Tag Archives: borderline personality disorders stories

#29 – “The Borderline States” – An Essay by Lloyd Ross, Ph.D., Therapist with 40 Years’ Experience Treating People Labeled BPD

I recently emailed Dr. Lloyd Ross, a clinical psychologist from New Jersey with 40 years’ experience treating individuals labeled borderline. I asked him for his views on the DSM model of BPD, the causes of borderline states, what is the best treatment for BPD, and can it be cured. Here are highlights of his responses, with my emphases in bold:

Highlights of Lloyd Ross’ Viewpoints on BPD, excerpted from his essay below:

On therapists who don’t want to work with people labeled BPD:

Lloyd Ross: “To avoid their own discomfort, poorly trained therapists describe borderline individuals as untreatable. Well trained therapists do not have that opinion. Well trained therapists have done well with these individuals, provided the therapist knows both what to expect and what he is doing.”

On good outcomes for people labeled “BPD”:

Lloyd Ross: “With proper insight oriented therapy, people labeled as borderline do go out in the world and function quite well in relationships, employment, etc. Like the rest of us, the goal is not to be cured from some non-existent disease, but to simply resolve the issues in our development that stop us from functioning in a relatively comfortable manner.”

On BPD as a medical diagnosis:

Lloyd Ross: “(As a medical diagnosis) the only “borderline states” that have any validity for me are on the border of Mexico or Canada… In addition, there is absolutely no real science behind any of the DSM/ICD diagnoses.”

On how the word borderline can be useful:

Lloyd Ross: “To use the term “borderline” from a developmental point of view is very different… Using the term “borderline developmental issues” enables us to go back in time and try to help the individual to undo, modify, and soften development that did not go smoothly the first time around.

On the developmental approach to working with people labeled BPD,

Lloyd Ross: “Using this model, the therapist works toward a stronger continuum of emotional development so that a person can function in a more whole way. Borderline states are not a disease or medical issue and therefore, nobody is “cured.” People just learn to handle various issues in their lives in a smoother, more comfortable manner for them.

On suicide prevention:

Lloyd Ross: “According to Bertram Karon, Ph.D., one of the world’s most prolific researchers on effective psychotherapy with patients labeled schizophrenic, suicidal, and borderline, ‘The best suicide prevention is effective psychotherapy.‘ ”

On the value of medication in treating people labeled BPD:

Lloyd Ross: “The medication approach (anti-depressants and/or anti-psychotics) is useless in people with borderline, suicidal, and PTSD symptoms. In fact, anti-depressants are probably one of the major causes of iatrogenic (doctor induced) suicide in this country in the past 15 years, especially with individuals labeled borderline.”

On trauma as the cause of borderline states:

Lloyd Ross: “The cause of “Borderline Personality Disorder” as with all of the “made-up” psychiatric diseases, is trauma at various times and stages in a person’s development… The failure of all-good and all-bad perceptions to fuse is the genesis of all pathologically borderline states.

My Interaction with Dr. Ross

So (this is Edward writing again) these were my favorite parts of what Dr. Ross said about BPD; for the full context, see his essay below. I had originally found Dr. Ross because he is a member of ISPS, the International Society for Psychological and Social Approaches to Psychosis, with which I’m also involved. In my first email, I asked Dr. Ross for detailed answers to my questions about what causes BPD, what best treats it, is it curable, and how best to understand Borderline Personality Disorder.  I wanted to see how much his viewpoints agreed with mine, and to share an informative and hopeful professional viewpoint on BPD with readers of this blog.

In response, Dr. Ross decided to write a single essay incorporating his responses to all the questions. That essay, “The Borderline States” forms the main part of this post. I highly recommend reading it to see how a psychologist who’s worked with over 100 people labeled BPD understands the condition. To Dr. Ross, thank you for taking the time and for giving me permission to post your essay here.

For anyone wanting to know more about Dr. Ross, he is a leading member of the International Society for Ethical Psychiatry and Psychology (ISEPP), and is listed halfway down this page: http://psychintegrity.org/isepp-leadership/

LloydRoss1

Lloyd Ross, Ph.D.

Dr. Ross also features in a Youtube interview about helping people labeled schizophrenic here: https://www.youtube.com/watch?v=wyL0jjI93OI . I want to note that Dr. Ross did not edit this video (the silly cartoonish elements, which in my opinion detract from its message, were added by the filmmaker Daniel Mackler). But you can see from the way Dr. Ross talks that he is an experienced, committed therapist.

Lastly, I want to note that Dr. Ross’ viewpoints appearing on my site does not mean that he endorses or agrees with everything else on this site. His viewpoints are his own. Here is his full essay:

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THE BORDERLINE STATES

By Lloyd Ross, Ph.D.

During my 40 years as a clinical psychologist, I have worked with approximately 100 to 150 people who would be considered to fall into the developmental framework of what psychiatry, in its simplistic and arbitrary way, views as borderline. These people were seen by me for at least one year or longer, some multiple times per week, and others once per week. Some were also seen at multiple times in their lives with months or years separating periods of therapy.

Before discussing this topic, I would like to make clear the issue of psychiatric diagnoses of “mental disorders.” I am a clinical psychologist who was psychoanalytically trained from an ego-developmental point of view. I have been in full time practice for almost 40 years and have always avoided psychiatric diagnoses, as I see the various recreations of the DSMs/ICDs as nothing more than an attempt to medicalize things that are not medical to begin with (human behavior, experience, and development). On that basis, the only “borderline states” that have any validity for me are on the border of Mexico or Canada.

In addition, there is absolutely no real science behind any of the DSM/ICD diagnoses. All of them were developed in committee rooms inhabited by mostly elderly white psychiatrists, many of whom represented the financial interests of the pharmaceutical industry. When I do write down a DSM or ICD diagnosis for a patient, and only at a patient’s request, it is usually because they need it to submit their claim to an insurance company (Unfortunately, that is the way things are in this society). The diagnosis I use is almost always “Post Traumatic Stress Disorder,” for several reasons:

  1. It is the closest thing to a real diagnosis in the entire list of diagnoses, in that anyone who is having enough emotional difficulties to seek help has had personal trauma of some sort as one of the factors that caused their difficulties.
  2. From a developmental point of view, the stage of development we are in or approaching when trauma occurs is a good predictor of how, when, and where it will manifest itself in a person’s life.
  3. The term itself, “Post traumatic stress disorder,” is sufficiently vague and innocuous to the public to make the term less of a problem for an individual than terms such as schizophrenia, psychopathic or sociopathic personality or borderline personality disorder, none of which have any real scientific meaning.

I approach human (not medical) diagnosis as a strictly developmental issue. This is because of the influence of Margaret Mahler on my training, with some influence from Donald Winnicott, Edith Jacobson, Anna Freud, Renee Spitz, Heinz Kohut, and Ruben and Gertrude Blanck. I come primarily from Mahler’s framework and was supervised by her. Therefore, any real diagnosis that I do comes from an ego-developmental point of view.

The Causes of Borderline States

When looking at a detailed history of people commonly diagnosed by others as “borderline personality,” I and others have found that these people have experienced emotional trauma at around the time in development when children make and solidify their attachment to the mother figure. To be a bit more specific, it is associated with trauma during that time frame and there is always deprivation around that time frame also. I am sorry for making it such a complicated thing, but when you don’t simply slap a diagnostic label on somebody, but are instead dealing with a real live very unique individual and their complex developmental problems, the issues are no longer simple. In addition, to perceive a human being as literally being a diagnostic category—a “Schizophrenic” or a “Borderline” –dehumanizes that person.

The cause of “Borderline Personality Disorder” as with all of the “made-up” psychiatric diseases, is trauma at various times and stages in a person’s development. That is why taking a carefully detailed history of that person’s development, events in his life, and memories in his life is so important. All extreme mental states, whether with someone diagnosed as schizophrenic, borderline, neurotic, etc. which are meaningless terms, are the result of things gone awry or not having been negotiated at various stages in development, resulting in trauma.

