I Hate You—Don't Leave Me (10 page)

In many cases the broken parent-child relationship takes the more severe form of early parental loss or prolonged, traumatic separation, or both. As with Dixie, many borderlines have an absent or psychologically disturbed father. Primary mother figures (who may sometimes be the father) tend to be erratic and depressed and have significant psychopathology themselves, often BPD. The borderline's family background is frequently marked by incest, violence, and/or alcoholism. Many cases show an ongoing hostile or combative relationship between mother and pre-borderline child.

Object relations theory, a model of infant development, emphasizes the significance of the child's interactions with his environment, as opposed to internal psychic instincts and biological drives unconnected to sensations outside himself. According to this theory, the child's relationships with “objects” (people and things) in his environment determines his later functioning.

The primary object relations model for the early phases of infant development was created by Margaret Mahler and colleagues.
⁵
They postulated that the infant's first one to two months of life were characterized by an obliviousness to everything except himself (the
autistic phase
). During the next four or five months, designated the
symbiotic phase
, he begins to recognize others in his universe, not as separate beings, but as extensions of himself.

In the following
separation-individuation period
, extending through ages two to three years, the child begins to separate and disengage from the primary caregiver and begins to establish a separate sense of self. Mahler and others consider the child's ability to navigate through this phase of development successfully to be crucial for later mental health.

During the entire separation-individuation period, the developing child begins to sketch out boundaries between self and others, a task complicated by two central conflicts—the desire for autonomy versus closeness and dependency needs, and fear of engulfment versus fear of abandonment.

A further complicating factor during this time is that the developing infant tends to perceive each individual in the environment as two separate personae. For example, when mother is comforting and sensitive, she is seen as “all-good.” When she is unavailable or unable to comfort and soothe, she is perceived as a separate, “all-bad” mother. When she leaves his sight, the infant perceives her as annihilated, gone forever, and cries for her return to relieve the despair and panic. As the child develops, this normal “splitting” is replaced by a healthier integration of mother's good and bad traits, and separation anxiety is replaced by the knowledge that mother exists even when she is not physically present and will, in time, return—a phenomenon commonly known as
object constancy
(see page 67). Prevailing over these developmental milestones is the child's developing brain, which can sabotage normal adaptation.

Mahler divides separation-individuation into four overlapping subphases.

DIFFERENTIATION PHASE (5-8 MONTHS).
In this phase of development, the infant becomes aware of a world separate from mother. “Social smiling” begins—a reaction to the environment, but directed mostly at mother. Near the end of this phase, the infant displays the opposite side of this same response—“stranger anxiety”—the recognition of unfamiliar people in the environment.

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.

PRACTICING PHASE (8-16 MONTHS).
The practicing phase is marked by the infant's increasing ability to move away from mother, first by crawling, then by walking. These short separations are punctuated by frequent reunions to “check in” and “refuel,” behavior that demonstrates the child's first ambivalence toward his developing autonomy.

RAPPROCHEMENT PHASE (16-25 MONTHS).
In the rapprochement phase, the child's expanding world sparks the recognition that he possesses an identity separate from those around him. Reunions with mother and the need for her approval shape the deepening realization that she and others are separate, real people. It is in the rapprochement phase, however, that both child and mother confront conflicts that will determine future vulnerability to the borderline syndrome.

The mother's role during this time is to encourage the child's experiments with individuation, yet simultaneously provide a constant, supportive, refueling reservoir. The normal two-year-old not only develops a strong bond with parents but also learns to separate temporarily from them with sadness rather than with rage or tantrum. When reunited with the parent, the child is likely to feel happy as well as angry over the separation. The nurturing mother empathizes with the child and accepts the anger without retaliation. After many separations and reunions, the child develops an enduring sense of self, love and trust for parents, and a healthy ambivalence toward others.

The mother of a pre-borderline, however, tends to respond to her child in a different way—either by pushing her child away prematurely and discouraging reunion (perhaps due to her own fear of closeness) or by insisting on a clinging symbiosis (perhaps due to her own fear of abandonment and need for intimacy). In either case, the child becomes burdened by intense fears of abandonment and/or engulfment that are mirrored back to him by mother's own fears.

As a result, the child never grows into an emotionally separate human being. Later in life, the borderline's inability to achieve intimacy in personal relationships reflects this infant stage. When an adult borderline confronts closeness, she may resurrect from childhood either the devastating feelings of abandonment that always followed her futile attempts at intimacy or the feeling of suffocation from mother's constant smothering. Defying such controls risks losing mother's love; satisfying her risks losing oneself.

This fear of engulfment is well illustrated by T. E. Lawrence (
Lawrence of Arabia
), who at age thirty-eight writes about his fear of closeness to his overbearing mother: “I have a terror of her knowing anything about my feelings, or convictions, or way of life. If she knew, they would be damaged; violated; no longer mine.”
⁶

OBJECT CONSTANCY PHASE (25-36 MONTHS).
By the end of the second year of life, assuming the previous levels of development have progressed satisfactorily, the child enters the object constancy phase, wherein the child recognizes that the absence of mother (and other primary caregivers) does not automatically mean her annihilation. The child learns to tolerate ambivalence and frustration. The temporary nature of mother's anger is recognized. The child also begins to understand that his own rage will not destroy mother. He begins to appreciate the concept of unconditional love and acceptance and develops the capacity to share and to empathize. The child becomes more responsive to father and others in the environment. Self-image becomes more positive, despite the self-critical aspects of an emerging conscience.

