Borderline & CRP

ABSTRACT:  Those with Borderline Personality Disorder live at the “Edge of Chaos.”  Sensitive to the initial conditions of their lives, they are labile, jostled by the slightest perturbations into unstable states of being.  They inhabit the borderline between psychotic and non-psychotic states.  Psychotic episodes are generally transitory and relatively brief, but the personality disorder, an attractive impulse without logic, is notoriously intractable. It can be conceptualized as a level of personality organization rather than a disorder.

Borderlines are raised within dysfunctional family systems where emphasis is on maintenance of family myths in the face of neglect and/or abuse (physical or sexual) through double-binding messages or communication given to the child victim.  There is a discrepancy between the social facade presented to the outside world and the actual transactions within the family.  The child creates defenses including denial of fantasies of "good enough" parents in order to deal with painful realities.  Family members often collude with the abuser either to justify the abuse or to keep it a secret.  The victim is damned by the fact that the abuse is either denied as real or the child is accused of causing it.  Therefore, the child is either mad (“crazy”) or bad.

KEYWORDS:  Borderline Personality Disorder, psychotherapy, dreams, REM,  placebo effect, family therapy, healing, spirituality, dreamwork

WHAT IS BORDERLINE PERSONALITY DISORDER?

The borderline personality is characterized by the following features according to the DSM-IV: (1) acting out in potentially self-damaging ways both socially and physically, including but not restricted to suicidal behavior, self-mutilation, fights, and accidents; (2) unstable and intense interpersonal relationships; (3) difficulty with the expression of anger; (4) uncertainty about identity; (5) mood swings; (6) intense ambivalence about being alone; and (7) feelings of emptiness and boredom.

The assertion that borderline disorders develop as a result of factors inherent in the family of origin involves rejecting the idea of developmental fixation.  Borderline phenomena can be better viewed as a response by certain children that entails structuring perception of the social environment in maladaptive ways in order to deal with incongruencies within the family.  These incongruencies need not occur in a context of overt physical or sexual abuse, although most often they do.  The important factor is that such children grow up in a matrix of double-binding, no-win situations, where their experience is fundamentally discounted, (Price, 1990).

The struggle to formulate a viable sense of a worthwhile self in the face of such dynamics is formidible.  The myth of the scorpion surrounded by flames seeking in its pain to sting itself to death comes to mind with regards to these individuals.  That devaluation is a double-edged sword with which narcissistically defended individuals seek to undermine the self esteem of others does not negate the fundamental nonacceptance of one’s self that stands at the root of these disorders.

The essential feature of this disorder is impulsiveness, a pervasive pattern of instability of self-image, interpersonal relationships, and mood, beginning in early adulthood and present in a variety of contexts.  Alternation between dependency and self-assertion is common.  They are generally pessimistic and socially contrary.  Under stress, transient psychotic symptoms may occur.  Complications include narcissism, dysthymia, major depression and substance abuse.

According to DSM-IV, in borderlines there are no Hypomanic episodes unless there is a coexisting mood disorder, such as manic-depression.  In some cases, both disorders may be present.  Predominantly more females than males are diagnosed with this disorder.

A marked and persistent identity disturbance is almost always present in these impulsive personalities.  There is a pervasive uncertainty about several life issues, such as self-image, sexual orientation, long-term goals or career choice, types of friends or lovers to have, or which values to adopt.  The person often experiences this instability of self-image as chronic feelings of emptiness or boredom.

Interpersonal relationships are usually unstable and intense, and may be characterized by alternation of the extremes of overidealization and devaluation.  These people have difficulty tolerating being alone, and will make frantic efforts to avoid real or imagined abandonment.

Emotional instability is common and includes radical mood shifts from boredom to depression, irritability, or anxiety, usually lasting a few hours or, sometimes more than a few days.  They display inappropriately intense anger or lack of control of their anger, with frequent displays of temper or recurrent physical fights.  Their impulsive activites are potentially self-damaging, such as shopping sprees, substance abuse, reckless driving, casual sex, shoplifting, or binge eating.

Recurrent suicidal threats, gestures, or behavior and other self-mutilating behavior is common in the more severe forms of the disorder.  This behavior is used to manipulate others but is actually the result of intense anger and is used to counteract feelings of “numbness” and depersonalization.  The dissociative aspects are amplified by extreme stress.

