Published by the American Psychiatric Association, the DSM-IV-TR provides a common language and standard criteria for the classification of mental disorders.
While visiting on an out of state journey, I went outside on the back porch to talk while dinner was cooking. As we sat in the sun and began to talk, a rather strange twist in the conversation occurred. The conversation changed from generalities to a story about one of the people inside the house who had Borderline Personality Disorder. As a listened, I was curious and perplexed about why a person I hardly knew was telling me about something so personal and so personally damaging to the other person. The story was filled with vignettes and illustrations that created an illusion about erratic behavior to support the claims being made. The accused person was described as such a difficult person to cope with, controlling, manipulative, passive aggressive and frustrating to deal with. It all sounded very bizarre and out of character for this to be happening on the back porch. As a result, this seemed even stranger as it went on to me because the two people bareley knew each other and had spent very little time together.
What I observed during the conversation was a person who was very convincing, impassioned, and had some reason to feel deeply enough to say these things to a perfect stranger, but I wondered what the real purpose in this conversation was? As I listened, the personal feelings of the person telling the story unfolded through private and very personal details of experiences, but this missing link was why me and why now? What really struck me as strange about the story was the there was little firsthand observation, just a lot of hearsay information from others people’s experiences spun into a conclusion. Pondering the question of why, it seems that this conversation was an intentional to influence my perspective to match a reality created in the mind of someone who had a goal in mind. Therefore, why this was happening was not abundantly clear at the moment, but I was determined to understand more about the actual issue beneath the words, accusations, and characterizations in this conversation. Consequently, I suspected that there was more to the story that I needed to know to understand how to respond. What was apparent was that there was a perception about the meaning of the frustration with relationship problems. As a result, the problem had been labeled as Borderline Personality Disorder. As the conversation proceeded, what I learned was that more than one person believed the label of Borderline Personality Disorder, which surprised me greatly. Evidently, in the conversations between my new acquaintance and other family members they had apparently accepted opinion, as fact, without ever questioning the veracity, reasons, and justification for this accusation. This seemed strange because, the person labeled BPD was a highly venerated and loved person. It made me wonder how intelligent people suddenly accept such a report based without reasonable causes.
On the other hand, the person telling the story expressed honest concern and a personal frustration with personal interpretations of problems experienced. While the story was expressed with such impassioned and convincing explanations, there seemed to be something more that looked like a personal agenda. Apparently, the conclusion made was based upon a feeling of adequate knowledge about counseling practices and that symptoms described were consistent with Borderline Personality Disorder. In fact, the person telling the story said, “It is Borderline”, referring to the person’s personal assessment. The confusion came when I was listening and it seemed as if everything that was said might be a reasonable explanation. However, there was nothing concrete to base the opinion upon except their personal speculation.
What I heard was a strong feeling of frustration that was labeled without a professional diagnosis from someone personally involved being influenced by their own state of mind, personal issues, and a some need to discredit another person with innocuous charges. Apparently, in the situation described there were some behavior anomalies not understood clearly and people who did not have the maturity or patience to think through reasonably. As a result, family members talked about this freely amongst themselves and the person labeled, had a life-altering label hung over their head by people unwilling to engage in a healthy discussion with the person directly. Therefore, the innuendo, accusation, and labeling resulted in an unfounded characterization of the individual by people who had no expertise, no diagnostics, or professional advice. Consequently, impatience, intolerance, and difficulty with life experience resulted in people who were critical and unwilling to try to understand better so they just accepted an irrational opinion.
I walked away from the experience wondering how people who are constantly telling each other how much they love each other in public could behave in such a coercive way toward someone they publicly embraced in private. My immediate observation was personal confusion because I did not see what I was being told as being real. On the other hand, what I witnessed was systemic behaviors that demonstrated unhealthy ways of managing life. In addition, what I saw people ready to easily dismiss a person by labeling them with an easy tag to explain away, invalidate, criticize, and destroy individual credibility on the altar of self-interest and selfish behavior. Therefore, when self-interest disables people from being capable of understanding life events that might require them to think or reserve diagnosis for someone qualified what behaviors actually were indicating, the low road of self-interest chosen. Reasonable people do sometimes do unreasonable things, but this made me wonder why the people involved in this story did not talk to the person individually and suggest a visit to a practitioner to gain better understanding?
