonstrated to be effective in a number of randomized clinical trials. She said two other approaches, called mentalization and Stepp, were also likely to be helpful.
Dialectical behavior therapy, a derivative of cognitive behavior therapy, helps patients identify thoughts, beliefs and assumptions that make their lives challenging and then learn different ways of thinking and reacting.
In effect, Dr. Linehan tells patients, “Your problem is that you don’t know how to regulate yourself, and I can teach you how.” She said thousands of therapists have been trained in dialectical behavior therapy, and many others practice it without special training.
But the value of the therapy can be thwarted if patients return to an environment that misunderstands them. Thus, Dr. Linehan said, it is important for others to recognize that people with borderline personality disorder are genuinely suffering. “They are in excruciating pain that is almost always discounted by others and attributed to bad motives,” she said.
The idea is “to validate the person’s emotional reactions, to say, ‘I understand how you feel,’ to pay attention, not to the situation, but to the emotion behind it,” Dr. Linehan said.
Alan E. Fruzzetti, a psychologist at the University of Nevada, said that families have to learn how to “soothe themselves, to realize that though the situation is awful, not to blame or be judgmental of the person but to see the person as also suffering.”
Reacting in a nonloving way magnifies the trauma tenfold, he said in an interview, adding: “You may have to leave a bad situation, but you must come back in a loving way, maybe say something like, ‘That blowout yesterday, I really want to understand your experience.’ ”
Therapists trained in dialectical behavior therapy can be located through the Web site www.behavioraltech.org.
What I was dismayed about was the reaction on Tara Parker-Pope’s Well Blog. The reactions were decidedly negative and clearly misinformed. There are many people (mainly ex-husbands and children of BPs) that posted comments that essentially said “it’s incurable” and “stop the abuse of the Non-BPs.” I know from my interaction that hope and management is possible.
 When Hope is Not EnoughGet the Non-BP book that has helped hundreds! My “followers” recently took a survey at my request and the “before and after” (before reading my book and participating in the ATSTP list) reactions were as follows:
Before -> After
Desperate->amazed
Overwhelmed->confident
Outraged->compassionate
Despondant->hopeful
Traumatized->becoming
Angry->relieved
Desperate->empowered
Change and healing IS possible with BPD and loved ones. I feel that Tara Parker-Pope introjects her negative opinion about BPD without actually doing what is necessary to make things work.
 Today I was reading the Psychology Today blog of Dr. Steven Stosny, called the “Anger in the Age of Entitlement” blog. Here is a nice article that married people (BP, Non-BP and others) should read:
Marriage Problems: How Can I be Me When You’re being You?
By Steven Stosny on August 18, 2008 – 3:09pm in Anger in the Age of Entitlement
Most people get married because they like the way they are with their partners – loving, compassionate, engaging, supportive, sexy, and flexible. They get divorced because they don’t like the way they are with their partners – resentful, turned off, frustrated, rigid, or bored, all of which they blame on their relationship.
In the course of this death march, many go into marriage therapy to find better ways to manipulate their partners into, at best, doing what they want or, at worst, becoming who they want. The self-defeating flaw in this strategy, apart from the fact that it hardly ever works, is cognitive dissonance — the discomfort generated by holding contradictory cognitions.
In marriage, cognitive dissonance is the difference between how you would like to be and how you are. For instance, “I am loving, compassionate, supportive, sexy, etc., yet I am not these things with you.”
This aspect of cognitive dissonance isn’t bad; it can act as a motivation to be true to your deepest values, by making you behave in more loving and compassionate ways. Unfortunately, most people who divorce or go to marriage therapy choose to resolve their cognitive dissonance with something like this:
“Since I am unable to be my loving and compassionate self with you, you must be too selfish, insensitive, withholding, demanding, emotional, rigid, sick, or defective in some way.”
This ill-fated resolution of cognitive dissonance only makes you both feel like victims and sends you searching online or in self-help aisles for a checklist that validates your suffering and a diagnosis that nails your partner.
Cognitive dissonance can undermine marriage (and marriage therapy) in sneaky ways, even when you are successful at getting what you want, namely, change in the other person. If you do get what you want by changing your partner, your self-concept is reduced to:
“I am loving, compassionate, supportive, etc., as long as you do what I want.”
