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Dear Dr. Robert,

My husband’s ex-wife has borderline personality disorder. She has been engaging him in a legal battle since she found out we were engaged – they have a teenage daughter together.

Her last legal battle did not go the way she had hoped and now she has been making threatening statements that include thoughts and fantasies of their daughter’s death.

My husband and I are in a panic and quite unsure as to how to proceed. Do we push to gain sole custody and perhaps a court ordered evaluation of the mother? Or do we treat this as another inflammatory statement and example of outrageous displays of anger and not react.

How often do people with BPD actually harm others? The woman has no history of violence, but recent events–loss of employment, her daughter becoming a teenager, her ex-husband’s remarriage and a failed attempt to exact revenge through the courts have us worried that she may “have nothing to lose” so to speak. We know that she is blinded by her anger and sense of victimization – could this cause her to harm her child to hurt her ex-husband (like she has fantasized in emails about doing)?

Thank you very much,

Christine

click on image

Hello, Christine--

I understand your concerns. In order adequately to reply to them, I should first fill in a bit of background.

The term "borderline personality disorder" arose originally to indicate someone who was on the borderline between neurosis and psychosis. The term "neurosis' is no longer used, but previously, someone who showed symptoms of depression, hypochondria, anxiety, obsession, or the like would be considered "neurotic," while someone who had lost touch with reality entirely (meaning shared, consensual reality) would be considered "psychotic." In this usage, the so-called "borderline personality" would be the most serious kind of neurotic illness—not so out of touch to be considered frankly psychotic, but disturbed enough so that, unlike most types of neurosis, treatment by means of psychotherapy was thought to be difficult or impossible.

Borderline personality disorder is difficult to treat because psychotherapy depends on the establishment of a working relationship between the psychotherapist and the patient, but the very nature of borderline personality makes ordinary relationships uncomfortable, problematic, and fraught. In fact, although BPD is not at all uncommon—according to the National Institute of Mental Health approximately two percent of adults, most frequently young women, suffer from it—many psychotherapists entirely refuse to treat borderline personality, and many others who do take on patients with borderline symptoms find themselves out of their depth and so fail to help those people.

Essentially, borderline personality disorder is a kind of mental illness characterized by pervasive instability in self-image, in moods, in interpersonal relationships, and in behavior. To take an example of this instability in relationships, a PBD type of person might at one moment regard a friend or loved one with great admiration, affection, and love, and then suddenly, without warning, switch over to an attitude of irrational disappointment, vehement anger, or even hatred. When this switch occurs, the BPD person will accuse the friend or loved one (or the therapist) of having abandoned, mistreated, or misunderstood her, or otherwise blame the other person for having caused the sudden breakdown in idealization and affection. Often, the BPD person interprets ordinary everyday events as intentional rejections. For example, if the therapist, due to a traffic jam or household emergency, arrived late for a session, the BPD person would not believe those reasons, and would accuse the therapist of caring more for other patients, or having lost interest in her. Regardless of any apology, the BPD person would feel rejected and abandoned, and would express those feelings through anger, depressed mood, threats ("I'll get even with you"), or even—and this is the core of your question—with violence.

Although there are various theories, including theories of genetic predisposition, about the causes of borderline personality, in my estimation the best of those regards BPD as the outcome of narcissistic wounds sustained in early childhood. Such wounds could occur in any of numerous ways—too many to list, really, so I will choose just one illustration to give the flavor of it. Suppose, for example, that a baby began nursing, but then the mother became ill or depressed and could no longer manage the feeding schedule. In the infantile mind, the loss of the breast might feel like a rejection, and the baby might also feel that this rejection was due to a lack of self-worth. In other words, mom has stopped loving me because I am a bad child. Once that pattern of thought has become established, other random events might also be seen as adding proof to it. Later, for instance, if a sibling receives a gift that seems better than the one that our child receives, the child might feel that this is due to her lack of value.

Now, each person's sense of self and self-worth is built up (or not built up) as the result of many thousands of such individual instances. A child who receives sufficient emotional support usually will become an adult with a workable sense of self-worth, but a child who lacks that kind of support may become an adult with a sense of self that feels not solid and stable, but full of "holes" like a Swiss cheese. Such a person, having a core self which is not solid but filled with gaps, will look to others—to relationships—to fill those gaps. That is why such a person is so super-sensitive to any aroma of rejection, for the "rejection" is seen not just as unfriendly or unkind, but perceived as a threat to the very integrity of the self which might, if not supported properly, disintegrate entirely into a kind of "insanity." And this is a very sticky situation, because the borderline type is looking, constantly and hypervigilantly, for the kind of support that he or she lacked as a child. She or he wants, in a way, to be treated like a child: never disappointed, always cared for, always protected from the cruelties and realities of ordinary life. And such a person demands that kind of treatment from other adults. But, although some people are able to offer that kind of support to an actual child, few would be able or want to offer it to another adult. Hence, this wounded self, which wants an extraordinary level of support and consideration--an impossible level really--by its very demand that such treatment be provided, is setting itself up for rejection. Then, when the inevitable rejection comes, the ego, the "self" begins to come apart, to disintegrate, and the anger, mood swings, and all the rest follow.

All of us experience changes, losses, and rejections in life, but if we have a reasonably firm sense of self, we are able to roll with those inescapable punches, and keep going. The borderline personality type often cannot roll with any punch, no matter how trivial, and so, instead of moving on after a perceived slight, may become fixated on having been "rejected," and then blame the person who did the "rejecting." As you are experiencing, this blaming often damages personal relations, drastically, making it impossible for anyone save the most determined friend or therapist to continue interacting with the borderline person.

With that background, let me address your specific worry. Borderline personality types sometimes do become violent when their anger at perceived rejections finds expression on a physical level. If that happens, usually the cause is not "nothing left to lose," as you wrote, but rather an extreme emotion of hatred or fury directed towards the person seen as having rejected or otherwise failed the borderline person. I imagine that your husband's having married you was perceived by his ex as a rejection of her (although of course it was not), and she may be feeling an inner rage that could spill over into violence, even violence directed at her own child whom she might view as an extension of her husband. Of course, none of this makes any sense, but that is the problem with borderline personality disorder. It is not rational.

Since you have asked for my specific advice, here it is: I believe that you should take these threats seriously. They may be simply histrionic, but possibly not. In my opinion, your idea of suing for sole custody along with a court ordered evaluation of the mother may be the best course. If you do proceed in that direction, there is the risk that you will further anger this already very unstable person, but it seems to me that for the protection of your husband's child you do need to have more control over this situation, and sole custody could provide that. I am sorry not to be able to be more definite, but that is one of the problems with borderline personality types—their behavior is very hard to predict.

Be well.

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