Monthly Archives: January 2015

#20 – Splitting Explained and Thoughts on DBT

Splitting is often mentioned in blogs and books about BPD. Here I’ll give an overview of this defense mechanism, offer ways of understanding it, and suggest ideas for overcoming it.

What does splitting mean? It describes how someone views themselves and others as all-good or all-bad at a given time, not as a mix of good and bad qualities. It can be illustrated with examples. Here are three scenarios that show splitting in action:

Example 1: The Mean Professor

In our first example, a “borderline” woman gets back a paper in her college English class with a grade of C. The professor notes that the grammar, syntax, and thesis need to be improved, and suggests a revision. He adds that the overall organization was on the right track, making encouraging remarks about several ideas. Nevertheless, the student feels rage in response to the grade of C. She views the professor as mean, as a harsh grader, and as “out to find and punish any mistake.” The student does not take in the positive remarks, which could have balanced her thinking by preventing the professor from appearing totally negative. By only focusing on the bad aspects of the situation and cancelling out the positive, the student remains internally attached to an “all bad” view of the outside world. This is an example of negative or all-bad splitting.

An important thing to notice about splitting is that the individual becomes actively involved in maintaining their view of the world in a “split” way, via the way they fantasize about and color external reality. In other words, the person’s mind only recognizes or takes in a certain kind of emotional stimulus – e.g. critical remarks in this case – and the person either does not recognize, or actively rejects, the opposite kind of stimulus – balancing, positive remarks. In this way the person does not experience any ambivalence, thoughtfulness, or reflective-capacity in relation to what is going on. Rather, the (only partially negative in this case) experience is responded to as if it really were 100% bad emotionally. This severely limits the ways in which the individual can respond to the outside world.

The origin of all-bad splitting was further discussed in the article on Fairbairn’s developmental model, here:

https://bpdtransformation.wordpress.com/2014/02/02/the-fairbairnian-object-relations-approach-to-bpd/

With regard to a person not recognizing positive experiences, or rejecting positive stimuli, these are examples of the out-of-contact and ambivalent symbiotic phases respectively. More on these phases can be found here:

https://bpdtransformation.wordpress.com/2014/02/08/four-phases-of-bpd-treatment-and-recovery/

Example 2 – A Date Turned Bad

In this second example, a “borderline” young man goes on a date with a young woman, meeting her for lunch. The pair have a relatively good conversation, finding some shared experiences in music, sports, and the schools they attended. At the end, the woman hesitantly says she would be interested in meeting again, and she gives an awkward, tentative hug to the young man.

This man had a difficult relationship with his own mother, who was distant and cold emotionally. Although he enjoyed parts of the date, he forgets the main conversation and becomes preoccupied with the awkwardness that ended their meeting. After going over it in his mind, he decides that the young woman did not like him, was just being nice out of pity, and has no interest in seeing him again. He can only understand her awkwardness at the end of the date as an unconscious communication of rejection.

This is partly an example of projection. However, it is also an example of severe splitting, in that the young man sees the woman’s attitude as all-negative while rejecting any balancing possibilities. For example, rather than viewing the woman as not liking him, he could consider that she might be nervous about expressing affection on a first date, or that she is relatively inexperienced with dating overall. These thought patterns would move away from the feeling of rejection. However, these ideas never occur to him, which is partly because he makes buries the memory of the good conversation, and fixates consciously on the negative (from his perspective) ending. Again, we can see that internally this young man is creating or “making” reality more negative than it really is, via the splitting of the woman into all-bad in his mind.

Example 3 – The Savior Parent

For a last example, a lonely, middle-aged “borderline” woman becomes involved with an older, successful professional man who wines and dines her, gives her gifts, and in general treats her with kindness. During these early good times, the woman views the man as a “savior”, the perfect gentleman, and the solution to all her problems. Even when he makes small mistakes, like his habit of being late to dates, she isn’t bothered.

However, after a few months, the man stops spending so much time with her, gives more energy to his other friends and hobbies, and has to travel more for business. He tells her he wants to take his time with the relationship. Once this happens, the “savior” image disappears, and the woman feels rejected. The “good child – perfect parent” internal images are replaced by her feeling like an unwanted, lonely child, with the man seen as an uninterested, rejecting parental-figure. Now, when they do meet and the man is a little bit late, she notices it immediately – it feels like a concrete example of how he is not concerned about her. Her feeling rejected by the lateness (all-bad splitting) is the polar opposite of when she would not even notice his lateness before, during the idealizing phase (all-good splitting).

