I Hate You--Don't Leave Me: Understanding the Borderline Personality

by Jerold J. Kreisman

Variable Sense of Reality Like neurotics, borderlines retain contact with reality most of the time; however, under stress the borderline can regress to a brief psychotic state. Marjorie, a twenty-nine-year-old married woman, sought therapy for increasing depression and marital disharmony. An intelligent, attractive woman, Marjorie related calmly throughout her initial eight sessions. She eagerly assented to a joint interview with her husband, but during the session she turned uncharacteristically loud and belligerent. Dropping her facade of self-control, she began to berate her husband for alleged infidelities. She accused her therapist of taking her husband’s side (“You men always stick together!”) and accused both of engaging in a conspiracy against her. The sudden transformation from a relaxed, mildly depressed woman to a raging, paranoid one is quite characteristic of the kind of rapidly shifting borders of reality observed in the borderline. Nonspecific Weaknesses in Functioning Borderlines have great difficulty tolerating frustration and coping with anxiety. In Kernberg’s framework, impulsive behavior is an attempt to diffuse this tension. Borderlines also have defective sublimation tools; that is, they are unable to channel frustrations and discomforts in socially adaptive ways. Though borderlines may exhibit extreme empathy, warmth, and guilt, these exhibitions are often rote, more manipulative gestures for display purposes only, rather than true expressions of fee...