Cultural Borderline Personality Style

Let’s imagine that a client named Linda walks into my clinical office complaining about emotional instability and difficulty with interpersonal relationships.  As I conduct my assessment, I ask her to describe her emotional reactivity and she recounts numerous instances in which she is sad, irritable, and anxious in reaction to day-to-day events.  Usually her emotional reactivity is in response to other people who fail to meet her expectations or who she believes have slighted her or judged her in a negative light.  In fact, Linda often has a difficult time accepting that other people disagree with her or see things differently, which can lead her to feel worthless and empty.  If she finds herself in a relationship in which other people are not affirming, Linda reacts strongly with intense anger and might even lash out.  As a result of her chronic anger and emotionality, she has a pattern of unstable and intense interpersonal relationships characterized by extremes between idealization and devaluation.  She’s all good with people when things go her way and might even idolize others when their thoughts align.  But when others disappoint her, watch out!  Linda is likely to react swiftly and strongly.  In an effort to cope with all this emotionality, she has developed a tendency to think categorically and to see things as black or white.  People in particular are either on team Linda or they are bad, awful people who deserve punishment.

Linda sounds like a mess doesn’t she?  Believe it or not, this presentation of symptoms is fairly common in my clinical practice and the diagnosis is a slam dunk.  Borderline Personality Disorder (BPD) is Linda’s diagnosis and while it is not uncommon to see clinically, it is actually difficult to treat.  These characterological traits are usually longstanding and behaviorally ingrained.

Now I want you to think about whether or not you have ever known anyone who acts like Linda.  My guess is that you have run across this kind of behavior pretty often, especially in the last few years.  While you might not have many people that you interact with in person who have these traits, I bet if we took one look at your Facebook or Twitter feed we would see lots of “friends” posting content that comes across as emotionally reactive, categorical, and angry.  Let me be clear:  I’m not suggesting that a large majority of our social media users have Borderline Personality Disorder.  I am suggesting that we have developed what I’ll call a Cultural Borderline Personality Style that drives us to be very emotionally reactive, chronically angry, and downright mean to others.  Whether it’s opinions about how to deal with COVID-19, politics, or even racial tensions, we have become categorical in our thinking and we see things as black or white.  If others don’t share our views about wearing masks to control the coronavirus or believe the way we do about the current administration, watch out!  We lash out with condescending monologues designed to position others as ignorant, uncaring, naive, or just generally incapable of thinking the issues through on the same level as we are.  This kind of categorical thinking is not only immature and unhealthy, it’s toxic.  And it is forcing a Borderline narrative on everyone around us where others are either on our team or they are bad awful people who don’t deserve dignity or respect.

I’m going to just say it:  We are better than this.  We have to be better than this.  Part of what has made America so special over the years is our ability to respond to crisis situations in unity and with deep appreciation for what we have in common.  Does that mean we don’t have room for improvement systemically on multiple levels?  Of course not!  There’s so much more for us to do together, but this can only happen when we agree to respond to each other in love and with a deep appreciation for the dignity of those we disagree with.  The world we live in is complex and nuanced and the categorical Borderline thinking will only lead to more chaos and division.

So what does our path look like going forward.  How do we address our issues without getting stuck in the negative borderline reactivity?  I offer us the same advice (based on the tenants of a special kind of psycho-education called dialectical behavior therapy (DBT)) I would give Linda at the end of our clinical session.

  1. We need to understand and practice mindfulness

Mindfulness skills help us focus on the present and attend to what is happening in our life in a calm way.  It helps us slow down and learn the value of the “wise mind”.  This allows us to avoid succumbing to intense emotions and acting out on others in destructive ways.

  1. We should practice distress tolerance

When we practice distress tolerance, we deal with negative events and situations by first soothing ourselves in healthy ways rather than becoming overwhelmed by emotions or hiding from them.  This allows us to be intentional about how we act rather than falling into intense and destructive emotional reactions.  When we manage stress effectively it also helps us to fully accept the brokenness of our world and gives us a road map for responding to the painful aspects of life with intention.

  1. We have to focus on EFFECTIVELY relating to others

We can’t bulldoze our way through life.  There are ways to interact with others that engender healthy interactions, listening, and problem solving.  This starts with respect, of ourselves and of others, and it will ultimately include forgiving others who don’t meet our expectations.

  1. We should seek to understand our emotion first

If we find that we are chronically emotionally reactive and angry, we should first try to understand where that anger is coming from.  Anger is usually a secondary emotion that is covering up another more threatening emotion like fear or hurt.  We feel much more in control of difficult situations when we can be angry because it helps us feel less vulnerable and more powerful.  The only problem is, most people in this Cultural Borderline Personality Style will respond to your anger by meeting or exceeding your level of emotion.  Seek to understand your core emotion first and then talk more about the fear or hurt underneath the anger.  That’s a sure fire way to engender the empathy and understanding that will actually facilitate a conversation that reflects the depth and complexity of the issues we are all facing together.

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