Being blamed for everything is tiring to say the least. Coupled with the BP’s inability to take responsibility (and blame) for his/her own actions, this aspect of BPD is maddening. It is impossible for one person to shoulder all the blame for everything in a relationship. One of my therapist friends once told me, “If you are responsible for everything, you are responsible for nothing.” I truly believe that it is impossible for anyone to take all the responsibility and blame in a relationship.

Why does a person with BPD seem so fixated on blame-finding? (Which I like to call “blame-storming” in a nod to “brain-storming”). Why does he/she go to great lengths to assign blame to anyone else (including God, the world, everyone, etc.) other than his/herself? The reason seems to be similar to that of the inability to take responsibility for his/her actions. He/She does not want to be seen as the “cause” of problems or of pain. This would again make him/her “all-bad” and in being “all-bad” he/she deserves nothing less than death. It is easier to find someone else (or something else, like karma or life itself) that is a more acceptable cause of his/her pain and problems. Some books call this “projection,” but I don’t think it is projection per se. It is more the fear of rejection, ridicule and emotional pain if he/she is at fault. It confirms his/her shame and that he/she can do nothing right. Through black-and-white thinking, if he/she is a bit at fault, he/she is doomed.

Sometimes I will hear my wife say that she “hates everyone” or that she feels “everyone is out to get her.” Clearly, these statements can be seen as paranoid or misanthropic, but ultimately she is expressing her belief that forces outside herself are to be blamed for how she feels.

Adapted from When Hope is Not Enough

Related posts:

1. Why you should NEVER let a person with BPD have access to a gun
2. BPD: What’s in a Name and How does it feel to be that person?
3. 10 Signs you’re a highly sensitive person (HSP)

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Judgment Hurts those with BPD

A person with BPD fears judgment almost to the point of being allergic to it. She is extremely sensitive to judgment from other people, even if that judgment is merely perceived. Because of the shame (the belief that she is a bad person and deserves to be deemed as such) and the rejection sensitivity, a person with BPD avoids situations in which her actions can be judged by others. When I say “judged” here and “judgment,” what I am referring to is not “using one’s better judgment” in a situation, but rather it is the sense that a person’s actions or the person herself can be judged as “right or wrong” in a given context.

Interestingly, even with a strong fear of judgment of herself and her own behavior and self, she also tends to judge other’s behavior and character harshly. How many times has your loved one with BPD told you that you were doing something “wrong” or that you are a “mean” or “bad” person?

Fear of judgment and emotional reactions to judgment (real or perceived) is a major issue for a person with BPD. Judgment of her actions causes emotional pain and to avoid judgment, she might lie or avoid social situations in which she feels she will be judged. If she is consistently concerned with doing something “the right way” or she feels that you think she “does everything wrong,” it is likely that she suffers from a fear of judgment.

Additionally, there is a stigma associated with being “crazy” when a person has BPD. A person with BPD might feel “not normal” inside and might have felt that way most of her life. However, if the outside world labels as “crazy” or “not normal” or “mentally ill,” it becomes an external validation for what she might already feel. The fact that others “know” about her can make her feel exposed. It is a form of judgment and fear of it that reduces the likelihood that the person will “admit” she has a problem.

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1. Language and what it reveals
2. BPD and Lying
3. Paranoia, Shame and Judgment Sensitivity

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Rage burns and burns

In the support groups, rage is one of the most talked about aspects of BPD. Why? Because it is one of the most difficult for the Non-BPD to endure. Many people ask themselves, why is this person so angry (with me)? It seems to make no sense. A person with BPD will fly into a rage about seemingly nothing. The smallest thing that is out of place or not done the way that this person expects causes sometimes hours of anger and raging, yelling and screaming and sometimes physical violence. Again, many Nons ask: “what’s up with that?”

Anger and rage are usually secondary emotions to other primary ones. Sensitivity to judgment plays a major role in the triggering of rage. The symptoms and feelings associated with BPD interact and, at times, feed each other. In the case of rage, I believe that it is fed by two other symptoms: shame and sensitivity to judgment (which is also fed by shame).

