Working With Families & Young Adults With Borderline Personality Disorder (BPD) – Part III

Borderline Personality Disorder, Families and Anxiety Management

All of us have at our command a vast array of defense mechanisms to help us manage anxiety and frustration. We can talk about an issue and come to a reasonable conclusion or we can avoid it. We can blame a problem on someone else or rationalize it away. All these techniques help shape our character and personality.

Some, if used persistently and to the exclusion of all others, can severely limit our ability to learn to compromise and create intimate relationships. Too often this is the case when a young adult suffers from emotion dysregulation, especially if he/she perceives their anxiety as being so intense, so overwhelming, that it threatens to result in the disorganization or disintegration of their very sense of self.

Some Common Defense Mechanisms

For the young adult, it is all about unconscious attempts to reduce anxiety.

SPLITTING: Here, when a conflict arises, the young adult seems to label one family member as good, understanding and compassionate while the other is insensitive, cruel and unable to understand or appreciate their perspective. These roles may switch between parents at different times.

Internally, this young adult has created a definition of the world as good/bad or right/wrong. Many young adults suffering from Borderline Personality Disorder, also known as BPD, seem to make decisions impulsively or to act out rather than having to tolerate the anxiety associated with the ambiguity of an imperfect solution made in the real world where we all live—a world that is not black/white but, rather, somewhere in the “grey.”

But it helps to eliminate anxiety when one perceives the world in a black or white manner. Then, the only thing left for us to do is exhibit anger and frustration, and anger provides the illusion of control. Nobody wants to be out of control.

Many times the entire family becomes polarized and actually begins to represent the internal world of the young adult. An atmosphere of frustration, helplessness and hopelessness can evolve. The suffering is intense for all parties.

DENIAL: Here, the psyche simply denies a set of circumstances occurred, even if an outside observer was present and saw the event take place. The young adult simply says it did not occur or they see the circumstances quite differently.

It is far more complex than simply lying. It is all about unconscious attempts to reduce anxiety.

The young adult can protect himself or herself from uncomfortable feelings by “stepping out of themselves” for a moment and disassociating from the feelings. Individuals who have been traumatized use this defense, and the process can become progressively more complex. In the most extreme situations individuals can disassociate from themselves by creating another or multiple selves.

PROJECTION:  This is a very common and effective defense mechanism: The young adult is able to “place” his/her feelings into someone else such as a parent or both parents. Once their frustration, fear and anxiety is seen as being “in” an accepting parental receptacle, they do not have to sit with their own feelings or learn to deal with them more skillfully.

PROJECTIVE IDENTIFICATION: Here, the young adult begins to identify with the parent or person who received the disturbing feeling (anger, fear). He/she can relax with a sense of relief as they watch the mom, dad or a friend who is left struggling.

This can be quite alienating. Parents can feel extremely upset because now THEY are angry and frightened and the young adult appears to act as if it is the parent’s problem, not his/hers. It is an extremely common mechanism seen in BPD families.

Many times these defensive mechanisms evolve at times of decision-making.

When a crisis occurs, it can create an opportunity for the young adult to escape from being responsible for his/her own decisions. Often, parents are put into a position of being the decision-makers.

When this occurs, the young adult has a chance to react against it rather than participate in submitting viable options and moving towards consensus. He/she feels controlled, misunderstood, not heard, disempowered and truly does not see their role.

Even if he/she reluctantly complies, it really “wasn’t their decision.” It was “forced upon them” by parents or external circumstances. They can point up how the parental suggestion is not appropriate, and, while there usually is some kernel of truth to their position, they are unable to come up with a viable compromise.

Unconsciously, the young adult may use slight differences in parental styles or views to create a wedge between parents. The resulting tension and the crisis atmosphere heightens the parental polarization, and the family dynamics can become progressively more chaotic.

By using such unconscious defenses the young adult’s world progressively becomes more limited and constricted. It is hard to compromise if you cannot see the grey. It is hard to achieve fulfilling, loving relationships if one cannot appreciate and empathize with the position of the other.

The young adult and his/her family will experience greater isolation and alienation, and the young adult’s self-esteem is progressively impaired.

For additional information about families and BPD, read the other articles in my series on Working With Families & Young Adults With Borderline Personality Disorder (BPD).