The Essential Family Guide to Borderline Personality Disorder

by Randi Kreger

  Worry and guilt hit parents particularly hard. Adult children of BPs engage in life-long struggles to feel good about themselves. Anger is a predominant emotion of partners, especially those separating from their BP partners. (Parents tend to turn their anger into depression.) Everybody feels helpless.

  Don’t Worry, Be Happy

  The nature of the disorder—unpredictability, lightning-fast triggers, mood changes—makes the future uncertain (here, “future” could mean five minutes from now or fifteen years from now). While all non-BPs worry now and then, family members of lower-functioning conventional BPs worry morning, noon, and night, because they’re dealing with life and death issues, including suicide.

  Dale Carnegie’s How to Stop Worrying and Start Living is a classic that has sold millions of copies. The advice it offers is just as good today as it was in the mid-twentieth century when the book was first published. The techniques it describes are the same whether the worrier is a fourth-grader fretting about a math test or a president debating whether the United States should enter a world war.3

  The Carnegie Problem-Solving Method

  Non-BPs feel so helpless in the relationship that they tend to forget they are capable people with fine problem-solving abilities. They often give up on solutions before they’ve researched them or thought them through. Or, they’re too depressed and upset to think straight.

  The trick to being a problem-solver instead of a worrier is to compartmentalize your world. When you feel awful, feel awful. Yell, scream, cry, and throw soft objects (or hard if you must) at the wall. Then, take a nap. When you wake up, brew some coffee or tea and put on your problem-solving hat. Focus on what you can do—not on what you can’t do. Ask friends and family to help give you a fresh perspective.

  These steps will help you become a problem-solver:

  Step 1: Choose one problem and lock the other ones in a box, for now. Then, calmly gather the facts for one of your dilemmas. Carnegie believes that half our worries are caused by trying to make decisions before we have all the facts.

  Step 2: Calmly analyze the facts. For example, don’t just say you can’t afford something. Put together a budget. If you cancel cable and brown bag it for lunch, how much will you save? Likewise for time, the other resource generally in short supply. No one has enough time, but someone’s out there watching reality TV. Weigh what’s important to you.

  Step 3: Arrive at a decision and act on it. Don’t give up too quickly, because there is no quick fix. On the other hand, don’t stick with a method that clearly isn’t working. (The difference between the two is often a matter of time. If waiting for your BP to change hasn’t worked for several years, it’s time to try something else.) Rethink or modify your plan as necessary.

  Not Guilty!

  The purpose of pain is to tell us something is not right. “Good pain” gets our attention so we do something about an injury or illness. Without it, we could bleed to death. Then there’s “bad pain,” that chronic stuff that does no good, except to those who invest in pharmaceutical stock.

  Guilt is like that, too. If you’re a writer who has a book deadline coming up but you’d rather surf the Web, “good guilt” can get you back on track so your publisher doesn’t have a heart attack. “Bad guilt,” on the other hand, benefits no one. Guilt may come from many places:

  1. Hardwired: The biologically based, irrational parental guilt that insists that if you had just done more of something or less of something else (no one knows what) your child would be on the fast track to the presidency of the United States. Don’t expect more from yourself than you do from the professionals.

  2. Cultural: Society believes that parents (that is, mommy) are always responsible for their child’s behavioral problems. This pops up everywhere. For example, “refrigerator mothers” were said to have caused autism, and schizophrenia was supposed to come from mothers who appeared to love their children but unconsciously rejected them.

  3. Stereotypes: As discussed in chapter 4, a long-standing belief is that all BPs have had abusive childhoods. Parents—especially fathers—are seen as suspect.

  4. Your family member: When non-BPs try to set limits or stick to their guns, BPs often press the “guilt” button. Parents and adult children are particularly vulnerable to this tactic.

