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Fraser Trevor Fraser Trevor Author
Title: Double Bind in the Theory of Alcoholism
Author: Fraser Trevor
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According to James Masterson (The Search for the Real Self: Unmasking the Personality Disorders of Our Age), the borderline personality is ...
According to James Masterson (The Search for the Real Self: Unmasking the Personality Disorders of Our Age), the borderline personality is also a learned response to the childhood environment. Masterson contends that as a result of childhood influences a person can develop what he has termed a "false self" in order to protect the "real self" from further trauma. He suggests that the real self is oriented toward mastering reality; but once those efforts have been thwarted the false self shifts the orientation from that of mastering the environment to one of avoiding bad feelings.
 In their book, I Hate You -- Don't Leave Me: Understanding the Borderline Personality, Jerold J. Kreisman, M.D., and Hal Straus identify five dilemmas which plague the borderline personality. They call the first "Damned if you do and damned if you don't." This refers to the kinds of communications borderlines give other people. The title of this book is a good example of this predicament. Another example is a woman I know who asked her boyfriend about his impressions of her amateur public performance about which she had misgivings. He replied "do you really want my honest opinion?" She insisted that she did. But when he told her his assessment of the performance -- which was not particularly encouraging -- she responded by telling him how wrong his perceptions actually were. Her communication was typical of the kind of confusing message that plagues the borderline's relationships.
 A second tendency which they cite as typical of the borderline is "feeling bad about feeling bad." Rather than attempt to understand or cope with feelings, the borderline tries to get rid of unwanted feelings. The person who "should" be happy adds additional layers of guilt and other difficult emotions to an already depressed or angry persona -- contributing to a seemingly endless spiral of feeling bad about feeling bad.
 The perennial victim is the third pattern they have observed. The borderline perceives herself at the mercy of the events and people around her. The woman whose happiness depends on her husband's financial success is one example of victim. The person who organizes his life such that the solutions to his problems lie in other people's hands is exhibiting a borderline tendency. "If only she understood me better ..." is one way that the victim puts the responsibility for his or her happiness on another person.
 Fourth is the quest for meaning in life. Borderlines continually search for that which will fill the emptiness they experience. Relationships and drugs are two common solutions for filling this void.
 The borderline's perennial search for constancy is the fifth behavior observed. The borderline exists in a world that is untrustworthy and inconsistent. Friendships, jobs, and skills are always in question. The borderline lacks the ability to experience consistency and predictability. It is as if all their experience is for naught. A woman I know has taken dance lessons for almost fifteen years and still she cannot see herself as a dancer; she seems to lack an ability to trust and rely on her skills.
 The sixth and last element of the borderline personality is what the authors characterize as the "rage of innocence." Borderline rage is unpredictable and intense when it surfaces. Sparked by seemingly insignificant events, it can appear without warning and often carries the threat of real violence.
 In considering the roots of the borderline personality, Masterson suggests that John Bowlby's research into the infant-caretaker attachment is significant. Bowlby studied the mourning process that children aged 13-32 months experienced when they were separated from their mothers as a result of hospitalization for physical illness.
 Bowlby noted three stages of mourning that these children went through as a result of the separation from their caretaker. The first stage is protest and can last a few hours up to several weeks. In the second stage, hopelessness, the child:
sinks into despair and may even stop moving. He tends to cry monotonously or intermittently, and becomes withdrawn and more inactive, making no demands on the environment as the mourning state deepens. (6, 58)
In the third stage, detachment, the child no longer rejects nurses, but when the mother returns to visit, the strong attachment to the mother typical of children this age is strikingly absent. Instead of greeting her, he may act as if he hardly knows her; instead of clinging to her he may remain remote and apathetic; instead of dissolving in tears when she leaves, he will most likely turn listlessly away. He seems to have lost all interest in her.
 Masterson realized that these same three stages of mourning and the defenses they produced were evident in his own adolescent and adult borderline patients:
I came to recognize that when my patients go through a separation experience that they have been defending themselves against all their lives, they seem to react just like Bowlby's infants in the second stage of despair. The separation brings on a catastrophic set of feelings, which I have called an abandonment depression. To defend against this mental state, they retreat into the defensive patterns encouraged by the false self, which they have learned over the years will ward off this abandonment depression.
In adults without a sense of their real self, the abandonment depression symbolizes a replaying of an infantile drama: The child returned for support and encouragement, but the mother was unavailable or unable to provide it. The acknowledgment and approval, so crucial to developing the capacities of expression, assertiveness, and commitment, were simply not there. (6, 59)
Masterson suggests that what characterizes the borderline personality is an over-reliance on primitive defense mechanisms learned in early childhood: denial and clinging, avoidance and distancing, projection and acting out.
