Connect with Bon

A free eBook – 4X4 for Nons

Here is a free eBook from Bon: Free eBook

Borderline Personality Disorder: Facts vs. Myths

Dialectical Behavioral Therapy is one of the most common and effective treatment approaches for BPD.

Borderline Personality Disorder: Facts vs. Myths
By Paula Durlofsky, PhD

Borderline Personality Disorder (BPD) is a serious psychiatric condition marked by a pattern of unstable and stormy relationships, an unformed sense of identity, chronic feelings of emptiness and boredom, unstable moods, and poor impulsive control in areas such as spending, eating, sex, and substance use.

Fear surrounding real or imagined abandonment from loved ones is a profound concern for people with BPD and often is what underlies their destructive behaviors. Some people with BPD will go to dangerous lengths to avoid this fear, for example, by becoming suicidal or engaging in self-mutilation.

Below are five of the more difficult symptoms of BPD:

  • problems with relationships (fear of abandonment; unstable relationships)
  • unstable emotions (frequent emotional ups and downs; high emotional sensitivity)
  • unstable identity (unclear sense of self; chronic feelings of emptiness)
  • impulsive and self-damaging behaviors
  • unstable thinking/cognition (suspiciousness; tendency to dissociate when under stress)

Although this disorder may appear easy to self-diagnose, a valid diagnosis of BPD involves an extensive evaluation. BPD is a complex condition, but with appropriate treatment most people will show improvement within a year.

Here are some facts and myths concerning BPD:

FACT: Many people diagnosed with BPD also struggle with depression, anxiety disorders, substance abuse, and eating disorders.

MYTH: People diagnosed with BPD are always difficult to deal with, likely to be physically aggressive, untreatable, depressed, or unable to live fulfilling and productive lives.

READ THE ARTICLE

BPD Myth Busting: 7 common myths about Borderline Personality Disorder

Bon debunks 7 common myths about Borderline Personality Disorder (BPD).

Myth 1: BPD is untreatable

Borderline Personality Disorder is treatable and in the past 15 years numerous evidence-based treatments have been designed to treat the disorder. Dialectical Behavior Therapy (DBT), Mentalization-based therapy and Transference-focused therapy have all been shown to improve the behavior, cognitive abilities and functioning of people with BPD.

Myth 2: BPD only affects women

A recent study by the NIAAA showed that the lifetime incidence of BPD was essentially equal in men and women. It has been widely accepted for many years that the gender breakdown of BPD is 75% female. It seems that the only reason that the 75% figure exists is that women are more likely to seek help for the disorder. In the case of men, they are less likely to seek help and more likely to end up in jail.

Myth 3: BPD is just a case of bad behavior

BPD is an actual mental/emotional disorder. The behavior is fueled by dysregulated emotions. If the emotions are well-regulated, the behavior will not take place. Since emotional dysregulation is a core feature of BPD, it should be one of the primary focuses. The behavior is what upsets the family members and loved ones. Yet it’s the emotions that are the engine for the behavior.

Myth 4: BPD is extremely rare

The same NIAAA study indicated a lifetime incidence of BPD in 5.9% of almost 35,000 adults. Earlier studies have shown a 2% occurrence. If it’s 5%, that’s one adult in 20 who has BPD.

Myth 5: Poor Parenting causes BPD

Recent studies have shown brain anomalies in the u-opiod system (pain relief) in the brain. Like clinical depression, which shows serotonin differences, a person with BPD seems to have a deficit in u-opiods and over-active u-opiod receptors. This can explain why one child may develop BPD and another does not, even when each is in the same home environment. That being said, many borderlines do experience abuse and/or neglect as children. The trauma associated with that abuse (or invalidation) seems to reinforce the natural BPD-like tendencies and causes the BPD to be more marked.

Myth 6: People with BPD are incapable of empathy

A recent book by Dr. Simon Baron-Cohen has received a lot of notice because he indicated that a lack of empathy was the root of evil. He also listed three conditions in which empathy is lacking: BPD, some forms of autism and psychopathy. In my experience, a person with BPD might lack empathy, yet that is only when they are in emotional pain. You can’t feel for others when you’re burning inside. Once the emotional pain becomes manageable, I find people with BPD to be quite empathetic. They understand emotions very well and if they can understand that emotions apply to other people, they show deep empathy.

Myth 7: People with BPD use suicidal gestures just to get attention

Many family members believe that suicidal gestures are merely “calls for attention.” I would counter that in the moment that the suicidal gesture occurs, the borderline really wants to snuff the pain and death seems like the only alternative. It is an ineffective use of skills and pain-quelling behavior. Most borderline suicide attempts are unplanned and impulsive. They will access whatever is on-hand – all the pills in the cabinet, for example – and impulsively try to commit suicide. However, all suicide attempts are serious and should be treated seriously and with compassion. Few people are in so much pain that they want to die. Borderlines are tragically such people.

