Friday, October 29, 2010

How to Disarm a Borderline, Part II

In my Part I post of October 6, I described how a lot of the difficult behavior of patients with borderline personality disorder (BPD) in their intimate relationships is designed to elicit in the observer one of three reactions: anxious helplessness, anxious guilt, and overt hostility.  Furthermore I expressed the view that, even though they will make herculean efforts to induce these reactions, and are very good and finding other folk's vulnerabilities in order to do so, they secretly hope they will fail in their efforts. 

Every time they succeed, they will do more of whatever it was that worked; every time they fail, they will do less of whatever did not work.  They will not give up easily, and if they've known you for a while, if one trick does not work, they will have a whole repertoire of other behaviors from which to choose. They will know how to push all of  your buttons in the most effective way possible.

Last, because of the variable intermittent reinforcent schedule, if you only occasionally react in the "wrong" way to them, that is worse than reacting badly to them all the time, because they will try that much harder and longer to elicit the "desired" response.  I said that in my next post I would start by saying what not to do. 

Here it is.  It's fairly simple, so this will be a relatively short post.  In future posts I will suggest counterstrategies for the most typical BPD strategies for eliciting the three responses, and then finally advise readers about what to do in the inevitable event that they slip up - so that the variable intermittent reinforcement schedule does not kick in.

IMPORTANT CAUTIONS:  Please be advised that sticking to this program is extremely difficult, so the services of a therapist who knows about these patterns are usually necessary.  Also, this section is designed for adults dealing with BPD adults - over 23 years old, actually.  This is not necessarily what you should do if you happen to be raising a teenager with BPD traits.

Without further ado, what not to do:

A. Try to please the unpleasable.  If they put you in a damned if you do, damned if you don't position (a double bind), try to do something to please them anyway.  If they "yes-but" all of your suggestions for solving any problem they present to you (that is, if they reject any and all offered solutions with a sentence that has the structure, "Yes, I could do that, but...), keep offering more solutions.  If they ask you to do something that is clearly impossible, try your best to do it anyway.

They never forget you have a choice

B. Make sacrifices for them.  Stay up all night talking with them and trying to reassure them about their latest emotional debacle when you have to go to work the next day.  Give them thousands of dollars to help get them out of a financial bind that they had put themselves in with profligate spending and irresponsible behavior.  Drop everything you are doing and rearrange your schedule for the entire day so you can do something for them like right now, even though the chances are 50/50 they will not even be there when you get to their abode - and be sure to cancel any planned activity that you've been looking forward to forever.  Drive a hundred miles out of your way to take them somewhere.

C. Get defensive.  Say, in frustrated tones, "You know, I'm only trying to help you" or "Don't you understand that I have other things to do?"

D. Act hostile.

E. Act guilty.  Because you know down deep you should be able to solve impossible dilemmas, and that their behavior is probably all your fault anyway.

F.  Stand there and take it like a (foolish) man.  Are they slapping you around?  Verbally abusing you will a barage of invective?  Impugning everything you stand for?  Screaming at you?  Just stand there and let them.  Maybe they'll stop.
G. Return in kind.  I knew a psychiatrist who got so upset with the verbal nastiness of his patient that he told her she was a dog and that she should have consulted a veterinarian.   See if you can stop the BPD person's pain-seeking behavior by inflicting more pain.

H. Lecture them.  Tell them all about how cocaine is harmful, that they should leave an abusive relationship, or that they should not ride their bicycles at midnight through crime-ridden parts of town in a bikini with hundred dollar bills hanging out their bras.  After all, they are just too stupid to figure these things out for themselves.  They'll tell you they think cocaine is good for them.  Argue the point.

I. Try to rescue the help-rejecting complainer.  Go to their house to try to take them away from an abusive romantic partner.  Let them move in with you rent free.  Loan them money that they will never pay back.  Try to mediate their disputes with others (trying to physically get in between two fighting adults is particularly important - maybe they'll both start in on you).  Cuss out the people who they claim have mistreated them.  Go ahead, I dare you.


