Michelle: A Study of Borderline Personality Disorder
By: Beth McHugh 2015
Like many people with borderline personality disorder (BPD), Michelle is initially engaging and personable at first meeting. She has a deep need to be liked by those she sees as her betters, and therefore is compliant with those she reveres. Hence she appears to be easy to get on with, and helpful and willing to please. But it doesn’t take long for most of Michelle’s endeavours to flounder, both personally and in the workplace, due to her BPD.
Michelle had formed an unhealthy attachment to her female supervisor, who she was intensely loyal to even when the supervisor was found to have a chequered career path and had been retrenched from several jobs due to unprofessional conduct and bullying in the workplace.
Michelle gravitated towards this supervisor she perceived to be “strong” and “powerful” and because of her own disorder, Michelle could not recognise that her boss had problems of her own. Michelle became second lieutenant to her boss, and hung on her every word. The boss, who was quite aware of the situation and well used to manipulating people, found Michelle easy prey and soon Michelle was doing all the menial jobs and basking in the second-hand glory of her boss’ success.
Michelle presented in therapy with a history of depression, but it soon became obvious that depression was only a small factor in Michelle’s life. Michelle began reading pop psychology books, and using the Internet to diagnose significant people in her life – most commonly her clients. This is always a dangerous move with serious repercussions, because, while most people would hesitate to diagnose a suspected heart condition, Michelle fell into that group of people who like to diagnose psychological illnesses in others. Unfortunately, she went one step further and applied her “findings” to her vulnerable clients – something which she was manifestly unqualified to do.
With no training at all, she diagnosed her own mother with borderline personality disorder, and had always had a troubled relationship with her. However, at 45 Michelle’s life has been a serious of turbulent experiences, beginning with not completing high school, an early pregnancy with a man who was not mature enough or ready to have a child, a history of drug and alcohol abuse and unstable relationships, both with male partners and with female friends.
A typical female friendship would begin with intense liking and sharing of intimacies, and Michelle would feel like she had found a “bestie”. However, within a period of six months, the relationship in question would have had several rounds of ups and downs on Michelle’s part, ranging from intense admiration and liking to devaluation and dislike, and then back again. This pattern of behaviour began in Michelle’s late teens and continues into her 40s. Consequently she has no close friends but a collection of acquaintances who she bounces off from one to the other, depending on who is currently in favour.
Her life partners display a similar pattern, with a revolving door of males and two children – a son in his 20s and a daughter under 10. Similarly her job history oscillates between periods of employment and non-employment – Michelle is unable to stay in a position for any length of time. Her longest continual employment to date is three years.
The depression that Michelle felt was, in part, driven by her inability to achieve goals as she saw her peers succeeding and thriving in comparison to her. Not having a close friend was a problem, which led to Michelle maintaining a relationship with a drug addict who did not work, pushing Michelle to be the sole income earner for her family.
It was her latest job that led to Michelle’s latest emotional downfall. Working as a peer support worker for people with a mental illness, Michelle was frighteningly out of her depth. With no formal training, she got the job because she claimed that she had dealt with living with a mother who had BPD. She did not acknowledge her alcohol problem to her prospective employee, and he in turn was too busy looking for staff to notice that Michelle was not emotionally stable herself.
Michelle coped at her current job by aligning herself with the office bully as described above. She found that working with mentally ill clients actually set off her own mental illness and she was unable to keep appointments and incurred problems with clients who found her charming but unreliable and ultimately unable to cope with their issues which made her effectively useless as a support worker.
On one occasion, she became overcome thirty minutes into a ninety minute session with a client, because that client was about to put in a complaint about Michelle’s boss. Michelle was not involved in this incident at all, yet she became distressed and started to make inappropriate statements to the client, such as “why didn’t they (her boss) tell me about this”, “I feel like I’ve been played for a fool”, “I’m clearly not a valued part of my team for them not to have told me this”, “I’ll have to reconsider my role at this job if I’m going to be treated like this”. She relayed repeatedly that she felt she had been “blindsided”.