When someone with BPD feels shameful and when you (as a “Non”) criticize or judge her behavior as “bad” or “negative,” the trigger for rage is pulled within the person with BPD. Why? Because your judgment reflects her shameful feelings and resonates deeply into her core beliefs about herself. She panics that you are “finding out” that she is a bad person. She has to (at all costs) defend her “goodness.” What I have found with my own borderline is that this is the point at which she will rage and introduce the “what about you?” argument. The “what about you?” argument is a way to rage at the Non and release anxiety about the Non finding out about her shameful “badness.” Some people in the support community like to call this “projection” or “denial.” I personally don’t believe it is actually projection or denial (although there are times in which projection is clearly there). It is a form of misdirection to try to take the focus off their inner shame and refocus the discussion on you and your faults.

Nobody is perfect, not even you. When a person with BPD rages against you, you often feel very imperfect – especially if she uses the “what about you?” attack. When someone with BPD uses the “what about you?” technique she is usually deflecting blame and judgment on you. However, you experience the rage as hurtful to your very self. You find that the rage “forces” you to defend yourself against her. That is what the “what about you?” attack/rage does best. That is its intention; it puts you on the defensive and shifts focus away from her and her behavior. As I said, it is form of redirection away from the person with BPD’s shame.

One interesting thing about raging is that once the anger and raging is done, it is usually over. Sometimes the person with BPD will be exhausted after the rage and will just collapse and go to sleep. The same is the case with tired children. Sometimes a tired child will have a temper tantrum (which is a form of rage) and then, once the emotions are released, she will either go to sleep or sit placidly in your arms. The inner agitation has been released and she is done.

Adapted from the FAQ from When Hope is Not Enough

Related posts:

1. The Borderline Child
2. A New Name for Borderline Personality Disorder (BPD)?
3. A primer on Emotional Dysregulation and its role in Borderline Personality Disorder

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The Elephant

I don’t usually get personal on this blog. Today, I have decided to get a bit personal. My “emotional” daughter has been texting me – worried about her mother’s (my wife’s) behavior. We have been going back and forth, trying to figure out what we could do to be effective in this situation. Eventually, I had to apply my boundary with my wife. I had to tell her “I will not talk to you when you’re in this state”. It was tough, yet it was the elephant in the room. The thing is… and this is what you nonBPDs need to learn about boundaries (and about which I have written volumes) is that when you apply your boundaries, you have to expect rage, denial and attacks from the borderline. I have been attacked via text messages all day after I did that. I just ignored the attacks, stayed on point and went like a train on the track toward the actual issue. I got a LOT of “what about you?” attacks (see When Hope is Not Enough to know that THAT means). Ultimately though, as a nonBPD, you have to be brave and mention the elephant in the room. It’s hard, it causes ripples with the whole family, yet it’s important. I just want you all to realize that applying boundaries will (most likely) cause rage, attacks and counter-blame.

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1. A Note about BPD and Boundaries And SWOE
2. Boundaries and BPD
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Collecting the grudges and injustices

I noticed today that my wife with BPD is a grudge collector. She holds onto blame from others for a long time. Judgments made about her actions and times that she has been blamed about things (especially when she feels she was NOT a fault) are repeated time and time again in our house. I suppose she ruminates on the perceived humiliation from these incidents. She also craves recognition for her “special abilities” such as her large vocabulary and early reading skills. This morning I began to think about the duality of humiliation and praise. I believe that one is the flip-side of the other. This “two sides of the same coin” situation creates dependence on others and, in my opinion, this sense of dependence leads to shame AND to over-deserving behavior (such as excessive shopping). The dependence is an emotional one, requiring external validation (praise) and eschewing external invalidation (blame). Of course, a grudge collector is never really free from the sense of blame and by ruminating on “why did he/she blame me for something I didn’t do?” and getting angry about it, over-and-over, the grudge collector just ends up being a slave to his/her own feelings of humiliation and to the reinforced anger of being unjustly accused. The thing is… if you are a grudge collector, you are trying to change that over which you have no power to change. You can’t change the past. It must be accepted as is. You can’t change others. They must be accepted as is. When you’re offended by someone else’s blaming you, I think it says more about you than it does about them. Yeah, there’s a ton of assholes out there that will blame you for things that you didn’t do. I think most of the time that blame-storming (as I call it in When Hope is Not Enough) is hatched from their emotional reaction to the situation. That is, they are frustrated with the situation and don’t want to face the “as is”, so they go the “if only” route. “If only you hadn’t done THAT, this situation wouldn’t exist.” And that says more about THEM than it does about you.