  Guilt is your enemy for two reasons: First, it feels bad and makes you miserable. Second, it blurs your thinking and can drive you to make the wrong decisions. We’ll talk about the second problem in the next chapter. As for the first, when you feel guilty, tell yourself that guilt is a luxury you can’t afford. As tempting as it may be not to, you need to put your energy elsewhere. Then, do it.

  Self-Esteem: How Low Can You Go?

  People who have low self-esteem question their abilities most of the time. They can’t think of any good qualities about themselves or take pride in their accomplishments. Their failures loom large, but their opinions about themselves run ten degrees below sea level. They think other people have more worth than they do. When others don’t respect them, they figure they’ve gotten what they deserved.

  Some sources of low self-esteem in non-BPs are obvious. In a letter to her ex-girlfriend Terry, a woman with BPD, Chris wrote, “My self-esteem plummeted because of your frequent unpredictable snapping, constant nagging and criticism, and general air of hostility. Even when I was alone, it was like you were constantly there, criticizing me, nagging me, or snapping at me. I began to believe that I really was klutzy, stupid, untidy, careless.”4

  In a post to the Welcome to Oz online family community, another non-BP says, “When the raging and criticism began, I started questioning my reality. He seemed so righteous in his rage. So certain. It made me feel small. Since it was pointless to argue, I sucked it all in. I knew if I weathered it out, it would pass, and we would get back to ‘normal’ (normal for us, that is). I didn’t know it was killing me bit by bit.”

  Other sources of low self-esteem are more obscure. Carolyn DeRoo, coauthor of What’s Right with Me, says:

  In this culture we are raised with the notion that if we do the right thing, things will work out for us. But some difficulties have nothing to do with us. We may be doing a whole lot right—even going above and beyond—but we’re still struggling. When that happens, we feel bad about ourselves. We question if we did the right thing.

  We need to disconnect from the belief that we’re doing something wrong just because this struggle exists. We need to bear in mind that this is just a basic part of life, even though it’s not reflected out there in the media. And we shouldn’t compare ourselves to others, because we don’t know how things really are for them.5

  DeRoo suggests that people in turbulent relationships get a more balanced view of themselves because they may have learned to censor their strengths. Think back to some of the most important people to you, now and in the past. What have they said they appreciate about you? What compliments have you received during your life?

  Write down the answers. “You want to see the nice things they say about you in black and white,” she says. “As you write, consider that these people, as far as you know, do not have a brain disorder that affects their perceptions and emotions. Doesn’t that make their assessments more persuasive—or at least as persuasive as those of your family member?”

  The next step is asking the question directly to those you trust the most. Listen to them tell you your good points out loud. The more embarrassing this might seem, the more you probably need to hear it. What about you? What do you like about yourself?

  If your BP is a parent who disparaged you or put her own needs before yours, you may feel worthless or fundamentally flawed. That’s understandable. Tell yourself, “The past is over; I’m not a kid anymore. It’s my life now to spend with people who love me and make me feel good about myself.” Seek professional help and take small steps in the right direction. Self-esteem comes with learning to trust yourself and your own perceptions.

  Anger

&n
bsp; Anger is often a sign that something needs to change. Who or what are you angry at? What is the reason for the anger? The answers to these questions can alert you if something needs to change. Family members often become angry when people with BPD overstep their boundaries—sometimes, boundaries they didn’t know they had. Non-BPs get angry at themselves, at the disorder, at the health care system, and, of course, at their BP.

  Some non-BPs don’t know that they’re angry because they repress it. Unvented, it settles into their bones where it remains as a kind of toxic force that can lead to depression and, over time, resentment and rage. All too often, family members (especially partners) let their anger simmer until they blow up in resentment when they’ve never really let their wishes be known.

  Buried anger has been shown to set off ulcers, heart disease, hypertension, headaches, back pain, depression, and fatigue.6 Learning from anger is good; managing it is essential. If you get angry at other people for misperceiving who you are or your intentions, keep telling yourself, “I don’t have to prove anything to anybody else.” Try to separate the disorder—especially the border-lion (see page 58)—from your loved one.

