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January 27 - February 20, 2023
Everything looked and sounded unreal. Nothing was what it is. That’s what I wanted—to be alone with myself in another world where truth is untrue and life can hide from itself.
Her father, an elder in the local church, demanded perfection from his daughter and her two older brothers, constantly reminding the children that the community was scrutinizing their behavior. Jennifer’s grades, her behavior, even her thoughts were never quite good enough.
during times of solitude, she would feel abandoned, which she attributed to her own unworthiness. Anxiety would threaten to overwhelm her unless she found some kind of release.
She desperately sought closeness, but when someone came too close, she ran.
The disorder also coexists with, and borders on, other mental illnesses: depression, anxiety, bipolar (manic-depressive) disorder, schizophrenia, somatization disorder (hypochondriasis), dissociative identity disorder (multiple personality), attention deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), alcoholism, drug abuse (including nicotine dependence), eating disorders, phobias, obsessive-compulsive disorder, hysteria, sociopathy, and other personality disorders.
Indeed, BPD patients consume a greater percentage of mental health services than those with just about any other diagnosis.
inconsistency is the hallmark of BPD.
A history of previous suicide attempts, a chaotic family life, and a lack of support systems increase the likelihood.
Mood changes come swiftly, explosively, carrying the borderline individual from the heights of joy to the depths of depression. Filled with anger one hour, calm the next, he often has little inkling about why he was driven to such wrath. Afterward, the inability to understand the origins of the episode brings on more self-hate and depression.
He may attempt suicide, often not with the intent to die but to feel something, to confirm he is alive.
To overcome their indistinct and mostly negative self-image, borderline individuals, like actors, are constantly searching for “good roles,” complete “characters” they can inhabit to fill their identity void. So they often adapt like chameleons to the environment,
When the idealized person finally disappoints (as we all do, sooner or later), the borderline person must drastically restructure her strict, inflexible conceptualization. Either the idol is banished to the dungeon or she banishes herself in order to preserve the “all-good” image of the other person.
Yet in BPD, relationships often disintegrate quickly. Maintaining closeness with her requires an understanding of the syndrome and a willingness to walk a long, perilous tightrope. Too much closeness threatens her with suffocation. Keeping one’s distance or leaving her alone—even for brief periods—recalls the sense of abandonment she felt as a child. In either case, the borderline individual reacts intensely.
He fears abandonment, so he clings; he fears engulfment, so he pushes away. He craves intimacy and is terrified of it at the same time. He winds up repelling those with whom he most wants to connect.
For example, some studies indicate higher rates of BPD among Hispanics, while others do not confirm this finding. Some studies have found greater rates of BPD among Native American men. Consistent studies are meager but could provide great insight into the child-rearing, cultural, and social threads that compose the causal fabric of the syndrome.
Long-term studies confirm that many patients recover over time and even more improve significantly. After sixteen years of follow-up, 99 percent of borderline patients achieved at least two years of remission and 78 percent experienced an eight-year remission (defined as no longer fulfilling five of the nine defining criteria).
Symptoms of a personality disorder, on the other hand, tend to be more durable traits and change more gradually; medications are in general less effective.
However, BPD mood variations are more transient (lasting hours rather than days or weeks), more unstable, and more often reactive to environmental stimuli.
Individuals with ADHD are subjected to a constant scramble of flashing cognitions. Like borderline patients, they often experience wild mood changes, racing thoughts, impulsivity, anger outbursts, impatience, and low frustration tolerance;
Both those with BPD and narcissistic personality disorder display hypersensitivity to criticism; failures or rejections can precipitate severe depression. Both can exploit others; both demand almost constant attention.
Promiscuity often reflects a need for constant love and attention from others, in order to hold on to positive feelings about oneself. The borderline individual typically lacks consistent positive self-regard and requires continuous reassurance.
BPD and Autism Spectrum Disorder (ASD)
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Someone with BPD often makes unrealistic demands of others, appearing to observers as spoiled.
“We are what we pretend to be, so we must be careful about what we pretend to be.” Or as some phrase it, “Fake it till you make it.”
The borderline adult never reaches that point of confidence. He continues to feel like he is faking it and is terrified that he will sooner or later be “found out.”
At the other extreme, he may be discouraged from maturing and separating, and may be trapped in a dependent child’s role, well past an appropriate time for separation.
Often, the frequent threats or halfhearted suicide attempts are not a wish to die but rather a way to communicate pain and a plea for others to intervene. Unfortunately, when habitually repeated, these suicidal gestures often lead to just the opposite scenario—others get fed up and stop responding, which may result in progressively more serious attempts.
