A Matter of Personality

From borderline to narcissism

Responding to “Borderline” Provocations – Part III

The best overall attitude behind effective responses is described.

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In my Part I post of November 4, I described how a lot of the difficult behavior of patients with borderline personality disorder (BPD) in their intimate relationships is designed to elicit in the observer one of three reactions: anxious helplessness, anxious guilt, and overt hostility. Furthermore I expressed the view that, even though they will make herculean efforts to induce these reactions, and are very good and finding other folk's vulnerabilities in order to do so, they secretly hope they will fail in their efforts. 

In Part II, I discussed how not to respond in these situation. (Again, the behavioral recommendations I give do NOT necessarily apply to either party in the relationship between an adult with BPD and his or her own parent. Altering that relationship is far more complicated and almost often requires extensive coaching by a knowledgeable therapist).

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In the posts that follow this one, I will describe what might be called effective “countermoves” to typical "borderline” provocations. 

As an aside, individuals with personality disorders that are not prominently “borderline” can also engage in these repetitive maneuvers at times, and the advice works just as well with them. The countermoves may work with anyone who is repeatedly trying to distance you (see Distancing: Early Warning [apologies to the rock group Rush]), particularly if that person is very good at it like an individual with BPD is.  

These provocative behaviors include: wild accusations and exaggerations, constant demands to do more for them when they reject all of your suggestions, illogical statements, absurd arguments, vague suicide threats, hostile-sounding statements, trying to get someone into a fight with a third party, escalating hostility for no apparent reason, and suddenly dropping a complaint in the middle of a heated argument and thereby drawing someone right back into the fight.

Unfortunately, I’m still not going to describe any countermoves in this post. I know, I know. I’m sounding like a tease who’s making promises on which he plans not to deliver, but I really will get to those specifics in the very near future. In order to make the specifics work, however, one has to know something about the reasoning behind them, the proper attitude to take, and some more overarching strategies. In this post I will focus on those things.

An observation held in common by many psychotherapy treatment paradigms for BPD is that respectful treatment of the patient by therapists in the face of the patient’s chaotic behavior patterns often seems to induce the patient to behave less chaotically with the therapist (although not with anyone else). It is particularly important for a therapist to respects differing values while not changing his or her own. 

To quiet down someone with BPD, one should look to find something that is wise, correct, or of value in their emotions, thinking, and behavior. One should never assume that someone with BPD’s problems stem primarily from crazy thinking, faulty interpretations, distortions of reality, or maladaptive assumptions – despite seemingly irrefutable evidence to the contrary. You should assume that individuals with BPD have unhappy lives and that therefore, despite all the evidence, they really want deep down to act better. 

Persons with BPD often have a high level of interpersonal skills, as evidenced by their reputation for being able to “manipulate” others. You should try to keep their considerable strengths in mind as you interact with them, and respect it. 

The provocations listed above are, in a sense, an invitation to invalidate the person performing them. Individuals with BPD have been invalidated by their families so often they think it is their job to act in ways that allow their parents, and everyone else, to feel justified in continuing to invalidate them. To counter this, one should aim to at least partially validate someone with BPD’s reality and try to make sense of their behavior within their current interpersonal environment. See also my post on invalidation to get a better idea of the importance of being willing to validate someone when that someone is practically inviting you to invalidate him or her.

The troublesome behaviors of someone with BPD must be looked at not as a problem with someone with BPD, but as imminently reasonable and understandable responses that derive from a problem for someone with BPD. You should not view someone with BPD as psychotic, malevolent, immature, or unintelligent but as someone who is struggling with a highly dysfunctional social network

And never forget that it is very likely that YOU yourself are part of that dysfunctional social network, so please do not act like you think that you are superior to someone with BPD in any way. If you do, you are inviting someone with BPD to knock you off of the pedestal that you put yourself on, and you will not know what hit you. 

Never treat someone with BPD as if he or she is fragile or incapable of being reasonable, particularly when tension occurs in your relationship. Ultimately, no subject should be thought of as too sensitive or taboo to discuss. While you should be sensitive to such issues such as incest or family violence, you should try to talk about such subjects when they arise calmly and reasonably even in the face of the person with BPD’s anxiety or acting out (This ain’t easy, and this is where a therapist for you would be useful if not indispensable). 

If you do not agree with what something the BPD says, calmly say you disagree without making an issue of who is right and who is wrong. If you feel that something you have said or done is being misinterpreted or is being taken out of context, kindly explain what you had meant to say or do without trying to convince someone with BPD that they got you wrong the first time.

Therapist par excellence Lorna Smith Benjamin employs what she calls the Caribbean Solution, named for the behavior of a hotel clerk confronted by an irate guest. You remain calm and friendly but continually reiterate your own opinion about a disputed interaction. 

Be scrupulously honest. If you actually have done something wrong, do not deny or minimize it, but do not go into a big mea culpa either. (The best way to come clean if you were physically or sexually abusive to someone with BPD when he or she was a child is another matter and will be not be discussed in this series of posts). On the other hand, I have seen individuals admit to things they had not done in order to pacify someone with BPD. Not a smart move.

You will have to be comfortable with your own limitations concerning what you can or cannot do for someone with BPD. Be respectful of your own needs. Never rush in to “take care” of someone with BPD in an infantilizing manner even when the need to do so seems to hit you across the face. If necessary, calmly declare helplessness without showing any guilt or anxiety about it, and stop making any suggestions.

You cannot be afraid of someone with BPD’s anger (unless actual violence is a real issue), neediness, or anxiety, and you must be completely unwilling to attack him or her in the face of provocation. Once again, this is where a therapist for you might be necessary. 

One last, extremely important point involves your tone of voice. If you are responding with anxious helplesseness, anxious guilt, or open hostility, it will show up in your voice, and the countermoves that I will soon advise will fall flat. The key descriptors of a much more effective tone: kind, matter of fact, and firm. Responding to provocative behavior and verbalizations with a matter-of-fact tone of voice – almost as if you were talking about the weather – can be particularly difficult considering the emotions involved. I would suggest literally practicing with a tape recorder so you can hear exactly how you sound.

In summary, be relentlessly respectful of BPD’s suffering, abilities, and values. Be humble without disrespecting yourself or your own well being. Be honest. Communicate an expectation that someone with BPD will be able to behave in a reasonable and cooperative manner, and play to his or her strengths. And keep it up consistently, or ye olde variable intermittent reinforcement schedule will rear its ugly head.

David M. Allen, M.D., is a Professor of Psychiatry at the University of Tennessee and author of the book How Dysfunctional Families Spur Mental Disorders.

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