Quotes from Jerold J. Kreisman

Others Act Upon Me, Therefore I Am

A continual tug-of-war develops between the wish to merge and be taken care of, on the one hand, and the fear of engulfment, on the other. For

The price tag of social change has come in the form of stress and stress-related physical disorders, such as heart attacks, strokes, and hypertension. We must now confront the possibility that mental illness has become part of the psychological price.

When the accoutrements of custom disappear, they may be replaced by a sense of abandonment, of being adrift in unchartered waters. Our children lack a sense of history and belonging—of an anchored presence in the world. To establish a sense of control and comforting familiarity in an alienating society, the individual may resort to a wide range of pathological behavior—substance addiction, eating disorders, criminal behaviors, and so on.

For the borderline, much of life is a relentless emotional roller coaster with no apparent destination. For those living with, loving, or treating the borderline, the trip can seem just as wild, hopeless, and frustrating.

A borderline suffers a kind of "emotional hemophilia"; she lacks the clotting mechanism needed to moderate her spurts of feeling. Prick the delicate "skin" of a borderline and she will emotionally bleed to death. Sustained periods of contentment are foreign to the borderline.

The borderline individual does not accept her own intelligence, attractiveness, or sensitivity as constant traits, but rather as comparative qualities to be continually re-earned

She felt like a child clad in the armour of an adult. She was perplexed at the respect she received from other adults; she expected them to see through her disguise at any moment, revealing her as an empress with no clothes. She needed someone to love and protect her from the world. She desperately sought closeness, but when someone came too close, she ran.

Her moods were totally unpredictable, and Ben was never sure how he would find her upon his return at the end of the day. At times he felt that he should enter their home by putting his hat on a stick and poking it into the doorway to see if it would be embraced, ignored, or shot at.

Mood changes come swiftly, explosively, carrying the borderline from the heights of joy to the depths of depression. Filled with anger one hour, calm the next, he often has little inkling about why he was driven to such wrath. Afterward, the inability to understand the origins of the episode brings on more self-hate and depression.

Central to the borderline syndrome is the lack of a core sense of identity. When describing themselves, borderlines typically paint a confused or contradictory self-portrait, in contrast to other patients who generally have a much clearer sense of who they are.

The world of a borderline, like that of a child, is split into heroes and villains. A child emotionally, the borderline cannot tolerate human inconsistencies and ambiguities; he cannot reconcile another's good and bad qualities into a constant, coherent understanding of that person. At any particular moment, one is either "good" or "evil"; there is no in-between, no gray area. Nuances and shadings are grasped with great difficulty, if at all. Lovers

For example, a patient may demonstrate characteristics that lead to diagnoses of both borderline personality disorder and obsessive-compulsive personality disorder.

the world is neither intrinsically fair nor exact; it is composed of subtleties that require less simplistic approaches.

The Truth part of the SET system is the most important and the most difficult for the borderline to accept since so much of his world excludes or rejects realistic consequences.

Most psychiatrists believe that the borderline syndrome has been around for quite some time; that its increasing prominence results not so much from its spreading (like an infectious disease or a chronic debilitating condition) in the minds of patients but from the awareness of clinicians. Indeed, many psychiatrists believe that some of Sigmund Freud's most interesting cases of "neurosis" at the turn of the century would today be clearly diagnosed as borderline.20

As the United States continues its quest to provide health care to more people in more affordable ways, there will be temptations to mandate treatments that are shown to be grossly equivalent, but less expensive. It will be important to maintain flexibility in such a system, so that we do not denigrate the art of medicine, which allows individuality in the sacred relationship between doctor and patient.

Quality time" becomes a guilt-induced euphemism for "not enough time.

New York Times writer Louis Sass put it this way: Each culture probably needs its own scapegoats as expressions of society's ills. Just as the hysterics of Freud's day exemplified the sexual repression of that era, the borderline, whose identity is split into many pieces, represents the fracturing of stable units in our society.2 Though

By 1970, 40 percent of World War II and Korean War POWs had met violent death by suicide, homicide, or auto accident (mostly one-car single-occupant accidents).27 The same trend has continued with Iraq War vets. According to U.S. Army figures, five soldiers per day tried to commit suicide in 2007, compared to less than one per day before the war.28

Raging Bull Criterion 8. Inappropriate, intense anger, or lack of control of anger, e.g., frequent displays of temper, constant anger, recurrent physical fights. Along with affective

Carrie, at forty-six, has had to learn that an entire set of previous behaviors are no longer acceptable. "I don't have the option of cutting myself, or overdosing, or being hospitalized anymore. I vowed I would live in and deal with the real world, but I'll tell you, it's a frightening place. I'm not sure yet whether I can do it or whether I want to do it.

Contemporary social forces implore us to embrace a mythical polarity—black or white, right or wrong, good or bad—relying on our nostalgia for simpler times, for our own childhoods.

Borderline individuals are the psychological equivalent of third-degree burn patients. They simply have, so to speak, no emotional skin. Even the slightest touch or movement can create immense suffering.