Do you really want this on your tombstone:
“As long as I got what I wanted, I was great to the people I love,” ?????
The irony is that the last thing you need is an externally regulated self concept, i.e., one determined not by your own behavior but by what your partner does for you. Externally regulated, your sense of self becomes totally dependent on your partner, not just for consistently doing what you want but for doing it with love and joy in his/her heart, since resentful submission is far from satisfying. Externally regulated, self-concept needs more and more validation, if not submission, from the partner to stay afloat. This sends satisfaction on a downward spiral as it necessarily destabilizes both the sense of self and the relationship.
Successful marriage is not about getting your partner to do what you want; it’s about being who you are, i.e., behaving according to your deepest values. For most people, this means being loving and compassionate to the people they love.
Happily, you have the best chance of getting your partner to do what you want by being who you are.
Consider the effects of positive reciprocity and negative reactivity. Which of the following is more likely to inspire cooperation?
1. Approaching your spouse as your authentic, loving and compassionate self
2. Approaching your spouse with entitlement and demands (even if couched in the rehearsed language of “behavior requests”)?
Marriage (and marriage therapy) run into a brick wall of cognitive dissonance when they focus on “getting your needs met,” or “getting the love you want.” They are more likely to have lasting success with focus on each of you being the partner you most want to be.
 Misinformation
Boy, it’s amazing how much bad information travels around the Internet at the speed of light. People are so misinformed about BPD it’s scary. Yesterday, I stumbled across the “Yahoo Answers” site for a question in which a woman asked if she could “help her partner with Borderline Personality Disorder?” There were 10 “answers” to this question. Here are some excerpts from each, which the misinformation pointed out:
“So, you sacrificed your children to a crazy person?? What is wrong with you?? Is there a clinical term for “glutton for punishment”?” Dissolve this toxic relationship immediately!
Judgmental. Non-BPs don’t need another person telling them to leave their partner; there are hundreds of people for that. This commenter is a “top contributor” too with 2,424 answers to questions thus far. I wonder how many wrong/inaccurate questions she’s answered. I guess some of her answers (like those in “Cooking and Recipes”) can’t hurt too many people (unless they poison themselves with bad brownies).
“Your Co-dependency is off the rictor scale when you place your partner ahead of your SONs safety…This is NOT about your partner.. This is about the health welfare and safety of your son… This is an abusive house hold!!!! GET OUT OF THERE IMMEDIATELY!!!”
Judgmental. Another voice saying “get out!” And the use of co-dependency, love it. I wonder if the woman asked the question, “My partner has cancer… is there anyway to help him?” What would be the answer then?
“You really should get yourself and kids out of that situation .Do it for the kids.”
Same.
“I hate to tell you this, but he’s not going to change. Personality disorders are incurable and they only end when the person with them dies.”
Oh yeah? Well, when did you get this information? 1980? The APA is considering taking the word “personality” out of BPD (and borderline for that matter). Look into the research before you hand out advice. DBT, SFT and Mentalization-based therapies all show promise in reducing the behaviors and feelings below the 5 of 9 threshold mark for diagnosable BPD. It is not incurable.
“you might want to get a little therapy yourself, bpd can really mess with your head sometimes… but then i am with my own mental problems. so take that with a grain of salt.”
Not bad advice.
“PLEASE SPEAK TO A THERAPIST ABOUT A BOARDRLINE AND WHETHER THEY CAN BE HELPED. imo and therapists I have spoken to the answer is no. Treatments (the VAST majority of the time) don’t work. Please don’t take my word for it, ask for yourself.”
Speaking to a therapist is not bad advice… but that the answer is they cannot be cured… that’s incorrect. BPD can be managed and all people in the support system can help. If this person had bipolar I – would you all tell her to “run away?”
“You’re [sic] “kind and loving husband” never existed. That was nothing more than a mask. Oh, you moved out? Then stay out.”
OK, leave him again… I think we got it. It’s amazing how angry people are with borderlines.
“Personality disorders CANNOT, repeat cannot, be cured. They are inflexible, self-sustained, and have a 99% chance of being incurable. Your gut instinct, and the FACTUAL evidence you’ve read on the internet, are guiding you in the right direction.”
