The Myth of the High-Functioning Borderline
While this post is popular and many people read it, it is old. If you’d like to get a newer/different perspective go to the UPDATE: see this link.
Today’s subject is the Myth of the High-Functioning Borderline. I have been scouring the research on BPD to find out if anyone in the research or therapeutic community uses this term or concept high-functioning versus low-functioning Borderline. I have yet to find any author in either the research community or therapeutic community reference this concept. It crops up in the support community (in “Stop Walking on Eggshells” and on both bpd411.org and bpdcentral.com). It also crops up in the “cross-over” community (see more later) but only in a sarcastic way. The idea of high vs. low-functioning BPD doesn’t seem to hold much weight in any other community than the support community.
What do I mean by referencing these “communities”? I think that there are basically three BPD/Non-BP “communities” out there: the research community, the support community and the therapeutic community.
The research community is comprised those scientists doing medical research (and psychological research) on BPD. They publish scholarly articles and research in medical and psychological journals. Some “supposed” psychological researchers publish in the less-well-known and scientifically suspect journals (see my article about “Demonic Possession and BPD” for an example of this type of researcher). For the most part, these researchers don’t try and “cure” BPD, they merely provide data to other professionals about the configuration of BPD, the biology of BPD and the “common” features of BPD. This group of people does not differentiate between high-functioning and low-functioning BPs. In fact I have found no reference to high- or low-functioning BPD at all in any of these research papers or reports.
The therapeutic community is those practitioners (mainly psychologists, psychiatrists, social workers, other “therapists” and consultants) that try and “cure” or remediate BPD in patients. Sterile operations during pharmaceutical production and packaging should be strictly observed. Some (very few) also serve the families, friends, spouses, children, etc. (the Non-BPs). Their purpose in life is to help the BP overcome or to effectively manage their disorder. In this group of people, I have found no mention of high- or low-functioning BPs. The only “partial” mention is that of Dr. Paul Mason, who co-wrote “Stop Walking on Eggshells” with Randy Kreger. Several of these people within the therapeutic community have written popular books about BPD, including “Sometimes I Act Crazy,” “Lost in the Mirror,” “The Angry Heart,” and “I Hate You, Don’t Leave Me.” None of these books, as far as I can tell, refer to the idea of high-functioning vs. low-functioning BPD. Of course, Dr. Marsha Linehan and Dr. John Gunderson are prominent individuals within the therapeutic community. Their theories about BPD have a distinct influence on how therapy is conducted with people with BPD.
The final community is the support community. This community is comprised of ex-BPs, Non-BPs and others who provide advice about how to “deal with” BPD or with someone with BPD. This community includes myself, the authors of “Stop Walking on Eggshells,” the author of “Tears and Healing,” A. J. Mahari, the proprietors of bpd411.org and others. Only in this community have I seen any mention of high- vs. low-functioning BPD.
Some individual and organizations actually straddle the support/therapeutic (or even the research/therapeutic) community split. These include: myself (at least I hope so), TARA, A. J. Mahari and others. Some of these are more therapeutic (or at least psycho-educational) like TARA. I try and be both psycho-educational and to offer support resources to Non-BPs; yet, in doing so, also try and dispel the many, many myths about BPD (where possible).
The problem with assigning either high-functioning or low-functioning to a person with BPD is that the very nature of the disorder debunks these categories. BPD is chiefly an emotional disorder (with impulse control issues). Emotions are ever-changing, like waves that carry the mind along for the ride. Whether someone is high-functioning or low-functioning at any given time will be subject to their current emotional state. If a BP is emotionally dysregulated they will adapt to that (usually) painful state in whatever way that they have learned will assuage the pain. Some people with BPD will cut themselves, take drugs, avoid situations or behave in other ways that might be considered harmful to themselves or those around them. If a BP is not dysregulated, he/she has no need to behave in these ways. The core point is that BPD is about emotional instability and no person with BPD will be always high- or low-functioning. A person with BPD will swing – sometimes wildly – between several polar ways of feeling and behaving.
I suspect many “high-functioning” BPs do not have BPD at all. I have read many, many posts on Internet boards in which the “BP” in question clearly does not have the disorder. Many times, if you read carefully, you will find that these “high-functioning” BPs are diagnosed by their (usually) ex-wives, just because the “xBPh” (ex-husband with BPD) raged or was selfish during their relationship. BPD is more than raging – and as a Non just because you’re “walking on eggshells,” it doesn’t mean that your “BP” has the disorder at all. In fact, recently the list owner of WTO (the Welcome to Oz Internet list) asked the women Nons on the list if there husbands (or, more appropriately, ex-husbands) exhibited the symptoms of Narcissistic Personality Disorder (NPD). Every “Non-BP” that responded to that request confirmed that their “BP” met the criteria for NPD.
NPD (which IMO is more likely a disorder that appears to be “high-functioning ‘BPD’”) and BPD are distinctly different disorders. There may be a slight bit of overlap – deep, deep down within the psyche of the individual (and that is shame, most likely), but the basic configuration of the disorders are quite different. People with BPD do not like themselves, for whatever reason. People with NPD adore themselves, for whatever reason. That alone separates the two disorders. While people with BPD may exhibit “deserving” behavior (that they deserve love, riches or whatever), people with NPD believe that being “special” is their birthright and want to be surrounded by important or exclusive groups of people. The thing to note with BPD is that the “deserving” behavior is counter-balanced with “undeserving” behavior – polar opposite feelings and behavior that is the hallmark of BPD. So, it seems unlikely to me that “high-functioning” (or low-functioning) BPs can actually exist.
Let’s briefly look at the DSM-IV diagnostic criteria for BPD and NPD , and we can illustrate the differences. First, BPD:
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- Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in (5).
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- A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. This is called “splitting.”
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- Identity disturbance: markedly and persistently unstable self-image or sense of self.
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- Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in (5).
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- Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
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- Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
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- Chronic feelings of emptiness.
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- Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
- Transient, stress-related paranoid ideation or severe dissociative symptoms.
And now NPD:
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- has a grandiose sense of self-importance
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- is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
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- believes that he or she is “special” and unique
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- requires excessive admiration
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- has a sense of entitlement
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- is interpersonally exploitative
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- lacks empathy
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- is often envious of others or believes others are envious of him or her
- shows arrogant, haughty behaviors or attitudes
Clearly, these two conditions are different. Some interpersonal aspects may seem similar (#8 in BPD and #6 and #7 in NPD); however, the emotional aspect of BPD (#6) is not present in NPD. There seems to me to be a split between self-hatred and the instability of self (in BPD), and self-importance and self-love (in NPD). I’m not sure this a gulf that can be bridged sensibly between the two disorders.
Why does it matter? Well, IMO it matters a lot, because the “prescription” that is effective for BPD is not the same prescription that works with NPD (or other variants on the Narcissistic spectrum). NPD is not a chiefly an emotional disorder, and emotional tools that are so effective with BPD will not be effective with someone with NPD. Now, you might say, “My ‘BP’ is diagnosed and he/she is always thinking about his/herself.” That may be true, yet, IMO, this type of “thinking” about oneself is really experiencing overwhelming negative emotions. It is difficult for anyone to think about anyone else when they are in deep emotional pain. As I have said in the past, I have coined (with the help of others) the term IAAHF (it’s all about his/her feelings) to help represent this state to Non-BPs.
