Wednesday, October 6, 2010

How to Disarm a Borderline, Part I

I selected this post to be featured on Mental Health Blogs. Please visit the site and vote for my blog!

If you are an adult in a relationship with another adult, either through blood or through a romantic liaison, who fits the description of a patient diagnosed with borderline personality disorder (BPD), then you already know that you have your hands full.  A New York Times blog post about BPD drew 470 rather contentious comments ( from people who were dealing with BPD relatives and other people who themselves have the disorder.  Although I am in neither category (hopefully), I wrote a few posts myself. 

I wrote about some of the ideas that I describe below.  A couple of people who said they were dealing with BPD parents did not like what I wrote, but showed that they had adopted some of the very behavior they were complaining about in their parents, as evidenced by their responses to me (more on why this might happen shortly).  I was being nice, so I didn't point that out to them.

Some people say that the only way that you will surely survive a relationship with someone with BPD is by cutting all contact with the "toxic" individual.  Some therapists even say this.

If you are in a romantic relationship with a person with BPD, that might indeed be the best course.  Has the relationship already been going on for quite a while?  You won't like hearing this, but this means you: you need to ask yourself why you are attracted to such a difficult person in the first place.  Please don't give me the usual crap like, "I didn't know what (he or she) was like that at first, but now I'm involved and I can't get out.  (He or she) was so charming at the beginning of the relationship!" 

Puh -leeeze!  You are like the wife who insists her husband is not having an affair while she looks for the stain remover to get the lipstick off her husband's shirt collar. Sorry, but most people run at the first sign of BPD behavior.  It is not subtle, and one does not often have to wait very long before one first sees it.

Well, you might object, the person threatens suicide if I tell them I'm going to leave them!  So, let me get this straight.  You're planning to sacrifice your whole life because someone might stab themselves in the heart in front of you and then quickly hand the knife to you before they die so your fingerprints are all over it?  If you feel so responsible for other people that you respond to this kind of threat by caving in to it, please, get some therapy.

When it comes to parents with BPD, however, the strategy of divorcing one's family, while better than remaining in a toxic relationship with them, creates other problems.  First of all, it's kind of lonely to have no family.  You will be faced with a cavernous hole in your life. 

Second, you came from them.  If they are monsters, what does that make you?  You undoubtedly share at least some of their toxic behaviors whether you like to admit to it or not, because one can not grow up in a toxic household without adapting to it in ways that are both problematic themselves and very hard to stop later on in other social contexts. 

Especially with your own children.  Attachment studies clearly show that the best predictor of one's relationship with one's children's relationship with one's parents or other primary caretakers.  Some people from abusive households wisely decide not to have children for fear that they, too, might become abusive.  But is that what you really want to do?

Besides, you cannot completely divorce yourself from your family, because you carry them around with you in your head. Literally. We in the biz call these mental representations schemas.

Your choices are not just limited to these two:
1) To either to continue to be mistreated, or
2) to cut off all contact with your family.

A third choice is to change the nature of your relationship with your parents so that you are not being mistreated but are still in contact with them.  Impossible, you say?  I disagree.  While you do not have the power to "fix" your parents, you do have the power to fix your relationship with them.  If you change your approach to them in a consistent manner, that will force them to change their approach to you. 

However, there is a big problem that you will face in doing this: since you have been in a relationship with them your whole life, they have developed a whole repertoire of behaviors, include recruiting other family members, to give you the powerful message, "You're wrong.  Go back to responding the way you used to."  If one strategy does not work, no worry.  There are plenty more where that came from. Scary to be sure, but not insurmountable if  you can enlist a therapist who knows something about the family dynamics in people with BPD.

Therapists like myself who work primarily with patients with BPD, regardless of their "school" of psychotherapy or their theoretical ideas about the causes and cures for the condition, all have independently developed some ways of getting BPD patients to be more cooperative with them.  (That is, cooperative just with the the therapist. Unfortunately, not with anyone else). We seem to have all come up with these little tricks of the trade independently, yet they are all very similar, as I described in a paper called, "Techniques for Reducing Therapy-Interfering Behavior in Patients with Borderline Personality Disorders: Similarities in Four Diverse Treatment Paradigms" (Journal of Psychotherapy Practice and Research 1997; 6:25-35). 

Marsha Linehan of DBT fame, Otto Kernberg of psychoanalysis fame, Lorna Smith Benjamin of interpersonal therapy fame, and myself (with my not-at-all famous treatment paradigm called Unified Therapy) all do pretty much the same things at the beginning of treatment.  (We then start to diverge considerably).  These strategies are survival skills for us.  Therapists used to come up to me all the time and ask me how I could stand to work with several patients with BPD at the same time, but it really is not a big problem if you know the "tricks."  I had to devise them a long time ago because I built up a private practice by taking referrals of these patients whom no one else wanted to treat.

As I mentioned, it is much harder for someone who is already enmeshed with a relative with BPD than it is for a therapist who has just met a patient with BPD.  One reason is the aforementioned repertoire of behaviors they have designed over many year specifically with you (the enmeshee) in mind.  They know all of your weaknesses and exactly how to take advantage of them.   Second, as a therapist, I do not have to deal directly with a bunch of interfering relatives like the enmeshee does.

The third reason has to do with something behaviorists call a variable intermittent reinforcement schedule.  This schedule is why slot machines in casinos are so successful.  You never know when the damn thing is going to pay off, and it pays off just often enough, so you keep pulling the lever until you lose your shirt.

I should mention that, as John Rosemond is fond of saying, people are not lab rats that blindly respond to rewards and punishments. However, if a person has a goal, and their behavior helps them to reach it, reinforcement schedules kick into play. It is not the person being "rewarded," but the behavior. It is not rewarding to have people hate you.

