How to Cope with Borderline Emptiness: a singular experience
Borderline Personality Disorder (BPD) is a behavioural disorder marked by instability in relationships, exaggerated fear of abandonment, intermittent anger, sudden mood swings, and chronic feelings of emptiness. Discussing borderline states of emptiness is of great importance, as it is because of it that the person with BPD finds himself/herself in an unbridled quest to fill it with alcohol, drugs, sex, and/or self-injurious behaviour.
Diagnosed with BPD 3 years ago, the chronic feeling of emptiness is, without a doubt, the symptom I struggle with the most daily.
In this article, I intend to report in detail my experience with these intermittent states of emptiness, and how Schema Therapy has helped me to understand (and overcome day after day) what is behind this chronic feeling, marked by the lack of meaning in life (and the constant need for others' approval).
Unraveling Schema Therapy in My Affections
Schema Therapy is a distinctive form of psychotherapy that was originally developed by Dr Jeffrey Young during the 1980s / 90s to improve treatment for people who weren’t responding well to standard Cognitive Behavioural Therapy (CBT). It was originally developed to treat personality disorders and is often used to treat borderline personality disorder (BPD) in particular, although it has also been used to treat other disorders such as depression and anxiety.
But what are schemas, and how do they develop in a person's life?
My therapist explained to me that schemas are ways a person sees, perceives, and feels themselves in the world. It is how a person works in face of situations and interpersonal relationships. These schemes are formed in childhood and have to do with how our basic needs were met, whether adequately or not, as follows:
Secure bond with caregivers and feeling of being accepted,
Autonomy, with its own valued identity,
Realistic boundaries during development,
Freedom to express oneself and validation of emotions,
Permission for spontaneity leisure activities.
When these emotional needs are not adequately nourished, the person can enter adulthood with deficits in their social skills, thus generating maladaptive schemas. These maladaptive schemas, which can be described as ways in which individuals interpret life events and the behaviour of others, can later disrupt life: individuals may make unhealthy choices, form toxic relationships, lack fully developed social skills, engaging in destructive behaviour patterns, having a poor sense of judgment, and experiencing feelings of worthlessness or insecurity.
Young structured maladaptive schemas into 18 structures, categorised into 5 different domains (set of schemas):
Disconnection and Rejection: Expectation that needs for safety, protection, acceptance, and respect will not be met in a predictable way. The typical family background is detached, cold, rejecting, withdrawn, lonely, explosive, unpredictable, or abusive.
Autonomy and Impaired Performance: Insecure expectations about self as well as family interfere with the child's ability to survive and function independently or perform successfully. The typical family background is overprotective, undermining the child's confidence to function well in everyday life.
Impaired Limits: Deficiency in internal boundaries, leading to difficulty respecting the rights of others, or making commitments. The typical family background is characterised by permissiveness, overindulgence, lack of direction, or a sense of superiority. In some cases, the child may not have been trained to tolerate normal levels of discomfort, or may not have received adequate guidance.
Direction towards the other: An excessive focus on the desires, feelings and responses of others, to the detriment of one's own needs - in order to gain love and approval. The typical family background is based on conditional acceptance: children must suppress important aspects of themselves in order to gain love, attention, and approval.
Over-vigilance and Inhibition: Excessive emphasis on controlling or suppressing one's feelings, often at the expense of happiness, relationships, or health. The typical family background is punitive, demanding, and perfectionistic. There is often a concern that things might fall apart if the person fails to be vigilant.
According to Young's approach, maladaptive schemas make up Personality Disorders. In practice, Schema Therapy works the Personality Disorder in parts, by stages of the person's life history. As if each of the schemes told a different pain in the individual's life. It is for this reason that, after the patient's anamnesis (an account of their medical history), the psychologist hands the person the schema questionnaire, to work on each unmet emotional need.
When I arrived at Schema Therapy (1 year and a half ago), my main complaints were: fear of abandonment, a chronic feeling of emptiness, and a constant need for approval and recognition. What I can say is that during the therapeutic journey, I was able to understand that each of these complaints had a common denominator: the false Self.
The false Self describes the Borderline's attempt to adapt to people and groups, imitating them by identifying with their characteristics, thus making exaggerated efforts not to be abandoned. For example, if a person with BPD starts dating someone from the literary world, they may start to "devour" books. If the person with the disorder relates to people who like a certain musical style, they may listen to, and appreciate, the sound preferred by this group. More than imitating someone, people with BPD do it because they fear not being accepted or abandoned by those they admire. Thus, the false Self (as the name implies) is not a true "me", but someone who seeks to shape his/her persona according to the people he/she meets and identifies with.
Thus, the false Self has to do with the central wound of abandonment. The person is afraid of being abandoned because of feeling inadequate or unloved by parents and caregivers. In my life, I remember, in an argument with my mother at the age of 8, being abandoned by her in the middle of the street. I was away from home, and we were returning from the paediatrician. I had no idea where I was, but I ran as fast as I could to catch up with her around the corner. Since that day, I remember developing an enormous fear of being abandoned in the middle of the street, by whoever it was.
The exaggerated effort to try to please someone forms a bottomless hole in the person with BPD, which he/she tries to fill with things like food, sex, alcohol, parties, work, without success. When the temporary pleasure these things provide is gone, the emptiness is there to remember that it exists.
During my adolescence (and before starting psychotherapy), I tried countless ways to fill this emptiness. It was a pain that I compulsively tried to numb with parties, alcohol, sweets, unstable relationships, and academic studies (staying days and months, not wanting to see anyone, to be recognised for excellence in the final exams). But all this seems to have an explanation:
According to a qualitative study of chronic feelings of emptiness in borderline personality disorder, people associate these states with feelings of disconnection from the self and others, as well as feelings of purposelessness and dissatisfaction.
The exaggerated fear of abandonment and the constant need for approval intensified in my life after my mother's death in 2015, when I felt purposeless and dissatisfied.
Despite her emotional lability, my mother used to be interested in my work and even gave me tips on what to write in my articles. Then, suddenly, I was alone again, in the middle of the street, without the person who, my whole life, had talked to me about everything. Thus, Schema Therapy emerges as a "therapeutic mother" for me, as it focuses on transforming that vulnerable child into a healthy adult.
Schema Therapy in Managing the Patient's Emptinesses
To transform the patient into a healthy adult capable of dealing with life's adversities, I filled out the Young Schema Questionnaire so that my therapist and I could work on my Early Maladaptive Schemas. As a result, the most activated schemas in my questionnaire were Abandonment, Distrust and Abuse, Social Isolation, Inflexible Standards, Grandiosity/Arrogance, and Seeking Approval and Recognition. During the sessions, I was able to understand the role that each maladaptive schema played in my life:
The Abandonment Schema is characterised by a pattern of fear in interpersonal relationships, with a high expectation that important people will abandon them. Fear of loss can come from the fantasy of being left by someone else and that important people are no longer available, such as in the case of my mother, who, despite having abandoned me during an argument, is no longer here to support me in our conversations.
In practice, my psychotherapist and I have been working on my character strengths, i.e. creative activities that I am good at doing, like writing this article. We have been working on meaningful experiences, that is, why I do what I do, and how my work has a positive impact not only on my life, but on the lives of those who request my work.
I think you've noticed by now that my therapist has been playing my mother. But this time, in a good enough way, with limits, respect, and without the "valuation/devaluation" dichotomy. Whenever I have a crisis, I am allowed to cry, without fear, without shame, and much less without criticism. All this because I am a human being, who deserves affection and respect, without the pain of abandonment or rejection.
Every day is a struggle, but it's a won struggle!