As the intermittent hospital stays continued, year after year, my mother could only visit occasionally, as we younger children began tugging at her time and attention. In any event, hospitals at the time allowed families to visit for only several hours a week.11 No doubt feeling helpless himself at the many hospital separations, my loving, outdoorsy father lost himself in his work—spending eighteen hours a day for weeks on end—roping problematic cattle for vaccination (he was a wizard with a lasso), or being bitten by surly dogs as he tended their broken legs, or pulling calves at two in the morning. The grinding work must have taken his mind off the athletic games he would never play with his oldest daughter. These were the very games he would later play so happily with us younger children—fortunately for us, our good-natured father had escaped the alcoholism and personality disorders that were so rampant in the other members of his family.
No, despite my parents’ unquestioned love, if anyone could be thought to have endured childhood stress, it would have been Carolyn.
Who was Carolyn? Who was this person who could appear so normal and yet be so disturbed?
On a little red heart dated December 25, 2000—four years before her death—I find:
Santa—I know I have been naughty and I don't expect any presents but since you have opposable digits, could you please unscrew this #%$# jar of Parmesan?
There is a little scrapbook Carolyn has put together: snapshots, newspaper clippings, and pictures of friends from eighth grade. Sandwiched among the labored signatures of friends, I find:
Good luck in High School, but with your mind you won't need it.
—Marilyn. (’60)
Get to the top even if you have to climb over somebody's back.
—John.
In the late 1980s there are a flurry of letters from Ron and a rival. Ron writes:
MY KILO
My Kilo with an articulate soft musical voice, a wonderful choice of words, laughter that sounds like the soft tinkling of silver bells, the graceful mannerisms of a princess, the poise of a queen. When she enters a room it brightens and seems to glow with her personality. If you enter a room expecting to find Kilo and she is not there, there are no words to express the dismal loneliness of that room. She is affectionate, warm, tender and considerate of others. If crossed she can be cold, disdainful and cruel. Her face has a wonderful animation when she is happy. She is feminine from the top of her pretty head to the tips of her toes. She needs no jewelry to show off her loveliness. Her beautiful ivory white skin and beautiful dark hair accentuates her loveliness. A very lovely woman is my Kilo.
When I have forgotten everything else, I will remember my Kilo and she will live in my heart and pay no rent.
No rent. Sounds like a bargain. Meanwhile, Ron's rival, Ed, writes counterpoint: “There are lots of fish in the water and a lot of them would love you. Including me.” A smiling fish with hearts fluttering around its nose swims past the signature.
Yes, indeed, things were heating up with Ron. I find a memo dated May 7, 1990, signed by Ron and Carolyn: “Ki and Ron have decided to meet on the mount in the year 2000.”
But the packet of letters instead fast-forwards to Ron's neatly clipped obituary. He died in Sequim on June 30, 1996, at the age of eighty-three. Carolyn was fifty-one. The obituary makes note of two sons, a daughter, a brother, two sisters, six grandchildren, one great-granddaughter, numerous nieces and nephews, and a “special friend.”
Not Carolyn.
L'affaire avec Ed didn't end so well, either: “I don't think we would ever get along so well, but I'd like to stay friends…”
How can I make sense of all this? Besides the letters, there are literally dozens of birthday, Valentine, Christmas, and what-not cards from a bounteous assortment of men. There is one from my mother, signed with the spindly writing of her last years, wishing happy birthday to A Wonderful Daughter—probably one of the last communications before my mother couldn't bring herself to speak to Carolyn again. There are recipes, report cards, childhood awards, more love notes with flattened, perfumeless flowers, mash notes. They tell me everything and nothing about Carolyn—mirrors reflecting mist.
But the letters and notes I've found do tell me that Carolyn was deeply loved, not just by my parents, but by many different people. That there was something captivating about her—something that allowed men, for a while at least, to think that she was the answer to their dreams.