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Clearly, the reviewer didn’t understand the idea of emotional dysregulation or the difference between motivation, intent, action and consequence. I attempted to separate and explain each concept in the book, but perhaps I did a poor job.

In “When Hope is Not Enough” I write about the concept of IAAHF (or “It’s all about his/her feelings”). That statement, which is an exploration of the idea “it’s not about you,” is a statement of intent and motivation, not a release from the consequences of someone’s actions. The “all about” statement concerns the motivations of a person with BPD’s actions – that is, rarely does someone with BPD intend to hurt the non-BPD, despite appearances. What the intention of this statement of intent seeks to do is release the non from the paranoia that their loved one with BPD is out to get them. This is typically not the case. Usually, the actions of a person with BPD are intended to reduce their own emotional pain (stemming from emotional dysregulation). Sometimes this emotional pain and emotional dysregulation is triggered by (what I call) perceptions that are “misaligned” with the situation. That is, the “attack” on the borderline is not intended by the non to be an attack at all and through a highly sensitive emotional profile and emotional dysregulation, the borderline will attack back as a way of defending their self from a perceived attack. But the real point here is that the motivation and intention of the borderline’s attack is actually to quell the painful feelings within herself, not to cause interpersonal strife or manipulate the non.

However, as I also say in “When Hope is Not Enough”, the action (or cause) sometimes has unintended consequences (or effects). When a borderline is emotionally dysregulated and overcome with feelings, the action that she takes is likely to be impulsive and the consequences of her actions are not taken into consideration. When behaving this way, the borderline will often behave in an “effect -> cause” way – meaning she will think “I feel bad, so you must have done something to specifically make me feel bad.” If a borderline is to consider the consequences, even the unintended ones, of her actions, she will need to approach the situation in a “cause -> effect” way. Intentions do not provide a free pass for consequences. As I have said on the ATSTP list, just because you didn’t intend to burn down the house while playing with matches, doesn’t bring the house back into existence when you express your intention. One thing that separates the understanding of consequences (that follow from a cause – and in this case the cause is the behavior of the borderline) from blame is that there is an analysis based on observation as opposed to judgment. If you feel that the borderline has done something “wrong,” then you are inserting your judgment, rather than understanding the observed consequences of the behavior. I tried to explain this fully in “When Hope is Not Enough”, but I suppose some people either are so caught up in fault-finding and blame-storming that they can’t separate judgmental thoughts from the understanding of consequences or I have expressed it poorly in the book. If a borderline can begin to understand the consequences of her actions (and especially powerful are those that go against her goals), then, in my mind, the borderline can become responsible for her actions and do so in an effective manner.

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1. Are you pissed off at someone with BPD?
2. Radio Program: Understanding BPD
3. Understanding Major Depression With Borderline Personality Disorder?

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I believe this feature is born of an unstable sense of self. A person with BPD has difficulty “locating herself in the world.”  While two of the other “core” features of BPD are “systems related” (meaning, those features are based on subsystems of the mind – the emotional regulation system, the impulsivity control system), shame and the preoccupation with interpersonal relationships are based more on a person with BPD’s view of herself. While it might seem that interpersonal relationships are outside of self, a more complex picture arises as we look more deeply into the mental configuration of BPD.

