has your wife or gf ever said to u that in the relationships it feels like she is...

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walking on eggshells? and you are confused because you have a safe house, there are no isssues really outstanding, yet she still feels that way. well, maybe it is something serious...

 

Walking on Eggshells: Dealing with the Borderline in Your Life

 

 

Many times, patients or others ask me for a recommendation for a book or help for dealing with an angry, destructive person who is ruining their emotional health. My recomendation for a self-help book when coping with the aftermath of the borderline personality is [COLOR=#5588aa]Stop Walking on Eggshells: Taking Your Life Back When Someone You Care about Has Borderline Personality Disorder.[/COLOR][COLOR=#5588aa][/COLOR] But first of all, what is a borderline and how do know if that is what you are dealing with?

 

Certainly, one cannot diagnose someone without evaluating them, but many times, the descriptions people give me of their significant other, parent, child, or friend leads me to wonder if the advice seeker is dealing with a borderline. The DSM-IV describes the symptoms of [COLOR=#5588aa]Borderline Personality Disorder [/COLOR]as:

 

1. frantic efforts to avoid real or imagined abandonment. (not including suicidal or self-mutilating behavior covered in Criterion 5)

 

2. a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

 

3. identity disturbance: markedly and persistently unstable self-image or sense of self.

 

4. impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating; [not including] suicidal or self-mutilating behavior covered in Criterion 5).

 

5. recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

 

6. affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

 

7. chronic feelings of emptiness.

 

8.inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).

 

9. transient, stress-related paranoid ideation or severe dissociative symptoms.

 

There are even [COLOR=#5588aa]books on how to divorce a Borderline or Narcissistic Personality [/COLOR]that give strategies to reduce the damage done to a person during the process. In a book entitled, "Splitting," one section looks at how a borderline can convince your own lawyer that they are right and turn the lawyer against you--I believe it and have seen it happen. I have worked in places where people believe that a borderline must be right because they are "intelligent." Intelligence and craziness are not separate traits--sometimes, someone who is intelligent can be even more emotionally damaging because they are smart enough to carry out manipulations that others can only dream about. So what do you do when encountering the borderline in your life?

 

Here are some tips from "Stop Walking on Eggshells" (page 140) with some of my own advice thrown in--for brevity's sake, I will list just a few, but if you want more detail-- [COLOR=#5588aa]get the book[/COLOR][COLOR=#5588aa][/COLOR] or go to [COLOR=#5588aa]BPD Central.[/COLOR]

 

1) Stop "sponging" and start "mirroring"--that is, some of those involved with borderlines tend to soak up the borderline's pain and rage and think this is helpful, but in reality, it is like filling up a black hole of emptiness and nothing is good enough. You can try to placate the borderline and work hard to give them love, care etc. but it is never enough. Instead--reflect the painful feelings of the borderline back where they belong--with the borderline.

 

2) Stay focused and observe your limits. Show by your actions that you have the bottom line. Communicate the limits clearly and act on them consistently. Protect yourself and your children by removing them and yourself from the situation. For example, if a borderline flies into a rage and starts accusing you of things you did not do, tell him or her that you will be taking the kids out until they calm down and you can talk later.

 

3) Ask the borderline for change. Figure out your personal limits (get help from a therapist if needed) and communicate these to the borderline in a clear manner. However, ask for changes in behavior, not necessarily for changes in feelings--that is, you can ask them to change the behavior of yelling at you, but don't tell them not to be angry.

 

Finally, the best advice for those who are not yet involved legally with a borderline is a statement I heard from a colleague recently, "Borderlines make great girlfriends (or boyfriends) but you wouldn't want to marry one."

 

That, I think, sums it up in a nutshell--no offense, but the damage I have seen on victims of those who have borderline personality is not something to be taken lightly. People say that those with BPD can change but often times, they wreck havoc on their spouses, children and/or parents and the abuse lasts a lifetime. Children of those with BPD have trouble in future relationships by seeking out the love of the BPD that they could never get or by avoiding people in the future for fear of more emotional blackmail. Spouses of the BPD seem devastated and often end up with lives of quiet desperation or in the throes of accusations in court and parents end up believing that they are inadequate and incompetent. None of it sounds promising.

 

Have any readers been involved with a borderline personality disorder--either married to one, or have a parent, child or friend with this disorder-and if so, how did you cope?