I think back to the question that has bothered me for so long—how could a disturbed individual attract so many people? The letters tell me. Beauty. Intelligence. Charisma.
I nudge the last of the packets back into place in the carton and close the flaps. Although I've set aside the diaries for careful reading later, the box feels somehow heavier as I manhandle it around, duct taping the spirits of the past. My weekend of investigation has left me feeling as if I've been shoveling water. But one thing has come clear. Carolyn showed “a pattern of unstable and intense interpersonal relationships.” Not only with us—her family—but with practically everyone she ever became close to.
I also know that, in 2001, Professor John McHoskey, who had previously done such interesting work relating Machiavellianism to psychopathy, found something very interesting about those unstable and intense relationships. In one of his final, crucial studies, McHoskey found something that might help explain not only the writings from Carolyn's box, but Machiavellian behavior in general.
“Welcome to the Psychiatric Hot Line:
—If you are obsessive-compulsive, press 1 repeatedly.
—If you are schizophrenic, listen closely and a little voice will tell you which number to press.
—If you have borderline personality disorder, hang up. You have already pushed everybody's buttons.”
—Anonymous
The year 2000 loomed with warnings of a Y2K disaster and biblical prophecies of doom. But nestled in his relatively remote Eastern Michigan University surroundings, Professor John McHoskey continued to gnaw at his Machiavellian research. To the unpracticed eye, it might seem the research bones had been picked clean. After all, McHoskey's previous work had shown that psychopathic traits corresponded tongue-in-groove with Machiavellian traits. The pathological lying of a psychopath, for example, matched the Machiavellian trait of duplicity. A grandiose sense of self-worth, found in both psychopaths and narcissists, corresponded to Machiavellian feelings of entitlement, superiority, and arrogance. Psychopathic “shallow affect” was echoed in the numerous studies showing a cool and aloof posture by those who received a high score on the Mach-IV test. And just as psychopaths displayed glibness and superficial charm, those with high Mach scores were found to be more persuasive and more likeable than their low-scoring counterparts. Even guilt was similar—neither psychopaths nor Machiavellians seemed to be troubled by it, but both personality types were perfectly happy to induce guilt in others to manipulate them more easily.
Despite the neat dovetailing, however, McHoskey was aware of one nagging detail. His seminal study had begun by simply assuming that the Machiavellians whom Christie had described were largely equivalent to psychopaths—the tests McHoskey had conducted as part of the study had merely confirmed that initial assumption. But a potential problem was that other personality disorders hadn't been checked. It seemed unlikely, but what if there was another syndrome that might even more closely match the characteristics of Machiavellianism?
There was one relatively straightforward way to find out. McHoskey could give a large group of people Christie's Machiavellian test. He could also administer a second test—one that showed predispositions for common psychological disorders. The results from both tests could then be compared to see which psychological disorder correlated most strongly with Machiavellianism.
THE DIMENSIONAL APPROACH TO UNDERSTANDING PERSONALITY DISORDERS
As it happened, the perfect tool had been developed for easily assessing possible clinical diagnoses: the Personality Diagnostic Questionnaire, or PDQ-4+. By
looking at the answers to ninety-nine true-false questions, a reasonably intelligent guess could be made as to whether the test-taker reported any clusters of behaviors consistent with DSM-IV Axis II criteria for personality disorders.
The PDQ-4+ is based on a dimensional view of personality dysfunction. That is, it contends that dimensions, or symptoms, related to personality disorders can be measured within samples of normal people. For example, some people might have a mild version of the impulsivity often associated with antisocial behavior, while others might have much stronger versions, or different varieties altogether. Each disorder could be described by a number of symptoms, and each symptom could come in mild, medium, hot, or extra hot versions. People with the hot or extra hot version of enough symptoms of a particular personality disorder could be said to have that disorder. Others, with slightly milder symptoms, or with only a few extreme symptoms out of the many that might characterize a disorder, could be considered to have a tendency for the disorder. Such individuals might not qualify for a clinical diagnosis, but an inherent predisposition was definitely there.