Which brings me to my final point: self-diagnosis. It is dangerous to diagnose your loved one with BPD (or any other mental disorder). Only a trained and knowledgeable (and yes, I know, there are too few of these) professional can diagnose a person with any disorder. Assuming on your own that your loved one has BPD can be troubling for the relationship (at best) and damaging to their (and your) mental health (at worst). After reading a self-help book, such as “Stopping Walking on Eggshells” (SWOE), one has to be careful to diagnose someone else with the disorder. Even my book, “When Hope is Not Enough” (WHINE), can be used to “diagnose” your loved one with BPD, but I’d like to dissuade you from doing so. Instead, I would suggest you use the tools in my book (or, for that matter, SWOE) and see if they work. If my tools do not work, I suspect either you haven’t practiced enough (it takes time, believe me, it took me 2 years) or your loved one does not have an emotional disorder. I personally tried what I learned in SWOE for months before I realized that those “tools” were not effective in my life – which is why I bothered to write a book in the first place.
If you are tempted to introduce yourself to a support group with the statement, “I am married to a high-functioning BP…,” I’d suggest you take a step back and see if your loved one has the other signs of an emotional disorder (which BPD is and NPD is not).
149 Comments
Markos
Well Bon, conceptualizing ‘the problem,’ and the way out, becomes a consequence of perspective and exposure. Which leads back to the ‘can’t know what you don’t know’ paradigm. Research can only go so far based on observation and analysis. Names and concepts like Mentalization and Dialectic Behavior are all great, yet don’t offer a full understanding of the dynamics involved. And bless everyone who has devoted their time to adding to the body of knowledge. If one employs the techniques, life does get better. Yet, better is a compromise if FIXED is the real objective.
Management of the controlled illness, though better, is not much fun either, I’ve done it. Many times, the ‘closer’ relationship eliciting the moderated behavior is the facilitation of dependency…… which creates an whole new dynamic with other problems. The BPD will feel ‘safer,’ but with no tangible motivation, they are less likely to find the true self. That is the situation most HF BPD’s actually create, knowingly or unknowingly.
Mentalizing is part of the puzzle, so is the ‘behavioral chain analysis,’ as is the themea approach. I find it interesting that everyone is right, in part, all have different pieces. But, there is that elephant that no one could know, the center of the puzzle…… unless you’ve been a borderline. Then you would have had to walk away with full congnizance, have the ability to conceptualize the difference between here and there, to see from whence it came. If you haven’t been one, its like asking you to describe the void. You can’t. But every borderline I’ve ever met, will smile a knowing comaraderie, and then describe its overwhelming presence.
It’s a big concept and applies much broader than you could imagine.
Bon Dobbs
Markos,
I certainly can’t answer your question regarding the factors required to actually get better. It is a puzzle and is more so for a person that is generally well-functioning in society and hides their inner feelings/self very well. I still hesitate to call this person “high functioning” because both high and low-functioning replies on external, observable behavior. The other day I was in the office of a well-know and well-respected researcher of BPD. I try to do advocacy-related things when I have the time, building awareness and understanding among the public and among mental health care professionals. Anyway, I was lamenting the fact that the most often used measurement for the effectiveness of any therapy (including DBT, MBT, STEPPS, Schema-focused therapy and others) is the reduction of suicidal ideation/attempts and the reduction in self-harm. As you know, many people with BPD do not utilize these behaviors to manage self-pain. Randi now calls these non-self-harmers (or non-parasuicidal BPs) “invisible” BPs. While I still think, based on my experience with interacting with 100s of people with the disorder and speaking with the experts in the field, that all BPD behavior is situational, I can understand how these BPs might fall through the cracks in the study of a therapy’s effectiveness. This researcher (who also has a family member with the disorder) told me that she’s like to see a therapy that can actually help BPs FEEL better on the inside. I think she hit the nail on the head. One thing that seems common to all BPs is emotional pain. Randi noted the “pain management” behaviors in all BPs and how they differed in her categories of “conventional vs. invisible.” All BPs experience emotional pain IMO. It’s the alleviation of that pain that I’d like to see as well. Without the pain, the behaviors are unnecessary and the “problems” for the Non-BPs cease to exist. I just try to focus on that pain, which is why I called this site “anything to stop the pain.”
Randi seems focused on the Non’s pain, which make sense since that is her main audience. Interestingly, that’s my main audience as well. Except that my focus is slightly different than Randi’s (from what I gather about her writings). She is more focused on stopping the emotional abuse (by any means necessary it seems). I am trying to encourage the development of a two-way compassion as an antidote to abusive behaviors. Perhaps I am misguided and there is no way to develop such as relationship with an untreated BP. However, the success that I have had and my list members have had would seem to prove otherwise. Still, it’s a fluid thing, as all of life is IMO.
I don’t have a cure for BPD. I never stated that I did. I only have a set of tools that helps point the direction of healing. It is up to each party to walk the path.
Bon
Markos
Bon, You and the researcher spoke of wanting to see a therapy to make the BP FEEL better on the inside. That is hitting the nail on the head, but not hard enough to drive it through the board and attach it the wall.
The question is, do you want a therapy to make BP’s feel good, presumably needing continuing therapy to continue feeling good. Or do you want a process wherein the BP becomes inherently good, all the time, regardless. I’m talking done. Over. Finished. Transformed. Joyful. Considerate. Loving. Helpful. Peaceful.
Okay, so you ask, who in society actually has all of that? And now we are starting to look at the real problem.
It is all about cause and affect, pain-behavior-response-response and more response. The cycle doesn’t stop until one is motivated and knows how to stop it. But, the pain is an effect of a deeper affect. And therein lies the path.
Writing about this is very difficult because of the interwoven threads, and the complex relationships forming the knots. I would love to invite you into my living room, show you where the elephant used to be, how he got there, the imprint he left, and why he is no longer there. It might take a few days, but you would walk away getting it.
I do know the path. Only the borderline can heal themselves, but most need to be taught how to do it. Being mindful is one thing, knowing what to be mindful about is quite another. Borderlines need help getting who they think they need to be out of the way. Unfortunately, sometimes those closest to the BP have to get out of the way, too.
It’s a tough road for everyone concerned, needing a soft heart, a strong arm, a very smart head, and a truckload of determination. But, it can happen pretty fast if the variables are lined up. That’s a big IF, and most aren’t willing to go for it. Like I said, for me it was one year, fixed or dead. I didn’t leave myself a lot of wiggle room.
I told my doctor friend in Germany, from the awareness she now has, 6 months of intensity and she’d have a new life. The borderline must decide it is time to be well. Then the work can begin. Until that point, most everything else is a game.
Bon Dobbs
Markos,
Thanks for sharing your thoughts with me. It is really appreciated. It’s got to be hard for you to revisit that “elephant”. Painful, I’d say.
My daughter, who has emotional regulation issues, went to therapy for 2 years. She is now done with therapy. It was skills-based and close-ended. Meaning, once she mastered the emotional skills, she was done. She feels much better now and has the tools to effectively manage her behavior (and in some ways her emotions). Yet, she’s not “cured” of emotional dysregulation or emotional pain.
Fixed or dead. Tough choices, not a lot of grey there! I think many people with BPD come to the same cross-roads. Unfortunately, too many opt for the second choice.
Take good care!
Bon
Markos
Hey Bon,
Actually, it isn’t hard to visit the elephant at all. That was then and this is now, I share with those I think it will help.
