Borderline Personality Disorder

Indicators of BPD - from BPD Central

• Is someone you care about causing you a great deal of pain?
• Do you find yourself concealing what you think or feel because you're afraid of the other person's reaction or because it just doesn't seem worth the horrible fight or hurt feelings that will follow?
• Do you feel that anything you say or do will be twisted and used against you? Are you blamed and criticized for everything wrong in the relationship - even when it makes no logical sense?
• Are you the focus of intense, violent, and irrational rages, alternating with periods when the other person acts perfectly normal and loving? Does no one believe you when you explain that this is going on?
• Do you feel manipulated, controlled, or even lied to sometimes? Do you feel like you're the victim of emotional blackmail?
• Do you feel like the person you care about sees you as either all good or all bad, with nothing in between? Is there sometimes no rational reason for the switch?
• Are you afraid to ask for things in the relationship because you will be told that you're too demanding or that there is something wrong with you? Are you told that your needs are not important?
• Is the person always denigrating or denying your point of view? Do you feel that their expectations of you are constantly changing, so you can never do anything right?
• Are you accused of doing things you never did and saying things you never said? Do you feel misunderstood a great deal of the time, and when you try to explain do you find that the other person doesn't believe you?
• Are you constantly being put down? When you try to leave the relationship does the other person try to prevent you from leaving in a variety of ways (anything from declarations of love and promises to change to implicit or explicit threats)?
• Do you have a hard time planning anything (social engagements, etc.) because of the other person's moodiness, impulsiveness, or unpredictability? Do you make excuses for their behavior or try to convince yourself that everything is okay?

Right now, are you thinking,  "I had no idea that anyone else was going through this."

Does this person:

• Alternate between seeing people as either flawless or evil?
• Have difficulty remembering the good things about a person they're casting in the role of villain?
• Find it impossible to recall anything negative about this person when they become the hero?
• Alternate between seeing others as completely for them or against them?
• Alternate between seeing situations as either disastrous or ideal?
• Alternate between seeing themselves as either worthless or flawless?
• Have a hard time recalling someone's love for them when they're not around?
• Believe that others are either completely right or totally wrong?
• Change their opinions depending upon who they're with?
• Alternate between idealizing people and devaluing them?
• Remember situations very differently than other people, or find themselves unable to recall them at all?
• Believe that others are responsible for their actions-or take too much responsibility for the actions of others?
• Seem unwilling to admit to a mistake-or feel that everything that they do is a mistake?
• Base their beliefs on feelings rather than facts?
• Not realize the effects of their behavior on others?

Does this person:

• Have trouble observing others' personal limits?
• Have trouble defining their own personal limits?
• Act impulsively in ways that are potentially self-damaging, such as spending too much, engaging in dangerous sex, fighting, gambling, abusing drugs or alcohol, reckless driving, shoplifting, or disordered eating?
• Mutilate themselves-for example, purposely cutting or burning their skin?
• Threaten to kill themselves-or make actual suicide attempts?
• Rush into relationships based on idealized fantasies of what they would like the other person or the relationship to be?
• Change their expectations in such a way that the other person feels they can never do anything right?
• Have frightening, unpredictable rages that make no logical sense-or have trouble expressing anger at all?
• Physically abuse others, such as slapping, kicking, and scratching them?
• Needlessly create crises or live a chaotic lifestyle?
• Act inconsistently or unpredictably?
• Alternately want to be close to others, then distance themselves?  [ Examples include picking fights when things are going well or alternately ending relationships and then trying to get back together. ]
• Cut people out of their life over issues that seem trivial or overblown?
• Act competent and controlled in some situations but extremely out of control in others?
• Verbally abuse others, criticizing and blaming them to the point where it feels brutal?
• Act verbally abusive toward people they know very well, while putting on a charming front for others?
• Can they switch from one mode to the other in seconds?
• Act in what seems like extreme or controlling ways to get their own needs met?
• Do or say something inappropriate to focus the attention on them when they feel ignored?
• Accuse others of doing things they did not do, having feelings they do not feel, or believing things they do not believe?

