Extraordinary sensitivity to perceived slights and insults.
Doing destructive things that could ONLY be done with intent and then claiming that they were accidents. Sometimes staging them to look like accidents or by acting out-of-character to make events happen.
Then going right into blaming or attacking you for suggesting they might have done it on purpose or otherwise not simply accepting it as an accident and moving on.
Bizarre accusations toward third parties.
Especially claims of persecution or extended slights by other friends or their family, usually when you see no such thing.
Typical “I love you so much I want to rip your eyes out of your head you bastard” rapid changes from one emotional extreme to another.
olives has a lot of good points, but IMHO some of them are a bit one-sided.
This is true, but the drawing and maintaining of boundaries can be exhausting. The BPD folks I’ve known have continually tested the boundaries. They have looked for new ways to needle and manipulate their friends and loved ones, ways that were totally unanticipated. I think it’s pretty reasonable for someone to decide they simply don’t want to do this kind of work.
This may work in a familial relationship with a person who has BPD. However, the OP is talking about a sexual/romantic relationship. It’s not possible to cut off a girlfriend for a year and expect her to be his girlfriend afterwards (obviously). Without the ability to make a powerful statement of the type you describe, boundary drawing and maintenance within a romantic relationship is probably much harder. After all, you have to do all that work, while seeing the person frequently and (probably) having regular sex with them. That makes things infinitely more complicated.
I don’t mean to be cruel by throwing your posts about your mother from other threads in your face, but from what you’ve said about your mom, things are not 100% rosy. In your recent thread about adoption, her behavior came off as rather self-pitying and narcissistic. Again, I think this is a difference between familial relationships and romantic relationships. While someone might be thrilled to have an improved but still flawed relationship with a self-centered mother or other relative, many people would prefer to simply leave a romantic relationship and look for a mate with fewer negative traits. And IMHO, that’s a reasonable choice to make.
Unfortunately, the change need not be positive. For example, when I changed how I behaved with my friend who has BPD, and drew some boundaries, she not only “de-friended” me, but made it her mission to destroy the much closer friendship I had with her sister. After ten years of horribly manipulative behavior, my ex-friend actually bought her sister a house in order to bribe her to stop speaking to me. She spread poisonous lies about me to other mutual friends, and did other things to try to get “revenge” on me for daring to make my own rules about our relationship.
For me, the bottom line is, yes, some BPD folks will improve given boundaries and understanding and effort from a loved one. But it is very reasonable for someone to decide, early in a relationship with a borderline personality, that they just don’t want to take the chance of putting in all that hard work and still getting a poisonous psychotic at the end of it all.
I’m sympathetic to those with personality disorders. They are usually the survivors of severe childhood abuse or other very chaotic situations. But my personal experiences with borderline personalities has been uniformly poor, so I felt it was important to let the OP know what he could be in for and that leaving is an acceptable option.
But hey, MichaelEmouse sounds like he can handle the situation.
An ultra-common suggestion is to read “The Gift of Fear” by Gavin DeBecker. Gives all the warning signs of abusive relationships of all strips and colors, illustrates how people get sucked in and stay even after suffering abuse, etc. etc. Illuminating.
Someone with “increased anxiety” sounds different from the horror stories people have been putting here. Perhaps your girls is more like Olives than like Inigo’s ex-wife. Having never met any of them, it’s tough for some random Internet strangers to say. But it sounds … hopeful, in a way.
Yeah, that’s the thing. If the person is really not that big of a problem, then they shouldn’t have been diagnosed with BPD. If the person has BPD, there is no angel so perfect that a successful relationship is possible.
Yeah, there are different diagnosis for “increased anxiety.” There are even different diagnosis for “increased anxiety” + “a little impulsive.”
I don’t know if it would be possible, but if you have serious intentions toward this woman, maybe a co-counseling session with her therapist. Her therapist, with her in the room, could explain to you how BPD manifests in your girlfriend, what the likely trajectory of the illness is, what you are likely to put up with. That situation would force your girlfriend to be honest (if she is not, and if she has BPD chances are good she isn’t).
Its possible she has a bad therapist who has tagged her with a BPD label when it shouldn’t be applied.
