ABSTRACT: Those with Borderline Personality Disorder
live at the “Edge of Chaos.” Sensitive to the initial conditions
of their lives, they are labile, jostled by the slightest perturbations
into unstable states of being. They inhabit the borderline between
psychotic and non-psychotic states. Psychotic episodes are generally
transitory and relatively brief, but the personality disorder, an attractive
impulse without logic, is notoriously intractable. It can be conceptualized
as a level of personality organization rather than a disorder.
Borderlines are raised within dysfunctional family systems
where emphasis is on maintenance of family myths in the face of neglect
and/or abuse (physical or sexual) through double-binding messages or communication
given to the child victim. There is a discrepancy between the social
facade presented to the outside world and the actual transactions within
the family. The child creates defenses including denial of fantasies
of "good enough" parents in order to deal with painful realities.
Family members often collude with the abuser either to justify the abuse
or to keep it a secret. The victim is damned by the fact that the
abuse is either denied as real or the child is accused of causing it.
Therefore, the child is either mad (“crazy”) or bad.
The borderline personality is characterized by the following features according
to the DSM-IV: (1) acting out in potentially self-damaging ways both socially
and physically, including but not restricted to suicidal behavior, self-mutilation,
fights, and accidents; (2) unstable and intense interpersonal relationships;
(3) difficulty with the expression of anger; (4) uncertainty about identity;
(5) mood swings; (6) intense ambivalence about being alone; and (7) feelings
of emptiness and boredom.
The assertion that borderline disorders develop as a result of factors
inherent in the family of origin involves rejecting the idea of developmental
fixation. Borderline phenomena can be better viewed as a response
by certain children that entails structuring perception of the social environment
in maladaptive ways in order to deal with incongruencies within the family.
These incongruencies need not occur in a context of overt physical or sexual
abuse, although most often they do. The important factor is that
such children grow up in a matrix of double-binding, no-win situations,
where their experience is fundamentally discounted, (Price, 1990).
The struggle to formulate a viable sense of a worthwhile self in the face
of such dynamics is formidible. The myth of the scorpion surrounded
by flames seeking in its pain to sting itself to death comes to mind with
regards to these individuals. That devaluation is a double-edged
sword with which narcissistically defended individuals seek to undermine
the self esteem of others does not negate the fundamental nonacceptance
of one’s self that stands at the root of these disorders.
The essential feature of this disorder is impulsiveness, a pervasive pattern
of instability of self-image, interpersonal relationships, and mood, beginning
in early adulthood and present in a variety of contexts. Alternation
between dependency and self-assertion is common. They are generally
pessimistic and socially contrary. Under stress, transient psychotic
symptoms may occur. Complications include narcissism, dysthymia,
major depression and substance abuse.
According to DSM-IV, in borderlines there are no Hypomanic episodes unless
there is a coexisting mood disorder, such as manic-depression. In
some cases, both disorders may be present. Predominantly more females
than males are diagnosed with this disorder.
A marked and persistent identity disturbance is almost always present in
these impulsive personalities. There is a pervasive uncertainty about
several life issues, such as self-image, sexual orientation, long-term
goals or career choice, types of friends or lovers to have, or which values
to adopt. The person often experiences this instability of self-image
as chronic feelings of emptiness or boredom.
Interpersonal relationships are usually unstable and intense, and may be
characterized by alternation of the extremes of overidealization and devaluation.
These people have difficulty tolerating being alone, and will make frantic
efforts to avoid real or imagined abandonment.
Emotional instability is common and includes radical mood shifts from boredom
to depression, irritability, or anxiety, usually lasting a few hours or,
sometimes more than a few days. They display inappropriately intense
anger or lack of control of their anger, with frequent displays of temper
or recurrent physical fights. Their impulsive activites are potentially
self-damaging, such as shopping sprees, substance abuse, reckless driving,
casual sex, shoplifting, or binge eating.
Recurrent suicidal threats, gestures, or behavior and other self-mutilating
behavior is common in the more severe forms of the disorder. This
behavior is used to manipulate others but is actually the result of intense
anger and is used to counteract feelings of “numbness” and depersonalization.
The dissociative aspects are amplified by extreme stress.
