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Reflections on Describing and Descriptions of Self-Relations by
Anita Joanne Snell
B.A., University of Victoria, 1990 M.A., University of Victoria, 1992
A D issertation Submitted in P artial F ulfillm ent of th e Requirements for the Degree of
DOCTOR OF PHILOSOPHY
in the D epartm ent of Psychological Foundations in Education ept this dissertation as conforming
to the required sta n d ard
Dr. R.y. Peavy, C o-S uper^sor (Departm ent of Psychological Foundations in Educatior
Dr. J . Anderson, Co-Supervisor (Departm ent of Psychological Foundations in Education)
Dr. A. Oberg, O utside Member (D ^ a rtm e n t of Com m unication and Social Foundations)
Dr. I. Dawson, O utside Member (School of N ursing)
". M. Baird C arisen, Exte
Dr. Ml Baird C arisen. External E x a m in er, Clinical Psychologist (Walla W alla, W ashington)
(Q Anita Joanne Snell, 1997 University of Victoria
All rights reserved. T his dissertation may not be reproduced in whole or in part, by photocopying or other means, w ithout th e perm ission of the
Supervisors: Dr. Vance Peavy Dr. Jo h n Anderson
A bstract
The influence an individual’s perspective h as on h e r or his
perceptions is a critical issue in the field of counselling. Counsellors are required to m ain tain a considerable level of self-aw areness in order not to confuse th e ir own experience w ith the experience of th e ir client. It is proposed th a t an essential component of such self-aw areness includes a knowledge of self-relations. The term self-relations im plies both a self stru ctu re - a relatively stable developm ental in teg ratio n of p attern s and aw arenesses - and th e dynamic, shifting relationships w ith in th a t self structure.
This study addressed the question: “How do four counsellors describe th e ir self-relations?” The purpose of th e inquiry w as to gain knowledge about a range of self-relations, from functional to problematic, therefore counsellors who work with individuals m eeting diagnostic
criteria of borderline personality disorder [BPD] were selected. Borderline personality disorder is significant to the study in th a t th e m ost commonly cited criterion for th is disorder is the experiencing of difficulties
concerning self-integration.
Following a detailed methodological description of th e interview and analysis procedures, th e resulting them es are explicated. Them es emerged from four general categories: (a) events th a t took place in th e interview, (b) personal them es, (c) professional issues, an d (d) th e interview er’s
HI
perspective. The principal finding was the identification of an inherent correspondence betw een the participants’ self-relations an d th e ir
th erap eu tic interventions. The m anner in which figurative language constituted th e individual styles of self-relations is explored.
Implications for practice include a discussion of dissociative processes th a t focuses on the significant qualitative difference between theoretical conceptions and lived experience. An exercise is included in th e appendixes th a t assists in the process of describing self-relations. It is recom mended th a t th is exercise be included as a com ponent of counsellor education.