Borderline Personality Disorder is diagnosed when at least five of the following appear:

(1) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of overidealization and devaluation;

(2) impulsiveness in at least two areas that are potentially self-damaging, e.g., spending, sex, substance abuse, shoplifting, reckless driving, binge eating;

(3) affective instability; marked shifts from baseline mood to depression, irritability, or anxiety, usually lasting a few hours and only rarely more than a few days;

(4) inappropriate, intense anger or lack of control of anger, e.g., frequent displays of temper, constant anger, recurrent physical fights;

(5) recurrent suicidal threats, gestures, or behavior, or self-mutilating behavior;

(6) marked and persistent identity disturbance manifested by uncertainty about at least two of the following: self-image, sexual orientation, long-term goals or career choice, type of friends desired, preferred values;

(7) chronic feelings of emptiness or boredom;

(8) frantic efforts to avoid real or imagined abandonment. (DSM-IV).

“All patterns of pathological personality--be they of mild, moderate, or marked severity--are deeply etched and pervasive characteristics of functioning that unfold as a product of the interplay of constitutional and experiential influences.  The behaviors, self-descriptions, intrapsychic mechanisms, and interpersonal coping styles that evolve out of these transactions are embedded so firmly within the individual that they become the very fabric of his or her makeup, operating automatically and insidiously as the individual’s way of life.  Present realities are often mere catalysts that stir up these long-standing habits, memories, and feelings.  Past learnings frequently persist inflexibly, irrespective of how maladaptive or irrational they now may be.  Sooner or later they may prove to be the person’s undoing.  Self-defeating vicious circles are set up that precipitate new difficulties and often reactivate and aggravate earlier unfavorable conditions of life.”  (Millon, 1981).

Those with all forms of maladaptation deteriorate in their functionality when they are subject to stress.  Under increasing difficulties they can become effectively immobilized and fail to cope.  This breakdown further increases difficulties.  When inner resources fail, they may abandon all attempts  to maintain psychic cohesion, and fail to discriminate between inner subjective experience and external reality.

“As reality recedes further into the background, rational thinking disappears, previously controlled emotions erupt, and a disintegration and demoralization of self often takes hold.  The upsurge of formerly repressed feelings and memories combines with new adverse experiences to undermine the individual’s remaining coping capacities.  Fearful of losing their tenuous hold on reality and threatened by surging emotions and uncontrollable and bizarre thoughts, these individuals succumb further.  Deteriorating to more primitive levels of functioning and retreating into an inner and unreal world, they may ultimately fall into a pesistent and more pernicious pattern of life.”

This disorder is a dysfunctional personality pattern that has crystallized into habitual, and enduring pathology.  When coping mechanisms and strategies fail to work under stress, they decompensate toward social invalidism and periodic but reversable psychotic episodes.

CONVENTIONAL TREATMENT OF BORDERLINE DISORDER

The borderline classification refers to a deeply ingrained personality pattern.  According to conventional wisdom, nothing but the most prolonged and intensive therapy will produce substantial changes.  There are many others disorders which can complicated the borderline profile in combination with it.

These associated disorders include anxiety disorders, obsessive-compulsive, somatoform, dissociative, affective, and  schizoaffective disorders.  Also there are many personality variants within the borderline syndrome. These include borderline-histrionic, borderline compulsive, and borderline-passive-aggressive mixed personality, and the hazy, dreamlike world of the decompensated borderline personality. There are different stages in the disturbance and different severity within those stages (Millon, 1981).

During quiescent periods there are different treatment goals than during decompensation.  Quiescent periods offer the opportunity to facilitate autonomy, build self-confidence, and overcome fears of self-determination.  These changes will probably be resisted.  Borderlines mistake encouragement toward self-responsibility for rejection, even from their therapists.  They think it is a criticism and effort to get “rid” of them.

When they feel secure in the therapeutic alliance, they can learn to face and tolerate contrary feelings and dependency anxieties.  Learning to face and handle unstable emotions is coordinated with the strengthening of healthier self-attitudes and interpersonal relationships.