Borderline Personality Disorder is diagnosed when at least five of the
(1) a pattern of unstable and intense interpersonal relationships characterized
by alternating between extremes of overidealization and devaluation;
(2) impulsiveness in at least two areas that are potentially self-damaging,
e.g., spending, sex, substance abuse, shoplifting, reckless driving, binge
(3) affective instability; marked shifts from baseline mood to depression,
irritability, or anxiety, usually lasting a few hours and only rarely more
than a few days;
(4) inappropriate, intense anger or lack of control of anger, e.g.,
frequent displays of temper, constant anger, recurrent physical fights;
(5) recurrent suicidal threats, gestures, or behavior, or self-mutilating
(6) marked and persistent identity disturbance manifested by uncertainty
about at least two of the following: self-image, sexual orientation, long-term
goals or career choice, type of friends desired, preferred values;
(7) chronic feelings of emptiness or boredom;
(8) frantic efforts to avoid real or imagined abandonment. (DSM-IV).
“All patterns of pathological personality--be they of mild, moderate,
or marked severity--are deeply etched and pervasive characteristics of
functioning that unfold as a product of the interplay of constitutional
and experiential influences. The behaviors, self-descriptions, intrapsychic
mechanisms, and interpersonal coping styles that evolve out of these transactions
are embedded so firmly within the individual that they become the very
fabric of his or her makeup, operating automatically and insidiously as
the individual’s way of life. Present realities are often mere catalysts
that stir up these long-standing habits, memories, and feelings.
Past learnings frequently persist inflexibly, irrespective of how maladaptive
or irrational they now may be. Sooner or later they may prove to
be the person’s undoing. Self-defeating vicious circles are set up
that precipitate new difficulties and often reactivate and aggravate earlier
unfavorable conditions of life.” (Millon, 1981).
Those with all forms of maladaptation deteriorate in their functionality
when they are subject to stress. Under increasing difficulties they
can become effectively immobilized and fail to cope. This breakdown
further increases difficulties. When inner resources fail, they may
abandon all attempts to maintain psychic cohesion, and fail to discriminate
between inner subjective experience and external reality.
“As reality recedes further into the background, rational thinking disappears,
previously controlled emotions erupt, and a disintegration and demoralization
of self often takes hold. The upsurge of formerly repressed feelings
and memories combines with new adverse experiences to undermine the individual’s
remaining coping capacities. Fearful of losing their tenuous hold
on reality and threatened by surging emotions and uncontrollable and bizarre
thoughts, these individuals succumb further. Deteriorating to more
primitive levels of functioning and retreating into an inner and unreal
world, they may ultimately fall into a pesistent and more pernicious pattern
This disorder is a dysfunctional personality pattern that has crystallized
into habitual, and enduring pathology. When coping mechanisms and
strategies fail to work under stress, they decompensate toward social invalidism
and periodic but reversable psychotic episodes.
CONVENTIONAL TREATMENT OF BORDERLINE DISORDER
The borderline classification refers to a deeply ingrained personality
pattern. According to conventional wisdom, nothing but the most prolonged
and intensive therapy will produce substantial changes. There are
many others disorders which can complicated the borderline profile in combination
These associated disorders include anxiety disorders, obsessive-compulsive,
somatoform, dissociative, affective, and schizoaffective disorders.
Also there are many personality variants within the borderline syndrome.
These include borderline-histrionic, borderline compulsive, and borderline-passive-aggressive
mixed personality, and the hazy, dreamlike world of the decompensated borderline
personality. There are different stages in the disturbance and different
severity within those stages (Millon, 1981).
During quiescent periods there are different treatment goals than during
decompensation. Quiescent periods offer the opportunity to facilitate
autonomy, build self-confidence, and overcome fears of self-determination.
These changes will probably be resisted. Borderlines mistake encouragement
toward self-responsibility for rejection, even from their therapists.
They think it is a criticism and effort to get “rid” of them.
When they feel secure in the therapeutic alliance, they can learn to face
and tolerate contrary feelings and dependency anxieties. Learning
to face and handle unstable emotions is coordinated with the strengthening
of healthier self-attitudes and interpersonal relationships.
