About the Elephant at the Kitchen Table E-Book

Manuela Rösel

• Herausgeber: novum publishing
• Kategorie: Gesellschafts- und Liebesromane
• Sprache: Englisch

Seitenzahl: 321

Veröffentlichungsjahr: 2025

Beschreibung

The behavior of people with borderline personality disorder is perceived as chaotic and irrational. However, it reveals a compelling logic when the "split" is consistently taken into account as the most prominent feature. Society as a whole denies what overwhelms it due to the disorder's complexity: an inability to form attachments and relationships, high functionality, and an inability to be cured. This book takes a clear look at common prejudices and misconceptions about borderline personality disorder. It offers support for those who care for people with the disorder because partners, friends, caregivers, and above all, the children of people with the disorder, have a right to understanding, clarity, and guidance.

Leseprobe

Table of Contents

About the Elephant at the Kitchen Table

Dedication

Foreword

1 Borderline: Causes, symptoms, and diagnosis

2 Borderline rarely comes alone – comorbid disorders

3 Symbiotic relationships – risks and side effects

4 Borderline Systemics

5 The drama of collective codependency

6 Misconceptions and prejudices

7 Questions and answers

A personal postscript

An authentic story

Acknowledgements

Help for those affected and their families

Contact points specifically for the protection of children involved

Literature

IMPRINT

About the Elephant at the Kitchen Table

or the chaotic logic of borderline personality disorder

Dedication

For Ronny

1991–2020

In loving memory

Foreword

For many years, I have been working with relatives of borderline personalities. With adults or even adolescent children of those affected, their partners, siblings, parents, or friends. Some of these people grew up in family systems that were characterized by the profound attachment disorder known as borderline personality disorder, and/or found themselves in such a constellation in their own later relationships. They are all familiar with the "egg dance" – the constant tension in the air, combined with the constant fear that the next word, the next unpredictable and inevitable frustration, could result in a devastating escalation.

In order to find a self-protective way of dealing with the mostly threatening outbursts and dramas of "their" borderline personality, most relatives use childlike survival strategies. They ignore assaults and provocations out of fear of the often inevitable escalation. They behave defensively, reservedly, and avoidantly.

There he sits, in the middle of the room, claiming it for himself: the "elephant," conspicuous and present. No one can get past him. He claims the life energy of all the people around him, without being able to grant them their own space for their own feelings and needs.

And they try to overlook him and, as far as possible, not to correct what is being staged in terms of conflicts and dramas in an authentic and realistic way. They deny the obvious and do not name what should be named. Because they often cannot classify or understand it. The chaos and paralyzing confusion often created by those affected is too overwhelming, and the self-doubt too great, their confidence in their own perceptions and knowledge of the accuracy of their own emotional experiences too small. From the experience that any authentic and open attitude can trigger a devastating drama, they have learned to protect themselves by avoiding confrontation. They usually behave in a co-dependent manner, which not only harms themselves but also the person affected at their side. This person thus has no chance of honest reflection or correction of their often distorted, responsibility-rejecting reality. The disorder is not only supported in this way, it is also confirmed.

Is this just a family systemic issue or also a social one?

I perceive society's view of borderline personality disorder as extremely distorted and flawed. There seems to be a lack of awareness of the high functionality of those affected, who can present themselves as impressively successful and socially competent. Serious antisocial and highly toxic behavior patterns of those affected are ignored, trivialized, imaginatively placed in a positive context, or simply attributed to relatives, even when they are obvious. The typical codependent, avoidant, and ignorant attitude is just as prevalent in family systems characterized by borderline personality disorder as it is in society's approach to the disorder.

Social workers, guardians ad litem, family court judges, counselors, and even clinical professionals such as psychiatrists, psychotherapists, and experts often have little or no access to the divisive mechanisms underlying borderline personality disorder. They rely exclusively on diagnostic manuals for guidance. These manuals describe pathological abnormalities, but completely deny the highly toxic pattern of division and its consequences.

And so, borderline personality disorder in its highly functional form seems to be a huge taboo.

In this book, I deal primarily with the seemingly irrational behavior patterns of borderline personalities: the contagious chaos of contradictions and schizophrenic expectations, the highly emotional instability that draws anyone who gives in to symbiosis into the painful world of borderline disorder. The resulting paralysis can only be overcome through understanding and differentiation.

