Borderlines Working with Borderlines

By Sonia Neale
Stormy Oceans

Stormy Oceans

If non-Borderline mental health workers are triggered by working with people with BPD then how do peer support workers with a diagnosis of BPD cope with working with Borderlines?

Triggers, both conscious and unconscious can catapult people in to the past where old issues surface and can affect how workers interact with their clients.

One of the symptoms of BPD is becoming emotionally overwrought with an inability to decrease that arousal and staying at that high level for several days. Obsessions, ruminations, delusions and even micro-psychosis around the event, always relationship driven, don’t diminish easily. When working as a peer, trigger upon trigger can occur where personal stuff gets activated, and it is not unusual for peer workers to have to leave the job they love because it can affect their own mental health.

Having worked with a therapist myself for many years, I am getting a sense of what it feels like to work with someone with low insight and sense of responsibility. It sucks, I feel devalued and the work we did together dismissed as irrelevant. Everything I have ever read about BPD countertransference and how workers feel came true.

The other part of me, understands the illness better than most, the lack of social skills, inability to find words to convey feelings, feelings of perpetual victimhood and had the utmost empathy for their inability to navigate through the dark, murky waters of BPD.

I have to differentiate my professional and my personal feelings and days after the event I am still slightly stinging from this. I went above and beyond the scope of my job description for this person. This is not unusual when working with people with BPD. They can easily evoke the “rescue gene” in me as I elicited the “rescue gene” in my therapist.

I know I did my best for this person. I know my heart was concerned only with recovery. All I can do is let go and move on and wish them all the best. Hopefully one day she will see that, like my therapist, I am not perfect, I just did my best.



The Many Faces of Being Borderline

By Sonia Neale
Interpret this!

Interpret this!

 

Misreading neutral facial expressions as hostile is reported to be what distinguishes BPD from other mental illness disorders according to this article from US News Health

Rolling the eyes, the extended blink, the nose wrinkle, the eyebrow rise, the lip twitch; all these can be erroneously interpreted as provocative, insulting and combative and cause huge ruptures in relationships. However, sometimes these interpretations are spot on. We can display our deepest prejudices in our facial expressions and not even know it.

The eyebrow rise can display surprise, the nose wrinkle can portray disgust and the extended blink, an indication that the person is either bored to death or that you have tapped into some shameful secret or synchronous event or both. I’ve been eerily accurate on several occasions with my therapist through the extended blink and the nose wrinkle; all confirmed by subsequent personal interrogation, just short of thumb screws, to extract a confession. But the hotter my mood, the less accurate I am. Depending on my internal state, misinterpretation is also possible.

People with BPD are highly tuned into their environment. Hypervigilance is another hallmark of BPD. This is a learned survival skill, where accurately interpreting the finer nuances of another’s intentions can save one’s life. Getting it right albeit half the time means you can go on to live another day. It means you will survive long enough to pass your genes onto the next generation. This makes perfectly logical evolutionary sense.

Checking faces and reacting to expressions is highly advantageous when your main care-giver or your so-called friends at school convey mixed messages, verbally annihilating on one hand and smiling sweetly while doing it. Or punching you in the face all the while grinning and telling you this is for your own good. It is hardly surprising when you become unconsciously and bodily tuned into your environment as a self-protection measure and have a meltdown when someone looks sideways at you.

Context is important. Press the pause button and check out what else is happening in the room.
What is the general mood of the conversation?
Are these people “safe?”
What else do I sense is happening between us?
Did they just look up, but because I was feeling enraged did I interpret it with hostile intent?

Relationship history is also very important.
What is your past relationship with this person?
Is their expression about you or them?
Have you triggered a personal memory for them?
I had an aggressive boss who gave me the lip curl once. Later on she told me she had been trying to get rid of me for six months.

Upskilling old behaviour patterns and mindfulness can settle nerves and give comfort that not everyone who blinks or grimaces is the enemy to be beaten and annihilated at all costs.

Photo:  Benson by Sonia Neale



Damning Diagnosis or Blueprint for Healing

By Sonia Neale

Fox Glacier, New Zealand

In 2005 I was given two diagnoses. One was for cancer and one was for Borderline Personality Disorder. Both diagnoses were delivered with a complete lack of caring and empathy, but the cancer diagnosis was not imparted with disgust and revulsion, either real or perceived. After the cancer diagnosis, I cried, came to terms with, made friends with and learned to live with it until surgery removed the tumour.

I was given support, love, kindness, empathy, flowers, fridge magnets that said “Don’t worry, be happy” and family and friends wanted to take me out on picnics. I found the BPD diagnosis far more difficult to take in; in fact it gave me chronic indigestion for many years. I was ashamed and embarrassed, told no-one and called it “depression and anxiety.” Going through the grief process, I cried, denied, got angry, bargained, got depressed and then accepted it and with that acceptance I grieved no more and started a new life. I then embraced it with loving/kindness.

Within that acceptance came peace and gratitude. Then came knowledge, education, advocacy and activism. I started to tell people, came out on my previous blog Therapy Unplugged and was surprised when people didn’t take out a restraining order on me. Then, turning it upside down, I made it my life’s mission to educate and inform the world that with the right treatment, the right support, people with BPD can recover and live a well life. I now work in mental health supporting people and educating organisations on what BPD is and what it isn’t.

BPD is no longer seen by some as a life sentence, an incurable, untreatable condition, just like cancer was a few decades ago. I still get upset, I still get angry, I still react with emotion to life, I still act on impulse occasionally and I still feel abandonment and rejection when people don’t reply immediately to my emails, but I no longer act on these feelings. I process them, decide how important they are and let them flow in and out of my mind, let go and move on.

The DSM is not perfect and I used it as a descriptive guideline, it does not define who I am, it describes my behaviours only. I am much more than the sum total of my diagnosis.

However, not everyone feels the way I do.

South Island, New Zealand

 

Photos by Sonia Neale:  South Island, New Zealand 2013



Welcome to Being Borderline

By John M. Grohol, Psy.D.

Borderline personality disorder (BPD) is probably one of the most misunderstood and most stigmatized of mental disorders. Even mental health professionals sometimes have a hard time hiding their disdain for people who have this disorder. Discrimination against people with BPD is rampant.

That’s why I’m pleased to introduce, Being Borderline with Sonia Neale, a long-time Psych Central blogger who approached me about starting this blog.

As Sonia says in her introduction to the blog,

If there is stigma within the general community about mental illness, then there is a special type of stigma within mental health services for people with Borderline Personality Disorder (BPD). Often there is a misconception that all people who suffer from BPD are low functioning. In fact, there are some high functioning people in the professional services whom you would not suspect have a BPD diagnosis.

Outward appearances can be very deceiving because with enough stress and pressure their internal thought processes and sense of self and the world can fragment and disintegrate without any external actions or behavior. [...]

No two BPD presentations look alike yet we mostly hear described the ‘acting out’ type of BPD presentations. BPD can be perceived as an untreatable, incurable and unrecoverable disorder.

I’m here to tell you that it is not.

Please continue reading her introduction and learn more about Sonia now… and please give her a warm welcome to her new blog!



 
 

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Recent Comments
  • BluCrystal: I found this post to be incredibly informative, as I was told by a psychiatrist that I have it and never...
  • Henderson: Thank you, Sonia, for your insightful blog. I saw this trait at work recently when my ex girlfriend, under...
  • Misscontent: Interesting observations of being a BPD peer support worker. I have recently been encouraged by my...
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