A recent study showed that the number one trigger of systems dysregulation (like wildly swinging emotions and impulsive behavior) is interpersonal distress. This interpersonal distress is more important as a trigger of dysregulated behavior than sweeping/major life changes – in fact major life changes, such as changing jobs, getting married, having a child – were ranked last of nine factors that trigger BPD distress. The interpersonal, moment-to-moment perception of the state of an important relationship is the most important trigger. That can be bad news for someone in a close relationship with someone with BPD. The person with BPD will be continuously scanning the interpersonal landscape for threats. Since shame is involved, people with BPD are likely to use others to regulate their internal systems and their self-view. In other words, a person with BPD uses others as a mirror to view their self.

Why is this so? I believe that a person with BPD’s lack of internal regulation causes her to internalize other people and use others to self-regulate. When someone has an inability to locate herself in the world, which very possibly arises from the emotional instability as a child, she seeks to have others locate her for her. She needs others to verify and validate that she’s “ok”. Unfortunately, because few of us are taught the language of emotional regulation, a person with BPD will likely learn that the interpersonal landscape is not safe; it is full of threats to their very self. It’s not an easy situation in which to live. If a person requires external validation and regulation, there develops a sense of a lack of control. Others are unpredictable, don’t understand how it feels and can damage the very core of her being.

People with BPD have described this internal feeling of emptiness and lack of internal controls as feeling “dead inside,” which is in itself, tragic. Extending this feeling to others through this preoccupation with close interpersonal relationships leaves a person with BPD with the feeling that others contribute to this unpleasant internal feeling. In other words, “it’s your fault that I feel this way.”

Many Non-BPD’s ask me why their loved ones with BPD don’t seem to trust them. To me, this aspect of BPD is a significant factor, along with other biological factors.

All of that being said, let’s suffice it to say that interpersonal relationships play a huge role in BPD. Social connections and attachments, including parent/child attachments, are the focus point of a person with BPD’s sense of well being. When these trigger dysregulation and/or ineffective modes of thinking and behavior, a person with BPD is lost in the world, floating free in a threatening sea of feelings, thoughts and behaviors.

One must understand that in order for the interpersonal tools to work properly, they need to be understood and applied in a step-wise fashion. I have often said to my list members that “you can’t boil the ocean” which means that you can’t jump to the end before you walk the path. You can’t do everything all at once. Instead, you have to take one small step at a time in a longer journey. The goal of all of my tools, attitudes, skills and approaches is (in my mind) a compassionate, trusting, respectful and two-way relationship in which both parties feel known, heard, understood and worthy. Achieving that goal is hitting a grand slam so to speak. Yet, I feel that a person must be given the fundamentals and practice those fundamentals before you can hit one out of the park. Emotions which are the first layer to unravel peel back from the onion that is BPD. Understanding emotions in oneself and others is vital to having a two-way relationship with someone with BPD.

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Lindsay Lohan Breaks Down in Court

Well, it’s been some time since I have written anything about celebrities with possible borderline personality disorder. Personally, I wish some celeb would just come out and admit that they have the disorder and help others by showing that there’s effective evidence-based treatments for BPD. I guess the stigma is too great and they feel that it would hurt their careers. Of course, for some, their behavior is what is hurting their careers. Today, I am turning again to Lindsay Lohan (click here to see all posts about LiLo). Lately I have been receiving a ton of alerts with news stories that contain LiLo’s name and reference BPD. These are usually in the user comments. I can’t find a single legit magazine or news article that has speculated on BPD and LiLo. Recently, her behavior has accelerated, even as she is facing jail. Here are some recent articles that could indicate that (in combo) LiLo has BPD (remember, this is just speculation at this point):

Lindsay Lohan goes Doctor Shopping
http://entertainment.oneindia.in/hollywood/top-stories/scoop/2010/lilodoes-doctor-shopping-for-prescriptionmeds.html

Washington, July 12 (ANI): Lindsay Lohan apparently obtains her dangerous combination of prescription drugs through “doctor shopping” across the country.

