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The Neurology of Love and Loss in Borderline Personalities
By Shari Schreiber,
the baseline of Borderline Personality Disorder is an extremely
complex set of psychic/emotional issues, which baffle laymen and
psychotherapeutic professionals alike. We tend to label these people
as "crazy," because their behaviors are so unlike anything
we've been exposed to--and they drive us nuts, just trying
to make sense of them.
it's core, this is an acute abandonment issue that begins in the
first year of life. Inadequate bonding with the birth mother starts
this ball rolling, and any/all painful deficits in nurturant care
and attention thoughout childhood, perpetuate and reinforce this
addition, it's not at all unusual for various clinical (or Axis
I) issues to be present among individuals who've developed borderline
personality features, which greatly exacerbates their inner chaos/drama,
while triggering much of their destructive acting-out defenses.
have worked with a variety of clients who've had multiple
diagnoses. They struggled with Bipolar Disorder, ADD/ADHD and
Borderline Disorder features. Two out of three co-existing disorders
is not uncommon, and our treatment options must be comprehensive
enough, to address BPD issues on a number of different fronts; not
just behavioral, not just neuro-chemical, and not just in reference
to long-held core trauma that's psychic/emotional. In essence, a
three-pronged approach must be implemented, to facilitate BPD recovery.
psychotherapeutic and medical professionals may be poorly equipped
to recognize/treat personality disorders, or assess for bipolar
and attention deficit issues. Hopefully, this blind-spot will one
day be altered, by educating students about these topics in graduate
and post-graduate course work.
stated in many of my articles, the paradoxical
nature of the Borderline is the most confusing/confounding aspect
of being involved with one of these people. In short, as you love
them (or their kids) more, they love you less, and push you away.
Their words and actions are completely incongruent/contrary--so
you end up scratching your head, trying to discern which is real
and what you can trust to be true, concerning their feelings
studies are suggesting there's a link between ADHD
(seldom seen or diagonosed in females) and Borderline Personality
Disorder. Attention deficit
issues are attended by mood cycles, which can certainly heighten
acting-out behaviors. This newfound awareness may help us more readily
discern what type of pharmaceutical intervention could lead to favorable
outcomes. While this does not imply that BPD problems are exclusively
neuro-chemical rather than emotional, we might just begin to treat/manage
the symptoms of this disorder differently and more effectively!
personal bias has always been to view BPD primarily from a core
trauma perspective, and that's how I'd (unwittingly) worked
with borderline personality clients long before I knew
about this disorder. In hindsight, my efforts were successful in
bringing about healing and growth--but the work spanned many years,
and there were frequent setbacks and regressions.
was distinctly aware of how neurological issues sometimes contributed
to difficulties within treatment, and a client's inability to hold
and make use of our work--but in hindsight, I probably didn't give
it the weight I should have, in light of some information I've recently
obtained. Essentially, more pieces of this puzzle have snapped into
place, and my views about treatment have broadened.
first look at Borderline Disorder through an ADHD lens. ADHD'ers
need lots of stimultation, or they feel dead, empty, invisible and
shut-down. This is also true for Borderlines, which prompts the
acting-out behaviors; starting fights, triangulating relationships,
punishing/shaming you (transference
and projection), those come-here/go-away cycles, the invigorating
intensity that accompanies breaking-up and making-up, the rageful
colleagues I've personally known who exhibit borderline pathology,
keep themselves running, fixing and rescuing. It appears they're
utterly addicted to chaos and drama, and these outside influences
are the distractions which prevent them from confronting
their own inner emptiness, dissatisfaction or pain. There appears
to be unresolved core
void issues among these people, but their need to maintain
highly stressful/busy lifestyles may be attributed to an ADHD difficulty
as well. These individuals could be solid practitioners, but their
friends and partners continue wrestling with the hot/cold cycles
of their disorder, and relational dynamics are predictably/routinely
creative ADD mind is typically exceptionally bright, and facile
at making abstractions. When it comes to analytical thinking, there's
nobody better at it than an ADD/ADHD'er--which is why they
make brilliant therapists. Sadly, all that brilliance is seldom
applied to their own psychic/emotional
distress, and if you've been watching HBO's In Treatment,
Dr. Paul Weston (superbly played by Gabriel Byrne) perfectly exemplifies
this 'wounded healer' issue.
