1 2 

"I just didn't know how to handle it," Bob said. "I knew she needed help but talking to her only made it worse later on." Finally the situation escalated to the point that Bob was forced to move and have his phone number changed.

While we've all had periods of depression or anxiety stemming from broken relationships, personal tragedy or professional setbacks, the situation outlined above depicts how a borderliner -- having never developed the proper emotional coping tools -- reacts in unreasonable and often dangerous ways. Feelings of rage, impulsiveness, and instability often instigate instances of stalking, vandalism, or obsessive and violent behavior.

Perhaps one of the most infamous examples of a BPD is that of Susan Smith, the Union, SC woman who confessed to drowning her two children by locking them in her car and rolling it into a lake. Smith had a history of suicide attempts, failed relationships, promiscuity and early sexual abuse -- all factors that fit the classic BPD profile.

Once a relationship is completely severed, borderliners usually continue to act-out in self-destructive ways such as being sexually promiscuous, abusing drugs and, in some cases, mutilating themselves. This is often done as a desperate attempt to gain attention in the hopes of developing some other secure, nurturing relationship.

It's a baffling and deeply troubling disorder for both family members and the medical field. Most experts agree that it's not a chemical imbalance, but a personality disorder brought on by dysfunctional or abusive relationships during the crucial formative years of childhood. It is usually anchored in a desperate fear of abandonment, which often stems from physical, mental, or sexual abuse.

Jordan's childhood was filled with many of these damaging influences and she's a testament to the indelible mark that childhood experiences can leave upon our bodies, minds and souls. She's also one of the fortunate ones, having been able to come back from seemingly insurmountable depths and use her experience to help both herself and others.

House of Pain

Decades before Jordan was even born, a horrible incident occurred that cast a shadow on her life, as she was forced to relive it through her mother's eyes time and time again. From the time she was a little girl Jordan was told the story of how her mother, while still a child herself, had witnessed her father shoot and kill her mother. It happened on a clear November day when Jordan's mother, along with several other children, were playing under a big oak tree that dominated their yard in Johnston County. As the children ran horrified from the nightmare unfolding before them, Jordan's grandfather then put the gun to his own head and pulled the trigger.

"My mother had told me that story so many times I thought I was up under that oak tree too," Jordan said. "Telling me that story over and over again was like treatment for my mother. After awhile it didn't even phase me. I was just sick and tired of hearing it. Finally I told my mother I didn't want to hear it anymore and I refused to listen."

Jordan believes that her grandfather, who had a history of depression and alcoholism, may have been the one to pass down her predisposition to BPD, as he was acting out in response to his fear of being abandoned, the cornerstone of BPD symptoms. Days before the murder/suicide, Jordan's grandmother had told her husband she was leaving him.

Jordan was raised in the small town of Smithfield where she said she was physically abused by her religious fanatic mother and mostly ignored or insulted by an errant father, a man she didn't see until the age of three.

Finally, Jordan left home as soon as possible and settled in Charlotte where she landed a job at an orphanage, already displaying her natural tendency to help others. Unfortunately, despite her new independence and freedom, her desperate search for love and approval led her into an abusive marriage. Fortunately, she was able to muster the strength to end the marriage after five months.

Jordan eventually relocated to Massachusetts in response to an ad she found in the newspaper for a governess. There, a whole new world opened for her. She remained in Massachusetts for a little over six years, learning about art and culture and working with blind children. Eventually she decided to head back to North Carolina and once again settled in Charlotte.

Yet by then the disorder had a strong hold upon Jordan and she was in a constant state of turmoil as feelings of anger and abandonment raged inside her -- she was being overwhelmed by the killing pain. By the time she had reached her early 40s she could no longer endure and one night took an overdose of prescription pills. It was to be the first of many suicide attempts -- she overdosed five more times during the next several years until finally she was taken away in restraints in 1991.

She spent a year at Charter Pines and was then transferred to Highland Hospital. It was there that she finally came to understand what BPD meant and where she also came face to face with the disturbing images of other women who suffered from BPD.

"When I got to Highland there were about 14 women there and when they got the killing pain they would just bang their heads against the wall like a hammer until someone stopped them," Jordan said. "They had scars and burn marks up and down their arms and legs. Just like the pain ended for me as soon as I swallowed those pills, for cutters their pain ends the moment they put the blade to their skin."