Chimera pretty much nailed it here, Michael. Not sure I can add much more. Since in the beginning of the relationship you can do no wrong, I’d pay careful attention to how she perceives and treats other people. (That is a good rule of thumb for all relationships in general, though.) There is a tendency in BPDs for ‘‘black or white’’ thinking, and part of the problem is that once she realizes you’re not the absolute perfect person she envisioned (an inevitable part of any relationship), she may feel betrayed and swing into the opposite extreme.
I agree completely. I just want Michael to make this decision based on the actual person involved and not based on a highly stigmatized diagnostic stereotype that may not in fact bear any resemblance to the actual woman he is interested in.
There is really nothing you have said here that I disagree with. It is hard not to paint the picture with my Mom as overwhelmingly positive because she’s a thousand times better than she used to be, and sometimes I feel like I have my mother back, the one I knew before she lost her freakin’ mind. Other times I feel like she is still seriously ill and always will be. It’s not just BPDs that struggle with ‘‘all or nothing’’ thinking.
But I think some of the things I’m saying here may have been taken in a way other than I intended. I am not encouraging all people to embrace their BPD lovers and family members despite whatever crap is slung at them. I am encouraging approaching this disorder from a place of empowerment.
When I say ‘‘drawing boundaries,’’ that includes being able to say ‘‘get the hell out of my face’’ and understanding you may never see that person again. I just see that so many people in relationships with BPDs seem to feel so utterly helpless in dealing with them. I’m saying you don’t have to be helpless. You can have the relationship on your own terms or not at all. I’m not saying every person is going to realize the error of their ways and come crawling back, but, with time, maybe. And if you lose that person forever, so what? You need constant abuse and manipulation like you need a hole in the head.
I don’t think there is anything more terrifying to a BPD than abandonment. As long as she’s the one who did the leaving, her sense of safety and security is in tact. As long as you are the bad guy and not her, she doesn’t have to wonder whether she’s an awful, horrible person who doesn’t deserve to live. The world of the BPD is not shades of grey, it is black-and-white, right and wrong, gods and demons. That doesn’t just apply to other people – it applies to herself as well. If you aren’t a terrible person, that means she must be. She had to decide who was the truly evil one. She spared herself and chose you.
I can’t say I really blame people for taking this mental illness so personally, and I’m not even implying I’m immune to that myself. But it’s really not personal. It’s just survival. People with BPD have particular cognitive schemas that dictate how they perceive the world. They have to make you fit, no matter what, otherwise reality crumbles and calls into question everything they ever believed about anything that ever happened to them. Then the depression comes rushing in, then they start cutting and thinking of suicide, and they hope, they hope upon hope, that you will show you care, because if you don’t care, this means they are really as unloveable as they suspect.
The reason Dialectical Behavioral Therapy works is because it begins to break apart these rigid schemas, and encourages the sufferer to consider that the world is full of shades of grey they never considered. It teaches them that their emotions and thoughts don’t dictate what is true, and that feelings pass. It teaches them that self-destructive behavior makes the situation worse, not better. Most importantly, fundamental, in fact, it teaches them that just because they have been labeled as BPD doesn’t mean they are hopelessly narcissistic, messed-up, doomed crazy people who no one will ever love.
There is a great deal of evidence that indicates that the stigma against BPDs does way more harm than good, that people with a diagnosis of BPD are treated differently than people with different diagnoses who share the exact same symptoms, to their detriment. We know that women are diagnosed with BPD far more often than men who share the same symptoms. This idea that people with such a diagnosis are ‘‘beyond hope,’’ ‘‘will never change,’’ ‘‘not worth your time,’’ etc is every bit as extreme and all-or-nothing than the BPD schema itself.
An excerpt from my own [unpublished] paper on the topic:
In the aforementioned book Trauma and Recovery, Herman (who was on the board that defined PTSD in the DSM-IV) argues that Borderline Personality Disorder is really an especially damaging form of PTSD caused by incidents involving captivity (which includes childhood abuse) and repeated trauma. She proposes a new diagnosis, ‘'Complex-PTSD,’’ take its place. While not every therapist accepts this as a legitimate diagnosis, some mental health clinicians took that and ran with it. I was diagnosed with Complex-PTSD. If you read the wiki, you will see there are a number of symptoms similar to BPD. I can only imagine how my future would have been different if someone had diagnosed me borderline.