In these examples, I use the quotations around “borderline” because these examples represent not “borderlines” (do we ever see a borderline walking down the street?), but unique human beings facing challenging past and present circumstances. As noted in other articles, I don’t believe that BPD is a valid diagnosis; nevertheless, “Borderline Personality Disorder” is a diagnostic word commonly used in association with splitting. Thus I will sometimes use the term, albeit reluctantly.

Understanding Splitting as a Normal Developmental Process

Splitting in itself is not something “bad”. Rather, it is a normal developmental phase that children pass through; the young child first takes in satisfying experiences and unsatisfying experiences separately, classifying them in different compartments in its mind. The problem of splitting continuing into adulthood only develops when the negative experiences outnumber or outweigh the positive experiences.

Integration (seeing the world ambivalently, as mixtures of good and bad qualities) begins to naturally occur in a child’s mind if more good than bad experiences accumulate over time. Let us look back at the three examples to see how someone with a higher capacity for ambivalence might have processed the same events:

Example 1 – The Constructively Critical Professor

Rather than “mean” and “out to punish any mistake”, a healthier student would have seen her professor’s remarks as constructive criticisms meant to improve her writing. She would have noted that the positive remarks indicated a concerned side of the professor, and then – holding them in her mind along with the critical remarks – she would not have twisted his image into that of a rejecting authority figure. These differing perceptions would probably affect her future behavior; making her more likely to rewrite the essay well and receive praise from the professor.

In contrast, the more troubled woman in the original example might do a lackluster revision in response to the criticism, lacking motivation due to her belief in the professor’s all-negative attitude toward her. This might lead to more trouble with the professor on future assignments, resulting in more all-bad perceptions by the student, and so on. In this way, all-bad splitting tends to form a vicious cycle where the same people are repeatedly seen as “all-bad”, related to unrealistically as “bad”, and then in reality they often do become more “bad”, treating the person less well than they otherwise would have. In other words, the person is modifying how they experience own reality via the splitting. The internal and external worlds of the person interpenetrate so that the internal negative perceptions come to shape and be shaped by how the person interacts with the outside world.

Example 2 – Ambivalence Over A Young Woman on a Date

As mentioned in the original example, a healthier man might have considered that the young woman’s awkwardness at the end of the date might not indicate lack of interest. Rather, a whole range of reasons could account for her behavior, including nervousness, lack of experience with dating, not being comfortable with expressing physical affection, a conservative upbringing, and so on. Keeping any of these ideas in mind, along with the memory of the positive aspects of their conversation, would have supported the idea that the woman could still like him despite her awkwardness.

Example 3 – A More Independent Woman

This woman’s idealizing reaction to the generous man in the initial phases of dating is not unusual. However, her reaction would be stronger than most, in that a lot of neediness underlies it. Her need for emotional support results in her wanting a perfect, all-giving parental figure, rather than just a lover. The need is not a bad thing in itself – it reflects a child’s developmental level emotionally – but it makes continuing an adult-adult relationship difficult. Because the woman wants a perfect parent, she is inevitably disappointed when the man starts to devote his energy elsewhere. At this point, the splitting shifts from all-good to all-bad, and things that did not bother the woman previously (like the man’s lateness) become upsetting.

A healthier person would not have such a strong need for the man in the initial phase of dating. Therefore, she would not be so vulnerable to disappointment when the man started to reveal imperfections later on. The man would neither be seen as so perfect initially, nor viewed as so bad and disappointing later on. Both of these differences in perception would result from increased ambivalence – the absence of all-good or all-bad splitting.

Why Does Splitting Continue Into Adulthood?

We have seen in these examples how a healthier person tends to use an integrated view of other people, containing good and bad elements together, to relate to others in a more complex, realistic way. This capacity is based on a predominance of positive experiences in these individuals’ life experience. As noted, integration naturally tends to occur when good life experiences outweigh bad ones, because a person feels safe to look at the small “bad” packet of experiences alongside the “good” group of experiences.

However, if a person’s negative experiences in life largely outweigh the good ones, then integration cannot occur in a way that feels safe. Very often, abuse, neglect, and a lack of positive relationships in childhood and/or early adulthood underlie this “structural deficit” – the lack of good experiences on which to base a capacity for ambivalence. The lack of feeling secure in childhood, and the related need to maintain hope in an overwhelming situation, are reasons that splitting gets maintained into adulthood in many adults who get the “borderline” label. Because their experience in reality – often with parents who neglect or abuse them – has been more negative than positive, they have to preserve hope of things getting better somehow. They do this using the splitting defense. With splitting, it is possible to pretend, on the basis of the few good experiences that one actually did have, that a perfect, good savior-parent or partner is still out there who can provide salvation. By contrast, it feels dangerous to the child (and later adult) to truly see that he is in great emotional danger as a result of his interpersonal world being more “bad” than “good”.

