I Hate You--Don't Leave Me - Jerold J. Kreisman [59]
In most settings, concentrating on the Truth segments of SET-UP principles (see chapter 5) can allow for reasonable guidelines. But when suicide is threatened, it is usually time to contact a mental health professional or suicide-prevention facility. Suicide threats should not be allowed to become “emotional blackmail,” whereby the friend or relation is manipulated to behave as the borderline demands. Threats should be taken seriously and met with prompt, predictable, realistic reactions, such as demanding that the borderline obtain professional help (a Truth response).
Jack, a forty-one-year-old single man, worked part-time while attempting to return to school. His widowed mother continued to support him financially, and whenever he failed at work, school, or with a relationship, she would reinforce his helplessness, by insisting he could not succeed in achieving his goals and suggesting he return “home” to live with her. Therapy involved not only helping Jack understand his wish to remain helpless and reap the inherent benefits of helplessness but also confronted his mother’s need to maintain control, and her role in perpetuating his dependency.
It takes only one actor in the drama to initiate change. Jack’s mother can respond to his dependency with SET-UP responses that express her caring (Support), understanding (Empathy), and acknowledgment of reality (Truth)—the need for Jack to take responsibility for his own actions. If his mother is unwilling to alter her behavior, Jack must recognize her role in his problems and distance himself from her.
Contending with Borderline Rage
After a while, for someone close to a borderline, unpredictable behaviors may become commonplace and therefore “predictably unpredictable.” One of the most common, the angry outburst, usually comes with no warning and appears way out of proportion.
The close friend, relation, or coworker should resist the temptation to “fight fire with fire.” The louder and angrier the borderline gets, the quieter and more composed the other person should become, thereby refusing to collaborate in aggravating the emotional atmosphere, and spotlighting the comparative outlandish intensity of the borderline’s rage. If the concerned individual senses the potential for physical violence, he should leave the scene immediately. Borderline rage often cannot be reasoned with, so discussion and debate are unnecessary and may only inflame the situation. Instead, one should try to cool off the conflict by acknowledging the difference in opinion and agreeing to disagree. Further discussion can come later when the atmosphere is more settled.
Living with Borderline Mood Swings
Rapid mood changes can be equally perplexing to the borderline and to those around him. From an early age, Meredith had always been aware of her moodiness. Without reason she could soar to great heights of excitement and joy, only to plummet, without warning, to the lower reaches of despair. Her parents indulged her moodiness by tiptoeing softly around her, never challenging her irritability. In school, friends would come and go, put off by her unpredictability. Some called her “the manic-depressive” and tried to kid her out of her surliness.
Her husband, Ben, said he was attracted to her “kindness” and “sense of fun.” But Meredith could change dramatically, from playful to suicidal. Similarly, her interactions with Ben would change from joyful sharing to gloomy isolation. Her moods were totally unpredictable, and Ben was never sure how he would find her upon his return at the end of the day. At times he felt that he should enter their home by putting