I Hate You—Don't Leave Me (12 page)

The borderline syndrome represents a pathological response to these stresses. Without outside sources of stability and validation of worthiness, borderline symptoms of black-and-white thinking, self-destructiveness, extreme mood changes, impulsivity, poor relationships, impaired sense of identity, and anger become understandable reactions to our culture's tensions. Borderline traits, which may be present to some extent in most people, are being elicited—perhaps even bred—on a wide scale by the prevailing social conditions.
New York Times
writer Louis Sass put it this way:

Though conventional wisdom presumes that borderline pathology has increased over the last few decades, some psychiatrists believe that the symptoms were just as common early in the twentieth century. They claim that the change is not in the prevalence of the disorder, but in the fact that it is now officially identified and defined, and so merely diagnosed more frequently. Even some of Freud's early cases, scrutinized in the light of current criteria, might be diagnosed today as borderline personalities.

This possibility, however, by no means diminishes the importance of the growing number of borderline patients who are ending up in psychiatrists' offices and of the growing recognition of borderline characteristics in the general population. In fact, the major reason why it has been identified and covered so widely in the clinical literature is its prevalence in both therapeutic settings and the general culture.

Few would dispute the notion that society has become more fragmented since the end of World War II. Family structures in place for decades—the nuclear family, extended family, one-wage-earner households, geographical stability—have been replaced by a wide assortment of patterns, movements, and trends. Divorce rates have soared. Drug and alcohol abuse and child neglect and abuse have skyrocketed. Crime, terrorism, and political assassination have become widespread, at times almost commonplace. Periods of economic uncertainty, exemplified in roller-coaster boom-and-bust scenarios, have become the rule, not the exception.

Some of these changes may be related to society's failure to achieve a kind of “social rapprochement.” As noted in chapter 3, during the separation-individuation phase, the infant ventures cautiously away from mother but returns to her reassuring warmth, familiarity, and acceptance. Disruption of this rapprochement cycle often results in a lack of trust, disturbed relationships, emptiness, anxiety, and an uncertain self-image—characteristics that make up the borderline syndrome. Similarly, it may be seen that contemporary culture interferes with a healthy “social rapprochement” by obstructing access to comforting anchors. At no time has this disruption been more evident than in the first decade of the twenty-first century, racked as it has been by economic collapse, recession, loss of jobs, foreclosures, and so on. In most areas of the country, the need for two incomes to maintain a decent standard of living forces many parents to relinquish parenting duties to others; paid parental leave or on-site day care for new parents is still relatively rare and almost always limited. Jobs, as well as economic and social pressures, encourage frequent moves, and this geographical mobility, in turn, removes us from our stabilizing roots, as it did in Lisa's family. We are losing (or have already lost) the comforts of neighborly nearby family and consistent social roles.

When the accoutrements of custom disappear, they may be replaced by a sense of abandonment, of being adrift in unchartered waters. Our children lack a sense of history and belonging—of an anchored presence in the world. To establish a sense of control and comforting familiarity in an alienating society, the individual may resort to a wide range of pathological behavior—substance addiction, eating disorders, criminal behaviors, and so on.

Society's failure to provide rapprochement with reassuring, stabilizing bonds is reflected in the relentless series of sweeping societal movements over the past fifty years. We roller-coastered from the explosive other-directed, fight-for-social justice “We Decade” of the 1960s, to the narcissistic “Me Decade” of the 1970s, to the materialistic, look-out-for-number-one “Whee Decade” of the 1980s. The relatively prosperous and stable 1990s was followed by the turbulent 2000s: financial boom-and-busts, natural catastrophes (Katrina and other hurricanes, major tsunamis, earthquakes, and fires), a prolonged war, and sociopolitical movements (antiwar, gay rights)—bringing us almost full circle back to the 1960s.

One of the big losers in these tectonic shifts has been group loyalties—devotion to family, neighborhood, church, occupation, and country. As society continues to foster detachment from people and institutions that provide reassuring rapprochement, individuals are responding in ways that virtually define the borderline syndrome: decreased sense of validated identity, worsening interpersonal relationships, isolation and loneliness, boredom, and (without the stabilizing force of group pressures) impulsivity.

Like the world of the borderline, ours in many ways is a world of massive contradictions. We presume to believe in peace, yet our streets, movies, television, and sports are filled with aggression and violence. We are a nation virtually founded on the principle of “Help thy neighbor,” yet we have become one of the most politically conservative, self-absorbed, and materialistic societies in the history of humankind. Assertiveness and action are encouraged; reflection and introspection are equated with weakness and incompetency.

Contemporary social forces implore us to embrace a mythical polarity—black or white, right or wrong, good or bad—relying on our nostalgia for simpler times, for our own childhoods. The political system presents candidates who adopt polar stances: “I'm right, the other guy is wrong”; America is good; the Soviet Union is “the Evil Empire”; Iran, Iraq, and North Korea are the “Axis of Evil.” Religious factions exhort us to believe that theirs is the only route to salvation. The legal system, built on the premise that one is either guilty or not guilty with little or no room for gray areas, perpetuates the myth that life is intrinsically fair and justice can be attained—that is, when something bad does happen, it necessarily follows that it is someone else's fault and that person should pay.

The flood of information and leisure alternatives makes it difficult to establish priorities in living. Ideally, we—as individuals and as a society—attempt to achieve a balance between nurturing the body and the mind, between work and leisure, between altruism and self-interest. But in an increasingly materialistic society it is a small step from assertiveness to aggressiveness, from individualism to alienation, from self-preservation to self-absorption.

