This post will continue with specific countermeasures to the usual strategies in the BPD bag of tricks used by them to distance and/or invalidate you, as well as to make you feel anxiously helpless, anxiously guilty, or hostile.
Today we discuss #3, countering illogical statements and absurd arguments.
People with BPD will sometimes say the most inane-sounding things as if they believe them with all their hearts. Things like, "I need cocaine. I don't feel normal without it." Or, "I should to be able to walk down dark alleys at 3 AM in seedy parts of town with $100 bills hanging out of my pockets." Upon hearing this, anyone with a lick of sense will feel like talking some sense into the person with BPD.
This presumes, of course, that the person with BPD has no common sense. In fact, it presumes that he or she is a complete moron. If there is one thing I have learned over the years, it is that, despite appearance to the contrary, people with BPD have just as much common sense as anyone else. Usually, they are of above average intelligence. So why would they say such ignorant sounding things?
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| You were expecting a good argument? |
The first thing to notice is that the statements above are actually true. If you are addicted to cocaine, indeed you do not feel normal without it. One should have the right to walk anywhere unmolested, shouldn't one?
The problem is of course that the cocaine is making these folks feel worse in the long run, and that taking such walks is a foolish thing to do, rights or no rights.
So the natural response to such statements is to want to argue with what the person with BPD says. Of course, this is actually invalidating to the person with BPD, because they are intelligent enough to already know what the other person is arguing for. In response, the person with BPD will then dig in and take the position, "My mind is made up; don't confuse me with the facts!" They will then start making arguments that actually are stupid, under the theory that the other person expects them to be stupid!
Individuals with BPD are extremely generous that way: they will give you what they think you expect of them.
If you want to make an obvious point as a springboard for a discussion, you have to use a disclaimer. You have to acknowledge that the person with BPD already is well aware of the point you are making. You might say, "But as you already know, cocaine is distructive in the long run." Or, "Of course you should have the right to do that, but as I am sure you are aware, actually doing it is dangerous. I do not understand why you want to take such a risk."
An important caveat is that you want to keep your statements as brief as possible, and NOT go on to explain what you just said or give additional information that justifies your opinion. The individual with BPD already knows why you think what you think, so there's no point in it. Going on again presumes that the other person is stupid.
The individual with BPD may then explain why they want to take the risk, or he or she may not. Generally, they will just drop the argument altogether. This may not calm your concerns about the risky behavior of persons with BPD, but as I discussed in Part V, you are really helpless to stop them if they are set on doing what they say.
What if the person with BPD does not drop the subject, does not accept the change in the conversation that you are suggesting (that is, talk about why the person wants to do something dangerous rather that argue stupidly about whether or not the something is dangerous), and/or says something that is inherently stupid? My advice: Refuse to argue. You might say something like, "I'm not going to insult your intelligence by arguing with you about that."
If you do not like that one, you can also just say nicely, "I disagree with you." Disagreement is not invalidation. It does not inherently make one person right and the other wrong. It is just a difference of opinion and nothing more. Many people with BPD have never experienced a respectful disagreement in their entire lives.
No matter what else the person with BPD throws at you after that, do not address it other than to state that you will not argue about it any further. Repeat as necessary.
Countering disqualifications is critically important in working with patients with borderline personality disorder, and is almost never taught in training programs.
ReplyDeleteJW
I think the (perceived) power differential plays a role here. I've found that often, as the DOCTOR, any respectful disagreement is perceived as invalidation. It's not hard to imagine why. Our degrees/credentials turn our opinions into psychiatric formulations and diagnoses, so when we offer an opinion, it can feel like an expert opinion, which can make patients feel very defensive (and in turn, lead to efforts to invalidate us).
ReplyDeleteIs there any advice you can offer to one such as I? I'am a mental health RN and have the most difficulty with BPD patients. In fact, I avoid most of them for fear of saying or doing the wrong thing. I do not wish it to be this way which is why I'am bent on educating myself better. Is there any books I can read or sites I can visit to help me with this?
