08.28.09

The Love / Hate Relationship for Borderlines

Posted in Borderline Personality Disorder, DID Education, DID/MPD, Dissociative Identity Disorder, Self Injury, mental health, therapy, trauma therapist tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , at 1:50 am by Kathy Broady

There are distinct differences between Dissociative Identity Disorder (DID) and Borderline Personality Disorder (DID).  There are many overlapping symptoms, and some therapists believe that all trauma survivors with DID are also BPD.  I, however, do not hold that perspective.

In my opinion, not all trauma survivors with DID are BPD.  However, I will guess that the greater portion of DID’ers are also borderline.  This makes the discussion of borderline behaviors an important topic for dissociative trauma survivors.

Borderline survivors are frequently characterized with black and white thinking, self-injury, impulsive behaviors, repeated crises, intense abandonment issues, suicidal behaviors, inappropriate anger, mood instability, irritability, paranoid thinking, an unstable self image, etc.  There are a wide variety of BPD behaviors that could be discussed over a series of posts.  I’ll save those topics for another day.

For this blog post, I want to focus on a particular aspect of BPD:  having a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. (see the DSM IV).

Unstable and intense relationships.

People with borderline personality disorder may idealize potential caregivers or lovers [or therapists] at the first or second meeting, demand to spend a lot of time together, and share the most intimate details early in a relationship. However, they may switch quickly from idealizing other people to devaluing them, feeling that the other person does not care enough, does not give enough, is not “there” enough. These individuals can empathize with and nurture other people, but only with the expectation that the other person will “be there” in return to meet their own needs on demand. These individuals are prone to sudden and dramatic shifts in their view of others, who may alternately be seen as beneficent supports or as cruelly punitive. Such shifts often reflect disillusionment with a caregiver whose nurturing qualities had been idealized or whose rejection or abandonment is expected.
http://psychcentral.com/lib/2007/symptoms-of-borderline-personality-disorder

Ok, that’s a lot of psychobabble talk, so what does that mean?

This is when the BPD survivor alternates between thinking someone is wonderful – excellent – the very best, and then thinking that very same person is horrific – awful – horrible.  The BPD survivor will show or feel excessive attachment to a new person, and in a sense fall madly in love with this person.  They put this new person on a pedestal, believing the person to be more incredibly perfect and wonderful than they could possibly be in real life, and they crave constant attention and special recognition from their new perfect person.  (But don’t ask the BPD survivor to admit that. All too many BPD survivors deny their craving for more, more, more.)

But of course, no one can stay “perfect” for long.  The perfect person will inevitably do something that just doesn’t measure up.  Typically, the “errors” created by the perfect person are that they did not shower the BPD survivor with enough individual, specialized attention.  This is nearly always the fatal crime – just not doing enough to keep the attention-starved BPD person happy with unquestionable importance.  So, before they know it, the perfect person will suddenly become the hated target, responsible for all evils of the world.  And when BPD survivors swing from the feelings of intense positive adoration to the angry hateful place, they are willing to, and actually desirous of, utterly destroying the same person they once loved.

Does anyone remember the movie, Fatal Attraction?  That movie portrays a Hollywood version of the love-hate relationship experienced by borderlines.  Hollywood was extreme in their portrayal, of course, but the love-hate flip-flop is easily seen.

For trauma survivors with both BPD and DID, the love-hate flip-flop can happen quickly and easily.  Remember, as DID survivors, they are very used to switching and to containing opposite life perspectives in opposite extremes.  So, when the dissociative BPD feels abandoned by their treasured “good object” and becomes upset with them, the flip into hatred might not be that far away.

The abandonment can be experienced in any number of ways.  Being very sensitive to any rejection of intense connection they desire, simple things can be interpreted as huge emotional offences — for example, if the once perfect person sets limits by saying “no” to a specific request, or by not offering extra time, or by going away themselves. Even if the reasons for being away are valid, no reason is good enough – every reason still means they are left behind, and that is not acceptable.

