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PART III: TYPES OF BORDERLINE PARENT

Dec20

Experts wonders whether there are actually distinct types of borderline personalities. The minds are divided but experts still try to distinguish between the different types of BPD in academic literature as well as in popular one. In Part III we will take a look at both of them. Please note that this list of types serves as a guidelines and person who suffers from BPD can have a mix of everything.

Popular Literature
Dr. Christine Lawson in a book Understanding the Borderline Mother introduces 4 types of borderline mothers that fall into high functioning or low functioning category:

High-Functioning BPD Mothers

The Witch
The Witch is someone who acts out viciously when they feel threatened, rejected and criticized. This type of mother seeks power and control over others, and reacts with unpredictable rage. Family members live in fear of triggering her. Unconsciously she is consumed by self-hatred and tends to be extremely hostile and cruel towards their children. She tends to be self-obsessed and has little or no concern for others. The Witch has no remorse and will not apologize for hateful acts she has done to her child. At the base of their need for power and control is their intense desire to prevent abandonment. This particular sub-group of BPD is very resistant to treatment. It is not uncommon for their children to develop depression, shame, insecurity, Post-traumatic Stress Disorder.

  • “There was a problem with my report card, showing I had a 0, even though I knew for a fact I had done the assignment. I didn’t have enough time to tell the teacher about it, so I would do so the next day, in order to fix my grade. I showed my Mother, trying to explain it to her, and even though I had a simple solution to fix it the next day, she proceeded to slap me across the face and scream at me for getting a 0, as well as proceed to call me lazy and not caring about my education. Yeah, I had the proof to show her I had done the assignment, could easily get my grade changed, and even then, I was still getting yelled at, grounded, and getting my things taken away. And slapped across the face.”

The Queen
The children of a Queen Mother are supposed to be her loyal subject. Queen needs to be the center of attention and uses her children to fulfill her own needs. “Pay attention to me! Love me, love me, prove to me you love me and do everything as I say!” If you disagree with her, don’t do as she says or you have your own needs, you don’t love her. Children are not permitted to have their own needs or opinions, and are not encouraged to become individuals in their own right.
She pretends to be a perfect woman who has it all together, independent, powerful, and in control of everything. They can be manipulative and vindictive and have a strong sense of self entitlement. They cross boundaries without recognition or regret. Inside they experience chronic feelings of emptiness and inability to self-soothe when distressed.

Low-Functioning BPD Mothers

The Waif

The Waif portrays the helpless victim, exhibiting how everyone is treating them and how they need protection. They can suffer from depression, anxiety, irrational fears, and feelings of vulnerability, helplessness, hopelessness and are prone to deep despair. But they are rejecting attempts by family members to help them. In this way, they passively control others and are generally unable to nurture anyone. 
They expect from the children to “save her” and believe that people are out there to get them and do not trust others. Children may feel that they can help if only they do more, learn more, and give more. Unfortunately the Waif continues to stay helpless as a means to control and avoid abandonment. She neglects her children, often they feel angry and alone and may develop codependency issues as adults.

The Hermit
Hermits may have a tough exterior and a superficial image of being confident, determined and independent. Except, they’re actually terrified of the world, and distrust everyone and are prone to rage and paranoia. They feel constantly betrayed by others and take criticism as a condemnation of who they are. Perfectionism is a hallmark of the Hermit, and they can rage or criticize (which they often do) when others fail to meet their expectations. They have no desire to go out in the world and have close friends outside of their family, especially their children. They gain their self-esteem from work or hobbies.

  • “My mother often said that as she got older, she became afraid of everything. We could never get her to try and go out with friends unless we took her out for coffee or shopping. We were the only real “friends” she had. And honestly, we were because we had to, or else, who else would she have?”

BPD types in academic literature

There were quite a few attempts to find different subtypes of BPD in academic research.

In The Essential Family Guide to Borderline Personality Disorder, Randi Kreger grouped BPD into:

  • Lower-functioning/conventional types is described as engaging in a lot of self-destructive behavior that requires frequent hospitalization. They are very low-functioning, meaning they may not be able to work or go to school. The author calls this self-destructive behavior “acting in,” an idea that correlates with the concept of internalizing symptoms.
  • Higher-functioning/invisible type is described as functioning well in most contexts, but engaging in a great deal of “acting out” behavior, such as verbal abuse, criticizing others or becoming violent. This description correlates well with the concept of externalizing symptoms.

One study examined types of borderline personalities based on a personality disorders that co-occur often with BPD. They categorized person in one of the 3 clusters:

  • Cluster A tended to engage in more paranoid thinking and eccentric behavior.
  • Cluster B tended to have more dramatic or arrogant personalities.
  • Cluster C tended to be more fearful.

Another study examined BPD subtypes in adolescent boys and girls. Interestingly enough study found reliable BPD subtypes in girls, but not boys. Girls with BPD tended to fall into one of the following categories:

  • high-functioning internalizing
  • depressive internalizing
  • histrionic and angry externalizing

Another study found three BPD subtypes:

  • withdrawn–internalizing
  • severely disturbed–internalizing
  • anxious–externalizing

Individuals with different presentations of BPD may respond differently to the treatment. In this study, individuals from the severely disturbed-internalizing subtype did not see symptom improvement with treatment, where those in the anxious-externalizing and withdrawn-internalizing subtypes did.

The last subtypes of BPD I want to write about is from T. Millon. He lists 4 subtypes of BPD:

  • The Discouraged Borderline looks like individual with Dependent Personality Disorder (codependent). They tend to be clingy, go along with the crowd, and walk around feeling somber and somewhat dejected. Deep inside however, there are often angry and disappointed with the actions of those around them. Scratch the surface, and that anger could explode, but they are much more likely to do harm to themselves by self-harming or even suicide. 
Some of the symptoms common to this subtype are: excessive dependence upon others, cycles of withdrawal and aloneness, passive, permissive, recurrent depression including tearful episodes (more common than rage episodes), anger can feel sudden and surprising to others, paranoia and self-persecution, more likely to deprive rather than indulge oneself, victimized, tendency to evoke sympathy, feelings of abandonment can invoke psychotic episodes, trigger desperation and suicidality, irresponsible behavior, uses drugs, alcohol, food, money, or sex for self-soothing, tendency to use fantasy to escape reality, gives away or destroys belongings, suffers from chronic or recurring illness or somatic complaints.
  • Impulsive Borderline seems to be a first cousin to the Histrionic Personality Disorder. These individuals tend to be flirtatious, captivating, elusive and superficial. They are highly energetic and seek out thrill after thrill. They are easily bored and seem to have it never ending appetite for attention and excitement. As their name implies, they will often act without thinking, getting themselves into all sorts of trouble. Such individuals can often be very charismatic and it’s easy to get caught in their spell. This type of person is in constant conflict with society. Bouts of violence are not uncommon. This person may have antisocial personality disorder as a co-occurring diagnosis. This person is operating in an Abandoned Child mode–a plea for attention, any attention–as well as an Angry Child mode. The Angry Child believes that other people deserve to be punished for his/her pain, and behaves accordingly. This type of person with BPD may have poor impulse control, abuse substances, or self-harm. On the other extreme he or she may not care about himself/herself, it’s all about what the other person thinks. This often results in extreme efforts to avoid disapproval and abandonment.
  • Petulant Borderline is unpredictable, irritable, impatient, and complaining as well as defiant, disgruntled, stubborn, pessimistic and resentful. They are torn between relying upon people and at the same time keeping their distance for fear of disappointment. They vacillate between feelings of unworthiness and anger. This anger can be quite explosive. This is a passive-aggressive person. He or she will injure himself or herself, either physically or emotionally, in an attempt to get needs met. This person has an unstable sense of self, a frantic fear of abandonment. They operate in an Angry Child mode. He or she is angry and will hurt friends and family as a result. They often doesn’t recognize the anger-the world is the problem, not them. They don’t know how to express their needs in a healthy way, so relationships seem to be a game of “If you really loved me” or “You should know what I want”.
  • Self-Destructive Borderline is marked by his constant sense of bitterness which they turn inward. They will often engage in self-destructive behaviors whether it is conscious or unconscious. Their levels of self-hatred can often reach monumental proportions leading them into all types of self-destructive behaviors, ranging from poor healthcare to reckless driving to performing humiliating sexual acts. This person often suffers from depression as a co-occurring diagnosis and is a self-injurer. This is a person who feels that no one cares, and reacts by not caring about himself or herself. They operates in an Abandoned Child mode. Since they don’t feel loved, they reacts in self-destructive ways in an attempt to feel something instead of nothing. They lives in terror of abandonment, is self-loathing, and has no idea who they are inside. Thoughts of self-injury or actions are a given in this type.

In case you want to deepen your understanding of your relationship with your parents, please take a look at my online workshop “Mending our childhood wounds and patterns” HERE.

