Alice had not a moment to think about stopping herself before she found herself falling down what seemed to be a very deep well.
—Alice’s Adventures in Wonderland
“I want you to listen to something. I need to know what you think.” Amanda pulled a small tape recorder out of her purse.
“Mother called yesterday and I taped our conversation. I feel so confused after I talk to her, I don’t know what to think. . . .”
The twisted, fragmented conversation was difficult to follow. Her mother’s train of thought frequently derailed with incomplete sentences trailing off into tangents. The borderline’s stream of thought can rush or ramble like a river, bending and twisting, flowing endlessly through the same gorge and over the same stones. On the tape Amanda sounded uninterested and annoyed, as if her mother was talking nonsense.
Without indicating whom she had in mind, her mother abruptly asked, “What was that girl’s name?” When Amanda inquired, “What girl?” her mother snapped back, “You know exactly who I’m talking about! Don’t play that game with me!” Amanda tolerated conversations with her mother by shutting down, withdrawing into herself. Shutting down, closing up, and “going in” are instinctual, life-saving responses to threatening conditions. The borderline’s tendency to blow hot and cold and suddenly lash out can catch her children off guard. Tidal waves emerge without warning, sweeping children away by gale-force rage. Naturally, borderline mothers may accuse their children of not listening, and telephone conversations frequently end abruptly with one party hanging up on the other.
Amanda envied her friends who enjoyed close, positive relationships with their mothers. Cristin Clark (in Ellis 1999) describes her relationship with an “ideal” mother in Blessings of a Mother’s Love: “The greatest gift my mother has given me is the belief that I can accomplish anything I pursue. Her words of encouragement have helped me through the most difficult times in my life. She is my biggest supporter and my best friend. Her belief in me is my inspiration to try new things. . . . Her unconditional love is truly a blessing” (p. 28).
Few mothers are ideal mothers. All mothers have personality defects. The borderline mother’s fear of abandonment, however, may consistently interfere with her child’s need to separate. In Amanda’s case, simply expressing her own thoughts could threaten her mother and trigger hostility. By replaying their taped conversation, Amanda was able to hear her mother’s disordered mind. For the first time in her life, she considered the possibility that she was not to blame for her mother’s unhappiness, and the oppressive veil of guilt began to lift.
Although no two borderline mothers are the same, clusters of symptoms reflect varying levels of functioning (see Table 2–1).
A personality disorder is a pattern of abnormal thoughts and behavior that impairs relationships with others. Personality disorders cut across all social classes, educational levels, and professions. Individuals with borderline personality disorder have different combinations of symptoms, complicating identification of the disorder. Thus, any five out of the following nine criteria are used to determine the existence of BPD (summarized from the APA 1994):
TABLE 2–1.
VARIATIONS IN MATERNAL FUNCTIONING
1. Frantic efforts to avoid real or imagined abandonment
2. A pattern of unstable and intense relationships
3. Unstable self-image or sense of self
4. Impulsiveness, and behavior that could be self-destructive (spending, sex, substance abuse, reckless driving, binge eating)
5. Suicidal gestures, threats, or self-mutilating behavior (hitting, cutting, burning oneself)
6. Intense moodiness, rapid mood changes
7. Feelings of emptiness
8. Inappropriate, intense anger
9. Stress-induced paranoid thoughts or dissociative symptoms (loses touch with reality)
Many borderlines do not self-mutilate or threaten suicide. Some borderlines never abuse drugs because they have a fear of taking medication. Not all borderlines express anger toward others; some direct anger only at themselves. As individuals, borderlines have their own unique combination of symptoms and vary in their level of functioning.
Although all borderlines experience fear, helplessness, emptiness, and anger, one of these emotional states may dominate the personality. As with the ingredients in a recipe, the main ingredient or emotional state determines the texture, or feel, of the individual. The dominant emotional state shapes the person’s character and may reflect the most pervasive and unmanageable feeling experienced in childhood. Four types of borderline mothers are described from a child’s perspective and are discussed in greater detail in subsequent chapters of this book. Borderline mothers may exhibit characteristics of more than one character type, as traits of one type may be found in another.
James Masterson (1988), an internationally renowned expert on borderline patients, compares their stories to the two classic folktales Snow White and the Seven Dwarfs and Cinderella. Although borderline mothers can be enchanting, their children stand as helpless witnesses to the darkness within. The angst of borderline mothers is pain born from their own childhood. Their children, consequently, live a never-ending story of pity mixed with fear. The four types of borderline mothers are the Waif, the Hermit, the Queen, and the Witch. These categories are designed merely to aid identification of the disorder and are not mutually exclusive.
