Chief Feature is sometimes easy to spot, but at other times extremely elusive. And sometimes, as other Work writers have pointed out, the Chief Feature seems to be the whole of the person! As a counsellor as well as a Work teacher, I believe this happens when the person concerned has a so-called "personality disorder", which affects their entire personality and their false personality. And with personality disorders, it's hard to distinguish where personality ends and false personality begins - hence the confusion.
Most people with personality disorders aren't interested in the Work. Those suffering from Narcissistic, Anti-Social, or Histrionic disorders - as well as many more - tend to blame other people for all their problems, and see no reason why they themselves should change. They are not usually depressed or unhappy, and neither the Work nor counselling attracts them.
But there is another type of disorder I want to consider here: Borderline Personality Disorder (BPD). Those who suffer from it often feel unhappy and dissatisfied with themselves. They sense there's something not right about their own psychological makeup, if only because they so often experience painful depression or anxiety, and they want to change. The Work attracts them because of the opportunity it offers to bring about a radical shift in their psychology. But their illness often prevents them from working on themselves in depth, when the Work begins to touch the inner parts of centres, because of the distress that looking within and observing themselves can cause.
Nevertheless, the BPD sufferer can benefit from the Work - if both they and their teacher understand the disorder and work with it.
For this to be possible, counselling is almost always necessary either before beginning the Work or for periods during the student's Work life; to avoid role conflict, counselling should take place with someone other than the Work teacher, and the Work itself temporarily suspended for the duration of the counselling.
In these conditions, BPD students can become valuable members of the group, and may even go on to become Work teachers once their inner world has been reordered and healed. Their condition may eventually lead them to great compassion and insight towards others with psychological problems.
But what exactly is BPD?
Although it has long been recognized, the condition came to public notice some years ago, when a number of psychologists theorized that the late Princess Diana suffered from it. And although we can't be certain that she did in fact have BPD, she certainly displayed a number of telling symptoms.
There are nine diagnostic criteria for BPD, and to be diagnosed with this illness the client must display at least five of them. In no particular order, because all are of equal importance, they are:-
An abnormal fear of abandonment or rejection;
A pattern of unstable, intense personal relationships which alternate between extreme liking (or loving) and extreme devaluation and belittlement of the people with whom they interact;
Identity problems: a marked and persistently unstable self image and sense of self;
Impulsive behaviour in at least two of the following areas: overspending; sex; substance abuse; reckless driving; binge eating; self harm; gambling. The person places themselves willingly into harm's way, sometimes by choosing to be around substance abusers or alcoholics, or reckless drivers;
Recurrent suicidal thoughts or behaviour;
Marked and severe mood swings, such as depression, anger, irritability or anxiety, which last a few hours but rarely more than a few days (unlike bi-polar patients);
Chronic feelings of emptiness and worthlessness;
Displays of inappropriate, intense anger, and difficulty controlling the expression of anger;
Signs of paranoia, sometimes of paranoid rage, usually when under stress; the patient falsely imagines that friends or others close to them are attacking them.
Additionally, though it's not a criterion for diagnosis, it is remarkable how often the family of a BPD sufferer contains alcoholics or drug abusers, and this has led some researches to conjecture there may be a genetic link.
It has also been suggested that the part of the brain corresponding to this disease can be demonstrated; researchers in this field say that the left brain, and possibly the fusiform gyrus, may show signs of change that correlate with this illness. Of course, we cannot say from this whether such brain changes, if they exist, cause the illness or result from it.
The effects of the above symptoms are apparent in the life of the BPD sufferer, which is usually marked by a series of broken relationships. Sudden breaks occur when the BPD sufferer imagines hostility in a close relationship (see the second and ninth symptom above); anger and even rage may be expressed, friends are abruptly dropped, family members are avoided.
The broken relationships are the result of the BPD patient's behaviour, which can be extremely distressing. Friends and family members are quite unaware of what they may have said or done to provoke such a hostile reaction - indeed, in reality they may have done nothing. But, faced with the BPD sufferer's anger and belittlement, they may feel they have no choice but to protect themselves by ending the relationship. Such breaches may be lifelong, since the BPD patient, lacking insight into the effects of their own behaviour, rarely apologizes.
To apologize would be to acknowledge having done something wrong, and this possibility is too upsetting to be faced.
The BPD sufferer has a deep, distressing feeling of emptiness, of utter worthlessness, due to inadequate mothering as a child. The mother rejected or seemed to reject the child, who then internalized the rejection and believed himself to be at fault. As an adult, the BPD sufferer is always looking for signs of rejection, abandonment, or negative emotions in those close to them, which obviously has a very distorting - sometimes fatal - effect on their relationships. They never quite feel they belong anywhere.