People with BPD may have other attributes that are not part of the DSM definition but that researchers believe are common to the disorder. Many of these may be related to sexual or physical abuse if the BP has experienced abuse earlier in life.

Pervasive Shame:  The all-pervasive sense that I am flawed and defective as a human being. It is no longer an emotion that signals our limits; it is a state of being, a core identity. Toxic shame gives you a sense of worthlessness, the feeling of being isolated, empty, and alone in a complete sense. Non-BPs share this characteristic.

Undefined Boundaries:  People with BPD have difficulty with personal limits-both their own and those of others. Non-BPs share this characteristic.

Control Issues:  Borderlines may need to feel in control of other people because they feel so out of control with themselves. In addition, they may be trying to make their own world more predictable and manageable. People with BPD may unconsciously try to control others by putting them in no-win situations, creating chaos that no one else can figure out, or accusing others of trying to control them.

Conversely, some people with BPD may cope with feeling out of control by giving up their own power; for example, they may choose a lifestyle where all choices are made for them, such as the military or a cult, or they may align themselves with abusive people who try to control them through fear. Non-BPs share this characteristic.

Lack of Object Constancy:  When we're lonely, most of us can soothe ourselves by remembering the love that others have for us. This is very comforting even if these people are far away-sometimes, even if they're no longer living. This ability is known as object constancy.

Some people with BPD, however, find it difficult to evoke an image of a loved one to soothe them when they feel upset or anxious. If that person is not physically present, they don't exist on an emotional level. The BP may call you frequently just to make sure you're still there and still care about them. [One non-BP told us that every time her boyfriend called her at work, he introduced himself using both his first and last name.]

Interpersonal Sensitivity:  Many individuals have noticed that some people with BPD have an amazing ability to read people and uncover their triggers and vulnerabilities. One clinician jokingly called people with BPD psychic.

Situational Competence:  Some people with BPD are competent and in control in some situations. For example, many perform very well at work and are high achievers. Many are very intelligent, creative, and artistic. This can be very confusing for family members who don't understand why the person can act so assuredly in one situation and fall apart in another.

Narcissistic Demands:  Some people with BPD frequently bring the focus of attention back to themselves. They may react to most things based solely on how it affects them.

Feelings Create Facts:

In general, emotionally healthy people base their feelings on facts. If your dad came home drunk every night (fact) you might feel worried or concerned (feeling). If your boss complimented you on a big project (fact) you would feel proud and happy (feeling).

People with BPD, however, may do the opposite. When their feelings don't fit the facts, they may unconsciously revise the facts to fit their feelings. This may be one reason why their perception of events is so different from yours.

Splitting: I Hate You - Don't Leave Me

People with BPD may have a hard time seeing gray areas. To them, people and situations are all black or white, wonderful or evil. This process of splitting serves as another defense mechanism. Peter, who has BPD, explains: "Dividing the world into good or evil makes it easier to understand. When I feel evil, that explains why I am the way I am. When you are evil, that explains why I think bad things about you."

Tag, You're It: A Game of Projection

Some people with BPD who act out may use a more complicated type of defense mechanism - we've named it "Tag, You're It"- to relieve their anxiety, pain, and feelings of shame. It's more complex because it combines shame, splitting, denial, and projection.

People with BPD usually lack a clear sense of who they are, and feel empty and inherently defective. Others seem to run away from them, which is lonely and excruciatingly painful. So borderlines cope by trying to "tag" or "put" these feelings onto someone else. This is called projection.

Projection is denying one's own unpleasant traits, behaviors, or feelings by attributing them (often in an accusing way) to someone else. In our interview with Elyce M. Benham, M.S., she explained that projection is like gazing at yourself in a hand-held mirror. When you think you look ugly, you turn the mirror around. Voila! Now the homely face in the mirror belongs to somebody else.