The goals of the worst of the behavior exhibited by people with BPD, for reasons I will not discuss here, is to cause in their targets one of three reactions.  The first two of these invariably lead to the third.  The three reactions they shoot for in their targets are a sense of anxious helplessness, a sense of anxious guilt, and overt hostility. 

The great big secret, however, is that folks with BPD are often highly ambivalent about getting these reactions.  They will try like hell to get them - and believe me, they are real professionals at it - but they secretly wish to fail. (How do I know this?  Experience.  But I can not prove it - because there is literally no way to set up an "empirical" experiment that would fill the bill - so readers can call this highly speculative if they wish).

If the persons with BPD succeeds at getting one of three reactions, they will continue to draw for it.  Pull out all the stops in order to get them, in fact.  If they fail at getting the reactions, however, they will suddenly become more conciliatory.  However, because of the variable reinforcement schedule, if they only occasionally succeed in getting one of the reactions with a person with whom they have already been interacting for a long time, they will keep trying much longer. 

Therefore, if you already have a history with them, and they have a track record of making you react in any or all of the three ways, their behavior will get much worse before it gets better.  If you can not keep your cool and occasionally react the wrong way, it becomes even harder to get the BPD's to change their behavior toward you than if you react the wrong way all the time!

In later posts, I will share with readers the therapist's tricks for avoiding "rewarding" the bad behavior of persons with BPD, but most people who are already enmeshed with a BPD family member will find it nearly impossible to employ them successfully without the help of a therapist who understands the family dynamics of those who suffer with the BPD traits, and who can prepare them for your "adversary's" formidable defenses.  I will start in an upcoming post with what not to do.


  1. FunctionalAnonBPDJuly 8, 2011 at 6:27 AM

    "If they are monsters"

    I carry the guilt and shame of actions I can not undo. I work every day to be a person who would never do such things again. I live in fear of getting sick again or reverting.

    and still BPDs are monsters

    1. '...and still BPDs are monsters...'

      And there is it, typical BPD behavior, where the finish line is self pity.

      If you have guilt and shame over actions you cannot undo, then make your amends and do not feel sorry for yourself.

      We all have to live with the things we do in life and if you have harmed people, your sympathy should go to them, not yourself.

    2. The stigma sticks even when the symptoms subside. Low-self efficacy + the impact of external and internal stigma = a self-fulfilling prophecy.

      Emotional regulation disorder suits the disorder much better. The maladaptive behaviours are coping mechanisms secondary to the primary problem of regulating extreme emotions. Treat the primary problem (emotional regulation) with CBT and medications if needed. Provide a coping mechanism tool kit a la DBT. Treat the secondary behaviours (coping mechanisms for the emotional dysregulation) with CBT and guided talk-therapy,etc. Reinforce that the label is not who the BPD patient is. Identify the traits but give the patients the autonomy of identifying these traits themselves.

      BPDs are individuals who share common traits. Not every BPD will have the exhibit the exact same traits nor to the exact same degree.

      It does hurt to be called "typical" and criticized for having "self-pity". It compounds the problem of feeling helpless which only fuels the "manipulative" behaviour.

      The most effective treatment I have received by far was by a psychiatrist and psychologist who abandoned referring to BPD in treatment and focused on the behaviours and cognitive patterns. In therapy we discuss day-to-day problems and my psychologist prompts the discussion in a way that allows for reflection on behaviours, triggers, and allows me to devise solutions.

      I sincerely wish more psychologists and psychiatrists were like this. I am a person. I am not a diagnosis.

      I know my situation is very different from many BPDs and I have improved drastically over the past years. I was unofficially DX at 15 and it impacted how medical and psychiatric professionals treated me. I started making progress when my former psychologist moved away and I was set up with a new psychiatrist and psychologist with this line of thinking. My former psychologist made me listen to mindfulness tapes during our sessions which was not helpful. I told my current psychologist that this was not effective and I wasn't learning anything. I need to learn how I work (self-identify emotional and behavioural patterns) in order to know how to cope better.

      I am prone to bias because of my personal experience of what has been most effective in treatment and I understand that what works for me may not be applicable with others. I am a higher functioning BPD with ADHD, recurring PTSD symptoms, anxiety, depression and a chronic pelvic pain/hormonal disorder (stage IV endometriosis which I was actually misdiagnosed and dismissed by my GP because she suggested my symptoms were psychosomatic and part of my BPD. The delayed diagnosis very well may have contributed to the progression to the most advanced stage of the disease) However I think it is safe to generalize when I say that the stigma associated with BPD impedes treatment by both unconscious and conscious biases in both the patient and therapist.

  2. hello, i am a 19 year old with BPD. i stumbled upon this after searching the internet for ways to control myself when i realize i'm acting incorrectly, irrationally, or generally out of control. after reading this, i make much more sense to myself, but please realize that there are BPD patients out there that do everything in their power not to be a statistic.

  3. My answer Dave, is you haven't lived with them and seen what they really do. You work with them a few hours a week. Your perspective is limited. I can bet that they downplay what they do to you. I had a family member with BPD try to kill their own daughter. Do you suggest some family healing? I certainly don't.

    1. Anonymous,

      You mean like the one who tried to kill me after I told her I was going to discharge her from a hospital? (that was before I knew how to deal with them). Or perhaps you mean the one who brought a gun to my office and shot herself to death in front of me?

      Actually, I can usually tell when they are downplaying what they do. And I also have interviewed many family members and listened to tapes of conversations of adults with their parents when their parents did not know they were being recorded - illegal in some states but not illegal for me to listen to.