For this new study, McHoskey decided to examine what is probably the most extensively studied group of humans on the planet: undergraduate college students. He administered the twenty-question “Mach-IV,” as Christie's Machiavellian test was known, as well as the ninety-nine-question PDQ-4+, to nearly three hundred students, sweetening the pot a bit by giving them extra credit for taking the tests.
MCHOSKEY'S FINDINGS
To understand the importance of what John McHoskey found in this, perhaps his most important research contribution, it's helpful to have a little background in how psychology analyzes people with problems. The DSM-IV—that ever-handy diagnostic manual—segregates people's various dysfunctions into different categories, or axes. Axis I includes all mental health conditions except the personality disorders, while Axis II describes the personality disorders. (Another axis has recently been proposed to incorporate personality-related genetic information.)1
There is some controversy about why a disorder might be classified as Axis I instead of Axis II. Fundamentally, the two axes are thought to be the same, but a distinction was drawn between those disorders that were thought to be due to biological factors, which were put into Axis I—and other conditions which were thought to be due to psychosocial stresses, which were put into Axis II. Thus diseases such as schizophrenia and bipolar disorder were classified as Axis I, while seemingly purely psychological conditions such as dependent and narcissistic personality disorders were classified as Axis II. Now, of course, it is recognized that many of both the Axis I and Axis II disorders are rooted in biology and genetics.2
The decision to use two separate axes was intended to draw attention to the more subtle disorders. But instead, the two axes had the unpleasant side effect of providing insurance companies an excuse to pay only for diagnoses involving the more florid—and thus seemingly more severe—Axis I disorders. This in turn meant that a person suffering from an Axis II disorder would often instead be diagnosed with an Axis I disorder so as to ensure insurance coverage. Thus, rather than drawing attention to personality disorders, the Axis I/Axis II distinction resulted in less interest in, and research on, personality disorders.3
Axis II is further broken down into three “clusters” of personality disorders that seem to share certain similarities. People with Cluster A disorders, for example, are often seen as odd or eccentric—they have difficulty relating to others. Cluster B sufferers tend to act in a dramatic, emotional, and erratic fashion. They frequently have difficulty with impulsivity and often violate social norms, as with antisocial personality disorder. Those with Cluster C personality disorders are often seen as anxious and fearful; they are frequently afraid of social relations. The specific personality disorders fall into the three different clusters as shown below:
CLUSTER A (ODD, ECCENTRIC) PERSONALITY DISORDERS:
Paranoid Personality Disorder: Pervasive suspiciousness, distrust, and resentfulness of others; vindictive, rigid, and good at avoiding blame.
Schizoid personality disorder: Indifferent to social relationships; attempts to avoid interpersonal interactions; lacks empathy. Also has difficulty with emotional expression.
Schizotypal personality disorder: Suffers from perceptual dysfunction, depersonalization, interpersonal aloofness, and suspiciousness; shows “magical thinking” with a belief in special powers.
CLUSTER B (DRAMATIC, EMOTIONAL) PERSONALITY DISORDERS:
Antisocial Personality Disorder: Problematic sense of right and wrong; deceitful and manipulative; easy willingness to lie; not bound by laws and social norms; irresponsible and impulsive; superficially slick and polished; potential for violence; enjoys humiliating others.
Narcissistic Personality Disorder: Possessed of grandiosity and exhibitionism; lacks empathy, hypersensitive to criticism, possesses a constant need for approval and admiration.
Histrionic Personality Disorder: Overly dramatic and theatrical; throws frequent tantrums; always wants to be the center of attention; manipulative and demanding; vain; sexually provocative.
Borderline Personality Disorder: Rapid mood swings; emotionally unstable with very troubled relationships that include intense fears of abandonment; inconsistent attitudes and behaviors; no clear goals or direction; frequently considers self-harm.
