Evil Genes
Page 13
Borderline Manipulation—and Very Real Remorse
Some experts in borderline personality disorder object to the word manipulation as applied to their patients. Well-known BPD expert Marsha Linehan, for example, particularly dislikes the word “manipulative” when referring to borderline patients. She feels that “this implies that they are skilled at managing other people when it is precisely the opposite that is true.”11
In fact, psychologists and psychiatrists commonly retrain themselves as well as their patients to view “manipulative” behavior from a different perspective to aid in therapy. As one treatment program states: “Rather than viewing themselves [individuals with borderline personality disorder] as someone who is attempting to manipulate, is attention-seeking, or is sabotaging treatment, the trainees [individuals with borderline personality disorder] learn to view themselves as driven by the disorder to seek relief from a painful illness through desperate behaviors which are reinforced by negative and distorted thinking.”
These are enormously effective therapeutic strategies. However, my purpose is not to aid in therapy but rather to analyze the ultimate effects of borderline-like and related behavior. Consequently, if the behavior and effects described here amount to manipulation, even if the person is not consciously aware of his or her intentions, it is called manipulative. In fact, it is clear that part of the reason that Machiavellian researchers did not recognize the affiliation between borderline personality disorder and Machiavellianism earlier is the use of understandably empathetic terms by borderline specialists that obscured the nature of borderline symptoms.
I would like to emphasize here, however, that although borderline traits can underpin some Machiavellian activities, many deeply dysfunctional, clinically diagnosed borderlines can be cognizant of and deeply remorseful regarding their problematic behavior. It's just that these borderlines often don't have the emotional toolkit they need to stop that behavior. The remorse these borderlines can feel is quite different from the remorselessness of psychopaths. But when borderline and psychopathic traits combine and are lit by the additional fuse of narcissism, as with some of the deeply sinister individuals who are featured players in this book, the resulting conflagration of a personality can be devastating.
For years, the borderline diagnosis was denigrated as a wastebasket diagnosis—“a label to be used when the doctor simply did not understand the patient or could not ‘fit’ the patient's symptoms into any other, more acceptable disorder.”13 However, the many recent breakthroughs that have emerged from neuroimaging and other data have provided strong evidence that borderline personality disorder is indeed real—and devastating to both the disorder's sufferers and the people around them.a.14
Paul Mason and Randi Kreger, authors of the classic book about borderline personality disorder Stop Walking on Eggshells, write: “It's no secret that [nonborderlines] often feel manipulated and lied to by their borderline loved ones. In other words, they feel controlled or taken advantage of through means such as threats, no-win situations, the ‘silent treatment,’ rages, and other methods they view as unfair.”15 Psychiatrist Larry J. Siever describes this behavior differently: “Although [people with borderline personality disorder] can be apparently manipulative, they don't think about the behavior as such. They're trying to meet their needs in the only way they know how…. They are trying to elicit a response to soothe them, to help them feel better.”16
Borderlines have rapid mood swings with a tendency to experience anxiety and depression; they also often show impulsive and self-damaging behaviors and suffer from chronic feelings of boredom and social isolation. Borderlines also have intense and unstable personal relationships, which they devalue and manipulate frequently. Coupled with these symptoms is a propensity to “self-medicate” with drugs or alcohol, or to have difficulties with food; they sometimes become bulimic or anorexic.
Looking back at my sister, I can see that she had problems with all four of these typical borderline symptom complexes, as well as the accompanying addictive and anorexic behavior. Her diaries lay out the symptoms in snippets:
Terribly depressed the past couple of months. Today seemed worse than most…
I believe I ate aubergine et jambon et fromage. Must have become fairly inebriated and crawled to bed—shame.
Am determined to do cleaning of premises in a first rate fashion, as I plan to handle the remainder of my life. Tomorrow is another day—we rather hope. It will be better; but better it won't be unless self-foibles are examined!
Finished cleaning chore, no mean task! It's what I call bumbuster. Vacuuming on the scooch gives one an appreciation of housework!
Unfortunately, Gary fed me info on Jack guaranteed to touch my heartstrings—ain't going there anymore!
$84 check for Jack from Sprint. Will sit on it for a while. Dinked for several hours with dinner prep, but too late to eat.
…a phone call from “Bob” of the American Legion speaking for Jack looking for refund check from Sprint. I'm sure am being set up as ogre and Jack, the poor victim.
…on a more hurtful note, apparently Janine [a former caretaker] is alive and well with her complaints of my dissolute behavior.
I must have said something to Peg yesterday on the phone that really rankled her. She called this morning and lit into me.
…sad letter from Mary—apparently the accident her daughter fomented is causing a ¼ mill suit…I would love to be able to supply her with some legal resources.
December 25th: Stomach revolt…Nougs [the cat] did not care for toys Emma and Sam gave her. She was agitated by the entire Christmas experience.