I’m so glad to know you sought help for your daughter, and she has control over her behavior. It will certainly make life easier. The state of the art does not offer a cure for her emotional issues, and that is unacceptable. The fact that your wife still struggles, is unacceptable. I feel for her. My fellow disordered wife of 30 years has watched my emergence, and is pulling herself out of her own swamp. What a wonderful life it is, to expect to have fun instead of the dread of resistance and dysregulation. There are reasons and a process for all of it, just depends on where you want to go, and what you are willing to give up to get there. Its a choice.
Fixed or dead may have been tough, and the pain of the process was unreal…. but not as bad as the prospect of remaining a borderline, and living a compromised life. I’m fixed, and free to be the caring, creative, thoughtful, passionate, and happy person I was meant to be. Life is sweet, I just wish others who suffer could know how clear the air is on the outside of the bubble…….
Markos
Angie
If you are simply trying to explain to the general online public that BPD and NP are different and illustrate that and that people are often misdiagnosed, fair enough. I agree that there are many people on forums who diagnose themselves or someone they know, and that they are probably often incorrect. I’m sure you understand, despite the slant of what you wrote above, that you yourself cannot diagnose anyone either, merely by reading a brief and sometimes second-hand description of them online. If you wrote the above article for an undergrad course in psychology, a professor would have come back with red marks all over your paper– you give no actual examples for what you’re referring to (specific examples of what you read online of “ex-wives” diagnosing their ex-husbands, etc.), and you provide no valid research or anything else for, that matter, to back up your point that BPDs are often actually NPDs. All you have is that you read some forums and from the symptoms described it seems to you– who have never met the actual person or their ex-spouse who’s penning the description– that they are NPD rather than BPD.
But this is a side point. My main issue is your argument that high-functioning Borderline Personality Disorder does not exist, and that it is instead Narcissistic Personality Disorder. Do you have anything to back this up? Any research you’ve read even, and would like to reference? Or is this too just from your interpretation of what you read on forums?
First, to your argument that high-functioning BPD does not exist: With every disorder, every intelligence, every skill, and every person there is an average (bell curve with IQ) as well as a high and a low. It is sound logic to say that everyone is not the same. Why would BPD be different? Because the emotional range is wide? Yes, the emotional range is wide– that is part of the disorder. But let’s compare two fictitious BPD examples: When Sally has an emotional down-swing she throws tantrums and cries and begs her partner not to leave, even to go to work. She occasionally, but rarely, throws and breaks a glass, though she often threatens to break things when she’s in a tantrum. Okay, then ether’s Jane, who, when in a tantrum, drinks to intoxication or uses drugs, cuts herself and repeatedly threatens to kills herself. Both women have the same fears (like abandonment) but Jane’s emotional behavior is considerably worse– more self-destructive and damaging. (If you want to find real examples of Sallys and Janes, just read some case studies.) So, while neither woman would be considered high-functioning compared to a normal functioning and non-BPD person, it is clear that Jane is higher functioning that Sally.
I consider myself high-functioning BPD. I am in my late twenties and not able to hold a job for more than several years, and I have never worked full-time. Relationships are stormy and last between-2-4 years. When I was a teenager, I occasionally cut myself, but they looked only like cat scratches at the time and there was no permanent scaring. My behavior is even-tempered around family members, co-workers, friends, and in public, and it is only the one person I’m closest to that suffers my tantrums with me. My credit is good and bills are always paid on time. I am terrified of abandonment are sometimes beg the person I’m with not to leave for work, but this happens probably once every three months. I am controlling and manipulative, and have the pattern of becoming quickly irritated and having a meltdown for no apparent reason. It could be once a day in very high-stress times, or once a month in low-stress times. I rarely break anything when upset, and I never hurt myself physically anymore. I own and successfully manage two rental properties, and I have for over five years now. I received my master’s from an Ivy League university and my lowest grade was one A-. I have all the symptoms of BPD except for the self-mutating behavior, and I only rarely mention suicide; I was diagnosed with BPD ten years ago, and it has been confirmed by several doctors since. I have not been on medication for ten years, and I’ve only attended several therapy sessions and non in the past several years.
Second, to your argument that high-functioning BPD is actually NPD: What makes you think NPDs are higher-functioning that BPDs? (More on that after.) Also, I realize that BPD and NPD have some common traits, and that BPDs can feel/act like NPDs when in certain moods, but it’s not consistent enough for BDPs to qualify as NPD. I think both disorders share a common root in childhood (some examples could include: insecure/ambivalent attachment; one parent praising them and the other directly or indirectly degrading them or expecting too much), but BPDs and NPDs coped with their conflicting external environment differently, and both have stuck with their pattern of coping since childhood. BPDs have coped by constantly seeking concentrated approval and by feeling that they both do and don’t deserve it, and part of that approval involves the person never abandoning them. They go through periods where they feel good and worthy, and periods where they hate themselves. NPDs have coped by very strongly denying that they are anything but great, and they go about this by surrounding themselves with shallow relationships (facebook is an effective tool for this) in which they receive much praise and admiration; they’ll lie and exaggerate to achieve praise and admiration, but regardless they will be convinced of it (unlike the BDP, who never fully believes or feels worthy of praise). NPDs do have down periods where they feel worthless, but they never blame themselves– it is always something external, like a spouse, or a recent move or job change. If they hit their wife and their wife then cries and calls the police, the NPD would blame the wife both for the hitting and for the stress she gave him afterwards, even using this as a reason for failing at something, like not going to work; my point s that if the NPD doesn’t have an external thing to blame their failures/impending failures on, they will create one and fully deny creating it/responsibility.
BPDs are afraid of abandonment; NPDs are afraid of others not believing that they’re great (perfect, elite, etc.). If a BDP is abandoned by the closest person to them, they will frantically try to win that person back or find an immediate replacement, then seeking a vast amount of reassurance. If a NPD is rejected by a person or a shallow group (meaning those without a deep connection, like facebook friends), they will first behave as if “surely there is some mistake” then convince themselves that the person/group wasn’t good enough for their company anyway, and quickly find replacements. BDPs seek one or few deep attachments with concentrated approval/reassurance, while NPDs seek many shallow attachments with approval spread out from as many directions as possible.
My point is that high-functioning BDP, as with any level of BPD, is very different from NPD.
And, finally, getting back to my question of why you think NPDs are higher functioning in general than BPDs. Most NPDs can only be in an environment as long as they’re receiving praise (no matter how shallow), and this means that they only function within jobs, schools, relationships, etc., as long as their need for praise/admiration is fulfilled. This leads to the same inconsistencies BPDs have in functioning. Yes, NPDs aren’t known to be suicidal, but they can be abusive even to the point of murder, which hardly seems better than BPD.
Bon Dobbs
I believe you missed my point. However, that was probably my poor expression of it. What I am saying is that BPD’s level of functioning is situational, based on the level of activation of the attachment system, emotional dysregulation and failure to “mentalize” (and other mental/emotional factors, such as substance use, physical well-being). I was never arguing that BPD didn’t exist. BPD most certainly DOES exist. I believe that NPD and BPD both exist, and that their “profiles” are different. I think many people (not saying you, just people that I have come into contact with) think that rage = BPD. I don’t. I also never said NPD are “higher functioning” than BPD (or that they were “better”). All I was saying is that I believe BPD functioning is situational (based on emotional activation) and that because of the rage, people mistake any rage (including NPD rage) for BPD.
Andrew
I can answer this. Yes you can have bpd and be highly intelegent. I was diog with bpd by Dr Gunderson at McLane Hospital this past year. I also have a mensa level IQ.
