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Today I am thankful that I understand what was probably going on with Steve.
One day while driving Steve to a political event, he told me he had a personality disorder label but he refused to tell me which one. At the time, I thought he was joking.
I am now believing that he was diagnosed with something that I never really believed in - Borderline Personality Disorder (BPD). When I was in graduate school, it was considered a basket case diagnosis; it was given to people who walked the border between sanity and insanity and people who didn't fit the diagnostic criteria for anything else. These were people believed to be attention seeking, who either choose to act out, or they were unfortunate enough to have seen an unethical psychiatrist. I actually saw an article this morning written by a psychiatrist where he replaced the term "a person with borderline personality disorder" with "crazy asshole". That didn't really sit well with me. I wonder...if anyone has filed a complaint with his state regulatory agency?
I submit this with caution. I mean the label is real. Using that particular label, one can easily go to a search engine and find countless stories that mirror what Steve and I endured. One can find countless treatment options and thus find hope.
I still don't like calling that set of symptoms Borderline Personality Disorder because it denotes a fixed set of traits and thus makes it sound like it's a hopeless situation. If one wants to learn about it, if one wants to know he or she is not alone in the experience, this is the label one would have to type into a search engine at this point in time to find information.
To this day, there is some controversy whether or not such a diagnosis actually exists. Certainly, there are people who have these issues and want to work through them. The issue exists. The controversy is whether or not it is a separate and distinct diagnosis.
BPD mirrors Bi-Polar II disorder (mood swings). It has aspects of narcissism in it (manipulative behavior, masking, self-absorption). In my opinion, I would say it has aspects of the secondary gain that hypochondriacs exploit: In other words, people often the diagnosis to manipulate others into accepting their bad behavior.
It is different from narcissism in that people diagnosed with BPD swing from idealization to devaluation. People with BPD think of themselves and others in black and white terms. One is either all good or all bad. There is no shade of gray. You're either an angel or a devil.
******
I believe that Steve may have been diagnosed with Borderline Personality Disorder in the past. I say this....because....I've spent the past two weeks researching personality disorders -AND-
many of the things that he said to me came straight out of therapy training manuals; he must know. He must have heard of BPD before; he certainly talks the diagnostic talk. He appears to know more about the disorder than I do. I have a graduate degree in psychology!
Yep...
Steve is reflecting his therapist's feedback towards me. In order words, he would come to me and say "my therapist says that you are [fill in the blank]." They were typically things that people with Borderline Personality Disorder are said to do. I don't think the therapist was talking about me.
1.
His therapist allegedly claimed that I was victimizing him by pretending to be a victim.
I'm not his victim. I'm just trying to process everything.
2.
His therapist allegedly said that I told him about being stalked in order to hook him into the relationship.
I told him about the stalking because....really....that is one danger inherent in hanging out with me. I thought he should know who the obese blond chick that follows me around is. If I were dating someone being stalked, I'd want to know.
3.
His therapist allegedly told him that I abuse him because I fear losing the relationship.
This was what he wrote on Facebook. He defined my abuse as talking for 15 minutes. I don't understand how he thought that I feared losing the relationship. I'd already lost it six times! He kept breaking up with me!!!
There were other aha moments reading through the literature. I find that the moment one pops in my head, several more do...and then they disappear the moment that I start typing. There really is too much to process.
Oh...I remember....if I needed to do things for myself, he thought I was abandoning him. He would often, out of the blue, complain that he knew I wanted to be rid of him. In August, he hit me with so many crazy accusations, went to Facebook and lied about me countless times, and had at least two people contact me to talk about him, I had enough. I couldn't take it anymore. In his bid to keep me with him, he pushed me away.
There were hundreds of times in my relationship with him where I wanted to scream at him and say
"Feelings are NOT facts!!!"
That is where the lies were born. He felt afraid that I would do something and run around to Facebook and tell my friends that I actually did those things. Sometimes he wrote that stuff on my Facebook wall, in front of potential clients and fellow political activists. Since I plan on returning to my work as a pain management consultant, I had to make my Facebook account private. From this point forward, I cannot friend people I do not know because they may or may not be future clients. They'll have to follow one of my numerous pages. It is an ethical no-no to allow my private life to be brought in front of potential clients.
*****
Steve did many of the things in the video. The unfriending and deleting on Facebook was a monthly occurrence. I had to unfriend him when he started to lie about me. I'd take him back when I thought he realized what he did wrong. I thought we had better boundaries. He was to keep things light if I were his Facebook friend. He couldn't do that. Now that he twists the truth, I can't even talk to him out of fear he'll take everything public. That was a hard reason to cut him off. It hurts.
Who wants a lover that she cannot talk to?
In the end, I couldn't trust him with anything. I have empathy for him. I care about him -but- I can't continually put myself in a position of having to defend myself from his attacks.
The danger of dating a man (or a woman) who distorts the facts is the chance that one could be arrested due to a false accusation. In July, he threatened to get a restraining order against me because I did NOT answer a Facebook message. In September, he sent me several messages accusing me of abusing his daughter because my driving scares her. Those things, in and of themselves, are warnings. At what point could he get that restraining order and twist the facts further? Maybe he saw me at the store across the street from our offices? That could get me in trouble. If he twists the truth, how far of a twist would it be for him to call the cops and say I menaced his daughter?