I am extremely critical of the current criteria in diagnostic manuals, which neither enable an understanding of pathological-irrational behavior nor reveal the serious attachment disorder that constitutes borderline disorder. On the contrary, they lead to misconceptions and prejudices and significantly obscure the clinical picture.

"Borderline personalities" are those who cut themselves, who cannot control their emotions, who consume drugs or alcohol, and who behave in a conspicuous and recognizable antisocial manner.

Is that really the case?

I consider the conclusions and consequences of such clichés in family law or in the support of those affected and their relatives in counseling centers or self-help groups to be a catastrophic failure on the part of the helping authorities. Judgments, decisions, or "advice" so often have devastating consequences—especially for the children involved, who are dependent on the competence of helping inst s and so often become victims of incompetent counseling.

Follow me into the world of "projective identification." Learn to understand the mechanisms of splitting and schizophrenic attachment. Let my dismay at misjudgments or advice that make relatives even more incapable of acting infect you. With my following remarks, I would like to contribute to understanding the seemingly incomprehensible, removing prejudices and their toxic effects, providing orientation, and strengthening confidence in one's own perception.

From paralysis to the ability to act!

Manuela Rösel, spring 2025

The names of the people who shared their authentic experiences with me for this book have been changed. Any similarity to real names is purely coincidental.

1 Borderline: Causes, symptoms, and diagnosis

1.1 Classification of borderline personality disorder according to diagnostic manuals

Anyone who deals with the topic of borderline personality disorder will encounter the so-called diagnostic criteria described in the ICD and DSM classification systems. Both relatives and those affected will find here the more or less pronounced symptoms, which initially offer a (superficial) basic orientation. However, there are no clues here that explain the confusing, irrational behavior of those affected in relationships. Criteria that point to behaviors that actually disrupt relationships, such as impulsivity, instability, idealization, and devaluation are listed, but the dependence of those affected on symbiotic relationships or an indication of schizophrenic attachment patterns (as I will describe below) as well as the highly manipulative acting skills of high-functioning borderline personalities, who initially appear completely unremarkable to the outside world, are not presented. This makes the latter very difficult or even impossible to identify using the diagnostic criteria.

This is a glaring deficiency with serious consequences for the identification of the disorder and the management of the clinical picture, as well as for the everyday lives of relatives and, in particular, for children in family law proceedings.

For the sake of completeness and to provide clarity and comparison, I will first outline the classification of borderline personality disorder according to the current diagnostic manuals:

DSM-5 and ICD-11

The  American Psychiatric Association, the association of psychiatrists in the US, first published its Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980. The aim was to standardize the diagnosis of mental illnesses. As research and therapy are constantly evolving, the DSM-5-TR is now available. It comprises a classification system that divides mental illnesses into diagnostic categories based on the description of symptoms and the course of the illness.

The International Classification of Diseases is now in its 11th revision (ICD-11) and was published for the first time by the World Health Organization in 2019. It largely corresponds to the diagnostic categories of the DSM-5-TR.

In the current DSM-5, borderline personality disorder is listed in the chapter on personality disorders:

"This is a pervasive pattern of instability in interpersonal relationships, self-image, and affect, as well as marked impulsivity. The onset is in early adulthood, and the pattern is evident in a variety of contexts.

At least five of the following criteria must be met:

Desperate efforts to avoid real or imagined abandonment.

A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

Identity disturbance: marked and persistent instability of self-image or self-perception.

Impulsivity in at least two potentially self-damaging areas, e.g., spending money, sexuality, substance abuse, reckless driving, binge eating.

Repeated suicidal behavior, suicidal gestures, or threats, or self-mutilating behavior.

Affective instability due to marked reactivity of mood, e.g., marked episodic moodiness (dysphoria), irritability, or anxiety, with these moods usually lasting a few hours and rarely more than a few days.

Chronic feelings of emptiness.

Inappropriate, intense anger or difficulty controlling anger, e.g., frequent outbursts of anger, persistent anger, repeated physical fights.

Transient, stress-induced paranoid ideation or severe dissociative symptoms."

