Pt. Two - And Then We Were Three: Understanding Borderline Personality Disorder
Note ~ There are ten personality disorders listed in the Diagnostic Statistical Manual for Mental Disorders. Their etiology is extremely complex as is management of them. The purpose of today's blog is to shed some light on Borderline Personality Disorder. Names have been changed for confidentiality. First, I invite you to read -
Pt. One - And Then We Were Three: A Troubled Relationship with a Borderline Sister
Part Two - And Then We Were Three:
Understanding Borderline Personality Disorder
It was towards the later part of
the lengthy eighteen year span of upheaval when I entered graduate school to
pursue a career as a Marriage and Family Therapist. In one of my first
psychology classes, we began studying the Axis II Disorders (often referred to
as personality disorders) cataloged in the Diagnostic Statistical Manual of
Mental Disorders (DSM 1V). One evening
in class as the professor moved through the ‘Personality Disorders’, my
attention was immediately drawn to Borderline
Personality Disorder (BPD). As I scanned the diagnostic criteria, my mind
grabbed hold of key words or phrases such as frantic efforts to avoid real or imagined abandonment…a pattern of
unstable and intense interpersonal relationships… identity disturbance…and chronic feelings of emptiness. I couldn’t believe what I was reading! Of the nine criteria listed that described
the manifestations of Borderline
Personality Disorder, I could see my sister Kelly clearly in at least seven
of them. Here it was – the explanation
as to what was wrong with Kelly!
Finally, the puzzle made sense!!
Perhaps there was hope for her! She could get help; she could get
better! Things could change. We could be sisters.
As my weeks of study continued and
as the professor knowledgeably guided us through the challenges of all the Personality
Disorders, a sobering and sad realization set in. Paraphrasing our diagnostic manual, the
professor acknowledged that with ‘personality disorders’, there is a pervasive pattern of some measure of unhealthy
behavior, affect, etc., beginning in
early adulthood and present in a
variety of contexts. In simpler
terms, these personality characteristics are not an explanation of stages the
individual is going through – these traits describe who the person is. This is the
individual’s personality. This is their state of being. In my naivete
as well as with my deep desire to know more, one night in class I raised my
hand and asked the dreaded question, “With Borderline
Personality Disorder, can an individual who seeks out professional
counseling or therapy heal from the issues of abandonment or intense rejection
and lead a more healthy stable life?”
For the next hour, the professor led us in an intense discussion on this
topic. There were no concrete answers. I
was reminded that the practice of psychology is a study of human behavior and when
working with injured individuals, there are always many variables to consider.
Although there were no absolutes,
the professor lifted my hopes a bit with a few concluding words. “Personality
disorders are very hard to treat. Borderlines
are especially challenging because
they often do not stay in therapy long enough to create any kind of healthy
change. But, there is always hope. This
is why we, you and I, have chosen this field – to bring healing to others and
to give them hope for a healthier way of being.” With his encouraging words, I
was determined to gain a deeper understanding of the disorder. After class that evening, I asked the
professor for any additional readings that he could recommend on BPD.
Without hesitation, he replied, “Get a copy of ‘I Hate You- Don’t Leave Me’. It’s really the best little book on
Borderline Personality Disorder I’ve ever
read!”
As soon as I purchased the book, I
devoured it. I read it again and again.
I shared my new insights and understanding with my two other sisters and
encouraged them to read it as well. Although about half of the book describes
in detail what life is like for the Borderline
and how the individual came to that place of being, the remainder of the
book gives specific strategies for those in relationship with the Borderline. Several of the most important tools I learned
were how to communicate with the Borderline,
how to set realistic expectations for the relationship, and how to honor my own
place of being in the process. However,
the most unsettling truth that I confronted and came to terms with was no matter what I did or didn’t do in my
desire to achieve a healthier relationship with my sister, it would not change
her.
***
About twenty years have passed
since I first read "I Hate You, Don’t Leave Me”. Although there has been more of stability in
Kelly’s life during these years, the relationship between Kelly and me as well
as my two other sisters has not changed.
There have been periods where the four of us came together in
celebration of a family event and we were able to sustain a calm reunion for a
while. And then, the peace was once
again shattered by an insensitive comment or an indication of exclusion on some
unfounded basis. In 2006, our mother
became quite ill. While we all rallied
around our mom to give support and help, there was a glimmer of hope that it
might draw the four of us a bit closer given there was a deep shared
concern. But even amidst the recovering process, words of care about our mother were
mis-perceived and again, phone
conversations ended abruptly and the familiar slam of the receiver
pierced our ear drums.
For almost two years, I once again
was one of three sisters. Then, my
daughter’s wedding in 2008 opened a window for the possibility of being one of
four, at least for a short period of time.
To my surprise, Kelly and her husband did attend the wedding, and it
actually was the beginning of a healthier time for all of us. For me, much of what I had learned in my
readings and studies of BPD helped me
immensely. In addition, I had worked with several clients who were Borderlines, and those experiences
taught me how to navigate through the challenges of the personality. Maintaining
strong boundaries, shoring up realistic expectations, and keeping
communications around safe territory were paramount to sustaining any kind of
relationship. Also, shortening periods
of contact aided in the stability of the time spent together.
In the summer of 2008, my husband
and I moved closer to family. My sister
Kelly and I spent more time together than we had in over thirty years. We went to a few movies together, had dinner
as couples with our husbands, and joined together as one large family for
special celebrations. For the first time
in my life, I felt I was indeed one of four sisters. As strange as it was, it
felt good. And then, in the Fall of 2009, the inevitable happened. A comment shared by one of my sisters to
Kelly was perceived as a deliberate attack on her family. Kelly exclaimed her
feelings of unforgivable hurt and ultimate rejection. There was no rational reason for Kelly’s
response or discussion of it. In a moment, the relationship with Kelly was
over. My sisters and I were
disowned. I was, once again, one of
three.
It has been almost exactly six years since the last exile from sisterhood.
During my own personal journey through this experience with Kelly as
well as coming to terms with my own healing truths, I have come to understand two
important tenets which have freed me from the troubled relationship with
Kelly. First of all, all relationships
take work, even healthy ones. But, when
any relationship consistently injures, harms, or erodes the integrity of my
being, it is my responsibility to take care of myself and step away from it. Because this unhealthy dynamic involved a
family member, I had let it go on far too long, and I had disrespected my
well-being in the process. It was time
to release it and free myself from it. Secondly, the more I learned about BPD, the more I came to grasp fully how Kelly’s issues of chronic abandonment and rejection stemmed from other sources and
other deeply embedded traumas in her life. It was never about what my sisters and I did or didn’t do or what we said
or didn’t’ say. With one simple yet profound insight, I realized my sisters and I were the triggers or the reminders of
such injustices, and thus, we became the recipients of the brokenness which
flowed from her fractured self. We
were never to blame for Kelly’s pain;
it was merely projected onto us.
It is
freeing to acknowledge that Kelly, to some degree, feels less threatened without
my two sisters and me in her life. Distanced from us, Kelly can be an only
child who can create her own sense of safety. Perhaps, she too, in her solitary
world, is more free.
Recommended Readings:
I Hate You, Don't Leave Me by
Jerold J. Kreisman, M.D., and Hal Strauss
The Normal One: Life with a Difficult or Damaged Sibling, Jeanne Saffer, Ph.D.
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