A few years ago I did a blog post (July 22 2013) about movies that purport to be about someone with borderline personality disorder, and mentioned that the two most accurate portrayals came in the movies Thirteen and Frances.
Recently I came across the clip from the latter movie which dramatically illustrates why clients with this disorder are so unpopular with therapists who don't know how to handle interactions like the one in the clip.
Frances with Jessica Lange came out in 1982. As I wrote in the previous post, it was highly fictionalized but inspired by the true story of a minor movie star named Frances Farmer who ended up in a mental hospital. In the clip, Frances cunningly makes her psychiatrist break into a cold sweat by zeroing in on his insecurities.
Check it out at the link below. Try to imagine how uncomfortable you would be if you were in the therapist's position.
When I first treated someone with the disorder as a psychiatric trainee, my very first patient had the disorder - and it wasn't even yet in psychiatric diagnostic manual, the DSM. She had been seeing another resident, who had moved on in the residency program. She described this woman as a Goddess - except for the fact that she had abandoned the patient and stuck her with me. She spent the first two or three sessions doing nothing but insulting or attacking me - mostly for my inexperience, of course. Then she went to my supervisor to complain about me, and asked to be transferred to a different therapist. Luckily, he was one of the few therapists at the time that was on to people like her, and told her she was stuck with me and to give me more time.
"Splitting:" the belief some therapists have that these patients see others as all good or all bad with nothing in between. There is strong evidence that this behavior is more of a strategy for eliciting certain reactions and is part of a "false self: or persona which is meant to stabilize a dysfunctional family of origin. But a lot of therapists don't seem to really understand the difference between innate ability and performance.
At the time, of course, I didn't know anything about any of that. Very few in psychiatrists in those days knew much of anything at all about family systems theory . I began wondering what on earth had made me decide to go into this line of work. But somehow I had managed to stay cool during the ordeal. The patient settled down and stayed with me weekly for the entire academic year.
I still had no real ideas about why she had been so hostile at the beginning, but at the end of treatment she made a confession that really peaked my interest in BPD. She said what she had been thinking at the time she had been attacking me - not in hindsight but at the time. She was secretly telling herself, "This guy is amazing. He's not throwing me out of the office." What she had been doing was literally all an act, and that in fact, she was secretly admiring me. Now why would anyone act like that?
https://www.google.com/search?q=lane+smith+and+jessica+lange+in+Frances&sca_esv=fbc3f32290323a31&sxsrf=ANbL-n4wub5Y-I9FiDbpMECVt3J9s_kFsw%3A1780024592766&ei=EAUZaua7LuOjqtsP5ZyPqQY&biw=1279&bih=758&ved=0ahUKEwjmg6ysxN2UAxXjkWoFHWXOI2UQ4dUDCBA&uact=5&oq=lane+smith+and+jessica+lange+in+Frances&gs_lp=Egxnd3Mtd2l6LXNlcnAiJ2xhbmUgc21pdGggYW5kIGplc3NpY2EgbGFuZ2UgaW4gRnJhbmNlczIFECEYoAEyBRAhGKABMgUQIRigATIFECEYqwJI8XxQsQdY0WFwAngBkAEAmAFioAHQCaoBAjE1uAEDyAEA-AEBmAIPoAKUCcICChAAGLADGNYEGEfCAg4QABiwAxjkAhjWBNgBAcICFxAuGLADGLgGGNgCGMgDGNoGGNwG2AEBwgIFEAAY7wXCAggQABiABBiiBMICCBAAGKIEGIkFwgIKECEYoAEYwwQYCsICBBAhGArCAggQIRigARjDBJgDAIgGAZAGD7oGBggBEAEYCZIHBDE0LjGgB8M2sgcEMTIuMbgHhAnCBwcwLjguNS4yyAc8gAgA&sclient=gws-wiz-serp#fpstate=ive&vld=cid:da6f290f,vid:X701amn7SmU,st:0
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