A paranoid idea manifests itself through the mental and emotional perception of being threatened, even when there is no reason for this in reality. Dissociative symptoms often manifest themselves in a frozen posture. Due to their experience of being detached from themselves (depersonalization), those affected are unable to act or react.

The DSM-5 offers an alternative model, which is also suitable for diagnosis due to its similarity in the presentation of symptoms and proposes the following diagnostic criteria:

"A. Moderate or severe impairment in the functioning of the personality, manifested by typical difficulties in at least two of the following areas:

Identity: Significantly impoverished, underdeveloped, or unstable self-image, often with excessive self-criticism; chronic feelings of inner emptiness; stress-induced dissociative symptoms.

Self-control: Instability in goals, preferences, values, and career plans.

Empathy: Limited ability to recognize the feelings and needs of others, combined with interpersonal hypersensitivity (e.g., a tendency to feel slighted or insulted); perception of others focused on negative characteristics or vulnerabilities.

Intimacy: Intense but unstable and conflict-ridden close interpersonal relationships characterized by mistrust, neediness, and anxious preoccupation with actual or imagined abandonment; close relationships are often experienced in extremes of idealization and devaluation, alternating between overinvolvement and withdrawal.

B. At least four of the following seven problematic personality traits, at least one of which is (5) impulsivity, (6) risk-taking behavior, or (7) hostility.

Emotional instability: unstable emotional experience and frequent mood swings; intense emotions or affects are easily stimulated, highly intense, and/or inappropriate to situational triggers and circumstances.

Anxiety: Intense feelings of nervousness, tension, or panic, often triggered by interpersonal tensions; frequent worry about the negative effects of past unpleasant experiences and possible negative developments in the future; feelings of anxiety, concern, or threat in situations of uncertainty; fear of mental breakdown or loss of control.

Separation anxiety: Fear of rejection and/or separation from important attachment figures, accompanied by fear of excessive dependence and complete loss of autonomy.

Depression: Frequent feelings of despondency, misery, and/or hopelessness; difficulty recovering from such moods; pessimism about the future; profound feelings of shame; feelings of inferiority; suicidal thoughts and behavior.

Impulsivity: Actions are carried out rashly as an immediate reaction to a trigger; they are determined by the moment , without planning or consideration of the consequences; difficulty developing and following through on plans; feeling of pressure and self-harming behavior under emotional stress.

Tendency toward risky behavior: Engaging in dangerous, risky, and potentially self-harming actions without external necessity and without regard for possible consequences; lack of awareness of one's own limits and denial of real personal danger.

Hostility: Persistent and frequent feelings of anger; anger or irritability even in response to minor slights or insults.

In the ICD-10, borderline personality disorder (F60.31) is listed as one of two subtypes of emotionally unstable personality disorder (F60.3):

"The impulsive type of this disorder is characterized by a lack of impulse control and unpredictable actions (F60.30).

In the borderline type, the individual's self-image and relationship behavior are even more severely impaired (F60.31). This type roughly corresponds to the definition of borderline disorder in DSM-5."

Since borderline personality disorder is always accompanied by elements of other personality disorders (such as narcissistic, histrionic, dependent, paranoid, or antisocial personality disorder), it is often difficult to differentiate between them according to the classic manuals. (I will discuss these so-called comorbid disorders in more detail in Chapter 2.) This often leads to misdiagnoses or even prejudices. In addition, important indicative information is not included in the diagnosis because significant others (relatives, friends, etc.) are not involved in the diagnostic process. On the contrary: partners, parents, or adult children are dismissed with the argument that diagnosis and therapy require a safe space, and are left alone with their burdens (in some cases, including trauma resulting from their relationship with the patient) with a " " attitude.

Borderline personality disorder is a serious attachment disorder! It is undisputed that those affected suffer considerably, but they transfer this suffering onto their caregivers. The latter become involved in the psychological crises of those affected and are abused as emotional mirrors of inner turmoil, experiences of destruction, powerlessness, and fear.

Who is most strongly confronted with the symptoms? And wouldn't it also be essential, in order to avoid misdiagnosis, to create a way of differentiating between the presentation of those affected, who are often highly functional, and the reality that relatives have to experience?

