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Thursday, August 5, 2010

Coping with a Spouse Who Has Borderline Personality Disorder

Generally, as a psychotherapist, I tend not to think of people in terms of diagnoses. People are more complicated than that, and looking at people only in terms of diagnoses tends to be reductionistic and pathologizing.

While a mental health diagnosis will not capture the complexity of a particular human being, there are times when it is helpful to understand and cope with people who are close to you who are suffering with emotional problems. It's also important to understand yourself in relation to this person, what's happening to you in this relationship and steps that you might need to take to protect yourself emotionally, physically, and financially.

As I mentioned in my previous post, borderline personality disorder (BPD) is a serious mental health problem. It's often hard to understand for the person who has borderline personality traits as well as his or her loved ones. As with any mental health diagnosis, borderline personality disorder is on a continuum. There are certain people who have various traits and not others, and there are also people who meet the full criteria for the disorder.

Living with a spouse who has borderline personality traits can be extremely challenging. Usually, it means that you're living in a very chaotic emotional environment where you've not sure if you're losing your mind or your spouse is "going crazy."

How Do You Know If Your Spouse Has Borderline Personality Traits?
Listed below are some questions that you can ask yourself. While it's understandable that, if you're not a licensed mental health professional, you're not qualified to diagnosis anyone, but the questions below will help you to begin to understand what you might be dealing with in your relationship:

Does your spouse or partner become irrationally angry or enraged at the drop of a hat over relatively minor issues?

Do you feel like your spouse goes back and forth at various times between idealizing you and devaluing you?

When your spouse becomes angry with you, does he or she "forget" everything that is good about you and your relationship so that you feel that he or she has done a complete "180"?

Does your spouse engage in emotional "cut offs" with you or his or her family members or friends with little provocation?

Do you often feel that you're "walking on egg shells" with your spouse because you fear that things you might say or do will cause him or her to become extremely angry and possibly violent?

Do you often find yourself avoiding certain topics because you're afraid that your spouse will have an angry or violent reaction?

Do you often feel misunderstood by your spouse and your efforts to try to clarify things that you've said or done are not heard or understood by your spouse?

Do you often feel manipulated and controlled by your spouse?

Are you fearful of asking your spouse for what you need emotionally because you're afraid that your spouse will accuse you of being "too demanding"?

Do you often feel that your spouse changes his or her mind a lot so that you're not sure what he or she wants from you?

Does your spouse accuse you of doing or saying things that you never did or said?

Does your spouse seem to go from trusting you to being highly suspicious and distrustful of you for no apparent reason?

Do you often find it difficult to plan social activities because of your spouse's changing moods, impulsivity, and unpredictability?

Over time, do you often feel like you're living with "Dr. Jekyll and Mr. Hyde"?

Does your spouse often seem very charming and engaging to other people, but when you're alone with your spouse, you see a completely different side of him or her that most people don't see?

Does your spouse abuse alcohol or drugs or engage in gambling or sexual addiction as a way to cope?

Does your spouse often accuse you of not caring for him or her so that you feel that no love or caring is ever enough?

Does your spouse vacillate between wanting to be emotionally or financially rescued to cutting you off emotionally?

Do you find that you and your spouse often go through frequent breakups and reconciliations?

Do you find that your spouse engages in a lot of "all or nothing" or "black and white" thinking and there often doesn't seem to be any middle ground in his or her thinking, especially when he or she is angry?

If you've tried to leave the relationship, has your spouse tried to use charm, manipulation or even physical violence to keep you from leaving?

Does he or she threaten to commit suicide or threaten to hurt you if you leave?

It's important to understand that the above characteristics are often common to many different types of emotional problems, not just borderline personality disorder. So that, as a non-mental health practitioner, you're not going to be able to analyze or diagnosis your spouse. Also, while your spouse does not need to have all of these traits, having one or two of these traits does not mean that your spouse has borderline personality disorder. The above list is meant to give you an idea of what you might be dealing with in your relationship.