The therapist serves as a model to demonstrate how feelings, conflicts, and uncertainties can be approached and resolved with reasonable equanimity and foresight.  This somewhat counteracts at least the cognitive portion of the impulsive personality.

Most borderlines seek and have maintained occasional satisfactory social relationships.  Their need for attention and approval, their history of at least partial encouragement in childhood, their interest in gaining some support and nurturance, and their desire to restrain contrary and troublesome impulses, all decrease the probability of inevitable decompensation.

The more support from family and friends, the less destructive the mental illness.  This means positive support.  Too much dependency creates mutual resentment and creates intolerable conflict.  The person needs to be encouraged to accept responsibility for his or her own care, welfare, and health.  Otherwise, a slow or fast decline into persistent social invalidism can result.

Clinging helplessness, resentful stubbornness, hostile outbursts, pitiable depression and self-denigrating guilt seem notably wasteful and self-destructive.  Borderlines wear people down and provake them to exasperation and anger, which, in turn, only intensifies the anxieties and conflicts they feel.

Signs of decompensation begin with marked discouragement and persistent dejection.  Conventional treatment offers supportive therapy and cognitive reorientation.  Efforts are made to boost their sagging morale, and encourage them to continue pursuing their range of activities.

Activity builds self-confidence and minimizes rumination and preoccupation with melancholy feelings.  They should not be told to “snap out of it,” as if it were a rational choice, nor pressed beyond their capabilities.  Failure to achieve these goals only strengthens their growing conviction of their own incompetence and unworthiness.

The limits of conventional treatment include electroshock therapy (ECT) for extreme depression and brief institutionalization during suicidal or hostile outbursts.  Antidepressants and antianxiety medication is generally prescribed.

TRANSACTIONAL ANALYSIS AND BORDERLINE DISORDER

The typical borderline comes into treatment because of intense disatisfaction with people, especially love relationships, loneliness, painful feelings of inadequacy, boredom with work and seething rage.  Relationships are stormy, never last long, and end in bitterness.  Payoffs from unpleasant endings include reinforcement of paranoia.  The self-destructive urge can express socially in angry termination of relationships whenever the slightest threat of rejection appears.  Suicidal urges and talk are common in the middle of the rejection game.

These individuals feel like they were born the wrong person in the wrong family, “No matter what I did, it was never right.”  Parents are often dissatisfied with the child from the very day they are born, if not before.  The child valiantly tries to assert his or her individuality against overwhelming odds.  But only depression follows self-assertive behavior.

Borderlines spend a tremendous amount of energy consoling themselves for perceived failures--reenacting the relationship with the actual parents and demonstrating the pathological corruption of the Nurturing Parent function.

The logic of family myths in physically and sexually abusive families is simple and damning for the victim.  The abuse is either denied as real or the child is accused of causing it.  The child is labeled either crazy or bad.  In such families it is difficult for children to value themselves and to feel they deserve to take initiative in a meaningful way.  They are forced to collude in distorting and/or denying reality in the service of the abusive family’s need to maintain a facade of social propriety.

Struggling with their parent’s “pure” persona and their secret, dark shadow side leads to splitting to deal with the abusive reality.  The child’s only out is to collude in the betrayal either by dissociating and developing amnesia for the experience or by using splitting to deny that the abuser is bad.  This strategy comes at a high price.  The goodness of the abuser becomes a direct function of the perceived badness of the child.  These children are left with tremendous retroflected anger and vicious internal voices.  With no outlet for anger, it is turned against themselves (Price, 1990).

Double-binds are the other transactional structures which create emotional crippling.  Conflicting messages are given.  If the message is an injunction, it must be disobeyed to be obeyed.  The child is not allowed to show any awareness of contradictions or the real issue involved.  They are punished or at least made to feel guilty for correct perceptions, and defined as bad or crazy.  When double-binding is chronic, it turns into a habitual expectation regarding the general nature of human relationships and the world at large.  This expectation does not require further reinforcement to persist.

Double-binds play a central role in the formation of borderline self disorders.  The child is forced to distort or deny reality in a way that compromises the capacity to develop an integrated sense of self and other.  Such double binds need not occur in a context of physical or sexual abuse, but in such situations it has the most damaging effect on the developing self.