In colloquial language, one could say that it feels safer to ambivalently reflect on what is going on in one’s life when one’s experiences with others have been primarily positive. When one feels threatened most of the time, it’s not possible to be consistently aware of just how bad things are. Such an awareness would be emotionally overwhelming. In this way, at least at first, splitting is a brilliant defense mechanism that can be emotionally life-preserving

How To Move Beyond Splitting

Here I would refer the reader to blogs, books, and essays that were discussed in earlier articles. Many sources describe how building a long-term good relationship with another person and/or group is crucial to recovering from what is called Borderline Personality Disorder. The borderline individual needs to build their internal positive images up – taking in many good, supportive, loving experiences with other people in the real world – until these memories become stronger than the negative images. Eventually, integration of good and bad perceptions will naturally start to occur, and splitting will begin to be overcome.

I like to use the framework of four phases, artificial as they are, to conceptualize progress from all-bad splitting to all-good splitting to integration. The essay below describes the phases of Therapeutic Symbiosis, meaning dominance of positive images over negative ones, followed by Resolution of the Symbiosis, meaning the integration of good and bad images. These are the phases that a borderline individual usually wants to aim towards, starting from either the out-of-contact or ambivalent symbiotic phase. These earlier phases represent periods in which all-bad splitting dominates, i.e. the person’s negative views of themselves and others predominate over their positive ones, preventing ambivalence:

https://bpdtransformation.wordpress.com/2014/02/08/four-phases-of-bpd-treatment-and-recovery/

Types of Therapy for Overcoming Splitting

From my experience, I have a bias toward psychodynamic-psychoanalytic therapy; I think it’s a great way to build the positive relationship needed to overcome splitting. In long-term psychodynamic work, one can painstakingly build a trusting attachment that serves to replace the negative relationships of the past. The therapist first helps the patient to understand (via the transference relationship) how their negative, splitting-based ways of viewing the world are unrealistic and serve to block the need for more positive relationships. They also help the patient to manage difficult feelings in a way the original parents could not.

Later on, as trust and attachment develops, the therapist functions as a good parental figure, helping the patient develop their internal positive self-and-other images to the point that the good images dominate over the negative images. The positive relationship inside therapy gradually transfers to relationships in the outside world. The therapist is eventually experienced as an independent, separate person that the (formerly borderline) individual can have a mature adult-adult relationship with. During this period, the patient becomes more able to experience relationships ambivalently, as good and bad at once.

A Critique of CBT and DBT

Cognitive-Behavioral Therapy or Dialectical-Behavior Therapy can certainly be helpful, and are great for helping people stabilize their lives on a short-term basis. While I do not that think that CBT and DBT are “bad”; it’s my opinion that they are sometimes formulaic and superficial. They can have a narrow, present-day focus that limits a deeper understanding of someone’s problems based on their life history. Also, some of these shorter-term therapy approaches have the following problems:

1) They focus on coping with symptoms of one’s “illness”, thus conveying the impression that BPD is a life-long condition that must be managed, not overcome.  This may be partly my perception; not all forms of short-term therapy are like this and some focus on strengths. From my direct experience with it, I remember that there are positive aspects to the DBT conceptualizations, like the “wise mind” concept.

2) In some cases, CBT and DBT keep the borderline person stuck, allowing them to “cope ” a little bit better, but using the same defensive structure and split views of reality that they have had throughout life. Readers can probably relate to feeling that a short-term therapy has only been palliative, rather than helping them break through their suffering to experience the world in a new way. I think deep improvement requires much longer than short-term therapies allow for, and that it involves understanding one’s history and defenses in depth.

In my opinion, CBT and DBT (both of which I’ve also experienced myself, years ago) do not often continue long enough to build the positive self and object-images to the point needed to overcome splitting; CBT and DBT are often given for periods of only weeks or months. Again, in my opinion, overcoming splitting and associated defenses usually requires at least a few years. That is not meant to be pessimistic – while years may sound like a long time, things can gradually get better and better. Also, CBT and DBT can definitely help a person toward stabilizing a difficult situation, coping better with difficult feelings, and starting to be experience the world more ambivalently. It is not that shorter-term or manualized treatments are bad; but they may be limited in what they can achieve.

