[beautifuldisaster78]

Hi,
I'll try to make this short but I really need some advice/insight and I need to give a bit of a background. I've been diagnosed and re-diagnosed several times. PTSD, MDD, Bipolar, GAD. This last visit with my psychiatrist I told him I felt hopeless with the meds because they weren't working. I had tried about every anti-depressant in the book. The ones that worked (Pristiq, Wellbutrin) caused my anxiety levels and my tachycardia to be unbearable.

He told me after a series of questions that he thinks I may be Borderline. He prescribed Lamictal and Librax for the anxiety/IBS. I'm not ignorant on BPD. I'm a psych RN for one. I also came across Rachel Rielands book "Get Me Out of Here" a year or so ago and read it. I remember reading it that I felt so much like her. Her thoughts, feelings, all of that I related to. Difference between her and I- was that she acted on it (cussing people out, screaming, etc...). I also didn't feel that I was manipulative. I've always been a "people pleaser" and hated conflict so I never did outwardly act on the intense emotion. Well- I can't say never. I have had a screaming fit once or twice and yelled at people. But it's rare. People for the most part see me as compassionate, quiet, and easy to get along with. Not the traits usually associated with a Borderline (from my understanding).

I am a single mom and 32 years old. There's always been something "abnormal" about me and I can remember thinking that from the time I was a kid. I was hospitalized at 14 for threatening suicide and anorexia. I toyed with self injury then and lately (last year or so) have been cutting quite frequently. I still have suicidal ideations frequently. I told my counselor today that the PD was suggesting the possibility of BPD, and he doesn't like diagnosis of any kind really, but he said I have some traits of it (social problems, cutting, suicidal tendancies) but he didn't see the manipulation side. Also my PD says that not all Borderlines are manipulative. (its not yet an "official" diagnosis for me, just a possible).

So to the point... I'm wondering, if I really am manipulative in some ways. Like, in my head, I just don't admit it (even to myself!). I tried to google manipulative behaviors to figure out if I am, but didn't come up with much. So how do I know if I am or am not? I think I'm willing to come to terms with it if I am... but I don't know?

I'm also wondering about the black and white thinking. All I've heard people explain this as is things either are, or are not with no grey area. Call me ignorant, but I don't get that either. I dont know if I have black and white thinking, because I don't understand what it is.

I'm currently re-reading Reiland's book. I don't "need" a diagnosis... but it'd be nice to feel like I fit somewhere... right now I feel just screwed up and totally alone.

Thanks for listening.

Hi Jaycee, I can relate to what you are saying. I think that many people when they hear the diagnosis of Borderline Personality Disorder immediately go to the "acting out" description of the disorder--think the famous female character in the movie Fatal Attraction (Glenn Close played the "manipulative, murderous psychoic Borderline that attacked Micheal Douglas when he broke off their affair). Like most movies, the characterization of the rejected lover was over the top, but a lot of people still think of that description when they hear the BPD diagnosis. People saw the Glenn Close character as manipulative with her threats and suicide attempts, but a lot of the recent research would say that her behavior were due to frantic attempts to cope with the pain she was experiencing internally--poor coping skills that actually drove away the very person she wanted not stay close to.

I also read Rachel Reiland's book a few years ago and although I could relate to a lot of her thoughts and feelings, I never acted out like she did so I wasn't sure I had BPD. But then I read Marsha Linehan's book on BPD and Jeffery Young's Schema Therapy book for treating Borderline Personality Disorder and I began to understand that there are many variations of the disorder. I think many people with BPD "act in", feeling a great deal of self-loathing and anxiety. I don't know about you, but most of the people in my life would never even know the extent of my emotional dysregulation, social anxiety and impulsivity. It doesn't play out in the social arena, it's well contained inside my head. I don't cling or depend on others, but I do quietly walk away from others before they can reject me. I don't manipulate because I don't allow myself to depend on anyone else. In a sense, I am overly conscious of never expressing my needs or asking for anything. I take excessive pride in the fact that I never rely on anyone--I really mean excessive because even borrowing a wrench to fix a pipe is a BIG deal for me. I will, in all honesty, go out and buy the wrench rather than ask for it from someone else. Not healthy by any means! I am getting better at expressing my needs now though!

