Borderline Personality

Borderline Personality

There are are two different kinds of borderline personalities. There are those who have difficulty being weaned. These are people who have difficulty with separations and tend to experience these events as rejections that make them angry. The second are those who have difficulty being bonded. They are detached emotionally and fearful of being dependent on anyone.

People who have difficulty being weaned

These individuals who make frantic efforts to avoid real or imagined abandonment. The perception of impending separation or rejection can lead to profound changes in self image and affect cognition and behavior. They experience intense abandonment fears and inappropriate anger even when faced with a realistic time-limited separation or when there are unavoidable changes in plans (e.g. despair when the therapist announces the end of the hour; panic when someone important to them is just a few minutes late or must cancel an appointment). They may believe that this appointment means that they are “bad.” These abandonment fears are related to an intolerance at being alone and a need to have other people with them. Their frantic efforts to avoid abandonment may include impulsive actions such as self mutilation or suicidal behavior.

These individuals have a pattern of unstable and intense relationships. They idealize potential care givers or lovers at the first or second meeting, demand to spend a lot of time together, and share the most intimate details early in a relationship. However, they may switch quickly from idealizing other people to devaluing them, feeling that the other person does not care enough, does not give enough, or is not there enough to meet their own needs and demands. Such shifts often reflect disillusionments with an early caregiver whose nurturing qualities had been idealized and whose abandonment or rejection is expected.

These individuals display impulsivity in two areas that are potentially self damaging. They my gamble and spend money recklessly, binge eat, abuse substances, engage in unsafe sex and drive recklessly.

Repair involves the person’s penchant to experience separations from the therapist. Since the therapist is a neutral person, it is easier to see the distortion of seeing the therapist as uncaring. This is better than focusing on the spouse or parents Separation can then be viewed more benignly. Since the therapist is a representative of society, this more benign view of separations is extended to others in the person’s life.

A person who has difficulty being weaned has experienced more gratification than a person who has difficulty being bonded. They have had some experience of a gratifying childhood to be able to be angry at the absence of gratification.

People who have difficulty being bonded: The schizoid personality.

There is a pervasive pattern of detachment from social relationships and a restrictive of expression of emotions in interpersonal situations. There seems to be a lack of desire of intimacy, they seem indifferent to developing close relationships, and do not seem to derive satisfaction from being part of a family or social group. They prefer to spending time alone, rather than being with other people. They often appear to be socially isolated or loners and almost always choose isolated activities or hobbies that do not include interaction with others They prefer mechanical or abstract tasks, such as computers or mathematical games. They have very little interest in having sexual experiences with another person and take pleasure in few if any activities. They claim that they rarely experience strong emotions such as anger or joy and appear cold and aloof.
Individuals complain of being cut off, out of touch, or of the point having gone out of life. People may call it depression, but it lacks the heavy, black, inner sense of brooding, of anger and of guilt, which are present in depression. Depression is more related to people. The person compelled to withdraw has renounced his relationships to people, even though he needs them.

External relationships have been emptied by a massive withdrawal of the pleasure seeking self. Effective mental activity has disappeared into an inner hidden world; the conscious mind is emptied of vital feeling and action; it seems unreal. Intense mental activity is apparent in dreams, but the person reports it like a detached observer.

The person describes depression. I’m very depressed. I’ve been just sitting and couldn’t get out of the chair. There seemed no purpose anywhere, the future bland. I’m very bored and want a big change. I feel hopeless, resigned, no way out, stuck. I just want to manage somehow to get around and put up with it.

The reason the person is compelled to withdraw and cannot be in or out of a relationship is because he has not out grown a particular kind of dependence on people: being close to another person means becoming just like the other person. Being close can feel like being swallowed up by the other and losing one’s sense of self. This compels the person to withdraw. Repair comes form examining the fears of dependency on the therapist. Sufficient bonding to the therapist strengthens the person, gives them a stronger sense of self, and facilitates feeling safer to have an intimate relationship.

Borderline Psychodynamics and Treatment

The following description applies to those borderline people who are struggling with being weaned. They have difficulty with separations, which they experience as rejection. Prior deprivation contributes to them feeling rage over prior frustrated dependency needs.

The infant has only the mother to depend upon. If the mother is not emotionally responsive, the infant sees her as a bad mother. The infant has to split this off into a parallel universe, because mother is all the infant has. He needs to maintain the image of mother as a good mother to feel secure and protected. Many disappointments contribute to an accumulation of bad mother experiences. Disappointments in later life bring all the disappointing experiences of mother that have been split off flooding back and the person becomes profoundly disillusioned with the other. He is compelled to then look for a more perfect other so as to keep the hope of finding love alive. A very unstable social life is the result. Disillusionment occurs if the beloved is less than perfect and his penchant for disillusionment interferes with his working with the beloved to correct the imperfection. The beloved is devalued and discarded. The process is called splitting and is characteristic of borderline personalities who have difficulty being weaned.

