Escape Plan From a Borderline Woman

When Your Loved One Has Borderline Personality Disorder

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For the next week, read through at least one newspaper or news magazine each day. Look for stories on persons who might be good examples of the antisocial personality disorder, such as murderers, white-collar criminals, and con artists. Clip the stories and bring them in for discussion. Look for evidence from the person's life and actual behaviors that match the characteristics of the antisocial personality listed in Table 19.2.

When evaluating the antisocial personality profile, it is good to keep in min the social and environmental contexts in which some people live. Psychologists have expressed concern that the antisocial label is sometimes applied to people who live in settings where socially undesirable behaviors (such as fighting) are viewe as protective. For example, in a high-crime area, some of the antisocial attitudes may safeguard people against being victimized. Thus, the term antisocial should be used only when the behavior pattern is indicative of dysfunction and is not simply a response to the immediate social context. For example, youths who immigrate from war -ravaged countries, where aggressive behaviors are necessary to survive each day, should not be considered antisocial. The economic and social contexts must be taken into account when deciding whether undesirable behaviors are signs of dysfunction.

Borderline Personality Disorder

The lives of persons with borderline personality disorder are marked by instability. Their relationships are unstable, their behavior is unstable, their emotions are unstable, and even their images of themselves are unstable. Let' s consider each of these, starting with relationships.

The relationships of borderline individuals tend to be intense, emotional, and potentially violent. They suffer from strong fears of abandonment. If such persons sense separation or rejection in an important relationship, profound changes in their self-image and in how they behave may result, such as becoming very angry at other people. Borderline individuals show marked difficulties in their relationships When others leave them, they feel strong abandonment fears and sometimes become angry or aggressive. Sometimes, in their efforts to manipulate people back into their relationships, they engage in self-mutilating behavior (burning or cutting themselves) or suicide attempts. A study of 84 hospital patients with a diagnosis of borderline personality disorder found that 72 percent had a history of attempting suicide (Solof f et al., 1994). In fact, among this sample, the average borderline patient had attempted suicide on at least three occasions. The relationships of borderline individuals are unpredictable and intense. They may go from idealizing the other to ridiculing the other . They are prone to sudden shifts in their views of relationships, behaving at one time in a caring manner and at another time in a punishing and cruel manner . They may go from being submissive to being an avenger for past wrongs. The movie Fatal Attraction contains a character with several features of the borderline personality disorder. See A Closer Look on page 637 for a discussion of how this personality disorder was portrayed in that Oscar -nominated movie from 1987.

Borderline persons also have shifting views of themselves. Their values and goals are shallow and change easily . Their opinions may change suddenly . They may experiment with different kinds of friends or with dif ferent sexual orientations. Usually, they view themselves as, at heart, evil or bad. Self-harming acts are common and increase when others threaten to leave or demand that the borderline person assume some new responsibilities.

Strong emotions are common in the borderline personality , including panic, anger, and despair. Mostly, these emotions are caused by interpersonal events, especially abandonment or neglect. When stressed by others, the borderline person may lash out, becoming bitter, sarcastic, or aggressive. Periods of anger are often followed by shame, guilt, and feelings of being evil or bad. Borderline persons often complain of feeling empty. They also have a way of undermining their own best ef forts, such as dropping out of a training program just before finishing or destroying a caring rela tionship just when it starts going smoothly .

The borderline person is characterized by huge vacillations in both mood and feelings about the self and others. They can shift quickly from loving another to hating that same person. They are very demanding on their friends, relatives, lovers, and

A Closer Look

Theories of the Psychopathic Mind

Here we will compare two theories about the origins of psychopathy: a biological explanation and a social learning explanation. Many psychologists have argued that psychopathy is caused by a biological deficit or abnormality (e.g., Cleckley, 1988; Fowles, 1980; Gray, 1987a, 1987b). Research along these lines has focused on the idea that psychopaths are deficient in their ability to experience fear (Lykken, 1982). Being deficient in fear would help explain why psychopaths do not learn as well from punishment as from reward (Newman, 1987). Psychopaths may pursue a career in crime and lawlessness because, in part, they are simply not afraid of the punishment because they are insensitive to fear.

The theory of Jeffrey Gray (1990) has been influential on a number of researchers looking for a biological explanation of psychopathy. Recall from Chapter 7 that Gray proposed a system in the brain that is responsible for inhibiting behavior. The behavioral inhibition system (BIS) acts as a psychological brake, responsible for interrupting ongoing behavior when cues of punishment are present. According to Gray, the BIS is the part of the brain that is especially sensitive to signals of punishment coming from the environment. People who sense that a punishment is likely to occur typically stop what they are doing and look for ways to avoid the punishment. The BIS is thought to produce feelings of anxiety in the presence of cues for punishment, which in turn interrupts ongoing behavior. Gray (1990) holds that people differ greatly from each other in terms of the sensitivity of their BIS systems.