Isn't borderline personality disorder also a systemic issue? Aren't relatives part of the pathological processes and thus also exposed to considerable risk themselves? And why are borderline personalities and their needs always the sole focus in all areas related to therapy and counseling? The therapeutic world revolves solely around those affected. And so clinical, counseling, and "helping" authorities bear joint responsibility for the emergence of the next borderline generation.

1.2 A critical look at diagnostic manuals and the denial of the high functionality of those affected

It is true that borderline personalities exhibit the behaviors listed in the ICD and DSM manuals. In this respect, the diagnostic criteria prove to be supportive and helpful. However, the reason for these conspicuous behaviors remains unmentioned in . The underlying and most essential behavioral pattern of borderline disorder, namely splitting, is not listed in either the DSM-5 or the ICD-10. Therefore, the diagnostic criteria provide only an extremely inadequate insight into the experiences of those affected and thus conceal a large part of the consequences that arise from their interaction and relationship behavior, including for their caregivers.

In addition, they allow the disorder to be recognized almost exclusively in those affected who behave conspicuously in society and are thus easier to diagnose based on their symptoms. One of the most pronounced prejudices, that borderline personalities can be classified primarily as low-functioning (unstructured, according to the specified criteria ...), thus becomes tangible.

This cliché is widespread, not only among professionals, and is one reason why drastic misjudgments occur in contact with affected family systems and, as a result, in family law. However, those affected often do not find therapeutic support because they are not diagnosed.

A highly functional borderline disorder describes a borderline type that appears completely unremarkable to the outside world. These individuals seem to have their lives well under control, appear well-structured, are often professionally successful, personable, amiable, and helpful. They come across as competent, often extremely attractive, and are well able to present themselves impressively. Those who do not know them well have no idea of their disorder.

However, in both low-functioning and high-functioning borderline personalities, relationships are dominated by divisive mechanisms, schizophrenic attachment, and toxic interactions. In both types, hidden (self-referential) motives are evident, but these are more or less concealed, depending on the degree of functionality ( ).

Although the diagnostic criteria make it clear that caregivers and relatives are exposed to antisocial behavior patterns, this insight often refers to the obvious pathological symptoms (emotional instability, outbursts of anger, substance abuse, etc.). However, what the underlying, usually less obvious divisive mechanisms mean for caregivers is neither defined nor attributed. As a result, there are repeated instances of drastically incompetent assessments by experts involved, misjudgments in family law, and inappropriate and sometimes dangerous advice from "helpers" (parenting advice centers, social educators, guardians ad litem, etc.), which tend to exacerbate the toxic drama and are of no support to either the relatives or those affected:

"The therapist who leads our self-help group [for relatives of borderline personalities] emphasized that we just need to show more love. If we only loved the borderline personalities properly, then everything would be fine." (Jürgen, 45)

"At the parenting advice center, I was advised not to provoke my daughter's mother [who has borderline personality disorder], to make more of an effort to stabilize her, and to refrain from seeking extended contact [with my daughter]." (Martin, 42)

"My therapist brought the topic of borderline personality disorder to my attention, and I was very afraid for our two-year-old son in view of the violent escalations. My husband is a doctor and can be very charming. The youth welfare office employee was very taken with him and completely questioned my statements. Borderline? That's only women, and you can tell when they have it. I should ask myself in therapy why I only want my child for myself." (Annett, 33)

These examples show that borderline personality disorder is regularly classified as low-functioning in a prejudiced manner and that there is often a lack of understanding of the basic pattern of splitting (symbiosis). Highly functional borderline personality disorder, which is characterized by an extremely positive presentation but is not congruent with the values presented, cannot be identified in this way. The portrayal of "care," for example, contains neither empathy nor mindfulness and refers more to the motivation to receive attention oneself (hidden motive).

1.3 Presentation behavior

Borderline personalities are tormented by inner conflicts, contradictions, and fears. They have been unable to complete the process of identity development (Who am I? – Development of stable values) and remain without a clear reference to themselves, feeling lost and disoriented. They are constantly overwhelmed, which manifests itself in permanent tension and frequent irritability. The highly toxic belief of those affected, "I am not," is associated with a great emptiness and a feeling of non-existence. How can one survive in a world in which one does not exist?