The following fictionalized scenario, which is not about any particular person, is an example of some of the problems involved in a relationship with someone who has borderline personality disorder traits:

Mary and John:
When Mary met John in their senior year of college, she thought he was one of the most charming and thoughtful people that she had ever met. She felt completely swept off her feet by him. She had also never felt so close to anyone before. No one had ever made her feel so terrific before. He thought that almost everything that she did was wonderful. When her friends met him, they also really liked him and found him to be very charming and engaging. He was funny and very generous. Often, when people met him for the first time, they would say that they felt he was so familiar to them, as if they had known him for a long time.

Before introducing Mary to his family, he warned her that his family tended to be very chaotic. He told her, "In my family, you need a score card to keep track of who's angry with whom and who's not talking to whom, but I'm sure they'll love you just as I do."

When Mary met John's family, which consisted of his parents and five brothers and sisters, Mary realized that what John had told her about them was accurate. Although they welcomed her with open arms, there was a lot of tension in the air between family members. She noticed that certain siblings were barely talking to each other and there seemed to be various alliances between certain siblings against other siblings. At various points in her visit, arguments suddenly erupted for no apparent reason, making Mary feel very uncomfortable. But, just as quickly as these arguments erupted, they also subsided just as quickly. John's mother said to Mary, "Don't mind us. This is just how we are. We fight, we stop talking to each other for months at a time, but we love each other and we always make up--until we begin fighting again"

Within a few months of having met each other, Mary and John got married. Mary was sure that she had never been happier and she had never felt so loved and appreciated in her life as she felt with John. During the first month or so, Mary felt like she was living with a prince and John treated her like his queen. He brought her flowers. He told her that he thought she was the best wife and lover that a man could ever have. He praised everything that she did.

Then, one day, without warning, all of this seemed to change. John was under a lot of stress at work and he felt that his boss was harassing him. Mary had never seen John in such an anxious and angry state. When she got home from work, she found John pacing the room back and forth. He told her that his boss was on his back and he was thinking of quitting his job. Mary was very surprised to hear John say this because during the first few months that John worked with this particular boss, John had nothing but praise for him. John often talked about what a great future he felt he had with the company and how much he loved his job.

Since John would often tell Mary how much he valued her advice, she began to tell John that maybe his boss was in a bad mood that day and things would probably go back to being as good as they usually are tomorrow. She was putting away grocery when she saw John whirl around with a look of rage on his face that she had never seen before. Then, John yelled at her, "Who's side are you on!?! Are you taking my boss's side!?!"

Mary was so shocked and dumbfounded by John's reaction that she dropped the eggs on the floor, which only made John more angry, "Oh God, Mary! What the hell are you doing? Look at this mess! You always make a mess of things! Can't you do anything right!?! And what do you know about my job. You're always putting me down! Why aren't you ever on my side!?!" Then, John suddenly walked out of the apartment, leaving Mary feeling like she was in the middle of a nightmare.

While John was gone, Mary tried to calm herself. She had never seen John like this before. She thought about what he had said. She could not ever remember putting John down or not being on his side. She couldn't understand how or why he would say these things.

About a half hour later, Mary received a call from John's mother. She told Mary that John had come to her house and he was talking to her and the rest of the family about the argument. She told Mary, "You know, Mary, John is very sensitive and you should try not to get him angry because he explodes. You're his wife. You should try to be supportive of him and not put him down. I thought you were different." Mary worked hard to contain her own anger about this intrusive call. She didn't want to explain herself to John's mother, so she decided to wait until he got home to talk to him.

When John came home a few hours later, he seemed like his old self again. He brought her flowers and told her that he was sorry that he lost his temper. He told her that he didn't mean all the things that he said, and he wanted to make up with her. Mary was confused, but she was glad that John was "himself" again and she thought that his overreaction earlier that evening might have been due to his being under a lot of stress at work. She decided to leave well enough alone and not bring up anything about John's boss or his work or the phone call from his mother that evening. That night, John and Mary made passionate love and, once again, Mary felt that no one had ever loved her as much as John.