Aiding the child in all these tasks are transitional objects—the familiar comforts (teddy bears, dolls, blankets) that represent mother and are carried everywhere by the child to help ease separations. The object's form, smell, and texture are physical representations of the comforting mother. Transitional objects are one of the first compromises made by the developing child in negotiating the conflict between the need to establish autonomy and the need for dependency. Eventually, in normal development, the transitional object is abandoned when the child is able to internalize a permanent image of a soothing, protective mother figure.

Developmental theories propose that the borderline is never able to progress to this object constancy stage. Instead, the borderline is fixated at an earlier developmental phase, in which splitting and other defense mechanisms remain prominent.

Because they are locked into a continual struggle to achieve object constancy, trust, and a separate identity, adult borderlines continue to rely on transitional objects for soothing. One woman, for example, always carried in her purse a newspaper article that contained quotes from her psychiatrist. When she was under stress, she would take it out, calling it her “security blanket.” Seeing her doctor's name in print reinforced his existence and his continued interest and concern for her.

Princess Diana also took comfort in transitional objects, keeping a menagerie of twenty stuffed animals—“my family,” she called them—at the foot of her bed . . . As her lover James Hewitt observed, they “lay in a line, about thirty cuddly animals—animals that had been with her in her childhood, which she had tucked up in her bed at Park House and which had comforted her and represented a certain security.” When she went on trips, Diana took a favorite teddy bear with her.
⁷
Ritualized, superstitious acts, when done in extremes, may represent borderline utilization of transitional objects. The ballplayer who wears the same socks or refuses to shave while in the midst of a hitting streak, for example, may simply be prone to the superstitions that prevail in sports; only when such behaviors are repeated compulsively and inflexibly and interfere with routine functioning does the person cross the border into the borderline syndrome.

The child's evolving sense of object constancy is consistently challenged as he progresses through developmental milestones. The toddler, entranced by fairy tales filled with all-good and all-bad characters, encounters numerous situations in which he uses splitting as a primary coping strategy. (Snow White, for example, can only be conceptualized as all-good and the evil queen as all-bad; the fairy tale does not elicit sympathy for a queen who may be a product of a chaotic upbringing or criticism of the heroine's cohabitation with the seven short guys!) Though now trusting mother's permanent presence, the growing child must still contend with the fear of losing her love. The four-year-old who is scolded for being “bad” may feel threatened with the withdrawal of mother's love; he cannot yet conceive of the possibility that mother may be expressing her own frustrations quite apart from his own behavior, nor has he learned that mother can be angry and yet love him just as much at the same time.

Eventually, children are confronted with the separation anxiety of starting school. “School phobia” is neither a real phobia nor related exclusively to school itself, but instead represents the subtle interplay between the child's anxiety and the reactions of parents who may reinforce the child's clinging with their own ambivalence about the separation.

Separation-individuation issues are repeated during adolescence, when questions of identity and closeness to others once again become vital concerns. During both the rapprochement phase of infancy and adolescence, the child's primary mode of relating is less acting than
re
acting to others, especially parents. While the two-year-old tries to elicit approval and admiration from parents by molding his identity to emulate caregivers, the adolescent tries to emulate peers or adopts behaviors that are consciously different—even opposite—from those of parents. In both stages, the child's behavior is based less on independently determined internal needs than on
re
acting to the significant people in the immediate environment. Behavior then becomes a quest to
discover
identity rather than to reinforce an established one.

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 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.

Often, entire families adopt a borderline system of interaction, with the family members' undifferentiated identities alternately merging with and separating from each other. Melanie, the adolescent daughter in one such family, closely identified with her chronically depressed mother, who felt abandoned by her philandering husband. With her husband often away from home and her other children of much younger age, the mother fastened onto her teenage daughter, relating intimate details of the unhappy marriage and invading the teenager's privacy with intrusive questions about her friends and activities. Melanie's feelings of responsibility for her mother's happiness interfered to the point where she could not attend to her own needs. She even selected a college nearby so she could continue to live at home. Eventually, Melanie developed anorexia nervosa, which became her primary mechanism for feeling in control, independent, and comforted.

Similarly, Melanie's mother felt responsible and guilty for her daughter's illness. The mother sought relief in extravagant spending sprees (which she concealed from her husband) and then covered the bills by stealing money from her daughter's bank account. Mother, father, and daughter were trapped in a dysfunctional family swamp, which they were unwilling to confront and from which they were unable to escape. In such cases, treatment of the borderline may require treatment of the entire family (see chapter 7).

Major traumas—parental loss, neglect, rejection, physical or sexual abuse—during the early years of development can increase the probability of BPD in adolescence and adulthood. Indeed, case histories of borderline patients are typically desolate battlefields, scarred by broken homes, chronic abuse, and emotional deprivation.