This workshop will help you with understanding the patterns, roles and attachment you are having in your family dynamic and will shine the light on your behaviors and wounds you are carrying with you. It will also teach you how to deal with your emotions that will evoke through this self-discovery.

PART II: DAMAGES OF GROWING UP IN BORDERLINE FAMILY

Dec18

In the title of this article I used the word “damage”. This word is a good description of how children that grew up in Borderline Families feel inside – damaged. Let’s go into details, what kind of emotions, feelings and actions are hidden behind this word. Many people in counseling who were raised by a borderline parent end up struggling with anxiety, low self-esteem, issues with trust and intimacy and difficulties being vulnerable with others.

Mind reader
Children of BPD parents routinely become overly sensitive to the moods and needs of others. They needed to adjust to their mothers mood and predict how she would react. Many grew up being afraid of their mother. They are constantly doing “risk assessment” monitoring their mother’s moods so they can manage the situations and protect themselves from anger and drama.
In adult relationships they are responding to these invisible demands from other people. The problem is many times they are adjusting to something that other (healthy) person doesn’t expect them to. The “secret” demand is not really there like it was in their childhood. It is really difficult for them to go out of this mode and trust that nothing bad will happen if they don’t please the other. The realization that we are all adults, responsible for ourselves doesn’t come “naturally” to them.

Are my emotions real?
It is extremely hard not to doubt their perception for the children of BPD parent. Their perception was always questioned and their emotions were invalidated. This may lead to children who deny or question their emotions and emotional responses. If you are constantly told that what you are experiencing is not real you star doubting your feelings and your views of reality.
Children have a very difficult time expressing their feelings because they can rarely distinguish between their feelings and their mother’s feelings.
This doubt is also shown in the perception of their childhood. Did it really happen? A part of them doesn’t believe it fully because it was always denied by their Mothers who never took the responsibility. Furthermore in calm periods, when the parent is behaving better they begin doubting whether the bad things actually happened. 
In adulthood this can be triggered every time someone is disagreeing with you. If you are not a 100% sure into what you wish to say you rather pull back and doubt your truth. More over even if you are a 100% convinced that what you are seeing is a red picture, you can become convince you may be seeing it wrongly, perhaps it is orange after all. You need a constant reassurance from others that what you are feeling and thinking is valid and right.

  • “I’d been so entrenched in that fog throughout my childhood and early adult life that I was unable to see clearly the reality around me.”
  • “When I found out, in 2006, that she’d drained my trust fund, I was horrified. But on some level, I was also relieved: so much of the nightmare of my relationship with my mother had happened in secret that I struggled to know if it was even real. But now I knew it was. Now, I had proof, and I could finally leave her, with a clean conscience.”

Hard to leave
Children of BPD parents have a really difficult time to physically or/and emotionally move away from their parents. Because they were hearing how bad of a child they were when they wanted to be independent they have trouble moving away or cutting their mothers off. This guilt is binding them to their mothers and it is really hard to cut it off for good. In my practice I mostly see emotional bond that is the hardest to let go. They feel obligation to visit their Mom, speak to her, make sure that she is O.K. Although it is apparent that they are not doing this because they want to but because it is expected from them.

Overly critical

They act and feel like they are never good enough. Lack of self-esteem is very common with them. They are really hard on themselves and at times even brutal. It’s like they internalized their Mothers criticism and now they are treating themselves the same way.

  • “I grew up hating myself and relying on my mother for all of my self-worth.”

Illusion of love
The adult children of borderlines struggle with the illusion that they were loved when they weren’t. They feel lack of love towards their parent but they blame them selves for that. This loop is created because a Borderline parent gave them the constant feeling that they are not loving towards them because they are a bad, ungrateful children. They often ask “I must be crazy if I feel like this about my mother right” or “maybe I’m not a good enough child, if only I try harder, she will love me” not realizing they will never measure up in their mother’s eyes.

  • “I feel like a horrible daughter for having bad feelings towards my mother. Sometimes I even think it would be easier if she was just dead. I try to explain my feelings to my boyfriend or a friend and everyone seems to think she is the nicest person ever. She manipulates everyone. They all think I am just being dramatic.”

Fantasy World
Many escape to fantasy world during the childhood and if they don’t resolve what was happening to them while growing up also in adulthood. It is very common that they fantasize the death of a parent. Only children who were severely physically or/and emotionally abused have these types of fantasies. The fantasy is the only way to get out of the toxic environment.

  • “I escaped my childhood like most traumatized children do, by disassociating from reality and fleeing into fantasy. There were window ledges and shade trees that called to me, closets and woods—places I could get away to dream.”
  • “I remember playing Tom and Jerry cartoon nonstop in my head before going to bad. This way the only way I could calm down and fall asleep.”

Anger

Unadorned the guilt, doubt, feelings of unworthiness bring to a lot of anger towards Borderline Parent and their Childhood. They find it unfair (and it is) that they had childhood like that and all the problems that are coming from it. They feel angry that they need to go through the therapy while their Mother is not taking the responsibility. They feel angry that they need to face the pain while somebody else was the one who FUCKED UP.

  • “I’m angry that I didn’t have a childhood, that I witnessed horrible things, was abused in many ways, and that my relationship with my siblings took a toll. I’m just pissed. But more than anything, I’m angry that my mother will never really “get it.” She’ll never see or understand the pain she has inflicted. Really all I want is an acknowledgment of what she has done and the amount of work I’ve had to do to dig myself out of this bottomless pit she dug for me. I want an apology. And then I want to be left alone. I’ve had to try to come to terms with the fact that I will probably not get that from her. Which just fuels my anger. Ugh. ”

Fear of becoming like Mother
The fear of becoming just like your parent can increase with age. Some even deny their wish to become a parent because this fear is running so high. They are trying to prevent the pain that they were feeling when growing up. Maybe comparison to you parent is not that obvious at first but it can occur in small everyday stuff like “I am not drinking coffee like my Mom did.” To overcome comparison and realize that same or similar features don’t make you your parent is really challenging.

  • “I resigned to spend my life proving that I was not her. I’d place a mental check mark in the “not-my-mom box” when I hit a milestone. Attain a college degree. Check that box! Still speaking to my dad after age 21. Check! Not addicted to alcohol or painkillers. Check. In retrospect, being on constant red alert for mom-like tendencies was concerning.”

Relationships
Children of BPD parents have trouble with interpersonal relationships. It is very often that they develop codependent tendencies. They can also use manipulation to maintain relationships or over pleasing behavior. It is not uncommon that they find themselves in destructive relationships which bring them pain. They are being unable to create a true intimacy. They are preventing it through constant fighting, distance (emotional or physical), manipulation, codependency etc.
 Because they were often told that the World is a bad place and they have trouble to trust people. Also to trust that they are worthy of love.

  • “I just realized why all my relationships (platonic and romantic) are superficial and hence not long-lasting. I have constructed an invisible armor around me for protection. If they don’t get too close, they won’t hurt me.”
  • “I have a hard time voicing my opinion and saying when I think I’m right. I’ve been in a relationship for 4 years and I’ve changed a lot during therapy. At the beginning of this relationship, I was pretty submissive and didn’t want to cause any conflict. I am now becoming more confident in myself and feel okay with a little bit of conflict.”

Realistic expectations
Perhaps the most difficult thing to accept is that Borderline mother is not capable of insight and will never truly understand why her child avoids her or sets boundaries with her. She is not taking responsibilities for her actions and is making you feel like you are overreacting or she was doing you a favor. It is really hard to accept that your mother will never acknowledge your feelings or agree with you when she is in the wrong. Yet alone apologize .

  • “Why do you act guarded around me?” Child “Because you have hurt me in the past and I don’t want to be hurt again” “I hurt you! I don’t remember that. When?” Child “You used to hit me with a belt when I was a child”
  • “I don’t remember that. You are making it up. You lousy shit”.
  • “My mother could not apologize. She could not take criticism. When it came to discipline and power struggles, she had to win.”

What the future holds?
Unfortunately being raised in BPD Family makes you prone to the development of psychological disorders like depression, anxiety, Post Traumatic Stress Disorder (PTSD), Narcissistic Personality Disorder and also Borderline Personality Disorder. Recovery from being raised by a borderline parent is often a lifelong process. Although it really gets better with time if you work on yourself. Being psycho-educated about what is going on is important first step towards understanding. You can only work on what you’re aware of.
I would recommend working with the therapies to help you deal with all the emotions, pain and feelings and give you the corrective experience. With time and many positive experiences you will be able to move away from the toxic dynamic. On that note it is also important to say that Borderline parents suffer as well. They have their own past traumas. That being said, parents are not off the hook for abusing their children. As an adult it is your responsibility that you take care of your own wounds before you become a parent. And it is very important that you start to take care of your childhood wounds, to stop the destructive cycle.

In case you want to deepen your understanding of your relationship with your parents, please take a look at my online workshop “Mending our childhood wounds and patterns” HERE.

