From a patient’s point of view, the diagnosis of Borderline Personality Disorder (BPD) can be an exceptionally traumatic and judgmental one. So it is a great pleasure to be able to find a book that is empathic toward people affected by this condition. Such a book is the second edition of “Stop Walking on Eggshells – Taking Your Life Back When Someone You Care About has Borderline Personality Disorder” by Paul T. Mason, MS and Randi Kreger.
Finally, there is a sympathetic, wise, insightful, blame-free, plain and simply written discourse aimed at non-BPs with significant other BPs in their lives. It explains what BDP is, symptoms of which can include abandonment and rejection issues, lack of self-identity, chronic emptiness, impulsivity, inappropriate anger, emotional instability, paranoia, splitting of people into all good and all bad and suicidal ideation. It provides everyday solutions for coping with BP behavior, how to get help for the affected person, what additional traits occur which the DSM does not mention, deals effectively with universal myths and everyday realities, explains succinctly why BPs act the way they do and generally destigmatizes BPD.
It is a most comprehensive book written for both sides of the borderline fence with easy to read chapters ending in succinct summaries. Text boxes are outlined in an attempt to highlight the main message of the relevant passage and although this is somewhat distracting, it does serve a higher purpose. However, a word of warning for any BPs reading this book: Although it is written in a very compassionate voice, it may unearth repressed memories from childhood and evoke unconscious triggering behavior you may not even be aware of until the damage is done.
Many technical and learned books by eminent psychiatrists have been published with regard to the behavioral and cognitive processes of people with BPD without actually explaining at a humanistic level what this diagnosis can mean to the person suffering and their mentally healthy wives, husbands, partners and children. This book augments and expands on our current knowledge of BPD with much additional important information including lesser known BPD traits such as pervasive shame, undefined boundaries, control issues, lack of object constancy, interpersonal sensitivity and situational competence.
Within some psychology circles, BP sufferers are considered the “cane toads” of therapy, a seemingly ugly, rampant species, much maligned and vilified, out of control, multiplying fast and taxing the health insurance system and the patience and time of all concerned. It is not unusual for these people to be weeded out of therapy by ruthless and unscrupulous mental health professionals who see them as excruciatingly difficult, exceedingly demanding, almost untreatable and virtually incurable with their perceived “divide and conquer” ability to split at will. In contrast, there are some very enlightened therapists who are changing the course of treatment and the quality of life for these people (think Marsha Linehan, founder of Dialectical Behaviour Therapy, specifically designed for BPD).
Stop Walking on Eggshells explains and defines BPD behavior in the historical context of genetic predisposition, a traumatic upbringing or social environment that needs to be viewed as dysfunctional early coping mechanisms and survival skills internalized at a very early age. This book offers new and healthier techniques for dealing with significant relationships that overlays old experience with new. I feel its most important message explains BPD behavior in terms of manipulation vs. desperation. In other words, BPDs do not deliberately consciously manipulate people; rather, they are emotionally desperate in their panicked and frantic efforts to connect with others in a most genuine and authentic manner.
The book is divided into three parts. Part One is Understanding BPD Behavior. This section gives much needed validation and vindication to children of BPs who need to understand their BP parents’ inexplicable behavior. Explained in graphic detail and with many anecdotes, it attempts to impart the knowledge that parental BP behavior and criticism is not about the non-BP child and everything to do with the other. It defines how the inner world of the BP develops, grows and explodes out of control and just how this critical voice can seriously damage non-BPs’ self-identity and self-esteem. As one non-BP said:
Even my body functions were criticized. My borderline mother claimed that I didn’t eat, walk, talk, think, run, sit, urinate, cry, sneeze, cough, laugh, bleed or hear correctly.
Many BPs fluctuate between extremes of idealization and devaluation, otherwise known as “splitting” which is an unconscious defense mechanism. BPs see people as either the wicked witch or the fairy godmother. The book states:
Because people with BPD have a hard time integrating a person’s good and bad traits, their current opinion of someone is often based on their last interaction with them – like someone who lacks a short-term memory.