Exam iners
Dr. R/^(pPeavy, Co-Supaj; f'laor -(Department of Psychological Foundations in Eddc^tiod)
Dr. J : Anderson, Co-Supervisor (D epartm ent of Psychological Foundations in E & ^ a tio n )
Dr. A. Oberg, O utside Member (De^^artment of Com m unication and Social Foundations)
D n I. Dawson, O utside Member (School of N ursing)
___________________
Dr. M. Baiijd T)arlsen, External Exam iner, Clinical Psychologist (Walla W alla, W ashington)
Table of Contents A b s tr a c t... ii Table of C ontents ... iv L ist of F i g u r e s ...viii A ck n o w led g em en ts... ix In tro d u c tio n ... 1
Evolving from “Psychology During Pregnancy” to “Self-Relations” . . . 1
Basis for Studying Self-Relations ...7
Review of th e L it e r a t u r e ...11
Overview ...11
Borderline Personality Disorder ... 12
D efinition of Borderline Personality D is o r d e r ...12
O rigins of the Term “Borderline” ...13
T he Pejorative Label “Borderline” ...15
Etiology of Borderline Personality D iso rd e r... 17
S p l i t t i n g ... 24
Definitions of dissociative disorders, sp littin g and s tr u c t u r e ... 24
Object relations theory and s p li ttin g ... 25
How splitting o c c u rs ...25
Regulatory splitting and self-defense s p l i t t i n g ... 28
A Description of the Problematic Life of Individuals w ith Borderline Behaviors ... 29
C u rre n t R e se a rc h ...31
Theories on the N atu re and C haracter of th e S e l f ... 32
S u m m a ry ... 38
Methodological C o n sid eratio n s...40
Research C o n t e x t...40
A ssum ptions Regarding Borderline Personality D isorder . . . . 45
A n Accounting of S e lf-R ela tio n s...47
O th er Assum ptions Guiding th e R e s e a rc h ... 49
G athering D a t a ... 51
Selection of P articipants ...51
Introducing th e P a r tic ip a n ts ... 52
Interview Q u e s tio n s ... 54
Overview o f th e Analysis of th e In terv iew s... 56
A D etailed Accounting of the Analysis Process ...59
R e-interview ing ... 61
O rganizing th e d a t a ... 62
T hem es and Reflections ...68
Overview ... 68
Striving to H ear th e P a r tic i p a n ts ...71
F u rth e r Reflections on Striving to H ear the Participants . . . . 80
Overview of Them es A rising Through th e Interview Process ...81
G etting R e a d y ... 81
F u rth e r Reflections on Getting Ready ...82
Struggling in the Interview or Trying to E xplain How You W alk . . . 83
F u rth e r Reflections on Struggling in th e In terv iew ... 86
C hanging T hrough the Interview Process or “G etting to Know M yself B etter” ... 87
Overview of Them atic Presentation of Individual Participants . . . . 93
The In h eren t Correspondence Between the P articipants’ Self-Relations and T heir Therapeutic In te rv e n tio n s ... 93
P e e t a ...94
In tern al process involved w ith answ ering a q u e s tio n ...94
Describing in tern al d ynam ics... 95
H aving a core struggle ... 96
Processing is s u e s ...99
W orking w ith c lie n ts ... 101
A b b o tt... 103
In tern al process involved w ith answ ering a q u e s tio n ...103
Describing in tern al dynam ics... 104
H aving a core struggle ... 106
Processing i s s u e s ...109
Working w ith c lie n ts ... 110
A m b e r ... I l l In tern al process involved w ith answ ering a q u e s tio n ...I l l Describing in te rn al dynam ics... 113
H aving a core s t r u g g l e ... 115
Processing is s u e s ...117
M a y ... 120
In te rn a l process involved with answ ering a q u e s tio n ... 121
D escribing internal dynam ics...122
H aving a core struggle ... 124
Processing is s u e s ... 125
W orking w ith c lie n ts ...126
F u rth er Reflections on the Inherent Correspondence B etw een the P articipants’ Self-Relations and T h eir Therapeutic Interventions ... 127
Describing S elf-R elatio n s...130
The M eaning Ascribed to the Language of Self-Relations . . . 131
M ay ...131
A bbott ... 134
P e e ta ...136
A m ber ... 139
Positioning Feelings in Self-Relations ... 141
Using “You” ...144
F u rth e r reflections on using “you” ... 145
W anting To Be the Same on the Outside as On the Inside . . 147
F u rth e r reflections on wanting to be th e sam e on the outside as on the inside ... 149
U nderstanding of Dissociative P ro c e sse s... 152
F u rth e r reflections on understanding of dissociative pro cesses...156
Credibility ...158
My selves and se lf-rela tio n s... 158
Im p lic atio n s...171
Implications for Practice ...172
Im plications Regarding Dissociative P ro c e s s e s ... 176
Im plications Regarding Figurative L a n g u a g e ... 178
Im plications Regarding Using “You” ...179
L im ita tio n s ... 180
Implications for Research ... 181
Concluding R em arks ... 184
R e fe re n c e s ...187
Appendix A: Describing th e Experience of “Being a Self” ...198
v il
Appendix C: Consent F o r m ... 204
Appendix D: Re-Interview Q u e stio n s... 207
Appendix E: Professional Issues L i s t ... 209
List of Figures
Figure One: Pictorial Representations of F our S elf-R ela tio n s...169 Figure Two: Two Depictions of the Process of S plitting ... 170
IX Acknowledgements ^
Dr. Vance Peavy, your belief in my capabilities was essential. T h an k you. Dr. A ntoinette Oberg, th a n k you for helping me le am th a t it is w h at I know th a t is necessary and im portant.