While I’ve worked as an intern with abusive parents who have BPD (not for long… bad idea for me) and researched the topic quite a bit, Sr. Olives actually is the one with the real knowledge, since he’s currently training as a practitioner of Dialectal Behavioral Therapy and has read many of Linehan’s books cover-to-cover. He’s a lurker, but so far my attempts to get him to join the Dope have failed. I don’t think he can handle that kind of time commitment right now.
I know nothing about the subject in question. But I greatly appreciate Olivesmarch4th’s extremely thoughtful, courageous and insightful posts in this thread.
I dated a woman with BPD for two years when I was young and sure I could take her “problems” and “help her through them”. (She was not diagnosed until after we broke up, and we thought she was simply manic/depressive.) When she was in a good space, things were wonderful - she was exciting, intelligent, funny, great in bed. But seconds later, she was evil. She: locked herself in our bathroom when I came home late from work and she felt I’d been cheating, threatening to kill herself. When I broke in the door, she accused me - to others - of being violently unstable and abusive. She would get me to ride along with her to the suburbs of the city we lived in, and then blow up at me over something I did in a dream she had and threaten to leave me there with no way to get home (yes, this happened more than once). She cheated on me several times - once, deliberately, with someone with HIV (I found that out later). She would prevent me from sleeping for several days on end when we lived together (easy to do - she was a trust fund kid and did not have to work like I did) and then pick fights with me once I was completely exhausted. I’m pretty sure that’s actually prohibited by the Geneva Convention. She would get pets she “could not live without” and then let them die through neglect or just let them run off. And so on. And so on. The final straw came when she beat the crap out of me one night, threatening to burn my belongings if I left, and I came to my senses - she would not get better, I could not help her, I was a moron for staying at all. By then, she had me so emotionally brutalized that I honestly half believed I was the one responsible for her behavior. I got a friend to come rescue me. I did lose most of my stuff, by the way, and had to steal what little I could get from our home when she was away. For years after, she told elaborate stories to any and everyone of how I was abusive and repeatedly raped her.
I’m sorry, but if she really has BPD, this is what you may well face.
Right back atcha, kiddo. I’m glad I decided to stay.
I really appreciate this comment more than you could imagine. I often feel like I’m not doing much more than making a fool of myself when I get deep into these sorts of threads, but I keep doing it, because it seems to help me process stuff, and I want it to help others too. I am glad to know someone is getting something meaningful out of it.
A word on **L. Ectomorph **and anger. I actually talked to my CBT therapist about anger today, and she very strongly didn’t agree with me that anger is a useless emotion. So what L. Ectomorph calls ‘‘generousness of spirit’’ in me is honestly probably some kind of pathological inability to fully accept anger as a legitimate emotion. That is sort of my homework over the next few weeks, to get comfortable with the idea that anger is normal and healthy. So I’m just slinking back in here to admit I may not be the best judge when it comes to the role of anger in healing.
That said, it’s one thing to be angry with the person who hurt you, and another thing entirely to be angry with every single person on the planet who has the same mental health diagnosis as the one who hurt you. Schizophrenics are often extremely resistant to acknowledging their illness, can be very taxing to deal with, can cause great suffering to loved ones, and may never change, but we have a tendency to recognize that is the burden of the illness and not an indictment of them, personally. We also seem to recognize that just because some schizophrenics may be violent serial killers, does not mean all schizophrenics are violent serial killers. Yet borderlines are just bad people. That doesn’t seem right to me.
Might want to hold off on that. Borderline Personality Disorder is (or was in the previous two decades) a general catch-all dump-bin for any sort of mental trouble.
I was diagnosed with it in '89. It was a crappy diagnosis with no basis in fact, MMPI or not. The hospital I was in had a whole ward full of BPDs–once upon a time, at least, it seemed like pretty much everybody between ages 16 and 22 had it.