Jealousy is frequently an intense motivator too.  When BPD survivors want a cherished relationship with their new perfect person, they have all kinds of jealous pangs if they believe someone else has a more treasured place than they do.   Instead of doing the work it takes to keep their own relationships in a positive place, they focus outwardly on relationships that belong to others, drowning in their jealousy and anger, and inevitably destroying the relationships they wanted to cherish.

For dissociative trauma survivors, the therapeutic relationship is an incredibly important relationship.  Developing and protecting this relationship is both central and crucial to the entire healing process.  DID’ers can spend years of time with their therapist, and cultivating the skills to keep this relationship in a workable, positive place is critical.

For BPD survivors, the therapeutic relationship is equally important.  However, these survivors often lack the skills needed to maintain positive long-term relationships, even with therapists.  Therapists very frequently become the target of the love-hate flip-flop dynamic.  Many therapists refuse to work with clients with BPD precisely because of this dynamic.

This love-hate borderline behavioral pattern should help to explain how any therapist can be the most dearest of therapists, and then a short time later, be the most hated. It’s a behavioral symptom of BPD. It doesn’t mean that the therapist is actually wonderful or horrible. It just means BPD survivor is acting out the black-white, love-hate, attachment-abandonment issue that is central to BPD.

When you know to look for it, you’ll see it happening all over the place in the trauma survivor population.

So when you hear someone attempting to destroy or bad-mouth someone else, consider the bigger clinical context of what this kind of behavior is about.

And please – work very hard to NOT do this to your therapist.  Your therapist will not likely become your worst enemy unless you make that happen.   Instead of destroying your cherished relationships, it is much better to protect them with all that you have.  Don’t believe lies.  Don’t tell yourself lies.  Remember who your therapist is and do not confuse your therapist with any other person (mother, father, perpetrator, etc). The disordered dynamics related to BPD are a complication, but they do not have to become an insuperable obstacle — you really can choose not to let these dynamics dominate your relationships, with your therapist or anyone else.

___________

By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

13 Comments »

  1. Wounded Genius said,

    August 28, 2009 at 5:34 am

    Fascinating. I have some of the characteristics above but contained in different parts – most in evidence is b&w thinking. I don’t idealise people though.. I think I have long-since given up even trying to imagine anyone could be anything other than unreliable and fundamentally flawed.

    Here’s a question – although obviously one should treat T with appropriate respect and not verbally abuse, dismiss and so forth, when you say “Remember who your therapist is and do not confuse your therapist with any other person” – surely that’s like saying ‘don’t let the transference develop’ ? – could you clarify?

    thanks!

    WG

  2. castorgirl said,

    August 28, 2009 at 6:43 am

    I find it so hard to trust myself and my instincts Kathy. We learned from an early age that our own instincts were often incorrect or ignored. It’s hard to move on from this position to a point where you can instinctively trust that voice inside saying “that person is lying”. Quite often that instinct is there, but it gets clouded in amongst all the other layers of messages and confusion.

    It’s also possible to try to protect a therapeutic relationship that is negative instead of positive. My previous therapist was a lovely person, but she wasn’t able to help me with the dissociative issues I was facing. I don’t blame her for not having the skills, but I do regret that she only showed signs of wanting to learn more after I had ended therapy with her.

    I wonder how you can tell when we are telling ourselves lies, as opposed to seeing reality from a different point of view. Every person will see a situation from a different viewpoint. Each of those views is a truth as they see it, so at what point does it become a lie? Is it about motivation? Dysfunctional thinking?

    Interesting post…
    Take care,
    castorgirl

  3. Aspects of BPD « Petrogenic said,

    August 28, 2009 at 7:02 am

    [...] was reading this post by Kathy Broady about BPD and DID. I’m not sure I agree with or understand all of it but there are [...]

  4. juliewtf said,

    August 28, 2009 at 10:58 am

    I am wondering if you recognize BPD behaviors in yourself and
    dont act on them….recognize them, acknowledge them and deal
    with them….does that make you borderline?
    Or is acting on those thoughts and feelings, the making of BPD?

