I Hate You—Don't Leave Me (17 page)

Rich lacked insight into his dilemma, insisting that it was always “the bitch's fault.” He dismissed his friends as not caring or not understanding—they were not able to convey
Support
or
Empathy
. The women he became involved with were initially sympathetic, but lacked the
Truth
component. Rich needed to be confronted with all three aspects.

In this situation, the
S
message would convey caring about Rich. The
E
part would accept without challenge Rich's feeling of “loving too much” but would also help him understand his sense of emptiness and his need to fill it.

The
Truth
message would attempt to point out the patterns in Rich's life that seem to repeat endlessly.
Truth
should also help Rich see that he uses women as he does drugs and self-mutilation—as objects or maneuvers to relieve numbness and feel whole. As long as Rich continues to search outside himself for inner contentment, he will remain frustrated and disappointed, because he cannot control outside forces and especially others, as he can control himself. For instance, despite his most frenzied efforts to regulate her, a new girlfriend will retain some independence outside the realm of Rich's control. Or, he could lose a new job due to economic factors that may eliminate the position. But Rich
can
control his own creative powers, intellectual curiosity, and so on. Independent personal interests—books, hobbies, arts, sports, exercise—can serve as reliable and enduring sources of satisfaction, which cannot easily be taken away.

Adjusting to a world that is continually inconsistent and untrustworthy is a major problem for the borderline. The borderline's universe lacks pattern and predictability. Friends, jobs, and skills can never be relied upon. The borderline must keep testing and retesting all of these aspects of his life; he is in constant fear that a trusted person or situation will change into the total opposite—absolute betrayal. A hero becomes a devil; the perfect job becomes the bane of his existence. The borderline cannot conceive that individual or situational object constancy can endure. He has no laurels on which to rest. Every day he must begin anew trying desperately to prove to himself that the world can be trusted. Just because the sun has risen in the East for thousands of years does not mean it will happen today. He must see it for himself each and every day.

CASE 5: PAT AND JAKE.
Pat was an attractive twenty-nine-year-old woman in the process of divorcing her second husband. As with her first husband, she accused him of being an alcoholic and of abusing her. Her lawyer, Jake, saw her as an unfortunate victim in need of protection. He called her frequently to be sure she was all right. They began to have lunch together. As the case proceeded, they became lovers. Jake moved out of his house and away from his wife and two sons. Though not yet divorced, Pat moved in with him.

At first, Pat admired Jake's intelligence and expertise. Where she felt weak and defenseless, he seemed “big and strong.” But over time she became increasingly demanding. As long as Jake was protective, Pat cooed. But when he began to make demands, she became hostile. She resented his going to work and particularly his involvement in other divorce cases. She resisted his visits to his children and accused him of choosing them over her. She would initiate brutal arguments that often culminated in her rushing out of the house to spend the night with a male “platonic friend.”

Pat lacked object constancy (see chapter 2 and Appendix B). Friendships and love relationships had to be constantly tested because she never felt secure with any human contact. Her need for reassurance was insatiable. She had been through countless other relationships in which she first appeared ingenuous and in need of caretaking and then tested them with outrageous demands. The relationships all ended with precisely the abandonment she feared, then she would repeat the process in her next romance.

At first, when Pat perceived Jake as supportive and reassuring, she idealized their relationship. But when he exhibited signs of functioning separately, she became enraged, cursing and denigrating him. When he was at the office, she would call him incessantly because, as she said, she was “forgetting him.” To her friends, Jake sounded like two completely different people—for Pat, he was.

SET confrontations of object inconstancy require recognition of this borderline dilemma.
Support
statements must convey that caring is constant, unconditional. Unfortunately, the borderline has difficulty grasping that she does not need to earn acceptance continuously. She is in constant fear that
Support
could be withdrawn if at any point she displeases. Thus, attempts at reassurance are never-ending and never enough.

The
Empathy
message should confirm an understanding that Pat has not yet learned to trust Jake's continual attempts at comfort. Jake has to communicate his awareness of the horrific anxieties Pat is experiencing and how frightening it is for her to be alone.

Truth
declarations must include attempts to reconcile the split parts. Jake has to explain that he cares for Pat all the time, even when he is frustrated by her. He must also declare his intention not to allow himself to be abused. Capitulation to Pat's demands will only result in more demands. Trying to please and satisfy Pat is an impossible task, for it is never finished—new insecurities will always arise.
Truth
will probably mandate ongoing therapy for both of them, if their relationship is to continue.

Borderline rage is often terrifying in its unpredictability and intensity. It may be sparked by relatively insignificant events and explode without warning. It may be directed at previously valued people. The threat of violence frequently accompanies this anger. All of these features make borderline rage much different from typical anger.

In an instant, Pat could transform from a docile, dependent, childlike woman into a demanding, screaming harpy. On one occasion she suggested that she and Jake have a quiet lunch together. But when Jake told her he had to go to the office, she suddenly began screaming at him, inches from his face, accusing him of ignoring her needs. She viciously attacked his manhood, his failures as a husband and father, and his profession. She threatened to report him to the bar association for misconduct. When Jake's attempts to placate her failed, he would silently leave the scene, which infuriated Pat even more. But when he returned, both would act as if nothing had ever happened.

