I Hate You—Don't Leave Me (13 page)

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Authors: Jerold J. Kreisman

BOOK: I Hate You—Don't Leave Me
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Ironically, borderlines may be well suited for this kind of combat. The narcissistic man's need to dominate and be idolized fits well with the borderline woman's ambivalent need to be controlled and punished. Borderline women, as we saw with Lisa at the start of this chapter, often marry at a young age to escape the chaos of family life. They cling to dominating husbands with whom they recreate the miasma of home life. Both may enter a kind of “Slap! . . . Thanks, I needed that!” sadomasochistic dyad. Less typical, but still common, is a reversal of these roles, with a borderline male linked with a narcissistic female partner.
Masochism is a prominent characteristic of borderline relationships. Dependency coupled with pain elicits the familiar refrain “Love hurts.” As a child, the borderline experiences pain and confusion in trying to establish a maturing relationship with his mother or primary caregiver. Later in life, other partners—spouse, friends, teacher, employer, minister, doctor—renew this early confusion. Criticism or abuse particularly reinforces the borderline's self-image of worthlessness. Lisa's later relationships with her husband and supervisors, for example, recapitulated the profound feelings of worthlessness that were ingrained by her father's constant criticisms.
Sometimes the borderline's masochistic suffering transforms into sadism. For example, Ann would sometimes encourage her husband Larry to drink, knowing about his drinking problem. Then she would instigate a fight, fully aware of Larry's violent propensities when drunk. Following a beating, Ann would wear her bruises like battle ribbons, reminding Larry of his violence, and insisting they go out in public, where Ann would explain away her marks as “accidents,” such as “running into doors.” After each episode, Larry would feel profoundly regretful and humiliated, while Ann would present herself as a long-suffering martyr. In this way Ann used her beatings to exact punishment from Larry. The identification of the real victim in this relationship becomes increasingly vague.
Even when a relationship is apparently ruptured, the borderline comes crawling back for more punishment, feeling he deserves the denigration. The punishment is comfortably familiar, easier to cope with than the frightening prospect of solitude or a different partner.
A typical scenario for modern social relationships is the “overlapping lover” pattern, commonly called “shingling”—establishing a new romance before severing a current one. The borderline exemplifies this constant need for partnership: As the borderline climbs the jungle gym of relationships, he cannot let go of the lower bar until he has firmly grasped the higher one. Typically, the borderline will not leave his current, abusive spouse until a new “white knight” is at least visible on the horizon.
Periods of relaxed social-sexual mores and less structured romantic relationships (such as in the late 1960s and 1970s) are more difficult for borderlines to handle; increased freedom and lack of structure paradoxically imprison the borderline, who is severely handicapped in devising his own individual system of values. Conversely, the sexual withdrawal period of the late 1980s (due in part to the AIDS epidemic) can be ironically therapeutic for borderline personalities. Social fears enforce strict boundaries that can be crossed only at the risk of great physical harm; impulsivity and promiscuity now have severe penalties in the form of STDs, violent sexual deviants, and so on. This external structure can help protect the borderline from his own self-destructiveness.
Shifting Gender Role Patterns
Earlier in the last century, social roles were fewer, well defined, and much more easily combined. Mother was domestic, working in the home, in charge of the children. Outside interests, such as school involvement, hobbies, and charity work, flowed naturally from these duties. Father's work and community visibility also combined smoothly. And, together, their roles worked synchronously.
The complexities of modern society, however, dictate that the individual develop a plethora of social roles—many of which do not combine so easily. The working mother, for example, has two distinct roles and must struggle to perform both well. The policies of most employers demand that the working mom keep the home and workplace separate; as a result, many mothers feel guilty or embarrassed when problems from one impact the other.
A working father also finds work and home roles compartmentalized. He is no longer the owner of the local grocery who lives above the store. More likely, he works miles from home and has much less time to be with his family. What's more, the modern dad plays an increasingly participatory role with familial responsibility.
Shifting role patterns over the last twenty-five years are central to theories on why BPD is identified more commonly in women. In the past, a woman had essentially one life course—getting married (usually in her late teens or early twenties), having children, staying in the home to raise those children, and repressing any career ambitions. Today, in contrast, a young woman is faced with a bewildering array of role models and expectations—from the single career woman, to the married career woman, to the traditional nurturing mother, to the “supermom,” who strives to combine marriage, career, and children successfully.
Men have also experienced new roles and expectations, of course, but not nearly so wide-ranging—nor conflicting—as women. Today, men are expected to be more sensitive and open and to take a larger part in child raising than in previous eras, yet these qualities and responsibilities usually fit within the overall role of “provider” or “co-provider.” It is the rare man who, for example, abandons career ambitions for the role of “househusband,” nor is this expected of him.
Men have fewer adjustments to make during the evolution of relationships and marriages. For example, relocations are usually dictated by the man's career needs, since he is most often the primary wage earner. Throughout pregnancy, birth, and child rearing, few changes occur in the man's day-to-day reality. The woman not only endures the physical demands of pregnancy and childbirth and must leave her job to give birth, but it is also she who must make the transition back to work or give up her career. And yet in many dual-earner households, although it may not be openly stated, the woman simply assumes the primary responsibility for the maintenance of the home. She is the one who usually adjusts her plans to stay home with a sick child or waits for the repairman to come.
Though women have struggled successfully to achieve increased social and career options, they may have had to pay an exacting price in the process: excruciating life decisions about career, families, and children; strains on their relationships with their children and husband; the stress resulting from making and living with these decisions; and confusion about who they are and who they want to be. From this perspective, it is understandable that women should be more closely associated with BPD, a disorder in which identity and role confusion are such central components.
Sexual Orientation and Borderlines
