Monday, July 20, 2015

BORDERLINE PERSONALITY DISORDER - Article 2

A FOLLOW-UP WARNING

By Helen Borel, R.N.,Ph.D.

Borderline personality disorder (BPD) is a life-long psychological illness where the patient has nearly zero sense of self. Such an emotionally erratic individual doesn’t feel self-grounded, feels loose emotionally, and so crosses your psychological space, time and time again, due to trouble recognizing that the You that Is YOU is not the She that is SHE. (Males have this disorder, too.)

In other words, the Borderline Personality IS BOUNDARY-LESS.  In a relationship with others, the borderline exhibits frequent anger and rage both of which are way out of proportion to anything the normal person in the relationship did or said.  A relationship with a borderline is doomed from the outset.  This is because...proven by varied and in-depth neuropsychiatric research...there is volumetric brain loss (decrease in imperative brain elements) and other decrements...and the source of these deficits, relative to causation of the cerebral defects, has not been as yet determined.

Suffice to point out, there’s less brain tissue in Borderlines, compared to normal brains, in the regions that regulate unpleasant emotions. So, the Borderline can’t calm herself down; everything she’s feeling that’s uncomfortable is someone else’s fault. And if you’re her significant other, her rage will routinely be directed at you.

To let you, the normal person in the relationship, down easy: A borderline can’t change this unreasonable, irritating, demanding, relationship-destructive behavior because there’s a glitch in her brain that, so far, no one has come up with a specific medication or a neurosurgical operation nor an eletroshock-type zapping that could alter and improve the Borderline’s incapacity to regulate anger and rage.

“Borderlines” were originally labeled thus because the malignancy of the emotional disruptions in their own lives and those they cause within the emotional lives of their family members and lovers is so severe as to appear to reside on the border between psychotic illnesses like schizophrenia and neurotic illnesses like chronic anxiousness.  Borderlines do, at times, slip into unreality, a feature of insanity.  Caught up in troubled feelings that their brains can’t modulate as normal brains can, they wreak havoc on themselves (sometimes cutting themselves and having to be psychiatrically hospitalized) and are a disaster for the recipient of their rages.

Borderlines don’t tend to benefit from Psychotherapy.  Because they either storm out of sessions
due to some imagined slight, or even a direct compliment can elicit anger.  Baffling behaviors
for professionals to deal with.  Therefore, don’t blame yourself if you find your borderline’s
behavior incomprehensible and unnerving.  And don’t look for any change toward improvement.
Outbursts will continue.  Except you’ll usually be blindsided by them due to their unpredictable
timing and due to the lability of the borderline’s emotional states.

You can’t, therefore, rely on a peaceful, predictable relationship of love and acceptance and growth and in-depth understanding. The borderline is all for herself .  In the equation of life, you don’t matter.  It’s “I need to feel better fast or I’ll cause immediate trouble and disruption in others’ lives.”

Contrary to what others in the fields of psychology and psychiatry have said, leaning
toward sympathy for the borderline and her imagined issues and slights, it’s difficult to
sympathize with a person who does nothing but destroy friendships, destroy work
relationships and destroy love relationships...not to mention what destructive outbursts and
calumny they inflict on their own close family members from their childhoods onward.

Also, contrary to many presumed “experts” in psychiatry: I believe (of course due to the abnormalities lately being found in the brains of borderlines from varied neuroscience sources) that not only do the parents of the borderline have nothing to do with creating this emotional “monster,” [similar to the disproven accusatory misnomer by psychiatrists decades ago, blaming the maternal parent for the advent of schizophrenia in her child...mislabeling these beleaguered women “SCHIZOPHRENOGENIC MOTHERS]...
but that, you can be sure THE BORDERLINE CAUSED A GREAT DEAL OF DISRUPTION IN THE FAMILY AND EMOTIONALLY-VICTIMIZED HER PARENTS AND SIBLINGS FROM TODDLERHOOD ONWARD.

Any hypothesis about parental causation in the advent of Borderline Personality Disorder is utterly false!  The child is born with a brain deficit.  The fault, dear Doctor, lies in the faulty brain.  A neurologic condition which will, I believe, one day be treated with a very specific, targeted chemical medicine that may help the brain modulate distressing feelings. Or a neurosurgeon will come up with a way to restore lost brain volume or perform some surgical magic that will mask the emotional dyscontrol deficit.  Or one of our physiologic psychiatric treatments, such as ECT (electroshock) or other cerebral-electrical therapies or something else maybe on the horizon will zap the brain into more normal functioning, more normal capacity to regulate unpleasant feelings.

In the meantime, we don’t have these miraculous chemical cures or lifetime treatments for Borderline Personalities.  So my advice is, steer clear of these troubled types.  They feel better when you attend to THEIR needs.  They become distraught, accusatory, rageful and emotionally destructive to you when you are seeking a balanced relationship.  If you choose to stay in a relationship with such a brain-disordered person, expect periodic chaos, disruption in your peace of mind, inexplicable attacks, yelling and screaming, storming out, begging to come back, promising to act more mature from then on...but NEVER BEING ABLE TO GET BEYOND THESE, SO FAR, UNCHANGEABLE DEFICITS IN THINKING AND BEHAVIORS.

Trying to make peace with a Borderline type is futile.  The negative, painful behavior toward you is guaranteed to repeat itself over and over again.  Listen: If your lover were diagnosed with
Tuberculosis, even if on Isoniazid, it’s a bad idea to kiss and intermingle that person’s saliva with
your own because of the tubercle bacillus.  You want to avoid infection.