Again, wrong… see above. “Factual evidence…” on the Internet is a laugh. The Internet is filled with angry (usually ex-) Non-BPs that are ready to tell the story of how impossible, abusive and awful their ex BPD partner was. I’m not going to argue that people with BPD can’t be abusive or rage at you – they can. However, if you see the problem for what it really is… it is more manageable than many other disorders. Educate yourself about it. Find out the facts. Learn skills. Or leave… it’s up to you.
“Personality disorders are pretty much the only mental problem that CAN be cured. It takes a long time and a good counselor. Personality disorders are not a biological disorder like the more commonly known mental illnesses. Personality disorders are conditioned behavior over a lifetime.”
Well, this is almost true. The behavior component is conditioned behavior and can be “retrained” out of someone. The emotional dysregulation and impulsiveness components are probably biological.
“You sound like a weak person. You would sacrifice your sons well being to have someone.”
Judgmental.
NY Times article mentioning BPD. I’d love to comment, but will have to do so later….
October 21, 2008
Mind
When All Else Fails, Blaming the Patient Often Comes Next
By RICHARD A. FRIEDMAN, M.D
Doctors and psychotherapists generally don’t like it when their patients don’t get better. But the fact is that lots of patients elude our clinical skill and therapeutic cleverness. That’s often when the trouble starts.
I met one such patient not long ago, a man in his early 30s, who had suffered from depression since his teenage years. In six years of psychotherapy, he had been given nearly every antidepressant under the sun, but his mood hadn’t budged.
Weeping in my office one day, he explained that he was depressed because he was a failure and a whiner. “Even my therapist agreed with me,” he said. “She said that maybe I don’t want to get better.”
I could well imagine his therapist’s frustration. She had been working with him for nearly three years without significant progress, and she was now doing what many clinicians do when the chips are down: blame the patient for failing to improve.
“I think he has an unconscious desire to remain sick,” she told me.
About a month later, I saw this patient respond remarkably well to a novel treatment. Free of depression at last, he was joyful and relieved — an odd reaction, you must admit, from someone who secretly wished to be ill.
Not just that, but he no longer felt like a failure and was much more upbeat about his future prospects.
I decided to challenge him. “How come you’re feeling so much better despite the fact that nothing in your life has really changed in the past few weeks?”
“Well, I guess I just think like that when I’m down.”
Exactly. His sense of worthlessness was a result of his depression, not a cause of it. It’s easy to understand why the patient couldn’t see this: depression itself distorts thinking and lowers self-esteem. But why did his therapist collude with the patient’s depressive symptoms and tell him, in effect, that he didn’t want to get better?
For an all too human reason, I think. Chronically ill, treatment-resistant patients can challenge the confidence of therapists themselves, who may be reluctant to question their treatment; it’s easier — and less painful — to view the patient as intentionally or unconsciously resistant.
I recall an elderly woman who was referred by a colleague for intractable depression, in which I have a special interest. I was eager to help her.several months and many treatments later, I began to get frustrated that she was no better and noticed that my thinking about her shifted. I wondered whether there was something about the sick role that she found rewarding.
After all, she had constant visits from friends and family members, not to mention an army of medical experts who were all trying, in vain, to cure her. If she got better, she might lose all that care and attention.
Then one morning, shortly after starting a new combination of antidepressants, she called. I did not recognize the cheerful voice. “I’m feeling really good,” she told me. “Not depressed at all.”
My delight aside, I felt chagrined that I had begun to write her off as a help-rejecting crank.
Of course, it makes good medical sense for therapists to rethink the diagnosis and treatment of any patient who fails to improve. But this is a double-edged sword.
Another patient, a young woman with unstable moods, was recently hospitalized with a diagnosis of bipolar disorder. When she failed to respond to two mood stabilizers, the staff began to entertain a diagnosis of borderline personality disorder, which involves emotionally chaotic relationships and impaired ability to function in the world.
“She’s pretty aggressive and demeaning, and we think she has some serious character pathology,” one of the residents told me.
But partly treated bipolar disorder can mimic borderline personality disorder, and after she received a third mood stabilizer, her “personality disorder” melted away, along with her provocative behavior.
