I Hate You--Don't Leave Me - Jerold J. Kreisman [57]
—From Death of a Salesman, by Arthur Miller
No one knew quite what to do with Ray. He had been in and out of hospitals and had seen many doctors over the years, but he could never remain long in treatment. Nor could he stay with a job. His wife, Denise, worked in a dentist’s office and spent most of her leisure time with her friends, generally ignoring Ray’s complaints of chest pains, headaches, backaches, and depression.
Ray was the only child of wealthy, protective parents. When he was nine, his father’s brother committed suicide. Although he never knew his uncle very well, he understood that his parents were greatly affected by the suicide. After this event, his parents became even more protective and would insist he stay home from school whenever he felt ill. At the age of twelve, Ray announced he was depressed and began seeing what evolved into a parade of therapists.
An indifferent student, he went on to college where he met Denise. She was the only woman who had ever shown any interest in him, and after a short courtship they were married. Both quit college and dutifully went to work, but relied on Ray’s parents to subsidize their household and Ray’s continuing therapy.
The couple moved frequently; whenever Denise got bored with a job or a location, they would move to a different part of the country. She would quickly acquire a new job and new friends, but Ray had great difficulty and would remain out of work for many months.
As they both began drinking more, their fighting intensified. When they bickered, Ray would sometimes leave and return to live with his parents, where he would stay until the family began to quarrel, then he would come home to Denise.
Frequently Ray’s wife and parents would tell him how fed up they were with his moodiness and multiple medical complaints, but then he’d threaten to kill himself and his parents would become panic-stricken. They insisted he see new doctors and flew him around the country to consult with various experts. They arranged hospitalizations in several prestigious institutions, but after a short time Ray always signed himself out against medical advice, and his parents would send him plane fare home. They continuously vowed to withhold further financial support but never stuck to their word.
Friends and jobs became an indistinguishable blur of unsatisfying encounters. Whenever a new acquaintance or occupation disappointed in any way, Ray quit. His parents wrung their hands; Denise basically ignored him. Ray continued spinning out of control with no one to restrain him, including himself.
Recognizing BPD in Friends and Relations
On the surface a borderline personality can be very difficult to identify, despite the underlying volcanic turbulence. Unlike many people afflicted with other mental disorders—such as schizophrenia, bipolar (manic-depressive) disease, alcoholism, or eating disorders—the borderline can usually function extremely well in work and social situations without appearing overtly pathological. Indeed, some of the hallmarks of borderline behavior are the sudden, unpredictable eruptions of anger, extreme suspiciousness, or suicidal depression from someone who has appeared so “normal.”
The borderline’s sudden outbursts are usually very frightening and mystifying—both to the borderline himself and to those closest to him. Because of the sudden and extreme nature of certain prominent symptoms, the concerned party can be easily misled and not recognize that it is a common manifestation of BPD rather than a separate primary illness. For example, a person who attempts to kill himself by overdosing or cutting his wrists may be diagnosed with depression and prescribed antidepressant medications and brief, supportive psychotherapy. If the patient is suffering from a chemical depression, this regimen should improve his condition and he should recover relatively quickly and completely. If, however, the destructive behaviors have been triggered by BPD, his self-harming