A Comparison of symptoms and responses in BPD to Adult Children of Alcoholics
Comparison of
BPD (borderline personality disorder) with
ACOA (adult children of alcoholics)
The following statements taken from the following 3 books shows the similarities
between BPD and ACOA.
Children of Alcoholism, A Survivor's Manual by Judith S. Seizes and
Geraldine Youcha, Crown Publishers, NY 1985 AC
Borderline Personality Disorders, the Concept, the Syndrome and the
patient by Peter Hartocollis, MD, Ph.D.; International Universities
Press, Inc. 1977 PH
Borderline Personality Disorder by Dr. John G. Gunderson, American
Psychiatric Press JG
CONTROL
AC pg. 60: There are three kinds of control
involved: the control other people have over them; the control they have
over people and events; and the control they exert over their own bodies
and minds.
JG pg. 88: ...these acts are used to sustain a belief
in the ability to exert omnipotent control over an object as well as to
prevent the consequences of object loss.
ABANDONMENT
AC pg. 80 Any switch - a rained out picnic or a
canceled appointment ... will bring on hours of internal despair because
these events are experienced as reenactments of scenes from a helpless
childhood.
JG pg. 80: Borderline patients had much more
separation, abandonment anxiety, object hunger and intolerant responses
to feeling needy or angry.
SEXUAL PROBLEMS
AC pg. 49: ...sexual identity problems...and may
become an overeater.
JG pg. 9: Sexual deviance is highly related to
impulsivity...
AC pg. 80: ...confuse physical contact or sexual
involvement with emotional warmth. They therefore become promiscuous,
but with little satisfaction from the sexual wanderings.
I see this apparent more in Histrionic Personality
Disorder, but histrionic 65% of Histrionic is BPD
BLACK/WHITE THINKING
AC pg. 63: ... to see the world and the people in
it fairy-tale fashion as all good or all bad.
JG pg. 179: The polarizations (good/bad, all/nothing,
now/never) within borderline patients repeatedly evoke polarized responses
from their environment.
PERSONAL COMMITMENTS
AC pg. 79: It does seem to be extraordinary for children
of alcoholics to make long-term commitments, marriage included.
JG pg. 4: Devaluation, manipulation, dependency and
masochism characterize and cause the intensity and instability of interpersonal
relationships.
UINDEFINED BOUNDARIES
AC: Wish for closeness, yet fear it.
JG pg. 33: Two major organization and sustaining
beliefs are: "Should I want more from you, or should I be angry at
you, you will leave: and if I'm compliant, something will be given to me
that will make me invulnerable and less destructive."
(continues)
Behind these conscious beliefs are concerns with
the destructiveness of their own aggressive wishes to find a powerful protector.
in any event, the basic tension between wanting more from the object and
fearing that less will be received accounts for the sustained dysphoric
characteristic of borderline functioning.
DEPENDENCE ON OTHERS
AC pg. 80: there are those who can't tolerate being
alone and therefore cling to friends, relatives, and just about anyone
who happens to be around.
JG pg. 8: Borderline persons tend to be compulsively
social because their sense of their own coherence and value depends on
the presence of others.
JG pg. 97: ...desperate to find someone, anyone,
to "hold onto," someone to feel in control of...
JG pg. 36: ...is evident in the need to have people
around -- even if without any evident emotional contact, in using radio
and television as hypnotics, or in heavy use of transitional objects.
DISSOCIATION - ANGER - DEPRESSION
AC pg. 170: ...feelings of depression, uncontrollable
anger, and incapacitating fears of disorientation.
JG pg. 9: In general, the occurrence of any mild
or brief ego-dystonic psychotic-like experiences in the absence of severe,
widespread psychotic symptoms at any time in the patient's past life is
a strong indicator for the borderline diagnosis.
JG pg. 3: ...four characteristics identify what they
called the "borderline syndrome." These were (a)
failures in self-identity, (b) anaclitic relationships, (c) a type of depression
based on loneliness, and (d) the predominance of expressed anger.
JG pg. 86: ...the depressions of borderline patients
differed from other patients with depression by their impulses to hurt
themselves.
JG pg. 16: Probably the most common form of
affective disorder found in borderline patients is unipolar nonmelancholic
depression.
JG pg. 103: ...manipulative behaviors are often indirect
expressions of anger...