It is a no-win situation for the child; even when dutifully and loyally complying with the parents’ distorted vision, they are labeled negatively and attacked.  The other crucial dynamic in these families is the desperate need to deny trauma in order to protect the image of the abusive parent as good.

Children deal with the reality of neglectful and abusive parents by maintaining an idealized image of the parents even if the cost is to deny reality and/or label themselves as bad.  The splitting of reality-based perceptions into good and bad by using denial, enables the child to lessen his or her anxiety and rage.  The child colludes with these factors in a desperate attempt to adapt to the social realities inherent in the family.

Borderlines structure their inner representations of Parent and Adult, and significant other in light of these factors in the family.  They introject the negative family dynamics into other relationships.  The child, even as adult, is permanently under the influence of a vicious internal parent.  These inner figures take on a life of their own.

The borderline is unable to integrate contradictory good and bad self- and other representations.  The resulting splitting involves the projection of split object and self-representations onto the here-and-now social environment.  Another form of projection common in this group is projective identification.

The individual projects onto another the rewarding and withdrawing relations the parent displayed.  Identifying with the aggressor, an example of this process, allows the child to experience feeling empowered rather than helpless.  They invite the other person to identify with the disowned, projected representation of the self as a victimized child, inadvertently showing them “how it feels.”

Such projective mechanisms can cause dramatic fluctuations and shifts which are independent of current environmental considerations.  Those who fail to form a cohesive view of themselves often exhibit dramatic shifts between different representations of themselves.  There is little capacity to integrate these elements into a functional, fully autonomous self.

Poor boundaries between self and others around responsibility for thoughts, feelings, and actions are common.  The child experienced being solely an extension of the parents.  This creates fear of engulfment and/or rejection.  Parents communicate the covert rule: “Don’t exist separate from my wants, desires, and representations of reality.”

Attempts to perceive reality get the child rejected.  The alternative is to discount oneself by allowing one’s reality to become an extension of the parent’s need to deny and distort untenable realities.

These children develop an abiding sense of incompetence and undeservedness, and fear of failure.  They are self-defeating in terms of relationships and success.  It is difficult for them to avoid depression because their deep-seated doubts about their abilities.  Their denial of reality is coupled with unremitting self-hatred and self-defeating patterns consistent with the injunctions ranging from Don’t Be and Don’t Be Sane to Don’t Feel and Don’t Make It.

The emptiness these people feel is revealed in their struggle with aloneness.  The constant striving to find and maintain a stabilizing object has been linked to abandonment issues.  They are attacked continually by internalized negative parent messages, flooding by images of abusive past experiences, and other anxiety-provoking dissociative phenomena.  They strive to maintain contact with a primary other in order to generate an external focus, thereby avoiding painful internal realities.

Messages of “You’re wrong,” with the implication of discounting that “You do not exist,” along with the double binds, create the disorder.  Devaluation is a double edged sword with which narcissistically defended individuals seek to undermine the self-esteem of others.  It does not negate the fundamental nonacceptance of one’s self that stands at the root of these disorders.

Borderline patients are aware of their separation from others and are threatened by it.  They have not completed their individuation and alternately distance and cling.  Their life position swings back and forth between “I’m OK, You’re Not OK” and “I’m not OK, You’re OK”.

The borderline is stuck in certain Child ego state emotions which operate in a dysfunctional manner.  Experience of one feeling keeps other feelings out of awareness, unavailable for problem-solving behavior.  Fear, anger, and sadness are Child ego state responses, to the threat of danger, to not getting what one wants, and to loss.

In the case of borderlines, great fears include fear of failure and negative internal Parent messages, engulfment or rejection.  Anger comes from wanting someone else (inadequate parents), thing or circumstance to change.  Sadness results when focus remains on what has been lost while not doing anything pro-active to change and adjust.  Sadness is part of the grieving process.  Sadness is the giving up of anger, dropping the effort and abandoning hope that one will be successful at instituting change (Thompson, 1983).

Fear, anger, and sadness are functional when they help us resolve our problems and are accompanied by functional behaviors.  Fear helps us avoid threats, anger precipitates change; sadness and grief help us give up hope for impossible change, and plan for a future that excludes what has been lost.  They may be uncomfortable, but not unbearable.

