The Essential Family Guide to Borderline Personality Disorder Read online

  Life itself is stressful enough that stress-reduction strategies such as yoga, meditation, and other relaxation exercises have become popular. When you add in the presence of a personality disorder in someone you love, your stress levels climb even higher.

  The degree of your stress depends in part on how BPD presents itself in your loved one. If your BP is at risk of suicide or self-harm, flies into erratic rages, or can easily become threatening to others or self, your stress level may rise to the level of hypervigilance, which is a symptom of post-traumatic stress disorder. Hypervigilant people are like the giraffes at a watering hole on page 57. They’re always on the alert, looking for danger. Their stress hormone levels rise high and don’t go down.

  Sometimes complicated predicaments have simple solutions. Abdominal breathing, or deep breathing, counteracts the “fight or flight” stress response. Depending on how long you do it, it can help you feel better, help you sleep better, and improve your concentration. This is a core skill that will be referred to in other chapters. It can slow down racing thoughts and quiet down your emotions.

  The first time you do deep abdominal breathing will be a minor production. Once you get the hang of it, you’ll be able to do it anywhere. Do the longer version when you have more time or are feeling stressed. Here’s how to get started:

  Step 1: Lie down on the floor or some other hard surface. Lie on a warm rug or mat, if you can. Try putting a pillow under your knees to support your lower back. Make sure you’re comfortable and warm.

  Step 2: Relax your body. Just . . . let . . . everything . . . go. Unclench your jaw and hands and let your shoulders flow back. Let everything get soft . . . picture a cat stretched out on a fur rug with butter-yellow sun streaming in from the window overlooking the garden. Put your brain on standby (but don’t fall asleep).

  Step 3: Put your hands on your stomach. Take a slow, deep breath so that your stomach, not your chest, rises. Your chest shouldn’t move. Breathe slowly, deeply. Put a very thick book on your stomach; it should be going up and down. When you do this, you’re using a sheath of muscles called the diaphragm. Practice.

  It wouldn’t hurt to breathe this way all the time. But make sure to do it for at least five minutes when you feel tension coming on.

  Get Some Shut-Eye

  On average, most people need an additional sixty to ninety minutes more sleep than they get.11 Late-night arguments and worry top the reasons why non-BPs don’t get enough sleep.

  As you sleep, your brain organizes the memories of habits, actions, and skills learned during the day. Deprived of sleep, your body cranks up stress hormones that send your blood pressure soaring—putting you at risk for heart attacks or strokes. Lack of sleep can also make it more difficult to master complex tasks and to find creative solutions to life’s challenges.12 In a study in Australia, transportation workers who were deprived of sleep for twenty-eight hours showed the same level of impairment in speed and accuracy as those who had a blood alcohol concentration (BAC) of 0.05 percent. After longer periods without sleep, the workers’ performance was as impaired as those who had a BAC of 0.1 percent. (In the United States, it is illegal to drive with a BAC of 0.08 percent or above.)13

  Pick Up the Pace

  You’ve always known that moving around improves your physical health. The equivalent of thirty minutes of brisk walking also provides an immediate boost to your brainpower and mental health, too. Psychiatrist John Ratey, MD, says that a bout of exercise increases the level of the mood-enhancing neurotransmitters dopamine, serotonin, and norepinephrine in your brain.14

  Jim Phelps, MD, is the author of the book Why Am I Still Depressed? The book, which is about bipolar disorder, has a brilliant chapter called “Exercise and Mood: Not the Usual Rap.”15 The chapter discusses the barriers to exercise (to begin with, it’s giving to yourself, it takes time, and the benefits don’t happen right away) and how to overcome them and make movement a part of your life. You can read the chapter for free at psycheducation.org/hormones/Insulin/exercise.htm.

  Making Changes the Easy Way

  Are you in love with immediate gratification? Most everybody is, not just people with BPD. In fact, the need for instant satisfaction is an epidemic. The cure for this “disease” is to take things slowly. Go ridiculously slow—say, a 5 percent change each day. If you’re spending five minutes walking on Monday, try increasing that by 5 percent on Tuesday. You can do it!

  Looking back on this chapter, what speaks the most to you? What is the easiest change you can make that has the most impact? Pick one. Do something. Then increase it by 5 percent tomorrow, or in a week, or whatever time frame you choose. For example, after you are finished reading this sentence, put the book down, take a deep breath, and think of something you like about yourself. Go ahead—try it!

  You’re probably wondering how much good 5 percent of anything can do. The answer is “a whole heck of a lot.” First, small steps add up in a hurry. We age a tiny bit each day. And as we age, our metabolism gradually slows. Sure enough, we get old and put on pounds before we know it.

  There’s another reason why small moves lead to big results: as long as you’re moving forward—no matter how slowly—you won’t be going backward. You’ll also find that success breeds success. Progress is its own reward, especially if you measure and track it. If you’re having a bad day and 5 percent seems too much, then temporarily scale it back to 1 percent.