Yet no part of this incident that her client was relaying concerned Michelle at all. Michelle was not hearing what her client was saying and she was making the incident about herself. Michelle’s paranoia, a typical symptom of BPD when under stress, was coming to the fore. Michelle was unable to complete her session with the client, and left early claiming she “needed a coffee as I’ve been blindsided”. Michelle could not separate herself from an issue that did not involve her at all, and could not deliver a professional service to a mentally ill person due to her own mental instability.
In reality, nothing had happened to Michelle at all. But due to her borderline personality disorder, Michelle couldn’t deal with what she saw as a mental “shift” to the working world she perceived. When her work colleagues were shown up to be not what Michelle thought, she could not function with her client and had to leave. This is akin to a nurse walking out on a patient in a hospital bed simply because the patient had stated that another nurse had done something unprofessional.
It was at this point that Michelle’s working life began to unravel. She made mistakes that other team members noticed, but worse, the government body that she was ultimately answerable to discovered her unprofessional work and began hearing more and more complaints from clients about her inability to provide the service that she was engaged to perform. Michelle’s drinking increased, her relationship with her partner became tense and she argued at home because the pressure of being sole breadwinner to her drug-user partner was also impacting on her 10 year old daughter’s life.
Michelle was referred for counselling by her employer and was stood down pending a demonstrated ability to return to work. More complaints from clients followed and her adored co-worker, the office bully, distanced herself from Michelle who had now become a liability to her in the workplace. In therapy, Michelle’s depression was found to encompass borderline personality disorder as well. By now, her breath stank and her teeth were strained brown around the edges. She wore black every day and effectively became a middle-aged Goth, much to the embarrassment of her son and co-workers.
Michelle was referred to a specialist drug and alcohol counsellor to deal with long-standing drug abuse issues, and a therapist who specialized in personality disorders to assist in getting Michelle in a more stable position where she could better manage her illness. Since BPD is a lifelong disorder, Michelle needs to learn better ways to manage her stress rather than through alcohol, and to increase her self esteem, which is distressingly low, making her a target for people like her bully co-worker who used her remorselessly until she was of no use at all.
Michelle’s relationship with her partner ended because she needed to get away from his drug-taking which fed into her own pattern. In therapy, Michelle began dealing with her deep sense of unworthiness, her low self esteem and her desperate need for love that leads her to self harm, with both substances and choice of associates. The threat of losing her daughter looms heavily but is a galvanizing force to achieve a more stable life.
Michelle was eventually laid off from her job due to her inability to cope with clients with mental illnesses who she finds far too threatening due to her own lack of grounding. None of her clients were actually a threat, and live successfully in the community. She is currently employed at Walmart where she experiences less stress. She hopes to retrain in retail and move away from social services because Michelle will always find it difficult to deal with stressful situations, such as those which can occur every day of the week when dealing with the unpredictable nature of people.
At 45, Michelle has finally unlocked the key that has led to personal unhappiness and depression for most of her adult life. She began therapy but has reverted to drinking more heavily to cope with her depression and anxiety over life issues. This behaviour is common in people with BPD who are not motivated to change. At present, Michelle is unemployed and unemployable, having lost her Walmart job due to her unpredictable attendance. Her partner now has court-appointed care of her youngest child. She lives in a share house, because her partner decided he could no longer tolerate her behaviors which have spiralled beyond what he is prepared to deal with. Michelle needs to deal with her relationship with her parents, in particular her mother, or else there is no hope for change for Michelle.
Michelle will always be fragile, but with help, can learn to control
triggers that stress her and get a better handle on her illness. Michelle
needs to learn motivational skills to assist her to stick to a program
of stress reduction techniques and to commit herself to a sustained
period of therapy to defuse much of the stress emanating from her dysfunctional
relationship with her parents, who are deeply concerned for their daughter’s
wellbeing.