I Hate You--Don't Leave Me - Jerold J. Kreisman [50]
The E statement should attempt to convey Alex’s awareness of Gloria’s current pain and his understanding of how such extreme circumstances might lead her to contemplate ending her life: “The pressure you’ve been under these past several months must be getting unbearable. All of this agony must be bringing you to the edge, to a point where you feel like you just can’t go on anymore.”
The most important part of Alex’s T statement should identify his untenable “damned-if-he-does and damned-if-he-doesn’t” dilemma. He should also attempt to clarify Gloria’s ambivalence about dying by acknowledging that in addition to that part of her that wants to end her life, another part of her wishes to be saved and helped. Alex’s T responses might be something like: “I recognize how bad you are feeling and your wish to die. I know you said that if I cared at all for you, I should just leave you alone. But if I cared, how could I possibly sit back and watch you destroy yourself? Your alerting me to your suicidal plans tells me that, as much as you may wish to die, there is at least some part of you that doesn’t want to die. And it is to that part that I feel I must respond. I want you to come with me to see a doctor to help us with these problems.”
Depending on the immediacy of the circumstances, Alex should insist that Gloria be psychiatrically evaluated soon or, if she is in imminent danger, he should take her to an emergency room or seek help from police or paramedics.
At this juncture Gloria’s fury may be exacerbated as she blames Alex for forcing her into the hospital. But Truth statements should remind Gloria that she is there not so much because of what Alex did, but because of what Gloria did—threatening suicide. The borderline may frequently need to be reminded that others’ reactions to him are based primarily on what he does, and that he must take responsibility for the consequences, rather than blaming others for realistic responses to his behavior.
When the immediate danger has passed, subsequent T statements should refer to Gloria’s unproductive patterns of handling stress and the need to develop more effective ways of dealing with her life. Truth considerations should also include how Gloria’s and Alex’s behaviors affect each other and their marriage. Over time they may be able to work out a system of responding to each other, either on their own or within therapy, that will fulfill the needs of both.
This kind of problem is especially common within families of borderlines who display prominent self-destructive behaviors. Delinquent or suicidal adolescents, alcoholics, and anorexics may present similar no-win dilemmas to their families. They actively resist help, while behaving in obviously self-destructive ways. Usually, direct confrontation that precipitates a crisis is the only way to help. Some groups, such as Alcoholics Anonymous, recommend standardized confrontational situations in which family, friends, or coworkers, often together with a counselor, confront the patient with his addictive behavior and demand treatment.
“Tough Love” groups believe that true caring forces the individual to face the consequences of his behaviors rather than protect him from them. “Tough Love” groups for parents of teenagers, for example, may insist that an adolescent drug abuser either be hospitalized or barred from the home. This type of approach emphasizes the Truth element of the SET-UP triangle but may ignore the Support and Empathy segments. Therefore, these systems may be only partially successful for the borderline, who may go through the motions of change that Truth confrontations force on him; underneath, however, the lack of nurturing and trust provided by Support and Empathy hinder his motivation for dedicated and lasting change.
Feeling Bad About Feeling Bad
Borderlines typically respond to depression, anxiety, frustration, or anger with more layers of these same feelings. Because of the borderline