This workshop will help you with understanding the patterns, roles and attachment you are having in your family dynamic and will shine the light on your behaviors and wounds you are carrying with you. It will also teach you how to deal with your emotions that will evoke through this self-discovery.

PART I: MY PARENT HAS A BORDERLINE PERSONALITY DISORDER (BPD)

Dec17

In this series of articles I won’t talk about BPD but I will focus on the dynamic that is created when you are raised by someone who is struggling with BPD. Until now there was a belief that more women than man suffer from BPD. That’s why I will talk about mothers in this articles. But lately there have been studies that have shown misdiagnosis in male population. It is now believed that percentage between man and women with BPD is close to equal.
From the birth on, the connection between you and your child is very important. It is crucial for physical survival but equally important for psychological well-being of the child. Unfortunately not everyone is having luck with their parents which can lead to serious mental disorder.
Most people would not believe what goes on in Borderline families. The dynamics are intense, destructive, subtle and not readily apparent to the casual observer. BPD is fragile and unpredictable personality. They can be very successful but they struggle with interpersonal relationships. These may be associated with episodes of impulsive aggression, self-injury, and drug or alcohol abuse.
People with BPD are often described as a child in an adult’s body. These individuals can be incredibly immature and seem to be stuck at an early age of psychological and emotional development. Consequently BPD parents frequently parentify their children-meaning they make them responsible for their emotional and physical needs which is a form of a child abuse. While a person with depression or bipolar disorder typically endures the same mood for weeks, a person with BPD may experience intense bouts of anger, depression and anxiety that may last only hours, or a day at most.
A mother with personality disorder often lacks empathy, feels entitled, rejects personal responsibility for her behavior, engages in bullying and intimidation, is dishonest, has the relative morality of a small child, has chaotic and extremely dysfunctional relationships, has no sense of fair play and is completely self-obsessed. The borderline parent lacks insight and believes that she is the fine parent of an ungrateful child and goes to any length to prove that this is the case. But how is it to be on the other side? On the side of a child?

What dynamic is in BPD Family?

No space for you
Children of BPD learn to sacrifice their true selves because they need to be focused on her BPD parent in order to survive. They are emotionally or physically abused if they feel differently as their mothers. If they reject her offering (advice, suggestion, emotion) they are portrayed as a bad, ungrateful, disloyal children. Because of the attachment issues borderline mothers tend to smother their children and treat them as small extensions of themselves. Child learns quickly that it is best to get along otherwise there will be a conflict or the emotional cut-off. For a child who is dependent on their mother there is no other way then to sacrifice his identity and go along with her. The child interacts out of obligation. Autonomy, the freedom of self-direction and self-expression, is not welcome. The following examples shows how every situation turns out to be about her:

  • Teenager child is telling her Mom that he feels depressed. Her response: “What do you have to feel depressed about? You know what I was going through when I was your age”. The feelings and potentially serious condition of a adolescent are ignored and denied. “Mom, I cannot make it to dinner tonight, I don’t feel well.” Mother: “You don’t feel well? I am still suffering from the Cesarean Section they gave me so that you could be born.”
  • “Even when trying to confront the issue, any issue, it gets made all about her pain.”

Splitting

Common defense mechanism of BPD is splitting. Which means that a person splits off the good and the bad in themselves and projects bad onto others. This can also be a reason why your mom is denying all the bad she has done and has chosen to see only the good in her. 
In families splitting often occurs by having a good and a bad child. Borderline mother forced teams with the good child whom is required to behave like her. The all good child often feels guilty that they survived the abuse especially relative to a no-good child. This dynamic causes a toxic, estranged relationship between siblings. The lack of closeness is creating isolation, every member of the family is on it’s own. 
The splitting also occurs by being good one moment (idealized) and being completely bad the next.

  • “In our family my brother was always priced by my mum. He could get away with everything. Everything that was wrong felt on me and my sister. We were taking her emotional abuse. But to think about his relationship with our mom. He needed to be there for her in every moment, listening to her, defending her and sleeping in her bed till early teens.”
  • “My Mom always priced me when I brought home the good note. She couldn’t stop giving me the compliments. How smart I am, how she admires my determination and motivation for school. The moment I brought home a bad note, well it wasn’t really bad, but it was not the best, I needed to sit and listen how lazy I am, how I will never become anything.”
  • “I sometimes wonder if she will ever be able to have a conversation with me without saying something along the lines of, “You’ve hated me since you were a little girl.” And then she just calls up one day and all is well, as though she hadn’t just threatened to end our relationship a day before. Usually, I get split back to the light side (as I call it) when she needs something that she knows I can provide. Then I’m back to being a good person.”

She loves to help
With borderline dynamic there are three kinds of things connected to help.

1. She is often a valid member of a community. Willing to help everyone and give all she has to them. Sometimes she can literally give your things to somebody else in a name of help.

2. When it comes to helping you it often comes with a high price. The problem is the help is not being offered for truly altruistic reasons, but rather it is being offered to support the mother’s desired image of being a good mother. In case you reject her help it can be taken as an offense. Once you ask for help they can control you with that and try to win a fight with throwing it at you even years after. “oh, you can’t do this for me but I could help you get a job during collage.” The child quickly learns not to ask for help and tries to avoid his/her mom helping them because they know they will have to pay for it at some point or they will be paying for it forever.

  • “Besides the fact that she’s done this so many times it’s turned into crying wolf at this point, her method of asking for help “with a knife to my throat” also takes away any of the warm feeling that I might get from helping her.”

3. She expects of her children to help her or better said save her from every emotional or physical problem she is having. They often play “I am your mother” card. “oh, you don’t want to do this for me but I am your mother. You should take care of your parents.”

Neglect
Physical and emotional neglect is very often in Borderline families. People with BPD can be so absorbed in their own pain that they are incapable of taking care of their child. They can also escape to substance abuse or other addictions while leaving the child to take care of him/herself.

  • “My mom locked herself in her room for days. I was very afraid that she will do something to herself. I was forced to take care of myself and younger siblings and also spending my energy to convince her to come out of the room.”
  • “She rarely showed affection. She would also get onto my brother and me if we said, “I love you”, as she would scold us and say to only say that phrase if you REALLY mean it. She would never come to you and show affection. We would go to her for hugs and kisses. I remember trying to hold her hand in the movie theater and her pulling her hand away, looking at me funny.”

Rage
Rage outbursts are very common in BPD families.

  • “Once my father moved out and I became a preteen, something changed. My mother and I started fighting. We fought the way I remembered my parents fighting: brutal, out-of-control arguments that would last for hours. I couldn’t tell if this was normal or not.
  • “My mother would fly into rages, telling me how awful I was for hours, and then, moments later, would coolly ask me what I wanted for dinner, appearing to not even remember that it had happened. She acted like I was crazy, and so I assumed that I was. She took me to a child psychologist to deal with whatever supposed defects I had that led to us fighting so often. Then she pulled me out of therapy after a few sessions, when she got into a screaming fight with the receptionist.”
  • “My mother could turn her rages and sadistic behavior on and off like a light switch. She would instantly become “normal” the moment another person entered the room. My mother could be nasty as a snake to my brother and me and then turn it off and be sticky sweet to whoever is at the door or on the phone. Even at a young age, this behavior made me sick.”

Criticism
Mothers with Borderline Personality Disorder often put-downs, insults and criticize their children.

  • “This is a woman who criticizes everything about me. From my “boring, plain, unadventurous” taste in clothes (not boring, just not enough like her), to my “annoying, inconvenient” pescetarian diet, to my need for a spiritual life (“religion is for weak, stupid people who need a crutch to get through life”). Although I am gifted with artistic talents that have won awards and put me on famous stages, nothing I do is ever done without a touch of criticism on my performance.”
  • “I became keenly observant of her methods, never questioned her authority, and strived to be the best at everything, because anything less was a massive disappointment in her eyes.”

But on the other hand they are unable to accept the criticism. They can even go against the law of physics if necessary.

  • “She didn’t see reason to change course if her direction conflicted with the instruction manual, or, say, the natural laws of physics.”
  • “In college, I finally grew brave enough to tell her she had a drinking problem, but after three pointless attempts at an intervention, my efforts seemed futile. Her reality, no matter how factually incorrect or emotionally unjust, was all she could see.”

Blame and guilt
BPD parent can use guilt tripping for many different occasions to achieve what they want. Often they use it because they are afraid of the separation and are making their child feel bad every time s/he wants to do or go somewhere on their own. They of course don’t forget to mention “how alone they feel and how bad of a child you are because you are not spending more time with her”. Although the time that is spend with her is mostly in conflict.
Consequently you grow up blaming yourself for everything-for your mothers mood, for unsuccessful relationships that you are having, for wanting to have time for yourself, for eating too much, for eating too little, for not being “more” successful, for…

  • “I proceeded to ask her why she always has to twist things to make me feel bad, and she proceeded to tell me that I should be ashamed of the way I treat her, and blamed me for making her feel bad. The meeting ended with her throwing her Christmas present, a check for the wedding (which she initially refused to contribute to in any way, and wanted me to invite about 5 of her personal friends) and some of my stuff through the window of my car, and tell me that she’s done.”
  • “Out of the blue my mom asks me what I think about my new Mother in Law. I tell her that I’m very happy with her, and that she is a kind, patient, gentle woman, who listens and gives good advice, and always roots for me. Well, I might as well have crashed the car at that point, because my mother’s reaction was horrific, and completely manipulative. She said, “Oh good. You must be so happy to finally have a mother that cares for you.”

