Levels of BPD severity

[How to communicate after a contentious divorce...]

Is there a measuring stick to determine how sever someone with BPD is? I think my exBPDgf has it really bad. On a scale of 1 to 10, I think she is a 10. Her eyes have not returned to a normal state for years. They are always glassy and dead or she blinks a lot and they move all over the place. She told me she is going to kill herself. I found her with a knife in a dark room a night sobbing. EVERYONE, IS EVIL! Her lecturers, T,family, me, workmates, friends and the list is never ending. New friendships are destroyed in a matter of weeks or months. She cycles from minute to minute. She starts dancing then she stops. She starts singing then she stops. She is involved in the church, then she stops. Her supervisors at work are the best people in the world, then all of a sudden they are evil. Does this case sound severe and is there a measuring stick?

[ex_bf_worried]

Is there a measuring stick to determine how sever someone with BPD is? I think my exBPDgf has it really bad. On a scale of 1 to 10, I think she is a 10. Her eyes have not returned to a normal state for years. They are always glassy and dead or she blinks a lot and they move all over the place. She told me she is going to kill herself. I found her with a knife in a dark room a night sobbing. EVERYONE, IS EVIL! Her lecturers, T,family, me, workmates, friends and the list is never ending. New friendships are destroyed in a matter of weeks or months. She cycles from minute to minute. She starts dancing then she stops. She starts singing then she stops. She is involved in the church, then she stops. Her supervisors at work are the best people in the world, then all of a sudden they are evil. Does this case sound severe and is there a measuring stick?

[JoannaK]

As of now, no measuring stick.  Changes are coming in terms of how someone with BPD is diagnosed, but they are a couple of years away.

She could be bipolar and/or schizophrenic from your description.  Her behaviors do sound extreme.  Has she recently been suicidal?

[ex_bf_worried]

T says she is bipolar and BPD, wow you are good. The suicide threats started last year. When she is in her depressive phase, goodness, she is depressed and she shakes uncontrollably and can get nothing done. When she is sleepless and feels as though she can take over the world, good heaves here comes the rages if I dont agree with her.

[brenbabe]

my ex had the glassy eyes, like two large pools of water, also whites of the eyes looked gray. the area directly around the eyes and nose was very red. almost looked like a bad case of allergies, that would come and go in like an hour or so. I swore he was using cocaine. maybe it was cocaine and BPD eye symptoms. you have me wondering.

[2010]

She starts dancing then she stops. She starts singing then she stops.

You are looking at her. Even if it's innocent- the Borderline will turn it into something else. You really do have to be careful with how you look at a Borderline, because they will turn it into a reaction. Borderlines mirror their idea of your reaction.

In working with self disordered patients, Masterson felt that counter transference (what you reflect back) can be a powerful force, as these patients are inclined to utilize projective identification to communicate their feelings rather than words.

As one Borderline patient once said, “When I want someone to know how I feel, I don’t talk to them about it, I just do stuff to try and make them feel the way I feel.”

The therapeutic response to the acting-out is to try to maintain neutrality by tracking the patient’s transference acting out of the rewarding (good) and withdrawing (bad) units, while also keeping the frame and paying close attention to his or her own emotional temperature.  Pretty exhausting stuff.

For Borderlines, the wished-for counter transference situation (what you reflect back) needs to resonate with the rewarding unit (good.)  (That's the maternal unit that tells her she exists- and when she acts out- it’s the one who will return to save her) Failing that, Borderlines will settle for getting you to resonate with the withdrawing unit (bad.) That's the image unit of punishment and certain annihilation (death) if she doesn’t have the rewarding unit to tell her she's safe. Both do not exist for her at the same time- they swing back and forth. She's happiest with reward, but never accomplishes a feeling of self without attaching to others and mirroring their reward.

People with Borderline Personality Disorder will typically under, rather than over achieve, as they experience the move toward success down the lonely and frightening path of separation from the rewarding/withdrawing objects.

“Acting helpless with the therapist by seeking advice or extra help, such as phone sessions, or not carrying his or her own tissues, or pen, or forgetting to bring transportation money, expecting that such displays of helplessness will engender the reward of caretaking from the therapist in return. A demonstration of rewarding unit clinging behavior and failure of self-activation characteristics are typical of borderline pathology. An intervention of confrontation which is designed to interrupt the borderline patient’s firmly entrenched defensive patterns, and provide a facilitative push that helps the patient overcome his or her resistance to continuing the work of separation/individuation. “ ~Judith Pearson

So you see she has been through the mill and is in pain, and there are times when you feel quite maternal toward her, so that you feel the need (pull) to help. It’s at this point that you have to realize that she is pulling you into a rewarding unit posture of taking over for her actions, and that if therapy is to succeed, she has to be the one motivated enough to do the work. Not you.

When you realize that she’s sabotaging herself, you may feel angry (withdrawing unit)- but you know that feeling is one she often incites in others – and had you responded to her angrily you would not have been the first to beat her up in her mind.  She will swing back and forth between these “splits” in people as they continue to return again in the form of the rewarding unit to save her.

One way to stop this behavior is to stop being that reward.  

[1stand10]

I have often wondered the same thing.  I heard of one lady Canadian psychologist refer to some as "BPD Lite."

As I read some of the posts, some people describe their pwBPD having tremendous rage, self mutilation, multiple suicide attempts, and infidelity among other things.  Sometimes I don't think mine is that bad but when she is bad it hurts.  Enough to make me want to leave.

[ex_bf_worried]

Mine was subtly bad towards me, I would get the occasional rage, I could not stand to watch her destroy all the r/s in her life, not being able to graduate from school, which meant I had to keep supporting her, not being able to plan anything. It just had to end for me because I was doing everything wrong and she did everything right.