Borderline Personality Disorders
I’ve had an interest in Narcissistic Disorders for various reasons over the past few years. I’ve read several books on the subject and most equate people with NPD (Narcissistic Personality Disorder) with vampires. These people drain your life energy so best to just keep your distance because there is nothing that can be done unless you want to allow your life to be sucked dry by their emotional needs and demands.
But I’ve been reading Ken Wilber’s Grace and Grit and and he says it can be treated. His focus is actually on Borderline Personality Disorder (BPD) but he claims Narcissistic Personality Disorder (NPD) is closely related.
According to Wikipedia, a Personality Disorder is a class of mental disorders characterized by rigid and on-going patterns of thought and action. The underlying belief systems informing these patterns are referred to as fixed fantasies - beliefs or systems of beliefs that an individual holds as genuine but can’t be verified in reality. The inflexibility and pervasiveness of these behavioral patterns often cause serious personal and social difficulties, as well as a general impairment of functioning. It includes overwhelming narcissism. The patterns don’t typically start showing up until early adulthood, but in rare cases can be traced back to adolescence. (Meaning, it is typically inappropriate to diagnose someone as having a personality disorder if they are less than 18 years of age because rarely can it be proven that a personality disorder pattern exists before that age.)
The DSM-IV lists both BPD and NPD under Personality Disorders in Cluster B (dramatic, emotional, or erratic disorders). They occur in early (primitive) pyschological development and because the conditions are so primitive, they were historically considered to be untreatable. (NPD is considered to be more primitive than BPD.)
According to Wilber, at a very young age (by 2 or 3 years old), the individual has to make the separation from the material world and establish a higher-order identity with the body as a separate and distinct entity in the world. Margaret Mahler calls this the “separation-individuation” stage of development. There has to be a separation and individuation from the mother. If this doesn’t happen, difficulties like BPD and NPD can occur. It’s called borderline because it exists on the border between psychosis and neurosis but isn’t quite either. Boundaries of self remain vague, fluid, confused. The world seems to “emotionally flood” the self which makes the self very volatile and unstable.
Most of psychology attempts to treat disorders by digging up something from the unconscious. But this doesn’t work with people with BPD and NPD because they haven’t yet reached that level of psychological development (that happens at the next level.) In otherwords, BPDs and NPDs haven’t yet developed a dynamic unconscious so there isn’t one to dig up.
Mahler, Kohut, Kernberg and others have created structure-building techniques which have been fairly successful at helping individuals develop stronger ego boundaries. This helps the individual differentiate self and other by explaining and showing that what happens to the other does not necessarily happen to the self. (Wilber’s example - you can disagree with your mother and that won’t kill you.)
In the borderline conditions, the problem is not that a strong ego barrier is repressing some emotion or drive. The problem is that there isn’t an ego barrier or boundary in the first place. So what you have to do is get the person up to the the level where they can repress and then psychotherapy techniques of digging into the unconscious can be used. But until then, the self isn’t strong enough to forcefully repress anything.
you may want to look at Cognitive Analytic Therapy - CAT - It has some promising approaches to BPD
Hi amida!!
Thank you for the recommendation. I just spent some time reading through the ACAT on-line intro. It looks like it has all kinds of applications. I’d never heard of it before.
I think I’ll have to spend some time with this at the library where I can access what has been written about CAT and BPD. There are only synopses available through a Google search.
Thanks for letting me know about it.
An interesting post and theory on narcissistic personality disorder which I understand is thought to affect less than 1% of the population at varying degrees, but as far as I can gather its exact causes are unknown.
Certainly it is suggested by Researchers in neuropsychology early childhood factors may have a bearing brought about by over indulgence or extreme admiration or maniapulation towards children in interaction by parents. The fact that most people with the disorder will never seek help, for evaluation of their upbringing and later life makes it even harder to obtain any reliable data or analysis to make reliable conclusions.
It is our Frontal lobes, the executive mechanism of the brain that enable us to view ourselves separately and where our degree of awareness (consciousness) takes place, to enable emotions to be disseminated and with other stored information( from other areas of the brain) to render rational decisions.
It seems plausible enough if such early childhood emotions were overly controlled or manipulated in an extreme manner than maybe that rigidity (evidenced by failure to recognise others emotions or feelings) emerges in later adolescence arising in some cases from the building blocks of childhood development.
Best wishes
Interesting observations, Lindsay. I didn’t realize NPD affected 1% of the population. That’s a lot of people and probably is a very low estimate since people do not seek help. BPD (which Wilber says is intimately connected to NPD) is thought to be 2% of the population.
