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I Hate You--Don't Leave Me - Jerold J. Kreisman [35]

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that are later expressed as a particular illness, depending on a variety of contributing factors—childhood frustrations and traumas, specific stress events in life, healthy nutrition, access to health care, and so on. Just as some have postulated that heritable biological defects in the body’s metabolism of alcohol may be associated with an individual’s propensity to develop alcoholism, so there may exist a genetic predisposition for BPD, involving a biological weakness in stabilizing mood and impulses.

As many borderlines learn that they must reject the either-or, black-or-white ways of thinking, researchers are beginning to appreciate that the most likely model for BPD (and for most medical and psychiatric illnesses) recognizes multiple contributing factors—nature and nurture—working and interacting simultaneously. Borderline personality is a complex tapestry, richly embroidered with innumerable, intersecting threads.

Chapter Four


The Borderline Society

Where there is no vision, the people perish.

—Proverbs 29:18

States are as the men are; they grow out of human characters.

—From Plato’s Republic

From the beginning Lisa Barlow couldn’t do anything right. Her older brother was the golden boy: good grades, polite, athletic, perfect. Her younger sister, who had asthma, was also lavished with constant attention. Lisa was never good enough, especially in the eyes of her father. She remembered how he constantly reminded all three children that he had started with nothing, that his parents had no money, didn’t care about him, and drank too much. But he had prevailed. He had worked his way through high school, college, and through several promotions at a national investment bank. In 1999, he made a fortune in the dot-com stock boom, only to lose it all a year later after some professional missteps.

Lisa’s earliest memories of her mother were of her lying on the couch either sick or in pain, ordering Lisa to do one chore or another around the house. Lisa tried hard to care for her mother and to persuade her to stop taking the pain pills and tranquilizers that seemed to make her so foggy and distant.

Lisa felt that if she was just good enough, she could not only make her mother better but also please her father. Though her grades were always excellent (even better than her brother’s), her father always maligned her achievements: the course was too easy or she could have done even better than a B+ or an A−. At one point, she thought she might want to become a doctor, but her father convinced her she would never make it.

In her childhood and adolescence the Barlows moved constantly, following whatever job or promotion her father chased after. From Omaha to St. Louis to Chicago and finally to New York. Lisa hated these moves and realized later that she resented her mother for never objecting to them. Every couple of years Lisa would be packed up and shipped like baggage to a strange new city where she would attend a new school filled with strange new students. (Years later she would recount these experiences to her therapist as “feeling like a kidnap victim or a slave.”) By the time the family arrived in New York, Lisa was in high school. She vowed never to make another friend so she would never have to say good-bye again.

The family moved into a posh home in a posh New York suburb. Sure, the house was bigger and the lawn more manicured, but that didn’t come close to compensating for the friendships she left behind. Her father rarely came home in the evenings, and when he did, it was late and he would start drinking and railing against Lisa and her mother for doing nothing all day. When her father drank too much, he became violent, sometimes hitting the kids harder than he intended. The most frightening time of all was when he was drunk and their mother was spaced out on pain pills; then there was no one to take care of the family—except Lisa, and she hated it.

In 2000, everything started coming apart. Somehow her father’s firm (or her father himself, she was never sure which) lost everything when

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