Wednesday, April 27, 2016

The Maturing Borderline

"True life is lived when small changes occur." - Leo Tolstoy

As I grow older, I mellow out to some degree.  Impulsivity, mood swings, and self destructive behaviors seem to diminish in dramatic intensity.  My family has adjusted to my erratic actions over time and doesn’t notice or respond to outrageousness as much.  Maybe because I have settled into a more routine lifestyle that no longer requires periodic outbursts to achieve my needs. 

With age a lot of us lose our energy to maintain the frenetic pace of borderline living.  Or perhaps there is a natural healing process that takes place for some of us as we mature.  In any event, those sharing a life with us can expect our behaviors over time- maybe a very long time, and sometimes without treatment- to become more tolerable.  At this point the unpredictable reactions become more predictable and therefore easier to manage, and it becomes possible for us to learn how to love and be loved in a healthier fashion.

“The changes in our life must come from the impossibility to live otherwise than according to the demands of our conscience, not from our mental resolution to try a new form of life.”

-Leo Tolstoy

Tuesday, April 26, 2016

The Borderline and Separation

Separation from parents, particularly during the first few years of life, are common in the borderline biography.  On the surface, these separations may appear insignificant, yet they have profound effects.  SLXLFor example, the birth of a sibling takes a mother away from her normal activities for a few weeks, but when she returns, she is no longer as responsive to the older child- mother has disappeared and has been replaced by someone who will always be different, one who now has mothering duties with a younger sibling. 

For the healthy child in a healthy environment, this trauma is easily overcome, but for the borderline in a borderline setting it may be one of a series of losses and perceived abandonments.  Extended illnesses, frequent travels, divorce, or the death of a parent also deprive the developing infant of consistent mothering at crucial times, which may interfere with our abilities to develop trust and constancy in our unstable and unreliable world.

In my case, my mother and father did their best to give me the attention I needed, but I had three younger sisters to divide that attention with.  As well, my father was traveled for his work.  He didn’t travel all the time, but as a child it seemed like dad was gone a lot, or at least more than I wanted him to be.  There are a handful of birthdays I remember being without my parents because they were away, and I have always hated my birthdays because of this.  When you look at it from a healthy point of view this is no big deal, but for someone with the tendency toward a Borderline way of thinking, it can be mistaken for abandonment.  It takes a mature person to be able to see beyond those feelings to the truth.

Wednesday, April 6, 2016


During therapy, both therapist and patient develop intense feelings called transference and countertransference.  Transference refers to the patient’s unrealistic projections onto the therapist of feelings and attitudes previously experienced from other important persons in the patient’s life.  By itself, transference is neither negative or positive; but it is always a distortion, a projection of past emotions onto current objects. 

Borderline transference is likely to be extremely inconsistent, just like other aspects of our life.  We will see the therapist as caring, capable, and honest one moment; deceitful, devious and unfeeling the next.  These distortions make the establishment of an alliance with the therapist most difficult.  Yet establishing and sustaining this alliance is the most important part of any treatment.

In the beginning stages of therapy, we both crave and fear closeness to the therapist.  We want to be taken care of but fear being overwhelmed and controlled.  We attempt to seduce the doctor into taking care of us and rebel against his attempts to control our lives.

As the therapist remains steadfast and consistent in withstanding our tirades, object constancy should develop- we begin to trust that the therapist will not abandon us.  I myself have never been able to achieve object constancy because of the many times my therapists have terminated treatment without warning.

As someone with BPD progresses in therapy, we should be able to settle into a more comfortable, trusting dependency.  We may pine for our previous ways of functioning and resent needing to proceed onward.  At this point we must also deal with our separateness and recognize that we, not the therapist, has elected change.  And we must develop new coping mechanisms to replace the ones that no longer work.  As we improve, the intensity of transference diminishes.  The anger, impulsive behaviors, and mood changes- often directed at, or for the benefit of, the therapist- become less severe.  Panicky dependency may gradually wither and be replaced by a growing self confidence.

Countertransference refers to the therapist's own emotional reactions to the patient, which are based less on realistic considerations than on the therapist’s past experiences and needs.