The darkness within the borderline Waif is helplessness. Her inner experience is victimization, and her behavior evokes sympathy and caretaking from others. Like Cinderella, the Waif can be misleading as she can appear to have it together for a short time. Internally, she feels like an impostor, and even if invited to the ball, feels unworthy. The Waif, like Cinderella, was a victim of childhood abuse or neglect, was treated as inferior, or was emotionally denigrated. The Waif’s emotional message to her children is: Life is too hard.
The darkness within the borderline Hermit is fear. Her behavior evokes anxiety and protection from others. Like Snow White, the Hermit feels like a frightened child hiding from the world. The Hermit fears letting anyone in because she was hurt by someone she trusted. She is vigilant about watching for danger and may be superstitious. The Hermit’s emotional message to her children is: Life is too dangerous.
The darkness within the borderline Queen is emptiness. Her inner experience is deprivation and her behavior evokes compliance. She is demanding and flamboyant and may intimidate others. The Queen feels entitled to exploit others and can be vindictive and greedy. The Queen’s emotional message to her children is: Life is “all about me.”
The darkness within the borderline Witch is annihilating rage. Her inner experience is the conviction of being evil, and her behavior evokes submission. The Witch can hide in any of the other three profiles as a temporary ego-state. She is filled with self-hatred and may single out one child as the target of her rage. The Witch’s emotional message to her children is: Life is war.
The Medean Mother is the most pathological (and rarest) type of Witch.
Recognizing individuals with borderline personality disorder is difficult because:
1. Borderlines seem normal to casual acquaintances.
2. Borderlines have unique symptom clusters.
3. Borderlines are different with different people, including their own children.
4. Borderlines have different external or public personalities.
5. Borderlines function well in structured environments and in specific roles.
Joan Crawford exhibited traits of a borderline Queen. Borderline Queens seem strong, determined, confident, and can be intimidating. Despite her royal position, Princess Diana exhibited traits of a borderline Waif, whose underlying feelings of helplessness evoked sympathy and concern. She admitted, “I am much closer to people at the bottom than to people at the top” (Smith 1999, p. 9). Like Cinderella, the glass slipper fit Diana beautifully, but she would never be comfortable wearing it. Biographer Sally Bedell Smith explains: “The fairy tale, it was clear, had gone horribly wrong. The royal love match turned out to be a sad tale of adultery, mental illness, betrayal, mistrust, and revenge” (p. 14).
In 1942, Helene Deutsch wrote an article that led to the discovery of BPD. Her description of “as-if” personalities identifies the borderline’s ability to behave as if she is normal in order to compensate for an inadequate sense of self. Deutsch observed that “the first impression these people make is of complete normality . . . It is like the performance of an actor who is technically well trained but who lacks the necessary spark to make his impersonations true to life” (p. 303). Behind their apparent competence and public persona lie deeply troubled souls.
Thornton (1998) states: “borderlines function quite well in some types of careers and situations. Where there is structure, they excel. This is one reason it takes them a long time to recognize a problem, unless someone notes their more dangerous behavior . . .” (p. 22). Gunderson (1984) explains that borderlines are compulsively social because their sense of self depends on their relationships with others. Smith (1999) writes, “one measure of [Princess] Diana’s insecurity was her habit of carrying as many as four mobile phones in her pocketbook and . . . spending nearly every free minute of the day on the telephone” (p. 279).
Borderlines are often popular among those who do not know them well. In high school, Laura’s mother was a member of the National Honor Society and Student Council. A biographer (Guiles 1995) stated that Joan Crawford “was forever worried about her image, about how she was perceived by others” (p. 75). She was, indeed, convincing to those who did not experience her dark side. Her personal secretary once said, “she was a star from the beginning. You would always notice her right away . . . I never saw her really be cruel to anybody, except some of the maids that she used to get angry with” (p. 87). Similarly, even those closest to Princess Diana seemed not to recognize her inner turmoil: “it was Diana’s dazzling public persona that lulled even her friends and family into disbelieving that anything could be seriously wrong with her—a common fate of the borderline” (Smith 1999, p. 12).
