Living with borderlines: unstable relationships.
I have been thinking over the past few weeks about Borderline Personality Disorder – a condition that I might have. I blogged about it here and the more I have read around the subject, the more pieces of the jigsaw puzzle fall into place.
The book I am reading currently is ‘Sometimes I Act Crazy’ by Jerold K. Kreisman & Hal Straus and it offers a source of guidance for sufferers of BPD and the people that love them. It contains practical advice on how to manage mood swings, develop lasting relationships, keep negative thoughts and destructive impulses at bay, and treat the disorder clinically. For me this would have been invaluable when I was drowning in waves of feelings I didn’t understand. I would experience states that seemed so palpably real at the time, only to dissipate moments or days later.
An individual must exhibit five of these nine symptoms to receive the BPD diagnosis:
- Frantic efforts to avoid real or imagined abandonment
- A pattern of unstable and intense interpersonal relationships characterised by alternating between extremes of idealisation and devaluation
- Identity disturbance: markedly and persistently unstable self-image or sense of self
- Impulsivity in at least two areas that are potentially self-damaging (e.g. spending, sex, substance abuse, reckless driving, binge eating)
- Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour
- Affective (mood) instability and marked reactivity to environmental situations (e.g. intense episodic depression, irritability, or anxiety usually lasting a few hours and rarely more than a few days)
- Chronic feelings of emptiness
- Inappropriate, intense anger or difficulty controlling anger (e.g. frequent displays of temper, constant anger, recurrent physical fights)
- Transient, stress-related paranoia or severe dissociative symptoms (feelings of unreality)
For me, the symptoms of the disease that threaten to undermine and overwhelm me the most are unstable interpersonal relationships, identity disturbance and anger. I want to focus on the first of these facets, but before I do, I just wish to voice what some people may already be thinking: doesn’t everyone go through these states? Isn’t every member of the human race affected by conflict with others, feelings of inadequacy and difficulty finding one’s own self, and feelings of rage? I would have to say that yes, BPD in that respect probably does touch everyone’s psyche in some deeply personal, unique way. It is one of the most common disorders that exist. I have had well-meaning friends saying to me things like this: ‘there’s no definition of “perfectly fine healthy human being personality” nowhere in psychiatry, hon. Everyone has these personality disorders, more or less pronounced, often more than one at once even, it’s more like traits that form our characters, I think.’ Totally agree and just for the record I personally think I am brave in tackling something that I perceive as real, in the sense it frequently threatens to derail me.
I’m going to cut right to the chase and give Kreisman & Straus’ practical steps for dealing with intense relationships for those who love a borderline. Firstly don’t try to win the ‘no win’. Defer to the borderline. Demonstrate unflagging constancy no matter what. The borderline often feels worthless and expects to be abandoned. Trust is a precious commodity. Much more valuable than what is said is the reassurance that you are going to be there.
Secondly predict the unpredictable. Borderlines live in a confusing, impenetrable world. His reactions may not be foreseen by the borderline himself, but may be easily predicted by those that love him. Tame the chaos. The upshot is, predicting his behaviour and letting him know sensitively, may discourage him from acting in the way you predicted.
Next up, detach occasionally. I would say ‘more than occasionally’. The more time you spend together, the more you end up frustrated and resenting his ‘unwillingness’ to change or to see the errors of his ways. You cannot be everything to him all the time Reassure him of your unconditional commitment to him by reminding him of your need for space – and implicitly, his own need for space, which doesn’t equal a break-up.
Number four is examine your own actions and motivations. Many partners of borderlines adopt a ‘saviour complex’. By trying to become his hero you may only succeed in becoming his goat. Examine your own need to be a hero, which may reflect your needs more than his. You are with this person to love and help him, not to rescue him. Empathy is more helpful than blaming others, blaming the borderline himself, or denying those feelings.
At number five, challenge unrealistic characterisations only when they are negative. The borderline’s closest personal relationships follow cycles of idealisation and devaluation. While unrealistic idealisation oughtn’t be fostered, it needn’t be contradicted. When the inevitable devaluation occurs, proffer reminders that emphasise the difference between the borderline’s feelings and actuality.
The sixth, and in many ways the most difficult, is learn how to communicate effectively with the borderline. There are all kinds of templates and models which offer help as to go about sustainable and mutually beneficial communication, including the SET system which balances all interactions with statements endorsing personal Support and Empathetic acknowledgement of the borderline’s stress with Truthful confrontations of realistic issues.