  You might think that this power tool would be the easiest one to learn how to use. It isn’t. It’s too easy to overlook or dismiss. Self-care is like food. Three times a day (plus snacks) you eat and drink to replenish the calories you have expended working, studying, taking care of your family, and so forth. Just like running uses up a lot of calories, having a borderline loved one takes a great deal of mental and emotional energy. Self-care replenishes that energy.

  Chapter 8

  Power Tool 2:

  Uncover What Keeps You Feeling Stuck

  Insanity is doing the same thing over and over again and expecting different results.

  • Albert Einstein •

  What you avoid controls you.

  • Elizabeth B. Brown •

  Consider the following questions:

  • Do you feel unable to move because danger lies in every choice, yet you feel compelled to do something?

  • Do you and your BP have an unspoken agreement that his needs are more important than yours?

  • Does your satisfaction with this relationship depend on your BP making significant changes—yet he hasn’t demonstrated a lasting desire to do so?

  • Have you made compromises you realize you can’t live with in the long term, but have no idea how to go back and change things?

  • Is this relationship too good to leave but too bad to stay in?

  If you answered “yes” to most of these questions, chances are you’re stuck.

  Psychotherapist Barbara Cowan Berg, author of How to Escape the No-Win Trap, says, “Double-bind situations often build up slowly and catch you off guard. They can be subtle and insidious, wrapping you up in a web of confusion. Most often, you don’t recognize situations that have the ability to make you crazy until you’re deeply involved.”1

  Non-BPs hold their borderline family member responsible for their entrapment. But after spending some time in Welcome to Oz, many come to realize that some inner need of theirs keeps them tied to the turbulence. This is mostly true of non-BPs who choose to be in a relationship with someone who has BPD; in fact, their inner needs may be one reason why they chose their partner or friend.

  Berg says that interpersonal double binds can appear to be about what is going on with the other party. But when you look more closely at the underpinnings of the conflict, the story is more about you.2 The longer you have been stuck in a chosen relationship, she says, the more likely it is that the solution to the problem lies within you.3

  Uncovering and resolving the source of your feelings of entrapment is the mos
t essential element that determines not only the course of your relationship, but the degree of distress you will experience from having a borderline family member. This is because feelings of helplessness and lack of control can cause just as much suffering as the presence of the personality disorder itself.

  Study after study has found that in different types of situations—at work, in relationships, in nursing homes, when facing terminal illness, while playing sports—the urge to feel in control of your own destiny is a universal motive. With it, we gain an inner sense of mastery and feelings of satisfaction. Without it, we are at risk for hopelessness, stress, and depression.4

  What Keeps You Stuck?

  Most non-BPs feel stuck for one or more of the following six reasons:

  • unhealthy bonds forged by emotional abuse

  • feelings of fear

  • obligation, roles, and duty

  • guilt mingled with shame

  • low self-esteem

  • the need to “rescue”

  Unhealthy Bonds Forged by Emotional Abuse

  Emotional abuse, according to therapist and author Beverly Engel, is non-physical behaviors or attitudes used to control, intimidate, subjugate, demean, punish, or isolate another. Abusers tend to degrade, humiliate, or instill fear in their victims. Emotional abuse includes symbolic violence, such as slamming doors, kicking walls, and throwing objects.

  The behavior and attitudes Engel refers to include classic BPD traits such as accusing, blaming, unpredictable responses, unreasonable demands, the “silent treatment,” criticizing, and constant chaos and drama. The effects can include a lack of motivation, confusion, and difficulty making decisions—all of which can keep people stuck.5

  Engel says that people who are emotionally abused wonder, Am I as bad as she makes me out to be, or is she just impossible to please? Should I stay in the relationship or should I go? If I am as incompetent as he says I am, maybe I can’t make it on my own. Maybe no one will ever love me again.

  You might think that the obvious choice for the abused person would be to simply avoid the abuser and try to rebuild self-esteem. Instead, the opposite occurs: people who feel abused and controlled develop strong, unhealthy bonds that keep them in a dysfunctional dance with the person who is bullying them.

  This dynamic is so well known it even has a name: the Stockholm Syndrome. The name comes from a 1973 incident in Stockholm, Sweden, in which hostages became emotionally attached to the criminals who held them hostage during a bank robbery.

  The syndrome includes these key elements:

  • the belief that the abuser/controller is an imminent threat to one’s physical or psychological survival

  • the presence of a perceived small kindness from the abuser/controller to the sufferer

  • isolation from perspectives other than those of the abuser/controller

  • the belief that one is unable to escape from the situation

  The following are signs that the Stockholm Syndrome might be at work:

  • thinking, I know she hurts me all the time and does terrible things to me, but I love her anyway! (Extremely common.)

  • receiving warnings from others about the relationship and dismissing them because others “just don’t understand.” Eventually, the sufferer avoids those who don’t approve of the abuser/controller.

  • giving the abuser/controller positive credit for small tokens of kindness (a birthday card) or for not being abusive when abusiveness was expected (such as not getting jealous when an opposite-sex co-worker waves in a crowd).

  • making excuses for the abuser/controller’s behavior (such as, “He couldn’t help it because he was abused as a kid”).

