Mental Health Month “Personality Disorders”

The first day I was interning in a crisis center, I heard two women talking, and one said; “Whatever you do, don’t ever see a client who has Borderline Personality, they’re the WORST”

Shamefully I had studied but didn’t know very much about BPD yet, as I was only a year into my studies. I went home that night and read up on it and subsequently read some books devoted to BPD including the well-known book “I love you / I hate you.”

Shortly afterward I found out a friend of mine was BPD (BPD often goes hand-in-hand with Bipolar, as we often see Anxiety and Depression co-morbidly). She educated me significantly in a first-person account of what it was like to suffer from a personality disorder.

The very words ‘personality disorder’ strike me wrong. It’s not really giving someone a chance is it? If we label them as being disordered in some way?

It is thought personality disorders ‘grow’ in childhood and upon reaching maturity can be responsive to treatment or not, depending on the depth and extent they were reinforced in childhood. They usually have triggers such as the link between BPD and being sexually abused in childhood.

Why this is – isn’t so hard to understand if we consider, we all have personalities that are shaped by our experiences – any wonder then that certain experiences will commonly shape certain personalities and responses/reactions. If we take this to an extreme, a ‘disorder’ is a disorder of that personality caused by something wrong and traumatic that occurs to a child.

Why then doesn’t every child who is sexually abused BPD?

Because BPD and other personality disorders must be reinforced. If you are abused as a child but someone finds out, the person is taken away, you are told it was not your fault, the trauma is made better by a rectify and love and lack of shame, then you may well be affected by that abuse but not altered by it in terms of your personality.

If however, the opposite occurs and that trauma is reinforced, then by its very nature of reinforcement, the personality ‘disorder’ forms and every bad thing that happens afterward goes to continue that reinforcement.

It can work something like this;

Child A gets raped by her step-father. Child A tells her mom. Her mom calls her a dirty little liar and beats Child A. Child A is then raped repeatedly by her step-father who threatens to kill her if she ever talks again. Child A remains silent to her abuse for years and it goes on, unpunished. At 15 Child A goes to a party, gets drunk and is raped by a friend. Child A is told by her friends she is a slut and deserved it. Child A internalized all of this and develops BPD which among other things is characterized by a profound lack of trust in others.

Phrased like this, are any of us surprised?

In other words, a personality disorder is a consequence to abuse. As such I find the use of ‘disorder’ punitive because we’re saying the person has something wrong with their personality we are focusing on that, without really considering how this occurred.

Why? Because BPD can be very destructive, both to the person with BPD and those who know them. When you are dealing with someone who is capable of throwing everything into flux, it’s hard to make time to consider the background. You are too busy putting out the fires. And that is why BPD is so feared by therapists and wrongly, stigmatized as being a personality disorder people dread. Whether people dread it or not, any health care worker should aim to help those under their care and treat everyone equally. Perhaps that is easier said than done, but this is why more time should be spent learning about the formation of personality disorders.

Later on in my training I was warned again about BPD folk and told that they can be highly manipulative and destructive, they can and will always try to bring you down. I recall thinking ‘I can’t see how anyone could do that’ but later on I saw several colleagues have to defend their licenses against false accusations by BPD patients who were ‘testing’ them or flexing their muscle.

It appalled me to think anyone, even someone mentally ill, could deliberately go after someone with the sole purpose of trying to ruin their life. I found it hard to understand and empathize with them on that. Which is why I now understand why mental health workers can fear certain diagnosis in people. But despite this, I believe, given the right training and awareness, people can find ways to help those who even lash out at them.

BPD is characterized by a pull-push approach to relationships, an intensity, followed by a rejection, both of which are extreme, due to an inability to trust people shifting from intense attraction/like, to repulsion and hate. For most of us, this extreme is not impossible to imagine, perhaps if we have fallen out with a friend who back-stabbed us or a relationship went wrong because someone cheated on us, we went from love to anger at very least. With BPD those emotions are amplified and far more aggressive, with anger as the source. BPD individuals stoke the flame and are among the most angry and vitriolic of the mental spectrum.

