Know the Infamous Dr. Jekyll and Mr. Hyde?

In Robert Louis Stevenson's 1886 Scottish novel, the protagonist, Dr. Henry Jekyll, struggles to suppress a second and dark personality within himself named Mr. Hyde. Jekyll tries mightily to repress Mr. Hyde, who increasingly surfaces and reigns terror without guilt or fear of consequences.

Does this characterization remind you of your partner or a family member?  One minute they are the greatest, most kind and affectionate person.  The next minute they are a hurtful, disrespectful, and selfish person?

How could someone so good, turn around and become so bad - and then flip back again? 

It's very possible that you are dealing with someone with personality disorder traits or even a personality disorder itself.

1. Have you been viewed as overly good and then overly bad?
2. Have you been the focus of unprovoked anger or hurtful actions?
3. Are things that you have said or have done being twisted and used against you?
4. Are you are accused of things you never did or said?
5. Do you feel manipulated, controlled, and sometimes lied to?
6. Are there alternating periods when the family member acts perfectly normal and very loving?
7. Do you often find yourself defending and justifying your intentions?
8. Do you find yourself concealing what you think or feel because you are not heard?

Four Core Symptoms of Personality Disorders 

The DSM-5.0, the American Psychiatric Association's listing of mental illnesses, identifies and describes ten specific personality disorders. People with personality disorders exhibit characteristic, emotional response patterns that create life problems for them.  Generally, each of the personality disorders has a characteristic emotional response pattern.

Some personality disorders are characterized by emotional sensitivity and a tendency to experience feelings with great intensity.  Other personality disorders are characterized by little or no emotional response, regardless of the circumstance or situation.  Yet another set of disorders are characterized by bouncing back and forth between these two extremes: from being overwhelmed with intense emotions one moment, to feeling numb and disconnected in the next.

The ten diagnoses in the DSM-5.0 represent ten specific enduring patterns of thoughts, feelings, and behavior. However, each of these ten patterns can be distilled down to four core features of personality disorders. In order to diagnose a personality disorder a person must exhibit at least two of these four core features.

1. Distorted thinking patterns (thoughts)
2. Problematic emotional response patterns (feelings)
3. Impulse control problems (behavior)
4. Significant interpersonal problems (behavior)

The 10 personality disorders are: Antisocial, Borderline, Histrionic, Narcissistic, Avoidant, Dependent, Obsessive-compulsive, Paranoid, Schizoid, Schizotypal

Three of the core features are related to feelings and behavior.  One is related to thinking and is often most challenging for partners and family members.  Common thought pattern distortions are:

1. extreme black-or-white thinking patterns;
2. patterns of idealizing then devaluing other people or themselves;
3. patterns of distrustful, suspicious thoughts;
4. patterns that frequently include unusual or odd beliefs that are contrary to cultural standards; or,
5. patterns of thoughts that include perceptual distortions and bodily illusions. 

For example, a pattern of black-or-white thinking is quite common in those with Borderline Personality Disorder. Things tend to be "all or nothing", "black or white", "all good, or all bad." This way of viewing the world can create a lot of emotional suffering and is particularly devastating in relationships. People are seen as either "all good" meaning they are perfectly loving and available to meet their needs at all times, or they are "all bad" meaning they are malicious and hateful, with no shades of grey in between. Sometimes, this view of another person can shift in just a few seconds from "that person is completely wonderful" to "that person is horrible." Take the example of a woman thinking that her partner is the most caring and loving person in the world. Of course, no one can achieve such a perfect ideal all the time so when her partner does one unloving or thoughtless act, such as forgetting their anniversary, the immediate conclusion becomes "He doesn't love me. He is so mean and horrible." Sometimes, it doesn't stop there, because "If he doesn't love me, he must hate me." It is easy to understand that this pattern of interpreting relationships creates great distress and will provoke an intense emotional reaction in people who think like this. Subsequently, their partners may be quite baffled and distressed by these extreme ways of thinking.  In such cases, conflict is likely to be frequent.