    H

  5. Kathy Broady said,

    August 28, 2009 at 2:28 pm

    Castorgirl,
    Thanks for the comment. I was thinking about following up this post with a more detailed post about what I mean by “protecting your therapeutic relationship”. And yes, of course, that is completely different from the idea of moving on from a therapist that genuinely isn’t able to help. Already, what you are saying is protective of her, for example, because you can still see her as a lovely person – just not trained in the areas you needed specialized work. No one is “bad” just because they are not trained in a specific area — that just means they are trained in other areas that are more fitting for other people.

    The surrounding / underlying issues in this particular topic blog are really very big, and will need definitely need expanding, so yes… I am sure that I will continue to write about them, one blog at a time. Heavens, I could probably write an entire book about this topic, lol. Plus, you’ve brought up some very good points. So yes, I will continue to address things, such as the questions about telling yourself lies, how to trust yourself (or not), etc.

    I’m hoping to have more time to write in the blog again, so… keeping my fingers crossed, I’ll get a lot more stuff up here about all this soon. :)

    Thanks again for commenting. I appreciate hearing from you.
    Warmly,
    Kathy

  6. Kathy Broady said,

    August 28, 2009 at 2:32 pm

    Hi Petrogenic,
    Thank you for reading the Discussing Dissociation blog. It’s nice to see that people take my posts, and really think about them. :) I think it is a real honor when folks link my blog to their blog, and talk more about the kinds of things that my posts mean to them. That’s good — I’m glad to see people thinking! :)

    You’ve brought up a good question in your blog – about the similarities/differences between DID and BPD – and while I’ve discussed that in my support group, SurvivorForum, I haven’t mentioned that here. Maybe I can expand further on those ideas here in this blog as well.

    Thanks again for reading, and I look forward to hearing from you at any time.
    Kathy

  7. Kathy Broady said,

    August 28, 2009 at 2:44 pm

    Hey juliewtf,
    It’s always nice to get comments from you. I look forward to seeing what you are going to say when I post, and thanks, because you do brighten my day with the things you write. :)

    Ok – to answer your questions, briefly…. (because to really answer them is a whole big post in itself)….

    I think that one of the biggest issues about the BPD behaviors is not letting them take over your life. Having the thoughts, feeling the feelings, is actually pretty normal, (especially coming from the trauma survivor point of view in life), and it’s not necessarily something that can be immediately prevented. And just having the thoughts and feelings doesn’t necessarily mean something “bad” anyway because … trust issues have to be addressed…. self-injury issues have to be addressed…. fear of others has to be addressed…. abandonment issues have to be addressed, etc. There is such an overlap in the way trauma affects a person, that of course, so many of the BPD-type issues are going to naturally surface, at least in a survivor’s thoughts.

    So, having the thoughts and feelings is not so much the problem as is the allowing the thoughts and feelings to blow up into a huge mushroom of a mess, and then acting on them without really understanding what they are about in the first place. So it’s the damaging explosion of uncontrolled and excessive behaviors that becomes the diagnosable issue… not just having the thoughts in the first place.

    If you have the self-control and the wherewithal to check further before you act, then you are doing what the DBT therapy teaches BPD people in the first place — to put more time in between having the feelings and acting out a huge response.

    Good question. I’ll think more about that, and hopefully, I’ll be able to address more of that in my future posts about this topic.
    Good to see you here. :)
    Kathy

  8. Kathy Broady said,

    August 28, 2009 at 3:09 pm

    ooops — Wounded Genius —
    sorry, I didn’t see your comment earlier. I’ve got it in here now, so… better late than never.
    And thanks for posting. And you’ve asked more good questions… :)

    OH gosh… yes, the transference issue is a great big huge thing. Quick answer to that (because like the others, this whole area needs a lot of room to expand in more posts…) I think the important thing to remember is that there IS a thing called transference, and there IS a thing called projection, and there IS a thing called displacement, and there ARE other emotional reasons why one would perceive their therapist in complicated ways.

