Resolution, Not Conflict

The guide to problem-solving.

Are BPD "Drama Queens" Manipulative, Sadistic, and Worse?

Having to interact with someone with a borderline personality disorder can be extremely maddening—for both sides. High intensity emotions are costly. They make interactions stressfully upsetting, emotionally draining, and demoralizing. Read More

Manipulative, Sadistic, etc.

Manipulative, Sadistic, etc. may be true if you take an external view of what is going on, but it is a mistake to consider these maladaptive behaviours as in any way intentional and not driven by dysregulated implicit mechanisms beyond the access of any kind of will to cause harm.

I think "H O" has pretty much hit the nail on the head in her correspondence

I also think that Dr Heitler's conclusion of a "comorbid diagnoses" couldn't be further away from the truth, and it is unfortunate that she cannot allow her brain to escape the paradigms of the "Kraepelinian Dichotomy".

I'm interested...

I'm interested in what you see as problematic with the idea of "comorbid diagnoses."

My experience has been that most people who are hyperemotional-responders fit the bpd-only description of H.O. At the same time there does seem to be a small but distinct subgroup of folks with bpd whose hurtful behaviors seem to have more intentionality about them.

For instance, I'm thinking of one woman, let's call her Mrs. R, who raged regularly at her in-laws. At one point Mrs. R. and her spouse wanted her in-laws to give them money to purchase a new home. For two months Mrs. R. was totally lovely to her in-laws. Then immmediately after the purchase, she returned to her hurtful attacks.

Is this pattern manipulative? Sadistic? Something else? How do you account for Mrs' R's ability to turn the raging on and off?

I see diagnosis in general as

I see diagnosis in general as problematic and the fact that you are trying to fit people in to a diagnosis, and when they don't fit, instead of concluding that it is the system of taxonomy that is faulty you try to squeeze them in to 2 boxes at once.

It's akin to playing the child's game where they have a number of shapes and a number of tiles and they have to fit the tile to the shape. It's like putting the triangle in to the circle and going .. "Aha! it fits both the triangle and the circle!"

H O clearly understands her dilemma and she's generously trying to gently encourage you, through your clumsy fumbling, to understanding the complex multiplicity of her dilemma, and yet you keep trying to divide it in to manageable, yet simplistic and erroneous piles because you're stuck in the Kraepelinian Dichotomy and you can't find your way out.

Try to think outside the box.

Critical labels are unnecessary and unhelpful

@Simon says. You raise an interesting point about the limitations of using diagnostic terms for psychological phenomena. I have written several blogposts myself making a similar point.

At the same time I would like to respectfully request that all my readers refrain from pejorative labeling of me and also of others who have written comments. Negative labeling such as "clumsy fumbling" do not belong in constructive dialogue.

In general, I delete comments with a hostile tone. I am leaving this one partly because I appreciate the opportunity to explain what my relatively recent policy has become on hostile comments.

Agree with Simon

While I do think (am hoping) your intentions are in the right place, I have to agree with Simon that you don't quite truly understand Borderline personality disorder. Your writer HO clearly does.

For years you yourself have written and thrown about pejorative labeling towards people who happen to suffer from BPD. The title of this article (without reading the article) could be construed rather pejoratively ....Evil sadistic drama queens...

most therapists refrain from name calling like that as it really isn't helpful to the sufferers and invalidates them which actually would cause them more anger symptoms. You yourself became angry when simon presented you as less than flattering so surely you could show some empathy in this regard.

That said I do like the turn from mostly bashing and stigmatizing to attempts at understanding BPD that your work latest has shown. But, I still don't quite think you get it. I think you are still trying to see bpd as pejoratively "BAD"... which for me, causes your work not to ring true.

You are correct...

You are correct about several points.

1. I don't fully understand bpd.

That's why I have found the correspondence with H.O. so enlightening, and why I'm sharing it publicly (which has been with her consent).

I would extend this point further and say that the understandings generally amongst therapists of bpd have been limited at best and mistaken to hostile at worst.