Even if a child seems to progress just fine, if and when trauma occurs, it lingers or appears dormant. When, even years later, that trauma is reactivated by another trauma, that person seems to exhibit or feel the original trauma again without ever connecting the two. That is why I use the diagnosis “Post Traumatic Stress Disorder” with insurance companies, for everyone, and not just those who come for help. There is no human being that I have met who has never experienced trauma, although the ramifications for some are more disturbing than for others.

A Personal Example of Trauma

I will give you a vivid example of trauma in myself. From the time I was five years old, until I was ten years old, I was ordered by my parents to come home from school immediately, without lingering with my friends, to babysit my grandmother because I left school at exactly 3:00 P.M. and the lady who took care of my elderly grandmother left at exactly 3:00 P.M. My grandmother was a very nice roly-poly lady who only spoke Polish and Yiddish, was blind except for being able to see shadows, and was able to walk from her chair to the bathroom to the bed by feeling along the wall. I, on the other hand, did not speak Polish or Yiddish.

My grandmother was alone for the five minutes it took me to get home and I would run all the way because I was told that if anything happened to her, it would be my fault, a rather heavy burden for a five year old. I would sit with her in a second floor apartment with very little communication and stop her from trying to cook. I would lead her to the bathroom and to the bed so that she didn’t fall, and sometimes would make her tea, watching that she didn’t spill it on herself. Either my aunt or my parents would come home between 5:00 P.M. and 6:00 P.M., but quite often, they went shopping first or had something else they had to do, and I would be stuck with my elderly grandmother for two to five hours. Also, since she couldn’t see, she kept all the lights off to save money so the apartment was usually dark.

When I turned ten years old, I was offered a part-time job and because work was so important to everyone in the family, when I got the job, my babysitting for my grandmother was over. What I remember most about the babysitting was that everything was always dark and boring. One day, I was very bored, and I could hear my friends playing ball in the street below. I opened the window and sat on the ledge, playing catch with a friend who was in the street. Someone called the police because they thought I was a jumper and they yelled and screamed at me.

After getting three advanced degrees, and spending a year in a horrific war, I came home and met my wife to be. I was always relaxed, mellow and calm, yet at the same time I could be cutting and sarcastic, all of which I admired in myself. After getting married, several days per week I would work late and come home when it was dark. When the lights were on in my house, there was never a problem, but if I came home to a dark house, I would feel enraged and walk in complaining, arguing, and finding fault with everything.

Since I was in my own training analysis at the time, I brought it up, thinking it had something to do with my time in Vietnam. I finally made the connection between the rage that I felt when forced to stay in a dark house watching my grandmother, and the rage I felt when I approached my house with the lights off. Having made that connection, I no longer became enraged when the lights were off, but I didn’t feel wonderful either. My wife and I discussed it and she kept the lights on for me, just like motel 6. Another point is that learning the connections don’t necessarily take away all the feelings but they do put you in much better control of those feelings.

That is a relatively minor cause of Post-Traumatic Stress Disorder. Who is a victim of it? Everyone, unless their childhood was just perfect, wonderful and magnificent, and so far, I haven’t met anyone who falls into that category, although I never met Donald Trump.

Understanding Borderline States Developmentally

I would like to discuss development at this point because most of the people seen by psychotherapists fall into this particular phase, including those with the arbitrary junk-science diagnosis of borderline personality. In normal development, when a child approaches the end of the first year or year-and-a-half of life, he/she begins to recognize that he is not one with his mother, but is really a separate person. This infantile recognition marks the beginning of the end of the “symbiotic” phase of human development and the very beginnings of the “practicing” sub-phase, sometimes better known as “the Terrible Twos.”

The practicing sub-phase is an early part of what we often refer to as the “separation-individuation” phase of development, which is so critical to our development that Margaret Mahler describes it as “the psychological birth of the human being.” In fact, she wrote a classic book just about that phase of human development. During the practicing sub-phase, the child’s mission in life is to prove that he is a separate, autonomous human being, while at the same time not losing his mother. He does this by exploring his world, by trying to do things independently from his mother, and by oppositional behavior, (saying “NO”.)

Sometimes, this phase of development can seem like a battle against parental figures, hence the name “terrible twos.” Problems that develop in the early parts of this phase of development which a child is unable to successfully negotiate often result in what they call “borderline issues” because they develop during the beginnings of the quest for reality on the part of the child, which occurs right on the border of these two stages. Let me go on with a description of the next part of the child’s emotional development.

The Identification Process, Splitting and Fusion in Childhood Development

While beginning the Separation-Individuation phase of development, the child begins to identify himself with others. This is also the beginnings of object-relationships. Since the primary object for all of us is mother (whoever mothers us, which could be the actual mother or a mother-substitute) a child will view his mother in very black and white terms as he begins the identification process. Mother in her nurturing role is seen as “good mother.” However, when mother says no to the child, restrains him in some way or frustrates him, mother is then seen as “bad mother.”

From a child’s point of view, “good mother” and “bad mother” are really two different people. This view occurs because of the absolute black and whiteness of the child’s thinking process at this age and is a normal age appropriate distortion of reality. The process is called “splitting.” When mother gives me what I want, she is “good mother” but when she doesn’t give me what I want, she is “bad mother.” These are totally two different people to the child.

Over the next year or two, depending upon intervening variables as well as the child’s developmental progress, the image of the “good mother” and “bad mother” slowly start to come together in a merging process. At a certain point, these objects “fuse” and we no longer see our mothers as a split object, one mother good and the other mother bad. When these objects fuse into one object, one mother, we begin to entertain a different, more sophisticated perception of mother. Now, mother is seen as basically “good mother” who sometimes is not so good. However, both the good and the bad are housed in the same person.

This is a much more benevolent view of mother and allows for imperfection. Since mother is the “primary object,” the first person that a child identifies with, his perception of mother is vital to his perception of himself. Once the good and bad objects are fused, the extreme view of the child is softened. He now also looks at himself and is able to perceive that: “I’m basically a good child, but sometimes I do bad things. Even so, I’m basically a good child.” This benevolent perception does two things. First, it brings us in closer contact with reality, and secondly, it softens out perfectionism both toward ourselves and toward others.

When Fusion Doesn’t Take Place, or What Causes BPD

The failure of all-good and all-bad perceptions to fuse is the genesis of all pathologically borderline states. Please be aware also that I am using the word pathology to simply indicate development gone awry or developmental stages that were not properly negotiated by the child for multiple reasons.

Sometimes, due to external issues that limit or skew a child’s development, or because of internal developmental issues, a child is unable to fuse the good and bad objects into one unified whole. In that case, the split object remains and the child continues to perceive dual mothers; one totally good and one totally bad. Under such conditions, when the child identifies with the primary object (the mother or mother substitute) and then looks in the mirror, he sees either a totally good person or a totally bad person with no redeemable good qualities, a rather harsh view of oneself. Under the above conditions, the child’s development makes him a potential candidate for suicidal thoughts, feelings, and actions as well as borderline personality issues.

In the so-called “borderline personality, the core issues precede the problematic object relations and there are also introjective insufficiency problems with good and bad objects. Most people dealing with this issue feel an “annihilation panic” based upon the relative absence of positive introjects that pretty much explain the “borderline” person’s feeling that he is existentially at risk.

In other words, in the so-called “borderline personality, it isn’t just the all-good, all-bad splitting that is a problem, but the paucity or insufficiency of positive introjects. Therefore, in people who are labeled borderline, the negative introjects predominate. Also, in come cases, they are able to solve the introject problem by, in a sense, becoming their own object or mother, thereby being able to comfort themselves without the need for anyone else. In the psychiatric establishment, these individuals are referred to as “psychopathic” or “sociopathic” personalities. They don’t need mothering because they can self-comfort.

Let’s go back for a moment to clarify what the mother-introject is. In normal development, the child internalizes a mental representation of the mother figure and the way in which she makes the child feel. Negative introjects always come from abuse that has taken place at around this time. (Sorry if I am blaming the mother figure but that is the way it goes.)