It's better just to never see him again. It hurts -but- if he cannot take responsibility for his behavior, I cannot be around him. When he acts out, he causes a lot of trouble for me. He doesn't understand....there are consequences to some types of behavior.
*****
People with that label can be manipulative, whether or not they mean to be. They can judge you but you are not allowed to judge them. They make excuses for their behavior. I do not know if they do it to get away with things. It is most likely that they do it because they are sensitive and have a hard time facing up to the way they behave. I don't know.....personality disorders are not my area of expertise.
Steve would misuse Non-Violent Communication (NVC); primarily the judging aspect. In NVC, one is tasked with listening to another while suspending judgment, so he or she could hear the meaning behind the words rather than jump to conclusions. The problem with this is that there are times when behavior has to be scrutinized. I was not allowed to judge Steve's behavior. Mine was held up to a ridiculous amount of scrutiny. His had to be accepted. I saw this quite a bit while reading through the BPD forums. People with the diagnosis were pleading to have their needs for acceptance met. People dealing with loved ones who had the disorder were trying to avoid the rage attacks and dealing with having to walk on eggshells to avoid the wrath of their loved one.
The other misuse of NVC is that he used it to excuse his abusive tirades. He would say that we need to focus on the needs he had when he started acting out. Then, he truly believed that NVC techniques would repair the breach. The problem with that is when I had a need, it would be dismissed or used against me later. For instance, if I had a need have a friendship with my lover, he'd say we couldn't be friends but still expected my intimacy. If I told him I needed anything, he'd find a way to use it against me later. That didn't work out very well.
The other striking thing is the minimizing of the impact of their behavior on others. I find myself pondering Steve's concept of Anarchy. I find myself wondering if that is how he relieved himself of responsibility when he broke the law, damaged another person's property, or hurt people. Maybe in his world, he can break laws because the government shouldn't exist. He can damage government (or quasi-government) property for the same reason. He seems pretty reckless with community property and so I wonder.....is Anarchy how he excuses it?
I'll be pondering these things for awhile.
He had to have been diagnosed. He must've known. If he wasn't diagnosed with Borderline Personality Disorder he most certainly had been diagnosed as Bi-Polar. The great tragedy of that is that there are treatments for both borderline and bi-polar disorder; they could have changed his life!
******
Let me explain my history with the issue....
I am so old that when I went to graduate school, Borderline Personality Disorder was very controversial, especially in Humanistic circles. I once heard a professor joke that only bipolar women who wouldn't sleep with their unethical shrinks were given that label.
After graduating, when a therapist suggested that my ex-husband had the disorder, I researched it.
A shrink told me that Borderlines are bi-polar people who engage in self-harm.
Okay....the Bi-Polar label disorder certainly has less of a stigma. Bi-Polar can be treated and managed. If you had to give someone a label, why not go with the one that makes more sense and doesn't make the person sound like a lunatic? Why not go with one that is more precise?
Besides, people denigrate the label and make it out to connote some fearful kind of psychopath.
This is why I do NOT believe in the "Borderline Personality Disorder" label and support efforts to change it. I believe that there are people who have this issue. I believe that therapists often diagnose it without checking for other issues. I believe the very name connotes a sense of hopelessness to the people so diagnosed and it makes it hard for them to get help. I think it scares potential mates, potential therapists, and potential friends away.
In my personal experience, psychiatrists are careless with the diagnosis. In my educational experience, it was seen somewhat as a joke. Back in the day, it was a billing tool. Borderlines were not real psych patients, they just came in to mess with your mind and the only way to deal with them was to ignore them. I thought this attitude did not help people. If the diagnosis is a basket diagnosis viewed as a joke, one should strive to be more precise and accurate in defining the issue.
I'll share an anecdote from my personal experience.
My younger sister, who has bi-polar disorder, was institutionalized for BPD on Christmas Eve. I had to work like heck to get her out of the hospital so she could spend Christmas with her young twin boys and infant daughter. I'll tell you the story. She lived in a loft above a rail train station. A few weeks prior, she looked out the window and saw a man standing on the tracks and a train was coming at him. She tried to open the window in time to yell a warning towards him. She was too late. He was hit and died at the scene. She fell into a deep depression because this event triggered her childhood trauma. She witnessed our mother's murder at the age of eleven. She witnessed our step-father's Christmas suicide at the age of fourteen. Christmas is a hard time for people with that kind of childhood history, especially the fact that the only dad she had ever known shot himself on that holiday in front of her. She was despondent and went to the local clinic to try a new set of psych drugs.
The doctor told her she had BPD and put her on a 72 hour psychiatric hold. He did NOT even ask if she had any other diagnoses. She NEEDED her family at that time of year. She NEEDED to be with people who loved her and understood her pain. The last thing she needed was to be thrown in a cold psychiatric cell with NO BLANKETS. There were no blankets.....oooh...!!! I chastised the doctor; he admitted to making the diagnoses based on the nurses notes which seemed to be more of a commentary on my sister's hair and clothing. Long story short, her boyfriend and I threatened to report the doctor to the regulatory agency. He let her out in time to celebrate Christmas.
