Pages

Wednesday, December 8, 2010

How to Disarm a Borderline: Part IV: The Kernel of Truth

Before reading this post, particularly if you are going to try this at home with a real adult family member with borderline personality disorder (BPD) (which is not recommended without the help of a therapist), please read my previous posts Part I (October 6), Part II (October 29) and Part III (November 24).  In this post, I will begin to run down specific countermeasures to the usual strategies in the BPD bag of tricks used to distance and/or invalidate you, as well as to make you feel anxiously helpless, anxiously guilty, or hostile.

When people with BPD try to distance you (again refer to my Distancing: Early Warning post of July 6), you can use the momentum generated by their attempt to push you away to actually move closer to them in the emotional sense. The idea is a bit like the philosophy of Judo, in which the momentum of an attack on you is converted into something used against the other person - with one exciting exception (apologies to C&R Clothiers for my boomer fans in LA) . In dealing with BPD, the goal is for both sides to win.


Tone of voice is crucial.  You can use the same, and exactly the right, words and sound as if you are indeed feeling helpless, guilty or hostile, or you can sound like you are at peace with yourself and with your own limitations.  Since this post is not an mp3 you can listen to, I will do my best to describe how you should sound. 

You should make any of the counter-statements described below sound completely matter-of-fact.  You should sound warm but not condescending, and like you are taking the opinion of the person with BPD seriously even if you do not agree with it. 

#1:  Wild accusations and exaggerated overgenereralizations.  When those with BPD make overly dramatic, hyperbolic statements or accuses you of having ulterior motives for what you are doing or saying, they are literally inviting you to invalidate them (See my post Validating Invalidation from September 23). 

What is going on here is that, since people with BPD have usually been invalidated on a recurring basis by their family of origin, they respond by making it easy for those people to continue to invalidate them.  And they will often practice this skill on lovers and mental health professionals, or even on innocent bystanders when those bystanders try to be helpful. 

I know it is hard to believe that they have an altruistic motive for behaving the way they do.  They will not usually admit to it, and if they do it will be in a disguised and very subtle manner so you will likely misunderstand what they are saying.  I explain the biological reasons why we are all willing to sacrifice ourselves to our kin group in my books, How Dysfunctional Families Spur Mental Disorders, written for the lay public, and A Family Systems Approach to Individual Psychotherapy, written for therapists.  Most people in the mental health field do not agree with this idea.

In countering this ploy, the idea is to resist the invitation to invalidate them without agreeing to all the exaggerated histrionics or without agreeing that you are some kind of schmuck.  Remember, disagreement and invalidation are not the same thing.  The key:  no matter how awful or crazy-sounding what they say is, there is always a kernel of truth in it.  Always, no matter how small.

The countermeasure, taught to me by the best professor in my residency program, Rodney Burgoyne, is therefore to validate the kernel of truth in the statement and simply ignore all the exaggeration and the negative implications.

Let's start with hyperbole or exaggeration.  My favorite statement of this sort of all time is "Life is a sh*t sandwich, and you have to either eat it or die!"

Eeewwww!  The temptation here to reassure the person who says this that things can not possibly be that bad.  Wrong move.  The counterstatement should be something like, "It sure sounds like you've been having a pretty bad time of it."  Trust me, anyone with BPD is frequently quite miserable for very valid reasons.

Or how about, "Why bother going to a therapist?  They're only in it for the money!"  I used to hear that as an accusation as in, "You don't care about me, you're only in it for the money!"  I could get all defensive sounding and say, "Well you know this is how I make my living!" or I can say very matter-of-factly, "Well, after all this is how I make my living." 

I always thought it was better for the patient to have a highly paid professional therapist rather than an amateur.  The amateur would be too busy out making a living to have much time to devote to the patient's therapy and learning how to be a good therapist.  You get the idea, though.  If you want the patient to get help, you say much the same thing in the third person.

"You don't really care about me" is a favorite accusation of people with BPD that is very hard to validate.  After all, how can you really prove that you care about someone?  You could argue til the cows come home and you still could not prove it.  In truth, there is literally no way to prove it. 