      If they are abusing their own children I have to report them to the authorities - and have.

      Being empathic means trying to understand why they do what they do; it does not mean condoning bad behavior - that is sympathy. If they are doing bad things, sympathy can not be empathic, because they know that what they have done is bad, and they know you know, so the "empathy" would be an obvious lie.

      BTW, I do not believe in the "bad seed" theory of evil.

    2. And yes I would recommend family healing in that case - but only with a chaperone present at all time.

  4. Therapist attitudes about persons with this illness are a huge part of the stigma. I've never tried to make anyone feel helpless, guilty or hostile deliberately. Nor do I sit around scheming about hurting or manipulating anyone (which is another stereotype of BPD).

    We are the furthest thing from people with anti-social personality disorder. If anything, I've been told I am too overly compassionate for my own good. We don't try to hurt people on purpose. Most of us are in mental hell and agony. We understand pain all too well. Why would we want to inflict it on someone else?

    I have PTSD from severe childhood abuse, and think the name of this disorder should be changed to Complex PTSD or anything but "Borderline", some ridiculous, inaccurate remnant of Freud. The reactions we have, can most of the time be traced back to abuse.

    We are constantly demonized on the Internet as vindictive, manipulative vermon no one should want to live with or marry, but, as your blog infers -- if someone in your family has BPD, and you're stuck with them, you might want to learn how to put up with them.

    We are unique individuals--not a diagnosis. Labels create stereotypes that can make therapists myopic. The best thing that has ever happened for us, is that Marsha Linehan "came out" about being borderline. The fact that you understand what I mean by saying she "came out" is proof of the harmful stigma that has been developed around this diagnosis.

    It was a big thing to admit she had the disorder that makes you an unwanted client for most therapists. The people trained to deal with the worst of the worst behavior will turn you away, because your very personality -- the essence of who you are -- is so horrific compared to the rest of accepted society.

    Sometimes I wish I never knew this about myself. The diagnosis has harmed my self-esteem irreparably. Knowing that most people, even therapists, makes me want to die.

    If any of this makes you feel guilty or hostile, that is not because I somehow wanted to make you feel that way.

    It is your interpretation and your reaction. I am what I am. I don't try to "make" anyone feel any way. I don't have the mental energy to manipulate anyone. It takes every ounce of energy I have to keep living one more day, knowing that the world hates me for what I am.

    You should own your own feelings and reactions. I'm always being told to own mine.

    1. Hi Anonymous,

      Thanks for writing in. You bring up several extremely important issues, and you may be surprised to learn that I agree with most of what you say.

      It's almost impossible to write about the disorder without offending someone.

      Even though I specialize in treating patients with BPD in therapy, in a sense I really don't believe in it. It's not a mental illness like most psychiatrists believe these days, but a complex psychological problem - and trauma and/or certain dysfunctional family patterns are at its core.

      The "diagnosis" is just shorthand for me, although it is also true that many therapists use such labels in the very stupid way that you are concerned about. But please don't tar all of us with the same brush.

      The name is indeed a ridiculous anachronism - an adjective, now without a noun. But we are kind stuck with it.

      People who meet criteria for the disorder are very diverse just as you point out - there are over 200 different ways just to meet 5,6,7,8, or all 9 of the criteria. So naturally any generalization I make may not apply to you or any other specific patient. But generalizations do provide a therapist with a first draft of an hypotheses about a patient and his or her family dynamics, which later changes with additional information. So generalizations do serve a purpose as long as one does not take them TOO seriously.

      There is indeed a stigma attached to patients who meet the description of BPD with mental health professionals, and a lot of therapists and psychiatrists won't deal with them, unfortunately. Personally, I love working with them, at least most of the time.

      It is also true that patients with BPD are highly compassionate people. So compassionate, in fact, that they sacrifice their own happiness for the needs they perceive in their families. And I absolutely agree with you that all of them (not just most) are in mental hell/agony.

      However, it is also true that they often make people very uncomfortable, and many of them have eventually admitted to me that they do it on purpose. (I could tell you stories that would curl your hair). They do this not because they are sociopaths or because they are trying to hurt anyone. In fact, what they are usually doing is drawing hatred onto themselves. They're good at it.

      Being compassionate and difficult at the same time is not contradictory, because it's not an either-or situation. People with BPD did not become aversive for a lot of therapists by accident.

      You are also right that no one can "make" anyone feel anything, but certain provocations have a very high likelihood of evoking certain reactions from other people. If someone keeps kicking you in the shin, for instance, chances are good that you will get angry at them.

      Understanding why a patient would do such a thing allows me to feel empathy, not hatred.

      I really am sorry if that does not come across in my posts. I've been criticized because sometimes I even use dark humor to make a point and to cut the tension. (The last thing patients need is a therapist who is as unhappy as they are).

      I sincerely hope you find the kind of help that you need to feel better about yourself.

    2. Uh, it is possible to comment without offending. You just choose not to.

      In my experience, doctors, psychiatrists, psychiatric nurses, crisis teams, and psychologists actually intensify anger, hoplessness, worthlessness. In fact for me, they brought developed anger in me that I never had in my entire life and I am in my 40s.

      Before seeing any of the above mentioned, I just had depression. When they realised it was treatment resistant they decided to label me as BPD and since I never had any of the traits in my life until they got stuck into me, I fail to see the accuracy of the diagnosis. Typical how so-called professionals are unable to treat people so they blame the patient as being difficult and therefore BPD instead of owning up to their own inadequacies.