The ever-growing reverence for technology has led to an obsessive pursuit of precision. Calculators replaced memorized multiplication tables and slide rules, and then were replaced by computers, which have become omnipresent in almost every aspect of our lives—our cars, our appliances, our cell phones—running whatever machine or device they are a part of. The microwave relieves adults from the chore of cooking. Velcro absolves children of learning how to tie shoelaces. Creativity and intellectual diligence are sacrificed to convenience and precision.

All these attempts to impose order and fairness on a naturally random and unfair universe endorse the borderline's futile struggle to choose only black or white, right or wrong, good or bad. But the world is neither intrinsically fair nor exact; it is composed of subtleties that require less simplistic approaches. A healthy civilization can accept the uncomfortable ambiguities. Attempts to eradicate or ignore uncertainty tend only to encourage a borderline society.

We would be naive to believe that the cumulative effect of all this change—the excruciating pull of opposing forces—has had no effect on our psyches. In a sense, we all live in a kind of “borderland”—between the prosperous, healthy, high-technology America, on the one hand, and the underbelly of poverty, homelessness, drug abuse, and mental illness, on the other; between the dream of a sane, safe, secure world and the insane nightmare of nuclear holocaust.

The price tag of social change has come in the form of stress and stress-related physical disorders, such as heart attacks, strokes, and hypertension. We must now confront the possibility that mental illness has become part of the psychological price.

Over the past four decades, therapeutic settings have seen a basic change in defining psychopathology—from symptom neuroses to character disorders. As far back as 1975, psychiatrist Peter L. Giovachinni wrote, “Clinicians are constantly faced with the seemingly increasing number of patients who do not fit current diagnostic categories. [They suffer not from] definitive symptoms but from vague ill-defined complaints. . . . When I refer to this type of patient, practically everyone knows to whom I am referring.”
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Beginning in the 1980s, such reports have become commonplace, as personality disorders have replaced classical neurosis as the prominent pathology. Which social and cultural factors have influenced this change in pathology? Many believe that one factor is our devaluation of the past:

This loss of historical continuity reaches both backward and forward: devaluation of the past breaks the perceptual link to the future, which becomes a vast unknown, a source of dread as much as hope, a vast quicksand, from which it becomes incredibly difficult to extricate oneself. Time is perceived as isolated points instead of as a logical, continuous string of events influenced by past achievement, present action, and anticipation of the future.

The looming possibility of a catastrophic event—the threat of nuclear annihilation, another massive terrorist attack like 9/11, environmental destruction due to global warming, and so on—contributes to our lack of faith in the past and our dread of the future. Empirical studies with adolescents and children consistently show “awareness of the danger, hopelessness about surviving, a shortened time perspective, and pessimism about being able to reach life goals. Suicide is mentioned again and again as a strategy for dealing with the threat.”
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Other studies have found that the threat of nuclear war rushes children to a kind of “early adulthood,” similar to the type witnessed in pre-borderline children (like Lisa) who are forced to take control of families that are out of control due to BPD, alcoholism, and other mental disorders.
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Many U.S. youth ages fourteen to twenty-two expect to die before age thirty, according to a 2008 study published in the
Journal of Adolescent Health
. About one out of fifteen young people (6.7 percent) expressed such “unrealistic fatalism,” the study concludes. The findings are based on four years of survey data totaling 4,201 adolescents conducted between 2002 and 2005 by the Adolescent Risk Communication Institute of the Annenberg Public Policy Center. Despite a decline in the suicide rate for ten- to twenty-four-year-olds, suicide remains the third leading cause of death in this age group.
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The borderline, as we have seen, personifies this orientation to the “now.” With little interest in the past, the borderline is almost a cultural amnesiac; his cupboard of warm memories (which sustain most of us in troubled times) is bare. As a result, he is doomed to suffer torment with no breathers, no cache of memories of happier times to get him through the tough periods. Unable to learn from his mistakes, he is doomed to repeat them.

Parents who fear the future are not likely to be engrossed by the needs of the next generation. A modern parent, emotionally detached and alienated—yet at the same time pampering and overindulgent—becomes a likely candidate to mold future borderline personalities.

Perhaps the hallmark social changes over the last fifty years have come in the area of sexual mores, roles, and practices—from the suppressed sexuality of the 1950s, to the “free-love” and “open marriage” trends of the 1960s sexual revolution, to the massive sexual reevaluation in the 1980s (resulting in large part from the fear of AIDS and other sexually transmitted diseases), to the gay and lesbian movements over the last decade. The massive spread of dating and “matching” websites and social media has made it so easy to establish personal contact that the old brick-and-mortar “pickup bar” is becoming increasingly irrelevant. Innocent—or illicit—romantic or sexual relationships can now be initiated with a few keyboard strokes or a text message. The jury is out on whether cyberspace has “civilized” the world of interpersonal relationships or turned it into more of a dangerous jungle than it ever was.

As a result of these and other societal forces, deep and lasting friendships, love affairs, and marriages have become increasingly difficult to achieve and maintain. Sixty percent of marriages for couples between the ages of twenty and twenty-five end in divorce; the number is 50 percent for those over twenty-five.
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Even back in 1982, Lasch noted that “as social life becomes more and more warlike and barbaric, personal relations, which ostensibly provide relief from those conditions, take on the character of combat.”
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