The mysteries in this disorder are what intrigue me so about it. Plus the desire to find real cures.

A request. Instead of telling me I don't understand, please write to share with us the additional understandings that you can contribute. At the same time, I do want to compliment you generally on the civil tone of your comment. A civil tone invites me to want to keep the dialogue going.

I want to say again that I would greatly appreciate any further understandings that you can share with me and with the readers of these articles. I am hoping that these posts offer an opportunity for all of us to pool our understandings. Together all of us can grow in knowledge. Together we can clarify how to alleviate the suffering caused by this disorder. That's my goal.

2. I wrote the title with the intention of being provocative.

My goal in the article is to clarify that terms like "Manipulative" are inappropriate. At the same time, my apologies if I have been ineffective in accomplishing this goal, so that instead the terms just sound offensive.

How many people are even trying to understand?

Dealing with BPD sufferers is really pretty simple: Don't make false promises, do back off when asked to back off, don't make false accusations, and don't laugh at us when we're crying. It's astonishing how fast the rest just falls into place. Borderline is just how extraverted brains react to trauma. We have to find out whom we can trust, and we have to be heard. The world is sadistic toward us for that, and we spend our lives trying to understand why. How do we turn the rage on and off? It's not that complicated: When we are distracted from what brought it on, we are distracted and begin to breathe again, letting oxygen get to our brains. When the trigger gets our attention again, it's triggered again. We're the exact opposite of sadists and the exact opposite of manipulators. It's super simple. I have never created drama. Every time I have ever felt swallowed by my own anger it's been because the person I was talking to was acting as if he hadn't heard a word I'd said. Simple, ordinary listening, a basic courtesy, is probably half the battle. When they listen I calm right down because I can breathe again. I have a normal, human need to tell my life story, to be taken seriously and to know whom I can trust. When someone promises me friendship and then tries to block me from being heard just because he doesn't want to know what the world I've seen is like, perhaps, just maybe, he is sadistic, but I'm not. Treating a deeply hurt person like a monster for having feelings and expecting the person to care how you feel, or even know how you feel, is a bit unrealistic.

Thank you for sharing.

I found your thought about on how helpful you find it when people show evidence of genuine listening especially valuable.

Cool

I'm really glad you said that. I have been through different kinds of professional and amateur help, and the most valuable ones include the counselor who just let me talk, believed me even when it might have been disturbing, and told me I was obviously emotionally exhausted and treated me like a human being looking for answers. A friend who has helped me enormously also just listened and then gave me perspectives on control issues and priorities, reminding me that she is not perfect either and giving suggestions about what I can probably change and what I probably can't. For example, I can't make cruel people I knew long ago admit what they did, or be different, but I can avoid places they lurk in, and I can ignore them and let them display their own irrationality instead of getting drawn in by arguing. One thing that was a hard pill to swallow was realizing that if I give up hanging around places that have been unsafe for me, I am relinquishing territory. But I know now that I am an adult and the territory I need to protect is in my head, not on the city map. Also, being listened to has given me the mental strength to listen to people with different problems, and I have found out that some of the people who implied that they could solve my problems were just afraid to say no. Because of that knowledge I have learned to do my brainstorming alone first and ask my friends to advise me only when all else fails. It makes me much less afraid of my friends' flaws.

The article and comments is

The article and comments is so helpful to me as it's been a challenge to support my sister with BPD. Anonymous, thank for sharing your story. I wonder what you mean about avoiding places that are unsafe to you. I don't mean to pry but I can't help thinking that it might be something my sister has not considered. Also, I wonder if a support group would be helpful. What would be the pros and cons for suggesting such to my mom and sister. We are separated by miles and my sister is a single mom of 2 children. Most of all, with anyone and any situation, acceptance and patience seems to be key.

