Borderlines

I really, really dislike this label, even though it isn’t one that I have collected (so far) in my career as a client and patient. Many therapists don’t understand the etiology of the cluster of symptoms that comprise “borderline personality” and therefore cannot work effectively with “borderline” clients.

For this reason, borderlines have gotten a bad reputation among therapists. They are considered difficult, unpredictable, boundary-breaking, ungrateful, and unchangeable. They are often subtlety or not so subtly discriminated against. In clinics, they are assigned to the junior staff, in private practice they are “referred out,” and in hospitals they are treated firmly, but with little empathy. Not always, but often.

It’s illuminating to consider where the term “borderline” comes from. In the early days of psychoanalysis, it was considered possible to analyze neurotic, but not psychotic, patients. Neurotic people got better as they talked freely about their pasts and their troubles, but psychotics tended to become more disorganized mentally if asked to free associate.

It was soon discovered that a group of people started off looking neurotic, and then suddenly, often temporarily, acted psychotic. Thus they were considered “on the border” between neurosis and psychosis.

If you read the old case histories, you may notice that these patients look to our eyes like high-functioning trauma survivors who were having flashbacks in the therapy hour. Some appear to be multiples that switched periodically. Since analysts in those days had no idea what a flashback was, they assumed that their patients had tricked them into thinking they were neurotic when they really were psychotic.

When clinicians started to study borderlines more closely, it was hypothesized that the mother’s behavior caused the syndrome. A mother that alternately pulled her baby very, very close and then became distant and rejecting set the child up for a lifetime of boundary problems. Makes sense, doesn’t it? Alternate invasion and rejection of the child’s very self could very well lead to huge difficulties with relationships. In this scenario, the father, other relatives, family friends, teachers, and clergy are ignored, and so is the possibility of physical and sexual abuse. There are many ways of stimulating and then abandoning a child, many ways of messing with forming boundaries. And needless to say, ritual abuse utilizes them all.

When people make the connection between early catastrophic abuse and present behavior, when they learn what flashbacks are, when they go, “Aha! So that’s why I always expect nice people to turn into monsters,” they have a chance, for the first time, to gain control over their lives and their behaviors. This is as true of borderline behavior as of any other symptom of childhood abuse.

What it comes right down to, is that, as ritual abuse survivors, we live on the border of past and present. We are not unchangeable; we are trauma survivors.

from Survivorship Notes, Monthly Notes, September 2000

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5 thoughts on “Borderlines

  1. This is so perfect. I remember a lot of people TELLING my I had BPD, but very few people ASKING me about what was truly happening with me or why I was behaving the way I was. I always felt like a throw-away “garbage” patient and that was quite re-traumatizing itself. Now that I have a fuller picture of my childhood and my diagnoses, I can see why they assumed BPD, but it still doesn’t excuse their dismissive and irresponsible treatment towards me. This is a stigma that does such tremendous damage to people.

  2. Dear Karen:

    Thanks for your comment.

    Everybody seems to have a slightly different definition. Here is mine:

    “The term ritual abuse is generally used to mean repeated, extreme, sadistic abuse, especially of children, within a group setting. The group’s ideology is used to justify the abuse, and abuse is used to teach the group’s ideology. The activities are kept secret from society at large, as they violate norms and laws.”

    The ideology can simply be hedonism or profit, as with child prostitution or pornography.

  3. I remember as a psychologist in grad school the training and teaching we had on “Borderlines.” The topic was quite popular at the time and it was treated as a “new” category. That was in about the 1980’s. I was actually taught (non verbally but it was loud and clear) that borderlines ARE difficult, demanding an dwill always be in therapy but they won’t really grow or change. There was a lot of good mother/bad mother talk and as a therapist you wouldnt’ want to be caught believing something “they” said completely. If you did, you were “drawn in” to treating them like whole people. Even as a student it seemed to me that the category was often used when a therapist confronted what THEY saw as a person having what THEY saw as conflicting or confusing reactions, reeling an dcoping mechanisms. If it got too complicated for the treating person, the diagnosis would often come up as Borderline and then the aha moment could be had by therapist. NOW I know what this is that I can’t manage. The labell gave them a place to plant what comes down to blame via descriptive terms such as “primitive” or “very young” or “complicated” accompanying with a sigh. At that time multiples were treated with an attitude of survior of something so horrible they HAD to cope in this way.
    It reminded me of a period not long before that when Schizophrenics were “created” by Schizophrenogenic mothers. Once defined, it was all neatly tied up in a treatable package. Oh well, it served to comfort the therapists anxiety.
    This is my first reading of this blog. Can you describe what RA is?
    Karen

  4. How clever of psychotic patients to trick their doctors into thinking they were neurotic! In days gone by probably few people knew the difference.

    I think that psychiatric name-calling has no place in therapy, and there are so many nasty or just plain unnecessary names that are applied to trauma surviors. DSM-III and IV, I believe, both eliminated the need for additional descriptors. If a person was MPD or DID, there was no need to apply any diagnoses that were subcategories of the dissociative disorder.

    Different personalities can look like they are obsessive compulsive or manic or depressive. Perhaps they are called psychotic because of their child-like, overly concrete thinking. I feel terrible for anybody who gets labeled borderline. Talk about the bottom of the pecking order…and I too have never collected that label.

    Mary

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