Aug 18

“I Hate You…”: And Other Books for Understanding BPD

Starting with the classic I Hate You–Don’t Leave Me, the following are three of the most widely read and recommended books for those wishing to have a better understanding of Borderline Personality Disorder (BPD).

I.  I Hate You–Don’t Leave Me: Understanding the Borderline Personality by Jerold J. Kreisman, MD, and Hal Straus (updated in 2010)  

Around a long time, this book’s most recent update, according to the publisher, “…now reflects the most up- to-date research that has opened doors to the neurobiological, genetic, and developmental roots of the disorder as well as connections between BPD and substance abuse, sexual abuse, Post-Traumatic Stress Syndrome, ADHD, and eating disorders.”

II. Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder by Paul T. Mason, MS, and Randi Kreger (updated in 2020)

From the blurb:

Stop Walking on Eggshells has already helped more than a million people with friends and family members suffering from BPD understand this difficult disorder, set boundaries, and help their loved ones stop relying on dangerous BPD behaviors. This fully revised third edition has been updated with the very latest BPD research on comorbidity, extensive new information about narcissistic personality disorder (NPD), the effectiveness of schema therapy, and coping and communication skills you can use to stabilize your relationship with the BPD or NPD sufferer in your life.

Beverly Engel, LMFT, author of The Emotionally Abused Woman and The Emotionally Abusive Relationship: “…It identifies two types of BPD—conventional and unconventional. While conventional BPDs typically exhibit overt behavior such as self-harm and suicidal ideation, unconventional BPDs don’t believe they have any problems. They project their pain onto others and refuse to take responsibility for their harmful actions. As an expert in emotional abuse, I have identified this behavior as emotionally abusive.”

III. The Borderline Personality Disorder Workbook: An Integrative Program to Understand and Manage Your BPD by Daniel J. Fox (2019)

Psychologist Daniel Fox has created a workbook that’s received great reviews from readers.

And, from I Hate You‘s author Jerold Kreisman:

Daniel Fox won’t let you off easy. The Borderline Personality Disorder Workbook is truly a book that expects you to WORK! If you think you might have some symptoms of borderline personality disorder (BPD), and are willing to address these problems, and, most of all, are truly committed to working hard at fixing them, this is the book you need.

May 08

“Welcome to Me”: A Different Kind of Therapy for Borderline Personality

Kristen Wiig stars in the new indie dramedy Welcome to Me, written by Eliot Laurence and directed by Shira Piven. IMDB describes it as “(a) year in the life of Alice Klieg, a woman with Borderline Personality Disorder who wins Mega-millions, quits her meds and buys her own talk show.”

MORE ABOUT THE PLOT OF WELCOME TO ME

John DeFore, Hollywood Reporter:

Wiig’s Alice Klieg was diagnosed as a youth as a manic-depressive. While the diagnosis changed over the decades (her shrink, played by Tim Robbins, currently calls it Borderline Personality Disorder), Alice didn’t: Shelves of VHS tapes and a collection of ceramic swans attest to a lifelong fixation on a shallow sort of self-examination, the kind of hear-my-voice empowerment daytime TV was built on. When she wins an $86 million lottery, she seems less excited about the money than about the chance to read ‘a prepared statement’ about the story of her life to news cameras.

THE TRAILER

WHO IS ALICE?

Betsy SharkeyLos Angeles Times: “Her particular brand of disorder means she is, as the saying goes, honest to a fault. Sometimes, that means reminding a good friend of her teenage bikini phobia on national TV, at others, it’s more graphic — like when a sexual urge hits her. Fortunately, this doesn’t happen a lot. More common is her raw emotional vulnerability.”

Christopher Gray, Slant:  “Beneath her acts of character assassination, Piven and Wiig suggest a searching in Alice that makes her both palatable and sympathetic. (The film only seems to look down on her when using her penchant to mispronounce words as a crutch for additional, unnecessary laughs.)…Wiig affords Alice with an occasionally startling range of false confidence and emotional vulnerability…”

Justin Chang, Variety: “There’s no doubt that Alice is effectively enacting a very public, very expensive form of self-therapy, but what makes Piven’s sophomore directing effort…such an offbeat delight for much of its running time is the way it privileges comedy over catharsis…Alice isn’t a puzzle that needs solving — she’s more fun unsolved, frankly — and the filmmakers seem well aware that of all the things this woman may need, our sympathy isn’t one of them.”

HOW MENTAL ILLNESS IS PORTRAYED IN WELCOME TO ME

Justin Chang, Variety: On her TV show, Alice, among other kinds of kooky segments, “proves astoundingly articulate on the subject of her illness and her treatment; and watches in critical dismay while younger actresses re-enact formative/traumatic episodes from her life.”