This patient had frustrated her clinicians with her lack of response to treatment. In turn, her doctors reacted by changing her diagnosis to a personality disorder. The change in thinking shifted the blame from the clinicians to the patient herself, who was now viewed more as bad than sick.
To be sure, some patients really do want to be sick. People with Munchausen syndrome, for example, deliberately produce physical or psychological symptoms for the express purpose of assuming the sick role. And they will go to extraordinary means to defeat doctors who try to “treat” them.
But a vast majority of patients want to feel better, and for them the burden of illness is painful enough. Let’s keep the blame on the disease, not the patient.
Richard A. Friedman is a professor of psychiatry at Weill Cornell Medical College.
 After learning about BPD and reading a biography of Kurt Cobain, I suspect that, if he was not a borderline, he suffered from a similar disorder. So, here is a detailed analysis of the case for Kurt Cobain having Borderline Personality Disorder.
When Hope is Not EnoughGet the Non-BP book that has helped hundreds! Substance Abuse
I don’t think I have to cite any references on this one. The bio I read makes it clear that Cobain was a junkie and used consistently. Also, despite his slim frame (5′7″, 130 pounds), he used far more heroin than others in his final days and his body was, for the most part, able to take it. He did overdose numerous times. Abuse of pain killers (of which heroin is one), is not uncommon with BPD (sometimes called “Bellman’s Syndrome”).
His heroin use eventually began affecting the band’s support of Nevermind, with Cobain passing out during photo shoots. One memorable example came the day of the band’s 1992 performance on Saturday Night Live, where Nirvana had a shoot with photographer Michael Levine. Having shot up beforehand, Cobain nodded off several times during the shoot. Regarding the shoot, Cobain related to biographer Michael Azerrad, “I mean, what are they supposed to do? They’re not going to be able to tell me to stop. So I really didn’t care. Obviously to them it was like practicing witchcraft or something. They didn’t know anything about it so they thought that any second, I was going to die.”
Eating Disorder (or chronic pain leading to one)
Kurt Cobain had a chronic, undiagnosed stomach disorder from which he developed an eating disorder, being unable to keep down food.
Throughout most of his life, Cobain battled chronic bronchitis and intense physical pain due to an undiagnosed chronic stomach condition. This last condition was especially debilitating to him emotionally, and he spent years trying to find its cause. However, none of the doctors he consulted were able to pinpoint the specific cause, guessing that it was either a result of Cobain’s childhood scoliosis or related to the stresses of performing.
Volatile Relationships
His relationship with Courtney Love was volatile. He also had volatile relationships with others in his band and with managers and ex-girlfriends.
Love arranged an intervention concerning Cobain’s drug use that took place on March 25. The ten people involved included musician friends, record company executives, and one of Cobain’s closest friends, Dylan Carlson. But Bassist Krist Novoselic tipped him off as he considered the idea to be “stupid”. However, by the end of the day, Cobain had agreed to undergo a detox program. Krist Novoselic drove him to the airport to catch his flight, but Cobain was far from wanting to go, in a fit of panic, Cobain drew violence and the two fought at the airport, eventually Cobain freed himself and ran through the airport lobby screaming “fuck you”, this would be the last time Krist would see Kurt alive.
Shame and Unstable Self Image
His lyrics probably do the best for this…
All Apologies:
I wish I was like you
Easily amused
Find my nest of salt
Everything is my fault
I’ll take all the blame
Aqua seafoam shame
Sunburn, freezeburn
Choking on the ashes of her enemy
Dumb:
I’m not like them
But I can pretend
The sun is gone
But I have a light
The day is done
But I’m having funI think I’m dumb
Or maybe just happy
Radio Friendly Unit Shifter:
What is wrong with me?
What is what I need
What do I think I think?
This had nothing to do with what you think
If you ever think at all
Bi-polar opposites attract
All of a sudden my water broke
I love you for what I am not
Did not want what I have got
Blanket acne’d with cigarette burns
Speak at once while taking turns
And of course, there are probably twenty more examples in his various lyrics. The only other musician that I can think of off the top of my head who consistently used the words “shame” and “I’ll take the blame” is Ian Curtis (Joy Division’s lead singer who also committed suicide).
