Wednesday, March 17, 2010

Borderline Personality Disorder



Alfred Adler, founder of Adlerian Psychology


Case Study

Bob,* a clean cut, twenty-two year-old college student sat attentively in the chair. He came to see me with several of his roommates, who were sitting in the waiting room. Bob was the one chosen to be their spokesperson.

“It’s about Sean,” Bob said. “He’s a nice enough guy, but he keeps us all going at one another, and we’re constantly running around trying to help him out of his difficult situations.

“Last night Sean was fired from his job at the pizza parlor. He said all the other workers hated him because he was a good worker and they were jealous. Now, he’s upset because it means he doesn’t have enough money for school and he’ll have to drop out. We all talked about ways to help and things he could do, but he always comes up with reasons why they wouldn’t work.”

Bob slumped back into the soft recliner. “We’re tired. This has been going on all semester. My grades are going down the tubes. We think he must be bipolar.”

I questioned Bob about his knowledge of Sean’s past. According to Bob, Sean was an abused child who felt alone, and his parents divorced near his eighth birthday. Sean lived with his mother, but sometimes ran away to live with his father, who ignored him in favor of drinking and carousing. Sean attempted suicide in high school by taking aspirin, as well as cutting on his wrists with a razor.

Sean’s roommates felt bad for him and wanted to help. Bob said he was the one who actually found the job for Sean at the pizza parlor, only three weeks ago. As we talked, Bob leaned forward, desperate for assistance. “What can we do? Isn’t there some medication we can give him if he's bipolar?”

I doubted a Bipolar diagnosis, and believed Sean suffered from Borderline Personality Disorder, so I asked Bob, “When Sean is down or angry, does this last for a week or more?”

“Oh no, he can be mad one minute and then singing a song the next. His moods swing like crazy.”

“OK,” I said. “Has Sean ever gone long periods of time without sleep and felt OK?”

Bob gazed out the window as he gathered his thoughts. “Well, I really don’t know. Sometimes, when he hasn’t been home all night, we suspect he's been out partying. Then when he does show up, he skips classes and sleeps all day.”

“And do you all agree that Sean needs your help?”

Bob swallowed and said, “Actually no. Two of our roommates feel he is just a large pain in the rear and needs to get his act together. They think we’re helping him too much, but we argue about it. We all went to high school together, except Sean, and were best friends, but now those two are going to move to a different housing unit next semester. The rest of us felt helping him was the right thing to do.”

I asked Bob what he knew about Borderline Personality Disorder and he said he was unfamiliar with it, so I explained, and told him his answers about Sean's behavior were more indicative of someone with Borderline Personality Disorder, not Bipolar.


Analysis

Bob needed to ask himself a very important question: When is too much help not helping at all?

Sean lived in a world of chaos and he perpetuated that through his behaviors. It wasn’t that he wanted to suck others into a vortex of confusion and frustration, but because that was his world, others unsuspectingly became entrapped in it.

At that point, Bob was so involved with trying to solve Sean’s problems that his world was turned upside down—he was exhausted and frustrated. Yet, no amount of intervention on Bob’s part would ever be enough to “save” Sean.

I told Bob he needed to extricate himself from his relationship with Sean and try to salvage his relationship with his friends. Once Bob understood this, he was visibly relieved.


Real Life Applications

Whenever we find ourselves “shooting someone else’s bullets,” and constantly fighting their battles for them, we need to stop and examine our situation. This is especially true when we are shooting those bullets in the direction of lifetime friends and family.

How to help in difficult relationships:

~ Setting limits: As in all relationships, it's necessary to establish boundaries. No one should be expected to give to the point of losing all that is important. The borderline personality is known for burning out relationships and causing friends to end up as enemies.

~ Communication with others: The case study above shows the need for active communication on the part of all who are involved in the chaos. If friends and family are not on the same page, then relationships can be split and a dear price will be paid. In this case, Bob was able to reconnect with his friends and together they all set limits in their interactions with Sean.

It is difficult in life to draw a line in the sand when it comes to helping others. However, an exhausting relationship may indicate the possibility of a borderline personality. Well-intentioned, good people can often become overwhelmed through their interactions with those suffering from a mental illness, and professional intervention may be the answer.

Until next time …

~ Russ


* Names have been changed.




4 comments:

  1. Great article again, Russ! Congrats! :)

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  2. Good reminders. It is similar to the airline attendant reminding parents to place the oxygen masks on ourselves before our children so we can best help. Losing ourselves in service is only service if we are helping.

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  3. Great article, Russ. Thanks for sharing such valuable information.

    I gave you an award on my blog today. Thanks for being such a great guy and always making me smile.

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