Gerald Adler, also a student of the ego-developmental model, extends this work further. He describes ideal treatment as an attempt to establish and maintain a dialectic therapeutic relationship in which the therapist can be used over time by the patient to develop insight into adequately holding onto positive introjects. In this manner, the arrested developmental process is set in motion to correct the original developmental failure. This is called the “Deficit Model” in that the focus is on what is missing in that person’s development. Therefore, the core of borderline issues precede the destructive internal object relations. The issues involve abuse, the absence of a positive introject, and an overwhelming constant feeling of being at risk, primarily due to the insufficiency of positive introjects.

Treatment for the Borderline, Suicidal or PTSD individual:

In this section, I would like to consider a number of treatments for these people and then the treatment of choice.

Electroconvulsive Shock; (ECT):

ECT, in short, involves placing two electrodes on the skull over the frontal area of the brain and then administering voltage that is comparable to being hit by lightening. This does several things. First, it causes a brain seizure which is not very pretty to observe. To avoid looking like a scene out of the movie “One Flew Over The Cuckoo’s Nest,” psychiatrists first administer sedative drugs to mute the external manifestations of the electric shock such as thrashing, broken bones, etc.

However, when they do this, to cosmetically improve the look of the treatment, they also have to increase the voltage, thereby creating greater cell damage and cell death in the brain, flatness of personality and affect, and slower thinking processes. This damage is similar to what occurs as a result of long-term heavy alcohol use, only more rapidly and in more focused areas, particularly the frontal lobes of the cortex or the cognitive and feeling areas of the brain. Keep in mind that ECT is similar to a motorcyclist head injury or explosion in that it is a “traumatic head injury,” only it is being caused by a physician. One of the side effects of killing off brain tissue in the frontal lobes is apathy, flatness of personality and affect, and slower thinking processes.

As a result of all this brain damage, suicidal thoughts (all other thoughts as well) are deferred and drastically slowed up. Therefore, ECT may temporarily defer suicide or soften the borderline issues, but it does not prevent it and when a person slowly and partially recovers from the shock, he may realize the lesser functioning he is left with permanently, an even greater motivation for suicide. ECT also significantly and drastically disrupts any psychotherapeutic process that is being carried on. Earnest Hemingway was “cured” of suicidal tendencies by ECT.

Bio-psychiatric Treatments:

The medication approach (anti-depressants and/or anti-psychotics) is useless in people with borderline, suicidal, and PTSD symptoms. In fact, anti-depressants are probably one of the major causes of iatrogenic (doctor induced) suicide in this country in the past 15 years, especially with individuals labeled borderline. Also, feeding a patient cocktails of neuroleptic (anti-psychotic) drugs acts simply as a temporary chemical restraint, often called a “chemical lobotomy.” In that sense, these drugs mimic ECT. I do not consider either real help for any individual and they make insight oriented therapy almost impossible.

Insight Oriented Psychotherapy:

According to Bertram Karon, Ph.D., one of the world’s most prolific researchers on effective psychotherapy with patients labeled schizophrenic, suicidal, and borderline, “The best suicide prevention is effective psychotherapy.” He goes on to say: “Of course the most effective way to prevent a suicide or a homicide is to understand the psychodynamics and deal appropriately in therapy with these issues.”

There are also a number of things that need to be confronted in any psychotherapeutic situation with a suicidal, borderline, or homicidal patient. Among them are his anger and rage, his and the therapist’s loss of control, and in a child, the significant parental issues, the patient’s developmental history, the ways in which the patient transfers his feelings (mostly bad and angry feelings) to the therapist, as well as other issues.

From the therapist’s perspective, he must be able to handle the transferential rage and aggression as well as his own feelings of lost control and counter-transferential issues. Finally, the therapist needs to deal with his own fears of the patient’s potential for suicide. Untrained,

fearful therapists, when they hear that a person has suicidal issues, get frightened and immediately refer to a psychiatrist, as though a psychiatrist has some magical powers to treat this problem. Unfortunately, when a therapist does this, the message to the suicidal person is “I am afraid of you and am not equipped to deal with your issues. The therapist is then immediately written off by the suicidal person.

Many therapists also do not want to work with people diagnosed as borderline for two reasons. The first is the rage that gets directed at the therapist. Borderline development results in a huge need to get rid of the aloneness they feel which results in rage that makes the therapist cease to exist. The counter-transference from an untrained therapist is a feeling of “I’m wasting my time here.” The second is that the amount of support needed is greater than with other kinds of development. You cannot resolve splitting until a strong positive relationship exists between the person and the therapist. In treatment, the unrealistic idealization of the therapist that the borderline person feels must be slowly worked through and discussed before it is relinquished and replaced by a more realistic view. The therapist’s goal is to slowly build up the earlier foundations of the ego structure through the relationship so that what is established is a not-so-harsh superego and thereby, less black and white pain in the face of imperfections and losses.

It should be understood that using this model, the therapist works toward a stronger continuum of emotional development so that a person can function in a more whole way. It is not a disease or medical issue and therefore, nobody is “cured.” People just learn to handle various issues in their lives in a smoother, more comfortable manner for them.

A Brief Word on Narcissism

Narcissism is often a component of borderline development. Narcissists are particularly hard to treat. They find it difficult to form the warm bond with a therapist that naturally evolves with most other patients. Instead, they often become cold or even enraged when a therapist fails to play along with their inflated sense of themselves. A narcissistic patient is likely at some point to attack or devalue the therapist, and it is hard to have to sit with such people in your office unless you are ready to accept that.

But narcissism is not limited to the most extreme cases who make their way to the therapists’ office. A healthy adjustment and successful life is based to some degree on narcissism. Healthy narcissists feel good about themselves without needing constant reassurance about their worth. They may be a bit exhibitionistic, but do not need to play down the accomplishments of others to put themselves in a good light. And although they may like adulation, they do not crave it.

Normal narcissism is vital for satisfaction and survival. It is the capacity to identify what you need and want. Pathological narcissists, on the other hand, need continual reassurance about their value. Without it they feel worthless. Though they have a grandiose sense of themselves, they crave adulation because they are so unsure of themselves that they do not know they have done well or are worthwhile without hearing it from someone else, over and over. The deeply narcissistic person feels incomplete, and uses other people to feel whole. Normally, people feel complete on their own.

”Narcissistic vulnerabilities,” as psychoanalysts refer to them, make people particularly sensitive to how other people regard them. You see it in marriage, in friendships, at work. If

your boss fails to smile when you greet him it may create a withdrawn, anxious feeling. If so, your self-esteem has been hurt. A sturdy self absorbs that so it’s not unbalanced. But if you’re vulnerable, then these seemingly small slights are like a large trauma. On the surface, extreme narcissists are often brash and self-assured, surrounded by an aura of success. Indeed, they are often successful in their careers and relationships. But beneath that success, feelings of inadequacy create the constant need to keep inflating their sense of themselves.

If they do not get the praise they need, narcissistic people can lapse into depression and rage. Thus, many workaholics put in their long hours out of the narcissist’s need to be applauded. And, of course, the same need makes many narcissists gravitate to careers such as acting, modeling, or politics, where the applause is explicit. Many difficulties in intimate relations are due to narcissism. Marriage brings to the fore all one’s childhood yearnings for unconditional acceptance. A successful marriage includes the freedom to regress, to enjoy a childlike dependency. But in marriage, a couple also tend to re-enact early relationships with parents who failed to give them enough love. This is particularly hard on those with the emotional vulnerabilities of the narcissist. All narcissists fall within the borderline spectrum of development, but not everyone in the borderline range of development is narcissistic.

In summary, a therapist who is not trained well will usually not want to work with a borderline person for all the reasons mentioned above. To avoid their own discomfort, they describe them as untreatable. Well trained therapists do not have that opinion. It is not a “mental illness,” (disease.) Rather, it is a breakdown of a developmental phase that we all go through and involves issues such as splitting, negative introjects, probably early abuse, suicidal issues, and narcissistic issues.