Abandonment
Abandonment issues are at the core of borderline personality disorder. They view separation as betrayal. They can use many forms of manipulation to try to prevent it. One of the most common manipulations is playing a victim, making you feel guilty, threatening with suicide and having an angry outburst. Abandonment doesn’t have to be real it can be something completely normal for child’s development. Like having a sleep over at a friend.
There are also other ways that BPD mother tries to prevent abandonment. One of them is to make the child her best friend. They develop a relationship with a child that is preventing him/her to become an individual. She may look to this child for comfort and validation rather than the other way around. It’s difficult to tell where the boundaries are between the mother and the child. Both tend to cling to each other in fear that the other one will leave.
It can also take the form of infantilizing their children. The mother is unable to tolerate her child’s developmental growth toward healthy independence. They find it difficult to adjust their parenting strategies to match the developmental needs of their children. Oftentimes, children who are being infantilized may develop depression, anxiety, developmental delays and may even be misdiagnosed with an autism spectrum disorder. In the extreme form infantilization can lead to Munchausen by Proxy.

  • “My mother always had a problem with either my Dad leaving (business trips, trips to see his family, extracurricular athletics) or her present husband (my step-father) going away. She stays home all the time, and presently has little to no friends.”
  • “There will usually be some kind of message or voicemail that doesn’t leave you the option of ignoring her, sometimes over-dramatizing what is going on to the point where it will make me panic, or at the very least, make it clear that I’m a horrible child if I don’t respond right away.”

Parental alienation
A mother with BPD may not be able to tolerate a loving relationship between her kids and their father. It is not uncommon for these mothers to speak poorly about their dads in an attempt to turn their children against them. The child can be used as a weapon to carry out her push/pull relationship with the father.

  • “Throughout my life, she looks for signs that I am “betraying” her with my Dad. She asks leading questions or comment about how I should or shouldn’t do something that might involve my Dad, testing me to see where I stand.”
  • “When my Dad showed me attention or gave me money to buy something nice for myself. She always punished me for it by silence for days or not giving me lunch money: “because your father already give you some.”

Jealousy
Mother with BDP is often jealous of her own children and sees them as a competition for attention, love, admiration and resources. The possibility that her child may be smarter, more attractive or popular can be very threatening to her.

  • “Even before that I could never bring anyone around my mom because she’d always find a way to make it seem like she was the perfect mom. The sickest part is that people would think she was this wonderful Christian women that could be the mom they never had. These people would confide in her and tell their deepest secrets and she’d share them with me. Trying to hurt me by showing me how much everyone loved her and wanted her.”
  • “I understand jealousy all too well. My mother actually slept with my first boyfriend to break us up. And she had a hand in my marriage crumbling as well.”

Control
There is a high need of control with BPD parents. They believe that they are entitled to unilateral control over the children. It is common that BPD mother sees the children as her property. She feels that everything that is going on in the family needs to go through her. In BPD families there are times with over-involvement, intrusive behavior and periods of withdrawn, avoidant behaviors. These behaviors may also manifest as oscillations between hostile control and coldness. It is quite common for parents with BPD to attempt to control their children’s behaviors, feelings, and actions to a degree that inhibits their child’s ability to develop independently.

  • “I always thought I had a great and loving mother who only wanted the best for me until I recently went to college. I realized it was more about controlling my life than actually wanting to help me. She was practically living through me. Every time I tried to tell her that she needed help, she became the victim and talked about how horrible of a daughter I was and all the lies I create.”
  • “I can’t make my own decisions because she always made them for me.”
  • “She always told me what to do and how to do it. How I should dress, who I should visit, with whom should I be friends, how should I prepared the food. She always corrected me in every way possible.”

Distraction
It is very common for BPD personality to find a way to distract themselves from reality of life. They turn to any kind of substance abuse and addictions, overspending, workaholism. Basically they can make every item their current obsession until they move on to a new one. They distract themselves from being left alone with their thoughts. It is very common that they struggle at nights when everything calms down.

  • “My mother is a shopaholic, and buys incredible amounts of stuff. She has purchased hundreds of hat boxes but she doesn’t wear hats. She purchased hundreds of shoes but she rarely leaves the house. As far as the eating, she is very, very overweight and binges on food through the night. She stays up all night and sleeps all day.”
  • “She also tends to really focus in on things that can distract her. When she was working, she obsessed with her work and left no time for any social life, and when she retired, she found new ways to stay constantly distracted”.

Center of attention
BPD personality demands attention at all times. They often creates high drama in order to get and keep the attention.

  • “On my wedding day my mother make it all about her. How her daughter is leaving her. She wept so loudly that we needed to stop the ceremony in order to calm her down.”

In Part I we saw what kinds of dynamics can occur in Borderline Families. In the second article (Part II) we will take a look at what kind of psychological burden a child who was growing up in Borderline Family takes with him/her.

In case you want to deepen your understanding of your relationship with your parents, please take a look at my online workshop “Mending our childhood wounds and patterns” HERE.

This workshop will help you with understanding the patterns, roles and attachment you are having in your family dynamic and will shine the light on your behaviors and wounds you are carrying with you. It will also teach you how to deal with your emotions that will evoke through this self-discovery.

NARCISSISTIC PERSONALITY DISORDER (NPD)

Nov7
  1. Definition of Narcissistic personality disorder (NPD)

The term narcissism was first used in relation to human psychology by Sigmund Freud in his essay “On Narcissism” after the figure of Narcissus in Greek mythology (Golomb 2003: 18).
The Myth: One day Narcissus was walking in the woods when Echo (mountain nymph) saw him, fell deeply in love, and followed him. Narcissus sensed he was being followed and shouted “Who’s there?”. Echo repeated “Who’s there?” She eventually revealed her identity and attempted to embrace him. He stepped away and told her to leave him alone. She was heartbroken and spent the rest of her life in lonely glens until nothing but an echo sound remained of her. Nemesis, the goddess of revenge, noticed this behavior after learning the story and decided to punish Narcissus. Once, during the summer, getting thirsty after hunting, the goddess lured him to a pool where he leaned upon the water and saw himself in the bloom of youth. Narcissus did not realize it was merely his own reflection and fell deeply in love with it, as if it was somebody else. Unable to leave the allure of his image, he eventually realized that his love could not be reciprocated and he melted away from the fire of passion burning inside him, eventually turning into a gold and white flower (Source: https://en.wikipedia.org/wiki/Narcissus_(mythology))
Narcissism is “a pattern of traits and behaviors which signify infatuation and obsession with one’s self to the exclusion of all others and the egotistic and ruthless pursuit of one’s gratification, dominance and ambition.” (Vaknin 2003:18) The narcissist constantly tries to repair his injured self-esteem by adoring and admiring his gilded self. (Golomb 2003: 18)

  • Diagnostic criteria

There is a whole range of narcissistic reactions, styles, and characteristics – from the mild, reactive and transient to the permanent personality disorder. NPD is commonly diagnosed with other personality disorders, such as Histrionic, Borderline, Paranoid, and Antisocial Personality Disorders (Vaknin 2003).
The ICD-10 (International Classification of Mental and Behavioural Disorders) defines NPD as “a personality disorder that fits none of the specific rubrics”. It relegates to the category “F60.8 Other specific personality disorders”, together with eccentric, “haltlose” type, immature,        narcissistic, passive-aggressive and psychoneurotic (ICD-10).
American DSM-IV-TR defines NPD as “an all-pervasive pattern of grandiosity (in fantasy or behavior), need for admiration or adulation and lack of empathy”.
The DSM specifies nine diagnostic criteria. Five (or more) of these criteria must be met for a diagnosis of NPD.
Proposed Criteria:

  • ‘Feels grandiose and self-important (e.g., exaggerates accomplishments, talents, skills, contacts, and personality traits to the point of lying, demands to be recognized as superior without commensurate achievements);
  • Is obsessed with fantasies of unlimited success, fame, fearsome power or omnipotence, unequalled brilliance (the cerebral narcissist), bodily beauty or sexual performance (the somatic narcissist), or ideal, everlasting, all-conquering love or passion;
  • Firmly convinced that he or she is unique and, being special, can only be understood by, should only be treated by, or associate with, other special or unique, or high-status people (or institutions);
  • Requires excessive admiration, adulation, attention and affirmation – or, failing that, wishes to be feared and to be notorious (Narcissistic Supply);
  • Feels entitled. Demands automatic and full compliance with his or her unreasonable expectations for special and favorable priority treatment;
  • Is “interpersonally exploitative”, i.e., uses others to achieve his or her own goals;
  • Devoid of empathy. Is unable or unwilling to identify with, acknowledge, or accept the feelings, needs, preferences, priorities, and choices of others;
  • Constantly envious of others and seeks to hurt or destroy the objects of his or her frustration. Suffers from persecutory (paranoid) delusions as he or she believes that they feel the same about him or her and are likely to act similarly;
  • Behaves arrogantly and haughtily. Feels superior, omnipotent, omniscient, invincible, immune, being “above the law”, and omnipresent (magical thinking). Rages when frustrated, contradicted, or confronted by people he or she considers inferior to him or her and unworthy.’ (Vaknin 2003: 19)