I warn you: Nothing you’re going to do will soften the Borderline's ways of dealing with inner feelings they don’t like.  In her mind, whatever occurs that she doesn’t approve of  will always be YOUR FAULT...at which she’ll justify her outlandish rageful words and behaviors.

LISTEN: It’s not only dating and “love” relationships I’m referring to here.  My expertise
arises mostly from patients in my psychotherapy practice who’ve suffered...and are often still suffering
well into their 40s and 50s...from a RAGING BORDERLINE MOTHER.  And so, they tend to
pick their dates and spouses from that familiar pool of screaming manipulative females
whose counterparts still live rent-free in their heads.

When you first meet such an individual, she will tend to get too close too fast.  Be wary.  This is a sign of LACK OF BOUNDARIES, of inability to see you as a separate individual, a being
unto yourself. Do not mistake seeming immediate warmth for maturity and potential for mature love and emotional growth.  Also, never mistake a high intelligence and/or a creative talent for
emotional maturity.  These do not equate!!!  A person can be highly intelligent and may be gifted in some art or other; beware though, the person can still be an emotional infant.  That’s the case with borderlines.  So don’t be fooled.  Be wary too, because this kind of personality is destructive as a parent to the emotional well-being of any children they may give birth to.  Woe unto you if you’re the normal parent in such a family.  You’ll not be able to shield your offspring from the
rages and diatribes of your Borderline spouse. And those children will be forever wounded by
such a defective parent.

Be smart.  There are safer lovers out there for you to choose among.  They’ve a mature view of
themselves and they take full responsibility for their own feelings and don’t play the blame game against you, nor blanket you with frequent destructive rages and dysphoric feelings.  As soon as you realize you’re in a relationship with a Borderline, get out of it.  The longer you put up with the uncontrollable behaviors, the deeper you’ll be hurt, the more distant will be your chances to be open to a real, mature love relationship.

(If you’re asking me, a healthcare and psychiatric professional, why it’s hard to fully empathize with Borderlines, here’s my answer: Because, though I know their brains can’t help it, they wreak such havoc, cause so much pain in others who only mean them well, and destroy what good and what love does come their way, that it feels like an exercise in futility to sympathize with them when I must have empathy for their victims, MY PATIENTS and all the others out there in the world who Borderlines’ misbehaviors harm.)

© Copyright 2015  Dr. Helen Borel.  All rights reserved.

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3 comments:

  1. Another great article, Helen. Thanks for putting it in perspective. Paul

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  2. You neglect Masterson's suggestion that the best treatment for BPD is to have one therapist over time, that can gently confront the patient when they start splitting into all good/all bad thinking. I empathise with BPD because all patients must be given the power to change and grow into maturity and wellness. To say BPD is a brain problem...therefore there is nothing to do but run...is irresponsible, like saying there is nothing we do for the handicapped but marginalize them.

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  3. You are incorrect*, Dr. Waugh. (Sorry for delay in response, been busy with illness, my in-production children's book about the brain, and my psych pts.)

    *I did not invent the what you call the "brain problem". It's recent research that shows some loss of volume in
    brain tissue that relates to modulating anger emotions in Borderline patients. As a physiologic condition, let's analogize it to appendicitis: Until we can rid the body
    of the pathologic part and/or restore something that's missing (anatomic tissue,neurotransmitters)which is somehow related to physiology of the amygdla which handles
    anger(in the normal brain), there's nothing but lifetime
    "support" to be the "therapy" for borderlines. Lacking that anatomic essential (maybe in the future, neurosurgeons will be able to restore some missing tissue in that brain region...or maybe some neurochemist will discover a substance that can be injected into that underdeveloped brain part to restore it to a normal ability to manage and modulate anger, tirades, blaming others for bad feelings, exploding inappropriately at one's children...HOPEFULLY,some day NEUROSCIENTISTS WILL
    FIND THOSE OR OTHER "CURES". In the meantime, as a therapist, I'm dealing with the victims of these rageful
    borderlnes and I must help them overcome their fears, anxieties, career-retardations, love-relationship failures that have resulted from having, for example,a mother who
    acted that way in his/her childhood...and, in all cases is still acting that way toward her adult children. In no way do I wish to "marginalize" any psychotic or borderline patient. Simply, I'm therapizing their victims. And they need to be in group therapy with other borderlines so they can either advise each other (with a professional like yourself helping them)or witness the effects of one of their co-patient's rages on themselves and maybe begin to
    modulate their ineffectual amygdala. I believe it may be possible in some borderlines,whose brains may be mildly affected by amygdalar-tissue-loss to learn how to calm themselves down a bit like normal brains do; however, there is a wide range of borderline brain pathology and those with greater brain defects will probably not be able to do this even with the best group or individual therapy...and that's if they come back to therapy after a few sessions.
    Well, to all readers of this, and to you Dr.Waugh, you can see how passionate I am about protecting all patients from physical and emotional harm. And nor do I harm any borderlines I take care of. Nonetheless, you have to agree that it's imperative to warn others to be alert to such uncontrollable rageful individuals who will end up hurting them if they get involved as friends, co-workers,lovers.
    Enough said, for now. Nor would I, Supreme Empath, ever
    marginalize anyone. If you knew my life history, you'd retract what you said. Thanks, tho', for taking the time to read my ideas and professional conclusions.
    Helen Borel,RN,BA,MFA,PhD

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