Friday, July 30, 2010

The Accidental Sociopath

My partner and I often discuss the film, Girl, Interrupted, as a blurred portrait of the borderline/sociopath.  In the film, the borderline personality is the main character, Susannah, played by Winona Ryder, but the character we both think most people see as borderline in the film is Lisa, played by Angelina Jolie. Lisa, however, is a sociopath.  (For Angelina's critique of the film, click here.)  Part of the reason we imagine this blurred portrait happens is that the general public misconceives of borderline personality as a standard sociopath.  Someone who will, as a therapist once described to me, cut your throat and laugh while you bleed out on the floor.  This is partly a problem of misinformation, partly a problem of cultural and professional bias against borderline personalities as difficult, scary, or overwhelming, and partly a problem of there being something a little bit true in the blurring of these two types.  There are moments when borderlines skid sideways into sociopathy:
Clearly there are fundamental differences between borderline personalities and sociopaths, differences which I appreciate. At the same time, when the borderline personality’s rage or desperation is evoked, one sees (and not rarely) responses that can closely correspond to the sociopath’s calculating, destructive mentality.
Once inside this mentality, I’m suggesting that borderline personality-disordered individuals can lapse into a kind of transient sociopathy. Commonly, victims of the “borderline’s” aberrant, vicious behaviors will sometimes react along the lines of, “What is wrong with you? Are you some freaking psychopath?” They will say this from the experience of someone who really has just been exploited as if by a psychopath.

Because this isn’t the borderline personality’s default mentality (it is the sociopath’s), several psychological phenomena must occur, I think, to enable his temporary descent into sociopathy. He or she must regress in some way; dissociate in some fashion; and experience a form of self-fragmentation, for instance in response to a perceived threat—say, of abandonment.

These preconditions, I suggest, seed the borderline personality’s collapse into the primitive, altered states of self that can explain, among other phenomena, his or her chilling (and necessary) suspension of empathy. This gross suspension of empathy supports his or her “evening the score” against the “victimizer” with the sociopath’s remorseless sense of entitlement.

For the most part, this article by Steve Becker trips my internal Borderline Bias Alarm System.  Lights flash.  Sirens set my teeth on edge.  For one thing, it's posted on a blog called LoveFraud.  Ick.   The article is part of the dense cyberforest of anti-borderline treatises, rants, warnings, and notes of regret posted to the web by non-borderlines about borderlines.  So I take what Steve Becker says with a grain of salt.


I'm intrigued by the idea of the transient sociopath.  It rolls off the tongue like the accidental tourist or armchair psychologist or incidental charges.

If you read the chapters, "Rocket Girl" and "Tantrum Artist," in Girl in Need of a Tourniquet, you will see that I descended into near-psychosis as a result of remaining suspended for too long in an affair with an unavailable lover.  I didn't have thoughts of "evening the score," as Becker says, but I definitely regressed, dissociated, and experienced temporary self-fragmentation.  I lingered on the psychotic end of the neurotic-psychotic borderline spectrum.  I collapsed, on occasion, into primitive, altered states of consciousness.

So.  What do you think of Becker's ideas about borderline personality and transient sociopathy?  

Do admissions (like my own) of a borderline breakdown that blurs lines between crazy-borderline and crazy-sociopathic risk further misidentifications of and biases towards the borderline personality?

Has your borderline personality ever threatened to trade hats with its sociopathic best friend?

What are we to make of this intersection of diagnoses?

Sunday, July 25, 2010

Beyond Remission, Beyond Stigma

Check out Kiera Van Gelder's intelligent discourse on the challenges facing individuals with borderline personality disorder as they reduce symptoms but continue to experience baseline affective dysphoria, longings for intimacy and community, and the stigma attached to the diagnosis.  Kiera is the author of the newly released memoir, The Buddha and the Borderline, and her work as an advocate for BPD individuals and as an educator of the general public and the professional psychoanalytic community is pathbreaking, passionate, and highly admirable.  I count her among my friends, colleagues, and best writerly compadres. 

Beyond Remission: Mapping BPD Recovery by Kiera Van Gelder from Kiera Van Gelder on Vimeo.

I plan to write a series of articles in the upcoming academic year about the question of calling someone A BORDERLINE or self-identifying as A BORDERLINE.  In this lecture at Yale University's annual BPD conference (in 2008), Kiera states a strong dislike for the rhetorical pattern of calling someone A BORDERLINE because it holds a person in the stigmatized and static space of a diagnosis and identity that is widely maligned.  She is totally right, but I want to complicate the picture a bit by using this idea as a point of respectful departure in order to begin thinking about what a queer feminist crip theory of borderline personality disorder would look or sound like.  I'm interested in borrowing Rosemarie Garland-Thomson's description of feminist disability theory -- embracing the supposedly flawed body of disability -- to make a similar proposal for mental illness in general and personality disorders in particular.