Researchers are beginning to examine the emotional lives of psychopaths, especially with respect to their experience of anxiety and other negative emotions. Psychologist Chris Patrick and his colleagues are following an interesting line of research. One study examined a group of prisoners, all of whom were convicted of sexual offenses (Patrick, Bradley, & Lang, 1993). Even in this group of severe offenders, some individuals were more psychopathic than others, as measured by Hare's Psychopathy Checklist (Hare, Hart, & Harpur, 1991). Patrick and his colleagues had the prisoners look at unpleasant pictures (e.g., injured people, threatening animals) to try to bring about feelings of anxiety. While they were looking at the pictures, the prisoners were startled by random bursts of a loud noise. People typically blink their eyes when they are startled by a loud noise. Moreover, a person who is in an anxious or fearful state when startled will blink faster and harder than a person in a normal emotional state. This means that eye-blink speed when startled may be an objective physiological measure of how anxious or fearful a person is feeling. That is, the eye-blink startle method may allow researchers to measure how anxious persons are without actually having to ask them.

The results from this study of prisoners showed that the more psychopathic offenders displayed less of the eye-blink effect when startled, indicating that they were experiencing relatively less anxiety to the same unpleasant pictures. However, when asked about how distressing the pictures were, both the psychopaths and the nonpsy-chopaths reported that the pictures were distressing. Overall, these results suggest that psychopaths will say that they are feeling anxious or distressed, yet direct nervous system measures suggest that they are actually experiencing less anxiety than nonpsy-chopaths in the same situation.

In another study, Patrick, Cuthbert, and Lang (1994) again used a group of prisoners who differed from each other in terms of antisocial behaviors. This time, the prisoners were asked to imagine fearful scenes, such as having to undergo an operation. The low- and high-antisocial prisoners did not differ in terms of their self-reports of fear and anxiety—all reported more of these emotions in response to the fear images than in response to neutral images, such as walking across the yard. Large differences, however, were found in their physiological responses to the fear images. The less antisocial prisoners were

This is the kind of photo used in the study by psychologist Chris Patrick, who found that psychopaths did not exhibit the normal fear response to such threatening stimuli.

more aroused by the fear imagery than were the antisocial subjects. In other words, the antisocial prisoners displayed a deficit in fear responding, when their fear responses were assessed with physiological measures, which are less susceptible to being faked than the self-report measures. These results are consistent with the idea that the psychopath is deficient in the ability to experience fear and anxiety. In a review of the literature, Patrick (1994) argued that the core problem with psychopaths is a deficit in the fear response. Events that would be threatening or anxiety-provoking to a normal person do not elicit these feelings in a psychopath. As a consequence, the psychopath is not motivated to interrupt his or her ongoing behavior to avoid punishment or other unpleasant consequences.

Other researchers have deempha-sized biological explanations for psychopathy and argue, instead, that the emotional unresponsiveness of the psychopath is learned (Levenson, Kiehl, & Fitzpatrick, 1995). The observed fearlessness of the psychopath may be the result of a desensitization process. If a person is repeatedly exposed to violence or other antisocial behavior (such as childhood abuse or gang activities), he or she may become desensitized to such behaviors.

That is, the callous disregard for others— the hallmark of psychopathy—may result from desensitization, a well-known form of learning. A prospective study of more than 400 victims of childhood abuse found that, compared with a control group, the abused children had significantly higher rates of psychopathy 20 years later (Luntz & Widom, 1994). By being victims of abuse, the argument goes, people learn that abusing others is a means of achieving power and control and obtaining what they want. Many psychopaths are motivated by interpersonal dominance and appear to enjoy having power over others. This can sometimes be seen in board meetings of corporations, in police stations, in politics, and wherever else one person has an opportunity to bully others. The point of this research, however, is that people who grow up to be bullies were themselves frequently bullied and abused as children.

Levinson (1992) has used results such as these to argue for a social learning model of psychopathy. He holds that, at some point, people decide to engage in antisocial behavior because they have learned, from observing others, that this is one way to get what they want. And, because of desensitization, the repetition of antisocial behavior makes similar behaviors more likely in the future.

Psychologists are currently debating the relative merits of viewing psychopathy as biological or as learned. Whatever the cause of psychopathy, the frequency and severity of antisocial behaviors almost always decrease as a person ages. It has been said that the best therapy for the psychopath is to grow older while in prison. The incidence of antisocial behaviors dramatically decreases in persons age 40 and older (DSM-IV). It has been widely known that, among criminals, those who make it to their fourth decade are much less likely to be rearrested for antisocial acts than are those in their twenties or thirties. For example, a study of 809 male prison inmates aged 16-69 found that deviant social behaviors, impulsivity, and antisocial acts were much less prevalent in the older prisoners (Harpur & Hare, 1994). There was less of an age decline in antisocial beliefs and callous social attitudes. Thus, although older psychopaths still don't care much about other people or their feelings, they nevertheless are less likely to impulsively act out these beliefs or to engage in actual antisocial behaviors. Whether the reason is getting burned out or growing up, there is a definite decrease in the range and frequency of antisocial acts with middle age, even among the most hard-core criminals.

therapists because they are manipulative. For example, they may threaten or even try suicide when they don't get their way. They are very sensitive to cues that others may abandon or leave them.

Table 19.3 lists the major features of the borderline personality disorder , along with examples of beliefs and thoughts that persons with this disorder might commonly have. Persons with borderline personality disorder, compared with those without, have a higher incidence rate of childhood physical or sexual abuse, neglect, or early parental loss. Many researchers believe that borderline disorder is caused by an early loss of love from parents, as may happen in parental death, abuse, severe neglect, or parental drug or alcohol abuse (Millon et al., 2000). Early loss may af fect a child's capacity to form relationships. Children in such circumstances may come to believe that others are not to be trusted. Although borderline persons have

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