I Hate You—Don't Leave Me (19 page)

When you join the borderline on his roller-coaster ride, you also must expect to experience a variety of emotions, especially guilt, fear, and anger. When self-destructive, the borderline may appear helpless and project responsibility for his behavior onto others, who may all too readily accept it. Guilt is a strong inhibitor of honest confrontation. Similarly, fear of physical harm—to the borderline, others, or yourself—may also be a powerful deterrent to initiating interactions. Anger is a common reaction when, as frequently occurs, you feel manipulated or simply don't like or understand a certain behavior.

Lois's mother called Lois frequently, complaining of severe headaches, loneliness, and an overall disgust with life. With her father long dead and her siblings estranged from the family, Lois was the “good daughter,” the only child who cared.

Lois felt guilty when her mother was alone and in pain. Despite Lois's love for her mother and the feelings of guilt her mother triggered, Lois began feeling angry when she saw her mother becoming progressively more helpless and unwilling to take care of herself. Lois began to recognize that she was being taken advantage of by her mother's increasing dependency. But when Lois expressed her anger, her mother just became more tearful and helpless, and Lois felt more guilty, and the cycle repeated again. Only when Lois untangled herself from this interlocking system was her mother forced to achieve a healthier self-sufficiency.

Most borderlines describe childhoods with characteristic features. Often, one parent was missing or frequently absent; had time-consuming outside interests, hobbies, or career demands; or abused alcohol or drugs.

If both parents did live in the home, their relationship was often not harmonious. There was frequently a lack of consensus about child rearing and, subsequently, one parent, usually the mother, assumed the primary parenting role. Such parents are rarely capable of presenting a united, collaborative front to their children. For such children, the world abounds with inconsistencies and invalidation. When the child requires structure, he receives contradictions; when he needs firmness, he gets ambivalence. Thus, the future borderline is deprived of the opportunity to develop a consistent, core identity.

The mother of a borderline may be blatantly ill, but more often her pathology is quite subtle. She may even be perceived by others as the “perfect mother” because of her total “dedication” to her children. Deeper observation, however, reveals her over-involvement in her children's lives, her encouragement of mutual dependencies, and her unwillingness to allow her children to mature and separate naturally.

Attempting to maintain consistent child rearing after separation or divorce is especially challenging. Consistency may be difficult for the borderline parent, who may consciously or unconsciously use the children to continue the battle with her spouse. The other parent should try to minimize conflicts by being highly selective in “choosing one's battles.” Trying to defend oneself or debate accusations will not alter the resentment and will only confuse the children. Often, the best approach is to redirect conversation away from the personal relationship. Try to get the spouse to focus only on “what's best for the kids.” Usually, common ground can be found and conflict can be minimized.

Separations from parents, particularly during the first few years of life, are common in the borderline biography. On the surface, these separations may appear insignificant, yet they have profound effects. For example, the birth of a sibling takes the mother away from her normal activities for a few weeks, but when she returns, she is no longer as responsive to the older child; in the eyes of the older child, mother has disappeared, replaced by someone different—one who now has mothering duties with a younger sibling. For the healthy child in a healthy environment, this trauma is easily overcome, but for the borderline in a borderline setting, it may be one of a series of losses and perceived abandonments. Extended illnesses, frequent travels, divorce, or the death of a parent also deprive the developing infant of consistent mothering at crucial times, which may interfere with his abilities to develop trust and constancy in his unstable and unreliable world.

Severe physical and/or sexual abuse is a common trauma in the history of the borderline personality. When a child is abused, he invariably blames himself because (consciously or subconsciously) that is the best of the available alternatives. If he blames the adult, he will be terrified by his dependency on incompetents who are unable to take care of him. If he blames no one, pain becomes random and unpredictable and therefore even more frightening because he has no hope of controlling it. Blaming himself makes the abuse easier to understand and therefore possible to control—he can feel that he somehow causes the abuse and therefore will be able to find a way to end it, or he will give up and accept that he is “bad.”

In these situations, the borderline learns early in life that he is bad, that he causes bad things to happen. He begins to expect punishment and may only feel secure when being punished. Later, self-mutilation may sometimes be the borderline's way of perpetuating this familiar, secure feeling of being chastised. He may see abuse as a kind of love and repeat the abuse with his own children. As an adult, he remains locked in the child's confusing world, in which love and hate comingle, only good and bad exist with no in-between, and only inconsistency is consistent.

Abuse can take subtler forms than physical violence or deviant sexuality. Emotional abuse—expressed as verbal harassment, sarcasm, humiliation, or frigid silence—can be equally devastating.

Stephanie could never please her father. When she was young, he called her “Chubby” and laughed at her clumsy tomboy attempts to please him by playing sports. She was “stupid” when her grades were less than perfect and when she broke dishes while trying to clear the kitchen. He ridiculed her strapless gown on prom night and, on graduation day, insisted that she would amount to nothing.

As an adult, Stephanie was always unsure of herself, never trusting flattering comments and hopelessly trying to please people who were impossible to please. After a long string of destructive relationships, Stephanie finally met Ted, who seemed caring and supportive. At every turn, however, Stephanie tried to sabotage the relationship by constantly testing his loyalty and questioning his commitment, convinced that no one whom she valued could value her.

Ted needed to understand Stephanie's background and recognize that trust could not realistically be established except over long periods of time. Not everyone is willing to wait. Ted was.

