TOO CLOSE FOR COMFORT
The Neurology of Love and Loss in Borderline Personalities

By Shari Schreiber, M.A.
www.GettinBetter.com

 

At 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.

At 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 original trauma.

In 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.

I 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.

Sadly, 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.

As 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 for you!

New 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!

My 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.

I 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.

Let's 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 outbursts, etc.

The 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 destabilized.

The 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.

If 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.

Loss 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 at all.

Emotionally 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.

Core-damaged 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.

Both 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.

The 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.

An 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.

 

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