1.1.2. Short comparison with other personal disorders
As mentioned earlier NPD is commonly diagnosed with other personality disorders. In this chapter I will introduced short comparison with four other personality disorder.
Opposite from patients with the Borderline Personality Disorder (BPD), the self-image of the narcissist is stable, he or she is less impulsive, self-destructive and concerned with abandonment issues. Also they are not as clinging as BPD patients (Vaknin 2003). Borderline and narcissistic patients both idealize and devalue others. But there is a different between them. BPD patient alternates between idealization and devaluation. For example, first they will idealize you, you will be the best therapist they ever had, and in the next session they will devaluated you, you will be the worst person they had ever know.  Nevertheless, the borderline patient cares about others. The narcissistic patient is more exploitative. Idealization is connected with expectation to satisfied patient’s grandiose fantasy. The minute expectations are not met, narcissist abandons you and looks for another one who will meet his grandiose fantasies (MacKinnon and others).
In short, on surface functioning of the narcissistic personality is much better than that of the average borderline patient. In general, NPD individuals are more capable of high, sustained achievement and will have more successful work history than the person with Borderline Personality Disorder. Both kinds seek attention, but unlike borderline, who seek nurturing attention, narcissist feel they deserve admiring attention because of their superiority (http://www1.appstate.edu/~hillrw/Narcissism/differentialdiagnosis.html).
Histrionic Personality Disorder (HPD) and NPD: Both personality types tend towards the demonstrative, exhibitionistic, dramatic and seductive in their behavior. Contrary to the histrionic patient, the narcissist is achievements-orientated and proud of his or her possessions and accomplishments. Narcissists also rarely display their emotions as histrionics do and they hold the sensitivities and needs of others in contempt. While the characteristic distinguishing feature of Histrionic Personality Disorder is coquettishness, the feature of NPD is grandiosity. Person with HPD is warm, playful, and spontaneous and can be dependent on others. These individuals are capable of love, empathy whereas those with NPD are not (Vaknin 2003; look at http://www1.appstate.edu/~hillrw/Narcissism/differentialdiagnosis.html).
While persons with NPD and Antisocial Personality Disorder (ASPD) share tendencies to be tough-minded, glib, superficial, exploitative, and unempathetic, NPD are less impulsive, less aggressive, and less deceitful. All ASPD are assumed to have a narcissistic personality structure, but not all narcissists are ASPD. Unlike a person with ASPD, the person with NPD has not learned to be ruthless or competitively assertive and aggressive when frustrated. A critical distinguishing feature is that in ASPD, there are no feelings of guilt or remorse and as opposed to ASPD, few narcissists are criminals (Vaknin 2003; see http://www1.appstate.edu/~hillrw/Narcissism/differentialdiagnosis.html).
Patients suffering from the range of obsessive-compulsive disorders (OCD) are committed to perfection and believe that only they are capable of attaining it. But, as opposed to narcissists, they are self-critical. However, someone with NPD is more likely to believe that he has actually achieved perfection. Shortly, the OCD seeks perfection, the narcissist claims it. The value systems of these two personality types differ as well: person with OCD has deeply held, rigid but genuine moral and socio-political beliefs. In contrast, the person with NPD might exposed such deeply held values but actually lacks any true commitment to them (Vaknin 2003; see http://www1.appstate.edu/~hillrw/Narcissism/differentialdiagnosis.html).

1.1.3. Defense mechanism
Over all narcissists intended to protect true self from hurt and trauma. He creates False Self which is omnipotent, invulnerable, and omniscient, through which he regulates his self (Vaknin 2003). To maintain that state, narcissists develop different defense mechanisms. There are three defense mechanisms that are the most common for narcissists: splitting, graciosity and isolation/distance.
Graciosity: narcissist creates relationships only with people who admire them or who he admires. Consequently he is afraid that others will disappoint him or demand attention for themselves. When attention is turned away from them, they distance themselves and leaves the relationship (Praper 1996: 180).
Distance and isolation: narcissist doesn’t realize that he is hurt and wounded. When they got the feeling that others don’t see them as perfect, feeling of inferiority is awaken in them. They are unable to take criticism and take a distance when this happens (Praper 1996: 180).
Splitting or black and white thinking can be seen as a developmental stage as well as a defense mechanism, which is also common in NPD. Narcissist believe that they need to be admired by others. The ones who don’t admire them are categorized as bad. Their ego is not capable of accepting good and bad objects in one person (Praper 1996, see http://en.wikipedia.org/wiki/Splitting_%28psychology%29#Narcissistic_personality_disorder).

1.1.4. Types of narcissism
We all go through narcissistic developmental stage in our lives. As infants and toddlers we all feel that we are the center of the Universe and it is impossible to imagine that our needs wouldn’t be met (Praper 1996). Here we talk about primary narcissism, where toddler doesn’t separate the mother from himself and he depends on her to satisfy his primary needs (Lasch 1979: 79). Both self and others are viewed immaturely-as idealizations (Vaknin 2003). Gradually toddler gains experiences that everything cannot be the way he wants. He realize that there are obstacles in the world, which brings him little disappointments and make him overcome primary narcissism (Praper 1996).
Secondary or pathological narcissism is a pattern of thinking and behaving in adulthood. It manifests in the chronic pursuit of personal gratification and attention, in social dominance and personal ambition, bragging, insensitivity to others, lack of empathy and/or excessive dependence on others to meet his responsibilities in daily living and thinking (Vaknin 2003). Lasch says that this type of narcissism tries to destroy painful disappointments in childhood and cover the childs rage towards people that hurtled him. (Lasch 1979: 79)
Manfield differentiates the exhibitionist type and cover narcissism, both belonging to secondary narcissism (Praper 1996: 178):
The first type is exhibitionistic type. Children during childhood get a lot of support in their grandiosity but there is no room for individuality and true feelings. This type is common for families with one child. Investment in one child raises grand expectations. The child should be born genius, and should use every opportunity to demonstrate this to others. When not acting as expected, he can be roughly rejected by his parents. Avoiding rejection, he continues to be brilliant, perfect, sweet. He also requires that others treat him as special (Praper 1996: 178).
The second type is the disguised type. The child has experienced that grandiose ideas are unacceptable. He learns to hide any such feeling and behaviors. However, he still develops perfectionism and hypersensitivity to criticism. The need for superiority is suppressed while suffering from feelings of inferiority. The truth is that he in fact doesn’t believe that he is inferior (Praper 1996: 179). The disguised type appears humble and modest, so impressively weak that it isn’t difficult to overlook the hidden grandiose self (Praper 1996: 223).
Also Millon distinguish 4 subtype of secondary narcissism in the following photo:

Table: Narcissistic Personality Subtypes (available at: http://www.millon.net/taxonomy/summary.htm)

  1. Origins of narcissism 

NPD has been considered as pathology of self as formation of pathological development of identity (Praper 1996: 175). Considering the work of Otto Kernberg, narcissism is an ego distortion. Ego functions enable us to observe our self and environment. With narcissism, the ego is unable to develop observations from environment in to cohesive picture of self (look Praper 1996: 176). Kernberg sees narcissism as a defense against feelings of individual anger and abandonment, stemming from the child’s rejection. As a result narcissists are distrustful and incapable of relying on others. Their relationships are marked by jealousy, control, and withdrawal (Žižek 1987: 118-119).
By Kerenberg, pathological narcissism originates from the serious frustrations in separation phase (Praper 1996). Kernberg points out that narcissism is a result of permanently cold parental figures, which express indifference or hostility towards the child. This inadequacy is reflected in their tendency to inflate their self-image (Otway and Vignoles 2006).
Kohut believes that narcissism is a normal aspect of infantile development. The child’s self-grandiosity is supported by mirroring and idealizing relationship between child and parent. If these needs are not met, the child as an adult may appear poorly adapted to adult forms of narcissism (Otway and Vignoles 2006). He also believes that the loss of the object that would allow binding and idealized mirroring force the person to direct fantasy only to himself. Therefore, the NPD is looking for a person who would idealize him. Hoping that through the binding with others, he will achieve the feeling of coherent self. In reality he is looking for mother’s admiration that was not there (Praper 1996, 177). The secondary narcissism happens because the process of archaic infantile narcissism to a healthy adult narcissism is interrupt. (Otway and Vignoles 2006).
By Winnicottu, the reason for narcissism is the lack of empathy and harmony between parent and child. Another reason can be overly intrusive behavior from the parent. Child develops a false self, which protects the true self from intrusion and damage. Therefore, narcissists always offer impeccable false self and protect himself against feelings of inferiority (Praper 1996:177).
Millon’s theory opposes to mentioned theories which believe that negative relationship between child and parent is reason for narcissism. Instead, Millon says that the reason is the excessive attention of parents, over-pampering, forbearance and admiration. Parents show unrealistic judgment of the child’s abilities, thereby increasing children’s self-image, which the environment does not necessarily support. Despite the differences in the theories, all believe that narcissism is a result of dysfunctional childhood experiences. (Otway and Vignoles 2006)