LOW SELF ESTEEM
AC Have a low opinion of yourself
PH: They feel low, inadequate, or wrong.
SUICIDAL TENDENCIES
AC pg. 49: ...most likely to kill himself, either
accidentally or on purpose.
AC pg. 169: "Most people, when their car breaks
down on the highway, either get out and fix it or call a mechanic.
When my car had a flat tire, I called the suicide hot line."
JG pg. 85: ...suicide gestures emerge as one of the
major discriminating characteristics of borderline patients...
+
JG pg. 86: Almost all the patients were involved
in suicide threats, overdosing or self-mutilation.
FEAR OF EXPOSURE
AC: deny or suppress feelings
AC: feel unnecessarily embarrasses and ashamed
JG pg. 169: ...may cling to a pharmacotherapist because
of a fearful reluctance to open their personal and interpersonal lives
up for review.
Characteristics Of Adult Children Of Alcoholics
1) We guess at what normal behavior is. Because of our
environment, we had no role models for normalcy, so we acted the way we saw other people act, people we thought were normal, and continue this performance into our adult lives.
2) We have difficulty following a project through from beginning to end; we procrastinate. Procrastination in the usual sense is the result of laziness. Adult children of alcoholics have never been taught how to solve a problem in systematic, manageable amounts. It was always all or nothing. Consequently, we don't have adult life skills.
3) We lie when it would be just as easy to tell the truth. Lies, specifically lies of denial, were used to benefit the alcoholics and pari alcoholics of our homes.
4) We judge ourselves without mercy. Since there is no way for
us to meet the unattainable standards of perfection we have
internalized from childhood, we are always falling short of the
mark we have set for ourselves. If we are responsible for some
positive outcome we dismiss it by saying, "Oh, that was easy,"
and so on. This is often confused with humility but is actually
poor self-esteem. We should keep our poor self-esteem in mind
when taking the Fourth and Fifth steps.
5) We have difficulty having fun. For most of us having fun was
just a childhood fantasy. We were always imprisoned by the anger and
hostility of alcoholism, even if physically removed from the alcoholic,
the disease was already part of us.
6) We take ourselves very seriously. The normal spontaneity of
childhood was squashed so many years ago by the pressure to
be adult. Living with one or more addicts forced us to be on
guard constantly. Seriousness was the only option. Now we can't
have fun.
7) We have difficulty with intimate relationships. For most of
us the only reference of intimate relationships was that of our
parents. Our inconsistent parent¡child relationships caused us
to feel an overwhelming fear of abandonment. We are left too
inexperienced and fearful to let ourselves get close to anyone.
8) We overreact to changes over which we have no control. As
young children the addict's life was inflicted on us as part of our environment. Our only recourse was to try to take control totally. Now any change which we are unaware of or have no control over leaves us feeling desperate and vulnerable.
9) We constantly seek approval and affirmation. The love we
received as children was very erratic. The affirmations we didn't get on a day to day basis as children, we interpreted as negative, leaving us with low self¡images. If someone likes us, gives us affirmation and accepts us, we usually judge them worthless. Our low self images thrive on this.
10) Because of our secretive childhood sufferings, we thought that things were always better in the "house next door." NOBODY could possibly feel the same way as we did. Therefore, we felt unique, not a part of the group, and always looking in through an imaginary barrier.
11) We are super¡responsible or super¡irresponsible. So much of
our lives are all or nothing when trying to please our parents we did more and more and more; some of us realized early in our childhood, that there simply was no pleasing them, so we did nothing. We people please until we burn out for two basic reasons; one, because we don't have a realistic sense of our own capabilities or, two because if we say NO, we're afraid someone might find out how inadequate we feel and no longer like us.
12) We are extremely loyal, even i n the face of evidence that
the loyalty is undeserved. Since starting a relationship is so
difficult and frightening, when we do so we expect it to be
permanent. This loyalty is usually caused by fear of abandonment. At home we always "hung in there" enabling the addict and denying the disease.
13) We are impulsive. As children our impulsivity was usually
denied or covered up by our parents. We seldom suffered the
consequences for impulsivity, leaving us with no deterrent, and
we allow our impulsive behavior to continue in our adult lives.
Adapted from Adult Children of Alcoholics, by Janet G. Woititz, Ed.D., 1987.