Like NPD, The cause of it is also unknown but it is thought genetic factors and environment predispose patients to BPD. The childhood history of these people is so varied that it is hard to nail anything down. A good number of the people were abused in their childhood, but not all. I’ve read in several places that Dialectical Behavioral Therapy is among the most recent successful treatments. It has mindfulness practice as a central component. Research shows mindfulness practice/meditation strengthens the frontal lobes.
As you mention, if early childhood emotions were overly controlled or manipulated and the child over-identified with the parent, then any discussion of childhood history will be seen as a very dangerous betrayal. Especially if the child had an overinvolved parent. It’s just way too scary! Breaking that dependence probably feels something like committing suicide. It seems much easier to cope with reality by remaining inside the emotional world of fixed fantasies, no matter how unstable that causes their lives to be.
Perhaps mindfulness training is a less invasive way to approach the problem.
I love your blog!!!
so you mean, if I have BPD (not saying I do)- meditation will help me regulate those crazy emotions ??? and could be a lot cheaper than $175 per hour sessions with the “doctor”?……
Kathy - There is a lot of evidence that shows meditation will help. But I imagine it would be most helpful in conjunction with medical advice.
Hia.
I was diagnosed by the Department of Vocational Rehabilitation with Borderline Personality Disorder. I’m not yet entirely sure I agree with it because there are so many ideas about what BPD even is! It’s difficult to get clear. But I love Ken Wilber’s ideas. They usually poke me in a sore spot, tho. And this one doesn’t disappoint.
The idea that BPD is essentially a lack of a sub-c is fascinating to me. I’ve never considered that, and frankly, doubt it. But it’s a very interesting idea.
The idea that in order to heal from BPD, one would have to develop a sub-c and then recover from the neuroses that reliably result seems so far from believable that I don’t even have words to describe. It sounds like something that might be on my Mother’s sub-conscious Christmas List. LOL
But not mine.
One of the reasons I love Wilber’s work is that I already work overtime at integrating and have been since I can remember. I have Archetypal Shadow Voices (not voices I hear, but Personas that have real traction in the real world). And it is true that they are close to the surface. But not above the surface - unless I really work at bringing them up. They are very primative. I’ve had, and still have from time to time, panic attacks - which according to Primal Therapy ideas are simply the spontaneous emergence of Primal Energy. From whence do we think that comes? I have dreams that are sneaky, metaphorical hints about what’s going on deep inside of me. I have to do a little work to interpret them.
And it is true, that I can identify exactly what emotions I’m feeling without too much effort and I can articulate them if the environment is safe. When interacting under pressure in an environment where my emotions are not safe, I develop an emotional blister… which can be easily popped under specific conditions. I can SUppress these. But REpress?
Why the hell would anyone want to do that? And who the hell does anyone think they are to require me to do such a thing? What an awful thing to suggest. I can’t even comprehend the amount of indifference one would have to have to ignore the obvious pain and damage that would do to someone. I am incredulous. And I feel utterly entitled to have the feelings I have. I am responsible for expressing them appropriately, but I am not under any obligation imaginable to stop feeling them. That is basically the definition of the theory behind trauma based programming. Unconscionable. Utterly.
Wow. That’s alot of traction! Fyew! LOL
But seriously, it’s not okay.
So, now let me express that a bit more responsibly, from the outside. Instead of from the inside.
The request, as I’m going to interpret this, to learn to repress my primal impulses and feelings in order to function in the world doesn’t meet my need for integration of my Primal Energy. I feel entitled to have it AND feel it and learn to contain it without hindrance from any outside source. I feel joy when I can identify AND contain my own emotions. This is meta-emotion. I feel loved, connected and intimate when I give myself this space and when others give me this space also. I feel love, connection and intimacy when I give myself and others this space. I don’t want anyone taking that away from me. I think its fair to request another solution from the world.
I need to integrate my need for autonomy and my need for compassion (to express it towards myself and others). I need to live and work with this kind of integration. This is a meta-need.
And.. I hear often that the outside world is not comfortable in one way or another with my intensity. Containing such opposing emotions as love and indifference or needs such as autonomy and compassion is very disorienting and/or triggering for many people to observe and doesn’t meet their needs for order, safety, stability or reliability. I’m wondering if there is some way to find a solution that meets the needs of both myself and the outside world.
It seems to me that to live integrated and not repressed is the solution and not the problem. True, it’s difficult to get along with others, esp. power relationships where it’s not safe to have primal impulses or feelings. But why is this unsafe environment considered in the right, and me in the wrong? Why must people not be conscious of, much less speak about, the impulse to do harm or damage property as punishment for grave injustice, rankism, bullying and double-bind situations? As long as I don’t commit the act, am I not being responsible by acknowledging it?