According to a source, Lohan goes to six different doctors for prescriptions.

“When one doctor says no to refilling a prescription, she will go to the next. It’s a whole process to get what she needed, ” TMZ quoted the source as saying.

Lindsay who has prescriptions for- Zoloft (antidepressant), Trazodone (antidepressant), Adderall (stimulant to control ADHD), Nexium (acid reflux) and the extremely powerful painkiller Dilaudid, have doctors both in Los Angeles and New York.

In fact, one of her past rehab facilities still prescribes her meds.

The source even added that, Lohan “would get a large supply every time” she visited a doctor.

Lindsay Lohan and Suicidal Ideation
http://www.hollywoodlife.com/2010/07/14/lindsay-lohan-suicide-watch-kill-herself-jail-90-days/

Lindsay Lohan would rather kill herself than be locked away in jail. The 24-year-old actress is reportedly so upset over the 90 day jail sentence looming over her since July 6, that she’s threatening to take her own life.

“She just kept repeating, ‘I can’t go to jail,’ and, ‘I’ll kill myself first,’” a source tells Star magazine. “She’s mentally unstable and getting worse.”

After Lindsay’s discovered she’d be serving time at the Century Regional Detention Facility in Lynwood, Calif., Star reports she went home and broke everything in sight.

“She ran around breaking mirrors, cutting herself and rambling like a lunatic. She tore her house apart before she finally just broke down,” reveals a source. “Lindsay’s on a 24/7 suicide watch, it’s so bad. She isn’t doing well with this.”

Not only is Lindsay going around saying she wants to kill herself but she’s taking a lethal dose of prescription drugs.

“She has been doctor shopping across the country,” she says. “She is utterly unable to control her use of any mind-altering substance.”

Lindsay Lohan and Self-Injury
http://www.radaronline.com/exclusives/2009/11/exclusive-self-harm-sign-%E2%80%9Cseverely-disturbed-behavior%E2%80%9D

In shocking phone conversations exclusively obtained by RadarOnline.com Lindsay Lohan’s mom, Dina, is heard expressing her concern over her daughter’s self mutilation. And with good reason, as experts in the field tell RadarOnline.com that self harm is often just one factor of greater, underlying emotional issues.

Renown psychotherapist, and author of Cutting: Understanding and Overcoming Self-Mutilation, Dr. Steven Levenkron tells RadarOnline.com that Lindsay’s behavior is a sign of disturbed psychiatric behavior and that it will take time and energy to help her heal. “Whether (a given patient’s) condition is termed being ‘out of touch with reality,’ ‘psychotic,’ or ‘in a diagnosed state,’ the scene constitutes severely disturbed psychiatric behavior,” Levenkron says. “ This is the element that must be present in order to meet the criteria for self-injury. ‘Severely disturbed behavior’ does not mean hopeless, but it does mean that it will take a long time, lots of focused attention, and an intense emotional bond between helper and sufferer in order to repair the damage.”

And Dr. Wendy Lader, PHD, President and Clinical Director of the S.A.F.E ALTERNATIVES program, a nationally recognized treatment approach, professional network and resource base, and an international speaker on self-injury elaborates, telling RadarOnline.com, “The main reason for self injury is to deal with emotional regulation. For whatever reason it helps them to calm down.

“People who self harm have the inability to communicate the depth of  their feelings.

“They can’t talk about their emotions. And they want to do something quick to deal with their frustration or anger. Cutting works immediately. As soon as they split the skin there is a release.

“The problem is that most people don’t just self harm by cutting. Many have eating disorders too.

“Its all about control. They have non over the way they are feeling but they can control their body image. It’s a dangerous combination.

“Some people describe the feeling as euphoric. But I think they are confusing that for release of tension.

“The way to help these people is to make them recognize that when they have an impulse to hurt themselves, it’s a clue that they don’t want to feel something.

“They need to focus on what it is they don’t want to deal with and try to attack it in a different way.

“Some people do manage to stop by themselves but others go their whole lives cutting or harming themselves.