 


When Toxicity and Misinformation Know No Bounds

Misinformation

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.

More on Hoovering

Cats and HooveringYesterday, I received a long and thoughtful comment about my post The Myth Of Hoovering. I wanted to respond to it, because I believe that the commenter actually misunderstood my point about hoovering and why I called it a “myth.” Certainly, I was well-aware that the post (along with The Myth of the High-Functioning Borderline) would be controversial in the non/BPD-support community. The commenter said the following about my post:

“Regarding the misinformation you mention, you’ve discounted the existence of the “hoovering” phenomenon on the basis that it’s not a conscious behaviour. In the link you provided, and in mentions of this concept I’ve seen elsewhere, I didn’t note any stipulation that the key ingredient of hoovering is premeditation. It’s merely an esoteric term to describe the behaviour that follows after the person with BPD has done something to scare off / push away their partner, and it is very compelling and sometimes very dangerous for the Non. It also mirrors the cycle of violence in cases of domestic abuse and you are dismissing the realities of countless victims who are so frequently told they should “just leave”. THIS is a shining example of ignorance. Whatever household appliance you name it after, the behaviour pattern in question most certainly does exist, in studies, interviews, textbooks, and therapy sessions, regardless of whether the person enacting it is conscious of its effects.”

The link I provided was to the definition of “hoovering” at BDP411.org. My argument against hoovering was to point out that hoovering is not a pre-meditated form of manipulation, but in reality, I should have made a more salient point about hoovering and the existence (or lack there of) of the phenomenon. The link on BPD411.org says this:

“The intent of the hoover is to get the Non back into the relationship.”

In my experience with BPs, this statement is not the case. The intent of hoovering or any behavior that a person with BPD does (when untreated and emotionally dysregulated) has nothing to do with the non. The intent to two-fold IMO: 1) to as immediately as possible feel better emotionally and 2) to confirm that the BP is not a “bad person” and deserving of love, no matter what poor behavior was previously exhibited to argue otherwise.

[amazonshowcase_aae6001f3f5766bb5a55f3fb147c3088]

You see, hoovering is routed in shame (shame of the BP, not the non). The person with BPD will want to confirm to themself that the non (who supposedly loves them – of course this goes both ways) does not discover that deep inside they are a shameful and unworthy person. I mentioned the “toxic self-consciousness” mind-set when I was talking about David Foster Wallace and his suicide. Toxic self-consciousness is there so that someone can be vigilant about protecting others from discovering their shame and thus, leaving them because they are “bad” and unworthy of love. The shame element is what feeds the fear of abandonment, not the other way around. Often, nons (and professionals) talk about the fear of abandonment as the “core” of BPD, but I believe that BPD actually has 3 core features that lead to the others (including fear of abandonment, rejection sensitivity, fault-finding behavior and others). Those core features are emotional dysregulation, shame and impulsiveness. So, in the event of a hoover, the BP is fearful that you (as a non) will discover their shame and this leads to emotional dysregulation (basically, panic) which can lead to impulsive behavior (including hoovering).

Another article from BPD411.org – the “rules of engagement” can be found here: Rules of Engagement. This is actually the article of which I was thinking when I posted my previous post on hoovering. Here’s what it says:

Rule #5: If at any time the Non figures out the Rules of Engagement for BPD Land, the BPD’er must change the situation, rewrite history, and thereby purchase the Non a one way ticket back to BPD Land.

Rule #6: If Rule #5 fails, the person with the disorder must use a major hoover, promise anything, mirror the Non exactly, seduce the Non, or engage in multiple acts of what ever worked last time to convince the Non that “this time will be different”.

As you can see rule #6, does imply premeditation, since “Rules of Engagement” imply premeditation. It states that a BP will use a major “hoover” to “convince the Non that ‘this time it will be different’.” What many of these documents and posts (such as the “Ten Demandments”) imply is that the BP is motivated by and reacts to the behavior of the Non. My view on this is that a BP will react and behave completely in response to their own feelings, shame and conditioned behavior. Very little of a BP’s behavior is about the non. In the words of WHINE – IAAHF (“It’s always about his/her feelings). Why does this matter?

