Borderline Quotes

“Kernberg saw the narcissist as very similar to the borderline: both struggled with managing powerful, negative emotions; both relied on splitting the world into good and bad. But where the borderline often cast herself as bad to preserve the goodness of others--on whom she relied for validation that she was real and alive-- the narcissist organized his internal world so that he was always good, the outside world always inadequate and unappreciative.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“the cognitive-behavior perspective has running through it an emphasis on order and category (inherited from the DSM) and on rational, logical processes (inherited from the cognitive revolution) that has rendered it unsuitable for BPD, or anyone lost in the diffusion of modern diagnoses. Just as the BPD diagnosis entered the new mainstream via the DSM-III, those who suffered from it were again set adrift—either mistreated or untreated by the new breed of medication-oriented psychiatrists on one side and CBT-trained psychotherapists on the other.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“A computer does not need to be programmed with a sense of what its function is: a piece of chess software isn’t trying to win, it’s just following rules to a logical outcome. So, too, does CBT presume people to be naturally self-driven and self-correcting, whether or not we speak of some underlying sense of purpose, personality, or self. Trying to understand how a person came to be the way they are, from this point of view, is as unnecessary as trying to find the specific software engineer who programmed your buggy computer. What matters is assessing the current, manifest problem and treating it directly. All this rests on a crucial assumption: that the removal of a symptom, like fixing a software bug, will restore the individual to a previously healthy state.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“Just as we often evoke psychoanalytic language without realizing it (“Don’t be so defensive!”), so too has the mind-as-machine concept entered daily speech in an insidious way. “I need to process this,” we say, though for the late twentieth-century cognitive-behaviorist, “processing” carried a very specific meaning. The idea was that people, like a computer, think and act according to rules and logic; that we are fundamentally rational beings. Emotional difficulties were therefore the result of faulty thinking that must be corrected, or conditioned behaviors that must be reconditioned. From this vantage there was little room for the psychotic core, for contradiction or ambivalence: the new metaphor conferred an implicit assumption that, as with machines, a healthy human is an optimized human. We should want to be well, to be productive, to be happy.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“The Freudian metaphor of archaeology as model for the human condition was systematically replaced by a more contemporary one: the computer. The mind was no longer dense strata, with some layers accessible near the surface and others buried far beneath. Understanding the mind, in turn, was no longer a matter of plumbing the depths to unearth that which had been lost to consciousness. Instead, the mind was now seen as a machine, sophisticated but nevertheless operating according to the basic algorithm of computational science: input, processing, and output.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“cyclothymic disorder (CD).8 It was formalized to acknowledge the large number of patients who seemed to show features of bipolar disorder—episodic peaks of mania and nadirs of depression—yet whose peaks never qualified as fully manic, nor the nadirs as fully depressive, with episodes that were often faster and blurrier than expected. CD seemed to defy what bipolarity was supposed to be, yet the psychiatric establishment seemed unable to consider that the bipolar framework might not apply here. No matter that CD patients often did not respond to the same treatments that tended to help other bipolar cases, namely mood-stabilizing drugs like lithium; or that while bipolar disorder had been found consistently in the population for as long as data had been collected, CD had mysteriously leapt from rare to very common in the late 1970s; or that while bipolar disorder seemed to be evenly distributed across men and women, CD was mostly diagnosed in women. It was and is a further diffusion of the borderline, which can be found spread indiscriminately throughout the DSM, from CD in the category of mood disorders, to DID in dissociative disorders, to BPD, HPD, and NPD in personality disorders.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“As psychiatric training focused more on disorders it could effectively treat, psychiatrists developed an implicit bias toward diagnosing patients with those disorders.7 When patients didn’t respond to treatment, they were marked as having an “atypical” or “treatment-resistant” case.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“The field’s emphasis on medication, beginning in the 1980s, placed BPD outside its purview—the condition had never, under any of its names, responded well to biological intervention. This did not mean that, post-DSM-III, psychiatrists began to accurately diagnose and refer out borderline patients as they passed through their offices. More likely, psychiatrists would misdiagnose these patients and then regard them as difficult.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“I was told you wanted to talk to someone who knew about dissociation.” “I don’t know about that,” he said. “That must have been one of the others. But yes, we hear talk of that word. One of the others has said that we have dissociative identity disorder. Am I saying that right? Things have become much easier since we learned that we are not a person.” “What are you, then?” “We are a system.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“A third picture emerged in bits and pieces. Haku was neither cis nor trans, but nonbinary. He was neither Japanese nor white, but nonracial. He was not even Haku—he said that he had heard the name before but did not identify with it. Presently, he said, he did not know his name. He referred to his parents as “the parents” and also said that they were not really his parents, because they had not created him.