First, BPD is a spectrum disorder. Borderlines can live at the far end of this spectrum where murdering their spouse, dog or children when they’re upset can land them in prison, or their symptoms may be fairly benign, and only manifest in self-defeating choices, both personally or professionally. [I’ve let go of a few who seemed hell-bent on self-destruction, because I respect my limitations.]
Second, Borderlines are attention whores. Like infants and very young children who’ve suffered emotional neglect at the hands of their mother, people with BPD features make no distinction between negative attention and positive attention.
If a child cannot receive nourishing, loving attention from his parental units, he’ll act-out to get attention from them, whether the outcome is harsh and punishing to him, or not. In short, ANY attention feels better to a very young soul, than none at all.
I recently mentioned un-fix-able clients in a post. It’s not that these clients can’t be helped, it’s that they won’t be. The reasons for this are numerous, but are mostly tied to doggedly repeating familiar choices and behaviors which feel a lot more natural and (therefore) comfortable. Risking stepping into unfamiliar, uncharted territory and not being able to predict the outcome (whether negative or positive) feels too scary for these people, and threatens what little sense of control they think they have.
Some far end of the spectrum Borderlines appear to have no common sense. They make decisions and choices based on immediate impulses, with no regard to consequences that will likely follow. The notion of ‘cause and effect’ is completely lost on people with BPD traits.
If this type of self-destructive Borderline is in standard psychotherapeutic treatment, it matters not to them how many kudos you offer based on an occasional ‘right’ choice, they get FAR more attention from you for the self-sabotaging wrong ones! You can talk with this client for hours on end, and never have them connect the dots on what you’re saying, or be willing to integrate a different plan for a far better outcome.
If you simply weigh the attention they’ve elicited from you when they’ve made self-injurious choices against the times in session they haven’t, you will see how cleverly you’re being emotionally manipulated to provide the attention they endlessly seek! This is no accident, my therapist friends.
Attention equals ‘care’ in the psyche of a Borderline. The more attention you give ‘em, the harder you try to help them SEE how injurious they’re being to themselves and offer alternative suggestions, and the more you fervently hope they’ll one day soon come outta the ether and begin making self-affirming choices, the more you are enabling that client to remain stuck, right where they are. They literally THRIVE on how hard they’re able to make YOU work.
Meaningful therapeutic intervention (in whatever form it takes) is a collaborative effort. If people knew how to make sound, emotionally responsible, adult decisions and choices regarding their personal and professional worlds, they wouldn’t fucking NEED another’s expertise to straighten ‘em out and set ‘em on a productive path.
So, what do we do with attention whores, whether they’re an ex or a patient? We cut off the attention, completely. We don’t try to gain closure. We don’t try to help them see the error of their ways. If they’re a client/patient in our practice, we leave them to their own devices, which typically spells disaster… but they might just occasionally surprise us.
When I let go of a psychologist client with BPD traits, he stopped using me as his ‘confessor’ after costly, self-destructive choices he refused to stop making, and improved. My absence apparently forced him to rely more on his own inner resources!
People won’t stand on their own two feet, as long as you’re always there to shore ‘em up. The clients I’ve had in their 30’s to 50’s who are still financially dependent on Mommy and Daddy to pay their way or get ‘em out of serious scrapes by rescuing ‘em with money, are emotionally underdeveloped wrecks.
These folks have never had the need to develop essential adult life skills, due to a parental ‘safety net’ that’s always there to catch ‘em, when they fall. And they’ll always fall, because when they make an irresponsible, shortsighted choice regarding their own well-being, there are NO CONSEQUENCES that result, which under normal circumstances, help humans learn what NOT to do again!
People with Borderline Personality Disorder traits face continuous struggles, because they have not had to learn to avoid them. Wealthy parents cripple their children by keeping them financially dependent. They also enmesh and control the child in ways he can never escape. Throwing gifts and money at children becomes the only ‘currency of love’ that emotionally inept mothers and fathers can offer. How sad is that?!
Wrapping back around to Borderlines, some are so enraged at their parents and how they were failed as children by them, they won’t accept sound guidance from anyone in a position to offer it. Borderlines transfer their long-held anger, parental resistance and resentment onto their therapist. This is expected within a useful and meaningful therapeutic alliance… but any clinician who fails to recognize how they’re being manipulated and used merely for supplies of attention in the process, should probably seek highly experienced, solid mentoring~ or expect to circle the drain with these types of clients indefinitely.
Personally, given how resistant some BPD clients are to receiving real help (and thank GOD this doesn’t apply to all) I think perhaps a psychiatric approach can be a better fit. These days, most psychiatrists are prescription writers. They don’t do talk therapy, and they don’t get emotionally invested in a patient’s personal upsets or day to day conundrums. They might listen, nod and take notes as a patient is rattling-on about their crisis du jour, but they don’t try to fix it~ outside of noting a diagnosis, and sending ‘em off to their pharmacy to pick up a scrip.
For an attention-addicted client who’s resistant to implementing rational, sound guidance and suggestions you might passionately offer, maybe it’s really best to refer ‘em out. OR, you can let ‘em stay, while leaving ‘em to their own devices.
Either way, with some poor undercooked souls, you’re literally gonna have to resist the temptation reinvent the wheel! These are children in adult bodies who may have to go thru a few more ‘rotations’ before they reincarnate as one who is highly motivated and emotionally mature enough to avert the agonizing challenges this lifetime has brought their way.