  1. Personal attributes

Main personal characteristics which are normally found in NPD:
Sensitivity to criticism: patients with NPD feel injured, humiliated and empty when criticized. They often react with devaluation, rage, and defiance to any5 real or imagined criticism. They are incapable to tolerate setbacks, disagreement, and criticism. (Vaknin 2003)
In personal relationships narcissist is not capable of attachment to others. He depends only on recognition from others. He doesn’t t trust people because he has pathological fear of over-dependency on others. That’s why he usually have short love relationships that in his mind shouldn’t be too stressful or emotionally demanding (Žižek, 1987). The relationships are typically impaired due to their lack of empathy, disregard for others, exploitativeness, sense of entitlement, and constant need for attention (Vaknin 2003).
Narcissist is unable to enjoy because he connects enjoyment with others. Enjoyments starts when others notice his enjoyment. A narcissist is totally external, which indicates inner emptiness and loss of their identity.
Narcissist is incapable of mourning. They are not able to converting rage, because of the loss, to the mourning. He is only able to forget the lost object, or to determine that in fact he didn’t like them anyway. After that he directs his energy towards new person.
For narcissist, the availability of people is taken for granted. To this type of person you are not a person with feelings, you are a ‘thing’ to feed off and sustain their existence.
Narcissist use manipulation to get what he wants. He knows exactly which manipulative tactic is going to work best in which situation. When he wants something from us he pays attention to us but the moment he doesn’t need us anymore he acts indifferent toward us. Narcissists work within win-lose strategy. They believe their world is positioned to serve their insatiable needs. (Žižek, 1987; Tonia Evans 2008)
Being perfect: narcissist has a fear of failure, for example loneliness and aging. That’s why they take care of their body, trying to stay young  and be under the spotlight-so they won’t get lost in the crowd of average people (Žižek, 1987).  They are either “cerebral” (intelligence or academic achievements) or “somatic” (physique, exercise, physical or sexual prowess and romantic or physical “conquests”) (Vaknin 2003). Which means they are trying to be perfect in physical appearance or in intellectual accomplishments.
Narcissist in society: narcissist sees himself as some kind of an exception. He seems adapted to the social norms but he doesn’t take them seriously. He plays this game just to avoid punishment and be successful in the society. He is convinced that everybody else is doing the same-“everyone is wearing masks, social life is just a game” (Žizek, 1987). A narcissist sees the admired person as “an extension of themselves.” If that person refuses them, they “immediate experience hatred and fear, and devaluate previous Idol” (Lasch 1979: 155-156). A narcissist avoids intimacy and associates only with people who are, like himself-perfect (Praper 1996: 180). Žižek mentions three types of other people, separated by the narcissist:

  1. The ideal-other: they expect approval and recognition, he identified with them
  2. Enemies, who are preventing his narcissistic affirmation, so they must be destroyed
  3. All the rest, the mass of people, ”suckers”: a grey average, which is here only to take advantage off and then reject them (Žižek 1987: 111).

 

  1. Narcissist as a patient

Several different approaches to individual therapy have been tried with NPD patients, ranging from classical psychoanalysis to Gestalt therapy. The emerging consensus is that therapists should set modest goals for treatment with NPD patients. Most of them cannot form a sufficiently deep bond with a therapist to allow healing from early-childhood injuries as a matter of fact they rarely turn to therapy at the first place (Frey, 2010).
“As of 2002, there are no medications that have been developed specifically for the treatment of NPD. Patients with NPD who are also depressed or anxious may be given drugs for relief of those symptoms (Frey, 2010).
Kerenberg noticed that narcissistic patients shows excessive self-centeredness, over dependency on admiration from others, prominence of fantasies of success and grandiosity. They avoid facts that are contrary to their inflated image of themselves. A narcissistic patient due to the pain of isolation protects himself with a position of self-sufficiency. They don’t let people emotionally close (Kerenberg, 2007, 505; Praper 1996:223).
They suffer from inordinate envy, which is conscious and unconscious. They show greediness, exploitative behavior, entitlement, devaluation of others, and incapacity to really depend on others. But ironically they need the admiration of others. They show a remarkable lack of empathy, shallowness in their emotional life and lack of capacity for commitment to relationships and goals. Also their self-esteem is regulated by severe mood swings. They have chronic sense of emptiness and boredom which they try to escape through eating, drug and alcohol use. In addition, their tendency to criticize and devalue their therapists (as well as other authority figures) makes it difficult for therapists to work with them (Kerenberg, 2007, 505, Frey 2010).
Patients with NPD may present typical complications of this disorder, including sexual promiscuity or sexual inhibition, drug dependence and alcoholism, social parasitism, severe (narcissistic type) suicidality and parasuicidality (=their aim is not to die). For instance, a patient with NPD tends to become depressed when his feelings are badly hurt, when his defenses have let him down and when he believes his world is collapsing. When wounded, he is at the greatest risk of acting out, either against himself or others. A patient experiencing a narcissistic rage may become homicidal, particularly if he has a need to seek revenge. Under conditions of severe stress and regression, a narcissist can experience significant paranoid developments and brief psychotic episodes (look Kerenberg, 2007, 505; http://www.lmars.com/n-personality-disorder.htm).
Using Heinz Kohut’s self-psychology model, the goal of therapy is to allow the patient to incorporate the missing self-object functions into his internal psychic structure. This process is called transmuting internalization. In this sense, these patients’ psyches are “under construction” and therapy is their building time. Empathy is being the key for making changes in therapy. Without it, the patient whose self is too weak to tolerate more aggressive interpretation, would not benefit from therapy and in fact may suffer more damage (McLean, 2007).
Therapists can recognize narcissistic patients by contratransfer. By feelings of boredom and emotional desertion. The therapist may become sleepy, absent, experiencing shame. He can react as all-knowing expert on life, competing with all the therapists that client had left earlier. When the client devalues him, he feels inadequacy and helplessness (Praper 1996:223).
“The prognosis for younger persons with narcissistic disorders is hopeful to the extent that the disturbances reflect a simple lack of life experience. The outlook for long-standing NPD, however, is largely negative. Some narcissists are able, particularly as they approach their midlife years, to accept their own limitations and those of others, to resolve their problems with envy, and to accept their own mortality. Most patients with NPD, on the other hand, become increasingly depressed as they grow older.” (Frey 2010)

References

LOSS IN CHILDHOOD, LOVE RELATIONSHIPS IN ADULTHOOD, part 3

Jun13

There is not a lot written on how beavered children form romantic relationships as adults. In the final section of the article we will take a look at behaviors in relationships that can occur due to the loss of a parent during childhood. When a child looses his/her parent the connection between love and loss is no longer separated. “Deep down I believed that all man will eventually leave me.” was wrote by forum user who lost her dad. Research showed that many bereaved children are more hesitant about forming romantic relationships in comparison to their peers. However most adults do find their ways of having a relationship despite the potential loss. Some ways are functional others dysfunctional. Here we will take a look only on the dysfunctions that may occur in a romantic relationship.

I am looking for a unicorn
Some of them are determined to find the love they once knew. They are desperately seeking and are determined to find unconditional love that will heal their inner child. “For some individuals, this search for “all-powerful” love can feel almost desperate. The individual believes not only happiness, but survival itself depends on finding the needed partner. “(Harris, 1995, p.155).
“We lost our father when I was 5 and my brother was 9. He has had very few relationships, while I have found that I was diving from relationship to relationship, hanging on to people who were bad for me – possibly looking to replace the male affection and protection I never received as a little girl without the father.”

I can’t lose you

Many form the relationship but the anxiety of losing somebody is persisting. “After 25 years of marriage I still pay careful attention if my wife will leave me for somebody else or die in a car accident.” People who have experienced the death of a parent early on can be sensitive towards experiencing future loss. They are also less resilient in facing the rejection. 
On the other hand fear of feeling the deep loss again can be controlled by not fully committing in the relationship. They are changing the partners quickly or leaving before they are left.

No love for me
Some don’t pursue romantic relationships at all. Although they can feel the need to be connected to another person they feel terror when they think about getting close to someone. It is also common that they are not able to feel their need for connection or they are denying it. “I don’t need anyone I am better of alone. I feel happy that way.”