  1. Hi, David,
    When you do (or did) your therapy, how did you involve the family members? What bothers me about therapy is that the person with the diagnosis is the one who goes to therapy, and the family members are left totally in the dark. In my experience, psychiatrists are not forthcoming with this information. If they were, they'd be out of a job. What you said needs to be conveyed on a large scale to parents/spouses, whatever, but we are the people who don't get instructed. Unless the family is told how they can help and what to do and what not to do, it's not going to happen. Psychiatry doesn't tell this to us, the family. Psychiatry says take a pill, the parents are not the problem, your relative's problem is biochemical, etc. So, great that you are saying this, but who has illuminated the people most affected by all this? Why do we have to dig this out for ourselves? (The way you describe the situation sounds self-evident, and the parents must be real morons not to see this. Then there is actually living with it, day in and day out.) What you are also saying seems to me like practicing low Expressed Emotion, another thing that psychiatry doesn't seem inclined to share with the parents. I never heard it once from my son's psychiatrists. Of course, there are parents who would completely reject the idea that they are somehow to blame, but so what? It should be mandatory that parents/spouses get to share in these ideas, which, as I said, have been withheld from us while our relative spends years in therapy. We are in the dark. You can work on the patient individually for years, but if the relatives were involved, improvements would be quicker.

  2. Rossa -

    You ask some great questions and make some really good points. I will try to address some of them in future posts.

    Very briefly, I personally try not to leave major family members in the dark - even the ones who have been severely abusive to my patients. It's ultimately up to the patient, however.

    The "family & spouses subvert the therapy" crap comes from the psychoanalytic tradition.

    My whole treatment manual is on line. You can click on the page under "Related Web Links" on the right side of this page. It's the second one listed.

  3. I have done a lot of these things - sacrificing time, trying to rescue, getting stern. None of it helped. Thanks for laying it all out so clearly so I can be cautious in the future.

    I have a Borderline friend who instead of getting angry right away, will take on the persona of a "gentle teacher" - she makes absurd assertions and defends them with this condescending calm which, if I disagree, escalates and will only end if I just walk away.

    She will argue with everything - sometimes she'll bait me - if I express a feeling, she'll immediately express the exact opposite just to argue. Then the next day, she'll express an opinion that agrees with my original one, as if nothing happened. She says she likes to "expand people's minds" (why she argues?) but she's illogical.

    It's such a circular thing, and it seems to come down to power - she wants to always have the upper hand morally and logically - even if her argument is sick (such as advocating violence), or illogical (defying natural laws). She claims sexual purity but will often mention dirty fantasies, or claims she can't stand swearing, while liberally using the f-word. She'll claim to be non-violent and peaceful, then go at someone with a machete.

    This friend in particular actually said "I have to stand up for things, even if I'm wrong - I don't know why, I feel like I'm being false to myself if I don't". I wonder, is that what BDP people in general feel? The inability to admit someone else's opinion is valid, without losing yourself?

    In talking with her, I felt I never found a consistent person and therefore never could figure out who she is. She called herself a "chameleon," it seemed to me, changing however she needed to in order to imagine herself on the right side of an argument, always.

    But how can I have a relationship with someone who dramatically changes her positions on life, the world, morality, even reality - just to suit her need to have the upper hand?

    1. Hi anonymous,

      When someone continually and repetitively makes obviously absurd and/or contradictory or hypocritical statements, they are inviting you to invalidate them. They do this because that is their job in their family of origin, where they are continually invalidated.

      That gives them the message that it is important to the parents to do that to them, so they sacrifice themselve and make the parents' behavior easier and seemingly less irrational.

      They do this on purpose though automatically and without thinking so they often are not actually aware of it in those terms at the time. Your friend's "chameleon" statement makes it clear that she knows exactly what she's doing, although she may not want to think about exactly why.

      When they do it to outsiders, they are recruiting them as enablers on whom they can practice their skills for their "job."

      While no countermoves are foolproof, general strategies for countering this are described in Part III.

      It's indeed very difficult to remain friends with someone who does this to you often unless you yourself have a need to invalidate other people -for whatever reason. (And if you put up with this sort of abuse, your friend will think you do).

      If that does not apply to you and you want to be friends with her for other reasons, the best thing you can say is "I'm not going to argue with you about that" and then change the subject. And then refuse to discuss it further and make that stick. Be aware that she may dump you as a friend if you do that.