Well trained therapists have done well with these individuals, provided the therapist knows both what to expect and what he is doing. Because it is not a disease, no one is cured. However, with proper insight oriented therapy, people labeled as borderline do go out in the world and function quite well in relationships, employment, etc. Like the rest of us, the goal is not to be cured from some non-existent disease, but to simply resolve the issues in our development that stop us from functioning in a relatively comfortable manner.

Finally, the term “borderline,” when used as a medical or psychiatric diagnosis, is both useless and harmful in that it is suggestive of some evasive disease. To use the term from a developmental point of view is very different and can be helpful in understanding what in a person’s development, was not negotiated properly or fully successfully. Using the term “borderline developmental issues” enables us to go back in time and try to help the individual to undo, modify, and soften development that did not go smoothly the first time around. This is something that is being done all the time by private-practice therapists, but not by what I call “the mental health industry.” However, that is a topic for some other time.

Below, I have listed a few books that should be helpful in understanding the treatment issues with individuals who are dealing with borderline issues. I have also included several books that support my opposition to the medical model approach.

Bibliography

Adler, G. (1977). Borderline Psychopathology and Its Treatment. Northvale, N.J.:Jason Aronson.

Breggin, P.R. (1994). Toxic Psychiatry. New York: St. Martin’s Press.

Jackson, G. E. (2005). Rethinking Psychiatric Drugs. Bloomington, Indiana: Author House.

Jackson, G.E. (2009). Drug Induced Dementia: A Perfect Crime. Bloomington, Indiana: Author House.

Blanck, G., & Blanck, R. (1972). Ego Psychology: Theory & Practice. New York: Columbia U. Press.

Colbert, T.C. (1996). Broken Brains Or Wounded Hearts. Santa Ana, California: Kevco Publishing.

Ferenczi, S. (1950). “Introjection and Transference.” In Sex In Psychoanalysis: Selected Papers. 35-93. New York: Brunner/Mazel.

Freud, A. (1936). The Ego and The Mechanisms of Defense. London: Hogarth Press.

Freud, A. (1965). The Writings of Anna Freud, Vol. VI: Normality and Pathology in Childhood Assessments of Development. New York: International Universities Press.

(Hartmann, H., Kris, E., & Loewenstein, R. (1949). “Notes on the theory of aggression.” The Psychoanalytic Study of the Child, ¾, 9-36.

Jacobson, E. (1954). “The self and the object world: Vicissitudes of their infantile cathexes and their influence on ideational and affective development.” The Paychoanalytic Study of the Child, 9, 75-127.

Jacobson, E. (1964). The Self and the Object World. New York: International Universities Press.

Karon, B.P., & VanderBos, G. R. (1994). Psychotherapy of Schizophrenia: The Treatment of Choice. Northvale, New Jersey: Jason Aronson, Inc.

Kohut, H. (1972). “Thoughts on narcissism and narcissistic rage.” The Psychoanalytic Study of the Child, 27, 360-401.

Mahler, M. (1960) “Symposium on psychotic object-relationships: III. Perceptual differentiation and ‘psychotic object-relationship’.” International Journal of psychoanalysis, 41: 548-553.

(51) Mahler, , M. & LaPerriere, K. (1965). “Mother-child interactions during separation-individuation.” Psychoanalytic Quarterly, 34: 483-498.

(52) Mahler, M. Pine, F., & Bergman, A. (1975). The Psychological Birth of the Human Infant. New York: Basic Books.

(55) Masterson, J. (1973). “The mother’s contribution to the psychic structure of the borderline personality.” Paper read at The Margaret Mahler symposium on Child Development, Philadelphia, May, 1973. Unpublished.

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#21 – My Nightmare of Psychiatric Hospitalization

“Mood disorders are biologically-based mental illnesses”, the psychiatrist announced authoritatively, surveying the 15 young-adult patients in front of him. “But while these illnesses might be biological, it doesn’t mean you can’t manage them effectively.”

My mind reacted explosively: How the fuck could you possibly know this, you pathetic excuse for a mental health “professional”? What actual evidence do you have?!

I desperately wanted to shout at him. But I remained silent, slouching backward in my chair in the mental hospital’s group therapy room.

After concocting a suicide plan that almost succeeded, I had been involuntarily committed to this hospital for my own protection. But I was now becoming a captive of a different kind: a prisoner of psychiatry’s hopeless ideology.

This is the story of my time in a mental hospital – what it taught me about myself, about my fellow human beings with “mental illnesses”, and about the web of lies that is American psychiatry.

Descent Into Hell

In my early 20s, having suspended my college career, I returned home to live with my family.  Living three hours away at college had become increasingly difficult – I felt isolated, depressed, scared, and hopeless. I couldn’t live on my own – my father’s physical abuse, and the lack of love in our family, had left me not knowing how to make friends, date girls, or feel secure living alone. But once I got home, the feelings of hopelessness continued unabated.

It’s hard to describe how bad things were to someone who hasn’t experienced these feelings.  I remember wishing that I could escape my mind and teleport into the body of another person whose mind was not as “diseased”. I read Dante’s The Inferno, and felt that I was literally living out the punishments of those condemned to the seven circles of hell.

Something felt profoundly unstable and “wrong” at the core of my being. It frequently felt as if my existence was under threat, that my core self might at any moment disintegrate. I remember reading an astronomy book describing how comets orbited the event horizons of black holes, constantly at risk of being sucked in and destroyed forever. That was how I felt.

To put these feelings into a more understandable context, they were based on the belief that I had no chance of a successful adult future. I saw other young people having relationships with the opposite sex, but I had no idea how to talk to a girl at the time. I couldn’t think clearly about getting a degree or starting a career, because getting through the next day felt overwhelming, let alone concentrating on schoolwork. I couldn’t enjoy anything – movies, reading, friends, etc. The all-consuming anxiety made every day a struggle.

Suicidal Intent

This horrific state of emotional affairs set the stage for me to become seriously suicidal. After returning home, I decided that I had tried everything and didn’t deserve to suffer like this. I formulated a plan to end my life, which won’t be elaborated except to say that it involved a lethal method and might have succeeded. I prepared loving letters for my family and friends, and planned the date I would end everything.

After I made my suicide plan, I remember walking outside during a sunset. We lived near the ocean at the time. In my fragmented state of mind, I looked at the beautiful sea, the sunlight glinting off the waves, and felt an overwhelming sadness. Part of me was urging myself to find a way to survive, but I couldn’t see any hope. Despite the despair, I still appreciated the natural beauty of the ocean.

My Plan Fails

My plan failed because I am a bad liar. My friends noticed that I had withdrawn socially, was barely communicating, and had stopped taking physical care of myself. All my energy was focused on ensuring the suicide attempt’s success by planning it down to the smallest detail. But knowing my history of abuse, my closest friend sensed something was wrong. When he asked me what was going on, I denied any suicidal intent. But the next day, he found an opportunity to look through my bedroom while I was out of the house. Showing a remarkable sixth sense, he rapidly located my suicide notes stashed in the side pocket of an old backpack. I will always owe him for this.

When I returned home, my friend had told my parents everything and the emergency psychiatric response team was rushing to our house. I was completely taken by surprise. Two policemen and two psychiatric specialists soon entered our house and questioned me. I tried to deny that I was actually planning to kill myself, but it was no use.

After a brief discussion, I was led out of the house – in handcuffs – and put in the back of a police car. I was to be taken to the local emergency room, since space was not yet available at the mental hospital. The police explained that I was not being arrested; handcuffing someone was their protocol when someone is involuntarily committed to a mental facility. This made little sense, but I was in no position to question them.

The Emergency Room

The next day or so is a blur. I had to stay overnight at the hospital emergency room, where I could not sleep because of nurses talking loudly. A guard constantly watched my room; at one point he explained that I was being put on a “5150 hold”, which meant I was to be detained for at least 72 hours for evaluation. My mind churned the whole night, going through endless scenarios: Where was I going? What were my parents thinking right now? How dare my friend get them to call the police without asking me? Am I crazy? Should I lie to the doctors, get out of the hospital, and follow through on my suicide plan? Had I been wrong to give up hope? Might hospitalization not give me some time to find a better escape, one that allowed me to survive and live? Shouldn’t I give myself another chance? How could life be so hard?