For this reason when befriending someone with BPD it’s important to secure firm and unwavering boundaries. Ensuring the BPD knows the ‘ground-rules’ in other words, don’t flirt one day, and be cold the next, don’t be close one day and distant the next, because by doing that, you are feeding into their fears that nobody is trustworthy, and that will only bring on an extreme response.

Many BPD’s confess that the hardest part of the illness is the social disapprobation and isolation. They do not maintain long-term friendships or relationships, they are at high risk for suicide and self-harm, they vacillate between self-incrimination and feelings of persecution. In short, it’s an instability of their psyche due to being fractured in childhood.

This is among the myriad reasons I condemn child-abusers unreservedly. It is not just rape and abuse, it is messing a child’s life forever when you take someone and you fracture them. If we can take child abuse more seriously and catch more of them before they go on to ruin more people’s lives, this will have the knock-on effect of reducing the numbers of people who grow up to develop BPD and save them from difficult and unfair experiences in life. The one positive of a personality disorder is you can prevent it from happening, we cannot do that with all mental illness but when we can, we have no excuse but to try our hardest.

Mental Health Month “Narcissism”

Social Media has spates of trending headlines and buzz-words. Periodically, ‘Narcissism’ will be among them. We know the basic meaning, the mythological story and how a modern narcissist can hurt relationships be they friendships or otherwise. But if we were asked to clearly define the process it might be tricky. That’s because the issue with a buzz-world is we gloss over the deeper meaning, we stereotype it, until we’re using it out of context and it loses the potency of its original meaning.

Thus, you will hear many people calling out narcissists, and in truth, fewer people are true clinical definitions of narcissists than we would imagine. Equally, some of those who labor the point regarding narcissism, are in fact guilty of the very thing they decry.

A narcissist as their core, is someone with low empathy for others, high self-regard, an inflated and delusional sense of self, an entitlement and sense of superiority to others. They can be charming and appear popular and ‘normal’ in some settings, only to be a down-low narcissist, or they can be an overt example. typically a narcissist is considered to have some sociopathy and inability to care for others meaningfully, as well as a belief they deserve more than others and others should act accordingly. Likewise, a narcissist will seek adoration and forms of worship over say, maintaining a give-and-take relationship. If they do something that appears giving it is with the knowledge they will get something in return, thus it is insincere.

Narcissists can also be very successful because they have less quam about their actions, they are confident, bullish, determined and strive for what they believe they are ‘owed’ as well as not being perturbed about the cost of achieving this or the damage inflicted upon others. Some narcissists will play games with people to manipulate them, in this sense they can be also described as sadistic and cruel.

As with any mental disorder, narcissism is on the spectrum and varies a great deal. It is a personality disorder manifested often early in life, and can be controlled, hidden or overt, depending upon its specific characterization within an individual. In other words, one size does not fit all. Typically with any personality disorder, it cannot be completely ameliorated but you can lessen its outcome if you are open to that, which many narcissists will not be because they suffer the delusion of self-aggrandizement.

Most of the time if someone hurts us, and we call them a narcissist they are not. Sometimes when someone calls out narcissistic behavior they are enabling it by their reactions to it. An example would be, if you call someone narcissistic but you do much the same in your own interpersonal relationships with people. It is possible to be  narcissist and not be aware of it.

With varying degrees of personality disorders, it is very hard to definitively say someone is a narcissist because many times you can display narcissistic behavior but not have enough to qualify for the actual personality disorder. With any mental illness it is dependent upon frequency, duration and extent of (symptoms).

If you are in a relationship of any kind with someone who is a narcissist you will expect to experience some of the following;  A sense that you are not entirely worthy of the individual and they feel you are lucky to be with them, difficulty in expressing successfully your perspective and that being understood. It is not as simple as being vain, confident, or even arrogant, narcissism is at the very core of a person’s nature and decision-making process.