Borderline mothers have difficulty allowing their children to grow up. The dependency of a newborn can be intensely satisfying to the borderline mother, but as the child becomes increasingly independent, conflict erupts. According to Daniel Stern (1985), the infant develops an “emergent self” during the first two months of life, and gradually learns to recognize the difference between self and mother (p. 75). The relationship between a borderline mother and her child may change dramatically when the child is approximately 2 years old, begins to speak, and expresses a separate will. The mother’s anxiety intensifies because the child is no longer totally dependent and cannot be completely controlled. When the borderline mother recognizes the child’s separateness, separation anxiety is triggered and different parts of her personality are split off and projected onto the child.
Christina Crawford and her brother had a different relationship with their mother than their younger sisters. Guiles writes: “To an observer, the situation ranged from one extreme to the other—the younger children rarely strayed far from Joan’s side, while Christina and Christopher seemed locked in a never-ending struggle to escape their mother’s tyranny, whether real or imagined” (1995, p. 144).
Adult children of borderlines may experience conflict with siblings who have different perceptions of the same mother. One patient lamented that her brother accused her of neglecting their elderly mother. The patient had been abused by her mother and minimized contact to reduce the possibility of conflict. Her brother, however, was the designated all-good child, and shared his mother’s negative perceptions of his sister. Thus, conflicts are common among siblings who have different relationships with the same borderline mother.
Children who are perceived as all-good are typically loyal and protective of their mother. No-good children, such as Christina Crawford and her brother, may be cut off, ostracized, and estranged. After her mother’s death, Christina (Crawford 1988) learned that she and her brother had been cut out of her mother’s will and that her younger sister had been given significantly less money than her twin. Loyalty is richly rewarded whereas the price of betrayal is symbolic beheading—the child is completely cut off.
The consequences of betrayal so frighten children that they may have difficulty speaking about their mother. Upon entering therapy, adult children of borderlines are initially reluctant to discuss their childhood experiences. Several patients developed psychosomatic symptoms such as feeling a lump in their throat or experienced panic attacks following sessions during which they discussed their mother. Disclosing negative feelings is painful and is often accompanied by disclaimers such as, “I feel guilty saying this but . . .” or “most of the time it really wasn’t that bad . . .”
The issue of betrayal is critical to understanding the dynamics between borderline mothers and their children. The borderline’s sensitivity to betrayal results in paranoid accusations, annihilating rage, and abandonment of the offending party. Because borderline mothers can misperceive a child’s normal need to separate as betrayal, children learn to deny, disavow, or repress their feelings in order to survive. All-good children may stay merged and unable to separate from mother. No-good children may distance themselves completely, although they are more likely to continue a conflicted relationship. It is rare for even adult children to abandon their mother, regardless of how many times their mother has abandoned them.
Every borderline mother has a dark place in her heart. In the Waif, it is a sad and lonely place. In the Hermit, it is a frightening place. In the Queen, it is an empty space. In the Witch, it is a place that is black with hate. A 6-year-old child of a borderline mother once mourned, “Mommy only loves me with part of her heart.” It is true that the borderline mother cannot love with all of her heart. Part of her heart was broken when she was a child.
Therapists find that borderline patients have had one or more of the following experiences:
1. Inadequate emotional support following parental abandonment through death or divorce;
2. Parental abuse, emotional neglect, or chronic denigration;
3. Being the no-good child of a borderline mother.
Given these factors, however, it is impossible to predict who will develop BPD because experience, by itself, does not cause a personality disorder. The experiences mentioned above place children at risk for BPD, but other factors can increase or decrease the chances of developing serious personality disturbance.
Children can be exposed to a variety of traumatic experiences and yet develop healthy personalities given certain circumstances. Studies indicate that the single most important factor affecting resiliency in children is the conviction of being loved (Werner 1988). The effects of parental abandonment, abuse, and neglect can be mitigated if children have access to a relationship with a loving adult such as a teacher, a minister, a neighbor, or a relative who is empathically attuned to the child’s feelings.
One way of understanding how BPD develops in the aftermath of a given trauma is to consider the degree to which the child’s emotional needs were met. When feelings regarding traumatic experiences are not worked through, emotional growth is stunted. Balint (1968) proposed that personality is influenced not only by traumatic events but by the degree of psychological support received from significant others. Therefore, parents must allow the child to express intense emotion in order to prevent repression of the feelings. Very often, the traumatic experience is never discussed, let alone worked through.
The loss of a parent through death or divorce is traumatic for children. Understandably, parents can be devastated by these experiences as well. Typically, children repress their own sadness, anger, and guilt in order to support their parents. If the child’s feelings are not expressed, unexpressed grief can form an underground volcano. Parents who are emotionally preoccupied, overworked, and struggling to survive may not recognize the child’s distress until minor events trigger cataclysmic reactions.