These emotions have a temporal quality:  fear deals with the future and what might happen; anger deals with the present we don’t like and want to change; sadness deals with the past and adjustment to losses we have sustained.  When feelings are out of temporal order, they are not functional.  This includes fear about the past, sadness about the future, and anger about the past which are defined in TA as dysfunctional rackets.

One “allowable” feeling may mask the others’ unconscious influence.  If one continues to feel angry, it masks underlying fear and sadness (chronic hurt and depression).  The primary way one gets stuck in fear, anger, or sadness is by not recognizing that another feeling is also present.  Only after realizing their fear and sadness can borderlines experience more control over their anger.

The therapist’s job is to help bring to awareness those hidden parts of the fear-anger-sadness complex.  All these feelings are painful: fear/paranoia; anger/rage; sadness/boredom-depression. Becoming aware of anger and expressing it does not mean becoming violent.  It means having an internal awareness and an emotional expression of the awareness.  The therapist’s job is to foster that awareness and emotional expression in safe and appropriate ways.

When behavior is not functionally consistent with feelings (for example, being angry and doing nothing), inconsistent behavior is the response to the hidden feelings of fear and sadness.  Because those feelings are not experienced consciously, no part of the feeling complex is resolved.  The original dysfunctional feeling is uncomfortable and one remains stuck in it.

Treatment of one stuck feeling entails the awareness and expression of all three feelings.  If the person is aware of and expressing his functional fear and anger, there is little drive to hold on to these feelings and they will be accompanied by functional behavior.  Sadness will be a rebuilding process after loss, not depressive inaction.  They become aware of the temporal appropriateness of emotions:  what they are afraid will happen, what they are angry about and want to change now, and what they are sad about that can no longer be changed.

CRP helps borderlines be aware of and express all three feeling states in safe and appropriate ways.  By accepting and experiencing all three states, their functions, and their temporal qualities, and the appropriate actions that go with them, they can get unstuck from dysfunctional feelings, and move on.  This re-organization results in a more stable individual with a new existential self-image.

They learn the full range of feelings needed for effective responses to threat and loss.  They experience fear, anger, and sadness as appropriate reactions and resolve these feelings through congruent actions.  This helps them in self-reparenting, developing a sense of utter reliability that may have been missing in their childhood.  Though borderlines are notoriously slow learning, not learning from past mistakes, CRP cuts below this level to restructure personality at the most fundamental level, dissolving old blocks, and facilitating natural healing.

BORDERLINE PERSONALITIES AND CONSCIOUSNESS RESTRUCTURING

Borderlines live at the edge of chaos, the very borderline between the psychotic and non-psychotic.  They drift in a twilight between reason and despair.  This condition of living at the threshold might be termed limerance. They have a rather tenuous hold on reality which can disintegrate along with their capacity to function.  “Borderline” is a rather odd term for a condition that might be better described as cycloid.  Both impulsive and erratic moods are combined in a single syndrome.

This condition might aptly be called “unstable personality disorder,” as behavior and moods are labile.  It is a periodic and circular insanity.  Borderlines shift almost randomly from depression, to anger, to guilt, to elation, to boredom, to normality, and so on in an unpredictable and inconsistent course.  This suggests a “strange attractor” as the formative source of the disorder.

The overall structure presents the picture of a checkered history of disruptions, predicaments, and disappointments in personal relationships, school and work performance.  Even talented, intelligent borderlines fail to fullfill their potential and keep pace with their age peers in accomplishments.

Deficits in social attainments, inability to learn from prior difficulties, a tendency to create self-fulfilling prophecies, and self-defeating behavior create a tight border of limitations within which they function with greater or lesser ease.  When dis-eased, they create digressions and setbacks from earlier aspirations, and fail to achieve a comfortable niche in life that is rewarding and fulfilling.  While they can be generally functional marginally, there are transient episodes of extremely bizarre behavior.

Each borderline is unique, and treatment must be adjusted accordingly.  They display a wide variety of clinical features.  This disorder can appear in combination with manic-depression, narcissism, passive-aggressive personalities, etc.  Each has different parameters, and each case lies somewhere on a continuum of severity of expression.