The therapist serves as a model to demonstrate how feelings, conflicts,
and uncertainties can be approached and resolved with reasonable equanimity
and foresight. This somewhat counteracts at least the cognitive portion
of the impulsive personality.
Most borderlines seek and have maintained occasional satisfactory social
relationships. Their need for attention and approval, their history
of at least partial encouragement in childhood, their interest in gaining
some support and nurturance, and their desire to restrain contrary and
troublesome impulses, all decrease the probability of inevitable decompensation.
The more support from family and friends, the less destructive the mental
illness. This means positive support. Too much dependency creates
mutual resentment and creates intolerable conflict. The person needs
to be encouraged to accept responsibility for his or her own care, welfare,
and health. Otherwise, a slow or fast decline into persistent social
invalidism can result.
Clinging helplessness, resentful stubbornness, hostile outbursts, pitiable
depression and self-denigrating guilt seem notably wasteful and self-destructive.
Borderlines wear people down and provake them to exasperation and anger,
which, in turn, only intensifies the anxieties and conflicts they feel.
Signs of decompensation begin with marked discouragement and persistent
dejection. Conventional treatment offers supportive therapy and cognitive
reorientation. Efforts are made to boost their sagging morale, and
encourage them to continue pursuing their range of activities.
Activity builds self-confidence and minimizes rumination and preoccupation
with melancholy feelings. They should not be told to “snap out of
it,” as if it were a rational choice, nor pressed beyond their capabilities.
Failure to achieve these goals only strengthens their growing conviction
of their own incompetence and unworthiness.
The limits of conventional treatment include electroshock therapy (ECT)
for extreme depression and brief institutionalization during suicidal or
hostile outbursts. Antidepressants and antianxiety medication is
TRANSACTIONAL ANALYSIS AND BORDERLINE DISORDER
The typical borderline comes into treatment because of intense disatisfaction
with people, especially love relationships, loneliness, painful feelings
of inadequacy, boredom with work and seething rage. Relationships
are stormy, never last long, and end in bitterness. Payoffs from
unpleasant endings include reinforcement of paranoia. The self-destructive
urge can express socially in angry termination of relationships whenever
the slightest threat of rejection appears. Suicidal urges and talk
are common in the middle of the rejection game.
These individuals feel like they were born the wrong person in the wrong
family, “No matter what I did, it was never right.” Parents are often
dissatisfied with the child from the very day they are born, if not before.
The child valiantly tries to assert his or her individuality against overwhelming
odds. But only depression follows self-assertive behavior.
Borderlines spend a tremendous amount of energy consoling themselves for
perceived failures--reenacting the relationship with the actual parents
and demonstrating the pathological corruption of the Nurturing Parent function.
The logic of family myths in physically and sexually abusive families is
simple and damning for the victim. The abuse is either denied as
real or the child is accused of causing it. The child is labeled
either crazy or bad. In such families it is difficult for children
to value themselves and to feel they deserve to take initiative in a meaningful
way. They are forced to collude in distorting and/or denying reality
in the service of the abusive family’s need to maintain a facade of social
Struggling with their parent’s “pure” persona and their secret, dark shadow
side leads to splitting to deal with the abusive reality. The child’s
only out is to collude in the betrayal either by dissociating and developing
amnesia for the experience or by using splitting to deny that the abuser
is bad. This strategy comes at a high price. The goodness of
the abuser becomes a direct function of the perceived badness of the child.
These children are left with tremendous retroflected anger and vicious
internal voices. With no outlet for anger, it is turned against themselves
Double-binds are the other transactional structures which create emotional
crippling. Conflicting messages are given. If the message is
an injunction, it must be disobeyed to be obeyed. The child is not
allowed to show any awareness of contradictions or the real issue involved.
They are punished or at least made to feel guilty for correct perceptions,
and defined as bad or crazy. When double-binding is chronic, it turns
into a habitual expectation regarding the general nature of human relationships
and the world at large. This expectation does not require further
reinforcement to persist.
Double-binds play a central role in the formation of borderline self disorders.
The child is forced to distort or deny reality in a way that compromises
the capacity to develop an integrated sense of self and other. Such
double binds need not occur in a context of physical or sexual abuse, but
in such situations it has the most damaging effect on the developing self.