“I encourage anyone going through this to be assessed.”

Lindsay Lohan and Emotional Regulation
http://www.torontosun.com/entertainment/celebrities/2010/07/13/14694551.html

Defence attorney Stuart V. Goldberg has spoken of his worries for Lindsay Lohan, insisting the jailbound actress lacks “awareness” of the “urgency” of her dire situation.

Goldberg was contacted by the Mean Girls star after her lawyer Shawn Chapman Holley attempted to resign last week, and held a six-hour meeting with Lohan, her mom and teen sister Ali in Hollywood to discuss her case.

The legal eagle, who ultimately turned down the case, admits the Lohans “didn’t seem to understand the urgency and gravity” of the situation, prompting Goldberg’s fears for the actress.

He tells People.com, “My impression of Lindsay is that she’s a fragile lost child – a sleeping beauty with her head in the sand. I found her not fully forewarned of the consequence of her actions.

“I’m concerned that she’s not disciplined or tethered enough to the reality of adult consequences. She doesn’t seem to have the awareness of what’s going to befall her.”

Goldberg asked Lohan if she might hurt herself, which moved the star to begin “sobbing quietly.” He adds: “She was genuinely in pain.”

He advised Lohan to move out of the “toxic environment” of Los Angeles but she seemed to refute the suggestion: “She was like Teflon to that comment. It just slid right off her. She seemed to have some inner deep sadness that that was her fate.

“My real worry for her is not just the jail time but my fear is that she’s overly susceptible to a probation system that’s set up for her to fail.”

The 24 year old was sentenced to 90 days in jail last week after Judge Marsha Revel ruled she had broken the terms of her probation from a 2007 DUI arrest by failing to attend court-ordered alcohol education classes.

Lohan’s lawyer Holley has been banned from quitting until papers for a replacement are filed in court.

Lindsay Lohan and Substance Abuse
http://www.mtv.com/news/articles/1643621/20100714/lohan_lindsay.jhtml

http://www.latimes.com/entertainment/news/la-ca-lindsay-lohan-20100704,0,4835943.story

Lindsay Lohan and Blaming Others
http://today.msnbc.msn.com/id/38127652/ns/today-entertainment/

LOS ANGELES — Lindsay Lohan had a message written on her middle fingernails while in court on Tuesday — and it was far from a note of contrition.

The 24-year-old actress — who was sentenced to 90 days in jail for violating her probation — had “f— u” written across her middle fingernail on both of her hands.

As previously reported on AccessHollywood.com, Lohan must turn herself into the court by July 20. She will then be held in Century Regional Detention Facility in Lynwood, Calif., where she will be in seclusion.

Steve Whitmore, a spokesperson for the Sheriff’s Department, told Access Hollywood on Tuesday that general, non-violent females are eligible to serve just 25 percent of their sentence — which in Lohan’s case would amount to around 22 days.

Clearly, the woman is in a lot of emotional pain, unable to regulate her feelings and behaviors and in need of someone to help her. Unfortunately, first, she has to admit she has an issue and seek help.

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One way to become non-judgmental is to become aware of your (often) unconscious and conditioned judgments. I often hear Non-BP’s say, “My BP is acting crazy” or some such. The labeling of anyone’s behavior as “crazy” is a judgmental label. The behavior that anyone does makes sense (even if it is emotional sense) to the person at the time they are doing those actions. Certainly, a person with BPD might perform certain actions that someone without BPD would find objectionable or “crazy.” However, because of a number of symptoms of BPD, especially shame and fear of judgment, labeling another person’s actions as invalid or crazy can undermine the trust that you are trying to build.

In this exercise, I would encourage you to take a specific time-frame – it could be an hour, two hours or a full day – and identify your judgments of other people’s actions, attitudes and interactions. In other words, if you find yourself thinking about another person (whether with BPD or not), “that person is an idiot,” that is a judgment and should be counted as one. Continue to practice this exercise such that you can become more aware of the judgments about others and about life that you make, even if those judgments are ingrained and unconscious. By making the unconscious biases conscious, you can more easily slip their grasps and become less judgmental of others, including your loved one with BPD.