In light of Olivesmarch4th’s comments, I’ll risk a little self-revelation. Having read the BPD diagnostic criteria, I’ve often wondered why that diagnosis never stuck to me. I think I may have simply been spared it by those who thought I didn’t need the stigma. In the past, I did have the emotional lability and disastrous self-esteem issues that seem to go with BPD. On the other hand, sometime about the time I turned 13, I realized that if I didn’t somehow learn to control my anger, I was going to kill someone–and somehow I did control it. But that emotion seemed to turn into intense anxiety (and the some of the self-destructive stuff) instead.
At 25, I would not have been a wonderful person to date because of my intense anxiety and tendancy toward periods of suicidal despair. I was also too much of a mess to be have much room for sympathy for anyone else. However, the vengeful and malicious behavior that often goes with BPD is just forgein to me.
Olivesmarch4th notes that BPD usually gets better with age. That’s one of the things that makes me suspect that my self-diagnosis is correct. As I came up on 40, I found my temperament changing in a fundamental way. My sensitivity level dropped, and my anxiety level with it. At worst, I now just have a little social phobia. I am also eight years into a relationship and five years into a marriage that has never included a serious blow-up.
The thing is, I’m pretty sure that it was a few people who didn’t run away when I was in my 20s that kept the worst of my despair from being lethal. My not entirely dispassionate reaction is this. I wouldn’t reject out of hand the idea of BPD manifesting mostly as anxiety–if you realize that that kind of anxiety and reactiveness sometimes leads to despair. I would certainly be cautious. I would run away at the first sign of maliciousness or vindictivness toward others; I’ve seen that and I can’t think of how anyone could deal with it. On the other hand, if you see only yellow flags and no red flags, if you can hang around for just a little while and act with kindness, you may be one of the few bright spots in what is otherwise a pretty bleak existance.
That’s just it. My ex-wife seemed hell-bent on being The Victim at all costs, and casting everyone else in their turn as The Villain. When we were in Marriage Counseling, virtually every session, I told her “I can’t be the Great Villain in your life.” Unfortunately, me trying to put a stop to her behavior triggered her abandonment issues (“I can’t live this way”, “I can’t be in a relationship with you if you are really afraid of me”, etc) which made me even more of a villain and her even more of a victim. I can see that now, but I’m still not sure how I could have changed her behavior at all. It wasn’t possible and I SHOULD have gotten out.
During our divorce process, she went so over the top in trying to slur me as this “obviously dangerous homicidal psychopath” (a term she threw around frequently during that process) that my own attorney had to threaten to file harassment charges against her to stop the flood of hysteria and false accusations. In the end, he gave me a 3/4" stack of emails and letters she’d written to him trying to get him to stop representing me or to get him to have me locked up, and that didn’t include the voicemails he got daily.
That is a whole container cargo ship full of “it can’t be me, so it has to be him”.
One of my theories of Insanity is that it is the gulf between what we THINK we are, and what we really are. Between what we want to believe the world is like and what it really is like. That it is this cognitive gulf, the seeminly obvious disparity between the two realities, that causes people to go farther and farther from reality (the one side) to try to force the fantasy (the other side) be true. You can see some of the same thing with personal philosophies, religion and Ideology. The further that ideology is from how the real world obviously works, the greater the disconnect between real problems and proposed solutions.
Unfortunately, as I say, “Everyone is insane. The only difference is the form.”
As a lurker, I’ve read every word you’ve written in this thread and also appreciate your perspective. I think you could write a wonderful book someday about healing from both a personal and professional perspective.
No, but he should take a hard look at the DSM criteria for a diagnosis of BPD so he can make an informed decision. And the clinical description of the disorder is enough to give anyone serious pause. After all, it is hard to deny that a person must exhibit some very extreme and disturbed behavior before getting the diagnosis.
So I would dispute that what people have described here are “stereotypes.” Most of the posters are describing real experiences with borderline personalities, not mere unfounded prejudices.
On the other hand, I think a lot of the scholarly work on BPD, especially what has come out since the development of DBT, paints too rosy a picture because it’s biased. As I mentioned earlier, only the most self-aware borderline personalities are willing to stick with that kind of prolonged treatment.