ReplyDeleteAnon-
DeleteI'm, of course, partial to my own way of looking at their behavior. You'll find a lot of the moves/countermoves I describe in the disarming borderline series of blogposts (and a whole bunch more) in Chapter Six on transference in my book: http://www.amazon.com/Psychotherapy-Borderline-Patients-Integrated-Approach/dp/0805842721/ref=pd_bbs_sr_1/102-0491677-8985747?ie=UTF8&s=books&qid=1183213581&sr=1-1
It's written for therapists but I think as a nurse you would have no trouble understanding it.
Dear Mr Allen, I have read through your borderline posts and am thankful for the concreteness, practical, typical examples of arguments, non-arguments and counterarguments, some more automated responses to give when you are lost for words, baffled in a 'sudden' fight with the person with borderline - you also point out honestly admitting when you don't know how to help. That I am helpless too. Yet this is crippling, helplessness for my own problems I can bear, I can sometimes avoid and let be, i.e. accept - but to see the helplessness of someone you love and your own on top, doubles, can be all-overwhelming. Do you have an advise on what to say to yourself (myself) about the guilt that you can't solve their (in this case my partner's) anxiety, Big Problem (that would be tiny to another), anxiously aggressive thoughts, this feeling of inadequacy that takes over. I can accept my own pain and slowly make it sit somewhere and stay there, live with it without it taking over, but with a borderline they put this pain (understandable) pain right in your face and their face everytime, like a giant roadblock, a silent volcano that spits fire seemingly out of nothing, and it becomes everyone's, mine, their problem and block everything. Of course saying how you are blocked by constant strife causes their shame, guilt, anger to erupt again, and there is no ordinary adequate outlet. I feel so ashamed and guilty I cannot do anything (and especially not anything 'right'), that I cannot help someone embrace the ambiguity of life and to not take things personally. What do you tell yourself if you feel guilty, inadequate, guilt and shame are acceptable when there is movement, it's doable if there is change, an incremental growth, but if the growth is little, fragile, temporary, erratic and sporadic?
ReplyDeleteHi Anonymous,
DeleteI agree it is very painful indeed to watch someone you love suffer and not be able to do much about it. Even among therapists, who have less of an emotional stake, it has been jokingly said that helplessness "hits you right in the God."
Unfortunately, I can't give you any specific psychiatric advice in this forum since every situation is different, and I would have to evaluate yours in person.
In general (this may or may not apply in your case), believe it or not, if one member of a couple continuously seems to make the other member feel helpless, and that other person keeps coming back, then the first person comes to the conclusion that the second person NEEDS to be made to feel helpless. So the more hopeless person #1 feels, the more they are made to feel that way.
The issues of person #2 come because of their own family issues - ones that frequently result in narcissistic issues (see http://www.psychologytoday.com/blog/matter-personality/201110/the-family-dynamics-narcissistic-personality-disorder-and).
This may require a therapist in order to sort out for both members of the couple. Unfortunately therapists who understand these dynamics are not easy to find. I list the kinds that might at the end of the post http://www.psychologytoday.com/blog/matter-personality/201205/finding-good-psychotherapist
2 years into a "relationship" with a BPD and Bi-Polar co morbidity. Ticks all the boxes, liar, substance abuse, risky sex and crazy driving, irrational fear of abandonment, splitting, editing, hyper sexuality, paranoia, depersonalization, low self esteem, feelings of emptiness, boredom, intense episodic dysphoria, rage, self mutilation, dissociative experiences ....and more psychs haven't even discovered yet! Stunning beauty, high achiever, super intelligent, often fun to be with but mainly on WhatsApp, in reality I don't exist because she has no empathy. I'm not a narcissist, definitely not a people pleaser, quite the opposite, seeming to spend most of my time pissing others off with little or no respect for their inadequacies, and unforgiving. Now I have existed the "relationship" because there is no further help or love I can give without destroying myself in the process. You just have to quit and take care of yourself. BPD's survive, they are programmed to by their traumatic childhood experiences, they will go on finding other victims. I'm just tired of being one of them.
ReplyDelete