I self-diagnosed myself after doing a lot of reading and I brought my thoughts on the diagnosis to a therapist I was seeing. She wasn't too keen on it, telling me like your therapist that I had some of the traits but I didn't fit the manipulation part. I continued to push the issue and we finally reached some level of agreement. I like Linehan's description that people with BPD aren't manipulating, even the noisy or acting out individuals, because being manipulative means preplanning and skill. Most people with BPD don't have that level of coping skills and the behaviors they engage in are attempts to find relief from their pain and get their needs met. What we do or say when overwhelmed emotionally actually works counterproductively. Either the individual ends up pushing her loved one's away (as in the noisy, acting out individual) or she walks away and isolates (as in the acting in individual who isolates in an attempt to prevent the pain of rejection/abandonment).

In any case, I'd suggest reading Linehan or Young. They both present a coherent, compassionate and intelligent description of Borderline Personality Disorder. Linehan's textbook is pricey and can be informationally dense, but it is worth getting through. Young's book is a much easier read, but doesn't go as indepth as Linehan in regard to the historical part of BPD. Good luck!

[Perna]

I think all behaviors have different degrees and all of us, borderline or otherwise have all behaviors at some time or another; we're all human. That being said, manipulation is often in the eye of the manipulated. I would ask friends about how they perceive you, how manipulative are you and can they give examples.

Mostly, for me, manipulation just means getting my own way How one manages that, whether by tears, threats/yelling, refusing to do anything else, etc. but how the manipulator views their behavior can be totally different, they may see themselves as empowered or standing up for themselves or simply sincerely believe all the other people are "wrong" and they have the correct way of doing things.

The childhood anorexia and the self harming and suicidal tendencies seem like they could be, again to me, a bit manipulative; manipulative isn't a bad word, it's just another word for trying to get "control" of one's life/world/situation. There are just better and worse ways to do that that aren't so damaging to self and others.

[beautifuldisaster78]

Jaybird-- thankyou so much! You have no idea (or maybe you do) how much your post meant to me. To hear that there is someone else out there that has experiences the same thing is such a relief. I was beginning to feel the odd one out type of thing- researching mental disorders and never coming up with an answer or likeness to myself. While I realize that everyone is going to have different aspects and personalities, I just wanted to know there was someone that could at least relate! I wholeheartedly agree that most people in my life (if not all of them) would be clueless about my severe internal emotional problems and perhaps both in shock and denial (in fact I'm certain my mom and brother would deny it vehemenatly). I was told my dad about a past diagnosis of Bipolar and he told my mom I was NOT Bipolar- he'd seen Bipolar people (he's a cop so he's taken a few to psych wards) and I was nothing like them. Appearently the differing levels of severity didn't occur to him. But BPD fits better in my understanding anyway.
Anyhow- all that to say thank you and I would love to talk with you more

Perna- thankyou as well for your description of manipulation. You're right about the control issue. I watched a movie on anorexia as a kid called "For the Love of Nancy" with Tracy Gold and I can remember her brother telling her "you control your brain Nancy"... To which she replied "I don't control anything anymore.". That stuck with me all these years because for me it was always about trying to find control in my chaotic world. Perhaps I am manipulative in ways I dont even understand.
As far as asking friends how they perceive me though- well, I don't have friends. I have many acquaintances mostly through work and whatnot but mostly I keep to myself.

I'm gonna look for those books. And I hope more people reply too. Also if anyone has a good description of black and white thinking- other than that listed in my previous post- I'm curious about that too. Thanks again.

Evenin', Beautifuldisaster, your post resonated with me too, so know that the feelings go both ways. I smiled when I read your original post because you mentioned that you're a psych nurse. I was an R.N. a number of years back and my speciality was ICU . .. I wanted so much to change and go into psych nursing. When it didn't happen, I went back to school and got my master's in psychology and went began a career working with severely emotionally disturbed children in the education system. But your post reminded me of very fond memories of my hospital days