The Mental Hospital

In the morning the guard told me to get ready because we were going to the psychiatric hospital. I expected to travel normally in a car, but instead I was strapped to a hospital stretcher and rolled into the back of a locked ambulance. I had the humiliating sense of being a prisoner, with everyone knowing why I was held hostage – because I was crazy and wanted to kill myself. The trip took almost an hour; at this point I hadn’t slept for about 36 hours. We finally arrived at the hospital, where I was wheeled inside a self-locking gate that led into “the ward”.

A Moment of Humor

Despite my horrible mental state, part of me was fascinated to see inside a real-life “asylum” for the first time. I was thinking about the movie One Flew Over the Cuckoo’s Nest, which I had recently seen. The ambulance drivers were pushing my stretcher along a hallway, taking me for evaluation in the Intensive Care Unit (ICU) – the place for the hospital’s craziest patients, as well as those arriving for initial assessment.

As we turned a corner, we came upon a long-haired, wild-looking young man. He looked like a young Jon Bon Jovi and wore an ill-fitting blue hospital gown. Four or five nurses faced him with looks of frustration on their faces.

“You’re nothing but a bunch of vaginas and penises to me!” shouted the young man in a loud, high-pitched voice. “Vaginas and penises! That’s all you are! You can go fuck each other for all I care! Go fuck each other, you hear me? What do you think about that, you motherfuckers?”

I could not help smiling at this. I was thinking, What kind of place is this? Are these people all crazy?

The nurses tried to convince him to go to his room, but the patient continued his verbal assault, eventually challenging a male nurse to fight him in single combat. At this point, two of the male nurses forcibly wrestled him to the ground. They pulled up his gown, and a female nurse plunged a syringe into his bare bottom. It must have been a fast-acting tranquilizer. With this done, the male nurses dragged his limp body to a nearby room.

I made a mental note not to call the nurses “vaginas and penises.”

The Strange Ward

Upon arrival, I was assessed by a series of nurses, who asked questions like the following:

“Are you planning to hurt yourself right now?” (No…)
“What’s your height and weight?” (6’2, 175)
“Are you carrying any weapon or sharp object?” (No… Of course, they had to body-check me)
“Will you tell us if you start feeling like you want to hurt yourself?” (Yes…)
“Are you feeling pain anywhere in your body?” (No…)

It was all so awkward. No one asked why I was there, or what had been going on to make me suicidal. They said the psychiatrist would talk to me. I had to fill out a superficial anxiety and depression questionnaire, and was then shown to my room.

The ward was a spartan place of accommodation. The rooms didn’t differ much from prison cells seen on shows like MSNBC’s Lockup. Each room had a small, uncomfortable bed bolted to the floor along with a basic toilet. They also had some old wooden cabinets, which made them luxurious compared to jail! Almost nothing else was in the room. Every 15 minutes, all day and all night long, a nurse would come to check that I hadn’t discovered some ingenious way to hurt myself. This made it hard to sleep at night.

Soon I wondered into the ward’s common area, a large square space with old sofas and a TV. Ten or twelve mostly young adults were sitting there, watched by three or four nurses. Some were staring into space, others watched the TV, one woman was talking to herself. Everyone seemed to be quietly doing their own thing. I had no interest in talking to anyone at first. I thought they were all crazy and hoped I didn’t become like them.

A nearby board listed group therapy sessions that occurred each day. I cannot remember what type of therapy they all were, but there was at least one Dialectical Behavior Therapy and one Cognitive Behavioral Therapy session.

Group Therapy

I went to a couple of these group therapies the first day. The CBT session featured a young psychology intern lecturing. He drew pictures explaining how thoughts, feelings, body, and the outside world were interrelated. I found it so superficial as to be no help in understanding anything (I was in a very negative mindset at the time). I wondered why they were not asking people to tell their own stories, or at least for their responses to the information provided.

I would soon find that exactly the same lecture was repeated every two days, with no variation based on the patients. Anyone new got to hear it for the first time, while everyone else got a repeat.

In the DBT session, the speaker explained the concept of wise mind, the place where emotions and thoughts overlap. He described how to distract oneself from negative feelings and be “in the moment.” He also stressed repeatedly “thoughts are not facts!”. The tone of this session annoyed me, because it felt like we were being talked down to like simple-minded children, or like computers needing to have our software reprogrammed.

The Psychiatrist

Being horribly depressed and ashamed, I was not in a mindset to appreciate these sessions anyway. I spent most of the time in my room brooding about the thwarted suicide plans, thinking bitterly about how unfair life was. On the second day, the psychiatrist assigned to my case called for me. I went into a small office to find myself facing an old man who looked like a mob boss out of the Godfather. He appeared Italian, with dark, tanned skin, and a smooth sense of accomplishment about the way he spoke.

“What’s so bad that you want to kill yourself?” he asked me.

I remained silent for a while, then told him about how depressed I was, how I couldn’t stop obsessing over negative thoughts, and how my father had physically abused me.

The psychiatrist thought about this, then asked for my family history of “mental illness.” I described how my dad had severe OCD and depression.

“It sounds like you have OCD too, plus depression” the psychiatrist said. “We have medications that will really help your obsessing, and they’ll help the depression too.” He prescribed three medications – including two antidepressants and an antipsychotic mood-stabilizer, if I remember right – all of which I was to start taking right away. At that time I didn’t know much about medications, otherwise I would have refused his prescription, or at least refused to take that many.

The psychiatrist also prescribed writing exercises. I was to “obsess” in a journal for thirty minutes a day – writing down every negative thought that came to mind. And the rest of the time I was meant to tell the negative thoughts to “go away, I’ll deal with you later!”

Toward the end of the session, I told the psychiatrist about my BPD diagnosis also. He responded that this was a tough condition that could be “comorbid” with OCD and depression. He said something like, “We don’t have a cure for borderline personality, but the symptoms can be managed”. I hated this idea right away. If I couldn’t really get better, what point was there in trying?

“These type of things can get better. We want you alive, that’s why you’re here and that’s why we’re treating you,” the psychiatrist said. I didn’t like this one bit – the messages seemed to be all confused – but it was more positive than some of the other things he said.

My View of the Psychiatrist

The psychiatrist’s worldview was alien to me. I intuitively felt that the medications would not help, while the writing exercises seemed ridiculous. The psychiatrist didn’t appear to see me as an individual. Instead he saw “borderline” and “depression” and “OCD” sitting in the chair, and he was trying to manage these “illnesses.”

When the psychiatrist said that BPD could not be cured, I felt furious. If I had a gun, I would have liked to shoot him right there and then. I imagined how satisfying it would be to put a bullet through his forehead, see his chair topple over onto the ground, the blood spilling everywhere, and for there to be one less idiot psychiatrist able to medicate patients into oblivion. It made me think of the opening scene in the movie Casino Royale, where James Bond confronts the traitorous section chief, whom he dispatches with a handgun (shown in the last 30 second of this clip):

Of course, I did not execute the psychiatrist. Nor would it have happened if I had had access to a weapon. Even in my crazy state, some part of me knew that this man probably had a family and didn’t mean badly – he just didn’t know how to understand people other than as illnesses. But my fantasies of hatred for his views were vivid, and I wanted to destroy what he stood for.

The Dead Zone

Over the next few days, I went to several more group therapy sessions, which continued to feel superficial and boring. I wanted someone to listen to my experience, not hear lectures about the mind and how to rigidly cope. But I started to become less suicidal and began talking with some of the other patients.

I continued meeting with the psychiatrist daily. He would only see me for a few minutes, asking how the medication was working and if I was having any more suicidal thoughts. I thought it was ridiculous that he was not talking to me for a longer time, getting to know me and understanding what might have caused me to become so hopeless. I would always say that I didn’t know how the medication was working, because I couldn’t possibly tell what was the effect of the medication and what was due to other factors. This frustrated him.