Behind the painful experience of emptiness for those affected is a lack of loving attention and stable reflection (attachment) in the first months of life (see section 1.4). During the splitting phase of development, if it proceeds healthily, an infant is "fulfilled" by the affirmation of its caregivers. It learns that the feelings and needs it perceives as threatening are good and right, and can then integrate them accordingly as belonging to itself. Parents who are capable of forming attachments support their child in being in a fulfilling attachment with themselves through their stable and loving mirroring. In their further development, the child then tries to assert their needs, based on the learning experiences that they are allowed to feel what they feel. The boundaries that the child encounters in the process help them to develop healthy social behavior.

If such stable and loving support from parents is not provided, the young (and later adult) person lacks a bond with themselves. They are not fulfilled by parental love, which has become integrated within them through the affirmation of their own feelings and needs. They remain "empty." The result is an often unbearable experience of meaninglessness. It is not without reason that borderline personalities often try at all costs to avoid and ward off the feeling and experience of emptiness.

Highly functional individuals in particular compensate for their unbearable experience of worthlessness by creating ideal self-images (schemas). Depending on the desired role, these are assigned corresponding positive attributes: the "caring, attentive, and loving" mother or the "successful, intelligent, understanding" man... Identifying with these schemata enables those affected to assume and portray a desired or externally expected role. In doing so, they can appear very authentic and convincing, as their portrayal—going beyond acting—corresponds to their current false identity at that moment.

However, the identification of those affected with the self-created pattern is not based on an actual integration of the values they portray. These are merely conveyed in order to gain acceptance, positive attention, and appreciation, or to assert their own interests.

The discrepancy between the portrayed and actual behavior, which is evident in a striking incongruity, is rarely uncovered. However, recognizing and uncovering the lack of consistency between verbal expression and actual behavior (contradiction) would be an indication of the presence of borderline personality disorder ( ). Unfortunately, and this is my long-standing experience, these opportunities to identify the disorder tend to be avoided, especially in family law proceedings. Time and again, clients report that the affected partners credibly assure others (helpers) how important it is to them that the other parent has regular contact with their child. In reality, however, contact is repeatedly refused or sabotaged in everyday life. The child is massively alienated and positioned, and continuously involved in the separation conflict.

"He repeatedly emphasizes that his parenting style is the only correct one, conveys to outsiders a great interest in his children's development, and emphasizes how much he cares about them. In reality, he behaves extremely disrespectfully and even abusively towards the children. He takes away things that are important to them as punishment. He emotionally blackmails them and puts them under pressure by demanding something (e.g., help with household chores) and at the same time threatening that this or that would happen if they did not comply with his wishes." (Hannah, 34)

"My ex-husband often put himself at the center of attention in a pronounced way. He made 'remarks,' spoke loudly, laughed, and enjoyed portraying himself as the perfect host, cook, husband, and father. He often used me and the children to get attention from others, for example by talking about the children's or my successes in an exaggerated and boastful way (not proud or appreciative), even though this made me and the children uncomfortable." (Claudia, 34)

"In parenting counseling or at the youth welfare office, Lisa always comes across as very understanding. She says that she knows she has made many mistakes, but now understands how important Lukas's dad is to him. That's why it's in her best interest for the boy to be with me as often as possible. Outside the door, she then said snappishly, 'Lukas belongs to me, you can forget about me voluntarily giving him to you'After that, I didn't see him for three months (he was sick, had toothache, they had something very important to do). The social services worker was visibly annoyed with me, but wrote to the mother and invited her to a meeting. No response. I still couldn't see Lukas and nothing happened. I felt completely helpless." (Jens, 43)

In such cases, I recommend clearly documenting the respective incidents and exposing the incongruous maternal/paternal behavior. However, this often elicits defensive (overwhelmed) reactions from the "helpers" ("Well, let's look ahead!" or "What do you hope to achieve by speaking badly about your child's mother/father?"). This is often associated with being perceived as a "demanding" (because rightly so) and "annoying" parent, which often triggers deep insecurity and fear of losing the support of the "helpers." Such situations require a comprehensive, clear, and objective attitude in which behavior that endangers the welfare of the child is repeatedly pointed out and named. Even though disappointment and justified anger are understandable, you should remain as objective and appropriately emotional as possible and maintain a cooperative attitude.