It is a no-win situation for the child; even when dutifully and loyally
complying with the parents’ distorted vision, they are labeled negatively
and attacked. The other crucial dynamic in these families is the
desperate need to deny trauma in order to protect the image of the abusive
parent as good.
Children deal with the reality of neglectful and abusive parents by maintaining
an idealized image of the parents even if the cost is to deny reality and/or
label themselves as bad. The splitting of reality-based perceptions
into good and bad by using denial, enables the child to lessen his or her
anxiety and rage. The child colludes with these factors in a desperate
attempt to adapt to the social realities inherent in the family.
Borderlines structure their inner representations of Parent and Adult,
and significant other in light of these factors in the family. They
introject the negative family dynamics into other relationships.
The child, even as adult, is permanently under the influence of a vicious
internal parent. These inner figures take on a life of their own.
The borderline is unable to integrate contradictory good and bad self-
and other representations. The resulting splitting involves the projection
of split object and self-representations onto the here-and-now social environment.
Another form of projection common in this group is projective identification.
The individual projects onto another the rewarding and withdrawing relations
the parent displayed. Identifying with the aggressor, an example
of this process, allows the child to experience feeling empowered rather
than helpless. They invite the other person to identify with the
disowned, projected representation of the self as a victimized child, inadvertently
showing them “how it feels.”
Such projective mechanisms can cause dramatic fluctuations and shifts which
are independent of current environmental considerations. Those who
fail to form a cohesive view of themselves often exhibit dramatic shifts
between different representations of themselves. There is little
capacity to integrate these elements into a functional, fully autonomous
Poor boundaries between self and others around responsibility for thoughts,
feelings, and actions are common. The child experienced being solely
an extension of the parents. This creates fear of engulfment and/or
rejection. Parents communicate the covert rule: “Don’t exist separate
from my wants, desires, and representations of reality.”
Attempts to perceive reality get the child rejected. The alternative
is to discount oneself by allowing one’s reality to become an extension
of the parent’s need to deny and distort untenable realities.
These children develop an abiding sense of incompetence and undeservedness,
and fear of failure. They are self-defeating in terms of relationships
and success. It is difficult for them to avoid depression because
their deep-seated doubts about their abilities. Their denial of reality
is coupled with unremitting self-hatred and self-defeating patterns consistent
with the injunctions ranging from Don’t Be and Don’t Be Sane to Don’t Feel
and Don’t Make It.
The emptiness these people feel is revealed in their struggle with aloneness.
The constant striving to find and maintain a stabilizing object has been
linked to abandonment issues. They are attacked continually by internalized
negative parent messages, flooding by images of abusive past experiences,
and other anxiety-provoking dissociative phenomena. They strive to
maintain contact with a primary other in order to generate an external
focus, thereby avoiding painful internal realities.
Messages of “You’re wrong,” with the implication of discounting that “You
do not exist,” along with the double binds, create the disorder.
Devaluation is a double edged sword with which narcissistically defended
individuals seek to undermine the self-esteem of others. It does
not negate the fundamental nonacceptance of one’s self that stands at the
root of these disorders.
Borderline patients are aware of their separation from others and are threatened
by it. They have not completed their individuation and alternately
distance and cling. Their life position swings back and forth between
“I’m OK, You’re Not OK” and “I’m not OK, You’re OK”.
The borderline is stuck in certain Child ego state emotions which operate
in a dysfunctional manner. Experience of one feeling keeps other
feelings out of awareness, unavailable for problem-solving behavior.
Fear, anger, and sadness are Child ego state responses, to the threat of
danger, to not getting what one wants, and to loss.
In the case of borderlines, great fears include fear of failure and negative
internal Parent messages, engulfment or rejection. Anger comes from
wanting someone else (inadequate parents), thing or circumstance to change.
Sadness results when focus remains on what has been lost while not doing
anything pro-active to change and adjust. Sadness is part of the
grieving process. Sadness is the giving up of anger, dropping the
effort and abandoning hope that one will be successful at instituting change
Fear, anger, and sadness are functional when they help us resolve our problems
and are accompanied by functional behaviors. Fear helps us avoid
threats, anger precipitates change; sadness and grief help us give up hope
for impossible change, and plan for a future that excludes what has been
lost. They may be uncomfortable, but not unbearable.