Before I spoke to other patients, the atmosphere on the ward often seemed stagnant, tragic, empty. It felt like being in a morgue with dead people walking around. The nurses “managed” the patients – watching them take their medications, controlling the difficult patients, coordinating mealtimes. Their were some kind nurses, but the majority seemed not to care about getting to know the patients. The most positive thing about the ward was its breakfasts – I remember we got French toast, bacon, eggs, and cereal most days!

The Other “Crazy People”

After about four days, I asked the psychiatrist when I could leave the hospital. He wanted my family to meet with the social worker and establish a plan for my starting therapy, plus establish ground rules to prevent me from hurting myself. This involved restricting my access to money for a period.

I was to stay for a few more days and, if it seemed like I was functioning ok, attending some groups, and not feeling suicidal, then I would be released. Until my release, since there was not much to do most of the time and I was feeling better, I began talking to other patients. That was one of the most interesting things about my stay. Let me describe a few of my fellow “crazy people”:

“Paul” was a big Latin-American man in his late 50’s with a jovial, outgoing personality. He spoke a little strangely, but was very friendly. He would always call me “Sir Edward” for no apparent reason. I told him about my English heritage; he was fascinated by my grandfather, a Jewish scientist who escaped from Nazi Germany. He told me how his family emigrated from South America to the US and established their own hotel business. Like me, Paul was a big racquet sports fan. We would talk about Agassi, Sampras, Federer, etc. debating who was the best. We had several table-tennis battles in the court-yard of the hospital ward. I would always beat him but it was close. I eventually asked Paul why he was there – to me, he wasn’t crazy at all. He said he had bipolar episodes, but they were now controlled with medication. I never saw any evidence of him being manic or depressed.

“Nicky” was a young woman in her early 20s. She was an attractive brunette, the kind of young woman to whom I was attracted but scared to approach. Eventually I struck up a conversation and found out that she had been hearing critical voices after using drugs, which led her to be hospitalized. She had a difficult relationship with her parents that led to the drug use and breakdown. But she kindly supported me when I told her how difficult things had been with my family. She also had coloring books which she would bring into the common area and get me to work on with her.

“Susie” was a middle-aged bipolar woman who had been experiencing hallucinations of sharp-fanged animals invading her apartment. She had had a difficult childhood with physically abusive parents. Nevertheless, she was an intelligent, interesting lady who had a successful career in a professional field. We would play board games together and she would beat me at Scrabble. I shared with her what had brought me to the ward, and she was warmly supportive. She reminded me of how important I was to my family; how hurt they would be to lose me.

“Ray” was a young man diagnosed with schizophrenia who had hallucinations and had been hospitalized several times. But he was a sweet person. It was clear that he wanted to be liked and to connect with other people, despite his “illness”. He didn’t even seem crazy to me. It turned out he had been able to work part-time on-and-off for several years, but the psychotic episodes, which I saw no overt evidence of, kept interfering with his functioning. He was on at least four or five different medications, which seemed like a lot. His mother would visit the ward every day and she clearly cared about him a bunch, sitting with him and holding him as if he were a young child. I was touched by her devotion, and introduced myself to the mother, telling her how nice I thought Ray was. I hope he got better going forward.

“Anouk” was a Middle-Eastern woman whose husband had physically assaulted her, leading her to flee from him, become severely depressed and suicidal, and eventually require hospitalization. She had a warm, motherly personality that was attractive to me at the time, lonely as I was. She told me about her five daughters and her dreams for their careers, and about how evil her husband was! She took a particular liking to me, and would give me high-fives and hugs when she saw me in the corridors. This went on even though patients weren’t meant to touch each other; somehow it seems that psychiatry has forgotten that friendly touch can be a healing thing.

“Jeanette” was another pretty girl in her early 20s. She had been admitted after running away from home and hitchhiking cross-country to “find herself”. She believed that plants had personalities and that you could be friends with them. She would keep a special hard-boiled egg in her room that had significance to her. Apart from these things, she spoke just like a normal person. I found her energetic personality quite likeable. But she was a social rebel and frequently argued with the nurses about rules. When they wouldn’t let her family bring in an I-pod, she became furious and acted out by stripping down naked and running through the common area with no clothes on! She was an absolutely gorgeous blonde. Hopefully she got better, and some lucky guy got to experience her beauty in a more private setting!

Reflections on The Patients Versus the Staff

Ironically, I got much more help from talking to patients than from the staff. The nurses mostly didn’t care about the patients as people, simply wanting to keep them under control. All the patients could sense this. The psychiatrist was worthless since we spoke only a few minutes a day about medication and practical matters.

But several patients treated me with genuine kindness. I kept in contact with a few of them afterwards via email and phone (even though the hospital warned against contacting other patients post-discharge… another stupid policy). To me, these patients didn’t have “mental illnesses”; they were just people dealing with serious challenges in living. I felt as if anyone could have reacted the way they did facing the same life challenges; but that wouldn’t make them “schizophrenic” or “borderline” or whatever. This experience influenced my thinking about BPD and other so-called “mental illnesses” being invalid diagnoses.

Several patients told me they hated taking medications, that they didn’t feel these medications helped, and that they got little out of the group therapy. One depressed man refused to take any medication; he just wanted to be there to be safe. The one good thing about the hospital – and I must acknowledge this for my own case – was that it kept me safe during a time when I might otherwise have hurt myself. For that protection I am grateful. I improved somewhat by the time of discharge, and was less of a risk to myself afterwards.

Psychiatry Doing More Harm Than Good

I believe that in many cases, mental hospitals dominated by psychiatry’s medical model do more harm than good. Ironically and perversely, psychiatry thereby becomes an obstacle to the recovery of the very people it is supposed to help. It promotes the message that people have biologically-based “illnesses” that they are stuck with for life. As I discuss in many other articles, this is a complete lie. And yet, it is presented as if it is the best that people can hope for.

Why limit people’s dreams with this type of reductionistic thinking for which there is scant evidence? Why not tell them that they are heroically dealing with understandable reactions to extremely challenging life situations, and that with understanding and love, they are likely to get better?

The answer, in large part, is that psychiatry’s reductionistic view of emotional problems as “mental illnesses” has infected the minds of most psychiatrists, who in turn infect their patients. And thus is promoted the pessimistic view of mental illness as a lifelong “disease”, rather than as a primarily psycho-social experience that can be overcome with sufficient support.

Psychiatry is also eager to prescribe as many medications as possible, which unfortunately do nothing to address the root causes of people’s problems. A prime motive is to perpetuate the billions of dollars in profit that companies like Eli Lilly, Janssen, Pfizer, etc. make, and to support the psychiatrists and shareholders allied with these companies. Helping the patient comes second, and if these patients could have done better with other forms of treatment and/or without medication, then too bad.

In my opinion, the network of drug companies and psychiatrists who weave lies about medication represent a fraudulent house of cards. Patients can protect themselves by learning just how ineffective medications really are over the long term. If more of us educate ourselves, then psychiatry will be progressively undermined. Newer studies are showing that most psychiatric drugs are barely or no more effective than placebos, and that the long-term side effects can be very dangerous. This is discussed in detail in the many articles on http://www.madinamerica.com

Lastly, the whole approach of the hospital was to “manage illness”, not promote healing and recovery. Even though there were signs on the walls extolling positive values like Hope and Responsibility, the interactions with the nurses, psychiatrists, and group therapists did not promote a sense of “we’re in this together” or “you can recover and do what you want.” Rather, the emotional message was, “You are the sick people, and we are the “normal” ones who will teach you how to manage your unfortunate afflictions.” Ironically, many of the patients were more helpful to me than the mental health professionals.