    3. I'm really sorry that you were the victim of this sort of mislabeling and incompetent help- it is far too common.

      I have to try to undo this kind of damage to patients all the time in my practice. You should see the crazy combinations of drugs I have to take people off of, and the number of people who get a diagnosis for which they do not even meet the commonly accepted criteria (flawed as they sometimes are).

    4. '...knowing that the world hates me for what I am...'

      The 'world' does not hate you for what you are, but people might hate you for what you do. Big difference.

      Your thoughts are not the problem, as we all have bad thoughts, it is your actions that are the problem, and it is much easier to change your actions than your thoughts.

  5. Have there been studies done to confirm these observations, that people with BPD DESIRE to make others uncomfortable? I do not desire to do that at all, and have not ever had thoughts like that. I don't get off on making others unhappy. What would be the point?

    The kind of help I need, is for people in the profession to stop demonizing us. Perhaps write a blog about how we might have some redeeming qualities.

    If anything, I try very hard not to offend anyone and live in constant fear of doing saying the wrong thing, lest I be ostracized further or inadvertently offend someone. The two others I know with BPD also try very hard to fit in socially and not step on toes.

    Making statements based on a few cases does not constitute empirical support. It does sounds like a rationalization for prejudice against a category of people you hate.

    I prayed and prayed for 18 years as a child for the future, for the suffering to end, to get out of there, and when I finally did, I was slapped with a demeaning label to cause further pain and suffering. To make me feel humiliated as a person, to stereotype me as a horrible person.

    When will the psychiatric profession stand up and do something for people with BPD? When will they argue for a change of the name? When will dialectical therapy be paid for by insurance?

    These are issues for the profession to consider. The reason these problems will never be addressed is simple: hate. We are a category of people that is hated and prejudged as having no redeeming value.

    For the sake of all of us, please re-examine how you refer to us in a global forum.

    First, do no harm.

    1. Hi Anonymous,

      I did not say that patients with BPD really WANT to make others uncomfortable; they are just playing a role. If they weren't, it wouldn't be so easy to get them to stop the provocations once a therapist knows the tricks of the trade (and all theorists of every stripe use variants of the same tricks, including Marsha Linehan).

      In fact, secretly BPD patients hope beyond hope that they will FAIL at making others uncomfortable. My post about the spoiler role explains in general terms why they do all this -

      My ideas are not based on just a few cases but on hundreds, since I watch videos of psychiatry and psychology trainees doing therapy as well as having dealt with patients with this disorder myself for 37 years.

      Until we figure out a way to read people's minds, this is not the sort of observation that is amenable to "empirical research." By the way, while there are some studies which are suggestive that parts of Marsha Linehan's theories about the origin of BPD might be on the right track, there are NO studies which directly confirm it (and the treatment outcome studies only show that DBT is good for reducing at most two symptoms of the disorder. Not good enough, in my estimation).

      There is no way I can convince you that I don't view these patients are horrible people. Believe it or don't.

      I don't know about where you are, but in most places insurance will pay for DBT. Just like with all therapy, however, it does not pay very well. I agree with you that psychiatrists, along with psychologists, social workers, and LMFT's, have all done a lousy job of advocating for psychotherapy for their patients in need - not just patients with borderline personality traits.

      I can't control how people might interpret what I say, but avoiding frank discussions and exchanges of ideas for fear that somebody somewhere will misunderstand what is being said would be very counterproductive. Sorry.

    2. BORDERLINE's - listen up: We get it, okay? WE GET IT. It's not fucking rocket surgery. We HEAR what you are telling us. We KNOW that you are suffering. We UNDERSTAND why you act the way you do. The same can be said of pedophiles and serial killers but society still holds them accountable, right? Don't you?

      Now, that is not to say that you are pedophiles or serial killers but like them, you get your needs met at the expense of others and like them, you are vilified not because of your DISORDER but because of your BEHAVIOR.

      SO - that being said, what you must accept is the fact that we do not need to hear ONE more explanation about what you are going through. Whatever the reason, whatever the cause, what we need for you to do now is OWN your own problem, ACCEPT responsibility for your actions, ACKNOWLEDGE the damage that you cause you and everyone involved with you and take an ACTIVE role in getting yourselves under control. Period.

    3. Exactly. The issue with Borderlines is that nothing, I mean NOTHING, is ever their fault. No matter what harm they cause others, it is ALWAYS because someone else *made* them do it, which is an excuse no one over five years old would ever tell themselves, much less believe.

      We all like to feel sorry for ourselves at times and we all justify and rationalize our behavior, but this goes way beyond that. Most Borderlines have no lasting friendships and yet it is never something they could have done to cause the break, absolutely never. It is always the other person's fault that they finally had enough of the screaming, the public spectacle, the endless phone calls, the guilt trips...the Borderline is a bully and a professional victim ALL the time, as they believe they are never, ever wrong about any thing they have done and they never apologize.

      Aside from that this is simply an unattractive quality in a human being, as we are *all* wrong sometimes and we all need to apologize sometimes, feeling like a victim leaves you no place to go. No way to change. And people finally give up and walk away, leaving the Borderline with the self-fulfilling prophecy of 'I knew they would leave me someday, see I was right all along'.

      Borderlines do not get abandoned by people in their lives, they push everyone away. And since abandonment is their worst fear, they are, in fact, their worst enemy and they themselves have created the hell that they most fear.

      But try telling that to Borderline, if you like abuse.