People with Narcissistic Personality Disorder exhibit distorted thinking when they go back and forth between over-idealizing themselves, and then completely devaluing themselves. In addition, they have a tendency to over-estimate the importance or significance of their abilities and talents. Persons with a Narcissistic Personality Disorder frequently have fantasies of having unlimited power, success, or special talents. These over-idealized beliefs about themselves can cause them to behave in ways that are arrogant, ruthless, and entitled.  Such behavior frequently causes a lot of conflict with others.  For example, a person with a Narcissistic Personality Disorder may ignore the social custom of waiting in a queue to purchase a ticket.  Instead, they will march to the front of the queue, believing they are more important than the other people in line and are therefore entitled to special treatment.  Of course, the people waiting politely in the queue do not respond well and conflict erupts.  Eventually, the person with Narcissistic Personality Disorder is likely to run into a situation in which they realize they have some normal, human limitations.  When this occurs, they are likely to find it extraordinarily difficult to cope with this realization.  Any inkling of failure is hard for them to tolerate. The sudden realization of ordinary human limitations typically leads them to completely debase themselves, shifting from the over-idealized fantasy of unlimited success and special powers, to a devastating and paralyzing sense of complete worthlessness, shame, and defeat.

Click here for a Comprehensive Personality Disorder Symptoms List

Borderline Personality Disorder is a Disorder of the Emotions

"I hate you, don't leave me", the title of Jerold Kreisman's (MD) 1991 book describing Borderline personality disorder has become a widely accepted short description of the disorder.

Borderline Personality Disorder is very much a disorder of the emotions. Imagine a person who is extremely sensitive to rejection (fearful of even perceived or anticipated rejection) and has a limited ability to modulate their emotional impulses (love, fear, anger, grief, etc.). To protect themselves from their own feelings, they are prone to adopt a multitude of dysfunctional rationalizations and cover-ups. For example, a person suffering from BPD may so fear rejection in a new relationship that they recreate themselves in the image of a person they believe would be lovable. When the negative emotions for making such a sacrifice surface - and not having the ability to modulate them, they lash out at the target of their affections for "making them change" - rather than face their own feelings of inadequacy / fear of rejection, ultimately damaging the relationship they so fear losing, and reinforcing their feelings of inadequacy / fear of rejection.

What is going on in the Mind of Someone with Borderline Personality Disorder

What is going on in a Borderline Personality Disorder sufferer's mind and how they are acting can be two entirely different things. To the sufferer, BPD is about deep feelings, feelings often too difficult to express, feelings that are something along the lines of this:

1. If others really get to know me, they will find me rejectable and will not be able to love me; and they will leave me;
2. I need to have complete control of my feelings otherwise things go completely wrong;
3. I have to adapt my needs to other people's wishes, otherwise they will leave me or attack me;
4. I am an evil person and I need to be punished for it;
5. Other people are evil and abuse you;
6. If someone fails to keep a promise, that person can no longer be trusted;
7. If I trust someone, I run a great risk of getting hurt or disappointed;
8. If you comply with someone's request, you run the risk of losing yourself;
9. If you refuse someone's request, you run the risk of losing that person;
10. I will always be alone;
11. I can't manage by myself, I need someone I can fall back on;
12. There is no one who really cares about me, who will be available to help me, and whom I can fall back on;
13. I don't really know what I want;
14. I will never get what I want;
15. I'm powerless and vulnerable and I can't protect myself;
16. I have no control of myself;
17. I can't discipline myself;
18. My feelings and opinions are unfounded;
19. Other people are not willing or helpful.

Is it Borderline Personality Disorder or Just a Difficult Time? 

It is important to note that even healthy, well-adjusted people without personality disorder traits can also occasionally fall prey to some of the distorted emotions and thinking that we just described as characteristic of personality disorders. The distinction is pervasiveness - personality disorder traits spreading widely throughout a person's life. For people with personality disorders the degree of their distortion is more extreme and occurs with greater frequency than for those people without a personality disorder. Additionally, people with personality disorders find it much more difficult to become aware of and to challenge their distorted thinking.

On the other hand, distorted emotions and thinking are quite common when people are feeling very distressed, depressed, anxious, or have substance abuse problems. Again, recall that a personality disorders is a variant form of a normal, healthy personality, so the difference is in the frequency, degree, and persistence of the distortion.

The tools and skills taught on this site work well with people suffering from Borderline Personality Disorder traits and also with people who are are struggling with short term distorted emotions and thinking.

Want to review the diagnostic description of Borderline Personality Disorder?