What about the person who can’t acknowledge it, but then suddenly blows one day and DOES all that and more? How is that better? How is it better to be both compelled AND bound at the same time - like a slave - by our unconscious Taboo even if our lives appear stable on the surface? HOW is that even tolerable? WHY would anyone knowingly tolerate it? I don’t understand. It makes no sense to me.
I have friends who have Asperger Syndrome and while researching this “disorder”, I’ve become aware that many who have it consider themselves to be lucky. While I scratch my head about why it’s a good thing to not grok why someone might be mad enough to throw things at you or be able to tell when someone is about to exploit or harm you, I understand some of their thinking.
They often remark about how “neuro-typicals” are over-reactive to the stupidest things. I can understand that. Especially since my pet theory about people is that we’re all suffering from PTSD of one degree or another and we’re all gonna have pre-conscious limbic system responses to some things which should eventually be consciously acquired, contained and integrated in a responsible way. Gosh, it would be great if we could all get on with that process instead of just freaking out and blaming others.
Even schizophrenia can be considered a case of social poisoning and spontaneous vomitting up of all the lies and inhumane demands laid upon human beings in this culture.
There are people with letters after their names who seriously consider the “insane” to be the ones on the right track and the demands placed upon people to bow to the corrupt just to survive are truly toxic and not simply normal responsibilities. It’s inneresting how this dovetails…
This may just be another case of the Pre/Trans Falacy. I’ll have to think on it for a while…
Thanks for letting me vent.
Hi Whitewave - I really appreciate the honesty of your thoughts! I think that what is important is that we consider all perspectives. What is considered to be “normal” in a particular circumstance is a perspective and not necessarily the “right” one. (If there is such a thing as the “right one”.)
Repression, as a form of denial, is problematic. Suppression is very often considered a form of self-control and I think would probably be considered virtuous by Aristotle and Nietzsche. Repression is never virtuous even though it is often dictated to us by current societal standards.
I tend to agree that what is blamed as some sort of individual flaw is really a fault of the culture. But at the same time, if individuals allow themselves to be blamed, rather than the culture, is that the fault of the culture? Or is it the lack of courage of the individual?
One of the main reasons I decided to homeschool my child was because he had been diagnosed as ADD. To me, that’s a cultural problem and not an individual problem so I pulled him out of school. But he still has to deal with the social repercussions of the problem. I can’t shield him from that.
Somewhere, there is a balance. I don’t claim to have found it. But at one point I thought by pulling my son out of the mainstream I’d find it and I didn’t.
Or maybe I did and it just hasn’t become apparent yet.
I think most of us have no clue as to how our egos operate. If this is something you’ve become aware of, perhaps you are beyond most of us even if you’ve yet found no solid solutions. But this doesn’t make you special. It is simply assurance that you are no more or less like the rest of us.
Praise Jebus! oops… any apology can be free! As any happiness.
Hi, arulba.
What a great response! Thank you so much for engaging me on this wonderful and deep topic!
I heartily agree that it is about perspectives. The amazing thing about Ken’s theory is that the person with BPD is trapped holding all perspectives with no emotional buffer and no autonomy to protect one’s self from the pain. So, rather than develop a sub-c to withdraw into and pack the pain away in, one develops over-reactivity and psychosis.
I was having dinner with some good friends last night and we were discussing this theory openly. One friend has been diagnosed with BPD before, and the other two were Mothers of women who have been diagnosed with it. It was a fantastic convo. There was much thinking out loud and trading of perspectives. One of the things I thought about was how we tend to go to the meta-level much more quickly than most.
For instance, if we are having trouble agreeing on politics, I will observe that we are having trouble agreeing and I will shift to simply honoring their perspective. I do this quickly, invisibly and until recently, “unconsciously”. But they may not make this shift at all. Even if I point it out. Even if I leave a trail of bread-crumbs. Its at this point that I become more vulnerable emotionally. If I’ve already done the work of respecting their perspective, I believe I’ve earned some sort of currency. But if they disagree, or don’t see it, my primal sense of entitlement leaves me totally exposed to crushing deprivation. At that point, I can often go ballistic.
LOL
God, it’s great to see this! Man! It makes things so much clearer!
The only problem with this line of questioning:
“…if individuals allow themselves to be blamed, rather than the culture, is that the fault of the culture? Or is it the lack of courage of the individual?”
is that when you consider that the time this pattern is being formed in someone’s life is usually during early childhood, the individual isn’t actually an individual yet at all. They are an extension of the Parent. They live to make the Parent look good. And in return the Parent keeps them alive. Those are literally the stakes. Courage is not yet even an option. Survival is dominating the hierarchy of needs.
As the individual ages, yours is the question that is often asked of them. But people tend to not realize that such individuals are now hard-wired into interpreting such situations as a survival event. It doesn’t matter how much cognitive reprogramming someone tries to do, all that just sounds like rationalizations and justifications for the other side to win and for the individual to surrender and die. This is when the reactivity and psychosis is triggered.