  • becoming preoccupied with the needs, desires, and habits of the abuser/controller in an effort to prevent the abuser/controller from having an outburst.6

  Feelings of Fear

  “Fear is at the root of every human struggle,” say Bill Klatte and Kate Thompson in their book It’s So Hard to Love You. “It is experienced in many guises and to varying degrees. Fear can take hold of your mind and twist your insides into knots.”7 The following fears are common for non-BPs:

  • fear for the BP’s health and welfare (common with lower-functioning conventional BPs). Suicide threats are the most potent fear.8

  • fear of conflict, for example, “I can’t say that. He might get upset.”

  • fear of being alone (abandonment). (BPs aren’t the only ones.)

  • fear of failing or being perceived as a failure (for example, with having a failed marriage).

  • fear of financial problems (common in partners).

  • fear of the unknown.

  • fear of the BP’s threats coming true.

  If fear is keeping you stuck, be specific about your fears so you can address them. Instead of saying, “I fear conflict,” zone in on what that really means to you. “I am afraid he will start an argument” is more specific. Keep asking yourself, “Then what?” “Then he will yell.” (Then what?) “Then I will become uncomfortable.” (Then what?) “Then I might have to leave the house. Then I would wait until he calmed down before I came home.” The answers to “then what?” may not be as scary as you think.

  Feel the Fear and Do It Anyway is a classic book that helps people face all kinds of fears. Author Susan Jeffers says that all we need to do to diminish fear is develop more trust in our ability to handle whatever comes our way. She writes:

  You know that you don’t like the fact that lack of trust in yourself is stopping you from getting what you want out of life. Knowing this creates a very clear, even laserlike, focus on what needs to be changed.

  You don’t have to scatter your energy wondering why [you’re afraid of something]. It doesn’t matter. What matters is that you begin now to develop your trust in yourself, until you reach a point where you will be able to say, “WHATEVER HAPPENS TO ME, GIVEN ANY SITUATION, I CAN HANDLE IT.” 9

  For those in chosen love relationships, the definitive fear is losing the relationship. Because of unhealthy bonds, the more dysfunctional the relationship, the worse the fear. We’ll come back to fear of losing the relationship in chapter 10, Power Tool 4: Set Limits with Love.

  Obligation, Roles, and Duty

  Dana has an abusive borderline/narcissistic mother, Gloria. Dana’s husband and friends keep telling her to cut all ties with her mom, and Dana would love to. But she can’t—it would feel too disloyal. If she doesn’t call her mother twice a week, she feels guilty. What kind of daughter would she be if she deserted her mother?

  Our concepts about roles and obligations are supposed to keep life predictable and create an orderly, stable society, say Klatte and Thompson.10 The family unit provides for the needs of each member in a grand attempt to perpetuate the species and perhaps the family name. Then, myths and ideals evolve around what the perfect parent, child, sibling, or grandparent should be like.

  The sad truth is that while families may have evolved to ensure the survival of its members, sometimes survival is dependent on giving up the myths of the ideal parent, sister, or other family member, and accepting reality, no matter how much we wish it were otherwise.

  Take a close look at your beliefs and decide which ones are based on myths and which are based on reality. This consists of asking questions such as “What do I do out of a sense of obligation? What feelings rise up when I ask myself that question? Which of my obligations feel good to me? Which ones do not?” Your situation is different in ways that may be hard to explain to others. But you don’t necessarily owe anyone an explanation.

  Guilt and Shame

  Shame is a global feeling: I am bad. Guilt is a more limited feeling: I have done something bad.

  Guilt drives parents to lose their sense of judgment and go to ridiculous lengths to assuage their guilt. A typical story is that of a couple who let their adult daughter live with them for free while the daughter ordered them to clean her clothes, feed her, and pay her bills.
r />   Perry Hoffman says,

  I have a cartoon I show at my presentations to families. It’s a picture of a duck walking down the hall to the living room, where the parents are sitting on the couch. And the mother says to the father, “We are absolutely, positively not driving Earl to Florida this winter.”

  That depicts what happens to families. Family members often lose their good intuition. They need to step back and say, “Let’s try to be objective about what we’re willing to do and not do.” It helps to have someone outside the situation give some perspective.11

  Clinical psychologist Debra Resnick says that about 25 to 33 percent of the parents of her dialectical behavior therapy clients overinsert themselves in their child’s life.

  They take on too much responsibility for their child’s behavior and don’t allow their child to succeed or fail on his or her own terms.

  Society says that parents who have a child who isn’t functioning well are not up to snuff. People feel embarrassed when they have to go to family functions and say that one of their children isn’t doing well. Parents need to acknowledge the shame, put it on the table, and formulate a plan to overcome it so it doesn’t act as a barrier.12

  Siblings feel guilty for having feelings they’re not “supposed” to have or for not having emotions they think they “should” have. Like other family members, they put themselves on trial in a kangaroo court and mete out punishment before the judge has banged the gavel.

  If you feel guilty, ask yourself, “What am I feeling guilty for?” Be specific. If you think you should have known something, what is it, and how would you have known? If there is something you regret, learn from it. Make amends if necessary, put a plan together to prevent it from happening again, and try to turn any aspect of what happened into something positive.