"In order to establish a coherent sense of self, the child in the first three years of life must learn that she is not a fused, symbiotic unit with the mother" says Masterson (6, 51). How is this to be accomplished? In his book, A Secure Base, Bowlby discusses the elements he considers most necessary to allow this process to take place in children:
. . . the ordinary sensitive mother is quickly attuned to her infant's natural rhythms and, by attending to the details of his behaviour, discovers what suits him and behaves accordingly. By so doing she not only makes him contented but also enlists his cooperation.
. . .
This brings me to a central feature of my concept of parenting -- the provision by both parents of a secure base from which a child or an adolescent can make sorties into the outside world and to which he can return knowing for sure that he will be welcomed when he gets there, nourished physically and emotionally, comforted if distressed, reassured if frightened. In essence this role is one of being available, ready to respond when called upon to encourage and perhaps assist, but to intervene actively only when clearly necessary. (2, 9-11)
What happens in early development to interfere with the child's efforts to develop a sense of self -- an identity which is separate and distinct from that of the caretaker? Kreisman and Straus contend that a large amount of anecdotal and statistical evidence exists to demonstrate that children who have been abused or neglected can be linked to borderline tendencies as adults.
 Masterson suggests that many of his borderline clients had mothers who themselves had an impaired sense of self. Consequently the mothers are not able to provide the secure base from which the child can venture out and explore the world. He cited one example of a mother with low self esteem and a fear of separation who tended to foster this fear of separation in her child. She encouraged him to remain dependent on her in order to maintain her own emotional equilibrium:
She seemed to be overwhelmingly threatened by her child's emerging individuality, which sounded as a warning that he was destined to leave her eventually forever. Not being able to handle what she perceived as abandonment, she was unable to support the child's efforts to separate from her and express his own self through play and exploration of the world. Her defensive maneuvers to avoid her own separation anxieties entailed clinging to the child to prevent separation and discouraging his moves toward individuation by withdrawing her support. (6, 54-55)
Consider what Masterson has suggested about the possible roots of the borderline personality: it looks like the ultimate double bind -- a world that expects one to grow up and become self sufficient while the caretaker is rewarding that same person for remaining dependent and helpless.
 Twenty years after the double bind theory of schizophrenia was published, one of the authors, John Weakland, published a paper in which he suggested that perhaps they had focused too closely on schizophrenia. He suggests that the real significance of the theory was its viewpoint that behavior and communication are closely tied. This theory was diametrically opposed to the established paradigm that emotional problems are a response to intrapsychic conflicts. Perhaps, he suggested, the double bind has far reaching effects in many kinds of emotional disturbance, and its explorations should not be limited to cases with a diagnosis of schizophrenia. Carlos Sluzki seems to have come to the same conclusion in his paper with the provocative title The Double Bind as a Universal Pathogenic Situation.
Sluzki notes that a child passes through three evolutionary stages:
(1) infantile dependence, marked by a relative lack of differentiation between the self and the non-self and a preponderance of the incorporation or the "taking" of objects; (2) transition; and (3) mature dependency, characterized by "relations between two independent beings who are completely differentiated; and by a predominance of giving" in object relations. (10, 231)
The transitional stage ushers in the core dilemma of all mental development: Dependence versus independence.
 The child's developmental task is to balance the need for security and dependence with his or her need to move toward independence. If the parents are to facilitate the child's emergence from dependence to independence they will need "to stimulate the impulse towards independence and to neutralize the needs for dependency." (10, 231) Without the parents' encouragement, it is difficult for the child to face the uncertainty and risks along the road to independence.
 Sluzki describes three modes of relationship between parent and child; this includes those areas of a child's life where he is dependent, independent or moving from dependence to independence with parents' help and supervision. For example, dependence is when a child cannot get to school without his parents' assistance. Independence is when the child can get himself to school without assistance. The third area entails that point in time where perhaps the child, with parents' assistance and encouragement, is learning the route to and from school but is not ready to do it for himself.
 As a child proceeds through life he and his parents must constantly redefine where those boundaries are. At best this is a very complex task; if parents are unclear themselves about these boundaries, then their children will have to contend with a great deal of confusion about what they can and cannot do.
 One example of a double bind that inhibits the child's growth toward independence is a parent who is in conflict about the desire for the child to be independent and the desire for the child to "be perfect." A child's ability to think and behave creatively will become increasingly limited if, for example, he is told to think for himself and then second-guessed as to his choice of actions. I know an otherwise responsible young man who spilled paint thinner and just walked away from it because he didn't know what he should use to clean it up. He seemed to be caught in a "damned if I do, damned if I don't" kind of experience. He seemed to think it would be better to walk away from the mess then to be criticized for using the wrong implement to clean it up. He has found it safer to retreat into helplessness and dependence rather than risk making a mistake on his road to independence.

 Exploring these kinds of common binds may give us useful insights into the behavior of the borderline personalities and schizophrenics. Could it be that the behavior which we see exhibited by each diagnosis is a different manifestation of the same communications knot -- the double bind? If so, then it may be that a major role of therapy is to unravel the conscious and unconscious double binds so that the individual can reorient himself toward more useful goals and motivations.
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