Carissa
Does a person with BPD ever turn on a loved one as a “test” of their love? I just moved from my sister’s good side (she claims she used to worship me), to her bad side (Let’s just say she no longer worhips me!) It feels like a test, like she’s doing everything in her power to make me hate her while desparetly hoping I’ll stick around and then prove that my love is real. Am I seeing this correctly? And if so, will sticking around prove my love, or prove that she can mistreat and abuse me and I’ll just take it?
Bon Dobbs
I have a saying in my book that goes “It’s all about his/her feelings” (IAAHF) which means that a person with BPD will be motivated entirely by his/her feelings at the time. This means that there is not real “test” of your love going on. She may feel upset by something and she is using you as a way to try to make herself feel better. In short, very little of a person with BPD’s behavior is about the other person at all. If you learn to deal effectively with the person with BPD, the idea of abuse and “taking it” or “proving your love” will disappear.
Carissa
It’s hard to not take it personally when the attacks are on your person. When she first turned on me I used every conflict resolution strategy I know, and she just got more angry and her accusations of the wrongs she’s saying I did got more elaborate. I sped-read through your book the first day I got it and I can see now that everything I was doing “right” was really so wrong; gently pointing out facts, striving for compromise,being resonable, defending myself, etc. All the “rules” have changed. When I first got your book I was thrilled that maybe there was hope for us, but now, as I think back on how much she’s hurt me and my family and at what I would need to do to restore our relationship, it feels like too much. Maybe this is a phase I need to go through before I’m able to push up my sleeves and get back in the trenches, but at this moment, I don’t know if I can. I’m not even sure I want to. I’m going to have to reread the book and spend some time thinking/praying about this. At this point she’s completely and viciously removed herself from my life, (a complete change from the 4-7 phone calls per day) so I’ve got some time for contemplation. I struggle with wondering if I have enough graciousness to do this, and with wondering how someone can stay true to themselves through this?
I so appreciate your responding to me, thank you. I also appreciate your straight-forward approach in your book and on this site. I’ve also got SWOE, but it’s felt a lot more clinical and harder to read. Or speed read, at this point! Kudos to your readers who reviewed your book on Amazon- that’s what made me add this book to my order.
Markos
Keep in mind, Carissa, your sister does not want to feel the way she does. She has a very complicated mental illness tying her head in knots. Being able to love a borderline in a way that is consistent, regardless of what she says or does, with boundaries you can live with is the most you can do at any given time. Wanting to become well is a very scary proposition for her…… becoming who she actually is, beyond the disorder, can only be achieved when she is prepared and able to let go of who she isn’t.
Just remember, what created the need for the disordered ‘order’ of her mind, was a lack of acceptance and unconditional love. However you can extend those gifts, even in the midst of the storm, the more she will trust herself to lower her defense. It is very difficult place for anyone to arrive, she will appreciate your trying even though she can’t afford to express it.
HighFunctioningBPD
Interesting reading your comments about high-functioning BPD. I looked over the listings of BPD and NPD. My wife is clearly not NPD. She very clearly exhibits all of the BPD criteria you list except for items 4 and 5. I believe she is so skilled at trying to paint herself in the perfect image to the outside world, that she prevents herself from acting in the manner of items 4 and 5. Her language during one of her meltdowns with me rings close to BPD, “…I feel so empty inside, like nobody cares if I’m alive or not. I feel so alone…”. It seems like this language coming from her own volition is very parallel to BPD. I guess it would show some level of self-assessment that could be inconsistent with BPDs projecting all feelings outward. Or perhaps she was trying to manipulate me to return to a closer state, as we were separated at the time?
It seems like she has exhibited all of the acts that are described as high-functioning BPD to me. Smear campaign against me, lying, manipulating, cheating, verbal abuse, portrayal of perfection to others, etc. She has slices where she has done the same to my family and friends.
I guess all of this stems from emotional pain. The sticky issue I have is labeling these traits and trying to construct a specific box around the individual. I would think there can be similar traits between individuals, enough to suggest similar treatments, but arguing over the categorization and degree of certain behaviors as to be dismissive of the existence of a problem seems counter-productive. I am not a mental health expert, but being dismissive of others’ opinions because of lack of a specified credential just doesn’t seem right. I do know my wife has a problem, regardless of categorization. Others have concluded as much as well (health care providers, her family, my family). She exhibits to a “T” the high-functioning borderline characteristics that have been described by many others. Arguing over the existence of this label could have the effect of keeping people from getting help when they and those around them need it.
Jennifer J.
PLEASE HELP!!!!
I am having real issues with my roommate, who I am desperately trying to be kind to and understand, but who is exhibiting ALL of the behaviors of NPD. It is very hard to deal with her and because of her symptoms she displays, she keeps people at bay, and so I am the only one around at the end of the day to pick up the pieces. She is constantly needing praise, is arrogant, haughty, has an ideal of what love is and should be, is a binge eater and is morbidly obese, and she honestly displays everything mentioned above according to the NPD symptoms. She has told me in the past that when she is upset or annoyed with someone, she will hold it in for months, perhaps years, and then finally lash out with unbridled fury toward people. This concerns me very much as I would be completely unaware of her true feelings toward me and I fear she could lash out at me if I were to annoy or bother her over the course of a few months/years. She lives two states away from her immediate family and has no connection to them except for by phone, etc.
Of course, I cannot ever be certain if she is actually NPD because she is only my roommate and it was suggested that it wouldn’t be wise to alert someone of this kind of disorder, but how would I handle this situation sensitively? Should I ask her to move out and suggest she seek help? Her personality is so abrasive, but in a passive way for the most part. She doesn’t understand social cues, non-verbal communication, etc. I am a teacher of students with disabilities and also work closely with those who are high functioning autistic, so I have some background in identifying those with high functioning autism, but I believe she is more borderline autistic and more NPD. She is truly pushing me away, but I feel a great deal of guilt and sadness when I think of asking her to move out. Will she lash out at me? Will she become suicidal? She really doesn’t have anyone to help her, except uncles or aunts and I know, for a fact, that she drives them all crazy. I am a very religious person and feel I can do her a service, but how? Should I talk to my pastor/minister and seek advice?
I have really been trying to pin down why my roommate is so “different” from other people, did some more digging past just “high functioning autism” and found this sight. I am at my wit’s end. Can someone please give me some frank, constructive advice? Should I ask her to move out before I say things I will regret that may harm her rather than do her good? HELP!!!!!
Blaire Davies
Hi
My ex husband tried to convince me I have / had BPD. When we were married, I suspected that he wasn’t always telling the truth and in fact caught him lying many times. We had many intense fights (BPD characteristic no. 6?) and when we weren’t fighting, there were times when I felt anxious and needed to be assured that he loved me, there were no others, that he wasn’t lying to me and that I was the love of his life (BPD characteristic no. 1?). There were times when we were happy and “in love”, I felt lucky and thought he was wonderful and other times when I had these dark moods, when I was sure that something was not right and we fight (BPD characterisctic 2 – “splitting”?). I should also mention that many times, he started the fights unprovoked by me – he had a bad temper and I was often “walking on eggshells” myself.
However, for the reasons I mentioned, he “diagnosed” me as a BPD. I guess he would call it a high-functioning BPD because it did not affect my work or any other relationship, either with family, friends or colleagues. In fact I function very well at work and have a demanding and high-flying career.
The fact is, I found out a couple of years into our marriage that he had been married before me and still was, i.e. he was committing bigamy and leading a double life. He was also stealing money from me to support his wife (he was unemployed for years). I had no idea he had even been married before.