So, while I can’t avoid “going there” mentally, I can contain it and observe it with compassion and love and after the stress neurotransmitters have run their course and I’ve calmed down, I can regain my autonomy and avoid burning the whole freakin’ place down.
I have courage. Enough to try and negotiate for my needs and desires and feelings even in a power situation where it is unlikely that I will win. After all, it seems to me that I’m literally risking my life.
LOL I hear ya about the ADD. Thinking at the speed of light and in short, pulsar-like bursts is not culturally correct. Listening to extremely long-winded lectures and tracking 100-mile long trains of thought is considered valuable and admirable. But it seems to me that homeschooling is, in fact, protecting him from the consequences of this dreadful “crime”. At least for a while. Hopefully he’ll be able to separate out that he’ll have an uphill battle when he’s on his own, and that that doesn’t mean he’s a bad guy. I’m sure you’re living that truth with him now. You have alot of power over how well he’ll be able to stay safe emotionally in the long run.
The word, “special” sure is interesting, isn’t it? It has so many meanings now that it almost doesn’t mean anything any more. But it seems to me that my friends with Asperger’s are special. They both have their “savant”-like abilities. One can fix a car, invent tools or make a computer chip that does what he wants it to do, by hand, with ease. The other remembers gobbs of appointments in her head without having to keep them all in a book. Scary!
And being their friend helps me to acquire conscious awareness about all the little unconscious assumptions we make, such as: it’s okay to openly express anger, but not jealousy. But why? Why do people get so bent out of shape when they express jealousy, out loud, in groups, about something that one of the others has or does? Why is that so extremely irritating? Why is it more irritating than if they were to express simple anger about something someone said or did? This is a really good question to ask. And it makes me more aware of what I can do to help them - and help myself. That’s a special contribution they make in my life.
It would be pretty sweet if some people could see me making a similar contribution instead of just getting in the way of progress or commerce all the time. [heavy sigh]
Thank you for your kind consideration and blog. You are, by far, the fastest responding blogger I’ve ever seen.
~Ww
Hi Whitewave,
I’m fairly new to all of this. What is a sub-c?
You are right about my comment on courage - at least in terms of our normal understanding of courage. But then again, what is courageous for one person is not necessarily courageous for another. We all have to act from where it is we are at and that’s what matters in terms of courage. Some of us have more to overcome or deal with than others and the acts of courage they are performing aren’t always so easily seen or recognized by everyone. But they are every bit as courageous as what is more outwardly and universally recognized and sometimes even more so. I fully agree. To negotiate for your needs when it seems you are negotiating with your life is definitely an act of courage.
By sharing your thoughts, you are providing a contribution, although I realize it’s likewise a contribution that isn’t always so readily seen.
Thank you for sharing so much of yourself. It definitely helps me realize I need to be more understanding of people who make me uncomfortable! It is important to ask why it is we get so bent out of shape when people don’t behave according to societal “norms”. It’s easy to provide surface answers about polite or whatever. But if we dig deeper, maybe our irritation is based on a societal insecurity that maybe isn’t so different from what it is you experience.
Hi, Arulba.
Sorry about that sub-c. reference. That’s not academically correct, although it works for me. UNconscious is the correct term, which you used to describe what I may not even have. The more I think about it the more weird that sounds. It’s just weird. How is this possible?!
Anyhoo, yes, things such as courage and love and hope are very subjective. I am so glad. God help us if everything could be determined and quantified.
You’re very sweet.
I work for an organization of mental health clients who believe people can recover from even the gravest mental illness. That’s not to say everyone DOES recover. But people can. I am an assistant recovery coach. All of my close friends and coworkers have a mental illness or developmental disorder of one sort or another. Many are dually diagnosed with more than one dx or substance abuse issues as well. Peer-support is quite different than the medical model and has evidence to support it’s success.
I know all that sounds like a commercial, but I’ve tried to describe it in other terms and it gets too confusing. Whaddayamean the Crazies are running the asylum?!!! And things of that nature. LOL But it works. I’m so much more functional now than a year ago! Holy cow. And my friends are too. I love them to bits and we all have wonderful things to teach each other. I’m really grateful to know them all. Even the scary ones.
Cool blog. I bookmarked it on the computer at work for them all to peruse through from time to time.
Hi Whitewave,
I was thinking about consciousness yesterday because I’d been listening to a lecture on Nietzsche. He says we developed consciousness through language. If we didn’t have language, we’d have no need of consciousness. That’s kind of a weird thought, too.
It sounds as though you do work that matters to you! Must be challenging but sounds like it is likewise rewarding.