An important question that I left the discussion with is what should be done when it appears a family member has unusual or strange behaviors that may be interpreted as Borderline Personality Disorder. Obviously, the place to begin is not to make spurious, unfounded, or unprofessional accusations because others do odd things that irritate us personally. What I learned from this situation was that the storyteller told me more information about their personal issues than they did about the other person. Indeed, it is easy to project personal frustration about life on someone else, when we are overtaxed and feeling anxiety because life experiences do not meet our personal expectations. In fact, what we usually dislike in others is what we most dislike about ourselves. When things like this happen, something to consider is that transference may be at work and we are vicariously trying to resolve something that is out of kilter in our own life through fault finding in others. It is a way of unconsciously saying there is something in my own life that I need fixed. So, when we suspect that Borderline Personality is an issue in someone that is a part of our lives what should be done?
A place to begin is to keep your suspicions to yourself and rely on professionals trained to diagnose, licensed to treat, and not personally involved. This will provide quantitative data based information that correlates with evidence based-theory to inform. Persons who are personally or emotionally involved with people who may have mental health issues should never take upon themselves to diagnose. When casual inference or accusations are made, there is the danger of damaging a person or triggering a “acting in” incident that permanently damages a person or that can be fatal. Information presently understood about Borderline Personality Disorder is that diagnosis is not a simple process, even from seasoned psychiatrists’ or therapists, because BPD is grouped within a cluster of personality disorders that are very similar in some ways. For many Borderlines, a common misdiagnosis Borderline Personality Disorder occurs by associating symptoms of the BPD with Bi-Polar disorder. Therefore, diagnosis requires in depth studies of symptoms and behaviors to determine whether they are a personality disorder or a metal heath condition that mimics symptoms that can be easily confused. Therefore, diagnosing should not be performed by curious or interested parties, but should be left to people who are capable, ethical, and professional. An important point to address is that people with mental health disorders, mood swings, or a family systems dysfunction are not bad people, they simply people who simply have a need for help in areas of deficiency in ways to improve health and functionality. Also, consider this that personality disorders are not a personal flaw, but they are personality disorders. Personality disorders have biological roots and demonstrate unique cognitive-behavioral patterns that devastate families, relationships, and life outcome; especially in family systems that label, minimize, criticize, and do not exercise patience and will not take time to understand. Another important issue is that personality disorders are not a sign of weakness, it is not simply a reaction to a stressful time or event, it is a pattern of thinking, relating, and behaving that demonstrates symptomatic behaviors consistent with the particular disorder. As a result, for those who seek treatment it is not uncommon for a therapist to see a patient for an extended period of time before making a formal diagnosis of Borderline Personality Disorder. As a result, care should be exercised in labeling or diagnosing individuals without expertise. When there is a personal involvement with the individual and we think they are having significant problems, diagnosis should be done by professionals who can offer objective observations.
The DSM IV list the criteria for the most common presentation of symptomatic patterns associated with a scientific criteria established through research about disorders. Therefore the criteria establish a pattern to build a scientific metric to rate the level of the disorder for developing a treatment plan that is focused upon the individual and the level of the disorder. Therefore diagnosis of people should be done by professionals who use scientific data, research, and diagnostic criteria to assign a diagnostic code and create a plan for treatment. When there is a question, the appropriate response is to keep your opinions to yourself and seek the help of medical-psychological professionals who are equipped to provide healthy solutions.
People with Mental Health issues Can be Hazardous to Your own Mental Health and Functionality in Life.
Another reason for seeking a mental health professionals assistance is when we suspect there is a real problem that needs more than what we can give. The truth is that no one lives in a vacuum and mental health has a systemic effect upon those whose lives intersect in relationships, family, or work. Certainly, other people’s problems and behaviors do affect us in an organic ways within a social or family system. A good example is that living in a family where there is ongoing, unmanaged, or untreated mental health problems makes you feel shame, like you are crazy, or trapped in a never ending cycle. The example given in this article effectively damaged a family relationship because irresponsible and uninformed responses were acted upon with no concern for the effect and no responsibility was taken for the actions. The truth that stands out is that when people do not live and respond in healthy functional ways there is a systemic effect. When we live with people with personality disorders or serious mental health issues, every individual is being affected by the process of what is happening every time live intersects. Having an awareness of what is occurring does impact lived experience by disabling functionality that is essential to maintaining balanced, congenial ways of relating. As a result, the storyteller and the collaboration others who made foolish and irresponsible comments without consideration resulted in a permanently damaged relationship matrix that severed ability for a functional way of engaging in healthy relationships. The lesson that I walked away from the conversation with is that people need to think about the effect of irresponsible statements before make assumptions about other people that can damage their lives. In addition, people who claim to understand mental health issues should be willing to take responsibility for their actions in an ethical way, should willing to acknowledge mistakes that cause damage to others, and not simply act as if the event never happened.
