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Higher Functioning Borderline Personality Disorder

The higher level functioning borderline personality disorder patient received love or warmth when meeting their mother’s needs, so they often have more capacity to function then the lower level borderlines, who received more aggression from their parents. They can function well, appear to be coping, unlike lower level borderlines who struggle to take care of themselves, with more destructive behaviour. According to James Masterson, they are more invested in obtaining love from their relationships, not focusing on themselves. So they’re pre-occupied with satisfying their partner, often at the expense of themselves. What they did was adapt their behaviour to get the love and approval from their mother and avoid abandonment or punishment when they activated their self. So life was not about supporting their self growing. So they follow others  to guide them  or take care of them, because their self is underdeveloped, by not being supported to grow. Often they come into therapy feeling they have missed out on achieving developmental milestones, not being where they want to be in life. They miss out on so much because their focus has been their relationship, not bettering their own lives and becoming responsible for that. The patient with a borderline personality disorder often trust others to take over their life for them, since they feel others know better. They do not trust their self, and this is where they get into trouble. Sometimes they invest so much into love, that they give up their life for their relationship, even taking care of partners, being co-dependent. The sacrifice for  giving up their self, is to get something back, love or approval. But aggression and anger gets acted out when the hopeful fantasy disappoints them, as they put so much effort in to getting loved or feel wanted, but feel mistreated and put up with too much, including affairs. They struggle with knowing boundaries.   Other times they can elicit care giving in others, so they get rescued and regress further. The love they seek actually destroys their chances of getting better and fully developing. So, they often feel behind, compared to where others are at in life.

Counselling  For Borderline Personality Disorder in Perth

Their teachers will say, “she has potential but gives up easily”, “she is bright but needs to be pushed”, “he lacks the motivation but can do it if he puts effort in”.  These patients will say “others see me better then I see myself”. For some they have such a distorted image of themselves,  developing an eating disorder, as an attempt to rid them of the feelings of badness or ugliness. They suffer from a distorted sense of self or negative ‘self representation’, as Masterson calls it. They have an illusion of badness and hate themselves, deep down. They feel bad, ugly, worthless, incompetent or odd when they activate their real self, so they move away from this into pleasing behaviors that make them feel good or loved, but are costly to them. So doing things to enhance themselves makes them feel bad about themselves, especially if they are going against what others want. Standing up for themselves elicits fear of being an outcaste or rejected. They feel they are causing trouble, when they are not. They expect others to not like them when they be themselves. They have fears that focusing on what they need will result in abandonment, so they avoid conflict or saying what they really think. They also have the distorted perception that they are hurting their partner if they do not do what he wants. They feel happy when pleasing others, otherwise they feel worthless, bad or selfish for focusing on themselves. A Masterson therapeutic approach challenges this negative distorted self belief, which keeps them trapped and regressed, so they can free themselves from their old patterns into moving forward with their own lives. These patterns are so entrenched, it takes a lot of therapy to confront these defences, because they will resist change, wanting to regress since it makes them feel better, even though being this way is destroying their life. So they find a way to not deal with these issues. Masterson therapy has a strict frame so they do not act out around this, so they can develop a stronger conviction in whom they are and have belief in themselves.

Borderline self destruciion

Counselling for Borderline Personality Disorder in Perth

Relationship With Borderline Disorders

In relationships they are so scared of rejection, they give up themselves, by pleasing their partner and going along with them, they often agree to do things which work against them, until they have enough and act out their anger. They can also be seen as having relationship dependency issues. Since they let others take over their lives, they blame them when life does not work out for them, not taking ownership or responsibility for themselves. They can feel anger when they feel mistreated or the victims, feeling bitter or resentful. They often lose everything  or gave everything up for love and have to start over after a breakup, having to rebuild their life.  They often encounter abuse from being in a relationship with a narcissistic  person. There can be a lot of damage after a breakup since their relationship was their primary focus, not themselves. They struggle to express their real self or know what they really need or want. So they hide their true feelings to not upset their partner. Often romance can trap them from focusing on their own lives. Putting faith in others to control their lives can cost them in the long run, especially with Narcissists who lure them in to rescue them. These clients do what feels good, not what they really need. When dating they are so preoccupied with wanting to know if a guy will return their call, they get so anxious that they often drive relationships away. After a break up many feel worthless, anxious, lonely, abandoned, slip into depression, some feel suicidal or self harm or unable to cope with being alone. James Masterson calls this the ‘Abandonment Depression’. These are the feelings they avoid by pleasing others, to keep partners there so they do not leave. But these pleasing, clinging or loving behaviours can be destructive to them. They do not feel good enough just for being them self. In fact being themselves stirs up abandonment feelings, so they give this up.

In work, they feel pressure or struggle with responsibility and dealing with conflict. For higher functioning borderlines, managing roles can be stressful because it demands them to deal with conflict or delegating roles which requires them to be assertive by asking people to do things, they fear upsetting people or not being liked, so they avoid their actual responsibilities’ and get stressed when they are not fulfilling their job. They feel rewarded for making people happy, so they let things slip or get out of control, often there is a mess to clean up. They find it hard to pull people up, so they suffer the consequences.   Others stay loyal to a boss or company, not wanting to leave them to go for what they really want, as they don’t believe they can get better. So they avoid promoting their own life or career, so they accommodate their boss by being loyal at the expense of their own self enhancement. Therapy challenges these defensive regressive road blocks and assists them to push through with challenges or go for what they really deserve in life, instead of accommodating others.

Borderline helplessness

Help me, I cannot help myelf

These patients are often bright but their self was not supported to grow or develop, so they lack the belief in themselves to trust themselves, so they don’t have the internal backbone to carry themselves through life. Often relying on others to carry them through or pick them up, otherwise they resort to destructive coping mechanisms. They lack a strong conviction in their self, so they struggle to initiate themselves, express themselves or put themselves out there. They go along with others, scared to voice their own opinions or not trust their own thoughts. They often listen to others and not themselves, taking on others advice or opinions about what they should do, letting others run their life for them. They put more trust others then they do themselves, often allowing partners to take advantage of them or abuse them, without realising it. They don’t have enough libidinal investment inside to trust themselves with making decisions or fear putting themselves out there and making the wrong decisions. The problem is they put more faith in others to take control of their lives, which can be dangerous to a vulnerable person who relies on others for direction. Psychotherapy for the borderline gives them the libidinal push to further progress the self.

Higher functioning borderlines live more in the loving or rewarding unit, whereas lower functioning borderlines live more in the aggressive unit, where they end up having conflict and do not have the communication skills to de-esculate from conflict. Both these units are distortions and the only way they can function properly is in the reality unit, which is the heart of the real self. Counselling assists so that  they can live within the realms of reality, by taking responsibility for themselves, becoming independent, living with healthy boundaries and limits.

Nancy Carbone

Counsellor and Psychotherapist for Borderline Disorder of the Self