The Consciousness Restructuring Process is a natural form of self healing.  CRP is a REM or dream journey process that restructures the fundamental consciousness dynamics and neural patterns underlying any disease structure or faulty personality organization.

Healing occurs within the journey (REM), first dissolving the old maladaptive form or self-image attractor, and allowing the emergence of a new self-organizing pattern of personality from a creatively reformed sensory existential self-image.  CRP is non-specific and works on changing the neurological consciousness structures, facilitating changes in old dysfunctional personality patterns.

Even when experiences have conditioned an individual into extremely stable patterns of unstability at all levels of being (existential, physical, emotional, mental, and spiritual), CRP can gently dissolve those old rigidities and nonadaptive patterns and strategies, creating permission and a physical basis for realizing changes at the deepest level.  With supportive therapy (reparenting and social skills) in conjunction with CRP, new strategies and coping tools can be incorporated at the deepest sensory levels, instigating permanent change.

In REM (Rapid Eye Movement) consciousness, natural healing occurs in the course of natural healing journeys.  Inner journeys recreate sensory memories of fetal experiences, and even the pre-sensory level of earlier consciousness structures when our incorporeal essence began to crystallize and take form.  REM is crucial to reaching these deepest consciousness structures, and to the subsequent healing dynamics that result from these encounters.  REM is the primary consciousness shared in common by both child and adult.

CRP posits that for the fetus and the adult, REM consciousness programs the brain with capabilities in each developmental stage.  In order to re-experience the learning processes that were so important to earlier development of our physical and personality structure, we re-enter the consciousness in which they they were fed or programmed into our being.  This is REM-consciousness, as research has shown.

We know from chaos theory that any complex system is very much influenced by minor perturbations or differences in its initial conditions.  In chaos theory, this is known as the “butterfly effect.” This is reflected in the unstable personality type of borderline disorder.

Even before birth sensory perceptions in REM consciousness shared by fetus and parents can greatly influence the physiology, personality and coping strategies of the future adult. Return to these consciousness structures in REM can very well allow us to rewrite this early programming, and to do so in the state that is associated with the formation of our nervous system and cells (Swinney, 1997).

The use of wakeful REM consciousness allows the borderline to fully experience with the senses the transformative or healing experience.  In the healing of trauma in REM, the brain and physiology are incapable of distinguishing between dream experiences and outer experiences.  Therefore, CRP, as a therapeutic process has real consequences in the real world, and is much more effective than simple visualization or imagination.

REM is conducive to new learning and the formation of new neural patterns.  It is our experiences that program us, and shape neural circuitry that in turn shapes both our personality and body chemistry.  Thus therapeutic experience can dissolve and re-write old outworn dysfunctional patterns and forms.  Fundamental perceptions of self and reality are changed, particularly those revolving around fear, anger, and sadness.

CRP journeys complete the cycle that has gotten stuck in the unstable personality.  This chaotic, implicate or complex consciousness is the dynamic in which healing transformations are initiated by changes in the primal existential hologram.

The chaos of no-change in the unstable personality is transmuted by deepening its imperative.  Things change and chaos ensues until the new order appears.  Chaos is actually the mechanism of change itself.  REM consciousness is the most chaotic or complex state of consciousness dynamics measured in the brain.  It is the state that most supports self-correction or the homeostasis effect.

The natural state and healing dynamics of any organism is healthy flow, being able to freely change and evolve to adapt to new conditions presented by a constantly evolving reality.  It is this flow and change-ability that supports profound self-corrections.  It is this ability to flow, adapt, and evolve that defines mental and physiological health.

Karakashian, Stephen J., “Differential diagnosis of the borderline personality: the first step in treatment,” TA Journal, Vol. 18, No. 3, July 1988, pp.178-184.

Millon, Theodore, DISORDERS OF PERSONALITY, DSM III: Axis II, John Wiley & Sons, New York, 1981.

Price, Reese, “Borderline disorders of the self toward a reconceptualization,” TA Journal, Vol. 20, No. 2, April 1990.

Swinney, Graywolf, HOLOGRAPHIC HEALING, Asklepia Press, 1997.

Thompson, George, “Fear, anger, and sadness,” TA Journal, Vol 13, No. 1, Jan.1983, pp. 20-24.