This was eight years ago. I guarantee my sister thinks twice about reaching out for help now due to this careless shrink. This is wrong.
The issue seems to have come a long way in the past 20 years. There are more detailed studies out about Borderline Personality Disorder. There are support groups and forums. Surprisingly, I came across entries from a BPD diagnosed man named Steve who seemed to write tales of experiences that mirrored what I went through with Steve. I don't think it was the Steve I know -but- it did hit some of the lessons home.
What resonated with me the most was a comment made by someone with that label in a forum. She had said that we shouldn't judge. We need to be sensitive to their needs. We have to be there for the person at all times. We cannot leave them. They deserve our love. We have to do as they wish for their mental health. This struck me as being similar to the things that Steve would say. It is as if they are stuck in toddlerhood, with an undying need for unconditional love without an understanding that the other people in their world have needs. It is as if they do not afford the other person the same liberties they take.
There were other comments from other diagnosed people claiming that people in relationships have to "pay to play." There was this idea that should one enter into a relationship, he or she is co-dependent and deserved to be used and manipulated. There was a woman chastising the partners of BPD diagnosed people saying that they deserved to be hurt because they chose to love. I'm thinking that woman was in the wrong forum. She seemed to be more Narcissistic than Borderline. I don't know. I need to learn more about the recent literature.
The very phrase "personality disorder" makes one feel like there is no hope for change. It is misleading. I do NOT believe it is a personality disorder. Personality disorders are fixed and cannot be treated. The research shows that this can be helped. The issue is real. People are hurting. Still, the label seems to be misleading. It is still controversial and there appears to be a lot of overlap with other, more rigorously studied, disorders. Most people with that diagnosis meet the criteria for other mental disorders:
61 % also have at least one anxiety disorder (e.g. social phobia).
49 % have an impulse-control disorder (e.g. intermittent explosive disorder).
38 % have a substance abuse or dependence disorder (e.g. alcohol).
34 % have a mood disorder, most commonly a form of depression.
Source:
National Comorbidity Survey Replication
*****
Labels are only a good shorthand for understanding behavior. It's easier to have empathy for someone who engages in abuse if you know what you are dealing with.
So....I submit this with the caution that I do not believe in the Borderline Personality Disorder label. I believe that there are people who exhibit these traits. I believe that these traits are developed in childhood. I believe that it is an impulse and/or emotional regulation disorder. I do believe the experts when they say it will take between 4-7 years of intensive therapy to see marked improvement in the symptoms.
I applaud the therapists trying to change the name of the label to more accurately reflect what it is. It is an emotional regulation disorder, not a personality disorder. Maybe a more accurate term will make future research easier. Maybe we can find new techniques of emotional regulation if we look for that!
Labels make it easier to describe something. It also makes it easier to communicate about a subset of issues connected to the label. Having a more accurate label will help in describing the disorder, researching it, and eventually treating it.
****
If you are curious, here is the DSM checklist. I highlighted what I saw in the relationship. I cannot get into the man's head. I don't know what his self-image truly is or if he feels empty. I do know that there was only one suicide threat in the past 3.5 years.
DSM IV
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)
I am going to audit a course on Cluster B Personality Disorders just so I'm up with the times. If I find a decent one open to the general public, I'll post it here.
****
You know....I am NOT Steve's therapist. My background is in health psychology -NOT- the diagnosis and treatment of personality disorders. I only know enough to recognize these issues and refer people suffering from them to specialists. Even if I were licensed to diagnose and treat personality disorders , I couldn't make the diagnosis with someone I know on a personal level.
But...I'll put it out into the universe. It could help one find others who have had similar experiences. It could help one find hope and help.
Just stay away from the shrink that calls it "crazy asshole" disorder.
*****
So....what does that mean for anyone reading this blog?
Well.....if you are NOT the therapist for the person abusing you, your primary responsibility is your own mental health. You have to draw boundaries. You have to stick with them. You have to hold the other person responsible for his or her behavior just as you are responsible for your own.
It is okay to leave someone who is trying to manipulate you, lying a about you, raging at you, and otherwise making your life a living heck.
It doesn't matter what label the other person has: If someone is making you crazy enough to think you have a label, it is time to take time for yourself.
Love ya,
S.
P.S. In my struggle to find a decent resource about BPD to share, I found this. It helps.
http://www.bpdcentral.com/blog/?Distorted-Beliefs-and-Attitudes-of-People-with-Borderline-Disorder-42
Cheers....
P.S.S. This is a late edit. I get a lot of hits on this and wanted to share something from my personal interactions with individuals diagnosed with BPD.
They appear to be focused on the amount of empathy they get from others. They seem to be almost obsessed with empathy. They'll often accuse others of lacking empathy when they don't get what they want.
It's just a weird thing I notice. Perhaps it is the subconscious mind's way of making sure they don't get into empty relationships that mirror the one they had with their primary parent in childhood.
To be honest, I don't know. I'll work on getting more experience with this population before running around trying to advocate for change.
