Relationships and Borderline Personality Disorder

why are you single

 

Once upon a time, I had a wonderful cadre of friends. I held game nights and wrote long letters. I sent cards for every holiday and stayed on friend’s couches when they were having a tough time. I strove to ensure that they knew how much I loved them.

Still, I lost many friends. Relationships failed over and over again because of my own actions driven my BPD symptoms. And any attempt I made to date ended in disaster.

I hurt anyone who got too close.

I Hate You, Don’t Leave Me is the seminal book on Borderline Personality Disorder, and as the title implies, relationships are a major obstacle for those of us with the diagnosis.

In fact, the DSM 5, which serves as the authority on psychiatric diagnoses, includes “Impairments in interpersonal functioning” as a necessary symptom of the diagnosis.  Part of this difficulty may include issues with intimacy.  Such as:

Intense, unstable, and conflicted close relationships, marked by mistrust, neediness, and anxious preoccupation with real or imagined abandonment; close relationships often viewed in extremes of idealization and devaluation and alternating between over involvement and withdrawal.

As perfectly painted in Cracked.com’s 5 Things People Don’t Get About Borderline Personality Disorder:

Do you remember the relationships you had in your early teens, when the hormones first started pumping and absolutely everything was HUGE and DRAMATIC? One day, you’re madly in love with a person or she’s your best friend, but as soon as she does anything to make you feel even slightly insecure, she’s suddenly the subject of pages of bleak poetry in your diary? Do you remember the constant anxiety and self-doubt, the fear that if you went even one day without talking to him, it meant he didn’t like you anymore?

Well, imagine that, only worse. And you never grow out of it.

The post goes on to point out that most people have a stigmatized view of BPD and our ability to maintain relationships from its misrepresentation in pop culture.

If you’ve heard of borderline personality disorder, it probably wasn’t in the real world, since we don’t make headlines (sociopaths are such spotlight hogs). No, you probably learned about it from a movie, even if the movie never used the term. At worst, these are the thrillers about obsessive, murderous women (Fatal Attraction and Single White Female), and at best they’re about clingy, out-of-control types (Jennifer Lawrence’s character in Silver Linings Playbook and Winona Ryder in Girl, Interrupted). It’s always a female who becomes obsessive and completely irrational at the prospect of rejection …

…people tend to think BPD just encompasses any and all psychotic behavior — or as some call it, “crazy bitch syndrome

This perception stigmatizes BPD to the extent most are scared of those of us with the diagnosis and doesn’t portray the real relationship issues that plague many with BPD.IMG_20150918_182259

Relationships are difficult for those with BPD in part because they have higher expectations of being rejected and are more anxious about this expectation.[1] And they have an implicit need of “extreme” inclusion.  In other words, they want to be included in relationships but even when they are, they may still feel rejected .[2]  For myself this plays out in the following way: I have friends who I expect not to include me, or to leave me after I prove to be difficult (which considering the number of suicide attempts alone, let alone my incredible daily mood swings, is more than an accurate statement.  And many have rejected/abandoned me.)  Then when someone asks me out to a trivia night, I still feel left out. I feel unfulfilled. While my friends feel like they are making a great effort to include me, I’m  thinking that I’m not really wanted.

Then there’s this black and white valuation/devaluation issue where I love someone until I hate them.  There’s no in between. If I perceive that someone fails me, I shut them out. I’m also rarely able to forgive.

I have, like many with BPD, incredibly poor boundaries, which plays in to another DSM 5 criteria of struggling to establish my identity.  I often look to others to confirm who I am and more so, I often am more willing to believe negative feedback from others of myself than positive feedback.

For many, there are issues of impulsivity and risk taking as well as hostility to others, yet other DSM 5 criteria. There are attachment issues and co-dependency issues.  And often the smallest things can trigger BPD symptoms (like an offhanded comment that somehow makes me feel rejected even if it wasn’t meant that way).

Yet for all the relational difficulties, those with BPD have some advantages.  Though they are “poor at appraising their own emotions, they clearly pick up on the emotions of others.” [3] Meaning that those with BPD have a natural ability for compassion.

We’re good at gauging the temperature of the room. We’re like emotional sponges. We can be great diplomats, really good at keeping everyone in the group happy, because we are self-appointed, full-time Keeping People Happiers. When someone’s in pain, we really feel that pain, so we’re an excellent shoulder to cry on. [4]

But this capacity for compassion is not enough.  I found for myself that relationships are more than hard, they are a source of my instability.  Thus one of the best things I’ve done to control my symptoms is to not have any relationships – so I decided to push others away.

