BPD: Stop Walking on Eggshells

People with BPD feel the same emotions as others and do many of the things that others do, but they (a) feel things more intensely, (b) act in ways that seem more extreme, (c) have difficulty regulating their emotions and behavior.

DSM-IV definition of personality disorder:

• an enduring pattern of inner experience and behavior that deviates markedly from the expectation of the individual's culture
• pervasive and inflexible (unlikely to change)
• stable over time
• leads to distress or impairment in interpersonal relationships

Criteria for BPD: A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: [I'm listing the ones relevant in my situation]

• Frantic efforts to avoid real or imagined abandonment.
• A pattern of unstable and intense personal relationships characterized by alternating between extremes of idealization and devaluation.
• Identity disturbance: Markedly and persistently unstable self-image or sense of self.
• Affective instability do to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
• Inappropriate, intense anger or difficulty controlling anger. 

When a caring person does something that a BP interprets as a sign that they're about to leave, the BP panics and reacts. They may burst into a rage or beg the loved one to stay. When your BP becomes upset, think about what happened that might have triggered fears of abandonment.

BPs look to others to provide things they find difficult to provide for themselves -- e.g., self-esteem, approval, a sense of identity. Most of all, they are searching for a nurturing caregiver whose never-ending love and compassion will fill the black hole of emptiness and despair inside them. 

At the same time, BPs have such low self-esteem that they don't understand why anyone would want to be with them. They are hypervigilant, looking for any cues that might reveal that the person they care about doesn't really love them and is about to desert them. 

A BP's current opinion of someone is often based on their last interaction with them -- like someone who lacks a short-term memory. 

BPs cannot handle inconsistencies and ambiguities, cannot reconcile one's good and bad qualities into a constant coherent understanding of the person. At any given moment, the person person is either good or evil, there is no in-between. Someone is either a friend or an enemy, a passionate lover or a platonic buddy. This is why BPs often don't like themselves -- they feel like failures if they don't attain perfection. 

BPs lack an essential sense of themselves, just as they lack a consistent sense of others. Feeling empty inside, they are dependent on others for cues about how to behave, what to think, and how to be. Being alone leaves them without a sense of who they are or with the feeling that they do not exist. 

Suicide seen as answer to overwhelming emotional pain. 

BPs need to control others because they feel out of control with themselves. Also, they're trying to make their own world more predicable and manageable. 

BPs are not intentionally manipulative; rather, this is a desperate attempt to cope with painful feelings or to get their needs met. They're acting impulsivity out of fear, loneliness, desperation, and hopelessness. 

High-functioning BPs appear normal to those outside the family.

Lots of projection -- denying one's own unpleasant traits, feelings by attributing them to others.

Non-BPs can feel brainwashed -- the BP isolates the non-BP, exposes them to constant messages, deprives them of sleep, abuses them, causes them to doubt what they know and feel. BP thinking: If there's just one thing wrong with me, I must be defective; I can't be defective, so if there's a problem, it must be someone else's fault.

Why the inconsistencies? Putting others in a no-win situation (e.g., you're too smothering, you don't care about me) allows them to self-validate when validation has been in short supply in their lives. Also, they have an inconsistent sense of self. In order to state their preferences, people must be able to clearly identify their feelings and beliefs, but some BPs have an inconsistent sense of self.

Sometimes BPs seem to be wanting you to "keep your distance a little closer." This is impossible. This behavior pattern results from two primary and conflicting fears: the fear of being abandoned and the fear of being engulfed or controlled by others. The urge to merge and the desire for independence cause them to look like a walking contradiction. Sometimes they seek closeness and nurturing and sometimes seem compelled to drive you away.

One you get too close, they feel engulfed or afraid of losing control. They don't know how to set healthy personal limits and genuine intimacy makes them feel vulnerable. They might be afraid that if you see the "real" them, you'll be repulsed and leave them. So they push you away, but the distance makes them feel alone.

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5 tools to take back control of your life:

1. Take care of yourself -- find support, mindfulness
2. Uncover what keeps you feeling stuck
3. Communicate to be heard
4. Set limits with love
5. Reinforce the right behaviors

Making changes within yourself:

• Know who you are, act according to your values, communicate what you need and want to the people in your life
• Detach with love (from Al-Anon): I'm not responsible for her disease or recovery from it; I let go of my obsession with her behavior and begin to lead a happier, more manageable life. 
• I didn't cause it, I can't control it, I can't cure it.
• Understand the effects of intermittent reinforcement. This can lead to feelings of addiction (98-99). 
• To get unstuck, stop focusing on the BP and work on becoming more of your own person. Help others without rescuing. Express confidence in your family member's ability to start finding solutions to her problems. "I'm here if you need me, but your choices belong to you.
• Believe you don't deserve to be treated badly. 
• Have a firm sense of who you are apart from the BP. 

Set boundaries:

• Kahlil Gibran: Stand together yet not too near together: for...the oak tree and the cypress grow not in each other's shadow. Enmeshment is comparable to the oak tree and the cypress growing so close together that their branches and roots become entwined. 
• Set limits and learn to take care of your own needs and live your own life. 
• Paraphrasing and reflexive listening: Make I statements; Restate key points; Make neutral observations; Stay focused on your message; Simplify; Give positive feedback; Ask questions.
• Responding to attacks and manipulation: don't defend, don't deny, don't counterattack, don't withdraw.
• Defusing techniques: agree with part of the statement; agree with the possibility that your critic could be right; recognize that she has an opinion. 

Asserting your needs with confidence and clarity:

• Stop sponging, start reflecting. 
• Ways to reflect or mirror BPD behavior: breathe deeply; keep seeing shades of gray; separate your feelings from theirs.
• Acknowledge before disputing.
• Prepare for the discussion: be specific; communicate one limit at a time; begin with the easy stuff