At The Borderline …
All beginnings are lovely – or so the sage proclaims. Relationships per se are difficult. Two individuals come together – attraction, lust, love, personality styles, personal and family histories, attachment, and lifestyles collide – and there you are in the middle of a daring, challenging, and steamy relationship. If this ship becomes a timeless elegant regatta or a wrack is heavily determined by the personality styles of the involved partners’. Remember we all have personality traits, which does not make us personality disordered.
Notoriously famous personality disorders discussed in films, courts, and domestic disputes are all part of the dramatic-erratic cluster: The Narcissist, The Antisocial, The Individual with Borderline Personality Disorder (BPD) or a combination of two: Antisocial Narcissistic and/or Borderline Narcissistic. The film Fatal Attraction (quite an excellent performance by Glenn Close) and the recent court case of Jodi Arias come to mind. What do all the films and print stories have in common? A bad ending! Dating a person with BPD is not part of your deal – or so you thought.
Jodi Arias – in my opinion, – a good example of a woman with quiet BPD (she functions superficially well but her chameleon-like façade breaks open once her relational views are challenged) murdered her ex-boyfriend Travis Alexander; Glenn Close in Fatal Attraction attempted to murder her former lover but failed and found her own death. Most real-life relationships with a partner who has BPD are not deadly. Nevertheless the healthy mate wonders, “Why are we on these constant roller coaster rides?” Sooner rather than later he starts to resent walking on eggshells around his lover. I use the pronoun his because more women are diagnosed with BPD; men instead earn the label antisocial much easier.
Interesting enough, it is frequently the healthier mate seeking therapy to relieve himself from the immense relational pressures. The repertoire generally includes parasuicidal gestures – none life-threatening surface wrist, ankle and upper thigh cutting – or suicide threats that scare a person who never dealt with somebody who is unable to regulate her emotions. These behaviors are sometimes perceived as manipulative: To get attention and one’s needs met – “I need you here; you can’t leave; I show you why.”
Scared and emotionally drained partners generally seek advice on how to get out; others are still confused about their partner’s behavior. They wonder, “I know it’s wrong. What happened to her? How can I fix it.” Well the answer is easy, “You can’t fix it!”
When the partner with BPD travels the roller-coaster of emotions (it’s a habit and due to the lack of coping skills not because it feels good) the healthier partner feels overwhelmed and describes his situation as being “stuck between a rock and a hard place;” feeling bad and responsible hence unable to leave her, he states his partner gets “incredibly angry and sometimes physically and verbally abusive.” What follows is a pattern of submissive, self-loathing behaviors. “One day I’m her king the next moment I am no good. There is simply no consistency.”
My view: “Nice summary – exactly! What you see is what you get!”
An individual with BPD has a frantic fear of abandonment – which doesn’t help the relationship. Her heightened sense of emotions and difficulty to soothe herself leads to major drama even when a partner is willing to stay and work with her to overcome the challenges. Many individuals with BPD have a history of brief and intensive relationships that ended prematurely and badly. Imagine why? Quite often the healthy partner leaves (or runs); he can’t deal with the emotional outbursts and relational roller coaster. Often the individual with BPD threatens self-harm or cuts to release tension. She will relentlessly reach out and obsessively try to reestablish the broken bond if the healthy mate decides to break up with her.
I always ask my clients “What’s your partner’s most valuable asset – other than her portfolio?” The correct answer is “consistency” – and consistent is what people with a history of BPD are not. They are very impulsive; volatile moods and angry outbursts are the norm; deficits in social perception and social skills become even more apparent when disappointments occur. Plus co-occurring disorders such as substance and eating disturbances, reckless spending and mood disorders add to the emotional burden. It’s overboard across the map: When it’s good it’s great – but when it’s bad it’s really bad. There is no middle ground when standing at the borderline.
The individual with BPD does not have an inner center; she does not know who she is. She tries to gauge her self-image at any given situation by interpreting the expressions of others (kind of the blind leading the blind giving her over-sensibility). Basically, she is like a feather in the wind. Hopefully, this evokes some compassion – imagine how scary when you are just drifting at the mercy of what you believe others may do or think. As Marsha Linehan (1993), one of the foremost researchers in the treatment of BPD proclaims in her book Cognitive-Behavioral Treatment of Borderline Personality Disorder over 70% of patients with BPD present with histories of childhood sexual abuse. Even when this is not the case, the pairing of a child with a difficult temperament (a child that is fussy and easily excitable by nature and difficult to soothe) paired with unreceptive, stressed out, or normative parents contributes towards the maintenance and further development of a difficult personality; lashing out, suicidal gestures, and self-depreciation become the hallmark of the individual with BPD.
Constant feelings of emptiness prompt her to seek stimulation from the outside. The partner becomes the main outlet for her entertainment, self-respect, or self-loathing – an overwhelming job to handle! Remember you cannot make somebody happy – happiness is an inside job! This contributes to the feeling of being emotionally drained in a partnership. But love endures and can cure anything, correct? Well, no, not really!