  Find a safe and healthy way to release your anger. Find a private place, pretend that you’re face-to-face with the person you’re angry at (even if it’s you), and say anything you want as loud as you want. You’ll find that the other person is a great listener. Writing letters you don’t send is an alternative, especially if you use a lot of capital letters and exclamation marks.

  As you do this exercise, you may be surprised at some of the things that come out of your mouth. You may uncover feelings and thoughts you didn’t know you had. The full force of the impact of your situation on you, the tangled mix of emotions, may give you a great sense of compassion for yourself.

  Practice Acceptance

  When you practice acceptance:

  • You acknowledge that things are the way they are at this very moment and that some things are beyond your control. You didn’t cause it, you can’t control it, and you can’t cure it.

  • You live in the present, not the past nor future. You don’t dwell on negative aspects of the past and try to assess blame.

  • There’s no place to go but up. Without acceptance, when you look around, all you see is what you don’t have. After you’ve accepted the worst, you will see how much you actually have.

  Maybe this sounds too “new agey.” Actually, it’s very old agey. We could go back to seventh-century China, but let’s take just a short 140-year (or so) jaunt to the American frontier. That’s the setting for Laura Ingalls Wilder’s “Little House” series of books. The 1970s TV series was an idealized, Walt Disney–type affair; in reality, Laura and her family lived a harsh life fraught by the struggle to survive.

  In her book The Long Winter, Ingalls Wilder describes how her family holed up in the kitchen during a blizzard season, living on bread and tea. They lost weight and nearly starved to death until Laura’s future husband risked his life to get some grain. Laura’s hands chafed from twisting hay into sticks to keep the stove going, and Laura and her sisters nearly froze. As they changed into their bedclothes, they could see the breath in front of their faces. Yet they didn’t complain. As Wilder wrote, “We knew it couldn’t be helped.”

  Yet most of the time, Laura was joyful. She saw her childhood as a wonderful time; her descriptions have delighted generations. Today, we have lost the ability to say, “It couldn’t be helped.” Today, we believe things can and should be controlled. And if they’re not, then someone’s to blame.

  Start by accepting the small things. For example, one woman on WTO found she was spending too much time being irritated by everyday problems. Every time she couldn’t find an important e-mail or bought a size small when she meant to buy the medium, it put her in a bad mood. One day she decided to change her ways and to expect everything to go wrong. Now it honestly surprises her when she finds the scissors where it’s supposed to be or when she actually finds that slip of paper with the important phone number on it.

  Once you’ve accepted that the worst may happen, you have no place to go but up. You reduce the amount of time you spend judging everything. In general, it’s not events that cause suffering, but the value judgment we put on them. In other words, the way you view a situation, person, or event has a profound effect on how you feel about it and is quite separate from the problem itself.

  Laughter, the Best Medicine

  Mona and her husband, Barney, were taking a walk in their subdivision when Mona’s cell phone rang. It was Gil, their son who has BPD. He just quit his job again (was fired) and was losing his apartment (evicted). Could he come back home for a while (as long as they would let him) and save up some money (then spend it on drugs) so he could afford first month’s rent and security deposit (buy more drugs)?

  This was very bad news. Mona told Gil she’d call him back, and she and Barney walked on, silently. Waiting at the light for traffic to pass, they spied the bumper sticker at the same time:

  I Child-Proofed My House, But They Still Got In

  The couple laughed until they cried. Literally. And lo and behold, when they were done, they felt better.

  Smiling and laughing triggers the production of endorphins, morphine-like chemicals that reduce pain and relax the body. Endorphins strengthen the immune system, which fights disease and hastens recovery.

  Among themselves, parents often use humor. For example, a group of parents on Welcome to Oz made a list called, “Why Parents and Other Caretakers Do What We Do.” Reasons included

  • We are a vital force in the economy. The mental health field would suffer a recession if not for us.

  • We love the lingo.

  • It’s only rock and roll, but I like it.

  • Whaddya gonna do?