    4. SteveinLA (so as to distinguish myself from all other other anonymous') I gotta second the prior 2 posts above me. I am "stuck" with a Borderline, (mother of my child) and as such I am on the constant prowl for info that can give me insight on how to better manage my situation. I am new to this site and I find David's analysis to be quite refreshing. To me, his "humor" is straightforward and obvious. That aside, I have read many a many responses from BDP's and every single solitary one of them are just like the morons at the top of this thread - complaining how all the therapists are out to get them and that they are victims of stereotyping. Listen Dip sh*ts, stereotypes are stereotypes because they are true. The stereotype that crime happens in bad neighborhoods, is because....crime DOES happen in bad neighborhoods. I have yet to come across the stereotype that people who walk alone in urban neighborhoods always meet interesting and exciting new friends. If you are the exception, blame your fellow Borderlines - they are the ones screwing up the grade curve - NOT the therapist. BDP's incessant blame shifting, and circular argument of victimization is simply more proof that BDP is practically untreatable. You " to see the accuracy of the diagnosis?? Listen A-hole, then why the f***k are you reading Blogs on severe behavioral problems?? Why are you not busy leading your normal, productive life and sharing intimate moments with all your friends and family??? The therapists is the one that needs to "own up to their own inadequacies?? No, A-hole - YOU do. Your recovery is not contingent on the rest of society getting their sh*t together first. The fact that some therapist comes across like some d-bag does not invalidate the fact that you are still a complete emotional f-up. You dont get a pass just 'cause some therapist or book used the "wrong" verb to describe your behavior. You are fuc*ing drowning, and all you want to do is complain that the person telling you to grab the rope is yelling at you too loud. Don't like being "demonized"??? Then just start acting like a fuc*ing normal person and stop making life hell for everyone. Oh cant do that, you say??? You feel so empty inside...??? You need help??? Clearly is this is the fault of all the Dr's and nurses and therapists in this country, for they are all intensifying the anger in the room. Funny though, how all the demonizing laser beams shooting out of the heads of every therapist in the country only seem to hit BDP'ers in the face and miss all the normal people. Amazing how all the stereotyping and hatred shooting out of the mouths of therapists have no effect on the behavior of "normal people" YET diabolically cripple the behaviors of all the helpless people who conveniently also got "labeled" as a BDP'er. Tragic. Seriously, either come to terms with your deficits and strive for your OWN recovery, or spare the rest of us your fuc*ing chaos. I have directions to the cliff you can jump off of. (Is it a wee bit obvious that I have some anger issues and a lack of patience regarding BDP'ers. Hope I didn't offend anyone.)

    5. "I have directions to the cliff you can jump off of?"
      The real problem is that idiots like the one above me can share the same intellectual space as a man posting about Psychology with a PH.D.
      Please, anonymous, raise the country's average intelligence and kill yourself, please.

  6. Hi Anonymous and Dr. Allen,

    Great dialogue! Both perspectives that you've introduced makes the issue more palatable; sorry it's at the expense of the two of you. Hope you both see the benefits of sharing your knowledge and insights.


  7. Don't know if you still check these comments, but I just want to say I have BPD and I completely agree with you. It's easy to misinterpret some of it as being offensive but it actually is incredibly empathetic. As for those comments, no, BPD people don't consciously WANT to hurt anyone in any way. But when I get emotional I act exactly as you describe, as that's what my brain tells me to do to feel better. It's very strange. But yes, I try to get those reactions and secretly wish to fail. I cannot emphasize enough how much I agree with that whole section. =) I'll definitely be reading more of your stuff!

  8. I'm not sure what camp I'm in. There's a woman I care about who defintely has BPD. I've known her for nine years, and I love her to bits.

    When it's great, it's great. But the silent treatment is finally making me want to walk. We've both walked away from eachother before, but now I feel like I've taken all I can take - if she doesn't want to speak to me, I'm not gonna sit there and accept the cold shoulder anymore.

    The 'new guy'(s) in her life, while never lasting as long, never seem to have to work as hard as I do with her -- and they get her body and her mind (it appears so, anyway).

    Just recently, she went from texting me excitedly near every morning to talk -- like it was when we first met -- to crying about her ex-fiance of a few years NC-ing her (she left him).

    Even as I comforted her as she cried, she made a dig about the worth of our relationship (I'm her ex) compared to hers with the ex-fiance. She basically said that despite everything and all the years we've known each other, I don't mean as much as some guy she hastily got engaged to.

    I took offense at that. So now, I'm currently being ignored.

    I've fed her, bought her necessities, forgiven her BS, and loved her like no other for nine solid years. Yet that means nothing.

    I could die tonight, and trust me, she wouldn't care - even if I'm one of the only two long-term people in her life who care.

    Do they cause pain purposefully? I don't think they do all the time. Sometimes they do, though, and I've had her admit it to me and had others tell me what she's said about me in the past - all lined with conscious malicious intent.

    That's the real.

    1. I feel your pain my man, but what is even more painfully obvious is that your entire post is all about "her." Everything is about her behavior at your expense. There's no "you" there. That's the "real" problem, not her BDP. The BDP part is her problem, that's for her to fix for herself. "Your" problem is that you are attracted to this bitch in the first place. You have no identity or respect for yourself and that's why you've attached yourself to her. You are broken inside, albeit in a different way, just like her. You wanna fix the situation? Fix yourself, and then she will instantly and magically become completely unattractive to you. Then just walk away. Problem fixed.

  9. I am shocked to see hateful comments. I am a Borderline and I was abused by Narcissist for ten years (I understand this is my fault for letting him do it, but it still hurts)ANd I was the first to look for help and to say I am sorry, while he wants to hear nothing about therapy. So if someone is offended by borderline--go work on your issues, dont shift blame on others!!!!!!

  10. I don't have BPD but just ended a relationship with a woman after 8 months, the first two months functional, the next 4 months becoming more and more problematic, and theast 2 of those 8 months being absolute hell on earth.