Christopher Gray, Slant: “The film rejects a fawning (or even particularly detailed) account of mental illness in favor of a plunge into the deep end of Alice’s bottomless ego.”

John DeFore, Hollywood Reporter: “The film is in no rush to ask whether Alice’s tsunami of ego is eccentricity we can enjoy or a serious illness that merits our concern. Dr. Moffet regularly urges her to get back on her medication, but casting Robbins in the part is like a signal that we shouldn’t take his lefty nanny-state advice too seriously.”

OTHER CHARACTERS

Susan Wloszczyna, rogerebert.com:

While some fine performers like Jennifer Jason Leigh get lost in the shuffle, others manage to stand out: Tim Robbins as Alice’s long-suffering if naggy pill-pushing shrink; Linda Cardellini as her one and only friend; Wes Bentley as the on-air infomercial spokesman whose company produces Alice’s show and who becomes her lover; and James Marsden as his opportunistic brother who serves as the film’s Faye Dunaway counterpart as he encourages Alice’s crackpot decisions no matter the consequences.

Leave it to Joan Cusack—has she ever been less than terrific?—to be the one person to be able to divert our attention from Wiig as the show’s disgusted director who nevertheless occasionally engages in a lively on-air back and forth with Alice as a kind of unseen God-like persona from beyond.

Oct 31

“Gone Girl”: Major Spoilers (For Those Who’ve Already Seen It)

***The following post is intended for those who had some questions after seeing the movie Gone Girl. In other words, read ahead only if you’re interested in major spoilers.***

If you saw Gone Girl in time for Halloween, good timing! And you’ll know what Linda Holmes of NPR means when she says: “…(T)he second half…is, in many ways, a horror movie about the great difficulty — and eventually the impossibility — of defeating her. She is the rare monster in a monster movie who wins at the end. Whatever she has to do, however offensive, however distasteful, however horrifying.”

What’s Amy’s Diagnosis?

Although psychiatrist Andrew Pierce (Health) allows that Amy is a “psychopath” he’s quick to add that this is becoming an outdated term within the field. Antisocial personality disorder is more appropriate.

Paul Puri, another psychiatrist interviewed (The Huffington Postregarding this issue, agrees. About the criteria:

…People who have no conscience and do things to abuse or hurt other people to a high degree of psychopathy, where they will hurt other people for their own enjoyment…They’re believed to have difficulty getting excited by…things other than cruelty or taking advantage of it.

Each of these experts adds that Amy also has aspects of Borderline Personality Disorder. States Puri about those with this condition:

Their core self feels very unstable, so they’ll do things to kind of help them feel more stable, and that will often be things like pulling people in to take care of them or in behaviors such as cutting themselves or parasuicidal behaviors like cutting or burning or getting hospitalized for the purpose of being taken care of. The other aspects of it are emotional mood swings in very brief periods, so they overreact to things that otherwise they might not react to.

The Effects of Being Raised as “Amazing Amy”?

Mark B. Borg, Jr., PhD, Grant H. Brenner, MD, and Daniel Berry, RN, MHA, who share a website called Irrelationship, state on their Psychology Today blog: 

Amy’s parents appropriated her childhood. Every detail of Amy’s upbringing was embellished in the pages of her parents’ highly successful children’s book series—and that is how Amy Elliot became Amazing Amy. Through the persona of ‘Amazing Amy,’ every failure and near miss was transformed into an unconsoled victory. Amazing Amy took care of her parents in every possible way: wealth and fame bought at the cost of their daughter’s development.

Most likely she’s a product of both nature and nurture, says Pierce. “Part of it is her disposition, and part is her parents not correcting and even worsening these tendencies. Her parents could have, if not tempered, at least not exacerbated what’s going on with her.”

THE ENDING OF GONE GIRL: Why would Nick stay with Amy?

The answer is found in the concept of “Irrelationship,” say the site’s authors. From their front page: “An Irrelationship is a kind of secret unconscious agreement between two people to ACT like they are together and loving – but the REAL reason is to keep them from feeling their feelings, and stay in denial about past problems.”