 

Update: Some readers have emailed or asked for more information on a promising treatment for BPD called Dialectical Behavioral Therapy (DBT). Take a look at [COLOR=#5588aa]Behavioraltech.com [/COLOR]for answers about DBT.

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[COLOR=#008400]Borderline Personality Disorder diagnostic criteria[/COLOR]:

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

2. a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

3. identity disturbance: markedly and persistently unstable self-image or sense of self.

4. impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

5. recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

6. affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).

7. chronic feelings of emptiness

8. inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

9. transient, stress-related paranoid ideation or severe dissociative symptoms

The DSM IV goes on to say:

The essential feature of Borderline Personality Disorder is a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity that begins by early adulthood and is present in a variety of contexts.

Individuals with Borderline Personality Disorder make frantic efforts to avoid real or imagined abandonment (Criterion 1). The perception of impending separation or rejection, or the loss of external structure, can lead to profound changes in self-image, affect, cognition, and behavior. These individuals are very sensitive to environmental circumstances. 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. sudden despair in reaction to a clinician’s announcing the end of the hour; panic of fury when someone important to them is just a few minutes late or must cancel an appointment). They may believe that this "abandonment" implies they are "bad." These abandonment fears are related to an intolerance of being alone and a need to have other people with them. Their frantic efforts to avoid abandonment may include impulsive actions such as self-mutilating or suicidal behaviors, which are described separately in Criterion 5.

Individuals with Borderline Personality Disorder have a pattern of unstable and intense relationships (Criterion 2). They may idealize potential caregivers 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, is not "there" enough. These individuals can empathize with and nurture other people, but only with the expectation that the other person will "be there" in return to meet their own needs on demand. These individuals are prone to sudden and dramatic shifts in their view of others, who may alternately be seen as beneficent supports or as cruelly punitive. Such shifts often reflect disillusionment with a caregiver who nurturing qualities had been idealized or whose rejection or abandonment is expected.

There may be an identity disturbance characterized by markedly and persistently unstable self-image or sense of self (Criterion 3). There are sudden and dramatic shifts in self-image, characterized by shifting goals, values, and vocational aspirations. There may be sudden changes in opinions and plans about career, sexual identity, values, and types of friends. These individuals may suddenly change from the role of a needy supplicant for help to a righteous avenger of past mistreatment. Although they usually have a self-image that is based on being bad or evil, individuals with this disorder may at times have feelings that they do not exist at all. Such experiences usually occur in situations in which the individual feels a lack of meaningful relationship, nurturing and support. These individuals may show worse performance in unstructured work or school situations.

Individuals with this disorder display impulsivity in at least two areas that are potentially self-damaging (Criterion 4). They may gamble, spend money irresponsibly, binge eat, abuse substances, engage in unsafe sex, or drive recklessly. Individuals with Borderline Personality Disorder display recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior (Criterion 5). Completed suicide occurs in 8%-10% of such individuals, and self-mutilative acts (e.g., cutting or burning) and suicide threats and attempts are very common. Recurrent suicidality is often the reason that these individuals present for help. These self-destructive acts are usually precipitated by threats of separation or rejection or by expectations that they assume increased responsibility. Self-mutilation may occur during dissociative experiences and often brings relief by reaffirming the ability to feel or by expiating the individual’s sense of being evil.

Individuals with Borderline Personality Disorder may display affective instability that is due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days) (Criterion 6). The basic dysphoric mood of those with Borderline Personality Disorder is often disrupted by periods of anger, panic, or despair and is rarely relieved by periods of well-being or satisfaction. These episodes may reflect the individual’s extreme reactivity troubled by chronic feelings of emptiness (Criterion 7). Easily bored, they may constantly seek something to do. Individuals with Borderline Personality Disorder frequently express inappropriate, intense anger or have difficulty controlling their anger (Criterion 8). They may display extreme sarcasm, enduring bitterness, or verbal outbursts. The anger is often elicited when a caregiver or lover is seen as neglectful, withholding, uncaring, or abandoning. Such expressions of anger are often followed by shame and guilt and contribute to the feeling they have of being evil. During periods of extreme stress, transient paranoid ideation or dissociative symptoms (e.g., depersonalization) may occur (Criterion 9), but these are generally of insufficient severity or duration to warrant an additional diagnosis. These episodes occur most frequently in response to a real or imagined abandonment. Symptoms tend to be transient, lasting minutes or hours. The real or perceived return of the caregiver’s nurturance may result in a remission of symptoms.