Suicide Attempts
I think these go without saying, considering his eventual actual suicide. But we know of at least one other:
Following a tour stop at Terminal Eins in Munich, Germany, on March 1, 1994, Cobain was diagnosed with bronchitis and severe laryngitis. He flew to Rome the next day for medical treatment, and was joined there by his wife on March 3. The next morning, Love awoke to find that Cobain had overdosed on a combination of champagne and Rohypnol (Love had a prescription for Rohypnol filled after arriving in Rome). Cobain was immediately rushed to the hospital, and spent the rest of the day unconscious. After five days in the hospital, Cobain was released and returned to Seattle. Love later stated that the incident was Cobain’s first suicide attempt.
 Many times I’ve seen Non-BPs mention that couples counseling doesn’t really work for them. One member of an Internet support list I used to be a member of posted a message about his BP “snowing” the couple’s therapist. In fact, just about every message (of hundreds) was about this subject. Clearly, Non-BPs are upset about the dynamics of couple’s counseling and feel that they get “dumped on” by the BP. The Nons end of feeling blamed for everything. When this subject came up in the ATSTP group recently, I turned to a knowledgeable member about this subject. She posted the following message (which I’ve edited slightly because I wanted to remove any reference to others in the group). BTW, I don’t normally repost messages from the group here on my public blog – I only do so when the message contains as much wisdom as this one does, doesn’t contain any identifyable “marks” and is not “personal” in nature.
Well, my experience has been that marital counseling doesn’t really help
much when a BP is involved, because counselors really don’t understand the
dynamics of BPD. While their goal is to promote better communication
between partners, they tend to focus on resolving the complaints.
Of course, BPs have LOTS of complaints (which
really are not the problem), so nons just end up feeling attacked… even by
the counselor at times. When counselors do this, it tends to validate the
BPs feeling that their nons really are the problem. It sometimes even
leaves the non feeling like he/she really is the problem.
I suspect you may want to continue this “counseling” approach, since it is
SOMETHING your BP has agreed to. If so, my suggestion would be for you to
be as honest as possible with the counselor about YOUR FEELINGS. Don’t
waste your time (and money) defending against your BPs accusations and don’t
point fingers back. (This only makes you look bad to the counselor… like
you never let your BP talk or express himself… ha!, I know!) Simply ASK
for advice on how to communicate better (since that is the goal of the
counselor to get you communicating with one another.) Try the suggestion a
few times, and if it doesn’t work, then you can come back the following
session and express your disappointment and confusion about why it isn’t
working. Eventually, after enough times of doing this, your counselor will
(hopefully) recognize that he/she cannot help you and will refer you to
someone more qualified (like a DBT specialist, if your lucky enough to have
one of those in your area.)
My only comment on this statement – which is wonderful IMO – is the idea that the complaints are “not really the problem.” If those complaints are not really the problem, what is? Well, I believe it is that the BP FEELS bad (negative emotions) and judged (so they judge back). I think if someone who DOES understand the dynamics of BPD works with a couple, the therapist can hopefully deal with the real issue: the painful emotions.
Often I see in the support groups on the Internet (especially the “Welcome to Oz” or WTO groups), people providing the “3 C’s” of understanding your role as a Non-BP. I’ve seen it quoted on BPD support websites too. These “3 C’s” go as follows:
- I didn’t cause it
- I can’t control it
- I can’t cure it
While these statements are generally true, I’d like to take some time to analyze these statements and add a fourth “C.” I’d also like to tell you what you CAN do – rather than what you didn’t or can’t do.
These statements help take the onus off the Non-BP for any responsibility for their loved one’s disorder. I can understand that. In part, they are about blame or, better, non-blame. I’ve seen many people say “when I came to terms with those ‘3 C’s’ I was free from FOG!” (which is fear, obligation and guilt, for those of you who don’t know). I want to write something about FOG specifically, but haven’t had the time.
OK, now let’s look at each of these statements and see how they fit into my way of thinking about being a Non-BP.