    I had no way of knowing what I was about to get myself into. She was kind, loving, compassionate and thoughtful. We lived together after two months of dating. Her income was not enough to support her and her son. I asked her if she would like to "give it a go" and combine income and live together in one place. She agreed, all was fine.

    The short of it: I was once a "God" to her. I could do no wrong. She said I was like a giant. She told everyone where she works about how "great" I was. I would tell her, "Really, I'm not great, I'm just a man who tries to do the best I can, and to love you."

    Within a short amount of time it all began to fall apart. Her behavior was self-defeating and negative, mixed with accolades, mixed with hostility, negative accusations, mixed with words of love and affection. By the time the last 2 of the 8 months came along, she was sabotaging our relationship and destroying our financial stability. Every single day... Every day... she deliberately provoked arguments (accusing me of not paying a bill, when I knew I did pay the bill). I had to go into my files and prove the bill was paid. That is time consuming, and quite frankly, after she accused me of "hiding money" before I pulled out the proof of the paid bill... I was not only NOT enthusiastic about furthering anymore compassionate conversation with her, I was down right pissed off!

    Now, after reading and searching the Internet to figure out what the hell she actually is, I am furious with myself for ever having tried to maintain a relationship with her beyond the first two months.

    Before she moved (I kicked her out) we got into a "good one." She just wouldn't stop with false allegations, exaggerated claims of things she blamed me for that I had no control over (example: my vehicle in a repair shop that she DEMANDED be fixed immediately and it was "my fault" that the repair shop didn't have it finished "in time.")... and the list goes on and on...

    One night I slammed my fist into a wall and I cracked a door. She took pictures of it and secretly set up a case against me for " abuse" and got a Personal Protection Order against me for one year.

    I have NO pattern of abuse. People who know me know that I am loving, caring, thoughtful and compassionate. I loved her. Before the PPO was filed... she told me where she lives, she invited me over for dinner, she asked me to spend time with her and her son... and then, here comes the PPO being served on me after inviting me to her new place. Talk about confusing! I didn't want anything to do with her. She called me! ...and then a PPO.

    So, what I would like to know is this:
    Is she going to stop now?
    What does she want from me? Is she done now?!
    I have a restraining order of "no contact" for a year. I'm glad! I didn't want ANYTHING to do with this woman. I kicked her out! I want her to leave me alone!
    Will she show up in places and stalk me?
    I want to know why this woman is trying to destroy me when all I ever did was try to love her. All of my friends are dumbfounded too.

    Will someone tell me what I might typically expect in the future from this woman?

    Thank you in advance.

  11. Hi,
    You mentioned a person in a long term relationship with a BPD should ask themselves why thet stay in it.
    As a person involved in a romantic relationship with a BPD woman, what might a person like me do to figure out why I am attracted to such a difficult person? Are there certain questions I can ask myself? Thank you.

    1. Hi anonymous,

      Thanks for your question.

      Really, finding the answer to that question may be something that requires the assistance of a good therapist - one who is familiar with these sorts of family dynamics. (The types of therapists I recommend are listed near the end of the post The answers are going to be somewhat different for each individual.

      In the meantime, two possible questions to ask yourself that may lead to the answer - and you really have to be honest with yourself, and it's best not to answer them in public - are:

      1. Who in my family of origin would be negatively affected (as examples: get more depressed, get envious, increase their drinking or drugging, increase the chances for domestic violence) if I were in a healthier, more egalitarian relationship?

      2. Why is it my job to try and "fix" someone who refuses to be fixed, and who undermines all of my efforts to help?

  12. This article (more accurately, my past relationship with a likely BPD) just sickens me. I did everything a healthy, functional, loving, caring, thoughtful, generous human being ...who is compassionate and forgiving, could do to love a woman who, within 8 months ended up making herself out to be my victim. Over and over I would remind her that I am not "doing" anything "to" her, and I was so confused. She broke me down, me not understanding what the hell was going on with her... and by then it was too late. I blew up, and I mean... I blew up! ....Now I have a restraining order of No Contact - Protection From Abuse against me. What did I do to earn that? I drank heavily one particular night and went into an angry episode and broke a door and put a hole in a wall. That is all I did. .....I was so damned frustrated. I thought I was going crazy! I kicked her ass out! NO MORE will I ever date or be with or around a person who I suspect as being BPD. Those people destroy the lives of good and loving people, and they enjoy doing it out of hate. Pure hate! They have to "win" or feel like a winner at something because their self-esteem is so damned low. But you would never know that because they charm the hell out of you to suck in their next victim. I do NOT feel any pity for a BPD. I believe they CAN help what they do to others. They are childish, immature brats who throw a fit because others don't do as they demand or want. If you don't, they bully you, mess with your emotions, your intellect, confuse you and break you down. Hell, I could do that also! ...But I don't because I actually love and care about others I am involved with, not destroy them! ....NO compassion IN THIS CASE of those who "have" DPD. I'm not buying it. Messing with others lives is damned near criminal, if not in some cases, down right criminal!

  13. You cannot disarm a person who has BPD, you will never know what will trigger them. Even if you try your best, you can still be sure your tone or the way you looked at them will trigger them. You can try different angles but nothing will work. I was in a relationship for over two years with a man who has BPD. He never told me he has it, but after a few weeks of dating I figured out that something was truly strange. A friend of mine who is a psychologist told me after describing my situation that he most likely have BPD. After doing more research I was convinced. He realises that he is off, different, but not really doing much to change it. He went to therapy but not really committed. He believes he can fix himself. LISTEN UP BPDs!!!! IT IS NOT YOUR FAULT THAT YOU HAVE BPD BUT IT IS YOUR FAULT WHEN YOU WON'T SEEK HELP, TREATMENT AND YOU REFUSE TO TRY TO GET BETTER! YOU NEED TO STOP ABUSING PEOPLE AROUND YOU WHO LOVE YOU THE MOST AND TAKE RESPONSIBILITY FOR YOUR ACTIONS. STOP PUNISHING YOUR CURRENT PARTNER FOR YOUR TOUGH AND SAD CHILDHOOD. ITS NOT THEIR FAULT.