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“His mother presented a new picture: Haku was a white transgender man with a long history of extreme and impulsive behavior beginning around age twelve. Haku had recently, on his eighteenth birthday, legally changed his name to that of a character from the Hayao Miyazaki film Spirited Away. His mother said Haku had a history of suicide attempts, destruction of property, and running away from home, sometimes disappearing for weeks at a time without contact.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“Debate often revolves around the question of whether DID or multiple personalities are “real”—a question that is, I think, long since irrelevant. Can we ever say that the naming of things, whether through diagnosis or some other form of labeling, is real? The relevant point is that Wilbur, and then others following her ideas from greater positions of power, made a categorical error. Rather than viewing multiple personalities as a metaphor for what it feels like to live on the borderline, they took it literally—and in so doing declared it to be its own thing. It’s unclear if we can ever fully return from such a rigid and highly publicized delineation. Whether Wilbur induced Mason’s perception of multiple selves or not, she gave it the stamp of authority.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“Multiple personality’ carries with it the implication that they really have more than one personality… . Dissociative identity disorder implies that the problem is fragmentation of identity, not that you really are twelve people. That you have, not more than one, but less than one personality.”6 The extent to which one finds this reasoning compelling may come down to a matter of taste—justifying a name is not the same thing as demonstrating its value.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“Wilbur’s diagnostic label became famous just as psychiatry’s dependence on diagnostic labels reached its height. The DSM-III, which was being prepared amid the Sybil craze, categorized illness by symptoms rather than underlying causes or theories—and in the wake of a best-selling book and popular movie, the symptoms of MPD started popping up everywhere. Patients began reporting experiences of having multiple selves in alarming numbers; if psychiatry hadn’t made room for these patients in its diagnostic bible, it would have had to cede authority over them.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“How did Wilbur manage to permanently etch a diagnosis into psychiatry’s bible? That she diagnosed Mason with multiple personalities is only of significance to the history of BPD or anything else because of how far that diagnosis spread. It began with Sybil: written in oily prose by Schreiber, the book sold millions of copies, and Sally Field won an Emmy for her portrayal of Mason. But, as ever, this was no coincidence. Sybil inflamed public imagination because it emerged at just the right time, in a kind of theoretical vortex. American psychoanalysis was quickly falling out of fashion, and once Sybil had made Wilbur something of a celebrity, the story of the long-standing rejection of her work by her colleagues sounded to the general public like the old guard trying to censor a modern voice. Modern, especially, in terms of how the book and film depicted psychotherapy sessions in which Wilbur connected Mason’s multiple personalities to her supposed traumatic childhood. Public interest in early trauma was unprecedently high in the mid-1970s, thanks in large part to the attention drawn to it by the women’s liberation movement—an evolution from the previous decade’s counterculturalism, which had been broadly infused with anti-psychiatry sentiments and now regarded ego psychology as patriarchal and sexist.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“Wilbur had been trained in the milieu of midcentury American psychiatry, which held no space for the borderline between neurosis and psychosis—“never the twain shall meet,” as Robert Knight wrote of the mainstream psychoanalytic attitude around the time Wilbur was training as an analyst. She concocted a new explanation to an old problem because she had little exposure to the knowledge that might have illuminated a common thread going back thousands of years. Perhaps this led Wilbur to overemphasize a salacious symptom rather than seeing it as part of a bigger picture—perhaps, as her sharpest critics suggest, she actively created for Mason the narrative of multiple selves as a way to make sense of something neither she nor Mason understood.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“Mason was renamed “Sybil,” which also served as the title of the book, published in 1973. In 1976 a TV movie adaptation followed, starring Sally Field. These works brought Wilbur’s term, multiple personality disorder (MPD), not only into the public consciousness but the professional one. A concept that had barely existed before 1973 exploded in prevalence over the ensuing decade.3 MPD was included in the DSM-III, four years before any paper by Wilbur on the subject was accepted for publication by a peer-reviewed scientific journal.4”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“Charcot presented the ease with which he hypnotized his patients as the ultimate proof that dissociation defined hysteria, concluding in an impressive feat of circular logic that hysteria could be diagnosed based solely on whether a person could be hypnotized.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“Children are frequently psychotic—that is, immersed in their internal world—but in ways we expect and therefore see as appropriate: they talk to imaginary friends; they get confused about whether things on TV are real or make-believe; they become so overwhelmed with emotion that they throw themselves to the ground, kicking and screaming.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“Psychosis only becomes a diagnosis when it appears at times or in places we deem unacceptable.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“By “psychotic” I do not mean inherently delusional; I mean that we all possess an internal world unbound by time, social rules, or logic. A place of raw emotion with no names or borders—where emotion is the logic.”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder

“When the voice that links the body to the soul vanishes, there is no way to put into words one’s feelings or will. I am reduced to pieces in no time at all.—YOKO OGAWA, The Memory Police”
― Alexander Kriss, Borderline: The Biography of a Personality Disorder