Having come across Remnants of a Life on Paper: A Mother and Daughter’s Struggle with Borderline Personality Disorder, by Bea Tusiani and her mother, Paula Tusiani-Eng, I came across a teaching guide that integrates this beautiful memoir into preparing psychiatrists to help those with borderline personality disorder by Frank Yeomans, MD, PhD of Weil-Cornell Medical School.
Yeomans goes through the characteristics (not symptoms!) of borderline. Reading his text just after a session with Dassi (a pseudonym), I found myself reflecting on Dassi’s difficulties with her emotions.
Here is Yeoman’s formulation of the connection between emotion regulation and the client with BPD:
The BPD patient “short circuits” the experience of intense and painful emotions. Successful therapy provides a combination of initially helping the patient develop skills to regulate these emotions, and then sitting with the patient in the presence of these emotions to get to know them better and to integrate them into the full range of the patient’s emotional life, leading to an emotional integration and the ability to master the experience of intense emotions. Two essential characteristics of those working with BPD patients are the ability to remain calm and to be accepting in the presence of extreme affects.
Thinking of Dassi’s family and cultural background, I found myself recognizing that her difficulties were not only with intense and painful emotions; they were with almost all emotions. Born into a large ultra-orthodox Jewish family, Dassi reported that from a young age she recalled her parents’ admonitions against her exuberance and neediness. Whether it was at home or in school, the only two socially acceptable ‘legitimate’ structures of her community, Dassi found herself in places that prized careful rational thought far more than messy feelings.
Feelings were taboo.
Now in her early thirties, divorced, the mother of two, and stigmatized by her culture and family of origin as a failure, Dassi spent most of her life ashamed of any feelings that exceeded a ‘dull roar’ as shameful. So her emotional life became a mess; her surroundings never accepted her feelings so she was denied the human connection that our God given emotions are supposed to evoke. The negativity towards her emotions that was modeled for her by her parents and teachers taught her to hate her feelings. As no one was there to teach her how to handle her feelings she never learned positive ways to live peacefully with herself; so she distracted, ignored, somatized, and intellectualized as much as she could for as long as she could. But you can only go so long burying the intensity of inner experience; for her, the eruption, which in a more emotionally tolerant environment would have evoked support, validation, and expression, took the form of a psychiatric breakdown and all of its horrible collateral damage.
The exciting part of my work with Dassi is that she’s beginning to understand that she is not ‘sick’ as much as she is the victim of a shaming culture. She’s coming to grips that she can find great wisdom in her feelings; far from being taboo, they are bridges to connection with her authentic self. With these new understandings she has formed loving friendships and plotted new goals reflective of the previously hidden and hated dimensions of her inner self. Still deeply observant, Dassi has found new meaning in her spiritual commitments.
© Dr. Josh Mark, 2014. Dr Mark brings his expertise in mindfulness based cognitive therapy and in Jewish Mindfulness to help others live lives of bliss and joy. He’s located in Jerusalem and available worldwide. Find out more about him and jewishmind.org.