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Depathologizing The Borderline Client - Page 6

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Colette: Why do you think I deserve to die?

Suicidal Part: You just do, and it’s my job to make sure you do.

C: What are you afraid would happen if I didn’t die?

SP: I’m not afraid of anything!

Dick Schwartz: Ask it what would be good about your death.

C: OK then, why would it be good if I died?

SP: You wouldn’t keep feeling good about yourself.

C: So you don’t want me to feel good about myself?

SP: Yes, because you’re a worthless piece of shit and a waste of space!

C: What’s so bad about me feeling good?

SP: (after a long silence) Because then you try.

C: And what’s bad about trying?

SP: You keep getting hurt.

Ultimately, the part revealed that it couldn’t stand another failure: it would rather have her dead than disappointed yet again. Colette showed the part appreciation for trying to protect her from that outcome, and we asked for its permission to heal the parts of her that had been devastated in the past by disappointment.

Fortunately, Colette’s story has a happier ending than Pamela’s. She realized that this wasn’t a suicidal part per se, but another, tougher extreme protector part that had been a major player in her life. Because of its belief that pain and suffering were her destiny and any good thing coming her way had to be false and delusory, it had limited the amount of confidence or happiness she was allowed to experience and had resorted to sabotage when it felt things were going too well. Without the unconscious constraint of this saboteur, the trajectory of healing went steadily upward.

The difference in outcomes between Pamela and Colette was related to my differing perspectives on borderline personality disorder. What helped even more was my ability to notice the parts of myself that were triggered by Colette, work with them in the moment, and then return to self-leadership. Regardless of your orientation as a therapist, this ability to monitor the openness of your heart and quickly recover from a “part attack” is especially crucial when treating borderline clients. As my experiences have shown, clients’ distrusting protectors are monitoring your heart, and they’ll test and torment you or terminate therapy the moment they sense it closing.

One of life’s great inequities is that so many people traumatized as children are reinjured throughout their lives because the original hurt has left them raw and reactive. It’s inevitable that borderline clients will, from time to time, trigger feelings of fear, resentment, and suffocation in their therapists. Your recognition of what’s happening inside you and authentic attempt to reconnect can become a turning point in the therapy. Many borderline clients have had little validation in their lives. When they’ve been in conflict with someone, they’ve typically been shamed and rejected for being too sensitive, emotional, or impulsive. As a result, they often carry the sense that they’re doomed to be alone along with a battery of unusually reactive and extreme protectors.

These clients deserve to be in relationship with someone who, after initially being triggered, can regain perspective and see behind the explosive rage, icy withdrawal, or manipulative controlling to the pain that drives those behaviors. As you become aware of the parts that try to protect you from these clients and get them to let your inner self shine through, not only will these “difficult” clients become some of your most rewarding, but your level of self-leadership and compassionate presence will increase.

Richard Schwartz, Ph.D., director of the Center for Self Leadership and the originator of the Internal Family Systems model, is the author of Internal Family Systems Therapy and You Are the One You’ve Been Waiting For: Bringing Courageous Love to Intimate Relationships.

Tell us what you think about this article by leaving a comment below or sending an email to letters@psychnetworker.org.

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11 comments

  • Comment Link Wednesday, 19 June 2013 23:49 posted by Cecille del Gallego, LCSW, CEAP

    So spot on and very well articulated....I think the article captures the complexity of working with those who have had enormous pain and who have been violated on so many levels. It gives voice to the deepest yearning that is essentially in all of us - to be seen, heard, accepted and believed in. Great job humanizing this "population"...

  • Comment Link Sunday, 16 June 2013 20:57 posted by Jake Eagle

    Dick, I really appreciate your article this month, Depathologizing the Borderline Client. The specific details you shared about using IFS—both in dealing with parts of your client as well as dealing with parts of yourself—were illuminating.

    This may not surprise you, but I recently experienced remarkable success using IFS with a client struggling with multiple parts—I don't label my clients—but she most certainly would be labeled with multiple personalty disorder by most in our profession.