3) Going deeper, CBT and DBT create the illusion that BPD is a valid diagnosis that means the same thing for different individuals, but let’s not go there this time. If I get started on that train, it will take a long time to stop! 🙂

Having made these criticisms, I should admit that they might be wrong. That is why I noted that these thoughts are only opinions. Generalizing about therapy is a dangerous thing to do – a lot of success depends on the quality of the individual therapist, regardless of orientation, and the resources and motivation of the patient. Also, people have many options that can help outside of therapy. Therefore, my critiques should be taken as generalizations that have little meaning for an individual. No doubt, many people have benefitted from CBT and DBT, and if it works for them, that is all that matters. As one of my old therapists said, we should “take what is useful, and leave the rest.” If you have positive experiences with any of these forms of therapy, please share it in the comments.

Other Approaches to Overcoming Splitting

The discussion above assumes that people want to use psychotherapy as the main vehicle to overcome their problems. Of course, this is not always true. My first recommendation for those looking for another approach is to check out Clare’s writing on overcoming BPD, at:

http://www.my-borderline-personality-disorder.com/2013/03/recovery-bpd-mbt.html

http://www.my-borderline-personality-disorder.com/2013/07/the-process-of-overcoming-bpd-follow-up.html

Clare has many great articles about how she recovered from her problems without using intensive psychotherapy. I find her way of thinking about “borderline” problems to be humble, helpful, and wise. At the very least, her approach is more mature and encouraging than a lot of the pessimistic ideas discussed by “non-borderlines” on other forums! I hope I don’t offend anyone with this 🙂

Second, self-help groups like 12-step and other similar organizations can be very helpful, and I recommend at least trying them to everyone. These groups can help to establish a foundation of positive, trusting relationships, and can therefore be crucial to eventually overcoming splitting.

Third, for many people it can be helpful to educate oneself skeptically about BPD! What skeptical education means is to read widely, taking in many differing viewpoints on borderline issues without accepting one viewpoint as right. In my opinion, a lot of information about BPD on the internet is either so superficial as to be useless, or just plain wrong (this especially applies to viewpoints that involve strong pessimism toward borderlines, as well as viewpoints that consider BPD to be an “illness” with a genetic or biological basis).

Unfortunately, negative viewpoints on BPD may have a strong influence on people who become identified with the term, causing them to think negatively about their future. In this way, the very concept of BPD can sometimes become yet another obstacle to taking in positive experiences, making an already challenging task of recovery harder. So, my thinking is that changing one’s view of BPD to something more hopeful and flexible, or even rejecting the diagnosis model entirely, can be useful.

Fourth, and this is a truism, but friends and family can be so crucial to getting better. I understand that for many people who identify with BPD, family are a problem. But this is not always the case. Whenever family and friends can be turned into supporters, and relationships with them used for growth, it helps. In my experience, the more isolated that people are, the more prone they are to all-bad splitting. This is because isolation maintains the deficit of positive internal experiences, leading a person to feeling less secure and supported. While in this state people are less able to reflect on their experiences ambivalently.

Fifth, Helen Albanese gave a good overview of how splitting can be resolved in BPD in her book, The Difficult Borderline Patient: Not So Difficult To Treat. It is a brief, non-technical introduction to psychodynamic thinking about splitting and BPD, and Albanese conveys a lot of optimism that the condition can be overcome. It is accessible to the layperson in a way that most psychoanalytic books are not. I recommend checking it out in the used books on Amazon! (I have no affiliation with the author).

Understanding Splitting When One Is “Borderline”

To conclude, I think people working through borderline issues can benefit from understanding in greater depth how splitting operates – how viewing themselves and others as “all-bad” traps them in a negative cycle of seeing the outside world as all-bad, expecting bad things to happen, inducing others to respond negatively, feeling negative in response to treatment which they are partly responsible for, and so on.

This is an encouraging perspective, because if one gains insight into how one is misperceiving reality as “all-bad”, one can then start to understand how to move past the distortions. In other words, a person can become aware that they are seeing reality in a “delusional”, one-sided way, and that there are more good parts to outside reality than they often perceive. This can be an eye-opening, sometimes amazing experience to a person who starts to see things as good and bad together for the first time.

Getting past splitting sometimes makes me think of the movie Inception, where there are different levels of reality symbolized in different levels of dreams. In the early phases of mostly all-bad splitting (like in one level of a dream), reality is viewed all one way or the other. But on the higher level, where integration or ambivalence reigns, the world appears totally different, more complex and complete. It’s like the difference between seeing things as three-dimensional and in color, versus black or white.

Ok, I will finish this here! I hope this had some useful ideas, and feel free to share any thoughts with me via email or in the comments.