In 1992, after about six months at Highland, Jordan was released.

"I came home from Highland on wobbly legs but I was standing. I knew I was at the top of my mountain. When I was taken away in restraints in 1991, no one would have bet a nickel that I would come back. But miracles do happen."

Several months after leaving Highland, Jordan decided to start helping other BPD patients while in the process of helping herself. She formed a BPD peer-led support group that meets every month at her apartment. This support group provides a crucial link to borderliners who are going through the same emotional turmoil and pain.

"It's gotten better but I'll always have the killing pain," Jordan said. "I had to figure out a way to get rid of that pain in a healthy way. When the pain comes it's like a huge wave. You know it's coming but there's not a thing you can do to stop it. But you can live through it."

A Real Pain

One member of Jordan's group who has taken that advice to heart is 34-year-old "Brenda." Brenda seemed like your typical kid growing up. She dated in high school, made decent grades, and never got into any real trouble. She went on to study child development at CPCC, and eventually had two children. However, despite these outward signs of normalcy, she was hiding a secret from most of the world, and at times even herself. Under her long shirt sleeves and pants legs are scars and cuts caused from years of self-abuse and mutilation.
Brenda started hurting herself at the age of 13, and from there it got progressively worse.

"When I got into high school I really went through stages of wanting to hurt myself," Brenda said. "I made 13 different attempts on my life."

For Brenda, the "stack-ups" of life began to intensify during adolescence and high school when self-esteem issues and being well-liked are so crucial. Brenda began to scratch herself so severely she would draw blood. When the scratches would heal she would only reopen the sores and make them worse.

"It was something I did almost daily," Brenda said. "I've got so many scars it's not even funny, I've got them all over my arms and legs. People sometime think I have AIDS because the sores and scars look so bad."

"The only way I can explain it is to compare it to someone who smokes," she continued. "They smoke when they get upset or to relax, I didn't smoke or drink, I hurt myself; that's how I let go. I had never been an aggressive person, I had always been very passive, that was my release."

Brenda eventually went to the Center for Mental Health where she was referred to Jordan's support group. Through the center and the support group Brenda eventually learned coping skills such as writing down her feelings or talking to others. She said she hasn't hurt herself in close to a year.

"Sometimes I still get the urge to hurt myself, but the support group has really helped me a lot. Finding other people who had the same problems and have gone through the same kind of thing really helped. I have a whole network of support."

Because of the unpredictable nature of BPD -- one moment a patient is engaging and calm, the next combative and argumentative -- the disorder often frustrates both family and friends as well as the psychiatric and medical community, which often perceive BPD patients as troublesome and beyond their scope of expertise.

Compounding the problem is the borderliners' underlying need for attention. In her book Imbroglio, author Janice M. Cauwels, Ph.D., states that many psychiatrists refuse to see BPD patients because they're often seen as provocateurs and expert manipulators with intractable disorders and treating them means constant late night "emergency" phone calls and visits.

"We are difficult to like, and even more difficult to love," Jordan said. "It's the last psychiatric diagnosis in the psychiatric community that still carries a stigma. We aren't worth the money nor the time. To therapists and psychologists we're a pain in the ass."

Richard Malnati, a Certified Clinical Social Worker at Carmel Psychiatric Associates, said that at one time the bulk of his patients were borderliners, but after getting married, Malnati said he had to reduce his caseload simply because he no longer had the time nor the emotional reservoir that BPD patients often require. But while Malnati acknowledges that BPD patients can be challenging, he feels that many therapists and doctors' trepidation are unfounded.

"For a long time there has been fear surrounding BPD patients," Malnati said. "I think that a lot of therapists just assume borderliners are going to be a very difficult cases. It's often a personal matter of the therapist's orientation and style, and the amount of time they can commit. I think some therapists may be a little threatened by things that aren't real. I think it's more a fear of the unknown. Borderliners are often imaginative, creative and smart people."

Indeed, many times BPD seems to plague celebrities and the rich and famous, people who appear to have full and exciting lives. "They feel so empty that they need this tremendous facade," Malnati said. "They need the biggest mansion, the glitziest guitar and the greatest fan club, but even with all of that they feel terrible inside."