All children have the following emotional needs:
1. To be held (to be enveloped by safe, loving arms)
2. To be mirrored (to see a positive reflection of themselves in their parents’ eyes)
3. To be soothed (to be comforted, reassured, and protected)
4. To be given some control (to elicit predictable responses to expressed needs).
Therapists have the opportunity to study the effects of trauma retrospectively. With hindsight, it seems clear that the degree to which a child’s emotional needs were met following a traumatic experience determines whether or not serious personality problems develop. Understanding the borderline’s inner experience, therefore, requires understanding her early experience and the feelings that were repressed.
Bowlby (1973) hypothesized that separation anxiety, grief and mourning, and defense are necessary and normal parts of attachment. He explained that anxious attachment patterns develop as a result of early abandonment, and that early experiences of loss through death, divorce, or emotional neglect trigger a fear of abandonment. As an adult, the borderline mother’s behavior reflects the degree to which her emotional needs were unmet as a child and the way in which caregivers responded to her. For example, children whose parents divorce often are told, “You’ll be all right, don’t cry. You’re a big girl. Just because Daddy is leaving doesn’t mean that he doesn’t love you. You’ll still get to see him.” Children are told how to feel instead of being allowed to express their own feelings. Healthier responses include, “You have a right to be upset about what has happened. You will have many different feelings that I want you to tell me about. Please, please, please come to me anytime and tell me how you feel. I will always take time to listen, to hold you, and let you scream and cry and tell me how you feel. It’s normal to be upset when something upsetting happens in life.” Unbearable pain that is expressed and acknowledged becomes bearable. But borderlines received no such responses in their childhood. Therefore, they are stuck in the past, trying to elicit what they needed as a child—validation of their unbearable pain.
Like a broken record, the borderline’s behavior seems compulsively driven, with the aim of eliciting what she lacked as a child. The Waif needed to be held, the Hermit needed to be soothed, the Queen needed to be mirrored, and the Witch needed control. Although no child’s emotional needs can be met perfectly, the degree to which these needs are met significantly influences personality development.
Joan Crawford’s father abandoned her mother before Joan was born. She once stated, “Due to an incident in my childhood, I didn’t dare trust anyone” (Thomas 1978, p. 78). Princess Diana was abandoned by her mother at age 6 and once told a friend, “I will always remember [my mother] packing her evening dresses into the car and saying, ‘Darling, I’ll come back.’ I sat on the steps waiting for her to return but she never did” (Smith 1999, p. 19). Apparently, Princess Diana sat by herself, alone in her sorrow. A child who is left alone following abandonment yearns for someone to notice her so that she might be held and comforted. How tragic that the whole world would one day know the pain of losing an elegant mother who left in a car and never returned.
Biographical information regarding Joan Crawford’s childhood suggests that following her father’s abandonment her mother was consumed with issues of survival. Joan Crawford’s success as an actress resulted from raw determination not to re-experience the pain of her childhood deprivation. Unmet needs for mirroring consumed her and she never again allowed herself to need anyone who might reject her.
Linehan (1993b) suggests that the key factor that leads to the development of BPD is an “emotionally invalidating environment.” She states:
An invalidating environment is one in which communication of private experiences is met by erratic, inappropriate, and extreme responses. In other words, the expression of private experiences is not validated; instead it is often punished, and/or trivialized . . . Invalidation has two primary characteristics. First, it tells the individual that she is wrong in both her description and her analyses of her own experiences, particularly in her views of what is causing her own emotions, beliefs and actions. Second, it attributes her experiences to socially unacceptable characteristics or personality traits. . . . [pp. 49–51]
When a child’s feelings are not expressed or validated following loss or trauma, grief is never worked through. The child feels emotionally orphaned and represses the pain of the loss. Unfortunately, abandonment followed by invalidation of the child’s feelings is a recipe for disaster.
In the absence of an emotionally attuned caregiver, children who experience chronic denigration are at risk for developing BPD. Physical, sexual, and emotional abuse are inherently denigrating. Other denigrating experiences can include being teased, ridiculed, humiliated, embarrassed, and harassed. Children who experience denigration and live in an invalidating environment are destined to develop serious personality problems. Chronic denigration can destroy even an emotionally healthy adult’s self-esteem. Denigration of a child can destroy the soul before self-esteem has a chance to develop.