  14. Where do I find more information about the third option mentioned above?

    1. Hi anonymous,

      I have several posts in this blog outlining the reasons people act the way they do as well as general strategies for working on option #3.

      Unfortunately I cannot give you a specific answer to your question that would work in your family. No family is an exact copy, and there are a lot of variations on the patterns described in the blog. And interventions that work great in one family can backfire in another. It takes a while in therapy to get all the necessary details and plan a detailed strategy.

      So, this option often takes the help of a knowledgeable psychotherapist, and therapists who do this kind of work can be hard to find. The therapy treatments I recommend are listed at the end of my post

  15. Having experienced hell from somebody I suspect is BPD, I see one common thread in all the comments from the BPD individuals here.

    1) They try to minimise the impact of their actions
    2) They refuse to claim responsibility of the impact their actions they have on other people
    3) They blame everyone but themselves for their suffering

    I'm sorry, but the truth usually hurts. And one thing BPD individuals cannot stand, they do not dare to face the truth about themselves and prefer to place the blame on others.

    But until they accept FULL responsibility for the impact of their behaviour on the lives of other people, they will NEVER get better.

    Until they decided to admit the TRUTH that there is no one but them to blame for their 'mental suffering' that life will begin to get better.

    Sorry, you guys hate me now because I tell the truth. You guys do not understand logic, but only manipulation of the people close to you.

    1. I don't think you fully understand bpd so you might want to refrain from such comments until you know better. I'm sure you feel scorned at the moment, which has inspired such a short-sighted attitude, but when you are in a better place, it would be good to reconsider the way you attack things you don't fully comprehend. I have bpd, and take full responsibility for the damage I caused during the worst of it. The feelings attached are that of severe depression, pain, hopelessness and fear - so, yes, I would agree that logic doesn't often play a role. Just the same, the actions of a person with bpd are rarely to be hurtful or controlling out of spite. And there is no such thing as accepting the "TRUTH that there is no one to blame but themselves" because the bpd is not something you cause for yourself. It's a psychological twist in the way we think and process things. In fact, figuring out how our psychology developed this way is one of the best ways to re-train our minds and behaviors. Yes, there are consequences for our actions that others and ourselves pay for. This applies to every human. Having bpd is not the fault of any particular individual, though. Lastly, that you felt the need to put mental suffering in quotations is proof of how much of the problem you are in the lives of others, especially anyone suffering through anything from momentary depression to bpd to schizophrenia. Since you can't understand it, it must not be real. I hope whoever in your life has bpd gets help because they can definitely work and learn to be better. And then, I hope they cut you off because you're a real piece of work. If they are harmful, at least they have a diagnosis. What's your excuse?

    2. Lauren nicely said. I am a non pwbpd but I have suffered much from a few and did my research to see that unless we all understand each other's way of thinking, we both will make bad emotional decisions and cause pain. It is very complicated to grasp from either side without much education.

  16. Hello. I just want to point out that your article enraged me at first. Not because it didn't make good points, but it seemed to really attack people with bpd as if we were horrible monsters when, in fact, people with bpd are usually the result of unfortunate upbringing or something traumatic. Then I read your replies in the comments and realized you do understand us on a more empathetic nature. While I do agree with much of what you said, I think it is just as important to help people deal with us at our worst as it is to help them understand us. We aren't inherently bad people. We simply have a distorted psychological mindset that needs to be handled differently, especially if we are doing our best to re-learn and outgrow it. I hope you combine your dark humor with your actual compassionate understanding a bit more in your writing from here on out. Thank you.

    1. Hi Laura,

      Thanks for you comment. Sorry if the post came across as attacking people with BPD - not my intent. On my Psychology Today blog I discussed the family dynamics of BPD before I started this series of posts, which gives them a different tenor - guess I should have thought of that on this blog. I finally did post about it on this blog at

  17. Hi David.
    Your question “why you are attracted to such a difficult person in the first place“? really made me think so I had a go at answering it in my case.
    Been sitting here for a few minutes and don’t know what to write. If I am honest her looks were what first attracted me and again if I’m honest the thought of hot sex with such a beautiful woman. However while I still consider her beautiful & I now know the hot sex wasn’t there, so why am I still attracted to her? There is no doubt (and despite what others may believe) I would love her just as much if we were not having sex at all - provided she was not looking for it (or using it) elsewhere. That being the case it’s not sex that attracts me to her, or is it? Do I subconsciously hope that if she made a real commitment to me things would change and the hot sex would appear? I don’t think so but in all honesty I can’t say for certain.
    So lets have another go. Why am I attracted to such a difficult person in the first place? After giving it some thought I believe it is the caretaker in me. I’ve know her for a few years and always said she looked so unhappy and all I wanted for her was to make her happy. I know no one can “make” someone else happy so let’s put it another way, I wanted to be someone she felt happy to be with. There must have been something she liked about me as she had made it obvious she was attracted to me, and she set out to date me. Is that the answer? No, because I was also attracted to her but would never have believed she would want me. Is that the answer - was I flattered someone so beautiful wanted me? Again no, she is beautiful however I knew she had “problems” so accepted that those same “problems” meant she might find a man like me attractive. Which brings me right back to the question as asked now, after all we have been through Why am I still attracted to such a difficult person? It’s not enough to say “I love her” because then the question is “why do you love her” when, rather than work on making the relationship a success, all she has done is work as hard as she can to drive me away? Perhaps I am now close to the answer, do I believe she really did love me but she felt unworthy for some reason? I think that is what it is in my mind, without doubt she is a wonderful woman to be with most of the time and I love her for lots of reasons and I believe deep down she still loves me. This would explain why “I am still attracted to such a difficult person”.