    Your therapist is going to remember that transference, projection, and displacement are going to happen in the therapy work, and we are not only prepared for that, but we are expecting it. It does happen, it will happen, it’s bound to happen. And preventing it from happening, is not so easily done, and really not necessary. So my point is to not say that transference, etc can’t happen, but to remember that it DOES happen. And to be very very honest about that, so that there are less mix-up’s for who the actual therapist is as a person, vs. who they are reminding you of at this point in time.

    It’s ok to say, “gosh, I am really working thru’ some transference issues about my mother with my therapist.” That is part of the healing process. We as therapists are ready, able, willing to do that. It’s ok.

    But when the survivor person forgets that so much of what they are feeling is transference, and they attack at the therapist, or cause harm to the therapist…. then that survivor person is really off-base, and not working on their issues. They are displacing their huge issues onto the therapist, and forgetting about what is going on underneath….. (the mother issues, the abandonment feelings, the hurt from not feeling special, the desire to truly want to be with the therapist / mother, etc.)

    The point being — use the transference that surfaces for your own healing. It’s going to happen, but keep the focus on where it came from, and don’t make the mistake of exploding it further onto the therapist when the depth of the issue really belongs elsewhere. If people incorrectly attack and blame the therapist, they are just hurting people (including themselves), and not working on healing their own stuff.

    I’ll be writing more about all this as well. Thanks for the question — and yes, there is a whole lot more I can say about that topic.
    Thanks for commenting!
    Kathy

  9. morunner said,

    August 28, 2009 at 11:00 pm

    What about counter transference too ?, the theraputic relationship is so complex. There is an interesting article/study in the latest ISStd journal. The study was looking at BPD and comorbidity with dissociative disorders in general not just DID. It was very interesting. The study was excellent and was done in a extremly rigorous way. The results show that many BPD patients do have dissociative disorders also. I am with you Kathy in that although many DIDers have symptoms of BPD not all meet the diagnostic criteria to be considered BPD and vice versa.

  10. Kathy Broady said,

    August 29, 2009 at 1:03 am

    Hi morunner,
    Oh yes, the therapeutic relationship is so very very complex….!!! There are just so many different layers to it, and a ton of different things that can happen during the course of time in a therapeutic relationship…. It’s hard to put it all into words, isn’t it?!!

    And yes, countertransference is another very real dynamic that factors into therapeutic relationships on a relatively regular basis. I think it would take a whole blog post — or more — to talk about that!

    Thanks for mentioning the ISSTD journal article – I haven’t looked at it yet, but that does sound very interesting. Has anyone else seen that article?

    Thanks for the comment — and thanks for reading,
    Kathy

  11. Protecting Your Therapeutic Relationship and the Therapeutic Community « Discussing Dissociation said,

    August 30, 2009 at 2:48 pm

    [...] Don’t assume that all “survivors” are automatically being honest with you (or themselves) when they are trashing a therapist.  Remember, they may be in the “hate” cycle of the love-hate dynamic. [...]

  12. Mona said,

    August 30, 2009 at 8:32 pm

    “They are displacing their huge issues onto the therapist, and forgetting about what is going on underneath….. (the mother issues, the abandonment feelings…”

    Your reflections on the need for survivors to take control of their transference issues is so right on! My first therapist and I worked for years on my issues with my mother, and lots of transference, before I could even begin to address my issues of abuse by a priest.

  13. pilgrimchild said,

    December 8, 2009 at 1:48 pm

    I used to have a best friend who is borderline. As much as I loved her, she wore me out. It was hard to keep up with which “side” I was currently on, as well as the rest of the world. I’d try to support her, but I couldn’t keep track of who was on her “Good list” and who was currently on her “Bad list”.

    ALL people have good & not so good aspects of themselves. With a few exceptions, I don’t think anyone is all good or all bad. There isn’t a black and white issue about people.
    Even with my old therapist, who dumped us and hurt us really badly– she is still a good person, even though she probably hurt us worse than anyone else ever did. But that doesn’t make her a bad person. She just happened to do something immensely thoughtless and cruel. But we still love her, and she still did a lot of good things with us in 7 years of therapy. That doesn’t make HER bad though. She’s someone good, who did a super mean thing.


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