I didn’t cause it
Actually, this statement is liberating, especially for parents of BPs. I think that many parents carry around a lot of guilt that they DID cause their child’s disorder. Even psychologist and therapists often blame the disorder on the parents. However, there are growing studies that suggest that there are many biological causes for BPD. In the case of Marsha Linehan, she provides a “biosocial” model, in which each element (biological and social) are required to cause BPD. The environmental part of that analysis is the “invalidating environment.” So, while you (either as a parent or spouse) didn’t cause the disorder, you may have inadvertently contributed to the disorder’s severity. By reacting to a BP in an emotionally invalidating manner, the disorder can get worse. That is why I spend over 30 pages in WHINE discussing emotional validation as a tool for healing. Of course, a parent might say “Well, I have other children. I’ve treated them the exact same way. Why don’t they all have BPD?” Which again is where the biological element enters. My suggestion for parents is to read the article referenced below.
I can’t control it
Why would you want to? No one can completely control another individual. Even parents can’t completely control the actions and behaviors of their own children. No, the only behavior (which is BTW what Non-BPs are so confused and angry about) you can control is your own. That is why I have made several statements clarifying boundaries. Boundaries can’t be used to control other people’s behavior. If you try and imposed rules on another person’s behavior, you get resentment, rebellion and (in the case of BPD) a statement: “You’re trying to control me!” How many times have you heard THAT in your interactions with a BP? I’ve heard it a bunch.
I can’t cure it
Again, this statement is true. Only the BP him/herself can “cure” the disorder (usually with the help of a qualified and knowledgeable professional). It is important that you re-read that statement – you cannot make your loved one “all better.” You can’t save him or her – especially from his or herself. What CAN you do then? You can contribute to an easing of the conditions under which the BPD behavior is severe. You can re-frame your relationship with the BP in such a way that the emotional invalidation that they have learned to expect is gone. You can encourage effective behavior and practice effective behavior yourself. How? I explain this in detail in WHINE – which is why I called it a “how-to” book.
Now, I think I need to contribute a fourth “C” to the mix. I didn’t make this “C” up. In fact I found it here, on A. J. Mahri’s “BPD from the inside out” page about a mother speaking out about the illness. Please read that page! It really helps define the feelings and confusion of a mother who needed to know she “didn’t cause it.” She offers a fourth “C” which is:
All I can do is cope with it.
 Apparently, someone over at Welcome to Oz (WTO) Internet list posted a message asking about me and what I am all about concerning BPD and Non-BPs. This lead to a huge spike in traffic with my average number of accesses basically doubling over the weekend. I’m still a member of WTO, so I decided to login and take a look at what people are saying about me over there. I haven’t posted in years and haven’t logged in in months.
Obviously, there are many, many new people who have no idea who I am or what I’m about. There are a few members still hanging around who do remember me. There are a couple of people who seem to have a pretty dim view of what I have to offer – although I think that those people don’t know me very well and have interacted with me only cursorily. First, today, I’d like to outline my philosophy about BPD and Non-BPs to clear up some of the mis-statements and mis-perceptions.
- I do believe that BPD is a serious mental illness and not a case of a “behavioral disorder.” In other words, BPD is not merely a case of someone just behaving badly. I further believe that much of the core issue with someone with BPD is emotional and based on poor emotional regulation skills. The reaction to strong negative emotions (and other factors, like shame and impulsiveness) cause the “poor behavior.” I put that in quotes because the behavior has a function and the function IMO is to make the BP feel better. A person (whether they have BP or not) CAN learn to behave differently in the face of strong negative emotions. It takes practice and requires the acquisition of emotional skills. However, I also believe that the emotional under-pinnings are not going to disappear, just because the person with BPD learns to behave more effectively. Emotionally, they are just more sensitive than other people – that is the way they are. In other words, I don’t believe that I have a “cure” for BPD, which was bandied about at WTO.
- I also believe that the only person that you can change in a relationship is yourself. It is my opinion that once you change your own approach to emotional situations, the person with whom you are having the relationship will react to the change in various ways. Sometimes they will have a fit. Sometimes they will appreciate the “new you.” And sometimes a complex combination of emotions will arise. My “methods” are a combination of emotional understanding (of your own emotions and of theirs), emotional validation (which is complex in itself), positive reinforcement and “inserting your (the Non’s) feelings” into the conversation. There are some other skills and sub-skills, but that’s a quick synopsis. IMO this complex combination of skills (which also require practice) will improve the relationship and make sure that you don’t “walk on eggshells” around the other person. Boundaries can help – however, boundaries are a subject unto themselves, and I find that most people don’t know what boundaries are and how to apply them properly.