Likewise, those subject to the natural manipulations of a narcissist will become versed in how to respond ‘correctly’ to their needs and thus, alter their behavior accordingly. It can take years to re-train yourself out of responding this way to a figure-head such as a narcissistic parent, or lover, and the beating it gives a person’s self-worth and confidence can require a lot of work to re-balance. This is because a narcissist is so confident they convince others they are right, even in the face of common sense. A narcissist parent will rear a child who is always considering the parents needs rather than the other way around, and thus, does not develop fully because they are attuned to the needs of another and not so much, their own.

We have been discussing how judging any mental health manifestation is wrong, and should be avoided at all cost. With Narcissism it is somewhat different. Narcissism, along with Sociopathy, Psychopathy, and other extreme personality disorders and mental disorders, has a poor cure or treatment rate, it often causes a great deal of harm and pain to others, and many who are ultimately imprisoned share these traits. While no good comes from judging, it is worthwhile considering whether becoming close to someone who is unable to treat these symptoms is a good idea, given the likely outcome.

Obviously someone who is a sociopath or narcissist shouldn’t be precluded from having a relationship or a life, but unfortunately in some ways, the damage of their personality can be so bad that it does come to that. Of course I feel some compassion for this, but it is tempered by the fact that someone who is a sociopath or narcissistic does not experience compassion or empathy and simply goes through life feeling they deserve what they want at any cost. Some milder forms that are say, manifested by trauma, can be treatable, but if they are entrenched, it is often a poor prognosis.

I have met some people who repeatedly are attracted to narcissistic types, this is because they learn patterns and unconsciously respond and repeat them without meaning to, because of early exposure to that kind of behavior. You could almost say it was masochistic and it is, though not consciously. It is a little like ‘better the devil you know’ because the familiar patterns of treatment become instilled and it is hard to break the cycle. In this regard, the victims of narcissists are more likely to be seen by mental health professionals than the perpetrators.

Ultimately then when we talk of narcissists we usually refer to the damage they wrought upon others and how best to help those people.

Learning to spot the signs of a narcissistic personality as well as increasing self-worth are the keys to overcoming the damaging cycle. This can include watching for people who only know how to talk of themselves, rarely show interest in others, and if they do it’s very much crafted toward gaining trust to get what you want. This is of course hard to gauge as it can be subtle and most of us have been on the losing end of a friendship with a narcissist.

There is no cure-all but the more self-respect we have, and the greater awareness of being taken advantage of, as well as looking out for people who are self-obsessed, will help us circumvent typical narcissists. This can include setting boundaries, ensuring that friendships are relatively equal (give-and-take) watching for obvious signs such as being self-obsessed, lack of empathy, lack of interest in anything but self, self-aggrandizing behavior, a need to be worshipped and/or continually praised and excessive vanity.

Just as those who are raped as children, can sometimes go on to rape children when they are adults because they are subverted into a twisted parody of their own abuse, and act it out, the same is true with narcissists. The victim of a narcissist will often exhibit narcissistic behaviors also. They will assist without knowing, the antagonism with the narcissist by responding/reacting in such a way that feeds the ego of that narcissist, they will also expect some of the same things their narcissist expects such as attention and adoration. It’s almost as if they learn from their oppressor and take on some of the traits.

This can be ‘fixed’ and is highly receptive to therapy, the first step being, admitting you have done this and wanting to stop doing it.

Breaking the cycle including your own reaction/response to narcissists is key. In some ways if you do not do this, you will aid and abet the narcissist and even attract others to treat you this way, just as you would any addiction. The behaviors are learned and highly addictive as all extreme forms of behavior are, especially if learned in childhood which they often are, such as in the case of a narcissist father and their children. The kids are literally trained into subservience, into blaming themselves as a narcissist will not take blame on themselves and are very good at displacing blame onto their victims.