Keep and mental or written tally of these judgments to see if, after time, the number of judgmental thoughts is reduced.

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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 Enough
Get the Non-BPD book that is designed for
staying and working on the relationship

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.

Related posts:

1. NY Times Article that Mentions BPD
2. Interesting Article from Time Magazine on BPD
3. Nice Article about BPD in LA Times

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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.

Related posts:

1. Are personality disorders enough to nullify a marriage?

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Misinformation

“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.

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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.

Related posts:

1. Interesting Article from Time Magazine on BPD
2. Article in Time about the DSM
3. A new article about BPD in NY Times and the reaction

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When Hope is Not Enough
Get the Non-BPD book that is designed for
staying and working on the relationship

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.

Related posts:

1. Princess Di and Borderline Personality Disorder
2. Understanding Borderline Personality Disorder from WHYY
3. New for May – Borderline Personality Disorder Awareness Month

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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.

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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).

Related posts:

1. Follow up on Substance Abuse

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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?

Related posts:

1. Role of Shame in BPD
2. Shame and BPD
3. Blast from the Past – BPD, Shame and Self-Image

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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.
….

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.
….

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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When you plant lettuce, if it does not grow well, you donít blame the lettuce. You look into the reasons it is not doing well. It may need fertilizer, or more water, or less sun. You never blame the lettuce. Yet if we have problems with our friends or our family, we blame the other person. But if we know how to take care of them, they will grow well, like lettuce. Blaming has no positive effect at all, nor does trying to persuade using reason and arguments. That is my experience. No blame, no reasoning, no argument, just understanding. If you understand, and you show that you understand, you can love, and the situation will change. One day in Paris, I gave a lecture about not blaming the lettuce. After the talk, I was doing walking meditation by myself, and when I turned the corner of a building, I overheard an eight-year-old girl telling her mother, “”Mommy, remember to water me. I am your lettuce.”" I was so pleased that she had understood my point completely. Then I heard her mother reply, “”Yes, my daughter, and I am your lettuce also. So please donít forget to water me too.”" Mother and daughter practicing together, it was very beautiful.

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Well, folks, I was wrong. This book is about nons and ways for the nons to handle the BP’s behavior. Unfortunately, for the BPs, it does nothing to help them heal. In fact, the idea of setting limits and boundaries for BPs only serves to pissd them off more. Let me tell you why:

BPD is a disorder in which the sufferer feels emotions more strongly that a normal person.

When they are in the throes of a deep feeling, they cannot think logically. The limit that you set merely acts as a judgement of their behavior and boundary to be stepped over. They need to feel that they are OK. They live in a state of shame. If you tell them, through boundaries, that they are not OK, the message merely serves to fuel the deeply-felt emotion of shame. The behavior will get worse and you will get even angrier. This cycle of shame-anger between you and the BP serves to make you feel even more like leaving, like they can’t be “cured” and distances you from them even more. That is the real BP “dance” or “merry-go-round”.

When talking recently to the BP in my life, she had been reading a post on the Internet about “boundaries” and “limits” when dealing with borderlines. The post said this man’s ex-wife was a borderline – a nigtmare and a total abuser of him and the relationship. So, he left her. I wonder how that made her feel? Shamed further, perhaps?

I’m not saying that everyone should stay with their BP partner. What I am saying is: if you decide to stay, you should help that person heal, rather than set limits, sign contracts, be angry, etc.

Remember, borderlines suffer a lot of internal pain. All day, everyday. And they will do anything to stop the pain, including cutting, starving, raging, spending and attempting suicide.

Buy the book that can make your relationship last and grow:

When Hope is Not Enough
Get the Non-BPD book that is designed for
staying and working on the relationship

Related posts:

1. Stop Walking on Eggshells and Boundaries
2. My best review of When Hope is Not Enough
3. Walking on Eggshells Quiz

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