From the pertinent Psychology Today post:

An irrelationship is a pseudo-partnership. It may look intimate, but it’s actually carefully constructed—usually without the participants’ awareness—precisely to avoid the openness, spontaneity, and reciprocity that characterize true intimacy, while enforcing the relational rules and roles of early childhood. And this repeats in our adult relationships—it may be why we end up in one bad relationship after another. And every time, it feels just like going home. Maybe that is why, in the final moments, as Nick is telling his sister about Amy’s pregnancy, and she is crying in anguish over her brother’s horrific fate, he seems to change. He looks relieved; at least, resigned. It seems that Nick is realizing (a la Poe’s, ‘The Purloined Letter’) that the letter always reaches its destination, and that this is a fate that was not imposed by but co-created with his partner.

And Dr. Puri sees another possible reason Nick stays (plus one similar to the above):

People can end up very desensitized…If you drop a frog in boiling water, he’ll jump right out. If you drop a frog in cold water and turn up the heat, he’ll slowly boil to death, because he just doesn’t realize enough to sense the big jump. So, there might have been small things that slowly progressed, and he made a reason for it, and before you know it things are so out of control that he doesn’t even see how far that’s departed from normal…The other thing is the nature of the way people repeat patterns in their lives. They often try to reset or correct a bad experience, but often they just keep on repeating it. So, if he is drawn to her, many times people are drawn to things that repeat from similar drama earlier in their life and they’re trying to, unconsciously, have a corrective emotional experience where things go better this time.

Yeah, About That Majorly Disheartening Gone Girl Ending

Emily Yahr, Washington Post:

Overall, this ‘happily ever after ending’ for the World’s Most Dysfunctional Marriage is a lot more difficult to take when you see Amy’s path of destruction. While Nick was a terrible husband, you can’t help but feel for him the entire film, especially when it’s repeatedly stated that Missouri has the death penalty if he’s convicted of killing Amy. When he’s ‘saved’ after she returns, you’re relieved for a second; but then you really, really want Amy to get the punishment she deserves for pulling off such a scheme.

…Unfortunately, in the movie, there’s no such closure — we’re just left with the unsettling feeling that many more terrible things are about to happen.

Jul 29

“Remnants of a Life on Paper”: Borderline Personality Disorder

There I stood, in a hole, deep in the ground. Did I dig it or just get in? Did I fall into it? Did someone else dig it and throw me in? Pamela Tusiani, Remnants of a Life On Paper: A Mother and Daughter’s Struggle With Borderline Personality Disorder

In the memoir Remnants of a Life on Paper: A Mother and Daughter’s Struggle with Borderline Personality Disorder (2013), authors Bea Tusiani, Pamela Tusiani, and Paula Tusiani-Eng describe Pamela’s struggles with this psychiatric illness, often considered one of the hardest to treat successfully. Pamela’s “remnants” in question are from her journals and visual art, culled posthumously.

Pamela was diagnosed at the age of 20 with severe depression and wound up having multiple hospitalizations and 12 ECT treatments. Although Pamela had been excelling in college, she had to leave there because of her difficulties.

According to Dr. Lloyd Sederer, The Huffington Post, it was after all the above occurred that Pamela finally received the more accurate diagnosis of BPD. “She was often suicidal, took overdoses of pills and cut herself frequently and deeply. After five months and five hospitalizations she seemed to be doing worse, not better.”

Next up was 19 months at an expensive residential facility in New England—and when this program wasn’t enough, a program in California, Road to Recovery. “Pamela’s course at Road to Recovery was labile,” states Sederer, “with times of sobriety and rebuilding her life and times of falling into states of impulsivity and self-abuse. She developed seizures, which proved to be ‘psychogenic,’ meaning that it was her psychology, not her neurology that produced them. Such is the power of the mind.”

Medications were never helpful enough and often harmful. Eventually Pamela’s prescriber agreed to try a drug called Parnate, something her mom had read could be useful with the type of “atypical depression” that’s often linked with borderline personality disorder.

Sederer: “Pamela was well into her journey of recovery when a series of treatment program and medical errors conspired to kill her. The awful irony was that she did not take her life, but irresponsible, stigmatizing and poor residential and medical care did.”

An example of one such error involved Pamela having severe side effects to the Parnate, which unfortunately was misdiagnosed—in all probability because she was viewed as a “mental patient.” Some of the other experiences mentioned in the book similarly seem representative of mental health stigma affecting not only the patient but also the parents.

Kirkus Reviews weighs in on what readers glean from the back and forth between Bea’s information and the viewpoints of her daughter:

The contrasts are often dramatic, as mother and daughter pull together, apart and back together in a painful dance that hurtles toward a tragic conclusion. Tusiani enumerates the unique difficulties of dealing with a mentally ill family member, from finding Pamela bleeding from a self-inflicted wound—she had a proclivity for cutting her arms and legs so she could ‘feel something’—to learning that Pamela, either through maliciousness or delusion, falsely accused her father of raping her. The unpredictable is always around the corner.