Sometimes the projection is an exaggeration of something that has a basis in reality. For example, the borderline may accuse you of "hating" them when you just feel irritated. Sometimes the projection may come entirely from their imagination: for example, they accuse you of flirting with a salesclerk when you were just asking for directions to the shoe department.

The BP's unconscious hope is that by projecting this unpleasant stuff onto another person-by tagging someone else and making them "it" like a game of Tag - the person with BPD will feel better about themselves. And they do feel better, for a little while. But the pain comes back. So the game is played again and again.

Projection also has another purpose: your loved one unconsciously fears that if you find out they're not perfect, you will abandon them. Like in the Wizard of Oz, they live in constant terror that you'll discover the person behind the curtain. Projecting the negative traits and feelings onto you is a way to keep the curtain closed and redirect your attention on the perfect image they've tried to create for themselves.

How can people with BPD deny that they are projecting when it is so obvious to everyone else? The answer is that shame and splitting may combine with projection and denial to make the "Tag, You're It" defense mechanism a more powerful way of denying ownership of unpleasant thoughts and feelings.

Some adults who enter into relationships with borderlines feel brainwashed by the BP's accusations and criticisms. Says Benham: "The techniques of brainwashing are simple: isolate the victim, expose them to inconsistent messages, mix with sleep deprivation, add some form of abuse, get the person to doubt what they know and feel, keep them on their toes, wear them down, and stir well."

Everything Is Your Fault:

Continual blame and criticism is another defense mechanism that some people with BPD who act out use as a survival tool. The criticism may be based on a real issue that the person with BPD has exaggerated, or it may be a pure fantasy on the borderline's part.

Family members we interviewed have been raged at and castigated for such things as carrying a grocery bag the wrong way, having bed sheets that weighed too heavily on the BP's toes, and reading a book the BP demanded they read.

One exasperated non-BP said that if by some chance he didn't make an unforgivable error one day, his wife would probably rage at him for being too perfect.

If you object to the criticism or try to defend yourself, your loved one may accuse you of being defensive, too sensitive, or unable to accept constructive criticism. Since their very survival seems to be at stake, they may defend themselves with the ferociousness of a mother bear protecting her cubs. When the crisis has passed and the person with BPD seems to have won, they may act surprised that you're still upset.

• What does BPD stand for?

  BPD stands for "Borderline Personality Disorder."

  
• Is BPD common?

  More than six million people in the USA have a BPD disorder, and these people greatly affect the lives of at least 30 million others.

• Why is BPD a problem?

  BPD can lead to suffering for both the BP and those whose lives they affect [non-BPs, or simply "nons."] BPD is linked to high conflict; divorce; suicide; substance abuse; child abuse; physical, sexual, and emotional abuse; eating disorders; estrangement from family members; and much more.

• I need some support for what I'm going through?   No one understands.

  The people in cyberspace understand. They've all been through it. Many have had experiences very similar to yours. Join one of the cyberspace mailing lists [they're like online support groups], you'll get support from people who care. There are separate groups for people with borderline partners, children, and parents. There are also groups for people WITH BPD.

• Is there hope for people with BPD?   Can they recover?  

  Yes. The Stone New York State Psychiatric Institute did an outcome study of 206 BPD clients admitted between 1963 and 1976 who spent three months or more in inpatient unit. Follow-up study showed:

  • Two-thirds of sample patients now in their 30s and 40s were rated as "good" or "recovered" on the Global Assessment Scale, a tool used by clinicians.
  • In this and other studies, "good" outcomes were related to the following: "likableness, candor, perseverance, talent and attractiveness, high IQ, and obsessive traits." [We didn't come up with this...we're just reporting it.]
  • Poorer outcomes were related to the following: "more [on the 'BPD' scale] anger and moodiness, continued substance abuse, sociopathy [innate 'meanness'], history of parental physical abuse and incest."
  • About 9% of BPD patients kill themselves.
  • BPD patients can get better, but it's slow. Every single recovered BP I have talked to had these things in common: Helpful, but not 100% prevalent, was:
  • Significant others who were supportive and caring and enforced boundaries and made it clear which behavior they would not tolerate. Often, this provided the BP with the motivation to get better. This is not a formal study. It is only from anecdotal experience.
• What can I do to make the BP in my life seek treatment?