Dr. Isabelle D aw son and Dr. John Anderson, th a n k you for your p atien t attention to th e development and completion of this study.
To my p arents, W alter and M argaret Karashowsky, I hope th e pride you feel in my accom plishm ents, and my gratitude, in some way repay you for all the support you h av e provided me.
To my colleagues, M arla Arvay, Elizabeth B anister, and M arie H oskins, I am honoured by th e cam araderie we have shared and look forward to more of the same.
T hank you to m y extended family for patiently enduring my long preoccupation, and for believing in me.
And of course, to my cowboy and to my star, th a n k you for being in my life.
The participants for this study have been individually acknowledged for their invaluable and greatly appreciated contributions io the section titled Introducing the Participants.
Evolving from “Psychology D uring Pregnancy” to “Self-Relations” W itnessing the birth of a child is, in my experience, one of life’s most profound events . .. When I first began assisting women through the childbearing year, many im pressions flooded into my consciousness; over tim e, I distilled a sense th a t m any issues for th e woman and her family were not being addressed. (Snell, 1992, p. 1)
So begins the introduction to my M aster’s thesis: A n Explication o f
Women’s Experience o f an Alteration in Psychology D uring Pregnancy (Snell,
1992). How th en did I journey fi-om studying psychology during pregnancy to exploring self-relations"? The answ er to th a t question forms the content of the following introduction to this doctoral dissertation.
From the outset of my doctoral work it was my in tention to continue researching in the area of psychological considerations during pregnancy. After all, I h ad worked diligently for m any years acquiring substantive theoretical and practical knowledge in this area. A num ber of influences gradually shifted this intention, not th e least of which w as th e opportunity made available through a sem inar course, “W riting R esearch”, to consider the
The term self-relations is meant to include a variety of conceptions of self-organization, such as: self-structure, internal working model of the self, self-integration, self-representations, self-reference, relations to own internal states, conceptualizing the self, and constructing the self. The use of any term implies the belief system from which it originates, the use of the term self-relations is intended to be as value-free as possible in order to allow easy movement within a variety of approaches and understandings of self theory. [A more thorough definition of self-relations is provided later in this section.]
2 question, “W hat am I deeply interested in?”
Such introspections led to an aw areness th a t underlying th e design and execution of th e research for my M aster’s thesis I h ad harboured an agenda to prove m yself “right”. I realized th a t, despite sincere efforts to practice bracketing^ throughout th a t research process, my strong opinions had influenced th e results of the study. W ith this aw areness came associated understandings of a personal nature concerning the em beddedness of my tendency to believe I am “right” in my convictions. It is from such
introspections th a t th e desire to ask a question I did not “know” th e answ er to developed.
As I struggled to decide the focus of my doctoral inquiry, I experienced fu rth er revelations th a t inspired th e eventual formulation of the research question for th is dissertation, “How do four counsellors describe th e ir self relations?” These revelations occurred after three doctoral students and m yself formed a directed study group on current theories of self. In reaction to our growing dissatisfaction with th e distance between th e theory we were reading and our lived experience of being a self, we decided to conduct our own research (Arvay, Banister, Hoskins, & Snell, 1995). O ur reading had
Bracketing involves the researcher bringing to conscious awareness her or his
presuppositions, assumptions, and premises about the topic and person under study. The researcher is expected to engage in a critical self-reflection throughout the research process and to utilize colleagues and supervisors to gain feedback in d eter m in in g the effectiveness of the researcher’s efforts to listen without prejudice (Kvale, 1983; van Manen, 1990).
exposed u s to a rich complexity of theory on th e n a tu re and character of th e self and our re su lta n t thinking an d discussions h ad engendered such a m aelstrom of personal theoretical confusion th a t we decided to bring some order to th is situation.