So why bother? Besides, at those times during which they are giving you a really hard time, in actuality you don't care, or wish you did not.   I usually reply, "I wish there was something I could say that would convince you that I do care."

Another type of accusation is more indirect and has trap within it.  Someone in LA, for example, might say, "Anyone who is willing to put up with this horrible smog and traffic is a moron."  Assuming that you happen to live there, this statement in effect classifies you as a moron.  If you agree with it, you are saying that you are one.  Of course, if the person with BPD also lives in LA, he or she is also admitting to being an idiot, so if you agree, you are insulting him or her as well.  So what's the kernel of truth? 

Are smog and traffic bad things?  If you answer no to this question, I would have to question either your sanity or your sincerity.  The counterstatement: "Yeah, aren't those things a bitch!"

Coming up in the next post in this series: #2, countering escalating demands on you to do more and more.

7 comments:

  1. Relating to a person with a diagnosis of schizophrenia is dead simple in comparison.

    ReplyDelete
  2. Most of the time I can deal with accusations. What I can't deal with is silence. For days, weeks, months... As we don't live together, I can only e-mail him... And get no answer. He only does this to me, always answering our friends very quickly, accepting their invitations... Which makes me feel better : at least, he's not alone. How do you deal with this type of distancing ?
    Thanks

    ReplyDelete
    Replies
    1. Hi anonymous,

      Unfortunately, I can't really give any advice about specific cases in this forum. I'd have to know tons more about you and your situation to even begin to offer you any halfway decent suggestions.

      If this is a romantic relationship and not a close relative, in general someone should be asking themselves why they put up with such treatment and/or think they don't deserve any better.

      Delete
    2. Dr Allen MD, I am in a romantic relationship & I am putting up with stonewalling etch from my BPD 46yo bf. I am of a rational mind and absolutely deserve better but chemistry is difficult & there are qualities about him that I admire. It is very difficult. I welcome your expert advice.

      Delete
    3. Sorry, I can't give any psychiatric advice here regarding any specific case that would be useful. Have you thought of consulting with a therapist in your area? The therapy treatments I recommend that come the closest are listed at the end of my post http://www.psychologytoday.com/blog/matter-personality/201205/finding-good-psychotherapist. They can be hard to find. You can ask about a therapist’s theoretical orientation before making an appointment.

      Delete
  3. Not sure if you still use this blog but wanted to comment anyway. I've had quite a few Borderline clients during my short career (3 years so far) but today was, surprisingly, the first time I had the "You're really nice and everything but I feel like you only come here [home therapy] because you're getting paid. I feel like you don't really care about me." I tried to put it back on the client and explore the transference, and then I did provide some reasons and self-disclosure to help her see that I do care, and that the therapeutic relationship is important to me. I also thanked her for letting me know she was feeling this way instead of trying to hide it.

    Not sure what the impact of my intervention will be but I'm sure glad I read this post. I will incorporate this advice into future sessions when I am confronted with further attempts to push me away.

    ReplyDelete
  4. At first let me say thank you for your articles! My wife of 7 years suffers from BPD and while it has always been an everyday struggle for the both of us, it seems to have gotten worse recently. Since I'm always inclined to help people I only recently realized how many mistakes I made myself by trying to put up with too much and handling things for my wife that she found difficult to deal with. She has also very big problems to find a therapist since nobody seems to want to treat a person with BPD. I'm trying to get support from a therapist as well but there are not a lot around who have with experience with BPD. We live in Germany and there is no program or organization available for BPD patients or their family. What I find most difficult is dealing with the tantrums. More often as not I start discussing at some point and of course it always get's worse then. It's hard to stay understanding and affectionate when you're being attacked verbally in a massive way. If I can't handle it I try to retreat and go to another room but while this helps me to cool down it exacerbates the situation for my wife. A lot of times I just kind of shut down now and can't bring myself to try and find a way back towards each other. During that situations I fell less bad being alone but my wife can't understand it at all and it hurts her immensely that there's times I don't want to be around her or can't stand it even. I hope we'll be able to get help at some point!

    ReplyDelete