I Hate You--Don't Leave Me - Jerold J. Kreisman [8]
This constellation of nine symptoms can be grouped into four primary areas toward which treatment is frequently directed:
1. Mood instability (criteria 1, 6, 7, and 8).
2. Impulsivity and dangerous uncontrolled behavior (criteria 4 and 5).
3. Interpersonal psychopathology (criteria 2 and 3).
4. Distortions of thought and perception (criterion 9).
Emotional Hemophilia
Beneath the clinical nomenclature lies the anguish experienced by borderlines and their families and friends. For the borderline, much of life is a relentless emotional roller coaster with no apparent destination. For those living with, loving, or treating the borderline, the trip can seem just as wild, hopeless, and frustrating.
Jennifer and millions of other borderlines are provoked to rage uncontrollably against the people they love most. They feel helpless and empty, with an identity splintered by severe emotional contradictions.
Mood changes come swiftly, explosively, carrying the borderline from the heights of joy to the depths of depression. Filled with anger one hour, calm the next, he often has little inkling about why he was driven to such wrath. Afterward, the inability to understand the origins of the episode brings on more self-hate and depression.
A borderline suffers a kind of “emotional hemophilia”; she lacks the clotting mechanism needed to moderate her spurts of feeling. Prick the delicate “skin” of a borderline and she will emotionally bleed to death. Sustained periods of contentment are foreign to the borderline. Chronic emptiness depletes him until he is forced to do anything to escape. In the grip of these lows, the borderline is prone to a myriad of impulsive, self-destructive acts—drug and alcohol binges, eating marathons, anorexic fasts, bulimic purges, gambling forays, shopping sprees, sexual promiscuity, and self-mutilation. He may attempt suicide, often not with the intent to die but to feel something, to confirm he is alive.
“I hate the way I feel,” confesses one borderline. “When I think about suicide, it seems so tempting, so inviting. Sometimes it’s the only thing I relate to. It is difficult not to want to hurt myself. It’s like, if I hurt myself, the fear and pain will go away.”
Central to the borderline syndrome is the lack of a core sense of identity. When describing themselves, borderlines typically paint a confused or contradictory self-portrait, in contrast to other patients who generally have a much clearer sense of who they are. To overcome their indistinct and mostly negative self-image, borderlines, like actors, are constantly searching for “good roles,” complete “characters” they can use to fill their identity void. So they often adapt like chameleons to the environment, situation, or companions of the moment, much like the title character in Woody Allen’s film Zelig, who literally assumes the personality, identity, and appearance of people around him.
The lure of ecstatic experiences, whether attained through sex, drugs, or other means, is sometimes overwhelming for the borderline. In ecstasy, he can return to a primal world where the self and the external world merge—a form of second infancy. During periods of intense loneliness and emptiness, the borderline will go on drug binges, bouts with alcohol, or sexual escapades (with one or several partners), sometimes lasting days at a time. It is as if when the struggle to find identity becomes intolerable, the solution is either to lose identity altogether or to achieve a semblance of self through pain or numbness.
The family background of a borderline is often marked by alcoholism, depression, and emotional disturbances. A borderline childhood is frequently a desolate battlefield, scarred with the debris of indifferent, rejecting, or absent parents, emotional deprivation, and chronic abuse. Most studies have found a history of severe psychological, physical, or sexual abuse in many borderline patients. Indeed, a history of mistreatment, witness to violence, or invalidation of experience by parents or primary