Over the next few weeks, everything seemed back to normal again--until John had an argument with his mother. Once again, John was pacing back and forth and he was very angry and upset. There were numerous calls back and forth between John and his mother where they were yelling at each other, crying, and hanging up the phone. As Mary watched things unfold, she told John, "Try not to let your mother affect you so much. Why don't you just let things simmer down before you call your mother again." John responded by losing his temper with Mary, "What are you talking about!?! My mother is the best mother a son could have. She's not bothering me! You're the one who's bothering me. You're never on my side. You're the worst wife a man could have! Why don't you leave me alone!?! I don't know why I ever married you!" Then, John stormed out of the apartment.

As these scenes became more frequent, Mary began to realize that John had serious emotional problems, and that his family was very dysfunctional. She became very vigilant when she got home to try to "read" John' s mood because she never knew when he was going to be his charming, loving self or when he would be angry and demeaning of her. She also began avoiding certain topics that she knew would make John angry to avoid dealing with his temper. But as careful as she tried to be, she was still subject to John's impulsive and destructive rage which often came for no apparent reason. She also often felt misunderstood by him, and when she tried to explain herself, John dismissed whatever she said when he was in an angry or anxious mood.

Over time, Mary began to realize that John stopped being as attentive to her needs. When she tried, very tactfully, to bring this up with John, he lashed out at her because he felt criticized, "Oh, like I don't have enough going on at work and dealing with my family! Now, you're going to make demands of me too! You're too demanding! I can't deal with it, Mary! You have to stop!" Mary began to explain that she often felt lonely and she couldn't understand what happened to their relationship. Hearing that, John's anger escalated and he began breaking things around the apartment.

Mary became so frightened that she started to run out, but John caught her by the arm and began begging her not to leave. He dissolved into tears and promised her that he would change, "You have to help me, Mary. I need your help. Don't leave me." At that point, Mary had already seen enough of this behavior to know that John was unable to keep his promises to change. She told him that she thought they both needed to get help and if he didn't get help, she would leave.

Since John had a very strong fear of being abandoned, he complied with her wishes. He asked his family doctor for a referral, and his doctor referred him to a DBT therapist who specializes in working with people who have borderline personality traits. Mary also began her own individual psychotherapy to deal with her issues in their relationship.

It took a long time and it wasn't easy, but John learned how to cope with his overwhelming feelings of anger and fear of abandonment. There were many times when John wanted to leave therapy because he felt the therapist didn't understand him. Then, there were times when he thought his therapist was the best therapist in the world. Mary also learned to take care of herself in their relationship. Over time, their relationship began to improve. The family dynamics in John's family never changed, but John and Mary learned not to get so caught up in them.

The above scenario represents a somewhat optimistic outcome of living with a spouse who has borderline personality disorder. Not every relationship turns out that well. For instance, people with borderline personality disorder often refuse to get help. It's hard for them to see that they have a problem, and they often blame everyone else. In other cases, they might go back and froth between blaming others and blaming themselves.

If you're the spouse who is on the receiving end of this behavior, it can be very hard, if not impossible, to deal with on an ongoing basis. One of the most challenging aspects of this type of relationship is that you often can't see when your spouse is going to shift from being loving and thinking that you're wonderful to being angry and blaming and accusing you of being the worst spouse ever.

When you go through these sudden ups and downs with your spouse, you might feel like you're on an emotional roller coaster. You might also feel that you hardly recognize this person, who is supposed to be your spouse, when he or she makes these sudden emotional shifts.

While there is a place for compassion and understanding, you should never allow someone to emotionally abuse you or your children. Remember that the person with borderline personality disorder traits is responsible for his or her behavior. If there is abuse, especially physical abuse, you need to make a safety plan for yourself and your children to be able to leave the household quickly, if needed, and go somewhere where you feel safe.

Even if your spouse refuses to get help, you probably need help yourself to deal with a spouse who has borderline personality traits. Only you can decide how much is too much and if you want to stay or leave, but by seeing a licensed mental health professional, you can sort this out and learn what your role is in participating in this relationship.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist

To set up a consultation, please call me at (212) 726-1006.