Places

In the search for energy and reality, I used to frequent all the nearby gathering places, just to know life still went on and to hope to run into someone who might listen to me or answer questions or give me energy. However, social gathering places tend to deteriorate over time as they become more and more the territory of people with too much time on their own hands and too many emotional needs or social agendas. I didn't understand that. Sometimes a place I associated with connection to my community had turned into a pickup joint full of defensive pickup artists, delusional paranoid people who thought the other regulars were there to laugh at them or something, con artists, pushers and narcissists. But I hung out anyway, refusing to concede the territory for fear that if I did I would end up with nowhere to go in the world. After talking about it with a few people, I have realized that I don't have the power to make a place be a good place again, I do have the power to go somewhere else, people with nothing better to do than harass folks like me in the park/bar/cafe/diner/in front of the store aren't worth free rent in my head, and no one can give me energy anyway, I have to get energy by resting.

Support Group

I would say a support group would be a really good idea, provided it was a good group. That way the interaction is spread out among members and doesn't concentrate on one person or another. The idealizing/devaluing thing is one of the most misunderstood parts of BPD in my experience of life. "Normal" people think we set them up while we thought they were setting us up. What happens is, we are social, but emotionally tired and a step behind other people, so we feel so relieved when someone acts trustworthy and respectful and caring that we get like kids about it, forgetting to expect disappointment. Then when they inevitably let us down, we think they had planned it all along, and relive all the betrayals of our childhoods and youth, and feel that the whole universe is laughing at us for believing in anyone -- again. So the trick is to be rested and go slowly when getting to know people, and to take time to remind ourselves that they will let us down and that when they do they probably were not planning to, and that no one can make us feel inferior without our consent. So to help with that learning process, a group of others with the same issues would probably be very useful.That way, if anyone "latches on" to anyone, others can provide a reality check, and if anyone lets anyone down, others can be supportive and talk them through it together.

Thank you...

@anonymous: Just wanted to thank you again. After reading your replies,in addition to the article, I was able to connect with my sister over the phone with a little more confidence. She described that "she has figured out and learned over the years about her particular situations and stresses that can trigger her bipolar"- those are her words. It was also good to hear that she has a few friends who also are in a similar situation as her-- but, I didn't probe to find out how reliable they might be. She is not currently in a support group but had success with that in the past. I might bring up the positive points you described if/when the subject might present itself again. She sounds great and has learned so much in these years since her diagnosis. I'd like to express my gratitude for coming across this article and comments.

Reply

Thanks for replying and caring. I definitely hope she gets better.

BPD stigma complex and insidious

Getting to the bottom of why BPD is so misunderstood and stigmatised is crucial in allowing the voices of those with BPD to be heard alongside those who genuinely care about them.

The fact is that the stigma towards BPD wasn't generated by the fear in the general public towards mental health generally, but by clinicians whose treatment programmes failed to heal the condition. Even the name "Borderline" still harks back to that fundamental misunderstanding.

Psych workers hated us because they treated our pain with contempt and then got frustrated with us for getting angry with them for that. Our reaction to their ineptitude became pathologised and forms the cornerstone of the mythology of the "BPD monster".

It took someone with an insider view to dispell these myths and create a treatment programme that actually healed the pain that informed our rational responses to professional maltreatment. However, even in the wake of Marsha Linehan's DBT these stigmas are still being generated by mental health professionals who refuse to accept just how wrong they were and the part they played in villifying us.

Another unique manner in which BPD stigma is still being generated is via "loved ones" of those who either have or are believed to have the condition. It is well known that abuse is a significant contributing factor in the development of the condition. Yet so much discussion around the condition is devoted to helping those who are believed to have been abused by those who have BPD. With our low self esteem and lack of boundaries we are often shaped by those who fail to nurture a valid sense of self in us and are predisposed to becoming prey in later life to those who share these qualities with our often narcissistic parents.

The testimonies of these "abused" family members and ex partners are taken at face value and most of the resources in the BPD awareness raising movement in the US are devoted to their needs whilst sidelining those of people who are suffering from the condition.