If you’re lucky, this is true. However, when a person with BPD (like my ex-friend) decides to keep inserting themselves in the lives of people who have “dumped them,” you end up having to deal with them whether you want to or not.
You’re not telling me anything I don’t already know. But on a practical basis, I don’t really care why she acts like a nutjob. All I care about is that she continues to have a negative impact on my life ten years after I cut off all direct contact with her. I think it’s perfectly fair to stop having sympathy for a person who makes your life hell.
The reason the person with BPD does the things they do is not personal. However, the impact on the lives of the people they come into contact with is absolutely personal and it is totally normal and understandable to feel violated on a personal level. There is not much that impacts more on a personal level than destroying friendships or stealing private personal information.
It is more accurate to say that if a person with BPD is open to doing the therapy, and they stick with it, it can work, but does not always work. I know a therapist who does DBT and she freely admits that most BPD patients are not willing to complete a full course of DBT.
I think your statements about the efficacy of DBT come off as implying it is 100% effective, and that is simply not supported by the evidence.
I actually do agree that the stigma amongst mental health professionals is detrimental, but I think that is a battle to be waged inside the profession. Most people in the population at large don’t have any clue what “borderline personality disorder” is. And most of the people who do know about it have learned about it because they have encountered someone with BPD in their personal lives. In fact, I think this thread serves as evidence that the reaction of those people is overwhelmingly not to reject someone with BPD purely due to the stigma. Instead, most people give the person with BPD plenty of second, third, etc. chances before cutting them off out of a need for self-preservation.
Nothing is 100% effective, but it has been proven to be more effective than any treatment for BPD that has ever existed. It is the only treatment recommended as a best practice for BPD by the American Psychological Association. That in itself is reason to feel optimistic. The concept of therapy in general until recently has largely been a sham… even today, about 50% of therapists use techniques that are not grounded in empirical data. We are finally getting real about the use of evidence in treatment applications. You bet I am going to pimp DBT at every possible opportunity. It, like any therapy, has its pitfalls, but it has proven efficacy in over eleven randomized clinical controlled trials including patients with comorbid conditions and substance abuse. It may not be perfect, but it sure beats the alternative approach: ‘‘Huh, my ineffective, unresearched methods aren’t working. Guess it’s her fault.’’
The diagnosis itself is extremely controversial, as is the concept of personality disorders in general. It’s pretty clear that BPD has been a dumping ground for basically anyone therapists find difficult. Some of the language in the DSM diagnostic criteria is obviously biased – ‘‘unjustified anger?’’ There is serious talk right now of eliminating personality disorders altogether in the DSM-V. Time will tell what actually happens.
Do you have any articles that discuss this issue? I’m genuinely curious. My understanding is that DBT is often targeted at the most severe cases of BPD–in the RTCs I’m familiar with you had to have a history of suicide attempts in order to qualify for treatment. I know that one of the major drawbacks of DBT is the time commitment, but it seems there is a measurable benefit even without completing the full course. That is generally the case with most evidence-based treatments. There is no question that getting people to stick to treatment is hard. Most people who go into treatment do not go for the BPD symptoms, but for treatment of some other comorbid diagnosis. That’s one way, I think, of getting a foot in the door.
If this seems like too rosy of a picture for you, try to look at it in historical context: this is the first time ever that we have a proven treatment for this disorder. That’s huge. How is that not reason to celebrate? If someone came up with a cure for AIDS that was long and difficult, but only 50% of the people were wiling to complete the medication series, and only 80% of those who completed the series were helped, wouldn’t we be thrilled? I mean suddenly we can cure 40% of the people with AIDS! Wouldn’t we, instead of rejecting that cure as ‘‘ineffective,’’ try to figure out how to get the other 50% to take their meds? Why discount such groundbreaking evidence just because the work is in its infancy? This isn’t personal, it’s just my axe to grind, and I will not climb down from my soap box until every licensed clinician is required by law to use evidence-based treatments (unless conducting research.)
Of course it’s normal and healthy to feel anger with your friend. Sorry if I gave you the impression I felt otherwise. It sounds like you went through a truly horrible ordeal (and maybe still are.) Your feelings are very understandable.
