Saturday, October 30, 2010

How to Disarm a Borderline, Part II

In my Part I post of October 6, I described how a lot of the difficult behavior of patients with borderline personality disorder (BPD) in their intimate relationships is designed to elicit in the observer one of three reactions: anxious helplessness, anxious guilt, and overt hostility. Furthermore I expressed the view that, even though they will make herculean efforts to induce these reactions, and are very good and finding other folk's vulnerabilities in order to do so, they secretly hope they will fail in their efforts.

Every time they succeed, they will do more of whatever it was that worked; every time they fail, they will do less of whatever did not work. They will not give up easily, and if they've known you for a while, if one trick does not work, they will have a whole repertoire of other behaviors from which to choose. They will know how to push all of your buttons in the most effective way possible.

Last, because of the variable intermittent reinforcent schedule, if you only occasionally react in the "wrong" way to them, that is worse than reacting badly to them all the time, because they will try that much harder and longer to elicit the "desired" response. I said that in my next post I would start by saying what not to do.

Here it is. It's fairly simple, so this will be a relatively short post. In future posts I will suggest counterstrategies for the most typical BPD strategies for eliciting the three responses, and then finally advise readers about what to do in the inevitable event that they slip up - so that the variable intermittent reinforcement schedule does not kick in.

IMPORTANT CAUTIONS: Please be advised that sticking to this program is extremely difficult, so the services of a therapist who knows about these patterns are usually necessary. Also, this section is designed for adults dealing with BPD adults - over 23 years old, actually. This is not necessarily what you should do if you happen to be raising a teenager with BPD traits.

Without further ado, what not to do:

A. Try to please the unpleasable. If they put you in a damned if you do, damned if you don't position (a double bind), try to do something to please them anyway. If they "yes-but" all of your suggestions for solving any problem they present to you (that is, if they reject any and all offered solutions with a sentence that has the structure, "Yes, I could do that, but...), keep offering more solutions. If they ask you to do something that is clearly impossible, try your best to do it anyway.

They never forget you have a choice

B. Make sacrifices for them. Stay up all night talking with them and trying to reassure them about their latest emotional debacle when you have to go to work the next day. Give them thousands of dollars to help get them out of a financial bind that they had put themselves in with profligate spending and irresponsible behavior. Drop everything you are doing and rearrange your schedule for the entire day so you can do something for them like right now, even though the chances are 50/50 they will not even be there when you get to their abode - and be sure to cancel any planned activity that you've been looking forward to forever. Drive a hundred miles out of your way to take them somewhere.

C. Get defensive. Say, in frustrated tones, "You know, I'm only trying to help you" or "Don't you understand that I have other things to do?"

D. Act hostile.

E. Act guilty. Because you know down deep you should be able to solve impossible dilemmas, and that their behavior is probably all your fault anyway.

F. Stand there and take it like a (foolish) man. Are they slapping you around? Verbally abusing you will a barage of invective? Impugning everything you stand for? Screaming at you? Just stand there and let them. Maybe they'll stop.

G. Return in kind. I knew a psychiatrist who got so upset with the verbal nastiness of his patient that he told her she was a dog and that she should have consulted a veterinarian. See if you can stop the BPD person's pain-seeking behavior by inflicting more pain.

H. Lecture them. Tell them all about how cocaine is harmful, that they should leave an abusive relationship, or that they should not ride their bicycles at midnight through crime-ridden parts of town in a bikini with hundred dollar bills hanging out their bras. After all, they are just too stupid to figure these things out for themselves. They'll tell you they think cocaine is good for them. Argue the point.

I. Try to rescue the help-rejecting complainer. Go to their house to try to take them away from an abusive romantic partner. Let them move in with you rent free. Loan them money that they will never pay back. Try to mediate their disputes with others (trying to physically get in between two fighting adults is particularly important - maybe they'll both start in on you). Cuss out the people who they claim have mistreated them. Go ahead, I dare you.