There’s something about the borderline personality that I adore. I have a few very close friends that have been officially diagnosed with borderline, usually during a point of hospitalization. These friends of mine are the type that yell and scream and dramatize and love very intensely, and are a thrill to be around. I have clung to them over the years as Kerouac must have clung to Cassidy, desiring to get saturated in moments of pure, intense, fiery life interaction.
But, despite my experience with said personalities, I will not claim to understand them in the least. (And in many ways, that’s part of why I adore them still.) Trouble once came when I began rooming with a good friend at the age of 20. Doctors had been going back and forth about whether she qualified as bipolar or something else, and much of our friendship centered around talking about our feelings and relationships. I credit her for turning me on to feminism and healthy eating, and that was the year that I switched my major from English to psychology, partly because she revealed to me the amazing world of neuropsychology.
But then winter set in, and the apartment began to lose the flare it had previously held. She gradually began to recess into her room and refuse all efforts to get her to go out or experience life. Much to my surprise, she stopped listening to encouraging words, often turning away from me in an air of malice and contempt for anything I had to say. Her room turned into a womb: uncharacteristically warm for the winter, and dark. She would put sweatshirts over her monitor to dim the light, and blankets over the windows so that she never knew what time of day it was. When walking into the apartment during the months of February and March, the charge in the air made you stiff upon entry, and each step inside had the potential to set off an IED. By April, her addiction to cutting herself became as intense as an alcoholic’s addiction to his hidden whiskey bottle.
She was eventually diagnosed as having borderline PD, and I regret to say that she and I are not friends anymore. This is very upsetting to me, as I was quite accepting of her and not at all afraid or shocked by her actions (which seemed designed to be shocking). In many ways, I feel that I failed her. However, my hindsight analysis of this situation, based on Linehan’s (1993) definition of borderline PD and the therapy required to help it, makes me think that I was just not the right person to help her. In truth, based on the transient and silly pejorative basis for such diagnosis as “personality disorders” (see Allison’s brilliant assessment of the ridiculousness of PDs), I’d bet that the chances were more likely than not that, whoever I was, I was not going to be able to help her. Assuming someone with a “personality disorder” wants to be helped, it takes a special person, a special therapist, to work with people in such states of distress. Linehan (1993) proposes DBT, based on Zen principles, but no matter what you call it or how you frame it, I bet Linehan is just great at therapy.
Monday, November 12, 2007
“The only people for me are the mad ones.”
Posted by Thrasher at 7:55 PM
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2 comments:
Cat,
It's funny -- I had a very similar experience with a roommate, and was similarly disappointed (in myself) when I felt I had "failed" her.
In terms of Linehan: it's really interesting that you mention her as "good" or "not good" at therapy. I was reading a while ago about some comparative studies looking at DBT to SPECIFICALLY suss out a "Linehan effect." It seems that people figured she was SUCH a good therapist that they wondered whether DBT technique was just a mask for the profound power extending from interacting with Linehan (or being trained by her). Not so sure of the results, but maybe Jim'll know...
I think the effects of DBT and similar interventions are not likely to be beholden to single great therapists, although great therapists probably add a lot. That could bring up questions of common factors again, and other issues that might take us too far from the topic. But in any event, the thing about BPD is that it is really, really difficult for all involved, and it is hard to assign blame for the problem, or credit for the recovery.
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