This toxic confluence of professionals who continue to stigmatise the condition and family members who resolutely deny any wrong doing in their treatment of children or partners with the condition means that the term BPD is now synonymous with all manner of abusive behaviour that is not in anyway indicative of what it means to actually suffer from the condition. The amount of people who are convinced they have experienced "borderline abuse" after having read some self help book or psychology today article about the condition are legion. So often when I am contacted by people asking how to deal with their loved one with BPD when asked if they are in treatment for the condition, respond "no, they are in denial and refuse to accept they have a problem at all!" Then it is simple THEY DO NOT HAVE BPD!!!

BPD is so painful you cannot have it and not in anyway be aware that you have a problem. You have no ego to defend yourself from all that life throws at you. You live in an existential hell, tormented by suicidal ideation and all manner of attendant maladies. Those with a diagnosis all say the same thing "I've always known I had a problem". Those who stigmatise us say "they never admit they have a problem".

Until the Psychiatric profession openly accepts its failures towards those suffering from one of the most accutely painful mental conditions that exist, stop conflating it with NPD and sociopathy, stop making third party diagnoses of the BPD based on the anecdotal accounts of abuse made by their patients in treatment, stigma will persist and stigma kills. It killed my friend in May last year. He took his own life after having been told by so many people he was evil, manipulative, attention seeking and that he deserved to die. Here is a video he made earlier that year. This is what BPD looks like. All else is stigma.

https://www.youtube.com/watch?v=D3IvUHeKPCw

Beyond poignant....

I watched the video. How very very sad that this lovely fellow did not receive sufficient help in time to relieve him of his suffering.

I will post today a PT article sharing his video.

Thank you for sending it.

Posted.

Thank you again Heinz for sending this youtube link. Very powerful video. And very sad.

The article focuses on the reality that bpd that presents mainly as depression and fearfulness is probably significantly under-diagnosed. The video is so poignant in this regard.

To access the article, go to http://www.psychologytoday.com/blog/resolution-not-conflict/201406/borde....

BPD

I was married to a BPD for 17 years. Divorced in 2004, after the 7th Shrink and 10th "Therapist" confronted her...and she still said it was all my fault. I have custody of the 3 beautiful kids, tring to shake off the fleas of their Mom. I have older Adult sisters who also variously fit the BPD archetypes. Stormy Interpersonal relationships for certain....and a refresher stint in Co-Dep school for me, ..which led me out of the Land of Oz !

Lots of therapy to merely understand ....an enigma.

I have found that having no contact with them is best.
Their Denial structure(s) is/are too strong, to overcome with gentle entreaties to civility, empathy, or logic. Having to constantly explain non-intended behaviors/ mis-perceived stimuli (triggers) from others and their BPD gross overreaction(s)ad nauseum--just made me very tired and very worn out.

Vesuvial outbursts, including their Physical violence, is finally a thing of the past.

Resistance (in their mind) just fuels them further.

When a BPD wishes to change, embraces change, and works towards change then, I shall try to strike words from the English language, somewhat , in an attempt to provide them extra safety while they re-learn that which they missed in childhood.
It is a horrible condition. I know they are miserable.

When a BPD DOES NOT wish to change, work towards change, etc--I feel a moral duty to warn self and others, that these are very Potent and harmful Individuals---and I will use every word in the English Language to do so.

A Drunk does not cease being a Drunk--just because I use some cute and amorphous euphemism such as, " An underdeveloped Dilettante in Fluid Management", in describing their behavior. The "Hole in the Soul" of alcoholism is not much different than the emptiness of BPD.
( See, Alcohol Counselor, who killed a man with her car and carried his body on her car, thru suburban LA--6/12/14 Sentenced-- " I wasn't drunk and it wasn't that far, that he was on my car hood")

How is that for Denial ? 3 levels ??

I suggest BPD's place themselves in such a Psychotic state oftentimes, that one CANNOT insult them--even if one tried. Cognitively, for the Non-BPDR' it is the equivalent of sticking one's finger in the eroding Dam....they are often oblivious to your efforts to help...no matter how heroic and selfless.

Do not tip toe verbally around them--when you should avoid them physically and completely.