I hate having to stabilize with alcohol first thing in the morning…
What comes clear from the diaries is not only the range of Carolyn's symptoms, both physical and mental, but the heartbreaking depth of her suffering as she attempted to cope with those symptoms. I can only imagine her scuttling crablike around her apartment as she attempted to clean—her polio-withered leg dragging limply behind. Her many manipulations over the decades had ultimately left her abandoned by her family (my family—me), and her few friends were either at an arm's length or seriously troubled themselves. Carolyn's last Christmas found her completely alone, her cat—not Carolyn—“agitated by the entire Christmas experience.”
The “Dinked for several hours with dinner prep, but too late to eat” comment was not atypical. According to her caretaker, Carolyn had an ironclad personal rule—she ate nothing at all, all day, until after 8:00 PM. Carolyn was five foot five in her stocking feet. A minimum healthy weight for a woman her size is around one hundred and twenty pounds. She weighed eighty-one pounds.b.17 (The forensic autopsy listed “malnourishment.”) And, of course, she was an alcoholic.
Even as she spoke of examining her “self-foibles,” she carried a curious cognitive blindness about herself—the very heart of the borderline experience. She clearly felt for Jack, for example, but was also purposefully manipulating him—keeping his much-needed money, then playing the victim when he became upset about it. Carolyn cared about Mary's problems and would have loved to help her, but at the same time, she didn't bother to explore what she might have said to her friend Peg that would have made her so angry. I am reminded of the words of borderline expert Jerold Kreisman: “The borderline is capable of great sympathy and comforting but often may lack true empathy, the ability to put himself in the other person's shoes, in appreciating how others are impacted by his behavior. Additionally, when they are hurt, their rage at those who have hurt them may be intense and cruel and devoid of concern or understanding for the other party.”18
In sum, Carolyn presented the classic enigma of the borderline—intelligence mixed with a surreal, well-defined pattern of dysfunction.
Was it the polio that had somehow brought about the dysfunction—perhaps through the trauma it brought into her childhood? Early trauma, it seems, can bring about borderline personality disorder. But if it was truly polio alone that was the ca
use of Carolyn's disorder, why didn't many other polio survivors suffer the same psychiatric symptoms as Carolyn?
I continued, month by month, year by year, to check the research literature. But I couldn't see a pattern.
Borderline Coping Behaviors
Fig. 6.1. Carolyn ready for Halloween in this undated photo. She was ever the enigma.
The diverse coping behaviors of borderlines can be devastating for those around them—just as my sister's behavior caused decades of desolation in my parents’ lives. Splitting, for example, is a coping process where the borderline swings between idealizing and devaluing people in relationships. A person is seen to be either all good or all bad, with the borderline unable to reconcile that there can be both good and bad within a person. On a larger scale, splitting behavior is shown when the borderline pits people against one another, making one group the “white hats” and the other the “black hats”—although who is considered as good or bad can shift from day to day, or even hour to hour. Authors Steven Leichter and Elizabeth Dreelin recount the following example of dealing with diabetic patients who also have BPD:
[A] 26-year-old phlebotomist enters the patient's room to obtain the venous blood specimen for [a] test. After one futile attempt at venipuncture (made futile because the patient wrenched her arm away from the technician during the process), the patient demanded that the venipuncturist leave her room and requested that the head nurse for that floor see her. When the head nurse arrived, the patient complained about how inadequate her care was because an inexperienced venipuncturist was sent to draw her blood. The head nurse then called the senior phlebotomist, who came to see the patient.
The patient induced the senior phlebotomist to admit that her younger associate was inexperienced. The patient separately got the head nurse for the floor to admit that it was unprofessional for the senior phlebotomist to comment negatively about her junior associate. In the end, the patient never allowed the blood sample to be obtained. When asked by the attending physician why the blood was not sampled, the patient responded that there seemed to be discord among the staff, and they failed to remember to draw her blood.19
Leichter and Dreelin add that it doesn't matter what specific issue actually caused the borderline patient to act that way. From the perspective of the borderline, what is important is that a problem is identified around which the borderline can set various health professionals in opposition to each other.
Splitting has been related to the poorly regulated emotions so often seen in borderlines. One theory holds that the phenomenon may be tied to how we store memories; memories made when we are in one mood are easier to bring back to mind when we are in the same mood. Mood instability would lead to fragmented memories of other people (and of the borderline herself), that would lead to the changing perceptions involved in splitting.20 Splitting may also involve overactivation of emotional processing (ventromedial prefrontal cortex) as opposed to rational processing (dorsolateral prefrontal cortex).
Borderlines also often have significant problems with their personal identity. One common manifestation of this symptom is a chameleon-like personality shift. A sufferer of this symptom writes: “I have a chameleon-like ability to take on the coloring of the individual I am with. But the act is done more to fool me than to fool them. When I ‘become’ a persona it's not worn over the real me as a cloak. For the time being, I have become who I'd like to be…I am not some kind of a Machiavellian manipulator with nothing better to do than ruin lives. The process isn't even really conscious” (italics added).21 Note how the writer feels obligated to point out that she is not a Machiavellian manipulator whose intent is to ruin lives—the implication, of course, is that most people perceive her to be doing so. (And that may prove her all the more Machiavellian in her desire to dispel that perception.)