- There was some argument at WTO that my motives were suspect, because I am trying to make some money on what I have learned and practiced thus far. I think the operative word here is trying, because I don’t really make enough money to even operate this website at a break-even level. No, I’ve not made much money at all as a “professional Non-BP” (if that’s what I am). What I have been able to do is have an impact on the lives of many people. That is pretty satisfying in itself, and I will not pretend that I wouldn’t like to do it full-time. I certainly enjoy interacting with others in my situation and exchanging advice, strategies, knowledge, etc. more than my “day-job.” But it will be a long time (and probably never) before I will be able to do that. Besides, most of my support activity and knowledge-sharing I do for free – either here on in my Google Group. There’s no charge for participating in that group or to read these posts. At this point, any money I do make just contributes to the cost of operating this website.
- I don’t think that BPs have to be “let off the hook” and that they have no responsibility when it comes to a relationship. I also don’t think that you, as a Non-BP, have to forgo your feelings to live alongside a person with BPD. Both of those ideas were suggested at WTO. Neither is true. I think everyone in a relationship will have emotions, reactions, expectations, etc. Everyone is allowed to have each of these. Everyone has certain responsibilities in a relationship as well. What I DO advocate is looking at the function behind behavior and understanding the dynamic that exists. Many times I’ve seen people suggest that my methods give the BP “undo advantage” in a relationship. Huh? I thought this was a “loved one?” I don’t think that “love is a battlefield.” It’s not us-agains- them. That is just more black-and-white thinking on the part of the Non. If you’re going through a bloody divorce with someone with BPD, I can certainly understand where this might come into play, but, as I have said, my methods are about “living with and loving” someone with BPD. There is responsibility on both sides of the fence. It takes a certain environment IMO to make sure that responsibility is acknowledged – and that environment has to be one that is validating, otherwise you’re going to be caught in a shame hurricane. Nothing will get accomplished.
- Finally, I believe that effective emotional skills are helpful for anyone in any relationship. Anger, sadness, spite, resentment, blame, etc., etc. lead to a corrosive environment within any relationship. My “methods” attempt to reverse some of the corrosiveness and build stronger, healthier emotional relationships. You may not agree with my methods, which is fine. Personally, I’ve had to try everything to find anything that worked.
I guess it’s better to be talked about a little, whether it is positive or negative, than to be ignored. Thanks to a group member of mine who notified me of the discussion and who defended me (you know who you are).
My wife has recently been really paranoid that the local moms don’t like her. She thinks that since they will sometimes not let their children come over to our house and play with my son that it means that they don’t trust her. OK, to be totally frank, my wife has been investigated by CPS twice. Once because of a DUI and once because she was over-medicated and went over to a judgmental woman’s house to pick up our children. The woman thought my wife was acting weird and reported her to CPS.
I think that many BP’s get paranoid about their self-image with other people. The combo of fear of judgment – which they perceive as judgment of their emotions and therefore judgment of their SELF mixes with the shame they feel about their self. Am I off-base here?
My wife has told me she has felt shameful about “the way she is” for years. Does that lead to personalization and thus to paranoia?
What do you think?
The judge in the Paul McCartney/Heather Mills divorce case has released the judgment to the public. It can be found here: Judge’s Decision. I have included this post here, because Heather Mills almost made my top five potential celebrity BPs. Here are some juicy details from the judgement. The judge was not too kind to Ms. Mills:
But I regret to have to say I cannot say the same about the wife’s evidence. Having watched and listened to her give evidence, having studied the documents, and having given in her favour every allowance for the enormous strain she must have been under (and in conducting her own case) I am driven to the conclusion that much of her evidence, both written and oral, was not just inconsistent and inaccurate but also less than candid. Overall she was a less than impressive witness.
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The proposed Amended Petition alleged a number of matters against the wife of verbal abuse, extreme jealousy, false accusations of violence, and that throughout the marriage the wife had shown a consistent inability to tell the truth.
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I assume for the purpose of this judgment only that in those interviews the wife lost her cool completely, went right over the top, and behaved in an erratic, out of control, and vengeful manner.
Ouch! OK, I took them out of context, but still – ouch!
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