    If I am wrong, am I just refusing to accept she does not love me and I’m clinging to the hope she will realise she does love me as much as I love her and therefore she will forgive herself for her cheating and resulting pregnancy and we will live as a happy family together until one of us dies? That’s where I am trapped, she has told me she does not love me - but do I believe her? She has said to others that she “hates me as much as she hates (insert name of the babys father here)” however she has no reason to “hate” me! Is this why I am still so attracted to such a difficult person - while it’s clear she has low self esteem and may not feel she deserves me, do I feel I need to prove she need not hate me and that I am worthy of her?

    1. Hi Fred2016,

      Unfortunately, I can't say anything about you or this woman without having spent a lot of time evaluating the situation in face-to-face psychotherapy.

      You might, however, see if anything described in the following post seems to ring a bell:

  18. I am a non, who's mother has traits of bpd. Who's first wife is a witch waif type traits of bpd. Short marriage.
    2nd wife was like meeting my best friend she mirrored me and my wants so well. Her traits turns out waif queen but quiet type very covert and subtle. 20 year relationship. Signs were here and there on menstrual cycles and after 1st child. Over the years she slowly pulled away from being my very best friend to a untrusting suspicious ect ect. At age 39 perimenepausal symptoms started messing with her and her bpd episodes went to severe levels. Never in previous years did I witness anything so shocking. I now represent all that is wrong with her and her life. Could not be more hated. I understand how and why and her distorted thinking. And tend to think if I knew then what I know now that I might have survived. But I doubt she let's me try. It would be amusing to try and that I could not hate her for how she is now. She is mostly a good person and ill and needs help seeing that therapy can help her cope better.

  19. To understand bpd. Realize that everything has 2 extremes sides and this person may bounce back and forth between the 2 extremes. Not realizing both can be true and both can be false at the same time. The true answer most likely is somewhere in the gray. They make assumptions on these extreme views. I believe everyone sees the extremes from time to time, but pwbpd see them more often so they make more assumptions and are more emotional. You can see how things could just snowball out of control and you really can't blame them for it. If everyone knew they suffered this and everyone else knew about it and understood and was compassionate about it. It still wouldn't be perfect cause people are different and have it more severely. Educate. Beware, be compassionate cause you don't know what someone is going threw.

  20. BPD persons are the most manipulative, dangerous, toxic and unstable people with whom you will ever meet. Run as fast as you can and keep running as they will destroy your life if you allow them. you may play armchair psychiatrist if you wish- that is your choice. Good luck if you believe you can change them.

  21. Very interesting article. My advice to BPD folks who are offended, would be to focus on online articles which are designed to help BPD sufferers, not those who are suffering at the hands of a BPD person. I imagine it's hard to read from the perspective of a BPD, however I am currently under attack by my daughter-in-law with BPD (they've had their 2 small sons removed due to her suspected abuse). I have been looking after the children for almost 2 years now and despite my constant forgiveness of her sneaky and persuasive behaviour, she is now ramping up her attack and leaving me with physical symptoms including heart palpitations, constantly stressing about what she might do next, anxiety and anxiety produced diarreah which happens several times before having to see her. She gets great delight out of her attacks and is garnering support from her naive family and friends (which makes me very afraid because some of them would think nothing of removing me from this situation). I also know another BPD sufferer who has only mild symptoms and is a nice guy. So, I'm sorry if this article and others like it may offend you, but it is the right of all people to know what some BPD folk are capable of and how to protect themselves and their families when they are forced to interact with a very manipulative, dangerous person. My BPD daughter-in-law has accused me of things SHE does, told everybody I have caused her great anxiety by my supposed 'emotional abuse' of her, told my grandchildren not to trust Granny, followed me in her car, lied, manipulated, has delusions that I am trying to 'destroy' her...the list goes on and on. So, please don't take away the rights of all of us who suffer from these individuals. I am a forgiving person, but I simply cannot tolerate this abuse any longer - nobody should.

  22. Been with a Borderline almost 10 years. Pure hell. The nonstop fight picking, negative advocate recruiting, talking to other people sexually, wanting to go to swinger clubs, police charges, draining bank accounts, lying, manipulating, the constant melt downs, on and on and on and on. Have no mercy on these people. Evil deliberately or not - they are evil. And DO NOT HAVE CHILDREN WITH THESE PEOPLE. They WILL turn them against you. From my experience they are also lazy, parasitic, needy, clingy, demanding bullies who can't stand healthy boundaries or the word "no". They aren't going to change. You'd better. Every day you spend wasted on them, is a day you could have a fulfilling happy relationship with a normal human being and building a beautiful, lifelong relationship. You can't get that time back. Don't waste any more. Ditch em and move on with you life. You'll look back grateful you did. 100%.

  23. "The three reactions they shoot for in their targets are a sense of anxious helplessness, a sense of anxious guilt, and overt hostility."

    Where does this claim come from? Why do you think they are trying to elicit these reactions?

    1. The claim comes from 45 years of clinical experience watching patients with BPD and their families, along with integrating all of the major theories and research about the condition. For the reasons why they do this, see