By definition, the struggles of adolescence and BPD are very similar: both the normal adolescent and the borderline struggle for individuality and separation from parents, seek bonds with friends and identification with groups, try to avoid being alone, tend to go through dramatic mood changes, and are generally prone to impulsivity. The teenager's easy distractibility is analogous to the borderline's difficulty to commit himself to a goal and follow through. Adolescents' eccentric dress styles, prehistoric eating habits, and piercing music are usually attempts to carve out a distinctive identity and relate to specific groups of peers, efforts similar to those of borderlines.

A normal adolescent may listen to gloomy music, write pessimistic poetry, glorify suicidal celebrities, dramatically scream, cry, and threaten. However, the normal adolescent does not cut his wrists, binge and purge several times a day, become addicted to drugs, or attack his mother; and it is these extremes that anticipate the development of BPD.

Some parents will deny the seriousness of an adolescent's problems (a drug overdose, for example) by dismissing them as a typical teenager's bid for attention. Though it is true that children often seek attention in dramatic ways, neither suicide attempts nor any destructive behaviors are “normal.” They instead suggest the possibility of incipient borderline personality or another disorder and should be evaluated by a professional. Compared to teenagers with other psychiatric disorders, borderline adolescents experience some of the most severe pathology and dysfunction. Borderline adolescents exhibit higher lifetime rates of sexually transmitted infections and medical problems. They are more likely to abuse alcohol, cigarettes, and other drugs.
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Usually others—parents, teachers, employers, friends—will recognize when the normal teenager crosses the border into borderline behavior, even before the adolescent himself. Continuous drug abuse, serial tumultuous relationships, or anorexic fasting are reliable indicators that deeper problems may be involved. The teen's whole style of functioning should be the focus of examination, rather than individual symptoms. This is especially crucial when considering the potential for suicide.

Suicide is a leading cause of death among teenagers, and is particularly prevalent in children who are depressed, abuse drugs, act impulsively or violently, and maintain few support systems—all prominent features of
BPD
.
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,
3
Threats of self-harm should always be taken seriously. Attempts to self-mutilate or harm oneself “only for attention” can go tragically awry. Parents who try to distinguish “real suicide” from “attention-seeking” miss the point—both are seriously pathological behaviors and require treatment, often hospitalization.

In the work environment, borderlines are often perceived as “strange” or “eccentric”: they may tend to isolate themselves, avoid personal contacts, and keep others away with an aura of surliness, suspicion, or eccentricity. Some habitually complain of physical ailments or personal problems, and occasionally have fits of paranoia and rage. Still others may act perfectly normal in the work situation, but appear awkward or uncomfortable around coworkers outside the workplace.

Many employers have implemented Employee Assistance Programs (
EAPs
), in-house counselors, and referral departments initially designed to help employees deal with alcohol and drug abuse problems. Today, many
EAPs
are also available to help workers confront other emotional problems as well as legal and financial difficulties.

Many EAP counselors are well equipped to identify features of alcohol or drug abuse, or of prominent psychiatric illnesses such as depression or psychosis, but they may be less familiar with the more intricate symptoms of BPD. Though the employee's supervisor, coworkers, counselor, even the employee himself may be aware of some dysfunctional or disruptive behaviors, the borderline might not be referred for treatment because his behaviors cannot be clearly associated with a more commonly recognized disorder.

The prospective employer may suspect borderline characteristics in an applicant who has a history of frequent job changes. These terminations will often be explained by “personality conflicts” (which, indeed, is often accurate). Other job separations may be sparked by a significant change—a new supervisor, new computer system, or an adjustment in job description—that disrupted a very structured (perhaps even monotonous) routine.

Because the borderline may be very creative and dedicated, he can be a most valuable employee. When functioning on a higher level, he can be colorful, stimulating, and inspiring to others. Most borderlines function optimally in a well-defined, structured environment in which expectations are clearly delineated.

Coworkers will be most comfortable with the borderline when they recognize his tendency to see the world as black or white and accept his need for well-defined structure. They should avoid “kidding around” with him and stay away from “good-natured” mocking, which the borderline may often misconstrue. It may be helpful to intercede if the borderline becomes the target of others' jokes. Frequent compliments for good work, and matter-of-fact, non-condemning recognition of mistakes with suggestions for improvement can aid the borderline's functioning in the workplace.

Similarly, when the borderline is in an executive position, it is important for employees to recognize and learn to deal with his black-or-white thinking. Employees should learn to expect and accept his changeability with a minimum of hurt feelings. They should avoid entanglement in logical arguments, because consistency may not always be possible for the borderline. They should look for allies elsewhere in the organization to provide reliable feedback and evaluations.

At play the borderline is typically unpredictable and sometimes very disconcerting. He may have great difficulty with recreation and play with a seriousness that is out of proportion to the relaxed nature of the activity. He may be your newly assigned tennis doubles partner who at first seems nice enough, but as the game goes on becomes increasingly frustrated and angry. Though you continually remind him that “it's just a game,” he may stomp around, curse himself, throw the racket, and swear to give up the sport. He may be your son's Little League coach who works well with the kids, but suddenly becomes wildly abusive to the teenage umpire or angrily humiliating to his own son—seen as an extension of himself—who strikes out with the bases loaded. Although these examples may describe borderline-like traits in some people who in fact are not borderline, when these behaviors are extreme or represent a consistent pattern, they may be indications of a true borderline personality.

The borderline's intensity interferes with his ability to relax and have fun. Others' attempts at humor may frustrate him and make him angry. It is virtually impossible “to kid him out of it.” If you elect to continue playing tennis with your borderline partner, judicious use of SET-UP principles may make the experience more tolerable.