Conclusion: A Sad Reality

Such is the reality of inpatient mental health treatment for many in 21st century America. I urge people to avoid inpatient facilities wherever possible, unless they are in real danger of hurting themselves or others, in which case hospitals can provide a critical protective function. As much as possible, seek help from outpatient therapists, family, and friends who are outside of the traditional psychiatric system. I believe the chances of recovery from BPD and other conditions is greater following this path. Getting stuck in a cycle of going in and out of hospitals, being overmedicated, and being treated as if one is an illness, doesn’t promote recovery.

I would also direct readers to these websites that are great resources promoting recovery outside of the traditional psychiatric system:

http://www.madinamerica.com – Many fascinating articles about the worthlessness of psychiatric diagnosis, the ineffectiveness of medication, and the value of therapy, understanding, and love.

http://www.mindfreedom.org – Another anti-diagnostic site that rejects labels and is similar to Mad In America.

http://www.isps.org – The International Society for Psychological approaches to Schizophrenia and other psychoses. Many of the clinicians listed on this site are also well-trained in treating Borderline Personality Disorder. Much of their writing about psychosis could be applied to BPD. They are an extremely empathic, innovative, and optimistic group.

Feel free to share any experiences you have with “the psychiatric establishment” in the comments!

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I welcome any correspondance at bpdtransformation@gmail.com

If you are struggling with BPD yourself or are trying to help a borderline individual, I would be happy to listen to your story and provide feedback if possible. Feel free to provide constructive criticism of this site also.

This article is the opinion of a non-professional layperson, and should not be taken as medical advice or as the view of a therapist who is professionally qualified to treat Borderline Personality Disorder or any other mental health condition. Readers should consult with a qualified mental health professional before undertaking any treatment.

– Edward Dantes

#2 – How Did I Recover from Borderline Personality Disorder?

People reading this page are probably searching for hope and encouragement, either because they have problems related to Borderline Personality Disorder or they care about someone who does. Or, perhaps they are simply curious and wonder whether BPD can be recovered from.

On this page, I will describe what allowed me to move from being an emotionally immature young person, suffering from many painful borderline symptoms, to being the relatively mature, functional, and symptom-free adult that I am today.

When I Was “Severely Borderline” – Teenage and Young Adult Years

From approximately ages 13-23, I was severely emotionally ill. I had the following symptoms, most of which are in the DSM-IV definition of BPD:

– Severe anxiety and depression most of the time, with little ability to comfort myself.
– Constant feelings of emptiness and low self-esteem.
– Acting out in various ways, especially overeating.
– Viewing other people and myself as all good or all bad, accompanied by childlike clinging toward the “good” people and extreme rage against the “bad” people.

– Very poor personal relationships in terms of their emotional depth – I had no real friends and tended to use people for my needs and then quickly lose interest in them.
– No clear identity or long-term goals – I usually only planned a few days or weeks ahead.
– A tendency to be paranoid and fear that other people were “out to get me”.
– Intense fear of losing important family members (fear of abandonment).
– Suicidal thinking when I became very depressed.

These symptoms persisted relatively constantly for 10 years starting in middle school. It is difficult to describe in words how painful or frustrating they were. Externally, I tried to appear normal and to function in school and work, but internally it was a constant emotional nightmare. I felt myself to be cursed, a walking example of Murphy’s Law, existing in a personal hell on earth. When first working on recovery, I had no idea where to go. Emotionally, I felt like a cork caught in the waves of a stormy sea.

My Progress Toward Being a Mature Adult Today

However, here is how I would describe myself today, at age 28:

– Able to regulate my feelings– I can comfort myself and rarely become anxious or depressed.
– Able to think in an ambivalent way, and to see others and myself as good and bad at once.
– Have confidence in myself, possessing a clear sense of what I want to do in work and relationships. I think long-term, able to plan months and years ahead.
– Able to feel genuine concern and interest in others, rather than only using them to satisfy my needs.

– Have had a good romantic relationship and several meaningful long-term friendships.
– No paranoid thinking, suicidal ideation, or fear of abandonment.
– Able to function independently in a job I enjoy; no need to cling to other people to function well.
– Have a strong core identity which persists through difficult times.
– Much reduced acting out – I still do occasionally overeat when under unusual stress at work, but it’s much less of a problem than before.

I am pretty happy with how my life is going today, and proud of myself for the work I did. How did I make these changes to develop a good life, and to lose almost all of my borderline symptoms?

What Helped Me Become Healthy and Non-Borderline

1) Long-term psychotherapy

Starting in my late teens, I was fortunate to be able to attend psychodynamic, psychoanalytically-informed psychotherapy. At first, I went once a week, and then for several years I went an average of twice a week, sometimes going three times a week during difficult periods. It was extremely expensive, and I was fortunate to have parental financial support to go to therapy (I later financed myself, sacrificing in other areas of my life so that I could go to therapy). Essentially, I used psychotherapy as a reparenting process in which I worked to be able to deeply trust someone else for the first time. My various therapists – I had four significant ones – provided me with crucial emotional support that allowed me to become independent in my job and to develop better interpersonal relationships. They were the substitute mothers for my emerging true self.

In other articles, I will discuss more extensively how and why therapy helped me, my views on therapy vs. medication, as well as options one has if one does not have the money to go to therapy initially (therapy is certainly not the only path to getting better, although it can be very valuable).

2) True friends

Starting in my late teens, I was fortunate to develop a close friendship with a man, Gareth, who knew about my history of physical abuse (my father beat me throughout my childhood). He was an older, middle-aged family man who I met via the shared interest we had in tennis. I took the risk of opening up to Gareth about my problems, and we developed a friendship that has endured to this day. We spent hundreds of hours talking through my past and present problems. There were many times I cried with him, as well as some periods when I became angry or paranoid and misunderstood his kind intentions. However, most of the time his support was extremely helpful, coming during a period of my life when I desperately needed love and understanding. I will be eternally grateful to Gareth for his decision to help me.

From about age 15 until the present day, I developed three other close friendships, with two men and one woman, all of whom helped me tremendously and gave me hope that life could get better. My relationships with Julian, Andrew, and Helena were similar in quality to the first one described above, in that I took the risk of opening up to these people, telling them my life story, and asking for help. However, they were not as deep or intense as the first one.

Today, I also have a number of other important friendships, but they are more “normal friends” that I enjoy for themselves and can share my present-day sense of self with. These friends do not know my history of being borderline in nearly as much depth as the four people I opened up to in my teens.

I will write more in another article about how genuinely opening up to another person for help is one of the most important risks a borderline person can take.

3) Family – My mother

Despite her faults, my mother supported me financially to go to psychotherapy, and she did genuinely care about me although it was difficult for me to feel that fact early on. She had a very difficult relationship with my father, and her decision when I was 18 to divorce him and live alone provided me with a stable, safe place to live for several years. As I became a young adult, I came to trust my mother more and risked talking to her openly about some of my problems. This occurred in parallel with my trusting and opening up to the friends noted above. To my mother’s credit, she matured along with me, becoming a supportive listener and a cheerleader for my developing independence. I owe much of what I am today to her heartfelt efforts to help me.

4) My passion – tennis

The one thing I always liked as a young child was the sport of tennis. I took group classes at the local club and viewed the coaches as substitute father-figures. The process of hitting the ball and running around with other children became addictive, and I developed an obsession with the pro game and players like Roger Federer. Perhaps surprisingly, this interest endured during my teens and early twenties even when I was struggling with all the horrible emotional symptoms associated with Borderline Personality Disorder.

Tennis had great value as something that distracted me from my emotional suffering during the most difficult periods, and had meaning for me in its own right. It also led me to work with children as an assistant coach in college, which eventually led to my present day job, in which I work with kids.

5) My own study of Borderline Personality Disorder

When I first learned about BPD, and later was diagnosed with it, I was terrified because of all the pessimistic descriptions about how difficult it was to help people with the diagnosis and how many therapists did not want to treat them. Online web forums were filled with horror stories about manipulative, evil, hopeless borderlines.

Over time, I researched BPD extensively and came to a more nuanced understanding of it. I understood it from a developmental perspective, meaning how traumatic childhood experience shapes later adult problems, as well as from an object-relations perspective, referring to how the traumatized individual uses psychological defenses and modes of relating that distort the external environment based on pathological internal views of themselves and others. More on that in later posts.