Now he is facing the possibility of being convicted and sentenced to prison according to the laws of my country, and he will probably use my “BPD” as his defense reason. I think he would argue that he was not functioning well mentally because of my disorder and hence was not able to do the right thing.
I read your article with interest because I don’t have any of the characteristics of NPD and I don’t have any of the other characteristics of BPD that you’ve listed. I have also not had any of the issues I’ve had in the relationship with my ex with anyone else. I am currently in a new relationship which has lasted for 2 years (we are now married) and we have had no issues at all. No fights, no fear of abandonment, no unstable moods, no anxiety, no “splitting”, etc. Is BPD something that can come and go depending on whom I am with?
Thanks – any further insight I could get on this would be helpful.
Heather
I understood the point of this article and felt that I should point out that the article is not debating whether “high-functioning” BPD is really NPD or even if you can characterize a person as high-functioning or low functioning generally. Obviously people see the differences enough in their partners and spouses that they see how they normally act. The important thing to remember though is that there are so many ups and downs, “recoveries” and “digressions” associated with BPD that my opinion on the matter, and what I feel is trying to be states in this article, is that the borderline sufferer has the capability in his/her lifetime to be both high and low functioning depending on support, circumstances, and personal acknowledgment.
In other words, there is sadly nothing that does not say that a relatively “high-functioning” BPD sufferer may not have a day, a month, a year, where he/she breaks and becomes “low-functioning”. As such, I would say that this is the reason there is no official diagnostic separation of the two. In this way perhaps the true introduction should not be “Hello, I am the spouse of a high-functioning BP”, but instead “Hello, I am the spouse of a CURRENTLY high-functioning BP”.
Markos
Just as BPD is defined by its pervasiveness, so too is recovery from the disorder. A BP will appear to recover if they find themselves in a loving, non-judgmental, nurturing environment that does not challenge their vulnerability. Place the same individual in a critical invalidating situation and the disorder will quickly emerge.
A true recovery means that new neuro pathways have opened and the brain has rewired itself to exist in any environment without dysregulated, reactive responses.
The distinction between high, mid, or low functioning is not in what the BPD does or doesn’t feel. The feelings are all the same. The difference is in how the BP reacts to those feelings. The variables are many, but a hefty IQ gives the high functioning BP the ability to create believable options in a situation where a low functioning would simply melt down. Typically, the high functioning will only be visible to a significant other, and perhaps their children, or a confidant very close to the relationship. Everyone else will know them as Mr. or Mrs. Perfect, usually doing more than 5 nons could ever hope to accomplish, proving their self worth.
Low functioning BP’s are what the medical community is used to seeing. High’s rarely seek help and if they do, to their own demise, they run rings around all but the most astute therapists.
Very high function BPs will rarely melt down, as they are harshly self critical and very disciplined. It is a lot of work to maintain the appearance of a perfect façade. Some situations are harder than others, but that high IQ can usually figure out a workaround for most.
Recovery is about letting go of all of the above and living in and accepting the simplicity of reality as it actually is, dealing with it all; good, bad; or indifferent. From such a place, digression is no longer a necessity.
Bon Dobbs
I’m not sure IQ is the correct measure of functioning level. I think it is the ability to handle one’s emotions. My daughter’s IQ scores went up about 30% after treatment. The only thing that really changed in her was her anxiety levels have decreased and she can better handle her emotions.
Markos
IQ is not the measure of functioning, it simply determines how many options a BPD can come up with; which does determine functionality. In a way it is unfortunate, because the disorder can be hidden behind a very functional appearance, quite possibly for an entire life.
When treatment is applied and successful to whatever degree, the brain activity is no longer ‘wasted’ in addressing mid brain fear and consequent confusion, which allows for greater neuro transmission in the frontal cortex, where IQ can actually be utilized.
The highest functioning can create their own safe zone of support which serves the same purpose, when vulnerability is controlled. It is sad, as most believe their cleaver manipulation is what life is about.
I spoke this afternoon a consequence of just such a situation. The 15 year old daughter of a very high BPD mother, who is a partner in a law firm, said it is her job to nurture her mother. Which is exactly why her mother wanted custody. The sole purpose, of course, was to ally the mother’s fear of being alone, and control a source of nurturing. The high functioning BPD will always find a way to meet their needs without addressing the real problem. And usually at the cost of anyone else’s emotional needs. The daughter’s life is a mess. At least she now knows why.
Queenbee
Hi
What I couldn’t understand is that I have read in various places on the internet that BPD can be co-morbid ie it can exist with other personality disorders and in particular NPD, within a person.
I thought this was a common, well known and researched ‘fact’? Even A J Mahari talks about the narcissistic element in the bpd, in her writings.
Hence, it was of no suprise to me that many women said that their bpd partners showed a lot of the NPD characteristics.
I went out with a guy who ticked every box you could tick for the characteristics of bpd. EVERY box! He seemed to be the poster boy for bpd. However, he also ‘fluctuated’ from being very unsure and needy to deluding himself he was the best, the brightest, no-one knew like him, his girlfriend was better looking than the girlfriends of his friends, etc….. and having a delusional and disconnected ‘arrogance’ about him. He was held hostage by his ‘ego’ in many ways.
His ‘needs’ and what he wanted/feared totally outweighed and blocked out any possibiblity of any ‘real’ giving to another.
marykay
My doctor just shoved the high functioning borderline personality jazz at me. I was going to not go to him anyway. This article helped me see that I am not this, but mostly the other. There is nothing wrong with defending yourself against health care errors. You should be aggressive. You should be your own best advocate. Its really nice to push this off on people when you hate them and are scared because they went to law school and you don’t do your job.
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barbara mercer
Having BPD is difficult enough without online information that is not accurate floating around. Bottom line is that only a therapist can help. Why should anybody try to “diagnose” someone else anyway?
High functioning vs. low functiong? I can appear fully capable in public, it’s at home I break down…textbook. IQ has nothing to do with mental illness either…mine is over 140…I still have emotional problems and a MA in psychology. I hope my struggle with BPD will give me a unique empathy for others.
Bon Dobbs
Barbara,
Your case helps illustrate my point of functioning. It has nothing to do with IQ. It has to do with what’s at stake emotionally in regards to attachment. Breaking down at home and functioning at work is normal if you have emotional regulation issues. If you read my update to this post (referenced at the top of the message) you will see what I am expressing here. My problem is that many books and Internet sites cling to the “high” vs “low functioning” BPD concept, when, in reality, what you describe is normal. Only a therapist can help, yes, however, family members can be helpful too if they truly understand the disorder and have proper communication skills.
Bon
Markos
Barbara,
Sometimes it is very helpful for others to be fully aware of a possible diagnosis because many Borderlines, especially those with higher IQs, will have to be convinced. As I’ve written before, high IQ BPDs can run circles around most therapists, which of course gets them nowhere but still defended.
Usually, it isn’t until life comes apart through loss, sickness, injury, or enough years of misery, when the narcissistic walls tumble and we become open to different ideas…… and eventually, different neural pathways. But, we must learn what that looks like, and how to get there, from others who have walked the walk. Only another borderline can know what its like.
Try to find a good therapist who has dealt with other BPDs, who is committed to more that just coping mechanisms. Coming out of the cloud of disorder is decidedly uncomfortable at best, terrifying at worst, but doable. You have the vocabulary from your MA in Psych, you need someone to teach you how to use in when observing your own thought processes, and apply what you know, to discover alternatives. It is you that must want to be different, and you that must do the work; but the right help and support system is what makes the journey possible.
