August 28, 2009
Posted in Borderline Personality Disorder, DID Education, DID/MPD, Dissociative Identity Disorder, mental health, Self Injury, therapy, trauma therapist tagged Abandonment, Abandonment Issues, AbuseConsultants, AbuseConsultants.com, Anger, Attachment, Attachment Issues, Betrayal, Black and white thinking, Borderline Personality Disorder, BPD, DID/MPD, Dissociative Identity Disorder, Fatal Attraction, Idealization, Intense Relationships, Jealousy, Kathy Broady, Love-Hate, Pedastal, Self Harm, Self Injury, Therapeutic Alliance, Therapeutic Bond, Therapeutic Relationship, Trauma Survivors, trauma therapist, Unstable Relationships 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.
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.
Kathy Broady LCSW