Perhaps one of the best examples of a celebrity diagnosed with BPD was Princess Diana, who confessed in 1995 that the strain of her marriage had caused her to throw herself down stairs and cut herself with razors, penknives and lemon slicers. Marilyn Monroe was also believed to have suffered from BPD.

Healing The Pain

Although BPD is starting to get more recognition -- many are calling it the anorexia of the 90s -- many maintain it is still grossly under-diagnosed and often goes untreated. Malnati believes that's because treatment is often limited to what is clinically known as "medically necessary." Disorders like depression, anxiety, or psychotic episodes are usually considered "medically necessary" and qualify for longterm treatment -- they are organic in nature and usually thought of as a physical ailment or chemical imbalance that can be treated with medication. BPD isn't necessarily considered organic, but rather a disorder brought on by abusive socialization that doesn't require longterm treatment. A person can still function with BPD and oftentimes the medical establishment's stance seems to be that just because you're feeling needy or socially inept doesn't mean you're medically sick.

However, many therapists feel that that viewpoint is preventing millions from getting the help they need.

"It is a behavior that is rampant and needs to get the attention that disorders like anorexia and bulimia get. I don't think it's rare at all. I think it's under-diagnosed. Many people manage their feelings in this way," said Jerre Jones, a Clinical Nurse Specialist at the Center for Psychiatry at Presbyterian Hospital, who said that oftentimes BPD patients are referred to her as suicide attempts because they've been admitted into the emergency room with their wrists cut.

Perhaps one reason BPD is being under-diagnosed is because many cases are going unrecognized or unreported, especially within the male population.

"Because of our socialization, borderline personality disorders as well as depression are more readily ascribed to females," Malnati said. "Men often work incredibly hard to try to cover up their depression. Instead of sitting at home with the lights off, they yell at everybody and push themselves to the edge. And just as depression looks different in a man because of what society will allow him to display, BPD looks different in men, too. If he's impulsive in areas of sex, we just credit that to the belief that all men are horny, that they always think with their penis instead of their brain. But if a woman acts out in the same way she's perceived as promiscuous, or someone with a disorder. So there are lots of prejudices that way; many men are walking around with this affliction but aren't diagnosed. But it's an equal opportunity disorder."

Most therapists and psychologists acknowledge that the road to recovery for BPD patients is often a long and painful one. Although each patient is different, nearly all cases involve having to dredge up and face long-suppressed feelings of anger, loneliness and hurt.

"You must be very gentle with these people," Jones said. "BPD patients are always second guessing their gut reaction, they don't really have a strong sense of who they are. They don't experience natural emotions such as joy, love, anger and hate the way others do. They have to relearn all these emotions; we call it 'emotional regulation.' Our goal as therapists is try to help them build self-esteem. So it's not something that's going to be cured in six sessions, it's an ongoing process."

Several years ago Jordan took a big step in this process and faced down a lifetime of suppressed emotions when she visited her father's grave.

When Jones first pulled up to the graveyard her hands were clenched into tight fists. They remained that way as she walked down to the gravesite. "I was holding a lifetime of pain, hate and rage," Jones said. Once at the grave Jones spoke out loud and told her father things she was never able to when he was alive. "I said, 'Daddy, your problems with me were your problems and you made them mine. I'm tired of them and I'm leaving them here with you.' I walked away and I didn't look back. I knew I would never return. When I got back to the car my hands were wide open. I had let go. I left all that hurt and anger behind. All that is part of the healing."

As a testament to her newfound strength, rather than denying her past, she faces it every day with pictures of her mother and father that still hang on her living room walls.

Another picture that hangs prominently in her apartment is one she bought while in Massachusetts when she would spend long hours in art galleries. During this time Jones said she was invariably drawn to one particular picture, a simple piece called "Torn Hat" by Thomas Sullivan which depicts a fresh, scrubbed-faced young boy looking out from under a large straw hat with big, open eyes.

"I would sit for an hour or more just staring at this child," Jordan said. "I had never seen anything of such innocence; not a blemish. And maybe I didn't know at the time that I was blemished, but I certainly knew what wasn't, and that child had never been blemished, he was innocent, there was no abuse. You could see it on his face and in his eyes. When I look at that picture today I know that my scars are still there, but I know they are less visible, I know the pain and the wounds are healing."

1 2