CLUSTER C (ANXIOUS, FEARFUL) PERSONALITY DISORDERS:
Obsessive-Compulsive Personality Disorder: Possessed of perfectionism that makes task completion difficult; rigid and inflexible; has a need for control; preoccupied with details and rules; unwilling to compromise; extreme “workaholic.”
Avoidant Personality Disorder: Inhibited; introverted; intense feelings of inadequacy; hypersensitive to rejection; socially awkward.
Dependent Personality Disorder: Submissive and clingy; passive; extreme lack of self-confidence; has difficulty making decisions and an intense desire to be taken care of.
Using these DSM-IV disorders as a foundation, McHoskey was looking for a correlation with Machiavellianism.4 As expected, those who fell into the dramatic, emotional, and erratic cluster B seemed to correlate most strongly with Machiavellian types of personalities. But oddly enough, antisocial personality wasn't the only disorder that correlated with Machiavellianism. Another disorder did as well—borderline personality disorder.
BORDERLINE PERSONALITY DISORDER
Preeminent psychiatrist Robert Friedel was to enter into his lifelong study of borderline personality disorder because of his sister, Denise. In his book Borderline Personality Disorder Demystified, he describes a youthful experience:
I was cleaning my golf clubs in preparation for the spring, but one was missing. I looked everywhere in the house—no club. Denise walked by, so I asked her if she had seen it. She calmly said yes, she had broken it in two and thrown the pieces into the snow behind the house. It seemed we had argued over something a few weeks earlier, and she had done it then. At first, I thought she was taunting me. She knew how hard I had worked and saved to buy those clubs. Surely no one would do such a thing, not even Denise…. Later, when the snow melted and I found the broken club, I realized that something was truly different about Denise, and that it was probably best not to provoke her in any way, for any reason.5
Indeed, borderline personality disorder, or BPD, is a disorder that can be so profoundly confusing that even today, despite thousands of studies, it remains little known and poorly understood. This is despite the fact that one to two percent of the population—some three to six million people in the United States alone—are thought to suffer from its most profound effects.6 A still higher percentage show symptoms of the disorder but are able to maintain conscious control of their impulses when necessary and are thus able to avoid diagnosis.7 Ten percent of psychiatric outpatients and twenty percent of psychiatric inpatients—hefty and expensive percentages!—have the disorder.8
Although women are three times more likely to have the disorder than men,
preeminent borderline researcher Joel Paris has noted, “If it were not inconsistent with clinical tradition, we could have described a single gender-neutral disorder that covers the present ground traversed by the criteria for antisocial personality disorder and borderline personality disorder.”9 In other words, antisocial and borderline personality disorders shade into each other.
Borderlines often show a variety of symptom complexes and coping characteristics, as shown in the sidebar.10 These characteristics can be perceived as being extremely manipulative and are often, in fact, malevolently Machiavellian in their effects. Underneath all of these behaviors is a tendency to make situations more explosive and emotional than the facts would warrant.
Borderline Personality Disorder
Coping Characteristics
splitting behavior
projection
blame shifting
control issues
interpersonal sensitivity
situational competence
narcissistic demands
“gaslighting”
chameleon behavior
Symptom Complexes
impulsive and self-destructive behavior
rapid mood swings with anxiety and depression
feelings of boredom and isolation
intense and unstable personal relationships
Even the term borderline itself is a result of the confusion that midcentury psychoanalysts felt when treating such patients—they theorized that the borderline syndrome was a form of pathology lying on the border between psychosis and neurosis. Although analysts no longer believe that patients with borderline personality disorder have an underlying psychosis, the name borderline has stuck. A much more descriptive label would be emotionally unstable. The central feature of the borderline condition is instability, affecting sufferers—and those around them—in many sectors of their lives. Additionally, borderlines have significant issues with boundaries. As psychiatrist Joel Paris writes: “[Borderlines] become quickly involved with people, and quickly disappointed with them. They make great demands on other people, and easily become frightened of being abandoned by them. Their emotional life is a kind of rollercoaster.”12
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