The movie “Fatal Attraction” illustrates this pattern. Glen Close and Michael Douglas meet in a bar. She is seductive, compliant and charming. He is debonair and flirtatious. They decide to go to bed together and have a wonderful time. When he wakes up in the morning, he said that was great, but I won’t be seeing you again because I’m married. She flies into a homicidal rage and proceeds to try to kill his wife and children. I can see how Glen Close might have been a bit miffed that he didn’t disclose to her to begin with that he was married. However, if there had been enough love in her to go to bed with him, you would think that would have tempered the hate. All the disappointing experiences she had with her mother came flooding back and Michael Douglass became the Devil incarnate. This is how splitting works.

The movie “It’s as good as it gets” is another love story. Jack Nicholson dines at a restaurant where Helen Hunt is a waitress. His severe obsessive compulsive symptoms alienate several of the other patrons of the restaurant. Jack Nicholson becomes infatuated with Helen Hunt and pursues her. She is put off by his obsessive compulsive behavior, but recognizes that he has some endearing qualities. She consults her mother about her dilemma and her mother says, “Honey, maybe this is as good as it gets”. The implication is that everybody has good and bad qualities, no one is perfect, and if one is to have a relationship one has to work on the imperfections to make the relationship better. Perhaps Helen Hunt could do this because she was less frustrated in her dependency needs as a child. Perhaps, Glen Close suffered more deprivation of her dependency needs as a child and therefore responded in a way that is typically borderline.

Bulimarexia is an example of a borderline personality that has difficult being weaned. Bulimarexia: demonstrates a pathological self sufficiency. This woman is humiliated at the idea of needing anything from anyone. Her rejection of food and obsession with thinness is in part an expression of this. She has to do everything for herself — Dr. Jeckel.

Mr. Hyde comes out during the binge. —-Intense needs to be loved is expressed largely in her turning to food. These needs are felt to be compelling and she consumes vast quantities of food.

After binge, she feels remorse over having over eaten. She returns to a focus on food and weight rather than on her need to be loved. Her need to be loved is split off and denied, although Dr. Jeckel still has some dim memory of the ego state, it is not integrated. She returns to a state of pathological self sufficiency where she is not dependent on anyone and unaware of any need to be loved. There is vertical split. —–fully conscious and then forgotten verses repression: a horizontal split where the memory is forgotten and no longer intrudes into consciousness.

Treatment involves uncovering the split off needs to be loved as they express themselves toward the therapist and interpreting the readiness to become disillusioned when gratification is not immediate or perfect. One works in the present as the needs are expressed in the transference and only go to the past when the patient does.

Jane primarily longed for dependency. She presented her longings as sexual – pining away for romantic love- What she really longed for was milk and cookies- dependency- but had difficulty admitting this because it would require her to trust the giver. Acknowledging sexual needs also were too threatening because submission to desire threatened being engulfed by the other. There was not a sufficient sense of self in Jane to allow her to be in a relationship, know her own separate needs and feel comfortable asserting them. Consequently, the surrender stimulated by sexual desire was too threatening. She feared that she would be smothered, engulfed by the other and lose all sense of her own personality. Intimacy stimulate claustrophobic anxiety.

She had enough positive experience to have a mind. She complained about friend A to B and about friend B to A, but she “forgot” about complaints to friend B when she was with her and affected a compliant, clinging posture. Similarly, she complained about me to the hospital staff, but not to me and the hospital staff would become alarmed that Jane was getting bad treatment. She did not want me to talk to the hospital staff. She “couldn’t trust me” if I did. She also didn’t want the manager, a psychiatrist colleague to talk to them either, but she was persuaded to allow that. He diffused the potential disruptive effects of her splitting and the effect of all of her complaints about me had on the hospital staff. On one level she was frightened I would find out about all the negative things and complaints that she had about me. She was frightened to complain to me directly, because she was frightened that would cause me to withdraw my love. Jane used splitting defensively. She split off her aggression because she feared to express it directly to me would cause the loss of love.

Helping her to acknowledge this, made her less frightened of making demands on me directly and enabled me to help her see the inevitable frustration of these demands more benignly. She could integrate her dependency needs and have the experience of being loved and gratified. She no longer needed to split off her need to be loved and her anger at being rejected.