Learning to be attracted to non-narcissistic people can be challenging when you are taught to be drawn to the magnetic inflated personality of a narcissist. Other people may appear ‘boring’ and ‘bland’ and not push your buttons including your sexual-desire, attraction buttons. It may seem ‘sick’ to be attracted to a narcissist but they are very adroit at becoming attractive enough to gain many followers. this is why narcissists are often in positions of power and/or lead others. They do have a magnetism and charisma that superficially impresses others. Sadly in some cases they are revered and never held to task for their less desirable traits.

It could be said our society is sick for our worship of certain narcissistic figure-heads and we should question the message we are sending by glamorizing narcissistic people in the media en mass. In many ways it is our society that creates a narcissist and certainly, we perpetuate them. What this also means is, we can change that.

 

Mental Health Month “Borderline”

This may offend some people.

I truly do not mean to offend but I must be honest. At this juncture I will not consciously be close friends with someone who suffers from Borderline Personality Disorder.

I realize that goes against almost EVERYTHING I have ever said about accepting people for who they are. It’s a giant screw-you to a group of people who have done nothing wrong and do not deserve exclusion of any kind.

But I’m being honest. I cannot.

I truly believe we should embrace and not judge people with mental illnesses. I believed this before I knew I had one. I believe that STIGMA is the single-most damaging phenomenon in the world virtually.

So why am I such a hypocrite?

Because I tried and tried, or maybe I just knew quite a few people who happened to be Borderline. I didn’t judge. I didn’t condemn. I didn’t ostracize. To me, a person with a mental illness is NORMAL and EQUAL to anyone else.

But I couldn’t do it. I admit this. I couldn’t hack it.

Why?

For me, people who are severely Borderline to the point where the symptoms show (some may be mildly) have messed me up too many times. I end up realizing this. If I keep on doing something – whatever it is – again and again with the hope of the outcome being different but every time I do it, the outcome is EXACTLY THE SAME then it’s my fault and my duty to myself to stop the behavior.

Unfortunately the behavior was befriending people with Borderline Personality Disorder. If you have it, and are reading this, you can say fuck you right now.

I’m sorry. It is not a happy choice. I don’t believe it’s right but I have to. Why?

Whilst training I kept hearing about Borderline patients. Most therapists dreaded them. That’s not an exaggeration. Truthfully I didn’t know much about Borderline. I only heard about it around that time, it wasn’t properly understood. I learned Borderline is a personality disorder often characterized by the “I love you / I hate you” extremes in behavior. It is often caused by some severe trauma in childhood and is hard to treat as with any personality disorder. Often times Borderlines will turn on a person not because they are evil or wicked but out of a ‘bites the hand that feeds’ set of responses, or because they perceive the other person to be betraying them.

They are not ‘bad’ or wicked or evil people. They are hurting. They are crushed by the things that caused them to develop this disorder. It is not their fault.

So according to how I live my life, I should be inclusive and welcoming and I was. The only problem was the same thing kept happening. It went like this;

A Borderline person befriends me or I befriend them. We get on well. We are friends nothing more. At first, the Borderline friend really likes me and I really like them. We have a good friendship and things are great. At some point the Borderline perceives that I either do not mean what I say, or I am ingenuous or I am a liar or I am fickle. It could be for a perceived reason or paranoia. It could be based on some degree of reality and then amplified by 1000 percent. The outcome is they switch, they turn on me, I become the ‘enemy’ the perceived reason for bad feelings they have. The bad things that have happened in their life become my fault because I am here, and their past is not. Their response to this is extreme. It can involve a great deal of abuse verbally. We end up not being friends anymore. I am hurt, they are hurt.

If I let this keep happening, though I no longer get hurt anymore, I would be exhausted! I cannot do this. Nobody could. That doesn’t mean Borderline sufferers could never have friends. I believe certain friendships are impossible and that includes me.

I am not blaming myself. If I did I would be buying into the most common accusation a Borderline will throw at me THIS IS YOUR FAULT ENTIRELY YOU DID THIS. I know that is not true.