Part One also explains how BPs lack a sense of self, feel empty inside, that they are different people depending on whom they are with, are dependent on others for behavioral cues, are panicked and bored when alone, judge themselves and others harshly, never feel good enough and see themselves as helpless victims of other people.
It further explains why BP impulsivity and substance abuse often go hand in hand with self-mutilating behaviors which include cutting, burning, breaking bones, head banging, needle poking, skin scratching, pulling out hairs and ripping off scabs. The purpose of self-injury is relief of mood violations, stress and anxiety symptoms, to feel more alive and less numb, to express anger at others and to punish themselves rather than gain attention or commit suicide. Self-sabotage and self-destruction is succinctly explained in this poignant quote:
When my father stopped abusing me, I had to make up for the hurt that had suddenly disappeared.
I was stunned to discover that some people learn to sew up their own wounds so they don’t have to seek medical attention. BPs are intellectually aware of the reasons they hurt themselves, but this does not make it any easier for them to stop. This lack of reasoning can be explained with this quote from Marsha Linehan:
People with BPD are like people with third degree burns over 90 percent of their body. Lacking emotional skin, they feel agony at the slightest touch or movement.
As this is an information guide and educational book for non-BPs, there is a section that focuses on appreciating, in a sensitive manner, destructive borderline behavior, and wisely explains you “have to leave your own world and journey into theirs.” It gives much “how-to” advice on non-BPD responses to borderline hysterics and tantrums and the positive effects and calming influence this has on the relationship, explaining how to hold steady under intense pressure and relentless provocation to actively retaliate with equal venom.
Part Two is labeled Taking Back Control of Your Life, and explains how to make the necessary changes within yourself. You can lead the BP to treatment but you can’t make them well or feel better; that is up to them. It clarifies the illogical basis of a BP’s self-denial that a problem exists and sheds light on the fact that a BP will seek help when they feel the benefits of doing so outweigh the obstacles in their path of change. Here is one woman’s unfolding epiphany:
My own shock was the look in my four year old son’s eyes when I lost it and began smacking him until his thighs and face was red. He hadn’t done anything wrong. I was beating him for being a kid when I didn’t feel like being a mother. And when he initially started bawling, it made me angrier. I hit him harder.
There is a part on using coping strategies for self-care, how to seek support and validation, how to seek out Internet help and community groups and above all how to keep a good sense of humor. Taking care of yourself, detaching with love, taking your life back, not allowing yourself to be abused, taking the heat out of the situation by gently paraphrasing and reflexive listening, creating a safety plan for imminent self-mutilation, how to bolster your own self-identity and self-esteem, taking responsibility for your own behaviour and remembering that sometimes, “… splitting and other BPD behaviour can be catching.”
“If you find yourself involved with a BP, you can bet that you have unfinished business with a parent.” The book explains this is an unconscious bid to duplicate the experience to resolve unfinished business with the parent. It gives information on how sexual, physical and emotional abuse has violated a BP’s personal boundaries and limits and the humiliation and shame that damages.
Abused children feel confused about what to let others do to them physically, how to let others treat them emotionally and how to interact with others in socially appropriate ways. […]
Children who experience abuse also learn to deny pain and chaos or accept them as normal and proper. They learn that their feelings were wrong or didn’t matter. They learn to focus on immediate survival.
To explain this another way, they are bound from scripts from the past.
Part Three focuses on Resolving Special Issues such as coping with the Borderline child. There is a heartfelt story about parenting challenges from a mother and father of an out-of-control 14-year-old daughter diagnosed with BPD after bipolar medication was ineffective. Various anecdotes explain how a family can be torn apart by a BP child and most importantly how they can be brought back together with therapy, the right medication, patience and most importantly unconditional love.
This book addresses the many complex and complicated issues for BPs and non-BPs. It is original, well-written and gave me a much greater understanding of what the non-BP experiences. I thought I knew mostly everything there was to know about BPD, but this informative book has opened my eyes further. If you have a BP person in your house or suspect a friend or family member might have BP, this is the book to go to for that helpful piece of advice that just may save your sanity.
Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder
By Paul T. Mason and Randi Kreger
New Harbinger Publications: Second edition January 2010
Paperback, 260 pages