It took a friend of mine who is a lawyer for a major corporation, who also has a MA in Psych, about 6 months of intense awareness, a lot of rage, and more observation to begin to see her thoughts, and understand the nature of her transferences, in real time. She can now make decisions about what she thinks, says, and acts, based on what she knows about what she feels, and is not imprisoned by dyfunctional emotions.
It will be a while before therapists really know what is going on, so hopefully you have one who is both empathetic with your true self, and tough on what is disordered. After you know what you are looking for through education, awareness, discipline and determination will take you there.
Markos
begjop
THanks for the article. Personally, I take issue with your suggestion that there is no such thing as a “high functioning” borderline. WHile you make some excellent points about BPD (and NPD, etc), I get the idea that your definition of “high functioning” is different than what I have learned. By labeling my wife as a high functioning BPD, I am only giving an indication of the degree of her BPD, which DOES mean a lack of some of the more extreme behaviors which you mention. Your suggestion that the HFBPD is more likely NPD or something is ridiculous when I apply this concept to my wife. Borderline is borderline, no doubt. But this is like saying the color RED is RED….but there may well be different shades of red that don’t preclude the bottom line: IT’S STILL RED!
Bon Dobbs
I think it would be helpful if you read my update to this post: http://www.anythingtostopthepain.com/mentalization-high-functioning-bpd which deals with mentalization and attachment and how it plays into high/low functioning. Also, this comment response to Randi Kreger regarding the functioning levels of people with BPD. http://www.anythingtostopthepain.com/myth-high-functioning-borderline/comment-page-1/#comment-2930
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V buckner
I find that the hight functioning BPD is the one who is better at hiding their disease. They are able to hold down jobs, for 20 years, no attempt to commit suicide, (which would get them into therapy big time). Beging able to hide their disease and put on a normal act, keeps them from being detected, enables them to do irrepairable damage to whole families and makes you feel like you are the crazy one. So, I believe there is definitely a difference between low functionting (those who try suicide) and high functioning (those who would never, ever attempt suicide….they care too much about themselves to do that.) I know from experiance being a mother with a son married to a BPD and son brainwashed into believing dil is always right. It’s an unbelievable miserable, horrific possition to be in.
Markos
Yes, unbelievably miserable, because it is unbelievably difficult. Just getting a very successful, articulate, and well read, high functioning BPD to admit there is a problem, is a problem. They are so validated by their achievements, they simply can’t believe that a mind like theirs could be ill.
And yet, a peaceful, quiet mind would be the barometer.
There are very effective ways to approach the HF BPD, but you have to bring your A game. They can charm most therapists and then run rings around them, being the entertainment for an hour; with no further therapy indicated. That is, unless the right questions are asked, cutting through the very well rehearsed persona.
Even a slight admission is quickly hidden, so, anyone who can play a role must be way out in front of the strategies. Which is why so little is known about the HF BPD animal, hiding in the plain sight of their success.
I feel bad for your son and his wife, I hope they will both get the help they need.
Highly Functioning Borderline?
I really appreciate your article. As a person who suffers from a “non specified mood disorder” as a result of being raised (and/or inherited) some condition from my borderline mother, I take issue with the idea that highly functioning borderlines don’t exist. If you were raised by a violent, sadistic borderline, it’s hard not to have acquired borderline or naricissitic traits. I have done therapy and seen a psychiatrist for several years (been on meds) which has greatly helped me deal with PTSD (stress), relationships and other childhood issues. There have been questions regarding whether I’m a borderline by health care professionals, but the label doesn’t stick – not suicidal, do not rage, can maintain long term relationships, no impulsive behavior, abandonment not really an issue (although I feel alone most of the time). I was very angry and did rage quite a bit in my twenties (anger was directed towards my mother for not being there) – this was borderline behavior, I believe. However, I worked through it as a result of maturation, therapy and medication, I believe. I’m also an excellent mother (so my psychiatrist says): BTW – I think so too. 🙂
So how is someone like myself categorized? As “once a borderline, always a borderline”, a recovered borderline who still has PTSD issues, or a highly functioning borderline? I seem to be in the nowhere zone. Borderlines are depicted by the research community as such “evil” individuals – why would anyone want to own up to that label? I certainly don’t – but I can see the childhood connection.
My point is: I believe the clinical/research is wrong to assume that all borderlines are alike – that even if they go through DBT, they will always be borderline. While they may continue having psychological “issues”, it might not, in fact, manifest in negative, destructive behavior or have a major impact throughout their lives. I guess, I’m saying, is there is hope. Those who can work through these issues, I believe, may turn out more resilient and healthier than most anyone else that does not have a mental disorder. Most people are not self reflective – instead go through life without really looking at who they are and examining their own issues. Borderlines do not have this luxury if they want to work through borderline issues. I takes a lot of work. So those researchers/clinicians who do not recognize this as a possibilty, do a disservice.
Also: something that was not mentioned in the article – medication can make a HUGE difference (especially in managing anger). So should we presume that someone on meds, whose mood swings and depression have stabilized is really lumped in a category with borderlines in general? The DSM IV criteria, no longer necessarily applies if borderline behavior is no longer exhibited – no self harm, no suicidal gestures. Medication is the number one thing that turned my life around. Lithium is GOD – I would never trade that for DBT – which never worked for me.
Markos
What you have taken note of is the fact that BPD is not a nice neat set of parameters. Each individual with a sensitive mind will have a different presentation; depending on their degree of sensitivity, raw IQ, and type and intensity of the inconsistent, neglectful, and/or abusive environment they came from. Presentation will also vary widely according to the current environment. No two BPDs are exactly the same, hight or low functioning. But percentages of the 9 characteristics in the DSM IV are very common, which is why they are used to diagnose the illness.
If you have not exhibited at least 5 of the 9 attributes over a sustained period of time, you are probably not a borderline. Although, being raised by one, you could not escape picking up some of the idiosyncrasies. But having idiosyncrasies and/or dysfunctionality, is not a disorder. Disorder is a parallel universe that is interwoven with reality. There must have been enough mitigating influences that brought enough stability, for you to retain a strong reference to an ordered and realistic grasp of the truth. If you didn’t, you’d know it. The fear and frustration of disordered perception is unmistakable.
I’m so glad you missed that train, and meds have been able to take care of your business. You are right, though meds can sometimes help, they alone won’t help anyone to a centered sense of self, borderline or otherwise. That will remain the task of dealing with the wounds and defenses of deficient nurturing, identifying the resulting and entrenched disordered processing; and with discipline and determination, learn how think and relate to ourselves and the world around us in a completely different way than we have ever known.
The dialectical thinking of DBT and the reflection of Mentalization are two very important skills for anyone, and imperative for the BPD. But they will not, by themselves, remit the illness. A full recovery is a much broader and deeper path; and unfortunately, one that is thought to be practically impossible by far too many in the mental health field. It is, quite possible.
So many pros simply don’t know what they don’t know. And they seem to be content enough with what they do know to refrain from acknowledging questions and answers that have already been posed, resolved, and documented. And what a shame as many would love to do the work to reach a higher bar, and leave behind their life of disorder; if only they knew how, or had a guide to take them there.
Its a peaceful, happy, connected, loving, and thoughtful life on the other side; without the need to project, blame or analyze anything. Imagine that, a wonderful life.
