Month: <span>October 2016</span>

Reader’s Question

My psychologist agrees that I have a lot of the symptoms associated with borderline personality disorder, but I haven’t been in any romantic relationships because I know I’d be a horrible partner. Does not being in a relationship mean I can’t have BPD?

Psychologist’s Reply

Not having been in a romantic relationship doesn’t necessarily mean that you can’t have borderline personality disorder. BPD can seriously impact relationships, but there are many other important symptoms associated with this personality disorder. The symptoms can range from mild to severe, but typically there tends to be an unstable sense of self, risky or impulsive behaviors (often including things like spending, sex, suicide/self-injury or even substance abuse), significant mood swings, a chronic feeling of emptiness, frequent anger and outbursts and sometimes paranoia or feeling disconnected from the present moment. (To read more on BPD, see the NIMH overview.)

There are certain aspects of BPD that can really damage a relationship. Those with BPD often experience intense, frantic efforts to avoid real or imagined abandonment. People with the disorder are often very sensitive and devastated by the feelings that come with loss and abandonment, whether the situation is real or just feared. These emotions are typically difficult for them and often lead to negative behaviors. For example, they may become inappropriately or disproportionately upset when their partner is late for lunch or doesn’t return a text in a timely manner. The fear of abandonment or rejection can lead to manipulative attempts to prevent the other person from leaving through the use of shame, guilt and anger. Persistent manipulation can easily drive their partners away, the exact thing they were hoping to avoid. The fear of rejection and abandonment can also contribute to high levels of distrust that could prevent the person with BPD from even wanting a relationship for fear of encountering those feelings. I’ve heard some with BPD even say they would rather be alone then potentially face those issues in a relationship.

Individuals with BPD are also prone to sudden or dramatic shifts in their views of others. These shifting views can often be very confusing for their partners, who wonder if they are loved or hated by them. Often they may idealize their caregivers or romantic partners and want to spend all of their time with them, quickly become attached, and share their deep personal secrets early in the relationship — only to suddenly shift and devalue the person. They may begin to feel the person does not care enough or put enough effort into the relationship and quickly become distrustful of them. Some studies have suggested that those with BPD have patterns of brain activity associated with disruptions in the ability to recognize social norms or modify impulsive behaviors and reactions.

Despite these issues, there is treatment available, including learning relationship skills that can help ensure a good, healthy relationship. There are proven and effective treatment strategies (like Dialectical Behavior Therapy, or DBT, and Interpersonal or Relational Therapies) that help those who struggle with the disorder. Even couples therapy can be used to help in addition to these. Many of those who suffer with BPD can experience repetitive disappointment and emotional pain from their relationships over time that lead them to strongly believe that love and commitment are out of reach. Try not to believe that. These valuable things are within reach for anyone, including those suffering with borderline personality disorder; it just takes commitment to treatment and partners who are willing to be patient.

Reader’s Question

I lost my job a few months ago and since then I’ve been unable to find the motivation to do, well, anything. I realized today that maybe what I thought was a pattern of behavior at work actually applies to my whole life. Namely: I flounder unless put under stress or a lot of responsibility. It seems counterintuitive to me, but I noticed it starting with the first job I ever had where I was just a lowly employee doing the bare minimum to get by. I felt listless. I was still a decent employee though, and eventually I was made manager — and as soon as I felt like I had control over something, everything changed for me. Almost overnight, I suddenly cared about what I was doing, would work extra hard, and was really involved in all aspects of it. I loved it and I really blossomed into a stellar employee. Any job since then has been the same: unless someone is really counting on me to handle something important, I can barely do anything.

My partner makes enough to support us and I’ve never really been in a situation where my monetary contribution is imperative. I hadn’t realized that perhaps it’s causing me to feel useless, and thus my life is lacking the responsibility I crave.

The biggest problem for me, though, is that recognizing the problem doesn’t help. It doesn’t help even though I know if I just forced myself to look for a job, a volunteer position, or ANYTHING that would promote those feelings of responsibility then I would start to shift back into my normal self. I just can’t seem to care. So how do I break the cycle? And why do I not just thrive under pressure, but require it?

Psychologist’s Reply

It sounds as if you’ve discovered how stress is very much like an ocean wave. Like surfers, we look for the optimal wave that isn’t too weak or too strong to help get us to shore — upright on our boards. When stress is too high, we can often get consumed by the wave, or knocked off our steady footing before reaching our goal. Sometimes we just avoid the strong wave altogether for fear of falling and failing. On the other hand, when stress is too low, we often don’t have the momentum to reach our goals, and the wave fizzles out too soon — which it seems you are experiencing.

I think you’ve done some really effective reflecting, however, and are beginning to notice the patterns and your needs for an ocean with bigger waves. It’s not something within you, but rather the interaction between your needs and your environment that aren’t matching well. I also suspect that the circumstances of how your last job ended — not by your choice, it seems — may be making it even more difficult for you to find the energy to care.

Often when people lose a job, it can feel much like grief. The multiple losses experienced with a job loss, such as loss of structure, accountability, social connections, and a place to go every day, can be significant. When we experience a loss and are grieving, we often don’t feel like ourselves. We feel more sluggish, tired, have changes in appetite, feel isolated or have difficulty reaching out to others. Combining these difficulties with the pressure to find a new job can be even more debilitating. In these situations, it can be helpful to talk with a trusted friend or a mental health professional to process the loss, to engage in greater self-care, and to find ways to set the pressure to find a job aside until you’ve worked through what the job meant and what it means not to have it now.

After going through the grief process, it may also be helpful to find someone who specializes in vocational counseling — many counseling psychologists have had training in vocational assessment and development. A well-trained professional can work with you to explore your interests, abilities, and values to find a good person-environment fit for you that will be more inspiring and motivating. Work is an integral part of our lives and our identities — and exploring to find something meaningful and satisfying may be worth the time and energy for you now. Knowing more about yourself and how you might thrive on a bigger wave could be useful as you explore potential career paths.