1.4 From splitting to individuation – healthy development from a developmental psychology perspective

Let's take a look at human developmental history before we delve deeper into the defense mechanism of splitting as a basic pattern of borderline personality disorder in this section. As complex as the disorder may be, the typical behavior patterns can be logically classified with knowledge of their background.

Most living beings in this world are autonomous and capable of acting immediately after birth, albeit often to a limited extent. Primates, however, which include humans, are completely dependent on the permanent availability of a caregiver and their unconditional care after birth.

The fact that a newborn baby is completely helpless and dependent conflicts with the need for stress-free brain development (neuronal maturation). This requires the cuddle hormone oxytocin, which, like fertilizer for growing plants, ensures that neuronal structures can develop and experiences can be integrated for further development (learning). Oxytocin has a stress-relieving effect on the body and slows down breathing and heart rate. This makes the baby feel safe and secure.

If the child were aware of its independence and inability to sustain itself, it would experience a permanent feeling of powerlessness and existential threat. Stress hormones such as cortisol and adrenaline would inevitably flood the small brain and cause irreparable damage.

Life, in its wisdom, has now created a way to protect the immature and extremely vulnerable infant brain by enabling the defense mechanism of splitting. This simply means that the infant cannot perceive itself as an independent being, but only as part of its caregiver (usually mother/father). It completely splits off its physical and psychological (emotional) self-perception and transfers it to its parent. This process is called symbiosis, in which mother/father and child merge with each other.

The child projects its self-perception onto its caregiver ("I am you and you are me") and identifies with them through their reactions (mirroring). The infant, which is unable to survive on its own, takes on the life skills of its caregiver in symbiosis with them, thus avoiding confrontation with permanent loss of control (flooding with stress hormones).

Have you ever observed mothers or fathers interacting with their infants, or have you been in contact with one yourself? Have you noticed that the person who is in contact with an infant instinctively imitates it?

This vital interaction, which is part of bonding, is called mirroring. When infants express their needs (e.g., hunger), they usually do so loudly and vehemently, and their agitation is clearly noticeable. In the infant's experience, every state of need is existentially threatening. They do not yet have the cognitive abilities to help them understand their situation. They only experience that they are dying. This is a moment of considerable stress, which inevitably burdens the child's brain with aggressive stress hormones if their needy state is ignored.

Caregivers who are capable of forming attachments will respond immediately to the needy child, touching them (offering attachment) and mirroring them ("I'll show you your feelings"). In doing so, they adapt their intonation and facial expressions to the child's expression, but remain calm and loving (minimizing stress) and convey the following information to the child:

"What you are feeling is right" (emotional confirmation),

"You are expressing yourself appropriately and are understood" (confirmation of behavior), and

"You will get what you need" (and can thus be self-effective).

On the one hand, the child's brain learns to calm itself down through external reassurance. On the other hand, the parts that have been split off from the child are returned to the child in homeopathic doses, allowing the child to integrate these parts into itself. Only in this way is the child able to develop elements of basic trust ("I feel correctly, my perception is okay, I am able to show myself correctly in order to be seen, my caregiver gives me security, and the world is a safe place").

Basic trust develops significantly in the first months of a person's life (splitting phase) and has a decisive influence on their self-image and image of others. At the age of three, when the first cognitive abilities begin to emerge as the neocortex matures, the little person has formed their image of themselves and the world (others). This image is based exclusively on the emotional attention they received from their caregivers in the first months of life.

The individual expression of basic trust then gives rise to self-confidence, self-esteem, and the ability to love others in later life. At the same time, trust or mistrust (depending on the attachment offered) towards other people develops, which in turn determines the schema (image) of community or partnership. Can I trust others and do I feel safe and secure with them, or do I feel tense, anxious, and threatened when in contact with others? Ultimately, this leads to the comprehensive conclusion of either trusting life/the world, getting involved, and affirming life, or experiencing life/the world as dangerous, fearing liveliness, and rejecting it.

The phase of division accompanies an essential process that the little human being must cope with. In the womb, the unborn child was completely safe and had no needs. It was warm, protected, secure, and nourished ( ). During this period, there are no challenging deficits. Only after birth is the infant confronted with its needs and the associated experiences and feelings. Hunger, fear, anger—the divided infant perceives every emotional experience of need as life-threatening. There are only two perspectives: either I am satisfied (life) or I am unsatisfied (death).