It matters because a Nons approach toward a perceived hoover will be different and more effective than in the past. When given the choice between “giving in” or “rejecting” a hoover – each comes with a price. The price of giving in can be your own shame, feeling of stupidity when things don’t change and/or anger at the other person for manipulating you and your feelings. The price of rejecting a hoover is (in my experience) rage, rejection, fault-finding and the “what about you?” argument that many BPs will use to deflect attention from their own shame. However, if you realize that the actual problem is not the hoovering behavior (which DOES exist, I’m not denying that), it is the feelings of panic and shame that motivate the hoovering, the act of hoovering can be faced more effectively. Meaning, if you solve the real problem (which is the emotional dysregulation and feelings of shame in the BP), the hoovering behavior will cease because the motivating factor is NOT “to get the Non back at whatever the costs” – it is to make the BP feel better and worthy of love in themselves.

As an aside, I had an experience with my cat this morning that could be seen as hoovering. This cat is not very loving (except when she wants to be). She was a stray and abused, so she is pretty shy about showing affection. I’ve had her for about 2 years. Anyway, last night she got locked out of the house all night. When I came downstairs at 7 AM this morning, she was sitting in the back window (on the outside) meowing. I opened the door for her and she ran inside and rubbed up against me, followed me around for about 20 minutes and made me pet her by pushing her head against my hand. This was all before she went to the food bowl, which is usually the first thing she does in the morning. Again, this is not an affectionate cat, normally. But she was upset and needed to have affection shown to her. After she calmed down and made sure we still loved her and didn’t abandon her, she went upstairs, climbed in the linen closet and went to sleep. My point is that even a simple animal (although cats are hardly simple animals, they have interesting personalities) undergoes emotional dysregulation and needs assurances and needs to feel better. If the point of hoovering is to feel better and to receive feedback from a loved one that you are worthy of love – what is wrong with that? I believe that in the moment, those feelings are completely genuine (although further emotional dysregulation at a later time might cause opposite behavior) and can be assuaged with emotional tools. In the case of the cat, I just had to pet her and reassure her that all was OK. Of course most cats hate vacuum cleaners, whatever the brand.

Net BPD Myth Debunking from “Tides…”

myths.jpgA few weeks ago I discovered the “Tides of Crazy Love Blog,” which is written by someone I “know” (meaning I know her via an email board). I LOVE her writing. I really do. Recently, she started “debunking” Internet myths and misunderstanding about BPD. More power to her! Here is an excerpt from her debunking the “Rules of Engagement” from BPD411.org (the first paragraph comes from BPD411.org):

“Rule #5: If at any time the Non figures out the Rules of Engagement for BPD Land, the BPD’er must change the situation, rewrite history, and thereby purchase the Non a one way ticket back to BPD Land.” (BON Note: this is excerpted from rules of engagement)”

[Oh, good grief! This rule is crazy-making to me! Sheesh! The author writes as if the BP has the ability to come up with some big elaborate plan to drink, steal, cheat and lie. I’m beginning to think this person was dealing with an NP or an anti-social-type, not a BP. (Or MAYBE she was an NP and was merely projecting her own inner motives behind why she feels BPs do what they do. BTW, I suspect that some nons do come out of BP relationships with many more narcisistic characterists than they went in with… especially when abuse is part of the history between them. This seems to be the case with my mother and my MIL, anyway.)

Again, BPs impulsively react during moments of dysregulation… initially in response to a feeling (anxiety or fear, oftentimes) and their behavior can escalate as a result of their thoughts when they believe someone has invalidated their feeling (judged/persecuted them.) Their instinctive (or possibly “learned” in abusive situations) nature is to please, they suffer incredible amounts of shame… therefore, why would they PLAN to be bad? The fact is, most never learned how to do this “planning” thing effectively, which is why they are so prone to total freak-outs. They don’t know what else to do at that moment to make themselves feel better. In addition, they sit around ruminating about their own mistakes so much, they don’t have time to come up with a plan for their own healing, much less a plan for anything else. They live in the moment.

Yes, that’s exactly it. I’d love to post “Tides…” complete debunking posts. They’re great. Check them out here:

http://thetidesofcrazylove.blogspot.com/2008/07/net-debunk-introduction.html

http://thetidesofcrazylove.blogspot.com/2008/07/net-debunk-rules-of-engagement-for-bpd.html

http://thetidesofcrazylove.blogspot.com/2008/07/net-debunk-rules-of-engagement-for-bpd_14.html

The Myth of the High-Functioning Borderline

bp.jpg

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. 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:

  1. Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in (5).
  2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. This is called “splitting.”
  3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
  4. 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).
  5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
  6. 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).
  7. Chronic feelings of emptiness.
  8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
  9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

And now NPD:

  1. has a grandiose sense of self-importance
  2. is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  3. believes that he or she is “special” and unique
  4. requires excessive admiration
  5. has a sense of entitlement
  6. is interpersonally exploitative
  7. lacks empathy
  8. is often envious of others or believes others are envious of him or her
  9. 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).