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I Hate You Don't Leave Me!

Published on July 26, 2008

I know that there are people who do not love their fellow man, and I hate people like that! -- Tom Lehrer

Borderline can be one of the most difficult personality disorders for the individuals, their family, friends and therapist. Some therapists are reluctant to see individuals diagnosed with Borderline Personality Disorder (BPDr, because treating them can be challenging and time consuming. It has been said that the motto of these individuals is:" I hate you, don’t leave me!" Generalizing about human beings is fraught with peril - we are all so very unique. An individual’s symptoms and severity of symptoms will vary greatly from person to person. Though BPD has a discouraging reputation, one of my favorite patients had this disorder. Sessions were an uphill battle and I was discouraged at times (as I am sure she was), yet we remained committed to treatment and she eventually reached her treatment goals. I still hear from her on a regular basis. BPD is diagnosed more often in women (75%), than in men. It is possible that the symptom cluster is simply not recognized as readily in men.

I have treated many women with Borderline Personality Disorder, and the work can be demanding. I would suggest that a mental health professional who treats patients diagnosed with BPD carry a lighter caseload to allow sufficient time for each client, especially in the beginning.

This disorder will appear in about 2% of the general population. Fortunately, disorder symptoms appear to improve as the patient ages.

1. She/he has a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

2. She/he tends to be impulsive in at least two areas that are potentially self-damaging (i.e. spending money, sex, substance abuse, ship lifting, eating disorder, recklessness.)

3. She/he has emotional instability (i.e. marked shifts from baseline mood to depression, irritability or anxiety) usually lasting only a few hours.

4. She/he has inappropriate intense anger or lack of control of anger.

5. She/he expresses recurrent suicidal or self-mutilating threats, gestures, or behavior.

6. She/he has marked and persistent identify disturbance, manifested by uncertainty about at least two of the following:
  • Self-image
  • Sexual orientation
  • Long-term goals
  • Type of friends desired
  • Preferred values

7. She/he has chronic feelings of emptiness or boredom.

8. She/he exhibits frantic efforts to avoid real or imagined abandonment (not including the suicidal).

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