Only the stable bonding ability of its caregivers and their loving reflection convey to the child that its feelings are okay, that its expression is correct, and that it can be sure of the presence and attention of its caregivers.

This form of stable, attentive interaction 24 hours a day for 12 to 15 months enables the infant to integrate its needy feelings (which are considered "bad" feelings in our society) as good and belonging to itself. With basic trust, parental life skills are also increasingly internalized. The child absorbs the stable and caring bond of the parents (from the outside) as a stable and caring bond with itself (from the inside). The quality of the inner bond therefore depends on the quality of the external bond during the developmental phase of separation. At the same time, the foundations for the little person's capacity for empathy develop. Separation ("I see myself in you") gives rise to the ability to feel oneself and empathize with others.

This capacity for empathy and compassion are qualities that shape social competence and the concept of 'humanity'. Without them, social, caring, and empathetic behavior is not possible. Any capacity for love, relationships, or parenting must be clearly ruled out without the capacity for attachment and empathy.

If the child has been offered a loving and stable bond, the split, which was an existential necessity as a protective defense mechanism, has served its purpose and is overcome between the ages of 12 and 15 months. The integration of one's own emotionality and the resulting bond with oneself now enable entry into the next phase of development, identity development.

How does this developmental psychological aspect relate to the occurrence of borderline personality disorder? I would like to discuss this in more detail in the next section.

1.5 Stressful situations in infancy and their neural consequences

The defense mechanism of splitting, which protects infants from harmful stress and allows the child's brain to mature healthily, embodies the whole wisdom of life: to preserve oneself, to thrive optimally, to acquire the basics of social skills, to strengthen and enrich oneself and the community, and ultimately, in the cycle of being, to lovingly accompany the next generation into a fulfilling life.

But what if the system into which a child is born exhibits precisely those characteristics that promote the development of borderline personality disorder? What consequences does this have for immature, developing neural structures? Are toxic systems actually responsible for the development of this serious attachment disorder, or is it "inherited"?

Borderline personality disorder is one of the disorders that is often passed on to the next generati ly (transgenerational transmission). Predispositions (genetics, epigenetics) certainly play a role here. However, social and attachment behavior within a family system has a far more formative and influential effect.

Let's first take a brief look at the genetic background:

"Put simply, genes produce proteins that control how nerve cells develop and "connect" with each other. In addition to the species-specific genes common to all humans, there are genes that lead to unique characteristics and have specific effects depending on the environment and experience. These genetic predispositions should be regarded as potentials or risk factors that only come into effect when the appropriate developmental conditions are present." (Gene expression; Rowe, 1997; Spitzer, 2002; Bauer, 2002; LeDoux, 2003) (P. Kaiser: Mehrgenerationenfamilie und neuropsychische Schemata [Multigenerational Families and Neuropsychological Schemata], Hogrefe-Verlag, Göttingen 2008)

Accordingly, predisposition has a significant influence on the severity of mental illnesses (anxiety disorders, depression, hyperactivity disorders, etc.). Scientists around the world are conducting family, twin, and adoption studies in an attempt to identify the genes that play a decisive role in the development of mental disorders. In doing so, they have discovered that it is not just one gene, but a multitude of genes that are involved in the development of diseases and disorders.

However, whether and to what extent a genetic predisposition manifests itself depends largely on external factors. Whether a child develops artistic abilities such as musicality depends on appropriate encouragement. Are the parents receptive to their child's talents? Are they interested in these talents and willing to encourage their child's special abilities? Or are they rather uninterested and unable to recognize their child's potential and support them in their development?

Whether predispositions develop or not, and to what extent, therefore depends significantly on external social factors.

This demonstrates the crucial importance of family systems. The emotional, sensory experiences of a child in the first weeks and months of life have a formative influence on their life.