Martin
The article and comments make fascinating reading and I’ve got a lot to think about out of it. I am apparently a high functioning Borderline. Diagnosis came late in life only because a traumatic breakup brought out the more acting out symptoms. Since studying the disorder I realise I have masked it well enough since, well, childhood really. Perhaps it is correct to say the high functioning is partly about hiding the disorder better. I was diagnosed satisfying 8 of the 9 criteria but there is always the element of depth of the disorder. I once read that sufferers can fall into 4 subtypes so one surely one Borderline can appear very different to another. This IQ thing.. I also read that BPDs tend to average at the higher end of the intelligence scores, I didn’t get to understand why but I managed a Masters and was a doctoral student. BPDs definately acquire people skills as to be a good manipulator means being able to read people at an advanced level. Maybe this is a form of intelligence?
I have experienced someone with NPD and there is clearly a lot of overlap and similarity probably with a lot of PDs. My experience of NPD is of a massively manipulative person craving importance and recognition. Everything seems to be about them and they seem to be unable to accept responsibility for any action that doesn’t paint them well. I guess it is impossible for us BPDs to see ourselves as others see us and seeing another PD was a real eyeopener for me. I guess there are lots of different ways for a bottomed out self esteem to make itself known.
Martin
Quote “Just as BPD is defined by its pervasiveness, so too is recovery from the disorder. A BP will appear to recover if they find themselves in a loving, non-judgmental, nurturing environment that does not challenge their vulnerability. Place the same individual in a critical invalidating situation and the disorder will quickly emerge.”
Just think that this comment is right on. This is exactly the situation I feel I am in. Well stated!
Markos
Welcome to the party, Martin….. probably not one you were looking for. I just read your comments and will have more to say later, but keep in mind the journey is all about turning what was a curse into a gift. It takes a while, but with the right initiatives, the sensitivity that has left you wounded can become an insightful looking glass with which to see a wonderfully rich world outside of yourself………. the question is always, how bad do you want to not have a disorder? The brain is plastic at any age, which means it can unlearn, relearn, or learn for the first time how to live in an ordered world; both inside and outside of your mind. I can tell you, its great. But you really have to want it, and put that healthy IQ behind the effort.
Martin
Thanks Markos for your reply.
I had a psyche assessment by an expert in PD’s (I’m told), and she told me I really didn’t fit in to the normal BPD experience at all. I had a lot of the problems that are typical of the BPD experience especially in relationships and sticking down a job, problems with self image etc. But what I call my breakdown almost unleashed an inner hell. She did wonder whether my experience was just that of a high functioning BPD who failed to cope with the stress of a breaking up relationship or whether it wasn’t true BPD at all. Interesting really.
It is strange, in a sense diagnosis of BPD explained so much of how disordered I knew I was and it was comforting. I felt understood and safe in a way as I had been reflecting on much of my behaviour both before and during/after the breakdown. So your comment about “how bad do you want to not have a disorder” is a very pertinent question. It is almost like saying “Do I want to be responsible for my life?”. To be completely honest with you I’m not sure if I do. I think the extreme element of my mental health is behind me and I am calming as time goes by. My life has no meaning to me, I have no interests in life and I feel that I am not really living. This is obviously a bad state to be in and actually wrong. This is why I feel I still need to work through more therapy. I had a 2 year psychodynamic therapy program that I got a lot out of but I think that I have still things to work through.
Markos
Martin,
The problem with the psyche assessment for HF BPDs is the very nature of the assessment. The markers for BPD are biased toward low to mid functioning BPD, which presents very different than high functioning. Nothing came to the surface in my neuro psyche/personality testing, though clearly there was something very wrong. It is only those closest to the HF BPD that know the depth of the issues; within the context of a broad, externally validated, high functioning life.
Most HF BPDs hold their pain beneath the surface until the tediously balanced equilibriums of their compartmentalized lives become unglued by external factors; then allowing the floodgates of buried emotion to open. The abandonment of a break up, or the threat of it, is the most likely initiative.
The question is, do you want to figure out the puzzle of your mind and find real peace, or do you want to rebuild those anxious equilibriums, and manage the illness. You are right about taking responsibility, and you are the only one that can. The extreme breakdown will be waiting, once again, behind the rebuilt walls.
Actually, I would ask you to carefully consider your comment about feeling your life has no meaning; and the extreme issues being behind you. The crisis of the moment may have passed, but the enduring feeling of meaninglessness remains. It is the source of that feeling that you have to deal with, both intellectually and emotionally, to remit the disorder. Again, how much to you want to have a mind and life that is peaceful and content? It takes a real commitment to do the real work.
J-9
Markos:
I am very intriqued by your comments regarding having cured yourself of the pain of BPD (if I understand what you are staying correctly). I was diagnosed as having borderline personality disorder about 11 years ago. I actually first diagnosed myself; I was researching why I had such intense problems with abandonment when I came across information about BPD and it seemed to “fit.” I found a research study being conducted and was assessed by the research team for inclusion into the study. I was found after a lengthy intake assessment to have BPD. Here is the study I participated in:
http://nyp.org/news/hospital/bpd-collaboration.html
I was assigned into the DBT portion of the study. For reasons that are too involved to delve into here, I dropped out after 3 months. I did find the DBT helpful for reducing my reactivity to the emotional pain I experience.
I’ve come to question whether I had/have BPD at all. I do not believe this is due to any denial on my part or any attempt at not taking responsibility for change. I was the one who recognized I had a problem and searched out answers; I had no difficulties accepting a diagnosis of BPD if it helped explain what was happening with me and if it gave me some hope for finding a solution. As with why I dropped out of the study, my reasons for my current perspective that I may not have BPD after all would take some time to explain so I will refrain.
Regardless of whether I did/do have BPD or not, I most certainly continue to suffer from intense abandonment anxiety and preoccupation with abandonment. I still have very intense episodes of emotional pain that can be triggered; once triggered, it is difficult to work my way out of it, I sort of have to ride it out. As Bon has pointed out in his posts, not acting out on the pain seems to be the primary goal of many treatments, but the pain remains. While I don’t harm myself or others when it occurs, it is very draining emotionally and takes an incredible amount of time and effort to work through until I’m at a point where I’m ok.
I try to be fiercly honest with myself (I suppose to the extent that anyone can, especially someone with a personality disorder if that should be the case lol) and have no issues with examining aspects of myself I do not like. To date my inability to eradicate myself of this pain is not for lack of trying…perhaps I just haven’t found the right thing to try. I’d greatly appreciate it if you could provide some guidance or information on how you managed your cure. Was it a form of self help or a specific type of therapy? Is it something you can instruct others in? Any information would be much appreciated.
Thank you in advance.
Markos
J-9,
The questions you are asking are quite relevant to remitting the disorder. Being able to see and understand the difference between management and resolution is very important to taking further steps. Wanting a deep sense of peace about who you are and your place in life itself is a prerequisite; which is far beyond learning skill sets and coping mechanisms to help you get through the day, month, and year.
To affect resolution, as I mentioned to Martin, you really have to want it. The process has many layers, that, each of the known therapies touch on…… which, is why your foray into DBT had only a partial effect; especially after a mere 3 months. You have to want resolution to stick with the process, which is much broader than DBT or any other single therapy. So, I agree that you haven’t found the ‘right thing to try;’ as it isn’t simply one thing.
To answer the next question…… yes, I do act as a mentor to many BPDs who really want to find a path out of the swamp of emotional pain, and are willing to do the work to get there.
Markos
J-9,
I realize my response to your questions would seem a bit generic. I am forced to write in generalities because the path for each must be tailored to meet each person where they are.