Painful experience has taught me and other family members, that Cognitively, you could respectfully call them Jesus, sweetheart, or honey,...and they likely will take offense, and the storm begins anew.
It is what is in their head--and not on our tongues, that is the Issue. There is no Logical Cause and effect, at play, for Language to trigger, as is suggested.

I just fired a person who I tried to help ( For FREE )for 6 months by finding a Lawyer to take her/ her mother's (increasingly questionable) case, and who is quite certifiably 99% BPD.

I did "Quit her" ..but with grace, dignity, not one bit of rancor, ....and completely in writing. Nonetheless, she has railed and threatened at me on countless Voice Messages, E-mails, and in Person (attempted). She Demands, barges into my office, waits for me at the door, ignores my boundaries completely and the fact that I have many real clients, with real problems.

Frankly, it was my Ex-wife all over again. Once that was "recognized" --I used standard non-threatening behavior, to ease her out of my life.
However, I was both a Participant and a Spectator to this latest dyad....rather than just an idiot ingenue.

The fact that I have a medical condition requiring regular treatment, is no excuse for my not dropping everything to deal with her latest storm.
She still completely mis-characterized 60 % of what was politely written and assigned ill motives and crazy-making to me--in order to avoid her "emptiness".
Verbally she is about 80% in her own mind, as opposed to the reality of the rest of us. Fascinating stuff.

She cognitively cannot even read and comprehend her e-mails of yesterday, and last week. A powerful clue.
I found my heart harden--but with calm determination, I eased her out the door.

My choice of less perjorious language will not change her psychotic storms. I'm Sorry.

God, these can be scary people.!

I am glad I now know how to get away from these people...without hurting them...or me.

Saying sweet things to them merely emboldens them, I'm afraid. It invites grander "Manipulations".

Those who want to get well, get well. Those that don't, repeat the behavior--again and again.

I'm happy. She is miserable. It is not my fault. I cannot fix her. She chooses to stay where she is.

I'm out of Oz.

Have a nice day.

Thank you!!

Reading this discussion was frightening to me. Poor little BPDs. Thank you for telling our side.

Yes, I understand there is enormous pain. But I always supported and listened, I never laughed, I offered affection, I took on all the burdens (household, personal) that I could. I made it clear I was ALWAYS there for him. Meanwhile he would be on the phone with his parents for hours telling them everything they had ever done wrong. They would apologize beg his forgiveness, be weeping on the phone, etc. Agree things could have been better, but he insisted they should have been perfect. Nothing was enough to stop his hate, manipulation and persecution of them. He did the same with me. With my son from the age of four. This was all between days of bitter silence, refusal to acknowledge others existed, hate-filled glares. Thirty-five years of empty threats of suicide.

For someone who doesn't understand people, he can somehow at the same time spot every little vulnerability and exploit it to the fullest. Twist the knife and thrust.

Again, I know there is enormous pain even though I cannot find his source, but his goal is to create enormous pain in others. So should there be one person with enormous pain, or everyone in their circle in enormous pain? I hope therapy and meds can help these people.

Meanwhile they say they only need a little understanding (which will NEVER be enough) as they spread the wealth of pain.

I think the BPDs in this discussion need to look at themselves more honestly. If changing the vocabulary regarding BPD can help them, fine. Change it. I realize that it may be impossible for them to look at themselves clearly, but enough is enough. I gave 44 years to this person and I was a fool. I have left him and will have a few years of peace, but I am myself shattered.

Balancing empathy and self-protection

Balancing self-protection and empathy are key when interacting--or chosing to disengage from interaction--with someone with bpd.

I am impressed with how thoughtfully you have approached these decisions. Thank you so much for writing and sharing your experiences.

Meanwhile I do hope that the day will come soon when people with bpd who choose to get help will find full relief from their pain and struggles.

My heart goes out also to the therapists who tried so valliantly to help you and your wife, and at the same time whose treatment options were not sufficient to win the battle.

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Susan Heitler, Ph.D., is the author of many books, including From Conflict to Resolution and The Power of Two. She is a graduate of Harvard University and New York University.

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