Is there hope for change?
My German grandmother used to say, “ Hope is the last to die.” Yes, certainly there is always hope yet – baseline behavior aka normalcy as you and experience it is a long hike away for people with BPD.
The good news is that once in our thirties our energy level decreases naturally and hence even individuals with BPD will have less vigor at their disposal. What’s the major challenge of BPD: It comes seldom alone! Substance and eating disturbances co-occur and mood disorders such as Unipolar Depression and Bipolar disorder generally require a combined treatment consisting of a medication regime and therapy.
Linehan (1993) developed a treatment approach for BPD called Dialectical Behavior Therapy (DBT). It’s a combination of Eastern Mindfulness Training and Western Cognitive Behavior Therapy. It’s an intensive program consisting of both group sessions for skills training and individual therapy with focus on validation and change of thought patterns.
Does treatment work?
Treatment can only work when your partner
a) Is ready for treatment – not to please you but because life has become unmanageable;
b) Commits to a consistent 12-months treatment program consisting of individual and group therapy;
c) Commits to working on homework assignments to transfer what she learns in therapy to real life;
d) Agrees to life affirming actions in form of working on the difficulties rather than continuing down the path of self-destruction;
Yes, you heard right – it’s not you who has to be ready – it’s her!
Remember therapy is generally more about unlearning old behaviors than learning new ones but for the treatment of BPD you really have to unlearn and reprogram – which is challenging to say the least.
The patient learns:
a) Emotion- regulation – how to deal with emotions without using drastic measures like cutting to decrease or avoid feelings;
b) Social skills – how to react and deal in a civil fashion with the partner and her surroundings;
c) Mindfulness – how to be in the moment without getting lost in a ‘constant head trip’ that leads into the past or future;
d) Distress Tolerance – how to increase tolerance for uncomfortable feelings and situations.
To say the least it is a challenge for both, the person in therapy and the partner who hopes for a quick change. It’s not easy to make a relationship work over the long run because it needs maintenance and most people ignore this fact. Imagine you never give your car a wash or oil change – here we go!
The degree of maintenance work and difficulty increases when one of the partners has BPD especially in combination with a mood, substance, or eating disturbance.
Remember it’s easy to end up in a relationship but it is very difficult to leave it! And it will be more difficult to end a relationship with an individual who has BPD. Why? Their frantic fear of abandonment and furious outbursts don’t accept the end of a relationship without major attempts to maintain contact or reinitiated the romantic-erotic part of the relationship. If the attempts to reestablish rapport fail you’ll receive angry messages and threats of self-harm. Guilt, blame, and I should hang on are the major reasons for staying – also fear of the partner’s expressions of self-harm in form of cutting or suicide threat.
The roller coaster may even be exiting to the healthier mate of the duo – at times. Never a dull moment – often Adult Children Of Alcoholics and people who grew up in unstable households find familiarity in inconsistency and feel their role is to be the savior.
What to expect if you stay?
Relational challenges require a lifetime approach if you date somebody with BPD. It helps to implement a quiet and structured lifestyle. If you travel a lot for work or your work schedule is inconsistent it’s harder on yourself, your partner with BPD, and your relationship.
Demands on you will remain higher throughout the relationship compared to dating a non-afflicted partner. If you feel overwhelmed, I strongly recommend you seek assistance in form of counseling from a therapist who may even specialize in the treatment of BPD. Why? He or she will understand your struggles more intimately and can give you a pretty accurate overview of what to expect. Then you can make an informed decision. Joying a support group is helpful if you decide to stay.
Keep your intentions in mind – is this a serious relationship for you? Know the challenges that will come up. If it’s not that serious – don’t pursue it. Why? Because your partner will feel more let down if you stay on and then eventually leave or disappear– it repeats a pattern for her; remember she wants desperately a committed relationship yet appears to do anything to sabotage it. If your partner with BPD has family support it’s a bit easier on you in terms of requirements – yet remember you will be the main target of anger and out of control emotions and expected to deal with them. You will also be the premiere outlet to practice newly learned social skills.
A final thought: If you are somebody who constantly finds a partner who is a fixer-upper chance is that you have your own attachment and relational issues that need mending. There is a reason why you always end up with people who need you to take care of them. Hence why not address your own issues first and the decision process of “Shall I leave or shall I stay” will take care of itself.
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Dr. Daniela E. Schreier, Psy.D, ABPP is a Board-Certified Clinical Psychologist. She is also trained in forensic and multicultural psychology. S.M.AR.T. Living LLC, Dr. Daniela’s Private Practice in Chicago focuses on relationship and life coaching. Dr. Daniela is a speaker, lecturer, and clinical and forensic media expert, and commentator. Connect with Dr. Daniela: Twitter/Facebook @doctordaniela or facebook @doctordfanpage