SET-UP principles must first of all address safety issues. Volatility must be contained. In the scenario above, Jake's
Support
and
Empathy
messages should come first, though Pat will probably reject them as insincere. In such cases it is imprudent for Jake to continue to argue that he cares and understands that she is upset. He must move immediately to
Truth
statements, which must first mandate that neither of them will physically harm the other. He must firmly tell her to back off, to allow some physical distance. He can inform her of his wish to communicate calmly with her. If she will not allow this, he can state his intention of leaving until the situation quiets down, at which point they can resume discussions. He must try to avoid physical conflict, despite Pat's provocations. Although unconsciously Pat may actually want Jake to physically overpower her, this need is based on unhealthy experiences from her past, and will likely later be used to criticize him more.

Truth
statements made during angry confrontations are often better directed toward the underlying dynamics than toward the specifics of the clash. Further debate about whether taking Pat to lunch is more important than going to the office will probably be unproductive. However, Jake might address Pat's apparent need to fight and her possible wish to be overpowered and hurt. He might also confront Pat's behavior as a need to be rejected. Is she so fearful of anticipating rejection that she is precipitating it in order to “hurry up and get it over with”? The primary
Truth
message is that this behavior is driving Jake away. He may ask if this is really what Pat wants.

All
Truth
statements must, indeed, be true. For the borderline, already living in a world of inconsistencies, it is much worse to make idle threats about the unenforced consequences of an action than to passively allow inappropriate behaviors to continue. In
Fatal Attraction
, for example, Alex Forrest, the main female character in the popular 1987 film (played by Glenn Close), exhibited several “textbook” borderline traits in the extreme. Entering into an affair with Dan Gallagher (Michael Douglas), a well-ensconced married man, she refuses to let go, even after it is obvious Dan will never leave his wife. By the end of the movie Dan, his family, and Alex are destroyed or close to it. Alex was used to resisting rejection by manipulating others. For Dan to say he was going to end the relationship without unequivocally doing so was destructive. Of course, he didn't know that following the termination of an intense relationship, the borderline is unable to “just be friends”—an “in-between” relationship that the borderline finds intolerable.

Because the borderline has such difficulty with equivocation, intentions must be backed up with clear, predictable actions. A parent who threatens his adolescent with revocation of privileges for certain behaviors and then does not carry out his promises exacerbates the problem. A therapist who purports to set limits for therapy—establishing fees, limiting phone calls, etc.—but then does not follow through invites increased borderline testing.

Borderlines are often reared in situations in which threats and dramatic actions are the only ways to achieve what is sought. Just as the borderline perceives acceptance as conditional, so rejection can also be seen this way. The borderline feels that if only he is attractive enough, or smart enough, or rich enough, or demanding enough, he will ultimately get what he wants. The more outrageous behavior is rewarded, the more the borderline will employ such maneuvers.

Although the SET-UP principles were developed for working with borderline patients, they can be useful for dealing with others. When communication is stalled, SET-UP can help focus on messages that are not being successfully transmitted. If an individual feels that he is not supported or respected, or that he is misunderstood, or if he refuses to address realistic problems, specific SET steps can be taken to reinforce these flagging areas. In today's complex world, a clear set of communication principles that includes both love and reason are necessary to overcome the tribulations of borderline chaos. Productive communication requires
Understanding
and
Perseverence
. Understanding the underlying dynamics of the communication and the needs of the partner reinforce SET principles. Perseverance is necessary to effect change. For many borderlines, having a consistent, unflappable figure in their lives (neighbor, friend, therapist) may be one of the most important requirements for healing. Such a figure may contribute little except for his consistency and acceptance (in the face of frequent provocations), yet furnish the borderline with a model of constancy in the borderline's otherwise chaotic world.

Coping with the Borderline

But he's a human being, and a terrible thing is happening to him. So attention must be paid. He is not to be allowed to fall into his grave like an old dog. Attention must be finally paid to such a person.

—From
Death of a Salesman
, by Arthur Miller

 

 

 

No one knew quite what to do with Ray. He had been in and out of hospitals and had seen many doctors over the years, but he could never remain long in treatment. Nor could he stay with a job. His wife, Denise, worked in a dentist's office and spent most of her leisure time with her friends, generally ignoring Ray's complaints of chest pains, headaches, backaches, and depression.

Ray was the only child of wealthy, protective parents. When he was nine, his father's brother committed suicide. Although he never knew his uncle very well, he understood that his parents were greatly affected by the suicide. After this event, his parents became even more protective and would insist he stay home from school whenever he felt ill. At the age of twelve, Ray announced he was depressed and began seeing what evolved into a parade of therapists.

An indifferent student, he went on to college where he met Denise. She was the only woman who had ever shown any interest in him, and after a short courtship they were married. Both quit college and dutifully went to work, but relied on Ray's parents to subsidize their household and Ray's continuing therapy.

The couple moved frequently; whenever Denise got bored with a job or a location, they would move to a different part of the country. She would quickly acquire a new job and new friends, but Ray had great difficulty and would remain out of work for many months.

As they both began drinking more, their fighting intensified. When they bickered, Ray would sometimes leave and return to live with his parents, where he would stay until the family began to quarrel, then he would come home to Denise.

Frequently Ray's wife and parents would tell him how fed up they were with his moodiness and multiple medical complaints, but then he'd threaten to kill himself and his parents would become panic-stricken. They insisted he see new doctors and flew him around the country to consult with various experts. They arranged hospitalizations in several prestigious institutions, but after a short time Ray always signed himself out against medical advice, and his parents would send him plane fare home. They continuously vowed to withhold further financial support but never stuck to their word.