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Section 4
Relationship Instability in Borderline Personality Disorder

Question 4 | Test | Table of Contents

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In the last section, we discussed rejection.  Three common rejection concepts experienced by many clients with BPD are personal attacks, perceived judgment, and self deprecation. 

In this section... we will discuss abandonment. For the purpose of brevity, I will limit my discussion to general abandonment and sexual abandonment. Regarding sexual abandonment, I will discuss the aspect specific to the feminine identity, which as you will hear, influenced Liz’s reaction to perceived abandonment. Sound interesting? Let’s get started.

♦ #1  General Abandonment
As you know, borderline personality disorder is characterized by frantic efforts to avoid real or imagined abandonment.  Pervasive patterns of instability in Gail’s relationships were accompanied by marked impulsivity and feelings of general abandonment.  Gail, age 44, stated, "All my life I’ve had a hard time keeping friends.  It’s not like I can’t make friends, I just can’t keep them." 

When I asked Gail what happened to end her relationships, she stated, "Well, I had this friend, Melissa, right? And Melissa was fun, we’d hung out together. But then she started hanging out with Jessica. I don’t know why Melissa would just quit wanting to be with me like that. I mean, whenever I tried to hang out with Melissa, Jessica would be around. At first, I was like whatever, but then it seemed like Melissa was letting Jessica push me out of the picture so I pushed back. Melissa got to thinking I was weird when I slashed Jessica’s tires so she couldn’t drive during the weekend we were supposed to go to the Dave Matthews concert!" 

How much do frantic efforts to avoid abandonment presently characterize your client with BPD? 

♦ #2  Sexual Abandonment
Now let’s look at sexual abandonment.  From preadolescence to mature sexual love, the issue of connection is integrated with sex. Therefore, clients with BPD like Liz, age 31, often struggle when an interpersonal relationship becomes sexual, and sometimes perceive unrealistic sexual abandonment. 

Liz,  stated, "Ever since my relationship with my boyfriend Matt got sexual, it always seems either really great and intense, or it feels like it’s falling apart." Liz’s romantic perception of Matt alternated between extremes of idealization and devaluation. Liz further stated, "Matt can be so great. When he’s around, he is so caring and loving. But sometimes, when he can’t see me, I get so angry because he acts like such an asshole! I’ll ask him to leave work early or ditch his friends and he acts like those things are more important to him!" Liz also described periods of anxiety when she couldn’t see Matt. 

She stated, "If he’s not around, I get real nervous because I don’t know what he’s doing or where he’s at.  I can’t stop thinking about him when he’s not with me." Later in this section, we’ll discuss a technique that Liz used to avoid her feelings of sexual abandonment, but first, think of your Liz.  To what level does your client with BPD experience feelings of sexual abandonment when his or her sexual partner is not around?

♦ #3  The Feminine Identity
As you know, borderline personality disorder is diagnosed predominantly in females.  As I found with Liz, connectedness may be basic to the feminine identity.  Development of self did not depend, as with men, on Liz definitively breaking away from the relationship.  For example, Liz’s sense of self was strongly linked to her investment in a caring relationship. 

Liz stated, "If Matt leaves me, I’ll not only lose him, but I’ll lose myself!"  Because Liz’s fear of separation and abandonment was so strong, she insisted on intimacy to maintain her feminine identity. I have found that clients with BPD like Liz find it difficult to allow trust and faith to predominate a sexual relationship. Do you agree? If so you may find the Abandoning Abandonment technique beneficial.

♦ 3-Step Technique:  Abandoning Abandonment
To help Gail and Liz with their mutual patterns of perceived abandonment, I implemented the "Abandoning Abandonment" technique.  This is a three step technique which focuses on the mindset a client with BPD has regarding interpersonal relationships. 

--Step 1 -The first step in the "Abandoning Abandonment" technique is to determine separation. I asked Liz to determine where she stopped and her boyfriend, Matt, began. After some discussion about her strengths Liz stated, "Even though I portray him as this all important guy, the truth is that I don’t really need him to survive and to be happy."

By determining where she stopped and Matt began, Liz was able to begin the "Abandoning Abandonment" technique because she understood that she existed separately and distinctly from Matt. Liz stated, "It’s good that Matt and I are separate people. I mean we have different feelings and different needs." 

--Step 2 - The second step was for Liz to reinforce that Matt’s words or actions are often about him and his history rather than about her. I stated, "When Matt refuses to leave work early or prefers to spend time with his friends, he is simply fulfilling his own social and financial needs."  Do you agree that helping Liz see that Matt’s absence was not intended as abandonment, could also help her avoid the extremes of idealization and devaluation that characterized her client with BPD? 

--Step 3 - In addition to determining separation and reinforcing that words and actions are not personal, the third step in the "Abandoning Abandonment" technique was for Liz to learn to say ‘yes’ and ‘no’ clearly.  For Liz, and possibly for your client with BPD, learning to say ‘yes’ and ‘no’ to herself was as productive as learning to say it to others.  I explained to Liz that by setting firm boundaries, she could begin to have a more defined sense of who she was. 

Would you also agree that firm boundaries can help a client with BPD begin to work on clear communication?  If you are treating a client with BPD like Liz, and your client’s spouse is receptive, could hearing this section help them to understand the client’s behavior? Are you currently treating a client with BPD who might be receptive to hearing this section during a session and learning about the Abandoning Abandonment technique?

In this section... we have discussed abandonment.  Two types of abandonment regarding clients with BPD we explored are general abandonment and sexual abandonment. 

In the next section, we will discuss methods of control.  4 methods of control commonly used by clients with BPD are manipulation, coercion, autocracy, and disengagement.
Reviewed 2023  

Peer-Reviewed Journal Article References:
Aarts, H. (2019). Goal setting theory and the mystery of setting goals. Motivation Science, 5(2), 106–107. 

Amaro, C. M., Mitchell, T. B., Cordts, K. M. P., Borner, K. B., Frazer, A. L., Garcia, A. M., & Roberts, M. C. (2020). Clarifying supervision expectations: Construction of a clinical supervision contract as a didactic exercise for advanced graduate students. Training and Education in Professional Psychology, 14(3), 235–241.

Borelli, J. L., Sohn, L., Wang, B. A., Hong, K., DeCoste, C., & Suchman, N. E. (2019). Therapist–client language matching: Initial promise as a measure of therapist–client relationship quality. Psychoanalytic Psychology, 36(1), 9–18.

Hopwood, C. J., & Zanarini, M. C. (2010). Five-factor trait instability in borderline relative to other personality disorders. Personality Disorders: Theory, Research, and Treatment, 1(1), 58–66.

Lazarus, S. A., Beeney, J. E., Howard, K. P., Strunk, D. R., Pilkonis, P. A., & Cheavens, J. S. (2019). Characterization of relationship instability in women with borderline personality disorder: A social network analysis.Personality Disorders: Theory, Research, and Treatment. Advance online publication. 

Santangelo, P. S., Reinhard, I., Koudela-Hamila, S., Bohus, M., Holtmann, J., Eid, M., & Ebner-Priemer, U. W. (2017). The temporal interplay of self-esteem instability and affective instability in borderline personality disorder patients’ everyday lives. Journal of Abnormal Psychology, 126(8), 1057–1065.

QUESTION 4
What are two types of abandonment regarding clients with BPD? To select and enter your answer go to Test.

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