Linehan (1993b) explains that invalidating environments do not allow the expression of painful or negative emotions. Invalidating families teach children that pretending to be happy is more important than being happy, and that talking about how you really feel only makes things worse. Unfortunately, the kind of invalidating interactions described by Linehan are typical of many borderline mothers. The no-good child who is the target of the mother’s rage therefore is at risk for developing BPD. No-good children are unable to break free from their mothers’ negative projections. Tragically, death may become an appealing escape. An adolescent patient who was the no-good child of a borderline mother wrote:
What does she want from me? How can I fulfill her dreams and make her happy? Just tell me. I’m dying to do it . . . dying. I’ll be her perfect daughter. I’ll be her perfect everything. I’m just dying to. I know she doesn’t want me around. I can just disappear. Please believe me. I’ll be quiet. I’ll be good. She won’t even know I’m here. She won’t even know that I’m dying. She won’t even know that I’m really already just dead.
Unjustly accused, the no-good child is sentenced without trial, held without bond, and may feel imprisoned for life.
Therapists sometimes warn family members not to depend on the person with BPD to validate their self-worth, yet young children have no choice. They can and will do anything to hold onto the good mother (the loving, caring person) who unpredictably turns into the Witch mother (the terrifying, raging beast). As they mature, the conflicts created by their need to separate often intensify.
Children of borderlines may wish they had a different mother as much as borderline mothers wish they themselves could be different. Many borderlines seek treatment when they realize how destructive their behavior is to their children.
[A borderline mother reported that her daughter’s first sentence was “Is mommy okay?” The mother explained,] “When I even pretend to cry, her eyes well up with tears . . . When I am happy and beginning to pull out of the black pit, she grows and changes at lightning speed, as if to make up for the time she lost trying to cope within my shadow. I am determined to get through this horror so I can be a real mommy, not a burden to her.” [Mason and Kreger 1998, p. 182]
Children raised by borderlines may spend their childhood balanced on the edge of disaster and may suffer from anxiety for the rest of their lives.
Although BPD can develop from a variety of circumstances, being raised by a borderline mother places children at risk for developing BPD. Borderline mothers may invalidate their children’s emotional experience, denigrate the no-good child, parentify the all-good child, and emotionally or physically abandon their children. Early intervention with borderline mothers and their children is essential in preventing the spread of this devastating disorder.
Brain development after birth involves a process of wiring and rewiring the connections among neurons. Early experiences shape the pattern of wiring and cause the number of synapses (the connections between nerve cells) to increase or decrease by as much as 25 percent (Turner and Greenough 1985). Studies (Heit et al. 1999) of the long-term effects of stress on the brain indicate that, “early stress can produce different kinds of neurological change with different consequences” (p. 5). Therefore, borderlines such as the Waif, whose early childhood experiences created overwhelming sadness, may be more depressed than fearful. Borderlines such as the Hermit, whose early experiences created fear, become hyper-perceptive of danger. Le Doux (1996) states that, “Unconscious fear memories established through the amygdala appear to be indelibly burned into the brain. They are probably with us for life” (p. 252). Although emotional regulation is a problem for all borderlines, the specific emotion that dominates an individual personality seems to vary.
Stone (in Cauwels 1992) explains that “when a borderline feels stressed and threatened, the habit memory system easily bypasses the cognitive and frontal lobe influence . . . She is like a soldier in a jungle, shooting first and then asking questions” (p. 219).1 Aiming at her own child, however, has tragic consequences. Once the shot is fired, the child’s trust is shattered.
BPD, like Post-Traumatic Stress Disorder (PTSD), may be the natural consequence of the brain’s response to emotional stress. The impaired judgment and impulsivity of the borderline may be linked with deficits in the functioning of the amygdala, the part of the brain responsible for the fight-or-flight response (Schacter 1996). Thus, the mind of the borderline malfunctions like a traffic light stuck on red or green. She may stop and go at the wrong times, unable to rely on the information relayed by her brain. Malfunctioning signals in traffic or in the brain can cause confusion, injury, or death if the individual is unaware that the signal is faulty. Helping the borderline mother, therefore, requires cooperation among neuroscientists, psychiatrists, and clinicians.