Another borderline trait, projection, happens when a characteristic possessed by the borderline is projected by the borderline onto someone or something else because the characteristic is just too painful for the borderline to accept. For example, Carolyn's cat, not Carolyn, was “agitated by the entire Christmas experience.” Those who deal with a significant other with borderline personality disorder often know instinctively not to try to tag their partner with the label of “borderline.” A true borderline's knee-jerk response would be: I don't have borderline personality disorder. YOU have borderline personality disorder. A common related defense mechanism is blame shifting: whatever has happened, no matter how culpable the borderline, it is always someone else's fault.
It's thought that borderlines may “attempt to establish control of their own emotional states by manipulating or controlling the behavior of others.”22 Typical borderline control strategies involve “putting others in no-win situations, creating chaos that no one else can figure out, or accusing others of trying to control them.”23 Another common borderline trait is “an amazing ability to read people and uncover their triggers and vulnerabilities. One clinician jokingly called people with BPD psychic…[Borderlines use their] social antennae to uncover triggers and vulnerabilities in others that they can use to their advantage in various situations.”24
One of the most difficult aspects of the borderline condition is that people with the disorder can be competent and in control in some situations, yet out of control in others. As Mason and Kreger put it: “[M]any [borderlines] perform very well at work and are high achievers. Many are very intelligent, creative, and artistic. This can be very confusing for family members who don't understand why the person can act so assuredly in one situation and fall apart in another. This ability to have competence in difficult situations while being incompetent in seemingly equal or easier tasks is known as situational competence.”25 What can make things all the more difficult is that others may not be exposed to the borderline's out-of-control or chameleon-like behavior, so that the nonborderlines would not be believed if they tried to explain how differently the borderline can act when out of the public eye.
Borderlines can often be very self-involved and will try, sometimes using outrageous methods, to bring or maintain the focus of attention on themselves. These traits are also characteristic of narcissistic personality disorder—a common borderline personality co-disorder. Many borderlines see their relationships with others as being only about themselves. They may feel threatened if their partner or children have other friendships and may act to sabotage these relationships.
“Gaslighting” involves the denial by a borderline (or other person with a conscious or unconscious desire for manipulation and control) that certain events occurred or certain things were said.c. The borderline may deny another's perceptions, memory, or very sanity. Here is an example of gaslighting with a college roommate:
I asked my roommate a question, she guessed at the answer but didn't know for sure if she was correct. So I emailed my mother the question and she verified my friend was right. So I showed her the email from my mother, the whole point being “Look, you were right!” Well somehow this triggered a 15 minute long screaming, yelling, belittling, venomous verbal tirade that ended with her screaming “And then you show me this letter from your mother to tell me I'm wrong!” THE EXACT OPPOSITE OF WHAT I SAID! I started yelling at her to look at the email to see that I was, as I said, showing her she was right and she refused to look at the paper, actually turned her head away so she wouldn't see the printed words. For whatever reason, she NEEDED to feel I was trying to tell her she was wrong and therefore stupid.26
As Mason and Kreger point out, nonborderlines base their feelings on facts, while borderlines change the facts to fit their feelings. Gaslighting denial can also occur because a borderline has been dissociating—the borderline does indeed remember the scene differently—and not accurately. Sometimes, however, it is very difficult not to conclude that the borderline is intentionally lying. As psychiatrist Theodore Dorpat writes in Gaslighting, the Double Whammy, Interrogation, and Other Methods of Covert Control in Psychotherapy and Analysis, “Gaslightin
g is probably the most commonly used and effective type of verbal communication individuals have for manipulating and controlling other persons.”27 One book on how to use gaslighting techniques on one's enemies suggests a succinct synonym: “mind-fucking.”28
The Impact of Borderline Personality Disorder on Others
Randi Kreger's passion for understanding and communicating information about borderline personality disorder came after seeing a therapist about her own failed relationship. Her intelligent and educated former boyfriend would often tell her she was talented and wonderful. At other times, however, he would careen into a different personality and scream that she was contemptible and the cause of all his problems. His insidious manipulations had left Kreger feeling as if she was “walking on eggshells”; the end of the relationship had left her with low self-esteem and a marked feeling of distrust. In-depth discussions with her therapist revealed that Kreger's former boyfriend had, in all probability, suffered from borderline personality disorder. This shocked Kreger into learning more about the disorder and, eventually, cowriting what has become a near-gospel self-help handbook for those loving, living, or working with those showing traits of borderline personality disorder.
Theta Rhythms
The effects of gaslighting on normal individuals can be extraordinarily unsettling and can contribute to confused behavior and scattered thinking patterns in those who have been subjected to the phenomenon. How might this confusion occur?