These emotions have a temporal quality: fear deals with the future
and what might happen; anger deals with the present we don’t like and want
to change; sadness deals with the past and adjustment to losses we have
sustained. When feelings are out of temporal order, they are not
functional. This includes fear about the past, sadness about the
future, and anger about the past which are defined in TA as dysfunctional
One “allowable” feeling may mask the others’ unconscious influence.
If one continues to feel angry, it masks underlying fear and sadness (chronic
hurt and depression). The primary way one gets stuck in fear, anger,
or sadness is by not recognizing that another feeling is also present.
Only after realizing their fear and sadness can borderlines experience
more control over their anger.
The therapist’s job is to help bring to awareness those hidden parts of
the fear-anger-sadness complex. All these feelings are painful: fear/paranoia;
anger/rage; sadness/boredom-depression. Becoming aware of anger and expressing
it does not mean becoming violent. It means having an internal awareness
and an emotional expression of the awareness. The therapist’s job
is to foster that awareness and emotional expression in safe and appropriate
When behavior is not functionally consistent with feelings (for example,
being angry and doing nothing), inconsistent behavior is the response to
the hidden feelings of fear and sadness. Because those feelings are
not experienced consciously, no part of the feeling complex is resolved.
The original dysfunctional feeling is uncomfortable and one remains stuck
Treatment of one stuck feeling entails the awareness and expression of
all three feelings. If the person is aware of and expressing his
functional fear and anger, there is little drive to hold on to these feelings
and they will be accompanied by functional behavior. Sadness will
be a rebuilding process after loss, not depressive inaction. They
become aware of the temporal appropriateness of emotions: what they
are afraid will happen, what they are angry about and want to change now,
and what they are sad about that can no longer be changed.
CRP helps borderlines be aware of and express all three feeling states
in safe and appropriate ways. By accepting and experiencing all three
states, their functions, and their temporal qualities, and the appropriate
actions that go with them, they can get unstuck from dysfunctional feelings,
and move on. This re-organization results in a more stable individual
with a new existential self-image.
They learn the full range of feelings needed for effective responses to
threat and loss. They experience fear, anger, and sadness as appropriate
reactions and resolve these feelings through congruent actions. This
helps them in self-reparenting, developing a sense of utter reliability
that may have been missing in their childhood. Though borderlines
are notoriously slow learning, not learning from past mistakes, CRP cuts
below this level to restructure personality at the most fundamental level,
dissolving old blocks, and facilitating natural healing.
BORDERLINE PERSONALITIES AND CONSCIOUSNESS RESTRUCTURING
Borderlines live at the edge of chaos, the very borderline between the
psychotic and non-psychotic. They drift in a twilight between reason
and despair. This condition of living at the threshold might be termed
limerance. They have a rather tenuous hold on reality which can disintegrate
along with their capacity to function. “Borderline” is a rather odd
term for a condition that might be better described as cycloid. Both
impulsive and erratic moods are combined in a single syndrome.
This condition might aptly be called “unstable personality disorder,” as
behavior and moods are labile. It is a periodic and circular insanity.
Borderlines shift almost randomly from depression, to anger, to guilt,
to elation, to boredom, to normality, and so on in an unpredictable and
inconsistent course. This suggests a “strange attractor” as the formative
source of the disorder.
The overall structure presents the picture of a checkered history of disruptions,
predicaments, and disappointments in personal relationships, school and
work performance. Even talented, intelligent borderlines fail to
fullfill their potential and keep pace with their age peers in accomplishments.
Deficits in social attainments, inability to learn from prior difficulties,
a tendency to create self-fulfilling prophecies, and self-defeating behavior
create a tight border of limitations within which they function with greater
or lesser ease. When dis-eased, they create digressions and setbacks
from earlier aspirations, and fail to achieve a comfortable niche in life
that is rewarding and fulfilling. While they can be generally functional
marginally, there are transient episodes of extremely bizarre behavior.
Each borderline is unique, and treatment must be adjusted accordingly.