One borderline patient, a 50-year-old daughter of a borderline mother, sought medical treatment to discern the cause of her cognitive difficulties. She reported that no psychotropic medication improved her mood or cognitive functioning. After seeing numerous specialists and receiving conflicting opinions, the patient was admitted to a well-known medical center. None of the physicians questioned the patient regarding exposure to chronic stress during childhood. Apparently, they were unaware of the research linking cognitive and emotional difficulties with PTSD and childhood abuse. The patient, however, discovered a dramatic improvement in functioning when taking steroids for bronchitis months later. Amazed and delighted, she announced, “Now I know how normal people feel.” Her cognitive problems and depression returned, however, when the treatment regime ended. Understanding the brain chemistry of BPD may require an interdisciplinary approach, providing an exciting frontier for collaboration between clinicians and researchers.
Although most researchers maintain that borderlines cannot be cured, they agree that they can learn to control their behavior and significantly improve the quality of their lives. Some studies (Gunderson 1984) suggest that a minimum of four years of therapy three to four times a week is needed, and that the typical duration is between six and ten years. Successfully treated borderline patients are better able to control their behavior, anticipate consequences, and reduce self-destructive tendencies. Behavioral change is possible, thus significantly increasing the quality of relationships with others. Borderlines, however, need access to long-term treatment.
Psychotherapy for the adult borderline is a lifelong need and provides structure, insight, and management rather than cure. Loss, separation, or stress can trigger a crisis that brings the borderline into (or back to) treatment. Borderlines may learn to control their behavior, but the underlying feelings of helplessness, emptiness, fear, and rage appear to be immutable. Realistic expectations regarding treatment, therefore, are essential. The borderline must learn to compensate for damage to the hippocampus, the part of the brain responsible for memory functioning, and the amygdala, the part of the brain that controls the fight-or-flight response. Borderlines, like individuals with other kinds of disabilities, can learn to compensate for memory difficulties and to mitigate emotional reactions.
Knowing the proper diagnosis is the first step to treatment. Some therapists are reluctant to inform the patient or family of the diagnosis of BPD. Yet growth cannot occur without understanding. Patients with BPD have a right to the truth just as much as patients who suffer from other incurable, life-threatening conditions, especially since over 10 percent of individuals with BPD commit suicide (Cauwels 1992). Just as the diabetic must learn to manage sugar intake and output, the individual with BPD must learn to manage emotional input and output. Psychotherapy, combined with antianxiety and antidepressant medications, can significantly enhance the borderline’s quality of life. In her book The Talking Cure (1997) Susan Vaughan explains how long-term therapy reroutes the brain’s neurons and creates permanent changes in self-perception. Medication does not replace the need for a therapeutic relationship.
Linehan (1993b) developed a treatment approach for borderlines called “Dialectical Behavior Therapy.” Her approach uses validation to reward the patient for behavioral change. Validation is the antidote for denigration and is the glue that repairs a fragmented self. When faced with rejection, failure, or abandonment, a healthy individual feels disappointment and sadness without experiencing disintegration of the self. Healthy individuals can withstand rejection and failure because they have had enough previous validation to maintain self-esteem.
Understanding that borderlines’ traumatic childhood experiences altered their brain chemistry legitimizes their suffering and validates their internal experience. However, they must learn how to compensate for deficits in cognitive and emotional functioning. It is ironic that the silence surrounding BPD re-creates the early experience of pretending that nothing is wrong. Like most clinicians, Linehan acknowledges the difficulty of treating borderlines. She explains that change is slow and frustrating, and warns therapists and family members to be prepared for a rocky road. Although the road is long and hard, the journey is well worth taking.
Masterson (1988) stresses the importance of early intervention for children of borderlines who may exhibit borderline symptoms during adolescence. His studies offer encouraging findings regarding the long-term outcome of borderline adolescents, most of whom have borderline mothers.
The behavior of the borderline mother can be as frightening to her as it is to her children. The vicious cycle of self-hatred is reinforced every time she behaves destructively. The good mother within the borderline would never dream of hurting her children. But when the Witch emerges, anything is possible. As Masterson (1980) explains: “[the borderline] is drowning in his struggle: he is floundering in this stormy sea, unable to swim, he cries out for help as he is about to go down for the third and perhaps last time . . . [Treatment] is as much a true rescue operation as the action of the lifeguard who dashes into the water with a life preserver” (p. 49). The earlier treatment begins, the greater likelihood of success. If left untreated, the borderline mother and her child can drown together.
1. Cauwels refers to Michael H. Stone’s discussion during the symposium on “Borderline Personality: Impulse Spectrum Disorder” at the 143rd annual meeting of the American Psychiatric Association, New York, May 16, 1990 in her 1992 book Imbroglio: Rising to the Challenges of Borderline Personality Disorder.