Stop Walking on Eggshells

Stop Walking on Eggshells

I read about five to six books a month--and I don't review enough of them. I just finished reading Paul T. Masson and Randi Kreger's Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder. What is Borderline Personality Disorder? Here's the DSM-IV diagnostic criteria:

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
2. a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
3. identity disturbance: markedly and persistently unstable self-image or sense of self.
4. impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
5. recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
6. affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
7. chronic feelings of emptiness
8. inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
9. transient, stress-related paranoid ideation or severe dissociative symptoms

If this describes a really difficult person in your life--you might want to read this book. BPD was only recognized in the 1990s--for what was previously considered just cranky, difficult, unpleasant people. Mason and Kreger provide a very readable description of why those suffering from BPD do these seemingly irrational actions--repeatedly hurting people that love them and try to help them--and then reacting in frustration and anger when they have done so. This book also explains why BPDs do this primarily to people that they care about--and manage to remain on reasonably cordial terms with people that they barely know.

Fundamentally, someone with BPD is in dread fear of abandonment, and seeks proof that loved ones won't abandon them--by repeatedly putting those loved ones to tests designed to drive them away. If their mistreatment drives the loved one away--it proves that the abandonment concerns are legitimate. If the mistreatment doesn't drive the loved one away--it proves that they are truly loved.

Stop Walking On Eggshells provides some discussion of the theoretical models. There appears to be some biochemical origin. There may be family dynamics that contribute. Those who have been sexually or physically abused seem to be at higher risk, although most BPDs are not in this category.

However, the book is primarily about methods by which those who have relationships with BPD sufferers can deal with those relationships--with a strong emphasis on boundary setting, methods for discussing the relationship that don't set off BPDs (discuss how what they have done makes you feel, not making statements about what the BPD sufferer is feeling), and for those who have the misfortune to be married to a BPD sufferer, how to handle the relationship. If the spousal or child abuse becomes so severe that it requires divorce, how to handle it to protect yourself and your children.

BPD seems to be primarily a female disorder. As the book points out, a lot of what might be recognized as BPD in men usually ends up in the criminal justice system--and this may explain the apparently female disproportion.