The Window and the Wound: Dysphoria and Anger in Borderline Disorders

Abstract

Carla is a twenty-five-years-old young woman with pensive and penetrating eyes. She looks dynamic and intelligent. She has come to see me unwillingly, pushed by her mother. Their relationship, she tells me, is (and always has been)a very conflictual one. Her mother "accuses" her of being constantly distracted, careless and inefficient both in life and at work; she also reproaches her for being extremely oppositional and for making life impossible for everyone in the family with her constant outbursts. Carla, with a ferocious tone, claims that, on the contrary, it is her mother who makes life impossible for her. This is, she goes on, the source of the incessant clashes plaguing their family life. Her father seems to be a helpless witness to all this. He is described as a tiny, inconsistent man completely absorbed by his job. Carla describes this situation with sadness. Hers, however, is a sadness full of impatience and dull anger. Such impatience and resentment emerge with particular harshness as soon as the subject shifts from a general description of her family situation to her own problems and her request for consultation. When I start inquiring about the reasons that lead her to me (for consultation) she immediately takes on an air of challenge: C. "I thought you were supposed to tell me that. I had no reason to come here! I have really nothing to say!" (the tone is very provocative and grumpy. I sense a very bad mood) T. (Surprised) "If you have nothing to say, well... neither do I... But I guess if you came here you must have done so for some reason". C. "Of course! But I thought you were the one asking the questions ... I don't feel like talking about all these things ... I have nothing to say. Besides, it took me one hour to find parking! I also live on the other side of town ... Plus, psychologists and psychiatrists do not understand a damn thing .... They are just 'shrinks' who don't really care about people!". She goes on with the same tone, pouring innumerable insults on the whole professional category...When I ask her if she is often in such a bad mood she replies that yes, it happens often, both when she is with her family and at work. Carla works for a pharmaceutical company and is responsible for quality control of the work of the other employees. "Not an easy situation", I remark, assuming that, having to evaluate the work of other people, she must often find herself in a difficult position due to recurring criticism and recriminations. Mine, I thought, was just a trivial observation. Carla did not think so. She reacts with an explosion of anger and discontent: C. "Here we go again!! You talk in clichés too! What you say is what everyone thinks. But it is absolutely false! What do people know? I'm not just another bitch!" -and so on.

Personal Identity and Narrativity in Borderline Personality Disorder: A Phenomenological Reconfiguration

“…Sometimes, this identification with others metamorphoses into dilution or diffusion of the self. Then the person adopts the form and characteristics of their casual partner and loses themselves in it [44]. These experiences are accentuated during periods of stress in which individuals with BPD can experience dissociative symptoms, such as losing a sense of themselves (depersonalization) or their environment (derealization).…”

“…Perhaps one of the most common experiences reported by people with BPD is a sense of emptiness . This emptiness, which has nothing to do with a form of freedom or casualness, is experienced as a weight that pulls the self down [44] and takes on several determinations [45]: the sense of emptiness is lived as a feeling of internal absence [4], an impression of deadness, nothingness, a void feeling swallowed [46], a sense of vagueness [47], an internal hole or vacuum, aloneness [48], an impression of woodenness [49], and numbness and alienation [10]. In the narrative interpretation of TPL, this feeling has been related to the absence of a stable and coherent history of self and thus to a breakdown in what we have termed the self-institution.…”

Narrative self-appropriation: embodiment, alienness, and personal responsibility in the context of borderline personality disorder

“…Although this question arguably has implications for forensic matters pertaining to assessments of culpability, e.g., where BPD impulsivity leads to criminal actions, I am primarily concerned with the implications this question has for a psychotherapeutic context. It has often been shown that selfdirected emotions, such as guilt and shame in particular, play vital roles in BPD, and that the characteristic anger present in BPD may be understood as resulting from these emotions [48,49,50,30]. In light of the above sketched framework, such emotions may be understood as (at least partially) resulting from experiences of being confronted with affects and responses that properly belong to oneself, but which are not growing out of a reflectively shaped intention.…”