Like you, my family would not describe me as a person who is "emotionally unstable" or "crazy". In fact, when I talk about my mental health struggles, they dismiss them pretty readily. But I'm the kind of person who has always been very successful professionally. I've remained in the same profession for over twenty-seven years and never relied on any one for any financial means. I believe now that I used work (workaholism) to numb myself out, to keep myself from really seeing or thinking about the problems in my life. I know that I hate vacations and work excessively. I'm social at work, well liked and respected professionally, but if you ask me what kind of friendships I have, I can now be honest and say that they are all superficial. The people I'm friends with probably wouldn't say that it's superficial, but if they were really really pressed, they'd have to admit that they don't know a lot about me. I only let people see what I want them to see or know. Often I feel that I'm a cardboard cutout that only allows people to see what I allow them to see. If any of this resonates with you, there is also an excellent book written by Vance Sherwood and Charles Cohen titled: Psychotherapy of the Quiet Borderline Patient. Although I don't think all of their description of the Quiet Borderline "fits" my own personal profile, there were things that they talk about that really connected with me, especially when they talked about the Quiet Borderline "playing or performing" a role. That is something I often feel. .. .and I've gotten so very good in performing my role that no one, including myself, really knows what lies beneath.

Take care,

PS: I just wanted to add that it has always interested me that sooooo many people with mental health issues RUN screaming from the BPD diagnosis. Yet, the literature actually identifies BPD as the MOST common disorder in the US and elsewhere in the world. . . . intersting, huh? Even therapists and psychiatrists avoid the diagnosis, even when they suspect that it is the correct diagnosis of the client they are evaluating. Why? Because the literature is so heinous in its description of the BPD client. No, social worker, psychologist, mental health counselor or psychiatrist wants to give the dreaded diagnosis:" You have Borderline Personality Disorder". But until they're able to do that, the disorder will be the hated, avoided and rejected; a disorder that no one wants to have hung around their neck. In fact, some insurance companies won't pay for treatment of personality disorders because they are believed to be "untreatable". Thankfully that is changing. There's talk of putting BPD on Axis I like Bipolar disorder, depression and anxiety disorders--it's where it belongs in my opinion. Just my take on things anyway.

[CatCan]

Thank you all for the book suggestions, and especially for the term “Quiet Borderline”. I took the quiz today for BPD and I scored “Likely”. That’s fascinating - I hadn’t even heard of BPD until a couple of years ago & I have certainly never had any treatment for it. My work history does not follow the pattern (more than 10 years at each of my last 2 companies), but my romantic relationships do - I start out thinking that the guy is amazing, wonderful, perfect in every way but within 6 months I feel contempt for him and anger at myself for having fallen into the same old trap. Like Beautifuldisaster, I have many acquaintances but no real friends. And I will always remember the comment on a work performance review from about 20 years ago, that said that I “see things as black or white - but she is usually right”. I think I have a lot of reading to do.

Again, thank you.

Hmmm. I am seriously out of love with the 'manipulate' label. I think it is probably the most pejorative term in mental health today and has been used for decades to deny people with a diagonsis of BPD the treatment they needed and deserved.

Fortunately, Marsha Linehan (the psychologist who developed DBT) has done something about it. She suggests that what people with BPD are really doing is using unskillful means to get what they want because theyvdon't have the skills to do it skillfully. This is the difference with people with BPD- *not* that they are trying to get what they want- everyone is trying to get what they want a lot of the time!!- but that they go about it the wrong way and get everyone's backs up. She says that 'manipulation' implies a level of skill that simply isn't there. I love Linehan's stuff. She- and her therapy- are just so very non-judgemental and compassionate. Do read it!

I can relate to not knowing whether the label fits, and it's something I haven't resolved for myself yet. I think it can be worse when we work in psychology/psychiatry as we're aware of all the worst stereotypes and stigma of the label, and perhaps we see the 'worst' cases. Would it help to think in terms of the funcionality of the label? What better insight or treatment would the label bring you, if you were to accept it?

[Perna]

Black and white thinking:

[beautifuldisaster78]

Jaybird- Funny, I've thought of switching to psychology too. But mostly I just dont want to go back to school right now. I've been told though- that it's not good for me to be in a psych field d/t triggering my own issues. Sometimes I think that's correct, other times I think it helps me because I see the worst of some patients and it motivates me to work harder not to end up that way! I looked up the quiet borderline book- cheapest I found it was $40, all the way up to $200! It will be awhile before I read that one. But it did intrigue me reading about it. And when I googled it, it spoke of the "as-if" personality and I can so relate to that. I didn't know there was a name for it but I've often likened myself to a chameleon who changes depending on who I'm with to fit their "mold" and be liked and accepted. I really dont have any identity of my own. I remember telling a "mentor" type person that was in my life a couple years back that I would have no idea who I was without the emotional instability, to which he replied "you have no idea who you are now." the truth of that statement left me speechless.