The first step I took was to deactivate my Facebook account in 2011.  I realized that watching the happy news of my friends was making me hate myself more and making me a horrible friend.  I’d see friends getting engaged, getting promotions at work, having babies, going on adventures, etc. while I was losing jobs, unable to keep a boyfriend, and seeing my mental and physical health deteriorate. I felt that it was unfair to my friends that I was envious of them and couldn’t be truly happy for them and it only served to trigger me (not to mention I wanted the constant attention of having someone to talk to on the chat feature).

The next step I took was to push away those I love.  I thought long and hard about this step following a suicide attempt.  I realized that I couldn’t put others through my emotional ups and downs.  I didn’t want them to see me continue to struggle and fail.  So I composed a mean email to close to friends, as mean as I could to ensure that they wouldn’t want to talk to me again and told them in no uncertain terms that I didn’t want them in my life, not to contact me anymore.  I still maintain that this was the kindest thing I could do for them.  I wanted them to go on living their lives without the burden of my diseases.

Over the years I’d lost so many friends to my mental health illnesses – often accused of attempting or threatening suicide as a means of manipulation and attention or told that my issues were “too stressful” for them to deal with.  Knowing that I didn’t want to be a burden on anyone and to head off the rejection, I decided that I wouldn’t keep any relationships, with very few exceptions, for more than 1 year.  And those that lasted longer had to be relationships that were much more superficial.  For the most part, the times I’ve broken this rule have ended in disaster.

I wish I could have stayed in your life, but I was too much and not enough at the same time. – Unkown

As a result, I don’t have anyone to call my valentine.  I didn’t have friends in town to visit me in the hospital when I had an abscess surgery 2 years ago that was literally my worst nightmare or when I had spine surgery 6 months later.  There was no one to keep me company when I broke my foot (and couldn’t afford pain meds) or had pneumonia (and could barely breathe let alone get soup to try to eat).  I had friends accessible through my epatient connections and online communities, but no one close by (thank goodness for apps like Favor and Postmates when I found out that they could bring me food).

Now, I have no friends in the city I currently live in.  I am alone.  Yet I can’t complain about it, because I know it is best for me and more so I am convinced it is better for others.  I don’t want to keep hurting them.  I don’t know how to repair old relationships even if I wanted to try.  And if I did repair these relationships, I fear that my instability would only increase in a time that I’ve been very fragile.

How then can you be my friend?  Be ready for the mood swings.  Be ready for the valuation/devaluation.  Be sensitive as to what you say (some say it’s like walking on eggshells).  Be consistent.  Be consistently available.  Listen.  Talk to me when I’m having a panic attack, just talk.  Know that it may take an inordinate amount of effort (that’s what I hate most about myself).  Learn DBT skills for interpersonal relationships.  Learn more about BPD for that matter (and all the other physical and mental illnesses I have).  Learn my triggers. Remind me that I am loved regardless. Remind me that I am safe (for me that’s more related to PTSD than BPD but still). Be patient – incredibly patient.  Be ready for me to impulsively push you away as furiously as I can.  Expect to see me threaten or attempt suicide (not because I’m trying to manipulate you, but honestly because I think that it would be better for the world if I didn’t exist).

I know this is too much to ask of anyone.

In return though, if you for those friends who survive, they find someone who will do anything for others, who will give of themselves until there is nothing left.  Someone filled with an immense amount of love and compassion.  I don’t think that those attributes make up for the burden of friendship I impose, but I really do try to make up for my shortcomings as best I can and I’ll continue to try.

Most of all, you will have to trust that even if I push you away, I will always love you and have been grateful for the love and kindness you have shown me.

charlotte

_______________________________

[1] Bungert et al. (2015). Rejection sensitivity and symptom severity in patients with borderline personality disorder: effects of childhood maltreatment and self-esteem. Borderline Personality Disorder and Emotion Dysregulation 2(4).

[2] De Panfilis, C. et al. (2015). When social inclusion is not enough: Implicit expectations of extreme inclusion in borderline personality disorder. Personality Disorders.

[3] New, A.S. (2015). Commentary: Bringing research findings ot the clinic and back: Commentary on the special issue on mentalization in borderline personality disorder. Personality Disorders: Theory, Research, and Treatment 6(4).

[4] Cracked.com’s 5 Things People Don’t Get About Borderline Personality Disorder

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