    I think what may have be unique in my approach is that I had her read the first 60 pages of Internal Family Systems after our first session. I asked her not to read any more of the book because I didn't want her to get caught up in the details, but the first 60 pages provided a context for our work. She immediately recognized herself reading your book and felt hopeful for the first time in her life. No one had previously been able to explain her confusion and internal conflict, but after reading your book she felt seen.

    During the six months of working with my client she has identified all of her parts, engaged in conversation with all of them, and now talks openly about her family and how they are learning to live together and love each other. It's been a remarkable and relatively quick transformation. I don't think it would have been possible without your IFS model.

    Hope you're well and maybe I'll see you again in Tulum.

    Jake

  • Comment Link Monday, 10 June 2013 16:23 posted by Kimberly April (not my real name)

    Thank you for humanizing the reality of the results of adult survivors of childhood abuse, and for specific ways to help therapists effectively relate to, treat, and heal those affected by this senseless horror. I am a survivor, and yes, I saw parts of myself in your dialogue. I am almost finished with my therapeutic journey of 4 long and sometimes painful years, yet also colored by unequivocal joy encontered through the ability to finally feel and deeply connect to another human being, my therapist. I appreciate all of your research and practical steps with parts work designed to help heal a shattered self. Doing parts work was one of the most painful yet healing parts of therapy after the much feared phase of establishing safety and trust, which took a very long time, and was filled with a lot of acting out in many forms.
    Thanks again for this article and your work which has given those of us who have survived destructive secrets of the past much hope for unibiased treatment and point us to a live worth living, full of connecting with others. I am not out of the woods yet as the termination part of therapy seems to be a difficult one full of loss and pain, because although I intellectually realize that my therapist is not my father, all my little girl wants to do is take her blankie and climb up on the couch and sit next to him, because he helped me feel safe and finally alive. (This definitely is embarrassing for me because I am older than he is, and part of the baby boomer generation.)I am sure I will get through this because my therapist has given me coping skills, and I know he will walk with me to show me the way. Although he will not walk for me, he will walk with me, and that for me makes all the difference!

  • Comment Link Monday, 20 May 2013 18:22 posted by toni aguilar

    this article has excellent advice for the therapist whose "parts" get too reactive and take things personally. (one of my clients taught me the term "QTIP"--quit taking it personally.) the rage (coming at us or simply to us)that some of these clients can exhibit is very difficult for some of us to handle w/o getting weary, no matter how compassionate or skilled we are. i DO believe in and use the idea of internal family systems, and i teach all my clients that all human behavior is purposive, geared toward whatever the subconscious THINKS it needs for survival. so i try to hang onto curiosity and that compassion at my core....but whew! i find it to be very hard work sometimes, choosing just the right words, the right tone, the right demeanor to help those protectors accept all of us who are in the room! thanks for running the article.

  • Comment Link Saturday, 18 May 2013 22:02 posted by Gary Brown

    though I am not a therapist, nor a phsychologist or anything like that, I have been reading and enjoying this magazine for five or six years. I found this article to be very interesting and if I might dare to say, insightful. I talk with a lot of people and many of them ask me questions similar to those a therapist might receive.
    I like to relate back to different articles I have read in this magazine to suggest things to those people. Many times I find that those to whom I speak find the way we interact to be thoughtful and insightful, I suspect this article will lead to further insights I might be able to share with those who ask for my input.
    Thank you for the article, I feel it was a very worthwhile read.

  • Comment Link Wednesday, 15 May 2013 16:14 posted by Suzanne Watts

    As a therapist treating survivors of sexual abuse, this article was very informative for me. Therapists can be very nervous about treating clients who have been diagnosed with Borderline Personality Disorder, especially if they are described and identified with that label. Viewing these clients as trauma survivors enables therapists to reframe their own countertransference reactions and possibly see the clients in a different light, as you so elequently pointed out.

    However, as the article concluded it appeared as though you might have been referencing a client with Dissociative Identity Disorder (Colette in your article). It is difficult to tell given the brief summary of your interactions. I found that internal family systems therapy is very effective in treating DID and am interested in learning more about it.

    In any event, all trauma therapists can benefit from helping clients speak to their inner "parts" which may have opposing messages at first glance.

    Thank you for the informative article!

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