Sexual orientation may also play a part in the borderline's role confusion. In line with this theory, some researchers estimate a significantly increased rate of sexual perversions among borderlines.
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Environmental factors that may theoretically contribute to the development of sexual identity include lack of role models, sexual assaults, an insatiable need for affection and attention, discomfort with one's own body, and inconsistent sexual information.
Family and Child-Rearing Patterns
Since the end of World War II, our society has experienced striking changes in family and child-rearing patterns:
• The institution of the nuclear family has been in steady decline. Largely due to divorce, half of all American children born in the 1990s will spend some part of their childhood in a single-parent home.
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• Alternative family structures (such as “blended families,” in which a single parent with children combines with another one-parent household to form a new family unit) have led to situations in which many children are raised by persons other than their birth parents. According to one study, only 63 percent of American children grow up with both biological parents—the lowest percentage in the Western world.
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Due to increased geographical mobility, among other factors, the traditional extended family, with grandparents, siblings, cousins, and other family relations living in close proximity, is almost extinct, leaving the nuclear family virtually unsupported.
• The number of women working outside the home has increased dramatically. Forty percent of working women are mothers of children under age eighteen; 71 percent of all single mothers are employed.
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• As a result of women working outside the home, more children than ever before are being placed in various forms of day care—and at a much earlier age. The number of infants in day care increased 45 percent during the 1980s.
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• The evidence clearly suggests that the incidence of child physical and sexual abuse has increased significantly over the past twenty-five years.
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What are the psychological effects of these child-rearing changes—on both children and parents? Though many of these changes (such as blended families,) are too new to be the subject of intensive long-term studies, psychiatrists and developmental experts generally agree that children growing up in settings marked by turmoil, instability, or abuse are at much greater risk for emotional and mental problems in adolescence and adulthood. Moreover, parents in such environments are much more likely to develop stress, guilt, depression, lower self-esteem—all characteristics associated with BPD.
Child Abuse and Neglect: Destroyer of Trust
Child abuse and neglect have become significant health problems. In 2007, about 5.8 million children were involved in an estimated 3.2 million child abuse reports and allegations in the United States.
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Some studies estimate that 25 percent of girls experience some form of sexual abuse (from parents or others) by the time they reach adulthood.
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Characteristics of physically abused preschool-age children include inhibition, depression, attachment difficulties, behavior problems (such as hyperactivity and severe tantrums), poor impulse control, aggressiveness, and peer-relation problems.
“Violence begets violence,” said John Lennon, and this is particularly true in the case of battered children. Because those who are abused often become abusers themselves, this problem can self-perpetuate over many decades and generations. In fact, about 30 percent of abused and neglected children will later abuse their own children, continuing the vicious cycle.
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The incidence of abuse or neglect among borderlines is high enough to be a factor that separates BPD from other personality disorders. Verbal or psychological abuse is the most common form, followed by physical and then sexual abuse. Physical and sexual abuse may be more dramatic in nature, but the emotionally abused child can suffer total loss of self-esteem.
Emotional child abuse can take several forms:
• Degradation—constantly devaluing the child's achievements and magnifying misbehavior. After a while, the child becomes convinced that he really is bad or worthless.
• Unavailability—psychologically absent parents show little interest in the child's development and provide no affection in times of need.
• Domination—use of extreme threats to control the child's behavior. Some child development experts have compared this form of abuse to the techniques used by terrorists to brainwash captives.
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Recall from Lisa's story that she probably suffered all of these forms of emotional abuse: her father hammered her constantly that she was “not good enough”; her mother rarely stood up for Lisa, almost always deferring to her husband in all important decisions; and Lisa perceived the family's numerous relocations as “kidnappings.”
The pattern of the neglected child, as described by psychologist Hugh Missildine, mirrors the dilemmas of borderlines in later life:
If you suffered from neglect in childhood, it may cause you to go from one person to another, hoping that someone will supply whatever is missing. You may not be able to care much about yourself, and think marriage will end this, and then find yourself in the alarming situation of being married but emotionally unattached. . . . Moreover, the person who [has] neglect in his background is always restless and anxious because he cannot obtain emotional satisfaction. . . . These restless, impulsive moves help to create the illusion of living emotionally. . . . Such a person may, for example, be engaged to be married to one person and simultaneously be maintaining sexual relationships with two or three others. Anyone who offers admiration and respect has appeal to them—and because their need for affection is so great, their ability to discriminate is severely impaired.
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From what we understand of the roots of BPD (see chapter 3), abuse, neglect, or prolonged separations early in childhood can greatly disrupt the developing infant's establishment of trust. Self-esteem and autonomy are crippled. The abilities to cope with separation and to form identity do not proceed normally. As they become adults, abused children may recapitulate frustrating relationships with others. Pain and punishment may become associated with closeness—they come to believe that “love hurts.” As the borderline matures, self-mutilation may become the proxy for the abusive parent.
Children of Divorce: The Disappearing Father
Due primarily to divorce, more children than ever before are being raised without the physical and/or emotional presence of their father. Because most courts award children to the mother in custody cases, the large majority of single-parent homes are headed by mothers. Even in cases of joint custody or liberal visitation rights, the father, who is more likely to remarry sooner after divorce and start a new family, often fades from the child's upbringing.

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