  Sometimes, family members use humor among themselves as a way to release tension, defuse anger, and address sensitive issues. This is why professional comedians can get away with saying things that would sound most inappropriate if they were voiced by anyone else. It’s okay to use this kind of humor at the appropriate time (away from your BP). If we can joke about Nazis (the film/play The Producers and the TV show Hogan’s Heroes), we can joke about BPD.

  Shared humor is a powerful way for people to bond and talk about the illness. A woman with a borderline daughter says, “One day we were at the mall and she said, ‘Come here quick, look at this! It’s for me!’ It was a shirt that said Drama Queen Academy on the front. And I said, ‘You’re right, that is for you.’ She was shocked I would let her have a sense of humor about herself. I said, ‘I think that’s great that you see that that’s for you.’ She wore it with pride. I thought, There’s hope for her because she has enough self-awareness to joke about the way she is.”

  Humor can also reduce hostility during a fight—sometimes even stop one or prevent one from happening. But it must be used cautiously, or it can sound sarcastic and backfire. The context, the moods of the people involved, and the subject matter being discussed are of the utmost importance.

  Lead a Full Life

  You need other people, outside activities, and feelings of accomplishment in your life to stay sane, let alone happy. You also need time alone to rest and think. If you’re shaking your head right now and saying, “That may apply to other people reading this, but not me,” then that sentence goes double for you.

  It isn’t always the amount of time you have, but what you do with the time. You can spend thirty minutes worrying or replaying something negative in your head, or read a novel or nonfiction book on a subject that interests you.

  Get involved in projects that make you feel competent and give you a sense of satisfaction. Hobbies that produce a finished product (a handmade cabinet, for example) are especially helpful. If you run out of ideas, review your past activities and accomplishments.

  Spending a day or more in another environment with different people can transform your life. As you relate to other people a
nd vice versa, it can help you remember what “normal” is. One overnight trip can power you up for a long time. Spend time alone with your thoughts, too. If you can get outdoors on a beautiful day, do it. Invite your senses along: hear a musical group perform or go to an ethnic restaurant. Whatever you do, just go.

  In his book How to Change Anybody, David J. Lieberman says, “Our identity is very much tied in with where we live, the people we know, and the places we know. By removing individuals from their environment, you shake up their self-concepts and make it easier for them to see themselves differently, and quite often, more objectively. You also get them away from the influences and triggers that snap them back into negative patterns.”7

  Chris, a non-BP, went on a trip alone with her sister Samantha despite her BP girlfriend’s objections (she couldn’t go for some reason). Chris writes:

  It was so good for my soul to spend a few days away so I could be myself. I could throw all my change, maps, and park guides on the table without you nagging me to be neat. I could mix all my stuff with Samantha’s without you getting on my back about keeping our own separate piles. I could eat at a restaurant without you commenting if I dropped a morsel of food on the table. I could relax. And to my sister, my behavior was totally normal.

  Those four days in Florida were like a little window to me of how things could be. This blanket of anxiety, which I had gradually come to accept as normal, had been momentarily lifted. I am starting to realize I am okay just like I am!

  Breathe Deeply

  Our bodies evolved so that when we saw a threat—say, the iconic saber-toothed tiger—our bodies would go into “fight or flight” mode. Our terrified brains tell our adrenal glands to release chemicals that sharpen our senses, tighten our muscles, and make our heart pound faster. Our bloodstream fills with sugars for ready energy. Now we’re ready to confront the enemy (fight) or run like heck (flight).8

  This response is supposed to turn off once the stressor is history. But our modern-day threats are continuing, not acute, and most of the time we can’t fight or flee. Some of the stress hormones stay high and can weaken the immune system, potentially making cancer and infectious diseases worse.9 Stress may negatively affect the heart, and two studies appearing in authoritative journals found that first-time heart attack patients who returned to chronically stressful jobs were twice as likely to have a second attack as patients whose occupations were relatively stress-free.10