Improving- I'm going to have to look up Marsha Linehan. Sounds interesting. As far as the label goes- I'm conflicted. I don't want it, because I think labels are bogus generalizations and stereotypes. (Also, it seems I remember the renewal for my nursing liscence asked the question if I'd ever been diagnosed with a personality disorder! That scares me!- plus like the insurance and stuff that was mentioned.

On the other hand, the label would bring me some peace, just knowing that there is somewhere I "fit." Not only that but then I would have something to explain to my family. For all my efforts to hide my inner thoughts, emotions, and struggles, I really kinda wish they knew what I was dealing with. Maybe they'd realize it was something more serious than some thought I could just "get over." I dunno- I guess its a matter of being taken seriously. Or a hope to.

[Perna]

Black and white thinking is known in logic as a "false dilemma":

http://www.sjsu.edu/depts/itl/graphi...m/dilemma.html

If you only think/believe there are two choices (go crazy or kill myself; my therapist is perfect except when she makes a mistake and then I have to quit therapy; I'm right, you are wrong), usually opposing choices, and can't imagine anything "in between", can't get out of thinking in terms of dichotomies, that is black and white thinking.

[beautifuldisaster78]

Thanks Perna! I'm going to have to check out that link. I do get that way with my counselor too. I wait all week to see him but then if he says something I think is wrong I get mad and want to quit. Although, I've never told him so. Sometimes, I envy the borderline trait of speaking your mind and letting anger out. I seem to internalize it all then take it out on myself later.

[beautifuldisaster78]

PS- I checked out that link and it's exactly what I was looking for to better understand. Thanks!

[Martina]

Well, you're a Psych RN - do you have a copy of the DSM-IV? Read the criteria for Borderline. Do you fit enough of them?

Even if you only fit some of them, is your therapist trained in DBT? I'm just starting DBT as there were no therapists in my area that did it until my new therapist opened up her practice a few weeks ago. So I can't say it's helped me, yet, but I'm told it's the best thing for BPD.

It can't hurt. DBT can also be successful for things like PTSD. It's worth a shot.

[Martina]

Also, being a Psych RN - do you do a little therapy along with meds? Or just meds?

I think for the sake of your clients, as well as yourself, it would be good to read up and study about Dialectical Behavioral Therapy. Look for the books by Marsha Linehan and Dr. Moonshine. Marsha Linehan invented it, Moonshine took a different perspective on it.

[beautifuldisaster78]

Hi. I don't have a therapist that does DBT- he kinda combines a little of everything but mostly CBT. I've been seeing him for nearly a year now though and dont want to switch. Guess Im a little attached. I do fit the DSM criteria on every one I think. There may have been one I missed but out of eight you only need five for a diagnosis. So anyway, yeah. As a psych RN I work nights so I don't get a whole lot of patient interaction. Mostly I hand out sleep meds and deal with any medical issues as they arise. I think the day nurses get to lead groups and things. I'm waiting for my turn on days. Ive looked up Marsha Linehan and watched some of her videos on YouTube. I'll have to check out Dr. Moonshine. I have always been fascinated with psych and read a lot so I'll look into it! Most patients I work with are children/adolescents so they don't have a Borderline Diagnosis yet. In fact I think when I worked with the adults I only saw 2 actual confirmed people diagnosed with it. Any axis II diagnosis are generally steered clear of. (the place I work is acute/crisis so patients rarely stay longer than a week or two).

Beautifuldisaster, You can get a DBT workbook and do your own thing. I found a lot of the exercises excellent! They also have a few sites on line that teach the techniques and there is at least one site on line that does a six month (or so) DBT course on line. I live in a pretty rural area and no one around here is trained in DBT so I had to do my own research. I've used the techniques with the adolescents I work with (with some adaptations) and they love them!

PS I tried to respond to your message but for some reason every time I tried to send an answer things shut down for me. Maybe my virus protection thingie won't let me send on a forum. Not sure.