Posted by Carolyn Kaufman | @CMKaufman at 9:00 AM
QUESTION: My MC (Andrew) exhibits many symptoms of borderline personality disorder, including splitting. With the splitting, he basically thinks of himself as a "good" Andrew and a "bad" Andrew. In his thoughts, the good part of him (whom he calls Leif) talks with the bad part. At first, it's just jumbled thought, sometimes doesn't make sense, and as it progresses, it develops two distinct voices. He thinks the bad Andrew is just worthless and a street whore (he's a prostitute) and the good Andrew is who he is trying to change into, to fix his life. I don't think this is split personality or multiple personalities because they are aware of each other, and it really is like two aspects of the same thing. Does this make sense, psychologically? Is it still borderline, or is this something else?
ANSWER: It sounds like you've got the gist of splitting, which is pretty commendable, since it's a tough concept. Typically, though, adult splitting is seen as a kind of defense mechanism, so people aren't really aware that they're doing it.
Let me explain splitting a little more, just so that makes sense, and then we'll talk about what might work well for your story.
According to object relations theorists like Melanie Klein, newborns essentially believe that the world is part of the same entity as them. In other words, they can't differentiate between themselves and the world. Later, they differentiate between "me" and the world, but Mommy (or Daddy, or whoever the primary caregiver is) is seen as part of "me." Still later, the child begins to understand that "me" and Mommy are different, but they have trouble seeing "good Mommy" (who acquiesces to them and fulfills their needs) and "bad Mommy" who says "no" or is otherwise frustrating or disappointing as the same person. This is splitting, and it's natural around 3-4 months of age. As we get older (i.e. around 6 months of age), we learn to see "good Mommy" and "bad Mommy" as part of the same person. That's why we can love and hate someone at the same time.
This natural process is interrupted in people who have borderline personality disorder, typically due to trauma of some kind (usually abuse). As a result, these children never stop splitting other people and either idealize or devalue them. They may swing back and forth very quickly from one side to the next, but they aren't really able to simultaneously integrate the good and bad.
People with borderline personality disorder never learn to regulate their emotions, so they have extremely tumultuous, even destructive relationships with others as they frantically try to get others to help them deal with a world they feel they can’t deal with alone.
You say Andrew has other borderline tendencies, but if splitting is the primary reason you’re using the borderline diagnosis, it might be simpler to move away from that diagnosis. (Borderline personality is an extremely painful disorder for the person who has it, and they often have depression, anxiety, PTSD, and incredibly disruptive behavior patterns, and that’s a lot to try to portray!)
At the same time, you’re right, it doesn’t sound like Andrew would qualify for dissociative identity disorder (multiple personality disorder). His relationship with his alter ego, Leif, isn’t dissociative enough.
It sounds to me like Andrew has just named a normal ego state and is relating to it in a way that works for him. Which is entirely possible and probably is not in itself diagnosable.
Everyone has multiple ego states. That’s normal. For example, the “you” that goes to Thanksgiving dinner with the in-laws probably acts a little different than the “you” that goes out for a raucous evening on the town with friends. Both parts are you, but they’re different sides or facets of you.
Some people are more aware of these different ego states than others, especially if they play very diverse roles in life. That sounds like the case for Andrew.
It’s even pretty normal for people to give their ego states names, though they may think of those ego states as “the party girl” or “the writer” or whatever. People also adapt their names based on the setting they're in. For example, an Andrew might be Mr. Whomever at work, but Drew with friends and Andy to his lover. And I know people who go by their given names (e.g. James) in formal situations but by a middle name or nickname that's completely different in informal settings (e.g. Tim).
If you want or need a diagnosis for Andrew, based on the brief description you gave me, I’d probably lean toward some kind of a mood disorder, maybe dysthymia (a chronic, low-grade, but extremely wearing depression) or a major depressive disorder (which is more crippling at its worst, but tends to get better and then worse and then better again over the years). An anxiety disorder is another possibility.
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