    2. For some reason (my own issues,I am guessing :-/) I have always been attracted to that type of women, and communicated a lot with them. My experience is that they don't value discussions or other people's opinions at all, but they never say that explicitly. It is emotionally very hard for them to express their true opinions, and they avoid it at all costs, and if they really do it, you won't miss that: that looks like you are talking to an extremely shy person, they will be struggling to spit out each word. It happens very rarely, anyways, and only if you ask long and hard (but gently)for that, and if they care. Moreover, they rarely manage to have a fixed opinion at all: as a good friend of mine helped me to understand (and opened my eyes on many aspects of their thinking), she is always so deeply impressed by every bit of information, that it affects her identity, like a kid holding a magic wand trying to flush himself down the tube to get into the Ministry of Magic after reading Harry Potter. So she is so much affected by the most recent information, that she easily falls for different religions, political views, ethnic identity of herself, often a few times in a week, based on who told her what (or what she read or watched), and what emotions that caused. She's desperately struggling to connect all those dots together in her head, mostly in vain, which produces an outside picture of a fascinatingly complex inner world of her, which isn't true at all. They hate to be asked anything what makes them make even slightest decisions or express opinions, because every time they have to deal with that mess in them which they don't like. Moreover, they have an extremely impaired self-esteem, and tend to interpret every word of yours as offensive, whether your critic statements and suggestions to them, or your praise of them, which they think is incorrect and undeserved. It is very important to be pay attention to subtle senses and express yourself as clear as possible, without any judgements, and paying attention to explaining your feelings (which they sense perfectly, but often misinterpret). What they often enjoy is "being silent together", passive entertainment where you take over the lead completely and make all decisions, like if you were spending time with a small child.

    3. All my talking has been once described as humdrum in one of those rare episodes when the truth leaked, and my attempts to please her turned out to be the number one distress factor in the friendly relation. So, those who seemingly enjoyed arguments were in the fact the ones most distant and closed; it's one of their defenses, they don't give any value to the essence of the argument at all, and they don't let close to their heart as that would be intolerable for them. Maybe she's practicing what she perceives as an important and particularly difficult skill, maybe she thinks she's trying to push on, but surely for her an environment of a dispute is deeply hostile and she feels she's a victim. What they often (always?) need is emotion - if they can't get positive ones form you, they will try to squeeze negative ones, and it is very characteristic of them to have much better skills of triggering negative emotions. I guess it may be the reason why they get attracted to narcissists - they admire the seemingly perfect self-control of a narcissist while feeling the desire to unlock other person's emotions where they see there are plenty, but they typically misinterpret other person's emotions and fail to understand how crazy and vulnerable a narcissist becomes when he get emotionally overwhelmed, this scares them off big time. They fall for theatrically expressive men with perfect self-control, while a sincere man is never like that. Act like that, take the lead, never ask for an opinion, don't argue, imagine you are with a child, validate them, don't do anything you are not comfortable with, don't expect anything at all in return, don't try to buy their good attitude, act superior, don't get attached at all, and it may work out. But never expect to be understood, praised, or loved by a girl like that, never open up - she won't relieve your loneliness, if you feel like that.

  4. I found all of the information you provide to be very helpful and want to thank you for posting this to help people like me. I'm currently in a relationship with someone with bpd..I never even heard of this disorder until she was diagnosed 3 months into our relationship. .we've been together for a year now and it's probably been the most difficult year of my life..I just don't know where to start ..I'm not sure if this is even worth it anymore. .it's taking its toll on me's stressed to the max and just don't know what to do anymore. .she hasn't made much effort to get better ..stopped taking meds and rarely does her behavioral therapy, but she does go from time to time . I don't see much progress and just don't know if it's worth it anymore. .I do care about her very much but it's costing me my sanity...what should I do ?

    1. Thanks for your kind words.

      Unfortunately I am not able to give you any specific psychiatric advice without personally evaluating you and your situation.

      It sounds like you yourself might benefit from discussing your situation with a therapist who understands these sorts of issues. The types of therapists I recommend are listed near the end of the post:

      They are a bit hard to find, but worth the effort. The most commonly practiced models from the list are schema therapists and Bowen Family Systems therapists (although the latter are not big on making psychiatric diagnoses like Borderline).

      Sorry I can't be of more help.