Friday, December 28, 2012

"I Hate You--Don't Leave Me: Understanding the Borderline Personality"

Today, I have another first for this blog--nonfiction! What is this blog coming to? AJ, you've only ever blog reviewed fiction and fantasy fiction! What's going on? Eh, curiosity: it happens. I'm actually rather impressed with myself--I've read three, almost 300 page books in the past week and a half. Granted, I'm a quick reader, but not nearly as quick as some, and usually I just get through 20-50 pages at a time. This past week or so, I've been sitting down for 100+ page stints. I'm feeling rather accomplished.

Now, if you want to talk fast readers, you should see my mother! Woman can read a few 500+ page books in the matter of a few days. And it has nothing to do with motivation or time, she just reads astonishingly quickly. If she and I were to read the same book, side by side, we'd hit a point where she got 10-15 pages ahead of me in the first hour, and by the end of the second, she'd probably be more like 50-100 pages ahead of me. It's really, astonishingly impressive. And it always gets me a bit miffed, as I learned to read, comparatively, ages before she did! But she'll beat me in a speed contest any day, and what's more, is she holds onto the details of the book much better than I, though she spends less time with it. Infuriating!

Anyways, I'm doing some research for a character I'm writing that I've been thinking of them having Borderline Personality Disorder. Psychology and particularly BPD and other personality disorders really interest me and I love working with psychological themes in my writing. So today's review is of "I Hate You--Don't Leave Me: Understanding the Borderline Personality" by Jerold J. Kreisman, MD., and Hal Straus.


2010 Paperback Edition, updated from the 1989 edition, published by Penguin Group Inc. 

Summary: "For years BPD was difficult to describe, diagnose, and treat. But with this classic guide, Dr. Jerold J. Kreisman and health writer Hal Straus offer much-needed professional advice, helping victims and their families understand and cope with this troubling, shockingly widespread affliction. This completely revised and updated edition includes information on the genetic, and developmental roots of the disorder, as well as the connections between BPD and substance abuse, sexual abuse, post-traumatic stress disorder, ADHD, and eating disorders, making it a vital reference for understanding and living with BPD" (from back cover of 2010 edition). 

This was one of the first books published on Borderline Personality Disorder back in 1989 and in 2010 it was updated to include up-to-date research, studies, and info. It's said to be one of the books to read on the disorder.

Reading reviews of the book on Goodreads, there were a lot of claims that the writers were sexist and the book was completely unhelpful. Most of those reviews were posted on the 1989 edition, which I have not read. In the 2010 edition, however, I did notice something in the case studies presented to the reader: while the authors did attempt to include male case studies, those presented were almost all of middle-aged men with little physical description included--the female case studies presented, however, were almost all of a younger age and were described as "physically attractive" or pretty. This presented only a mild problem to me, as I found the rest of the book to be extremely helpful and informative.

The book is separated into 10 chapters that outline the life of someone with Borderline Personality Disorder, the means of diagnoses, the possibilities of the development of the disorder, communication methods, treatment methods, and medication options. Of these, I found Chapter 2, which outlines the specifications of BPD in the DSM; Chapter 4, which outlines societal effects on people with BPD; Chapter 5, which outlines strategies on how best to communicate with someone who has BPD; and Chapter 8, which outlines the specific therapeutic approaches to BPD to be the most helpful to me and to my purposes. There's also a great appendix (esp. Appendix B) that lays out the evolution of the disorder, historically, which I found very, very interesting.