If you would like specifics, it would be more appropriate to explore that arena off the public airways. If you wish, feel free to get in touch with me through Bons email.
Robert Winston
Although I am not a mental health professional I have has a 20 year marriage to a person who fullfills 7/9 criteria for BPD and 9/9 of your criteria for NPD.
This person alternated between fear of abandonment, a desire to merge and then a fear of engulfment and a need for independence.
They alternated from having no sense of self to feeling that they are better than everyone else.
Obscessed by appearance.
One minute they feel worthless and the next they feel a huge sence of entitlement.
Accept no responsibility, blames everyone, never commited to therapy. Worked for several years blamed her boss, working conditions, co-workers. Felt she was better than them all.
They has made false accusations of domestic violence, abuse and child abuse against me.
I realise they have a mental health problems and behavious are a coping mechanism. The sad reality is the damaging effect themself, family and children.
Has been seen by two experiences psychologists but remains undiagnosed. One feels the likely diagnosis is uBPD with some NPD traits and the other uNPD with some BPD traits.
Father is a uNPD and mother uBPD.
Genetics and family environment can produce indeviduals with both NPD and BPD patterns of behaviour. They have been present in our time together for over 20 years.
To normal people they are considered “odd”, “not right”, “different”, “of but would not chose ato be their friend”
I agree this combination is not see by mental health professionals as they are subclinical. They do not cut or threaten suicide. In many ways the NPD element counter balance the BPD traits. Bothor either can be expressed ant any time.
This is a devastating combination for family members. It does exist. I am not suprised doubt it’s existance. You have to live it to understand it.
Karen Murphy
Please God help me….I am so desperate I don’t know what to do! I’m not in ANY immediate danger but I need SOMEONE to guide me towards PROPER help! Sick of the surface therapy when everyday of my life I’m filled with despair and hopelessness.
Please, Karen
Bon Dobbs
Karen,
Wow. Rarely do I see a message with this feeling behind it. I would suggest you try to find a DBT therapist in your area. It’s not easy to find one, yet they can help with the desperation. Best if luck.
Bon
Markos
Karen,
There are only a few therapists around who can understand the reasons why you feel hopeless and full of despair. Mine told me once the aloneness borderlines feel is existential in nature; which is not something a manual can address, or something many can relate to.
But there are those of us who have been there, and found the path to peace. When you become aware of the depth at which you must deal with your issues, and are not satisfied with mere comfort, management, strategy, or coping skills……. count yourself lucky that acting no longer works, and you are probably ready to do the real work. Like most, you need a guiding hand.
You won’t find the deeper answers you want in one place quite yet, but they are there now; like a puzzle, waiting for your beautifully sensitive, however disordered mind to piece them together.
Please understand there is a difference between Karen, and Karen’s disorder. Karen doesn’t have a palpable void at the center of her core, but Karen’s disorder has created a perception of it that feels very real. You can’t know the difference because you have experienced only the disordered version, so its impossible to imagine. The journey is to remove the spider web of defenses that don’t allow you the security and serenity of simply accepting and being yourself. Yeah, I know, who is that?
More help is on the way. A program is in development where recovered borderlines will help guide and mentor those who wish to be. In the mean time, find a smart, centered, and compassionate therapist, who is willing to challenge your perceptions. If you are into reading, its all out there in bits and pieces. Awareness is the ticket, and education teaches you what to be aware of…….
Karen Murphy
Thank you, Bon
I do go to a ‘supposed’ DBT therapist that hasn’t addressed the bpd symptoms or how to deal with staying alive. She said that she doesn’t like ‘labels’, but why does it have to be a label if it’s a true and accurate diagnosis?? Why can’t the symptoms be addressed without a ‘label’?? For her it’s a way out of dealing with hard issues…for me, it means NOBODY understands me, my thinking, my shell of whats left, my overwhelming emptiness. And they don’t want to. And now we’re moving in a month to a different state which means more doctors, more stress–and I hold very little hope I’ll find the right help there either. WHY is it so damn hard to find a THERAPIST that understands before it’s too late?
Markos
Unfortunately Karen, as I have posted many times……. therapists have no way of knowing how and why a person with BPD feels the way they do, because only someone who has been there can begin to relate, and understand the depth.
DBT is all about managing the emotional symptoms to a point where the desperation is alleviated. Certainly not a bad start, but it is just a start. A few of the previous comments were to the same effect as yours. The psycho-psychiatric industry is doing the best they can with little knowledge of what BPD is actually all about. And most with BPD don’t want to go there either. The disorder is their defense.
There is real peace, without emptiness, and with a very strong and secure sense of self; without grandiosity. It is a process of education, awareness, and disciplined application. You have to want it bad enough to be vulnerable, uncomfortable, and determined to follow through.
J-9 above, asked me how I did it. I offered to tell her if he/she got in touch through Bonn. Never did. I think most identify with their disorder to whatever degree, and they are afraid of the unknown of being well; and being at peace. Disorder, and its adrenaline, is the only identity they’ve known. This has been the case with a few I’ve mentored, sad as the result is.
I can tell you, resolution is worth the trip. Only you can decide its time. If you are miserable enough, you might be ready. But as I think you know, only the deeper work will get the job done, and keep it done.
Markos
Robert Winston
My undiagnosed BPD/NPD wife is back going down a well trodden path of being an abuser who likes to play the victim.
Verbally abusing me again in front of our children then blaming me and all around her for her problems.
She then goes running off playing “poor me”, look what he has done now, can you help me my husband is so bad.
Next week it will be “Why can’t we just be friends”!!
Markos
Robert,
You guys need a good therapist who is familiar with the typical BPD transactions you cycle through. What you describe will continue indefinitely until you intervene by seeking help, or someone leaves. You both create the resistance the other needs to keep the defenses in place.
The BPD wife of a man who attends a support group I coordinate left her husband of 20 years and 5 children. He ‘lived with’ her illness, and the life that gave him, never looking for resolution. If you do not get the help you need, you may have to live with the consequence of inaction.
Karen Murphy
Markos, thank you for the information. And the time to write back.
I feel like throwing my laptop out the window, a little rage here. I just wrote the longest letter to you explaining soooo much, so much thought, time, and feeling went into it that I could never remember what I said! And then just lost the whole letter. I am so frustrated!!!!! Basically, I’ve been begging for help for YEARS, I’m blunt about how I feel and what I need——-What I wrote previously was more detailed and a bit more fluid! Am I scared of the commitment it takes to get better–hell yea! Am I scared of getting better–hell no!! I’ve begged therapists- DBT’s, to give me something to do, homework-really ANYTHING to get something accomplished! A couple of print offs about self image, cognitive thinking, positive verbal direction! Yea, ok I’ve read these a hundred times, now what. Then there is no discussion about them???
I’ve read books to help me understand, ok, now what?? I am so sick of nobody ever telling me how to take a step-of any kind… I’m sorry I’m so angry, I really felt as if I accomplished something in my first letter-I felt relief after I wrote it-then it’s just GONE! I’m still shaking over it…..I’m sorry about the neg. energy of what I’m writing now.
I’m sorry also that I’m using this sight that I stumbled across, I started reading and was drawn in because finally I heard positives and compassion and possible solutions. Not easy to find about BPD, for me anyway. But, when I googled Bon, I read that this was the place to go if you have a loved one with BPD not actual borderlines themselves. So, now I really don’t know where to go–is there a different group I’m supposed to go???
Karen