BEAVERED CHILD AND SURVIVING PARENT, part 1

HOW DEATH OF A PARENT CAN TOUCH US, part 2

HOW DEATH OF A PARENT CAN TOUCH US, part 2

Jun13

In the second article I will explore what an effect can the death of a parent have on our emotional and mental health. Consequences can occur shortly after the death or later in life. It is important to know that psychological effects of a parent’s death can occur long after feelings of grief are behind us and we seem to have adjusted to our lives.  Not everything is due to this one event but we can’t neglect the researches that show higher risk factor of developing disorders associated with a childhood bereavement.

Inner world
Feelings that can occur after the death of the parents also depends on the nature of their death. Sudden, unexpected death, slow death and suicide often arise different kinds of feelings in us. Feelings can continue for a lifetime if not addressed. Many don’t even connect them anymore with the death of the parent, because they got so used to them through the years.

  • Shame can be connected to the suicide death as well as feeling different from other children who have both of their parents.
  • Guilt is often present. We feel responsible for parent’s death although we didn’t have any control over it. Suicidal thoughts can occur because child wishes to reunite with the parent, although these are rarely acted upon.
  • One feeling that is not often talked about is a feeling of relief. That can arise from seeing your parent going through torture due to the disease as well as in cases where the parent was unloving or abusing. Their death brings peace to the child and the family.
  • Some detach form the enormous pain of the loss. They block out the feelings. They numb themselves even with a help of drugs or/and alcohol.
  • Feeling of profound emptiness that can come in waves or we feel it all the time. Some try to fill the emptiness while others accept it as a part of them. “I am filling my emptiness with reading obsessively, my siblings socialized excessively. Nothing bad, just in extremes. But it could as well go really bad because drugs are easily accessible.”
  • Feeling of being rootless and having no solid ground is shared by many.
  • Tendency to control/dominate in relationships. Control can occur due to a fear of loosing someone again. On the other hand others shy away from forming emotionally intimate relationships for the same reason.
  • Idealization of the lost parent. Children invent not only perfect, idealized parent, but also a parent who makes their every wish come true. On the other hand some block out the image of the parent completely or build unrealistic images of them to detach from the painful memories.
  • Adults who have experienced a childhood bereavement sometimes do not expect to live longer than their parent did. Some stop living after that point in their lives and they appear half alive. This connects them to the deceased parent. This dynamic can occur especially when the parent  of the same sex died.

Higher vulnerability

Studies have revealed many negative outcomes associated with a childhood bereavement:

  • Increased likelihood of substance abuse.
  • Higher risk of criminal behavior. Parents are not only mentors but serve as a safe net. They set the boundaries to the child when they are in their experimental phase. In the absence of a parent some children find themselves running wild. They don’t know how to control impulses and moderate behavior. At first the lack of a parent feels like freedom but it soon become overwhelming. Rebellious behavior can include anger, violence, criminal behavior and sexual promiscuity.
  • Academic underachievement and lower employment rates. Almost all kids will have some trouble in school after the death of a parent. But for those already struggling, the crisis can be devastating to their performance. On the other hand child can become driven to over achievement. Keeping themselves extremely busy to avoid painful emotions.

The following factors increase the risk of psychological disorders (anxiety, depression):
-loss occurred before child was 5 years old or during early an adolescence,
-loss of mother for girls before age 11 and loss of father for adolescent boys,
-conflictual relationships with the deceased preceding the death,
-psychologically vulnerable surviving parent who is excessively dependent on the child,
-lack of an adequate family or support by a community (supports),
-unstable, inconsistent environment. Including multiple shifts in caretakers and disruption of familiar routines,
-experience of parental remarriage if there is a negative relationship between the child and the new partner,
-lack of prior knowledge about death,
-unanticipated death (suicide, homicide)(Source: https://www.ncbi.nlm.nih.gov/books/NBK217849/)

BEAVERED CHILD AND SURVIVING PARENT, part 1

LOSS IN CHILDHOOD, LOVE RELATIONSHIPS IN ADULTHOOD, part 3

BEAVERED CHILD AND SURVIVING PARENT, part 1

Jun13

In this article we will touch very deep loss-the loss of a parent. It is hard to imagine how deep it cuts if you haven’t experienced it on your own skin. The best comparison I found was a comparison with a mountain climbing. Imagine that it is your first serious climb and you are accompanied by the professional climber. You rely on him with everything. He will show you the way, he will make sure that the way is safe, that you stay hydrated. In the middle of the mountain, your company dies. You are left alone. Chaos! Fear! That is exactly what a child who lost a parent feels. If a parent can disappear forever then nothing is safe and predictable anymore. Experience of the loss brings destruction to the family as a whole which often stops function as such and breaks down to individuals in the family.

Most people remember the day of the loss as being the end of their childhood. It marks a point before and after the life changed drastically. How was your experience like?

Grief
There is no universal face of grief. Children watch responses of the surviving parent and learn how they are “suppose to” mourn. “Is it O.K. to cry or I need to be strong and tough?”
The way someone grieves also depends on the age of a child. For example, those under the age of two may show loss of speech, while children under the age of five can respond by eating, sleeping, and urinary disturbance. School-age children may become phobic, preoccupied with body functions, withdrawn, or excessively care-giving. Especially in boys sadness may be replaced by aggression. Adolescents may respond similar to the adults, but they may also be reluctant about expressing their emotions due to the fear of being different.
Children who lost a parent when they were infants can feel absence instead of loss. “I don’t know what a “father” means. When I started school, I remember feeling different from other kids who had a mother and a father. /…/ There were no image (of father), just me, my brother, and my mother.” (Harris, 1995, p.18).
“My oldest brother was 13 when she died, and all he can talk about is what life would have been like if Mom had lived because he knows what life was like with her, he can really miss her. I never had her, so I don’t feel the loss. “(Harris, 1995, p.18).
Grief may continue on and off for many years, although it may get less intensive.



How did you and your family grieve? Did you grieve at all?

What a surviving parent can do for their children?

  • After such a traumatic event the best you can do is to keep child’s routines as regular as possible. That will lessen his anxiety and eventually bring back feeling of stability and security.
  • 
It is important for a child to have an adequate information about the death, suitable for their age. They are often afraid that a living parent can die as well. It is important to talk about their fears and reassure them that they are not to blame.
  • It is best to avoid any additional changes, such as moving homes, changing schools. Changes makes parental death significantly more difficult to deal with.
  • Sometimes the child lost not only one parent but has also lost the one who is still alive. They are (understandably) in such a pain themselves that they can’t manage keeping a family together. It is very important for a surviving parent to seek help form the community and/or professional therapist. Some surviving parents can respond to loss with abuse, neglect and anger towards their child. They can also make the child their “partner” or fall in such a deep depression that they withdraw from a child’s world completely.

How was it in your family? How did surviving parent manage to keep the family together in a long run? Did the surviving parent seek help?

Don’t talk about it

In some families the parental loss could not be talked about at all. Children can deliberately hide their feelings in order to protect the surviving parent. In my clinical experiences clients had little space to talk about their loss. Not that it was particular forbidden to talk about it but at the same time the topic was not mentioned because they wanted to save their family form any further pain.
It is essential to go through the painful feelings when grieving. Talk to your child about your feelings and encourage them to express theirs. You can also start some rituals that encourage family members to express their feelings. For example make a family gathering at the grave a yearly event where everybody can express their feelings and remember the deceased. Celebrate their birthdays or visit their favorite restaurant together every couple of months. Create a space where it is O.K. to express emotions about the loss for years to come.

Did you talk about the loss in your family? It is still O.K. to talk about it now as an adult?

-About 4% of children in Western countries experience the death of a parent.
-1 in 9 adults in a survey said they have lost a parent before they were 20 years old.
-40% recall frequently pretending to be O.K. not to upset their surviving parent.
-63% feared their surviving parent would also get sick and die.
Source: Poll by Greenwald & Associates for New York Life Foundation and Comfort Zone Camps.

HOW DEATH OF A PARENT CAN TOUCH US, part 2

LOSS IN CHILDHOOD, LOVE RELATIONSHIPS IN ADULTHOOD, part 3

AFTER BIRTH SUPPORT OPTIONS IN BERLIN

May11

In the spirit of my article Postpartum care and Eastern concept of “doing the month” in this article I am listing different types of care/help you can turn to during the postpartum period.