Studies have demonstrated that, when shown photographs of faces expressing various emotions, the BPD client is likely to interpret a neutral expression as being angry. Skewed perceptions of this sort can easily pose great problems in daily interactions, as even a mild expression of disagreement or a dissenting word often seem to these clients to be aggressive or rejecting.
Additionally, seeking for a sense of self worth can lead the BPD to try out many activities, ideas and philosophies, although usually they do not last long because none can bring the inner reassurance and calm which the sufferer so badly needs. Hobbies are eagerly taken up and then rapidly abandoned. Solutions to distress are sought in therapies such as diet or exercise; timetables and plans are made; sometimes expensive equipment is purchased; then, the next month, a new "remedy" is found.
But, difficult as this condition is for the sufferer, there is hope for those willing to persevere, and counselling can be very fruitful for this type of client.
The type of therapy chosen is usually a method that works with the cognitive skills, or the Intellectual Centre. Prolonged psychoanalysis can be counter-productive, because the client is led back into the past and easily gets stuck in it. Moreover, since BPD clients are usually likable and possess good verbal skills, the therapist can be led into colluding with them, believing that there really is nothing much wrong with their client and agreeing that it is all the fault of other people that their relationships are so difficult!
Using cognitive skills, however, the client can be helped to see patterns of black and white thinking, of recurrent anxious or angry thoughts and feelings, and to observe the effects of their own actions on other people. This type of therapy (CBT) can help the client to reduce the severity of negative emotions and to include the Intellectual Centre as well as the Emotional Centre in conducting relationships. Of course, these are Work terms, not those used in counselling.
A relatively new type of therapy - Dialectical Behaviour Therapy - is actually quite similar to the Work technique of self-observation, and can be very helpful to BPD sufferers. The client is encouraged to stay in the present moment, to be mindful of their thoughts and feelings, and of their physical state when experiencing them. Over time, the BPD client may learn to control intense emotions, to reduce destructive and self-destructive behaviours, and to improve their relationships.
One problem faced by BPD sufferers is they are often completely unable to see the effect that their own behaviour has upon others. They may insult and attack people, especially if they feel that their own beliefs and ideas are threatened, reacting with paranoia to any type of disagreement. In their own mind, these aggressive reactions are completely justified, and they cannot understand why friends, colleagues or family members are hurt and distressed by them. The day after they have attacked someone verbally, they may completely "forget" what they have done, and expect the other person to be as pleasant and friendly as ever. They are bewildered when this does not happen.
Of course, the "forgetting" is a defence mechanism, or a buffer, a form of repression which enables the BPD patient to bury their own destructive behaviours below the level of consciousness. The sufferer cannot bear to feel that he or she has done something destructive, or that people may be hurt by them, because this realization could trigger the fear of abandonment which always underscores every relationship. Ironically, this behaviour may bring about the very rejection they seek to avert.
A further problem for BPD sufferers is their lack of good boundaries. They easily become codependent and place too much reliance on other people. They can quickly become over-familiar with others, too, and try to impose their own beliefs and ideas upon them. The closer such a person becomes, the more the BPD feels he has the right to insult them and ignore their feelings. And he genuinely cannot see why such conduct is offensive and harmful, so he cannot resolve conflicts by apologizing and adjusting his own behaviour.
With all these problems, the BPD may still be a fun, lively friend, and a good companion, always providing that others make allowance for her sometimes destructive conduct. In counselling, BPD clients can make good progress and may eventually succeed in changing their behaviour and their attitudes to gain real insight and to maintain good relationships. Their experience of mood swings can make them empathic and compassionate friends and helpers, as long as they avoid codependence.
In a Work group, an unhealed BPD student is a liability. I have had two BPD students. One had actually once been a student of Beryl Pogson, and was excluded from Mrs Pogson's group because of his paranoid attitudes and attacks on other students. Of course, he did not inform me of this fact when he applied to join my own group! I later learned of his history from Marian Davison, my own teacher, and then I understood why this student was so difficult.
I possessed the private records from Mrs Pogson's meetings, and from them I saw that he had not changed at all in 20 years. He was making exactly the same objections and offering the same harsh judgements in my group as he had done with Mrs Pogson. He had no insight into his own false personality and its effects on others, and was incapable of working on himself. After a few meetings I had to ask him to leave - and he was extremely angry with me for doing so. He really could not see himself as others saw him, and this was his tragedy.
Another BPD student, however, has done very well. She realized from her own observations that she had many problems, but she had a strong Magnetic Centre and truly wished to work. From time to time she would temporarily leave the Work group in order to have counselling from a therapist experienced in helping such clients, and eventually she gained much insight. Her level of Being began to change, and I believe that one day she may become a Work teacher. If she does, her illness will have given her the advantage that being a Wounded Healer brings.
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