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By now everyone’s heard the famous Mitt Romney quote: “There are 47 percent of the people who will vote for the president no matter what. All right, there are 47 percent who are with him, who are dependent upon government, who believe that they are victims, who believe the government has a responsibility to care for them, who believe that they are entitled to health care, to food, to housing, to you-name-it -- that that's an entitlement. And the government should give it to them. And they will vote for this president no matter what. ... These are people who pay no income tax. ... [M]y job is not to worry about those people. I'll never convince them they should take personal responsibility and care for their lives."
I’ll leave it to someone else (http://www.cbsnews.com/8301-503544_162-57515033-503544/fact-checking-romneys-47-percent-comment/) to fact check this quote. What I want to discuss here are those whom Mr. Romney is talking about, because I do know some.
A quick look around Facebook should reveal to almost anyone how many people are tired of “welfare queens” and don’t want our tax dollars to support these people.
I’ve lived for many years with someone with BPD and spent time in a support group for those living with people with BPD. I hate to say this, but the only people I know of with the attitude Romney describes, are people with BPD. (Sorry, if you have BPD, just bear with me and read to the end before getting upset.)
It isn’t only those with borderline personality disorder who have this mindset, but people with other personality disorders, too. Martha Stout, in her book The Sociopath Next Door, describes this exact entitlement attitude among those with APD. And it also occurs in people with NPD (narcissistic personality disorder). Considering that about 9% of the population is estimated to have personality disorders (depending on the country sampled), I think there’s a good bet that an awful lot of folks who answer Romney’s description are those with PD’s.
PLEASE NOTE: In saying this, I am NOT referring to: Those who are elderly and now are receiving Social Security after a lifetime spent working; those who are desperately poor through no fault of their own—divorce, job loss, loss of a home due to the housing meltdown, too young to work, too physically ill to work, a member of our vast and growing population of working poor--and may these conditions be temporary for these people!
I’m talking about those who really do just want to lie back and let someone else pay the bills…those who for all intents and purposes really do appear to be what some like to call, “bone-lazy”. A fair number of PD people have this mindset. Sorry to say it, but they do.
Why do these people have this mindset?
Feelings of entitlement are a big factor for those with APD. They just don’t want to do anything hard or boring, and feel that they shouldn’t have to push on with the daily grind if they don’t like it, despite the fact that that is what everyone else has to do. APD’s have about the biggest entitlement mindset in the known galaxy. For narcissists, many times there is a deep feeling of inferiority there that they are covering up. A deep fear of failure, and of not turning out to be as good as they present themselves to be.
For borderlines, the situation is murkier. Many, many borderlines hate themselves and believe themselves to be stupid or otherwise less than competent. Think of Marilyn Monroe stumbling through a script. Even though her brilliant performances proved her talent time and time again during her career, she still couldn’t internalize that truth and begin to believe in herself. She was so worried about being perfect that she handicapped herself tremendously.
Borderlines often have such a hard time controlling their emotions that when they can’t, and they let loose with some inappropriate response in a workplace or a family environment, they suffer intense embarrassment and self-recrimination as a result. Other people are giving them the moral diagnosis. “Her worst enemy is herself.” “Why can’t he just get it together?” Doesn’t exactly inspire confidence, does it? If this happened to you about ten million times during the course of your lifetime, believing in yourself enough to apply for and then perform at a job could seem very difficult indeed.
Not only may people with BPD, and sometimes people with NPD, feel incompetent to solve many life or work-related problems, they may actually be incompetent to solve them. The central feature of BPD is emotional reactions to just about anything that fly off the charts compared to those a person without BPD might have to the very same problem or situation. Someone with BPD has spent a good deal of their life terribly emotionally upset, and emotions interfere with the brain’s ability to learn and to think clearly. So when other kids were learning how to think and problem-solve in school and at home, the person with BP wasn’t. Now that person is an adult and finds him/herself confronted with situations that look easy when other people handle them, but that he himself doesn’t have a clue how to tackle.
