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You might notice that when dealing with someone with BPD, everything that he/she feels and everything that goes wrong seems to be your fault. You probably feel blamed for many, many things including things over which you have no control.
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. Continue reading Ask Bon: Why does this person blame me for everything? →
 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.
 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
 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.
Why being a grudge collector makes you into a slave and dependent on others for justice and self-worth. Reexamining the duality of praise and blame and how people’s feelings play a roll.
 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.
Often, I have had nons say to me that they want their borderlines to be accountable and responsible for their actions. I recently got a 1 star review of “When Hope is Not Enough” that indicated that the reviewer felt that my approach to BPD was a “recipe for walking on eggshells”. It’s clear to me that the reviewer didn’t really understand the content of my book. The reviewer went on to say that: This book doesn’t hold a BPD anywhere close to being responsible for her actions by granting the notion of “emotional dysregulation” a power of grand excuse.
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.
 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.
Continue reading Lindsay Lohan and possible BPD (more detail this time) →
I have been working on a second edition of When Hope is Not Enough, in which I am adding some exercises as well as some new tools and perspectives to make the book even more effective. One of the exercises is in learning how to be mindful of one’s judgmental attitudes. I often say that people with BPD are almost allergic to judgment. I find that this can be tracked back to shame which in turn can be tracked back to an unstable sense of self. Here is the first draft of the exercise:
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.
 Are you and your BP on the same team? I often hear people with BPD/ERD say that they feel that their loved ones are “not on my side” or that the loved ones are “supposed to be on my side.” This phrase stuck out at me when I read the story about the suicide of Megan Meier (the “MySpace suicide” case), because, although I have no insight into Megan’s mental health, clearly when she was insulted and rejected on MySpace, and she was emotionally dysregulated. She came to her mother, and after her mother admonished her for the use of foul language on MySpace, Megan cried and said, “You’re my mom. You’re supposed to be on my side!” ( This according to her mother’s reports).
When someone is highly emotional, they need to know that they have an advocate and that someone is on “their side.” I often ask my consulting clients (especially partners of people with emotional regulation issues) if they feel that their partner and they are “on the same team.” Many times the answer is no. Why does someone have a desire to have someone on their side, even when the “sides” are not desired, intended or even clearly delineated? The answer in my mind comes down to shame and rejection sensitivity.
If a person has shame (or even low self-worth, which is similar), then the person is likely to have a high level of rejection sensitivity. Being rejected by others is painful, especially for emotional people. Having an advocate of their “side” of the issue, which is essentially answering, “I am on your side no matter what the situation,” is tantamount in these highly emotional, social interactions that involve rejection. One can be “on their side” emotionally without condoning whatever behavior that one doesn’t agree with.
There are teaching moments and there are times that one doesn’t teach. If you try and teach, punish or impart values during a period of emotional dysregulation, the relationship will be damaged and nothing effective will be accomplished. Instead, emotional validation and support can be used to cool the bonfire. Once it is cool, then a teaching moment can present itself.
 Misinformation
Boy, it’s amazing how much bad information travels around the Internet at the speed of light. People are so misinformed about BPD it’s scary. Yesterday, I stumbled across the “Yahoo Answers” site for a question in which a woman asked if she could “help her partner with Borderline Personality Disorder?” There were 10 “answers” to this question. Here are some excerpts from each, which the misinformation pointed out:
“So, you sacrificed your children to a crazy person?? What is wrong with you?? Is there a clinical term for “glutton for punishment”?” Dissolve this toxic relationship immediately!
Judgmental. Non-BPs don’t need another person telling them to leave their partner; there are hundreds of people for that. This commenter is a “top contributor” too with 2,424 answers to questions thus far. I wonder how many wrong/inaccurate questions she’s answered. I guess some of her answers (like those in “Cooking and Recipes”) can’t hurt too many people (unless they poison themselves with bad brownies).
“Your Co-dependency is off the rictor scale when you place your partner ahead of your SONs safety…This is NOT about your partner.. This is about the health welfare and safety of your son… This is an abusive house hold!!!! GET OUT OF THERE IMMEDIATELY!!!”
Judgmental. Another voice saying “get out!” And the use of co-dependency, love it. I wonder if the woman asked the question, “My partner has cancer… is there anyway to help him?” What would be the answer then?
“You really should get yourself and kids out of that situation .Do it for the kids.”
Same.
“I hate to tell you this, but he’s not going to change. Personality disorders are incurable and they only end when the person with them dies.”
Oh yeah? Well, when did you get this information? 1980? The APA is considering taking the word “personality” out of BPD (and borderline for that matter). Look into the research before you hand out advice. DBT, SFT and Mentalization-based therapies all show promise in reducing the behaviors and feelings below the 5 of 9 threshold mark for diagnosable BPD. It is not incurable.
“you might want to get a little therapy yourself, bpd can really mess with your head sometimes… but then i am with my own mental problems. so take that with a grain of salt.”
Not bad advice.
“PLEASE SPEAK TO A THERAPIST ABOUT A BOARDRLINE AND WHETHER THEY CAN BE HELPED. imo and therapists I have spoken to the answer is no. Treatments (the VAST majority of the time) don’t work. Please don’t take my word for it, ask for yourself.”
Speaking to a therapist is not bad advice… but that the answer is they cannot be cured… that’s incorrect. BPD can be managed and all people in the support system can help. If this person had bipolar I – would you all tell her to “run away?”
“You’re [sic] “kind and loving husband” never existed. That was nothing more than a mask. Oh, you moved out? Then stay out.”
OK, leave him again… I think we got it. It’s amazing how angry people are with borderlines.
“Personality disorders CANNOT, repeat cannot, be cured. They are inflexible, self-sustained, and have a 99% chance of being incurable. Your gut instinct, and the FACTUAL evidence you’ve read on the internet, are guiding you in the right direction.”
Again, wrong… see above. “Factual evidence…” on the Internet is a laugh. The Internet is filled with angry (usually ex-) Non-BPs that are ready to tell the story of how impossible, abusive and awful their ex BPD partner was. I’m not going to argue that people with BPD can’t be abusive or rage at you – they can. However, if you see the problem for what it really is… it is more manageable than many other disorders. Educate yourself about it. Find out the facts. Learn skills. Or leave… it’s up to you.
“Personality disorders are pretty much the only mental problem that CAN be cured. It takes a long time and a good counselor. Personality disorders are not a biological disorder like the more commonly known mental illnesses. Personality disorders are conditioned behavior over a lifetime.”
Well, this is almost true. The behavior component is conditioned behavior and can be “retrained” out of someone. The emotional dysregulation and impulsiveness components are probably biological.
“You sound like a weak person. You would sacrifice your sons well being to have someone.”
Judgmental.
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