One patient, when feeling lonely or afraid, would cut different parts of her body as a way “to take my mind off” the loneliness.
Many with BPD deny feeling pain during self-mutilation and even report a calm euphoria after it. Before hurting themselves, they may experience great tension, anger, or overwhelming sadness;
Borderline patients frequently report the calming effects of self-mutilation; rather than feeling pain, they experience soothing relief or distraction from internal psychological pain.
If the relationship with mother is supportive and comforting, reactions to strangers are mainly characterized by curious wonder. If the relationship is unsupportive, anxiety is more prominent; the child begins to divide positive and negative emotions toward other individuals, relying on splitting to cope with these conflicting emotions.
An insecure teenager may ruminate endlessly about her boyfriend in a “he loves me, he loves me not” fashion. Failure to integrate these positive and negative emotions and to establish a firm, consistent perception of others leads to continued splitting as a defense mechanism. The borderline adolescent’s failure to maintain object constancy results in later problems with sustaining consistent, trusting relationships, establishing a core sense of identity, and tolerating anxiety and frustration.
Degradation. Constantly devaluing the child’s achievements and magnifying misbehavior. After a while, the child becomes convinced that he really is bad or worthless.
If you suffered from neglect in childhood, it may cause you to go from one person to another, hoping that someone will supply whatever is missing.
Anyone who offers admiration and respect has appeal to them—and because their need for affection is so great, their ability to discriminate is severely impaired.
“Loneliness can be as damaging as fifteen cigarettes a day.”
Isolation can trigger feelings of hopelessness, emptiness, fear of abandonment, and paranoia—all primary criteria of BPD.
A person with BPD shifts her personality like a rotating kaleidoscope, rearranging the fragmented glass of her being into different formations—each collage different, yet each, her. Like a chameleon, she transforms herself into any shape that she imagines will please the viewer.
The S stage of SET, Support, invokes a personal “I” statement of concern. “I am sincerely worried about how you are feeling,” “I’m concerned about what you’re dealing with,” and “I want to help” are examples of Support statements. The emphasis is on the speaker’s own feelings and is essentially a personal pledge to try to be of help.
With the Empathy segment, one attempts to acknowledge the sufferer’s anguish and chaotic feelings with a “You” statement: “How awful you must be feeling.” “This must be a difficult time for you.” “You must have felt really desperate to do this.” “It’s impossible to imagine what you must be going through.”
The T statement, representing Truth, recognizes the reality of the situation and emphasizes that the person with BPD is ultimately accountable for his life and that others’ attempts to help cannot preempt this primary responsibility.
Borderline confusion often results in contradictory messages to others. Frequently, the person with BPD will communicate one position with words but will express a contradictory message with behavior.
In this situation, Alex is confronted with two contradictory messages: (1) Gloria’s overt message, which essentially states, “If you care about me, you will respect my wishes and not challenge my autonomy to control my own destiny and even die, if I choose”; and (2) the opposite message, conveyed in the very act of announcing her intentions, which says, “For God’s sake, if you care about me, help me, and don’t let me die.”
Much of dramatic borderline behavior is related to his interminable search for something to fill the emptiness that continually haunts him. Destructive relationships, binge eating, self-injuring, and drugs are some of the mechanisms the borderline person uses to combat the loneliness and to capture a sense of existing in a world that feels real.
“I don’t like who I’ve become, but it’s how I cope,” she confessed. “You’re a good person, Martin. You know what you want in your life and deserve it. I wish it were different, but I’m not there yet. You know the kind of woman you want to be with. I don’t know who I am, but right now I know I’m not that person. I don’t know if I ever could be.”
Indeed, some of the hallmarks of borderline behavior are the sudden, unpredictable, and “out of nowhere” eruptions of anger, extreme suspiciousness, or suicidal depression from someone who has appeared so normal.
She may even be perceived by others as the perfect mother because of her total “dedication” to her children. Deeper observation, however, reveals her over-involvement in her children’s lives, her encouragement of mutual dependencies, and her unwillingness to allow her children to mature and separate naturally.
If he blames the adult, he will be terrified by his dependency on incompetents who are unable to take care of him. If he blames no one, pain becomes random and unpredictable and thus even more frightening because he has no hope of controlling it.
When the abused child learns early in life that he is bad, that he causes bad things to happen, he begins to expect punishment and may feel secure only when being punished.
Child abuse can take subtler forms than physical violence or deviant sexuality. Emotional abuse—expressed as verbal harassment, sarcasm, humiliation, or frigid silence—can be equally devastating.