We developed a research design th a t would enable us to investigate individual an d common m eaning-m aking constructs about “being a self”. We interviewed each other asking, “W h at is your experience of, or w hat is your theory of being a self?” The tran sc rip ts from th ese interview s were analysed individually an d collectively by th e four of us, an d them es were identified.
We discussed and clarified our understanding of our lived experience of being a self and th a t un d erstan d in g shifted an d grew, causing us to
further struggle w ith creating consensual boundaries around this spiralling, interactive process of increasing u nd erstan d in g and, therefore, changing data. As we negotiated categories an d clarified mean in g (a trem endous advantage to our methodology w as th a t we could provide absolute insight into w hat each participant m eant) we struggled w ith th e esoteric n a tu re of our topic an d th e challenges in h e re n t in dealing w ith fluid data. O ur
discussions b u ilt one on the n ex t u n til we were very fam iliar with each other’s “way of being a self”; or, ra th e r, we were fam ilia r w ith how we each presented, developed, and changed our conceptions of being a self. I believe the opportunity we created to hav e these discussions is unique, combining deeply personal aw arenesses w ith academic intentions in a collaborative
4 research project.
D espite th e degree of in te re st and excitem ent I felt from my
involvement in th is study, I persisted in the assum ption th a t my dissertatio n study should derive directly from my M aster’s thesis. Accordingly, I
continued my attem p ts to hone a question th a t m et two criteria; one, th e question would be about som ething I didn’t “know” and, two, it would be, in some m anner, connected w ith psychology d u rin g pregnancy.
One la st event occurred th a t proved to be a catalyst in shifting my assum ptions concerning th e necessity of researching psychology during pregnancy. I was unexpectedly offered the possibility of changing my
employment and the decision-m aking process th a t followed this offer resu lted in a significant realization: I learned th a t my experience and knowledge are transferable w ithin a ran g e of situations. I also came to realize th at I h a d been restricting m yself in order to satisfy an underlying desire for a sense of continuity. I now appreciated th a t w hatever I chose to study would be
informed by my experience, and th a t the constancy I strove to m aintain w as present w ithin me, not w ith in any given area o f interest.
The way was now clear to fully engage w ith th e question, “W hat deeply in terests me?” T he answ er to th a t question developed through a process of reflecting, ta lk in g to colleagues an d com m ittee members, and writing. I was initially d raw n to learning m ore about a psychological event term ed splitting. My aw areness and u n d e r s t a n d i n g of my own history of
sp littin g behavior had developed as a resu lt of p articip atin g in th e previously m entioned doctoral research project [see Credibility for fu rth e r discussion]. I became curious to know more about th is behavior.'*
I learned th a t such disruptions in self-integration are described as a diagnostic criterion of borderline personality disorder [BPD]. This knowledge began th e process of refining my inquiry; I decided to focus on individuals experiencing problems w ith self-integration as described by th e diagnostic criterion for BPD [see L iterature Review for fu rth e r discussion].
In developing th e research question it became evident th a t it was the range of self-integration, firom problematic to functional, th a t interested me. I defined self-integration as the interrelationship of a n individual’s various parts. Splitting behavior occurred when an individual could not integrate the affect generated in certain circumstances and subsequently split off an aspect of aw areness.
The term self-integration did not quite capture w hat it was th a t in terested me, although it was a facet of th a t interest. For a tim e I used the term self-reference as a descriptor of th e active relationship a n individual has w ith h er or his self. E ventually I came to use the te rm self-relations, which
Splitting is a term that may be used synonymously with dissociation [see Literature Review]. The DSM-IV describes this essential feature of the Dissociative Disorders as a “disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment. The disturbance may be sudden or gradual, transient or chronic” (American Psychiatric Association, 1994, p. 477).
