In part one, we discussed the biosocial model, which explains how symptoms arise and how problems continue. The bio part involves the idea that emotional sensitivity is inborn, and the social part is the invalidating environment. I like to share a story to explain what an invalidating environment can look like. I call it my sandwich boy story. Imagine, 4-year-old kid, playing outside, and his mother calls him in for lunch, gives him a sandwich, he eats his sandwich, and goes back outside to play. Fifteen minutes later he comes back in and says, “Mom, I’m starving” to which his mother replies, “No you’re not, I just gave you lunch, go back outside and play.” Now, our little boy is very confused. On the one hand, he is having an internal, biological experience called hunger, and he was pretty sure it was hunger. He’s 4, so it’s probably not a craving or social pressure, it’s probably genuine hunger. At the same time, his mother, who knows everything because he’s 4, said he’s not hungry. So, he must not be hungry. And our little boy learns to ignore his internal experience. Now, if this happens once in a while, he’ll probably be just fine. If this keeps happening over and over again, then there’s a good chance our little boy is going to learn to ignore his internal cues, he’ll become more and more confused about how to manage internal sensations, and this could be a pretty big struggle for him, ignoring his internal experiences until they overwhelm him. In this story, is the mom a bad mom? Absolutely not. And is the kid a bad kid? No. So exactly the same way, with people struggling with emotion dysregulation, being in an environment, even one that is loving, supportive, caring, and invested in the success of the child, can communicate over and over again that their feelings don’t make sense and can’t be trusted. And when the people who one trusts the most teach you that, you can get pretty stuck in not knowing how to manage your emotions. You often end up in that shove, shove, shove, explode pattern.
For people struggling with bpd, it’s really nothing to do with being born with a “bad personality” so much as it’s about the transaction between that biological propensity and the environment it functions in and the learning that happens as a result of that transaction. The words “gaslighting” and “manipulating” can sometimes be heard to describe people with bpd, and not only is that hurtful to people who are majorly suffering and trying desperately hard to live, it is also factually incorrect. Manipulation, according to its definition, requires control or influence wielded in a skillful manner. People with bpd are b’davka not skillful and not in possession of large amounts of control. The entire disorder is characterized by dysfunctions in regulatory systems, meaning their ability to control themselves or others is poor, by comparison, to the average. The best manipulators are therapists – we are literally trained in skills for how to control and influence people skillfully. Hopefully we use our powers for good, and only try to influence people to reach their own goals, and someone with bpd is certainly not in possession of any impressive gaslighting or manipulating abilities by any stretch of the imagination. What can get confused for manipulation is the person’s inability to effectively communicate their needs through repeatedly being ignored for appropriate communication and reinforced for escalations. A large part of treatment is breaking the pattern of reinforcing ineffective communication and providing instead opportunities for reinforcement of effective communication (enter phone coaching and, my favorite - nachas reports!). Ultimately, people suffering from bpd can learn to appropriately communicate about their emotional needs, control and influence their emotions, tolerate high levels of distress without making their lives worse, and build a mindful awareness that substantiates it all. People with bpd can be lots of things, such as sensitive, loving, compassionate, creative, brave, thoughtful, empathic, and often highly intelligent. Gaslighting and manipulative just don’t make the list.