we investigate the current medical model for borderline treatment,
a lot of these folks are put on SSRI's
(Selective Serotonin Re-uptake Inhibitors), but in my view, this
could easily exacerbate a Borderline's symptomology. SSRI's
tend to slow us down, and make us feel drowsy/lethargic. Both Borderlines
and ADD/ADHD'ers thrive on stimulation--and whenever there
isn't enough of it available, they're adept at creating it! To experience
serenity and calm, could literally feel like death to a person suffering
with either disorder.
of relationship means loss of stimulation to a person with
attention deficit issues or borderline personality features. The
loneliness or aloneness they experience can be overwhelming, when
there's nobody there to distract from it. Their frantic
search for a mate is frequently driven by a dire need to escape
their own inner quiet, and feelings of nothingness that
accompany it. Hence, their desperate pursuit of a relationship,
is largely a defense against a lack of excitement and stimulation--whether
that produces pleasurable or painful sensations
of aliveness! This has one feeling like even destructive
or undersatisfying relationships, are far better than none
sound, healthy individuals are attracted to harmony and peace in
their personal and professional relationships, and their world in
general. They relish calm and serenity, and stress of any type is
averted and avoided whenever possible. They have rich, satisfying
inner lives, and have learned to entertain themselves--whether they're
coupled or not. This may not have come naturally, given any difficulties
they had to surmount in childhood--but they've worked toward
attaining a sense of contentment and balance within.
people are prone to developing personality disorder traits, as early
trauma has undermined trust in Self and others. This usually drives
a powerful need for self-reliance in the Narcissist, but too
much autonomy can feel isolating and lonely. He could feel
imprisoned by his need to avoid the engulfment
(or loss of Self) he felt with his overbearing mother in childhood,
and maintains his romantic relationships at arms length, to avert
the stifling abdication of his hard-won selfhood.
The Borderline craves love, but cannot trust it. BPD loving is inextricably
entwined with loss--so closeness prompts deeply-held anxiety that
devastating abandonment pain will surely follow.
Borderlines and Narcissists consistently attempt to balance their
needs for attachment, with their inherent dread
of it--which of course, makes for highly conflictual relationship
dynamics. While each feels a powerful need to bond, each is
profoundly frightened of the ramifications of that choice.
Borderline constantly wrestles with their need for closeness and
the fear of loss (or emotional annihilation). This inner turmoil
catalyzes tremendous ambivalence, because they're literally terrified
of what they want (and need) the most! Their inability
to feel self-contained for longer than brief episodes, triggers
their desire to seek containment (safety/soothing) that's furnished
by others--but as this is achieved, abandonment fears are reactivated,
and the vicious cycle that typifies BPD (come-here/go-away) is repeated.
ADHD'er similarly has needs for emotional attunement and closeness,
but is easily bored, and has to 'change the channel' on whatever's
happening at that time (including lovemaking), to circumvent feeling
engulfed, restless or agitated. It's pretty hard to pin an ADHD'er
down for extended periods of intimacy, whether physical, sexual
or emotional in nature. In addition, many partners of ADD/ADHD'ers
must carry the lion's share of responsibilities in a marital or
family dynamic, due to their greater capacity for organization and
staying on task with household or parenting duties. This can lead
to conflict, in an otherwise harmonious coupling.
you have an iPhone, iPad or iPod this app will let you hear
here, to determine if you're in an abusive relationship!
MY BPD LOVER BE RIGHT ABOUT ME??
This is a work
in progress. Stay tuned for more.
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