  Think about something that is very, very difficult for you to do. Lose 25 pounds. Change careers. Overcome poor self esteem. Think about how hard this has been for you to do, even though you may want to do it very much.

  

  Now... imagine that you didn't want these things. What are the chances that you would lose the weight, get a new job, and buy a book on self-esteem? Pretty low.

  Recovery from BPD is a hard thing to do. For the borderline (BP) it may involve facing horrible childhood abuse or deep-rooted feelings of shame. People with BPD feel stigmatized. The only way through it is to want it very, very badly.

  You cannot make someone want this, any more than someone can make you want to change yourself. It has to come from within.

• I'm concerned about my children and the effects of my spouse's behavior on them. What should I do?

  This is a very serious issue that is discussed in a chapter of Stop Walking on Eggshells (1-888-357-4355 or 1-800-431-1579). Here are some hints:

  • Join a non-BP list with active topics of discussion.
  • If the BP is acting abusive, remove your children from the situation temporarily. Take them out for a walk or ice cream. If your BP is consistently abusive to your children, determine your legal rights, especially if you are a man.
  • Be a consistent oasis for your kids. Follow through. Do what you say you will.
  • Tell your children that no one has the right to abuse them. Try to help them understand that mom or dad's behavior is not about them. Tell them this every time you see them being abused.
  • Become involved in your children's life. Nothing is more important. Have fun with them. Create good memories. Listen to them. Respect their feelings. Take them seriously. Believe them.
  • Do not make excuses for abusive behavior. Do not tell yourself things like, "The kids will probably turn out OK, they'll just learn some hard lessons early in life." Do not excuse the borderline for their abusive behavior just because they have BPD.
  • Don't throw up your hands because tackling this problem makes you uncomfortable. Fight for your children's mental health. Ask yourself, "What would I do if a stranger was acting this way toward my child?" Then, do what needs to be done as long as it is within your legal right.
  • Stop taking the borderline's actions personally. Rage, screaming, verbal abuse, self-mutilation, blame, criticism, and all the other things that make life difficult are not about you at all. It's part of the BPD.
  • Do some good things for yourself and your body. Have some fun. Take a walk. Stop drinking or abusing drugs, if you are.
  • Join a non-BP list.
  • Learn all you can about BPD.
  • Learn to take care of yourself.
• My therapist doesn't seem to know very much about BPD.   What should I do?

  Your therapist is very typical. If you read the entire BPD Central site, you may know more about BPD than the average therapist. In addition, your therapist may suspect BPD, but not have mentioned it.

  The reasons for this are complex. For right now, trust your instincts. If your therapist doesn't seem to be helping, listen to your feelings. Learn all you can about BPD and interview potential therapists.

Life-Saving Links:

• BPD Central
• Facing the Facts - When a loved one has Borderline Personality

[ "Understanding Abuse and Borderline Personality Disorder" reproduced from www.bpdcentral.com Thank you for making this information available ]

Excerpt: The information in this book reflects the best of three types of research:an exhaustive, three-year survey of the latest scientific studies related to borderline personality disorder (BPD), interviews with more than two dozen top mental health clinicians and researchers, and the collective experiences of thousands of people affected in one way or another by BPD.

All these individuals are members of the Welcome to Oz Online Family Community located at bpdcentral.com or the Facing the Facts message board at www.bpdfamily.com

  Download: The Essential Family Guide To Borderline Personality Disorder