In the case of BPD, many sufferers have never acquired some basic interpersonal skills. Picture this example: Two people who hate cigarette smoke are sitting in a restaurant when a third diner lights up. One of the non-smokers has BPD. The BP immediately begins flapping around like a chicken, saying very loudly, “Oh, my God, that person is smoking. I hate cigarette smoke, it ruins my dinner. What’s the matter with that idiot, he should be in the smoking section! This is horrible.” (Add a loud, stagy cough.)
What are the reactions of the other people in the scene? The smoker is probably angry and feels affronted. The third diner is probably embarrassed, and getting the message that she’s supposed to go confront the smoker and ask that person to stop, and she’s probably fuming about this unstated order from the BP.
How would you handle the situation? You would probably go over to the smoker and nicely ask them to stop. But this doesn’t even occur to the BP. Why not? The BP has spent her whole lifetime in a family where if she spoke up about what she wanted, she got yelled at, and, having BPD, she feels way worse getting yelled at than you or I would. This particular BP has had the experience of having family members and friends scurry off to solve the problem when she behaves this way, so many times that not even an inkling that the other people in the scene might want to be asked politely for their cooperation, or that this is how most people in this situation know to handle it, ever comes up for her. Put this person in a work situation, and what’s likely to happen?
Lastly, the phenomenon of apparent competence is common with BPD, meaning that a BP sufferer, knowing he or she doesn’t know how to handle a situation, pretends he or she does, and no one finds out until there is a crisis at hand. The BP is just too afraid of the interpersonal problems that will result if the BP just says, “I can’t figure this out. I don’t know what to do here.” What happens to this person in the workplace?
It’s not true that all of these people are unable to change. (In some cases, the biochemical abnormalities in the brain may be such that the person may never be able to function as well as a non-PD person can. But many, many PD people can at least improve.
However, they need help to do it. And help isn’t free.
It is true that our desired endpoint, looking at this subgroup of “47 Percenters” from the outside and from the standpoint of a society that understandably wants its members functional, would be for those with PD to recognize that they have a problem, go for help, and comply with the help, becoming as functional as their particular biology will allow. But, as many family members of those with PD can readily attest, an awful lot of these folks never will. I personally have given up on mine after almost forty years and two attempts at therapy. How much of this aspect of a PD is biological? How much of it is cowardice?
I don’t think anyone is actually doing any research in this area at this time. I sure hope I’m wrong. But here’s the thing:
Much of the time, there really is an inborn biological problem in the brain of those with a PD. Do we really want to withdraw all means of support from those whose problem they did not ask for, and who really do have a diagnosable medical problem that prevents them from being self-supporting, regardless of what the dynamics of that are? What kind of society does that make us?
Before you answer, think about the children living at home with a parent with a PD. It’s true that some parents with a PD can reach within themselves and still be good parents through heroic effort. But many, many more are abusing their minor children behind closed doors.
Because such a parent can appear mentally healthy to other people, that child is left wondering why mommy or daddy is so nice to other people but so mean to him at home; and if the child should try to reach out to other adults for help, the child may not be believed. Children in the homes of PD parents may suffer emotional abuse, sexual abuse, and/or physical abuse.
Now take away all sources of household income for that non-self-supporting parent with a PD, because we’re tired of welfare queens, and that lady on Fox News waving a phone and saying, “Obama gave us a free phone and he’s gonna give us more stuff!” made us angry. We don’t want to support that woman or anybody else like her.
Say she’s like this because she has an undiagnosed PD. We take away all sources of income. She tries work and gets fired, because she isn’t able to interact with others in the work force. What happens to her child?
Well, for one thing, the stress level in that household is going to go up. Life is stressful enough with a personality disorder even if one does have enough money. Now there is none. There are no lights; there is no heat. Maybe there isn’t enough food. How is that mother going to treat that child at home, if she was abusing him or her before? What are that child’s chances for a productive life in society?
Let’s face it, PD’s are out there—about 9% of us--and they are one reason 100% of the people in any given society are not going to be self-supporting. When we look deeply at the reasons why some people have a victim or an entitlement mentality, we can see that simply cutting them off isn’t the answer, no matter how much some of us don’t like the idea of what they may see as paying taxes to support "dead weight."