  • Partner: Talk to him. Let him know what you need from him and were he needs to take over after the baby is born.
  • Friends and family: If possible ask your family or friends to help you with cooking, cleaning and taking care of your older kids. Sometimes family can stress us out. It is important to think through who you would even ask. You don’t need extra stress, you need an understanding hand.
  • Online community can represent a great source of information and support. In Berlin there is a great Facebook group for Expats “ExpatbabiesBerlin” also “Supermamas Berlin” whose concept is to bring new mums in touch with more ‘experienced’ mums who live in the same neighborhood. Mums bring food, gift, and support to new mums. The new mums returns a favor to another new mom in the neighborhood at a later time.
  • Hebammen (midwives) offer pre and postnatal care. During the postnatal period (“Wochenbettbetreuung”), insurance will cover up to 26 visits for up to eight weeks after the birth. During these visits, she ensures that both the mother and baby are doing well. She will answer all questions regarding baby and you and will give suggestions if you will need specialized help. Here you can find the Hebamme list. In the search engine you can enter wanted area, language and type of care.
  • Familienzentren: All round Berlin there are Familienzentren. Each Zenter offers a variety of activities, support or help to young parents and families. Write to Zentren in your neighborhood to find out what they can do for you. Here you can find a list.
  • Aufsuchende Elternhilfe is meant for Families during the pregnancy and untill the child’s 1. year. The staff members of the Aufhilfe Elternhilfe provide support and health advice, social counseling, they can run errands, take care of older kids, accompany to the pediatrician and assistance in dealing with authorities. Help is free of charge. For more information turn to Kinder- und Jugendgesundheitsdienst des Gesundheitsamtes in your districts or contact organization directly, HERE.
  • Help through volunteers: Various projects, such as „Wellcome“, „Känguru“, or „Berliner Großelterndienst“ offer families help by trained volunteers. These offers are mostly free. For more information look at their webpages.
  • Home help as a health insurance benefit (“Haushaltshilfe als Leistung der Krankenkasse”): If the discomfort exceeds the normal level after birth (caesarean section, a multiple birth, premature birth, postpartum mental health issues, problems with breastfeeding) there is the possibility that your health insurance company will cover the costs of household help. You need to go to your doctor (Hausartz) and get a prescription where they state why and to what extent support is needed. You will need to pay 10% of the daily fee yourself – but not less than 5 euros and not more than 10 euros per day.
  • Paid help during pre/postnatal period: cleaner, babysitter, doula, sleep consultant, lactose consultant, pelvis floor consultant.

POSTPARTUM CARE

May9

After the baby comes, attention shifts from you to your baby. In most cases even mom can only focus of taking care of the baby, but who is now focusing on her? It is very important that after birth you are your own number one advocate and you take good care of yourself. You don’t need anyone’s permission, that is your right. Taking great care after birth helps prevent postpartum depression, anxiety and obsessive compulsive disorder. Furthermore, it helps your body to heal fully.

I heard so many times from my “after birth support system” that you are not allowed to donate blood 1 year after giving birth because birth is the same as going through a major surgery. Even if you don’t feel it, it doesn’t hurt to realize that your body is going through its own demanding processes during the pregnancy and also long after birth.

I believe many mothers don’t realize how important it is to take at least 3 months to nurture themselves after birth. I took a whole year. To me, my only job the first few months was taking care of myself and the baby. Meaning breastfeeding, being close to her and snuggling.

How to nurture yourself? Sleep, rest and eat well. Make sure that you are getting enough vitamins, minerals and amino acids through nutrition into your body. A lot of the nutrients will go through breastfeeding to the baby. You need to have enough for both of you. Seek advice from your doctor about supplementing if needed.

A wonderful concept that convinced me was so called “doing the month” (zuo yuezi) that derives from Chinese culture. While exploring this concept I figured out that a lot of eastern countries follow the similar idea. Of course, this is an old concept so some of its directions don’t apply to today’s mothers, but let me pinpoint some of the guidelines that are followed after the birth in different cultures:

  • In these cultures, the postpartum period is a time when the mother is supposed to recuperate, her activities are limited, and her (female) relatives take care of her. How long after birth this period last varies a little bit from culture to culture but mostly its lasts somewhere between 3-6 weeks, and in Korean culture up to 100 days.
    During those weeks, visitors are prohibited, and new mothers and newborns are not allowed to go out unless it is really necessary. The reason behind it is to avoid contact with a possible source of infection. Mothers are encouraged to abstain from chores, food preparation and cleaning. This time is meant for rest and being with a newborn.
  • As mentioned above, women who practice this tradition are not alone, and that lowers the anxiety and stress of motherhood. In these cultures, friends and relatives provide the family with meals and take care for other children.
  • Cold/hot concept: One common belief is the necessity of maintaining a “hot-cold balance” within the body and with the environment after the birth. Cold and wind are pathogenic factors in Chinese medicine, meaning they can trigger a disease process. In many non-Western cultures, blood is considered “hot.” During the birth women losses blood and it is considered to be in a cold state. Consequently the goal is to keep the mother warm after birth. This is achieved through various ways: food, warm environment, clothes, and baths. In China there is “no shower” rule after this period. This rule made sense in the past because there was an absence of proper shower systems and hair dryers. Back then, new mothers could have easily gotten a cold after a shower. Nowadays this doesn’t apply anymore, but some still follow this rule.
  • Food: Mothers are fed very simple but special foods and a number of herbal drinks to promote healing and recovery, boost their immunity and improve their milk supply. It is advised to eat warm and cooked foods. Cold food in Chinese medicine means that food has a cold (or hot) characteristic and not that is physically cold. For the list of cold foods according to Chinese medicine look here.
  • Pampering during this time is also very important. In India mothers are given massages with warm oils daily.

The most common underlying theme throughout this concept is protecting the mother and newborn from exposure to pathogens and extra stress. This may quicken recovery time, potentially preventing postpartum mental health issues and other health problems, while promoting healthy milk production and a healthy immune system for both the mama and baby. If this concept felt close to you try to apply it as much as possible after your birth. You can also read the article “Where to find extra help in Berlin, Germany” HERE.

EMOTIONAL AND PHYSICAL DIFFICULT PREGNANCY

May8

This is an article for future moms who struggle with their pregnancy. I wanted to open up about a topic that is both close to my heart, and at the same time seems to be a taboo for pregnant women to talk openly about it. Although I don’t know about your experience, but when I was going through mine, many people “allowed” just one experience of pregnancy – the experience of joy. Every time I went off this script, I could see it in their faces – worry. Looking at me with the thought in their mind: “Will you be a loving mother?” or they try to advise me on how to help myself become a happy pregnant lady. No, I wasn’t  imagining my feelings, and my hormones also didn’t trick me to feel something that was not there. Many people start to feel uncomfortable when you describe your pregnancy as unpleasant, having doubts, having no feelings towards your baby, etc.

My pregnancy wasn’t planned, and I was experiencing a state of shock and a lot of deeply negative emotions deeply into 5 months of being pregnant. Some of them could be connected with my really bad physical state until the 19th week, but not all of them. I dealt with life struggles the same as I advised my clients. I talked about how I feel. Consequently, I was getting different responses from people around me, but only a few had a sympathetic ear.

Even if you were planning to have a baby, you still can be shocked when you find out. Being pregnant can be something that is hard to comprehend at times. A lot of pregnancies are unplanned, or women feel society’s pressure to have a baby. However, even if you planned it, you can still experience negative emotions while pregnant. And you have every right to feel this way.

There is a range of feelings that can occur here, and I will write about a few of them: Doubting if you will manage to handle it, doubting if you will love your baby, not wanting to have your baby, not feeling connected, being deeply disappointed about the gender of your baby, feeling sad about becoming a mother, hating your pregnancy, hating body changes, worrying that your life will end, worrying that you will have no freedom, etc. Also, some of your dormant traumatic memories can awake while pregnant or postpartum. It is not uncommon that we remember our childhood trauma while becoming a parent.

All the feelings that you are experiencing while pregnant don’t tell how you will feel as a mother. For example: you can be looking forward to your baby but once it’s born, you can feel resentment or have trouble to connecting with it or . It can happen that you will have intrusive thoughts about you or your baby. What kind of thoughts? Killing you baby, hitting it, throwing it. You can find a little bit more about different pre/postnatal mental states HERE.

The medical environment can brush off these things too easily. In my experience nobody asked me if this pregnancy is planned and how I feel about being pregnant and becoming a mom. Probably they assume that all is well because of my age. Furthermore, so many doctors shared with me that this is really happy occasion. I believe we should be more careful in the medical field about how we approached someone. It is safer to ask a person about their feelings then just assuming happiness.

My belief is that it is important to talk with people who aloud you to feel how you feel and/or to seek safe therapy space were you can discuss your feelings no matter how “negative” they are. I am not here to give you advice or to have therapeutic goal to put you “on the right path” so that you would feel joy about this time of your life. I am here to listen, to hold your emotions and to create a nonjudgmental, safe place for them in case you decide you want to deal with your emotions in psychotherapy.

Do you want additional support for upcoming childbirth? I prepared an ONLINE WORKSHOP for pregnant soon to be moms, that want to emotionally prepare for upcoming childbirth in the safety of their own home.

When I was pregnant, I used my psychotherapy knowledge to prepare myself emotionally for the birth. Finding the lack of resources out there to not just technically but also emotionally prepare me for childbirth gave me the boost, to create this workshop for other women as well.