Prof. Dr. em. Willi Butollo (Director of the Munich Institute for Trauma Therapy) also emphasizes that traumatic experiences affect children more severely the younger they are. "The younger a child is when they experience trauma, the more profound the impact." (2016)

What neurological consequences result from the constant loss of control that children are exposed to in destructive systems? Peter Kaiser explains this in his book "Mehrgenerationenfamilie und neuropsychische Schemata" (Hogrefe-Verlag, Göttingen, 2008):

"Experiences of uncontrollable frustration, i.e., the incongruity between needs and their satisfaction, are regularly accompanied by the release of stress hormones: This leads to damage to the brain due to permanently high cortisol levels. The associated glutamate production leads in particular to a shrinking of the hippocampus, which impairs the formation of explicit memory content and orientation in space and time. This can lead to excessive emotional reactions ( ) (LeDoux, 2003; Grawe, 2004). Due to constant stimulation, the synapses in the brain regions responsible for negative emotions become increasingly conductive and develop to a particular degree. […] By the age of ten months, this predisposition and these life experiences have already formed a permanent neural structure that allows us to predict how the child will react to stressful situations in the future." (Costa & McCrae, 1988; Bauer, 2002; Grawe, 2004)

The inability of parents to show affection to their child therefore has serious and irreparable consequences for the neural development of the child's brain.

In systems lacking attachment and affection, children also have to experience not being comforted and consoled in their pain, fear, and powerlessness (stress). Oxytocin, the counterpart to the stress hormone cortisol, is thus unable to mitigate and regulate the state of stress. As a result, the child's ability to calm itself down is not developed, or only to a limited extent. This leads to a constant state of arousal and a resulting high cortisol level. This, in turn, has a degenerative effect on the hippocampus. It is a vicious cycle.

Borderline personalities suffer from this continuous stress. Their cortisol levels are permanently elevated, while their oxytocin levels are significantly too low. As a result, those affected suffer from constant restlessness and tension. From this emotional state, which is staged externally due to divisive behavior patterns (externalization...), they create a reality that matches their emotional experience (coherence). In doing so, they maintain and reinforce the stress in the same form that they (unconsciously) had to experience in their early childhood destructive experiences. The neglected child, who was ignored in the expression of their highly dramatic distress, is often closer to death than to life. Trapped in a lifelong repetition of pain and powerlessness, they can never really live, but only survive each day.

Over time, the ongoing stress leads to a progressive reduction in the size of the hippocampus, which, as already described, results in impaired memory and increasingly affects orientation in space and time.

Against this background, there is a noticeable increase in pathological behavior in the later life of a borderline personality. An increasing improvement or "disappearance" of the behavior typical of borderline personality disorder (prejudice) can therefore be ruled out.

Current neuroscientific findings clearly show when and through what influences borderline personality disorder develops. It must also be emphasized that this disorder is a serious neurological impairment that can be influenced by therapeutic interventions but cannot be cured! The irreparable neurological damage in the limbic brain cannot be reached by therapeutic measures, so that the mechanism of splitting cannot be reversed. Psychotherapy can therefore only influence the prefrontal cortex. Specialized support, such as DBT (dialectical behavior therapy according to Marsha M. Linehan), can be an effective form of assistance, provided that those affected take responsibility for themselves and commit to a long-term therapeutic process.

1.6 How does borderline personality disorder develop?

At no other time in life is the human brain as vulnerable and susceptible to disruption as in the first few months of life. Disturbances such as the loss of caregivers or the confrontation with their inability to form attachments, which manifests itself in contradictory behavior, neglect, or even abuse, cause permanent, uncontrollable deficiencies (loss of control). This causes vast amounts of stress hormones to be released. The resulting permanently elevated cortisol levels ultimately lead to irreparable damage to the child's brain.

On an attachment level, the child is not able to integrate their emotional needs as something normal. They remain empty and disoriented, trapped in their permanent deficit. The parents' lack of relationship skills is transferred to the child, who remains disconnected from themselves and their caregivers, trapped in the loneliness and neediness of their first months of life. They are neither enabled to develop a bond with themselves nor are they able to form bonds with other people later in life. They remain trapped in the developmental phase of splitting and cannot overcome it.

Borderline personalities, whose biographies often include early childhood trauma, thus remain stuck in the primitive early childhood behaviors of splitting. Those affected do not reach the subsequent developmental phase of identity formation (and any subsequent phases), which ultimately leads to the typical symptoms listed in diagnostic manuals and the symptomatic behaviors described therein.