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An APD allegory in the form of a Star Wars fan fiction begins, on the Fiction page. Prologue up, 10/14/18. Chapter Two up, 10/21/18.
Movie Review: Black Swan from a mental illness perspective, on the Op-Ed page. 7/10/18
Supermodel Gia Carangi: Was It Really BPD?
"Gia Carangi was a story all right. Sex, drugs, rock and roll, 10-car-pile-up beauty, high fashion, Eurotrash, big bucks, fast cars, homosexuality, AIDS, an early death?"
?Boston Globe review of Thing of Beauty, Stephen Fried's superb biography of the model.
Gia Carangi. Better known as just Gia, she was arguably the world's first supermodel. Immortalized in Stephen Fried's 1993 biography and the 1998 HBO movie that made Angelina Jolie a breakout star?not to mention the hundreds of classic fashion photos she left behind?Gia is one of our truly timeless beauties.
Gia moved from Philly to New York in the winter of 1978 and became the instant darling of Vogue magazine at eighteen. She seemed poised for greatness?a half million dollar a year modeling career, TV, the movies?the sky was the limit. But she fell victim to heroin abuse. Blackballed from modeling for such offenses as tardiness, no-shows, even shooting up while on set, she fell from grace and suffered a horrible death from AIDS at age twenty-six.
The stories about her are legendary: She once got into a fistfight with Vogue fashion editor Frances Stern. She walked out on a huge Versace fashion shoot with Richard Avedon. She shot up during a bathing suit and summer wear sitting for Vogue and appeared in the magazine with track marks on her arms. Once she shocked everyone on a shoot by appearing on camera with blood running down her arm from injecting heroin.
Openly gay, she pursued women with poetry and bouquets of yellow roses. She once lured a girlfriend into her car and simply took off with her to parts unknown. She climbed to another girlfriend's window stories above a New York street?trying to impress her?rather than use the front door. There are darker tales of violent arguments with girlfriends, of stealing to buy drugs, even from her own mother. An altercation at an airport over a knife, dangerous car chases with the police?What drove Gia to such extreme and desperate behavior?
Almost thirty years after her death, her growing cult of fans rivals those of Elvis or Marilyn Monroe for sheer devotion. But with all the attention that's been given to the details of her life, the PD Reader only wants to know one thing: Why hasn't Gia's real problem ever been named? For if her life story isn't screaming out, "Help me, I have borderline personality disorder!" we don't know whose is.
What is borderline personality disorder?
For that matter, what is a "personality disorder", period? Borderline PD expert Shari Y. Manning is the author of Loving Someone with Borderline Personality Disorder, one of the best borderline books around (remember her name?we'll come back to this author a lot in our discussion of Gia).
Dr. Manning writes that someone with a personality disorder "exhibits a chronic pattern of behaviors that are based in his or her personality, which means essentially that they affect everything: moods, actions, and relationships." Personality disorders are classified as "Axis II" on the five "axes" of mental health disorders, meaning they are chronic, usually lifelong. (The other occupant on this lonely axis is mental retardation.) This would be opposed to most of the mental health disorders you commonly hear about, such as depression or bipolar, where the symptoms tend to come and go, leaving the person "normal" (if there is such a thing) between episodes. Often an episode of depression or bipolar mania can be battled into submission with medication. Not so the personality disorders.
Manning tells us that the central feature of BPD is a biochemical abnormality in the brain that is present at birth. A borderline person?s emotional response to just about any stimulus flies right off the chart compared to the emotion a person without BPD would usually feel in the same situation. A BP?s day is full of huge, huge highs and incomparable lows. A quote from Sharon Beverly, from Stephen Fried?s Thing of Beauty, illustrates well what we?re talking about here. Sharon was Gia?s first big love; they dated in Philadelphia in the mid-seventies when Gia was still in high school.