Part of the disconnect here, I think, is that I am way interested in this on a research level as much as a personal one. I don’t mean to discount anyone’s feelings in taking that approach.
I don’t know if this information will help, but in my case anger is very useful sometimes. There have been times I was in a bad situation, and feeling like shit on a stick, and the way I moved from feeling like shit to “up an’ at 'em” was when I got angry. Angry at whomever was mistreating me, angry at me for allowing it, and I rolled up my sleeves and whooped some ass (not literally).
What’s not useful is anger that controls you, or anger that blinds you, or anger that builds barriers between you and the good people in your life. Anger that keeps you out of the pits of despair, though, is very useful. Visual Purple, welcome and I’m glad you got better.
olives, I spent time as a graduate student in psychology, so I approach this from an academic perspective as well as a personal one.
I agree that a lot of psychological treatment is not grounded in science. This is a huge problem. I find it contradictory that you decry the lack of evidence-based treatments in psychology, and yet speak in unscientific, unqualified, “pimping” terms about DBT.
When I read about evidence-based treatments in the literature, they do not use unqualified language like this:
To me, that is marketing speak. Scientific discussion of the efficacy of evidence-based treatments discuss success rates of the treatment, and what features of the disorder show improvement. I have a huge problem when drug companies laud psychotropic drugs in this sort of unscientific way, too. It’s great that DBT is a breakthrough. But that is no reason for us to cast off the need for accurate description of success rates in favor of unqualified hurrahs.
I have never said that DBT is ineffective. In fact, I think it’s a pretty great thing, overall. It’s helpful for far more than borderline personality disorder. I went through “DBT lite” to help with my anxiety problems, and it was very effective for me. This led me to research the treatment and I have a lot of interest in it. Even so, I could never speak about it as glowingly as you do.
I am all about the need to properly qualify statements about the efficacy of treatments based on science. Too many people who seek mental health treatment–myself included–have been burned by professionals who “pimp” treatments in unqualified marketing speak, whether they be drugs or therapeutic techniques. In the end, it is the patient who suffers if their experience doesn’t match the laudatory statements made by the enthusiastic psychologist.
On a more personal note: I have approximately the same level of graduate education that you and your husband currently have in psychology. We are, in my view, peers. I don’t mean to be snide in saying this. It’s just that I feel you are wasting your time trying to explain some concepts to me that I already understand all too well (like the psychology of my BPD friend, for example).
I figured as much, but I am trying to keep in mind that other people reading this conversation do not necessarily know anything about BPD. My responses were for everyone in this thread, not just you.
I honestly don’t know how I feel about this point you’ve raised. In a world where many therapists feel perfectly comfortable peddling bullshit and calling themselves ‘‘experts’’ on any number of disorders, it seems perfectly rational to encourage others to use the treatments based on actual science. In my view, that’s what I’m doing here… separating the wheat from the chaff. I guess it depends on what your goal is: mine is the implementation of evidence-based treatments. Knowing how the market works, it seems the best way to get therapists to use EBTs is to create a demand for the treatments.
I am not a clinician, and I do not have any level of education in clinical psychology. I am a macro social work student planning to specialize in behavioral mental health policy, and I am interested, specifically, in shaping the implementation of EBTs. I try to keep current with the latest research because I feel it will be my role to help bridge the gap between researchers and clinicians. I am under the impression that researchers are in desperate need of people who can market their treatments, because obviously evidence that something works is not sufficient for clinicians to use it. I feel we have a crisis on our hands, an injustice of epic proportions, in the irresponsible use of treatments that are not based on science. I have a personal stake in this, because I have a chronic mental illness, and I am furious that the industry wasted 8 years of my fucking life on treatments that have no evidence to support them. Clients deserve to have the expectation that they will receive the best available care when they seek treatment.
I disagree strongly that I have misrepresented any facts on DBT, but given my own experiences as a consumer of mental health services, I can see your point. I think the use of qualified language is of utmost importance in scholarly pursuit, but where do you draw the line when your actual goal is to, well, market these treatments? It sounds like you detest the idea of marketing, but if that’s the case, then how do we win this war? These are not rhetorical questions. I’m curious what you really think.