The fact is that Borderline Personalities do create havoc and make life very difficult. If you have ever questioned someone’s behavior or mental health, then maybe you should consult a professional. Maybe you are wondering if you are living or working with a person who may be a Narcissistic or a Borderline Personality; then here is some helpful advice from Dr Tara J. Palmatier, PsyD who is qualified to speak about the disorder.
If you are convinced that a person you love has Borderline or Narcissistic personality traits, how does it affect you?
Censoring your thoughts and feelings. You edit it yourself because you’re afraid of her reactions. Swallowing the lump in your throat and your hurt and anger is easier than dealing with another fight or hurt feelings. In fact, you may have stuffed your own emotions for so long that you no longer know what you think or feel. (This is a trait of both BPD and NPD).
Everything is your fault. You’re blamed for everything that goes wrong in the relationship and in general, even if it has no basis in reality. (This is a trait of both BPD and NPD).
Constant criticism. She criticizes nearly everything you do and nothing is ever good enough. No matter how hard you try, there’s no pleasing her or, if you do, it’s few and far between. (This is a trait of both BPD and NPD).
Control freak. She engages in manipulative behaviors, even lying, in an effort to control you. (This is a trait of both BPD and NPD).
Dr Jekyll and Ms Hyde. One moment she’s kind and loving; the next she’s flipping out on you. She becomes so vicious, you wonder if she’s the same person. The first time it happens, you write it off. Now, it’s a regular pattern of behavior that induces feelings of depression, anxiety, helplessness, and/or despair within you. (This is a trait of both BPD and NPD).
Invalidation–Your feelings don’t count. Your needs and feelings, if you’re brave enough to express them, are ignored, ridiculed, minimized and/or dismissed. You’re told that you’re too demanding, that there’s something wrong with you and that you need to be in therapy. You’re denied the right to your feelings. (This is a trait of both BPD and NPD although; BPDs are slightly more capable of empathy than NPDs).
Confusion–Questioning your own sanity. You’ve begun to wonder if you’re crazy because she puts down your point of view and/or denies things she says or does. If you actually confide these things to a friend or family member, they don’t believe you because she usually behaves herself around other people. (This is a trait of both BPD and NPD).
Distorted reality “But I didn’t say that. I didn’t do that.” Sure you did. Well, you did in her highly distorted version of reality. Her accusations run the gamut from infidelity to cruelty to being un-supportive (even when you’re the one paying all the bills) to repressing her and holding her back. It’s usually bull, which leaves you feeling defensive and misunderstood. (This is a trait of both BPD and NPD).
Isolating yourself from friends and family. You distance yourself from your loved ones and colleagues because of her erratic behavior, moodiness and instability. You make excuses for her inexcusable behaviors to others in an effort to convince yourself that it’s normal. (This is a trait of both BPD and NPD).
Walking on landmines. One misstep and you could set her off. Some people refer to this as “walking on eggshells,” but eggs emit only a dull crunch when you step on them. Setting off a landmine is a far more descriptive simile. (This is a trait of both BPD and NPD).
All good or all bad–splitting She places you on a pedestal only to knock it out from under your feet. You’re the greatest thing since sliced bread one minute and the next minute, you’re the devil incarnate. (This is a BPD trait).
Absence of boundaries. Borderlines and Narcissists make the rules; they break the rules and they change the rules at will. Just when you think you’ve figured out how to give her what she wants, she changes her expectations and demands without warning. This sets you up for failure in no-win situations, leaving you feeling helpless and trapped. (This is a trait of both BPD and NPD).
Emotional Abuse–You’re a loser, but don’t leave me. “You’re a jerk. You’re a creep. You’re a bastard. I love you. Don’t leave me.” When you finally reach the point where you just can’t take it anymore, the tears, bargaining and threats begin. She insists she really does love you. She can’t live without you. She promises to change. She promises it will get better, but things never change and they never get better.
Passive Aggressive Manipulation. When that doesn’t work, she blames you and anything and anyone else she can think of, never once taking responsibility for her own behaviors. She may even resort to threats. She threatens that you’ll never see the kids again. Or she threatens to bad mouth you to your friends and family. Then you are an emotional hostage. (This is a trait of both BPD and NPD).
http://shrink4men.wordpress.com/2009/01/21/relationships-with-borderline-narcissistic-personality-women/
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