Fried writes, ?It was immediately clear to Sharon that Gia had no emotional middle. ?She was an extremist, and she found emotions traumatically hard to deal with,? Sharon said. ?There was a very sad side of her. It wasn?t a sadness that was really blatant?she was always in a good mood, always joking?but it was there. She always questioned why she would get upset. She felt that she had a very rough life and felt that it took a lot of energy to deal with the world as it was. She could never pinpoint where the unhappiness came from, just something inside of her that she could never satisfy. I don?t think she was talking about her parents. I don?t even think she meant anything that tangible was rough. She just meant living and thinking and breathing and having to mentally deal with waking up and living was a hard thing for her.??
Sounds an awful lot like Marilyn Monroe and the late Princess Diana, doesn?t it? These are two other famous women with BPD?also extremely beautiful, also adored for the electricity that comes across to the viewer in their photographs; for the way they communicated exclusively through the printed photograph. Well-known for that neediness, that wistful quality of sadness and longing that made people around them want to take care of them. If you have read as much about borderline personality disorder as we have here at the PD Reader, you know that this quote by Sharon Beverly describes the internal experience of BPD perfectly, as well as the feeling BP?s often inspire in those around them.
A BP can become so upset or angry over a relatively small issue that he or she can?t control his or her behavior. The borderline behaves inappropriately and gets a negative reaction from the people around him or her?people important to the BP, parents, friends, teachers, or employers. Then the BP feels ashamed. After all, the message he or she is getting from absolutely everyone is that he or she shouldn?t have felt that way and should be able to control his or her behavior. But the problem, documented by modern medicine with MRI?s and PET scans, is that the BP can?t. Maddeningly, BP symptoms are often situational?in this arena or with this person, the BP performs well, but in that arena or with that person, the BP cannot.
People are born with varying degrees of susceptibility to the extreme emotional sensitivities of BPD. On one end of the spectrum are those whose ability to regulate emotion is so impaired that even the calmest home environment, with the most competent and compassionate parenting, isn?t enough to prevent these children from having severe adjustment and mental health issues in adolescence and as young adults.
Then there are those with a milder susceptibility to the disorder. If these children experience excellent parenting and a good fit between themselves and their environments at home and school, BPD may never develop to the point that the individual meets the criteria for a formal diagnosis. But raise the same children in environments where parents are unable to meet their needs?whether through abandonment situations such as illness or divorce, or outright emotional, sexual, or physical abuse?and a child who otherwise could have been fine turns out to have full-blown BPD.
Gia's family history sounds something like this. From Thing of Beauty: "...Joey, Michael [Gia's older brothers], and Gia were often left to their own devices. 'It was real peanut-butter-for-breakfast time, at least from the way Gia described it,' recalled one friend. 'Nobody was paying attention to those kids.'
"'We could've used some disclipine,' said Michael. 'Every child needs it. We were allowed to do what we wanted. I could stay out as long as I wanted and nobody would know. I don't think my parents ever talked to us about sex. In the back of your mind, you want discipline, you want to be told stuff by your parents--just to know that they care and that they know what you might be going through. Gia was the youngest, the breakup affected her the worst. And I feel girls need more attention than boys anyhow.'" Fried also quotes Gia's aunt Nancy Adams: "Kathleen [Sperr, Gia's mother] was driving up there [to New York, where Gia was just making it big in modeling in the late '70's] to do Gia's laundry...When Gia and her brothers were kids, their mother wouldn't do anything for them. They had to get up themselves, they had to do their own clothes. Now Gia's a model, and she's driving to New York to do her laundry for her."
Gia's mother, Kathleen, left the family when Gia was eleven. When she remarried the next year, Fried tells us, her children did not even find out about it until after the wedding.
Mental health clinicians use the Diagnostic and Statistical Manual of Mental Disorders (DSM) to diagnose BPD and all other mental and emotional illnesses. At this writing, BPD is still diagnosed using the nine diagnostic criteria in DSM-IV-TR, and will be until DSM-V is published in May of 2013. Until then, the DSM-IV criteria are what we've got, so let's look at them one by one and see if, and how, Gia fits. Next...Criterion 1.