Borderline Personality Disorder

 

While some of my Borderline clients were physically abused as small children, most were not actively abused by their parents. The three most common childhood experiences they report were some combination of the following:

 

• Early abandonment trauma
• Having to help their mother manage her emotions
• Receiving little or no training or encouragement in how to become an independent adult

 

 

Example 1: Early Abandonment—Sandy the Unwanted Child

 

Sandy knew from early childhood that she was an unwanted child. When she was a toddler, her mother was pregnant with another child and due to give birth soon. She dropped Sandy off at an aunt’s house. The aunt was asked to take care of Sandy for a few weeks after the new baby was due to be born until things were more settled.

 

Sandy at 18 months had no sense of time and cried for her mother every day. Not only did her mother never visit her, but she left her there for two years. She appeared to have forgotten Sandy existed and was content to leave her with the aunt forever.

 

Finally the aunt confronted Sandy’s mother and told her that she needed to raise her own child and it was time to take Sandy home. After she went back to live with her mother, Sandy realized that her mother had little or no interest in her.

By the time she was six years old and in school, she became a “latch key child.” This meant that she wore the key to the apartment on a string around her neck under her clothes. She was expected to walk home from school by herself, let herself in with the key, and wait for her mother to get back from work.

 

Therapy: By the time Sandy came to me for therapy, she was thoroughly messed up emotionally, convinced she was unlovable, and very afraid of being abandoned again. She was also very, very Borderline!

 

Just to mention a few of her coping mechanisms:

• She banged her head against the wall when she could no longer bear her own thoughts and feelings.
• She was barely functional. She worked as a waitress in a diner despite (as it turned out) having a very high IQ.
• She had decided that her only way to get revenge on her mother was to fail at everything she did. She told me that she wanted to be a “living reproach” to her mother. She was willing to ruin her own life so that everyone would know that her mother had failed at the job of raising her.

Talionic Revenge: James F. Masterson in his book, The Narcissistic and Borderline Disorders (1981), introduces the concept of “Talionic Revenge” to describe one of the issues that needs to be resolved in the therapy of Borderline clients. The name “Talionic Revenge” is taken from the Biblical law “Lex Talionis” which requires “an eye for an eye and a tooth for a tooth” for justice to be served.

Masterson asserts that at some point towards the end of therapy, the Borderline client reaches a crossroads. One road involves staying Borderline and continuing to seek revenge against their parents to make up for their childhood mistreatment, while the other road to full healing involves relinquishing this wish for revenge and moving forward.

Sandy reached this milestone eventually and gave up acting crazy, went back to school, and then to graduate school where she trained for a profession more in keeping with the actual level of her talents.

 

Resolving Abandonment: During the first two years of her therapy, Sandy did something strange. She chose to leave every therapy session 10 minutes early, before her session was over. I sensed this was a very important and sensitive topic. I waited till Sandy had worked through many of her other issues before I asked her why she did this. Her answer made me glad that I had trusted my instincts. Sandy said;  
 

It was very important to me that you never commented on me leaving early. I might not have been able to talk about that then. I might have even dropped out of therapy. I watched the clock and left early because I knew that I could not stand to hear you tell me: “ Sandy, you must go now.”

  

By the time we had the above conversation, Sandy had developed enough internal support to be able to speak about her abandonment trauma and how it had affected every area of her life.

 

Example 2: Helping Mother Manage Her Emotions—Billy and his Stomach Aches

  

Billy’s parents moved to the suburbs away from their extended families before he was born. His father Dave was very proud that he could provide his wife June with a beautiful new house in the suburbs. Unfortunately they knew no one else who lived there and June was lonely because Dave was gone all day at work or commuting to and from work. June missed her siblings and parents.

Dave thought that having children was the solution to June's unhappiness and in a very short time she found herself pregnant with Billy. She had a lonely, miserable pregnancy where she was sick a lot and homesick for her extended family.
  

June had post-partum depression and the depression lingered for years in one form or another. Billy loved his mother, was a very empathetic child, and he sensed her unhappiness. He tried to cheer her up.

 

Dave was happy to encourage Billy to spend lots of time with June because this made him feel less guilty for leaving her every day.

By the time Billy was supposed to go to school, he felt torn between going out into the wider world, learning new things, and making friends and his sense that his mother could not cope without him. He started to develop stomachaches whenever it was time to leave for school. 
 

The Parentified Child: Billy became a parentified child. This means that instead of his mother fulfilling the parental role and taking care of Billy’s emotional needs and encouraging him to learn the skills necessary to become an independent adult, the opposite happened. Billy remained “Mommy’s little man” and stayed a child to take care of her emotional needs.

 

Therapy: By the time Billy was grown and had entered therapy with me, he was immature, conflicted, and still spoke to his mother by phone every day. On an unconscious level, he believed that something terrible would happen if he actually grew up, left his mother behind, and became an independent person following his own desires.

 

Separation Fears: James F. Masterson in his books on Borderline Disorders notes that many Borderline clients unconsciously believe that if they fully separate from their mother and become adults one or both of them will die or go crazy.

 
  

In Billy’s case these buried beliefs showed up in a dream towards the end of his therapy:
  

I am waving goodbye to my mother. I am leaving to go to college. My mother cannot go with me. I come to a big bridge that I must cross. I suddenly get very afraid. I look back and see my mother standing at the beginning of the bridge. I am about a third of the way across and I stop.
  

I suddenly realize that if I cross over without my mother, something terrible will happen. We will be truly separate and nothing will be the same between us ever again. After a long pause, I decide to risk it and go forward.

 

Punchline: Not every child who develops a Borderline adaptation was overtly abused—and many children who are abused do not become Borderline. Two key features are often present in the childhood of children who do develop Borderline Personality Disorder: Abandonment in early childhood (before age 4) or engulfment by the emotional needs of their mother or other primary caretaker.

 

-Elinor Greenberg, PhD