By embracing the term BORDERLINE as an identity, I am working to destigmatize the label and to throw light on the biased norms that shape the stigma, to demystify the illusions of normalcy that make us believe most people are mentally balanced and physically whole and symmetrical, while a few of us freaks or gimps or borderlines are tearing our hair out and muttering to ourselves about paperclips and conspiracies on the subway.

I'd like to begin thinking about ways of reclaiming and revalancing BORDERLINE like others before me have reclaimed and revalanced QUEER and CRIP, drawing on the work of Nancy Mairs, who wrote the oft-cited essay, "On Being a Cripple," and the more recent follow-up piece, "Sex and the Gimpy Girl," as well as on Robert McRuer's powerful philosophical treatise, Crip Theory, and on the examples being set by figures like Bethany Stevens on Crip Confessions and another up and comer blogging under the name CripChick.

"We're here, we're borderline, we're fabulous!"

It has a certain ring to it.

This approach would be less about educating the public on neurodiversity and more about taking an anti-bias approach to borderline personality advocacy.  (For more information about anti-bias education, look here and here and here.)  What I like about the anti-bias approach to education is the way it replaces the so-called politeness of ignoring difference with attention to the social production and maintenance of difference through the internalization of bias, the reproduction of stigma, the manufacturing of consent to norms that are unhealthy and unjust, and the inequitable distribution of resources.

I'm curious to hear everyone's thoughts on this preliminary sketch of an idea to use crip theory (a kind of in-your-face self-naming that refuses the usual hierarchies of normal/abnormal, able/disabled, sane/insane) in order to get past the mistaken notion that personality disorders, attachment disorders, and mood or affective disorders are unusual or rare,or signs of weakness or marks of moral failure.  They are actually, as I say in Girl in Need of a Tourniquet, as common as dirt, and it would be nice if the world around us stopped pretending otherwise :-)

Of course, just like the word queer, it's one thing to self-identify as queer and quite another for someone else to call you a queer, so perhaps a queer feminist crip stance towards reclaiming borderline personality may need to remain a first-person kind of thing, something you call yourself in specific contexts to make specific interventions in cultural narratives of mental illness or misogynist bias, not something other people (your doctor, your ex, your boss, your lover) should ever call you.

What do you think?

Can BORDERLINE be reclaimed and revalanced in an analogous way to QUEER and CRIP?

And what do you think about using crip theory to talk about mental illness and personality disorders in addition to the usual topic of physical impairments?

Should CRIP be reserved for radical disability activism devoted to physical/visible impairments?

Is "borderline pride" a useful strategy for acknowledging borderline personality as a "type" rather than a terrible illness or untreatable condition?  Or does it undermine potentially life-saving changes in behavior among borderline personalities?  Can one have borderline pride and a deep commitment to improving quality of life (a.k.a., recovery) for borderlines?

Let me hear from you.

Thursday, July 22, 2010

Borderline Personality at Work

This blog post is a follow-up to comments made on my previous post, "Waiting to Exhale: A Question of Borderline Personality Stigma."  I tried to post it as a comment, but it was too long, so here it is as a blog post of its very own :-)

I am touched and reinvigorated by these stories of coming out or staying in the BPD closet.  I really appreciate everyone sharing your own evolving experience of being borderline and your decisions on how to navigate this condition in specific contexts (e.g., education, the work place). 

I especially connected with Cheri's post above:

"Before I came out at work, people didn't understand why I sometimes reacted strangely - in one meeting they thought that I was angry and glaring at everyone, when in reality I was trapped in my own head flogging myself, riddled with anxiety and unable to speak.

I much prefer putting myself out there a bit and explaining why I sometimes have difficulties than people thinking that I'm being a bitch."

Being out as a borderline personality at work is something I am just now experiencing -- barely -- because of course my book came out and my colleagues are congratulating me on the publication.  No one has addressed the subject matter of BPD specifically, which is kind of nice for now, since it remains such a controversial and stigmatizing diagnosis.

I am fascinated by the idea of having colleagues who know enough about BPD to recognize silence as a sign of anxiety instead of disengagement, anger, contempt, or a disgruntled attitude.  I've been thinking a lot in the past few months about how I come across in meetings with other faculty, and about how I come across in the university classroom.  Students have remarked in the past that I looked angry, or that I seemed angry when they didn't understand something, when of course my memory of such days are of feeling overwhelming anxiety at the prospect of being unclear or unsuccessful in my attempt to teach them something.  When I'm upset with myself, when I feel my veneer of apparent competence is cracking - the look of anger visible to other people is really a look of anger directed toward myself.

I hate the idea of being misunderstood, of having my good intentions and collaborative energy lost in the whirl of my uneasiness when my ideas are questioned.  I want to be seen as industrious and insightful, but my Rosie the Riveter impersonation tends at times towards the abrupt.  

