I Hate You--Don't Leave Me - Jerold J. Kreisman [11]
Socioeconomic Factors
Borderline pathology has been identified in all cultures and economic classes in the United States. However, rates of BPD were significantly higher among those separated, divorced, widowed, or living alone, and among those with lower income and education. The consequences of poverty on infants and children—higher stress levels, less education, and lack of good child care, psychiatric care, and pregnancy care (perhaps resulting in brain insults or malnutrition)—might lead to higher incidence of BPD among the poor.
Geographic Borders
Although most of the theoretical formulations and empirical studies of the borderline syndrome have been conducted in the United States, other countries—Canada, Mexico, Israel, Sweden, Denmark, other Western European nations, and the former USSR—have recognized borderline pathologies within their populations.
Comparative studies are scant and contradictory at this point. For example, some studies indicate higher rates of BPD among Hispanics, while others do not confirm this finding. Some studies have found greater rates of BPD among Native American men. Consistent studies are meager but could provide great insight into the child-rearing, cultural, and social threads that compose the causal fabric of the syndrome.
Borderline Behavior in Celebrities and Fictional Characters
Whether the borderline personality is a new phenomenon or simply a new label for a long-standing, interrelated cluster of internal feelings and external behaviors is a topic of some interest in the mental health community. Most psychiatrists believe that the borderline syndrome has been around for quite some time; that its increasing prominence results not so much from its spreading (like an infectious disease or a chronic debilitating condition) in the minds of patients but from the awareness of clinicians. Indeed, many psychiatrists believe that some of Sigmund Freud’s most interesting cases of “neurosis” at the turn of the century would today be clearly diagnosed as borderline.20
Perceived in this way, the borderline syndrome becomes an interesting new perspective from which to understand some of our most complex personalities—both past and present, real and fictional. Conversely, well-known figures and characters can be understood to illustrate different aspects of the syndrome. Along these lines, biographers and others have speculated that the term might apply to such wide-ranging figures as Princess Diana, Marilyn Monroe, Zelda Fitzgerald, Thomas Wolfe, T. E. Lawrence, Adolf Hitler, and Muammar al-Gadhafi. Cultural critics can observe borderline features in Blanche Dubois in A Streetcar Named Desire, Martha in Who’s Afraid of Virginia Woolf?, Sally Bowles in Cabaret, Travis Bickle in Taxi Driver, Howard Beale in Network, and Carmen in Bizet’s opera. Although borderline symptoms or behaviors may be spotted in these characters, BPD should not be assumed to necessarily cause or propel the radical actions or destinies of these real people or the fictional characters or the works in which they appear. Hitler, for example, was probably driven by mental malfunctions and societal forces much more prominent in his psyche than BPD; the root causes of Marilyn Monroe’s (alleged) suicide were probably more complex than to say simply it was caused by BPD. There is little evidence that the authors of Taxi Driver or Network were consciously trying to create a borderline protagonist. What the borderline syndrome does furnish is another perspective from which to interpret and analyze these fascinating personalities.
Advances in Research and Treatment
Since publication of the first edition