I Hate You--Don't Leave Me - Jerold J. Kreisman [95]
Growing and Changing
“Change is real hard work!” Elizabeth often noted. It requires conscious retreat from unhealthy situations and the will to build healthier foundations. It entails coping with drastic interruption of a long-established equilibrium.
Like Darwinian evolution, individual change happens almost imperceptibly, with much trial and error. The individual instinctively resists mutation. He may live in a kind of swamp, but it is his swamp; he knows where the alligators are, what’s in all the bogs and marshes. To leave his swamp means venturing into the unknown and perhaps falling into an even more dangerous swamp.
For the borderline, whose world is so clearly demarcated by black-and-white parameters, the uncertainty of change is even more threatening. She may clutch at one extreme for fear of falling uncontrollably into the abyss of another. The borderline anorexic, for example, starves herself out of the terror that eating—even a tiny morsel—will lead to total loss of control and irrevocable obesity.
The borderline’s fear of change involves a basic distrust of his “brakes.” In healthier people these psychic brakes allow a gradual descent from the pinnacle of a mood or behavior to a gentle stop in the “gray zone” of the incline. Afraid that his set of brakes won’t hold, the borderline believes that he won’t be able to stop, that he will slide out of control to the bottom of the hill.
Change, however gradual, requires the alteration of automatic reflexes. The borderline is in a situation much like a child playing a game of “Make me blink” or “Make me laugh,” struggling valiantly to stifle a blink or a laugh while another child waves his hand or makes funny faces. Such reflexes, established over many years, can be adjusted only with conscious, motivated effort.
Adults sometimes engage in similar contests of will. A man who encounters an angry barking dog in a strange neighborhood resists the automatic reflex to run away from the danger. He recognizes that if he runs, the dog would likely catch up with him and introduce an even greater threat. Instead, he takes the opposite (and usually more prudent) action—he stands perfectly still, allows the dog to sniff him, and then walks slowly on.
Psychological change requires resisting unproductive automatic reflexes and consciously and willfully choosing other alternatives—choices that are different, even opposite, from the automatic reflex. Sometimes these new ways of behaving are frightening, but they typically are more efficient ways of coping. Elizabeth and her psychiatrist embarked on her journey of change in regular weekly individual psychotherapy. Initial contacts focused on keeping Elizabeth safe. Cognitive techniques and suggestions colored early contacts. For several weeks Elizabeth resisted the doctor’s recommendation of starting antidepressant medicine, but soon after she agreed to the medication, she noticed significant improvement in her mood.
The Beginnings of Change: Self-Assessment
Change for the borderline involves more of a fine-tuning than a total reconstruction. In rational weight-loss diet plans, which almost always resist the urge to lose large amounts of weight very quickly, the best results come slowly and gradually over time when the weight loss will more likely endure. Likewise, change for the borderline is best initiated gradually, with only slight alterations at first, and must begin with self-assessment: before plotting a new course, one must first recognize his current position and understand in which direction modification must progress.
Imagine personality as a series of intersecting lines, each representing a specific character trait (see Figure 10-1). The extremes of each trait are located at the ends of the line, with the middle ground in the center. For example, on the “conscientiousness at work” line, one end might indicate