I have done some research on BPD in the past, so much of this information was not necessarily new to me. There was a fantastic section, as I mentioned, on the societal influence on BPD that I bookmarked and wanted to share:

"Some of these [societal changes since WW2] may be related to society's failure to achieve a kind of 'social rapprochement.' As noted in chapter 3, during the separation-individuation phase, the infant ventures cautiously away from mother but returns to her reassuring warmth, familiarity, and acceptance. Disruption of this rapprochement cycle often results in a lack of trust, disturbed relationships, emptiness, anxiety, and an uncertain self-image--characteristics that make up the borderline syndrome. Similarly, it may be seen that contemporary culture interferes with a healthy 'social rapprochement' by obstructing access to comforting anchors. At no time has this disruption been more evident than in the first decade of the twenty-first century, racked as it has been by economic collapse, recession, loss of jobs, foreclosures, and so on. In most areas of the country, the need for two incomes to maintain a decent standard of living forces many parents to relinquish parenting duties to others; paid parental leave or on-site day care for new parents is still relatively rare and almost always limited [and, as my roommate pointed out to me, usually only available to those who could afford an off-site babysitter/daycare]. Jobs, as well as economic and social pressures, encourage frequent moves, and this geographical mobility, in turn, removes us from our stabilizing roots...We are losing (or have already lost) the comforts of neighborly nearby family and consistent social roles" (pg 81, 2010 edition).

Hopefully you're still with me--I know that's a long passage, but it was one of the most intriguing parts of the book. I hadn't considered the role society might have on a personality disorder. There was also a good bit of...I won't call it raging per say, but noting aggressively of the newly changed role of the mother in current society: that so often, women are now expected to juggle marriage, children, and a job and (the writers noted) this frequent diversion of attention can lead to a neglect of the children, as fathers often have their own jobs to worry about and don't spend as much time taking care of the children as much as they "should." I'm certainly not making any sort of judgment here--I personally felt very conflicted during those sections; it's true that a woman's role has altered in a way that doesn't change her "duties" but rather adds to them. I was raised to believe that a woman should go to college and get a job and be able to provide for herself without any support from family or a spouse/partner. Yet there is some evidence that having so much on her plate, a mother (or mother figure, if you prefer) doesn't have as much time as she "should" to pay attention to her children and this has an adverse affect on them. The conclusion I finally came to is that the mother figure needs to build up a support system--father figure, family, friends, etc.--to help her maintain her offspring and give growing kids the support they need. But you can draw your own conclusions. 

Anyway! See, this is what happens when I read non-fiction! I try to have opinions and such and want to start arguments! Oh no!

Overall rating: 4/5 Stars. I had issues with the case studies presented describing females as "attractive" when it wasn't necessary and with the discussion of the effects of the changing of "traditional" family roles. (Good Lord, how many quotations must I have used in this post!) However, outside of those things, I found the book to be appropriately informative and interesting. It makes no specific recommendations, but rather lays out all medication and therapy/treatment options, as well as discussing how someone comes to develop BPD, and the best strategies (they have) to communicate with someone who shows BPD symptoms. I would recommend this book to those diagnosed, and friends and family of those diagnosed--I think the treatment options, the communication chapter, and the resource appendix make this book absolutely worth reading!

News on me, for those interested: I'm still jobless, but I'm preparing as best I can for the upcoming holiday season! I'm still struggling a little with the holiday season as I adapt to new traditions, but I think I'm doing pretty well overall. This year, I will cook my first major holiday meal. I honestly thought I would be much, much older when my time came to do so, but here I am, preparing anxiously! Wish me luck! I'm just glad my years of Scandinavian Christmas lutefisk is over! For the duration of my childhood, you had to eat three bites of lutefisk or Santa wouldn't come! Do you have any crazy Christmas traditions like that? Let me know in the comments below! And let me know what you think of this post or if you have any recommendations for me!

I'm actually ahead in blog posts right now. As I write this, I have a post scheduled for the 21st (which for me, is tomorrow!) and this one should be coming out for the 28th. I'm hoping to continue this thread and keep a book review coming out every Friday if I can. Obviously this will only be possible my schedule permitting, but being ahead by two weeks, currently, should definitely help! So expect to see those!

Happy reading and Merry Christmas to you!
AJ

Related Book Reviews:
Two or Three Things I Forgot to Tell You, by Joyce Carol Oates 

Upcoming reviews:
Get Me Out of Here: My Recovery from Borderline Personality Disorder, by Rachel Reiland

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