I studied the writing of many therapists who had successfully treated individuals with BPD, including Harold Searles, Vamik Volkan, Otto Kernberg, Heinz Kohut, Gerald Adler, James Masterson, Peter Giovacchini, Jeffrey Seinfeld, and others. I met Gerald Adler and James Masterson in person and interviewed them about their views on the treatability of BPD. From this research I developed an overall picture of what was necessary in the “big picture” for borderline individuals to become non-borderline. In essence, the traumatized person needed to learn to trust and accept support from another person, and to be helped via a therapeutic alliance to develop healthy adult ego functions that they never developed as a child. By around age 20-21, I understood BPD in more depth than many therapists do. Understanding it taught me what was necessary for a successful recovery process.

I will write much more about these issues in later articles, but for now, the point is that having a map of where to go when struggling with BPD helped immeasurably.

6) Eventually abandoning the concept of BPD

Paradoxically, I now no longer believe that Borderline Personality Disorder is a valid diagnosis. This is despite the fact that I was diagnosed with it, and have recovered from having almost all of its symptoms.

As I improved, I continued to be periodically worried or depressed by the idea that I was still a borderline. I would often fear that maybe the writers who said borderlines were untreatable and hopeless were right, that I would always be a borderline, and that if I did improve I would inevitably relapse.

Today, I view BPD as an archaic, outdated term, one fabricated by psychiatrists to (mis)label a wide range of severely abused and neglected people. To me, a more realistic view is that “borderline” symptoms exist on a continuum of severity, i.e. that there is no firm line that divides borderline from non-borderline. Looking back, it is obvious that as I recovered there was no past time at which I suddenly no longer “had” BPD, if I ever had it at all. Of course, I did have (and gradually stopped having) all of its symptoms, which were real and extremely painful.

Once I realized this, I experienced a paradigm shift in which I was no longer worried by the diagnosis of BPD, since I regarded it as invalid.

7) My curiosity, resilience, and aggression

By my nature, I have always been curious. This helped me when dealing with BPD, since it spurred me to extensively investigate the disorder and how it could be treated, as well as to eventually question its validity as a useful diagnosis.

Even more important, I am one tough cookie (I was going to use another word, but want to keep this blog’s language clean!). Starting in my early teens, I promised myself that I would get better or die trying. After reading about how borderlines often failed to improve, I defiantly predicted that I would recover. I weathered the long, slow storm of many years of depression, anxiety, rage, and uncertainty, never giving up despite times when things seemed hopeless.

Lastly, I can be a pretty direct and blunt person. Aggression is often regarded as a “bad” thing in our society, but aggressively seeking out the truth or defending oneself when under attack can be good things. My aggressive rejection of those who are pessimistic about BPD was important in my recovery. I’m not afraid to say what I really think, as you will see on this site!

These qualities are partly genetic. They certainly helped me with my challenges. Each person has their own strengths, and there are other ways in which I’m not as gifted as others. For other people working to recover from past trauma, it may be these or other strengths that are most useful on their journey.

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I welcome any correspondance at bpdtransformation@gmail.com

If you are struggling with BPD yourself or are trying to help a borderline individual, I would be happy to listen to your story and provide feedback if possible. Feel free to provide constructive criticism of this site also.

This article is the opinion of a non-professional layperson, and should not be taken as medical advice or as the view of a therapist who is professionally qualified to treat Borderline Personality Disorder or any other mental health condition. Readers should consult with a qualified mental health professional before undertaking any treatment.

– Edward Dantes

#1 – The Goal of My Website About Borderline Personality Disorder

The main goal of this website is to show that meaningful recovery from Borderline Personality Disorder is possible, and to illustrate one way of getting there.

My Life Today

My name is Edward Dantes, and I’m 28 years old. I am a teacher working in an academic institution in the Eastern United States. At age 18, I was diagnosed with Borderline Personality Disorder by a psychiatrist. I have spent the past 11 years working to recover from severe childhood abuse and neglect, and have now reached a place where I can definitively say that I am better.

By “better”, I mean that for the most part I’m emotionally healthy – I like my work, enjoy several hobbies, have good intimate relationships with family and friends, can regulate my self-esteem, and can handle difficult emotions without acting out. Most days, I feel real, alive, and excited about what I’m doing.

I still have periodic struggles and doubts. But my core self is so much stronger than before. Or rather, I have a core identity where there was none previously. As one of many people who have recovered from severe childhood problems, I hope my story will encourage other survivors who want to do the same.

My Past Struggle

In my late teens and early 20s, I was severely borderline. My life was a living hell dominated by severe depression, constant anxiety, terrible self-esteem, suicidal thinking, acting out of various kinds, a lack of any intimate relationships, being unable to sustain full-time school or work, and the horrible feeling that things would never get better. As a young adult, I often despaired of ever succeeding at a job, having real friends, or having a successful romantic relationship.

However, slowly but surely, I did get better. I educated myself in great depth about BPD, and discovered what had helped others with the condition. I sought therapy and found friends to support my recovery. I rejected the prevailing societal view of the disorder as a biologically-caused, life-long condition that can only be managed rather than fully recovered from. This shift in my thinking became critical. I found out the truth – that meaningful recovery is possible, and that many people diagnosed with BPD have recovered enough to live good, rewarding lives.

Today, I have 0 of the 9 symptoms of BPD, whereas 10 years ago I had at least all 9 symptoms listed in the DSM-IV definition of BPD. I trust my progress and have every reason to believe that it will continue.

Confronting the Pessimists

Apart from promoting this positive vision of recovery, another purpose of this site is to confront those who say that Borderline Personality Disorder cannot be effectively treated. Many people on internet forums and the therapeutic community believe that BPD is a life-long condition. They believe that it can only be managed and “lived with”, but not deeply recovered from.

Nothing could be further from the truth. Getting better from BPD is possible, although it requires hard work over a period of years. Recovering to the point where one is essentially healthy and “normal” in the sense of enjoying work and relationships has been achieved by many former borderlines. Unfortunately, many borderlines and their families are not aware of the resources that are needed to recover, nor do they understand the disorder in depth.

On this site, I will present a powerful counterexample to pessimism about BPD. I will explicate the disorder from a variety of viewpoints, and present strategies which were useful in my recovery.

Additionally, this site will confront the American medical view that seeks to cast BPD as a genetic or biologically-based disorder, one that needs to be treated primarily with psychotropic medications. It will expose the lack of strong scientific basis for such claims, and will analyze the emotional and financial factors that might motivate supporters to hold this viewpoint.

The Validity of the Borderline Disorder

Lastly, I wish to radically challenge the notion that BPD is a valid scientific diagnosis as it is defined in the DSM. From my own research and life experience, and despite being diagnosed with it myself, I now believe that the DSM version of borderline personality disorder has little validity. That is not to say that the symptoms BPD represents are not profoundly real and that people do not suffer from them greatly – they are, and people do.

However, my viewpoint is that BPD is more useful as a metaphorical or symbolic term that encapsulates a range of severe problems in functioning and relating. In other words, BPD represents a large, nondistinct area of severe psychological distress, rather than a discrete syndrome. Psychodynamic theorists would call this region “preoedipal” and “preneurotic”, but not “psychotic”. Re-conceptualizing BPD has been a useful step toward recovery, since it allowed me to view myself as existing on a subjective continuum between sickness and health, rather than as having a discrete “disorder”. For me, this was freeing.

Disclaimer

Lastly, this website should not be taken as the advice of a medical professional, but rather as the opinion of a layperson. However, coming from the “inside out”, I can give a viewpoint of BPD and how to recover from it that is fundamentally different from any professional opinion.

It is my hope that this website will prove useful both to those who have been diagnosed with BPD and to family members of such people. If it does nothing else, it will hopefully challenge people to think differently about BPD, both in terms of what the disorder actually is, and in considering how much people diagnosed with it can change for the better.