Or I suddenly feel like the little girl out of place, dressed up in a business suit that swallows her whole, and I want to run from the room and cry.  I have cried over work with the same tormented hurricane tears usually associated with the borderline personality in love.  I have sat in my car and screamed into my hands while my face streaked red and wet.  

I don't know that I would expect students or colleagues to translate my facial expressions differently based on knowledge of my diagnosis, but the process of thinking through how I am perceived could maybe help me adjust my demeanor so I don't broadcast anxiety/frustration/disappointment/self-loathing to my audience in the skewed images of rigidity/standoffishness/arrogance/my-way-or-the-highway-ness.

Not that I have full control over my emotional demeanor.  Sadly, I still experience a kind of "frozen" affect that feels like insecurity but looks like impatience.

Amanda Smith also made a great comment on the question of stigma and being out as borderline at work: "And don't forget self-stigma. Even with lots of current information about the disorder, I sometimes think, 'Gosh, I should have a handle on this behavior or that behavior by now. Why can't I be more like him or her?'"

Why can't I be more secure.  Why can't I be more patient.  Why can't I be more confident.  Why can't I respond in a lighthearted way, without my voice quavering or my mouth going dry. 

The questions irritate like saddle sores beneath the yoke of the workplace.

Ben writes, "Too often, sensitive people take their disenfranchisement and run with it, advancing into the margins instead of facing their society squarely, bravely."

This is definitely the challenge facing all of us.  Some days I get it right.  Some days I still want to close the blinds and hide :-)

I am looking forward to starting a new academic year -- new classes, new meetings, new colleagues -- and knowing that my at times strangely intense feelings of rejection at work are just as disproportionate and internally generated as the feelings of rejection I experience in romantic love.  I may not be able to change the feelings just yet, but I am eager to find out the difference it will make to say to myself, "These feelings are too big to be about this meeting, or this colleague, or this student," and to take a step back while the intensity storms through my body and leaves and, in the big picture, means much less than I once thought.

The feelings, in fact, may not mean anything.

They may simply be there.  And then not be there.

I picture myself returning to my office after a difficult meeting or class period and smiling upon my discovery that the world has not gone up in a ball of fire, that the sky is not falling, that my job is secure, and that I am just fine.

Thursday, July 15, 2010

Waiting to Exhale: A Question about Borderline Personality Stigma

In the lesbian, gay, bi, trans, and queer community, people often remark on the fact that "coming out" is a strange and misleading image of what it means and what it feels like to reveal one's sexual orientation.  The usual image of coming out looks like this: a person walking through a door, stepping out of a closet, standing up in a gesture of pride once and for all to say I am gay and I am glad for everyone to know about it!  But of course coming out doesn't work that way.  As a lesbian, and now as spouse to a transguy, I come out, stay in, walk through the grocery store in an oblivious haze, take the microphone at a rally, correct (or do not correct) pronouns over dinner or in a hallway conversation at work every single day to some degree or another.  It is a constant flow of outness and in-ness and in-betweenness.

There is no single coming out moment.

The same is true of coming out as a borderline personality.

I can come out or not as borderline personality depending on my comfort level, my audience, my mood, the stakes, and so on.  As with my late-blooming lesbian-ness, I rarely expect people around me to react in a positive way to my coming out as borderline personality.  Mainly, this is because I am paranoid as shit.  Turns out, the people around me are pretty cool about the borderline thing (and about the lesbian thing and the transguy spouse thing). 

My campus publicity office has put my new book on blast as a top headline on the university's website.  I feel all melty and in love with my campus for doing this. Usually I feel like they hate me.  Obviously, my borderline personality patterns extend beyond my loved ones to work acquaintances I rarely even see in person who probably do not hate me or love me or think about me very much at all.

I came out again on The Frisky.  I held my breath and waited for the mean comments.  But the comments weren't mean. They were engaged, enthusiastic, uplifting, personal, earnest, vulnerable, and real.  Authentic.  My absolute favorite emotional demeanor.

My new friend Kiera wrote a book called The Buddha and the Borderline.  It's coming out on August 1, 2010.  As part of the pre-release publicity, Kiera came out of the psycho closet.  I like her bold language.  She sounds fearless.

We are in the age of coming out.  We may actually be in a post-coming-out era.  Coming out is so nineties, you know?  I kissed a girl and I like it.  I have borderline personality and I'm kind of okay with that, too.  Or, I want to be okay with it but I'm still kind of nervous.  The general public is playing it cool, though, standing with one hip cocked to the side and singing along with Perry Farrell that nothing's shocking.

Has borderline personality rocketed from psycho closet to cause celebre?  I'm relieved but also really surprised. 

Tell me what you think.  Is the stigma not as bad as I thought?