From Sederer’s concluding remarks:

…(N)o parent, no mother, should see a child die. And to lose a child who may have recovered is all the more agonizing. Bea Tusiani only tells us at the end of the book that she is a writer — though it is plain enough how powerful a writer she is as she lets the story, the events she chronicles, show us so much about her daughter, her family, and our flawed mental health and medical systems. What is also so inspiring about the book Bea Tusiani has given us, which is why I found hope (reason to believe), is how she gives us a front-row seat, so we witness the courage, love, determination and stamina of the Tusiani family. I am sure that Pamela would be proud to see how her pain, spirit and resilience — and that of her loved ones — have been so sensitively and cogently captured in these ‘remnants …on paper.’

Jun 11

“Fatal Attraction”: Another Look At Alex’s Mental Health

When actress Glenn Close participated last week in the White House Conference on Mental Health Awareness she stated to CBS News that her portrayal of Alex Forrest in Fatal Attraction (1987) would be different today as a result of her own increased awareness. “I would read that script totally differently.”

Even the two psychiatrists she consulted back then about the role, though, failed to mention that Alex seemed mentally ill.

Close can now see that her character’s depiction has contributed to stigma regarding mental illness, which seems to bother her a great deal. “Most people with mental illness are not violent.”

For a reminder of Fatal Attraction, here’s its trailer:

Since the film, “fatal attraction” has become synonymous with terrorizing and stalking someone, while the term “bunny boiler” has come to indicate, as defined by the Free Dictionary, “a woman who is considered to be emotionally unstable and likely to be dangerously vengeful.” (Due, of course, to what Alex does to the pet bunny.)

Many movie viewers, including scholars, have diagnosed Alex with Borderline Personality Disorder (BPD). Jeremy Clyman, M.A., points out in Psychology Today, though, that the persistent notion that Alex has BPD is highly problematic:

…(B)ecause Glenn played a crazed stalker much more than she played a nuanced, plausible sufferer of BPD. So when people say, ‘You want to know what BPD individuals look like – go watch Fatal Attraction,’ harm is being perpetuated. It’s a sad state of affairs because BPD is a poorly understood diagnosis to begin with and individuals with this label suffer enough stigmas… we don’t need a misguided, over-dramatized prototype of BPD floating around the zeitgeist.

What are the actual characteristics of borderline personality disorder? NAMI (National Alliance on Mental Illness) lists some of the hallmarks. Someone with at least several of these traits might have BPD:

  • Frantic efforts to avoid real or imagined abandonment by friends and family.
  • Unstable personal relationships that alternate between idealization (“I’m so in love!”) and devaluation (“I hate her”). This is also sometimes known as “splitting.”
  • Distorted and unstable self-image, which affects moods, values, opinions, goals and relationships.
  • Impulsive behaviors that can have dangerous outcomes, such as excessive spending, unsafe sex, reckless driving, or misuse or overuse of substances.
  • Self-harming behavior including suicidal threats or attempts.
  • Periods of intense depressed mood, irritability or anxiety lasting a few hours to a few days.
  • Chronic feelings of boredom or emptiness.
  • Inappropriate, intense or uncontrollable anger—often followed by shame and guilt.
  • Dissociative feelings—disconnecting from your thoughts or sense of identity or “out of body” type of feelings—and stress-related paranoid thoughts. Severe cases of stress can also lead to brief psychotic episodes.

Treatment can include therapy, medication, and support and help for one’s loved ones. The positive news, according to NAMI: “Recent research based on long-term studies of people with BPD suggests that the overwhelming majority of people will experience significant and long-lasting periods of symptom remission in their lifetime.”

Regarding Alex’s diagnosis, others have focused more on her probable erotomania, a condition involving delusions that the object of one’s love interest returns the feelings.

But many viewers have never had a need to diagnose Alex Forrest at all. As described by Desson Howe in The Washington PostClose’s portrayal of the out-of-control stalker was that of a “she-wacko” who “becomes the female equivalent of the vengeance-crazed Robert Mitchum in ‘Cape Fear’ or the robotic Arnold Schwarzenegger in ‘The Terminator’.” A dramatic character who terrifies Michael Douglas’s character and family and thus we moviegoers in the process.

Related to her stellar performance, Howe went on to predict a slew of more “she-wacko” scripts for Close. Who knew she’d not only not go on to represent all kinds of screen “she-wackos” but would actually become the founder of Bring Change 2 Mind, a campaign against the type of mental illness stigma that has affected some of her own family members.