But .. I accept that I am a certain ‘kind’ of person just as a Borderline is a certain ‘kind’ of person and we – do – not – work.

Why? I don’t know. Maybe I’m too high on the sensitive scale, or the intensity scale, or the closeness scale, maybe I’m too affectionate, maybe I’m too effusive, maybe I’m not effusive enough. Maybe it doesn’t matter.

One thing I know. I can’t do it. And they can’t do it. So unfortunately, contrary to anything else I believe in, I shy away from making friends with someone who admits they are Borderline and that is very sad and I feel very badly about that. But there is no choice. Just as many therapists refuse to see or are reluctant to see, Borderline patients, I am basically avoiding a problem I cannot solve. I realize that is wrong on many levels I just don’t know what alternative exists besides me being a punching bag and I will not let that happen.

Classic Borderline symptoms include; Too much intensity, an extreme adoration of a person that is over-kill and too sudden, the opposite response of extreme dislike/rejection/hate of a person that is sudden also. Many times someone with Borderline is a survivor of childhood sexual or physical or emotional abuse of the worst kind. Borderline is more common among those who suffer from Bipolar Disorder 1.

I feel Borderline people have a really hard time of living in this world. They almost didn’t have a chance, and I admire them for surviving. I would like to help them, befriend them, support them. I do support them in believing them equal to every dignity and right anyone else has. They are not bad people. But the hardest part of being Borderline is that you drive people away. You don’t mean to but you do it. You end up isolating yourself when you least want to. You are lonely but cannot keep lasting relationships. You don’t want to be angry or hateful but you end up being because you perceive that’s what is being done to you.

It’s incredibly unfair.

A friend of mine who was Borderline told me a very valuable lesson. She said, when you are friends with a Borderline person you had better have immaculate boundaries. By that she meant – don’t send mixed-messages of any kind. Do not contradict yourself. Do not say one thing to a Borderline and the opposite to someone else. Do not act like a lover if you are a friend. Do not say you are a friend if you are an acquaintance. Borderline people are very literal. They will take you at your word and if you diverge from your word they will hold you to it.

That might sound like a good thing and in theory it is. Sometimes we have awful boundaries and can be real teases or send mixed-messages. So having healthy and well stated boundaries can really help any friendship. But in the case of Borderline sufferers, people who do not have well-defined boundaries or are very needy, very insecure, very anxious, may inadvertently clash with a Borderline and cause their symptoms to be exacerbated or triggered. In other words not everyone is a good match to be friends with a Borderline. This is not just on them. It’s on us.

I recognize I am not a good match for a Borderline. When I look at my friends they actually do fall into distinct categories. They are either; Very secure and confident. Very sincere, stable and compassionate or very messed up and mentally ill and lonely. The latter is the group I have struggled with the most. If I’m depressed and my friend is depressed it can often work because we can mutually support the other, and understand. A Bipolar friend may get exasperated with me because I’m never manic. A Borderline friend will find me to be imperfect.

I am. I’m imperfect and I’m not super-secure and confident.

So – note to self and note to any Borderline people – we don’t mix well.

This is the first time in my life I have actually realized a good boundary is not being friends with or their being friends with me, a certain group of people. It feels wrong. It feels discriminatory. But it isn’t. It is the setting of those boundaries and the accepting that not everyone gets on and if we know we don’t get on with a certain kind of person then be respectful, we kind, be good, but don’t go the full hog and befriend them with the expectation your friendship will work.

That is growing up. That is experience. That is logic and ultimately, it’s more merciful than keep on doing the same thing expecting a different result.

As for those who suffer from Borderline Personality Disorder. I won’t be the one to write about you because that would be insulting and insensitive. But I will say this, in this Mental Health Month period I hope much is written about BPD people to help them and help others not stigmatize or judge them. A personality disorder is a mental disorder and requires the same level of compassion and treatment as any other.