They display a wide variety of clinical features. This disorder can
appear in combination with manic-depression, narcissism, passive-aggressive
personalities, etc. Each has different parameters, and each case
lies somewhere on a continuum of severity of expression.
The Consciousness Restructuring Process is a natural form of self healing.
CRP is a REM or dream journey process that restructures the fundamental
consciousness dynamics and neural patterns underlying any disease structure
or faulty personality organization.
Healing occurs within the journey (REM), first dissolving the old maladaptive
form or self-image attractor, and allowing the emergence of a new self-organizing
pattern of personality from a creatively reformed sensory existential self-image.
CRP is non-specific and works on changing the neurological consciousness
structures, facilitating changes in old dysfunctional personality patterns.
Even when experiences have conditioned an individual into extremely stable
patterns of unstability at all levels of being (existential, physical,
emotional, mental, and spiritual), CRP can gently dissolve those old rigidities
and nonadaptive patterns and strategies, creating permission and a physical
basis for realizing changes at the deepest level. With supportive
therapy (reparenting and social skills) in conjunction with CRP, new strategies
and coping tools can be incorporated at the deepest sensory levels, instigating
In REM (Rapid Eye Movement) consciousness, natural healing occurs in the
course of natural healing journeys. Inner journeys recreate sensory
memories of fetal experiences, and even the pre-sensory level of earlier
consciousness structures when our incorporeal essence began to crystallize
and take form. REM is crucial to reaching these deepest consciousness
structures, and to the subsequent healing dynamics that result from these
encounters. REM is the primary consciousness shared in common by
both child and adult.
CRP posits that for the fetus and the adult, REM consciousness programs
the brain with capabilities in each developmental stage. In order
to re-experience the learning processes that were so important to earlier
development of our physical and personality structure, we re-enter the
consciousness in which they they were fed or programmed into our being.
This is REM-consciousness, as research has shown.
We know from chaos theory that any complex system is very much influenced
by minor perturbations or differences in its initial conditions.
In chaos theory, this is known as the “butterfly effect.” This is reflected
in the unstable personality type of borderline disorder.
Even before birth sensory perceptions in REM consciousness shared by fetus
and parents can greatly influence the physiology, personality and coping
strategies of the future adult. Return to these consciousness structures
in REM can very well allow us to rewrite this early programming, and to
do so in the state that is associated with the formation of our nervous
system and cells (Swinney, 1997).
The use of wakeful REM consciousness allows the borderline to fully experience
with the senses the transformative or healing experience. In the
healing of trauma in REM, the brain and physiology are incapable of distinguishing
between dream experiences and outer experiences. Therefore, CRP,
as a therapeutic process has real consequences in the real world, and is
much more effective than simple visualization or imagination.
REM is conducive to new learning and the formation of new neural patterns.
It is our experiences that program us, and shape neural circuitry that
in turn shapes both our personality and body chemistry. Thus therapeutic
experience can dissolve and re-write old outworn dysfunctional patterns
and forms. Fundamental perceptions of self and reality are changed,
particularly those revolving around fear, anger, and sadness.
CRP journeys complete the cycle that has gotten stuck in the unstable personality.
This chaotic, implicate or complex consciousness is the dynamic in which
healing transformations are initiated by changes in the primal existential
The chaos of no-change in the unstable personality is transmuted by deepening
its imperative. Things change and chaos ensues until the new order
appears. Chaos is actually the mechanism of change itself.
REM consciousness is the most chaotic or complex state of consciousness
dynamics measured in the brain. It is the state that most supports
self-correction or the homeostasis effect.
The natural state and healing dynamics of any organism is healthy flow,
being able to freely change and evolve to adapt to new conditions presented
by a constantly evolving reality. It is this flow and change-ability
that supports profound self-corrections. It is this ability to flow,
adapt, and evolve that defines mental and physiological health.
Karakashian, Stephen J., “Differential diagnosis of the borderline personality:
the first step in treatment,” TA Journal, Vol. 18, No. 3, July 1988, pp.178-184.
Millon, Theodore, DISORDERS OF PERSONALITY, DSM III: Axis II, John Wiley
& Sons, New York, 1981.
Price, Reese, “Borderline disorders of the self toward a reconceptualization,”
TA Journal, Vol. 20, No. 2, April 1990.