I ran into "New Hope for People with Borderline Personality Disorder" in a bookstore. I was very intrigued by the title, thinking that maybe, just maybe they had figured something out that might be helpful to our community of NonBps. I was disappointed. Then I was shocked. Then I bought the book so that I could be sure and give it a fair review. Now, after having read most of it, I'm just angry at the authors irresponsible views towards NonBPs.
First, let me say that the book does a decent job of reviewing the current state of the art in borderline personality disorder research. It does not overstate, nor understate the recovery rates for borderlines who enter treatment under the various therapies suggested. It's fair in that way, and as such it contains information that is probably very useful for the borderline who has admitted that they have a problem and are willing to work like hell on it. Someone with a diagnosis of BPD, who can afford and is in DBT, would probably benefit from reading the book (at the very least they might benefit from the part of the book about getting insurance to pay). The chapters on eating healthy and so forth are common sense, and most of us would benefit from eating better.
On the other hand, this book is a little bit like a book on nano-technology. It's interesting, but not terribly relevant. While it is true that some day nanobots will course through my (or my grandchildren's) bloodstream cleaning up clogged arteries, it doesn't do a dang bit of good to me today if I'm suffering from heart disease to know this. It's also important to point out that this book, as so many others do, deals almost exclusively with low functioning borderlines. The way this book defines a "cure" to BPD means that if a person meets 5 of 9 criteria, and works a couple of years hard in therapy, and get down to 4 of 9, then they are "cured". Does this mean that they can have a deep personal relationship? Probably not. So I'm a little confused as to what sort of "hope" they are really holding out here. Perhaps it's just my view of the world, but this book seems to reconfirm my belief that the vast majority of borderlines, and nearly all high functioning borderlines, just never ever get better no matter what. What I mean by better is "able to function nearly normally in an intimate relationship." Admittedly a much higher bar than, "stops cutting", "stops making suicide threats" and so forth that the book talks about. A good portion of the book is devoted to some non-traditional healing approaches like music therapy, eastern medicines, and so forth. While I'm sure some of this stuff can work, it has the feeling of throwing drinking straws to a drowning man.
For parents of borderline children, I can see why the book might be appealing. I think that it's is important to maintain some degree of hope as a parent. However, I would point out that some of what's in this book is downright DANGEROUS to many NonBPs. For example, quoting from page 237,
"Furthermore, professionals who lack understanding of the biological foundation for the impulsivity and emotional dysregulation characteristic of those with BPD sometimes offer families inappropriate advice, such as "You have a right to a life", and "You need to create personal boundaries and set limits." Such advice serves to frame the person with BPD as the "enemy" from whom family members must protect themselves, thus reinforcing family anger and possibly extinguishing whatever feelings of empathy may yet remain. Although well-intentioned, establishing such boundaries often disregards the jeopardy they may create because the person with BPD will usually misinterpret the boundaries as punishment or blame. This may explain why "tough love" can be a more dangerous than effective technique for people with BPD."
One of our list members who's significant other is in DBT claims that this position does not reflect the teachings of practitioners of that newer form of therapy, and that DBT does teach family members supportive and appropriate boundaries. That being said, this book is not necessarily all about DBT, so the portion of the book that describes DBT would probably be worth the price of the book if it helped you to decide whether DBT would be appropriate to your circumstance.
The book speaks about the importance of validation for those suffering from BPD. Fine, I don't disagree with that point of view, validating feelings (not actions) IS important as described in the book. However, it is JUST as important that the NonBP's are validated as well. This is TOTALLY discounted in the book. Statistics for BPD suicide are in the book, equating it with one Titanic sized ship going down full of BPs every day for a year (which is statistically overstating it, since it's spread out over the natural life span of the borderline, but I digress).
NO similar statistics are provided for borderline homicide of their significant others. Between 1976-2000, the national homicide rate was 8.4 homicide victims per 100,000 people per year. In the year 2000, despite being a lower than average year, 15,517 homicides were reported. It has been reported that the incidence of borderline personality disorder in the prison population is upwards of 40%. Now, I'm going to break the rules of statistics with this, but I'm trying to make a point here... If this rate is maintained amongst murderers, this would mean that somewhere in the vicinity of 6200 murders were committed by people with borderline personality disorder. (Understand that to some extent these numbers are pulled out of mid air, so don't quote me, there hasn't been a good study on this matter. But I doubt my assumptions are off by an order of magnitude.) Even sticking with the general population number of 2%, you are left with a lower limit of over 300 murders per year by borderlines, which I believe is the absolute floor for this number. Reading the newspaper has led me to believe that the number of Nons murdered by borderline significant others is staggeringly high.
Around 1800 murders a year are spouse or girlfriend boyfriend. I would guess that the majority of those involved someone who suffers from BPD. So, statistically, your borderline significant other is somewhat more likely to commit suicide than to kill you. Nevertheless, being killed by your borderline significant other is a distinct possibility. Also your chances of being involved in serious physical abuse is much higher. As an adult, you have your own choices to make, but these things should be taken into account by rational people.
In my five years on the lists, I am aware of three suicides by borderlines, and one homicide of the NonBP. All were terrible tragedies. Interestingly, there have been no suicides reported amongst NonBPs (although how we would find out about, I don't know). I am aware of hundreds of people who allowed themselves to be physically abused and thousands of people who allowed themselves to be verbally abused. I guess the point I'm making about the book is that once again, it's ALL ABOUT THE BP! Even the chapter on how BPD affects the Nons is very invalidating towards the NonBPs. You see, we aren't allowed, according to the rules proposed in the book to have boundaries or a life. I disagree strongly. You are as entitled to a life and to safe boundaries and to an abuse free existence as anyone else. To put the good of the BP in your life ahead of yourself is admirable to an extent, the problem is that most Nons are willing to live a Non-Existence in order to help their BPSO. And the sad part is that in many cases, most cases in fact, it doesn't even help the borderline.
You are not a punching bag. You are not an endless well of support. You cannot pour your soul into the bottomless pit of need forever without refueling. This book indicates that is exactly what is expected of you. This is total BS, and it's a DANGEROUS idea. I respect parents who try to make a difference in their children's lives. For EVERY other type of relationship, I think this book does more harm than good. Even for parents of borderline children, I think the book is full of dangerous ideas, even though it does have some educational points.
If there is one thing I KNOW for a fact after dealing with thousands of NonBPs, it is this: NonBPs almost always better their lives when they set and maintain appropriate boundaries over time. Borderlines on rare occasions get better when they admit freely that they have a problem, they want to get better with every ounce of their soul, they go to good therapy, they work like hell for years on end to implement what they learned in therapy and their significant others (if they have any) are educated about BPD and participate in therapy themselves as well. Borderlines who do not meet ALL of these criteria NEVER EVER get better EVER.
Since high functioning borderlines almost never admit that they have a problem, and blame others for all of their misfortunes, I believe that they present a particularly poor prognosis. New Hope speaks mostly to lower functioning borderlines, as much of the professionally written literature does. It's not the professional's fault, they generally only meet low functioning borderlines, so that's who they study and work with. If your significant other is low functioning, read the professional literature with some hope that it might apply to them. If they are high functioning, I think you are better off with the information gleaned from the thousands of man-years of experiences shared on these lists than with the relatively poorly informed professionals who deal almost EXCLUSIVELY with low functioning borderlines.
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