6 includes the actual components of o u r experience of being a se lf (e.g., parts, roles, aspects, thoughts, feelings) a n d th e relationship betw een such
components. The term self-relations, therefore, implies both th e self-structure - a relatively stable developmental in teg ratio n of patterns a n d aw arenesses [see L iteratu re Review for further discussion] - and the dynam ic, shifting, relationships within the self-structure. P u t simply, self-relations is the
experience of being the particular se lf th a t you are in v arying contexts, both
in tern a l and external.
My focus now centered on u n d erstan d in g how individuals experienced th e ir self-relations, including problem atic self-relations. A discussion with a colleague resulted in the decision to interview counsellors in o rder to leam about th e ir self-relations, and to le a m about th e ir perceptions of th e ir clients’ dissociative processes. The rationale for th is decision rested in my
assum ption th a t therapists® working w ith dissociative clients could provide p ertin en t observations and tre a tm e n t approaches concerning problem atic self-relations. As well, I determ ined it was likely th a t such th e ra p ists would be inform ed and articulate in term s of describing their own self-relations.
The preference for obtaining th e d a ta through the in terv iew process stem s from my experience as a research er using this methodology, and my occupation as a therapist. As an experienced therapist I feel confident in my
listening skills a n d my ability to facilitate exploration.
The foregoing chronology of the development of th e research question is intended to provide th e read er with an u n d erstan d in g of th e context from which th is study originates. My experience as an interview ee in our
collaborative rese arch study (Arvay et al., 1995) provided a n essential un derstanding o f my self-relations®, and th a t u n d erstan d in g deeply informs this study.
B asis for Studving Self-Relations
In order to g ain knowledge about self-relations in general, an d about interru p tio n s in self-relations, th e site of th e research focussed on four th e rap ists who w ork w ith individuals m eeting diagnostic c riteria of borderline personality disorder [BPD]. An assum ption u n d erly in g th e research was th a t by interview ing such th era p ists a w ea lth of insight,
experience, and expertise concerning self-relations would be m ade available for analysis. Osborne (1994) sta tes th a t “th ere seems little doubt th a t
descriptive research m ethods are particularly suited for exploring th e m eaning of h u m a n experience th a t can be accessed th ro u g h personal com munication” (p. 186).
If the reader is interested in being furthered oriented to this study there is an exercise contained in Appendix A [Describing the experience of “being a self”] that involves putting into language the all-familiar-yet-rarely-described experience of self-relations. This study
can be understood on a cognitive, academic level without having direct experience of the
8 It w as m y intention to gain a n in-depth description of individual
therapists’ self-relations, how they u n d ersta n d th e ir clients’ dissociative behavior, a n d th e m an n er in which th ese conceptions influence th eir work w ith these clients. I believed th a t th e ra p ists who work w ith clients m eeting BPD diagnostic criteria would have developed, to varying degrees, theories around self-relations. This assum ption arises, in p art, from my reasoning th a t it can be illum inating to study som ething w hen i t is not working properly in order to u nderstand how it operates w hen it is functional.
B orderline personality disorder is significant to th e study in th a t th e most commonly cited criterion for th is disorder is th a t of problems w ith self- integration. K em b erg (1993) describes th e core "syndrome” of BPD as
“identity diffusion”. Stevenson and M eares (1992) m ain tain th a t “borderline personality disorder is a consequence of a disruption in th e development of th e self” (p. 358). Ryle and Marlowe (1995) sta te th a t “ ... discontinuity of experience an d th e im paired recollection of one s ta te while in another is both caused by, an d serves to reinforce, th e absence of a central self-observing and self-m anaging capacity” (p. 23).
These theoretical observations on th e n a tu re an d dynamics of
borderline personality disorder not only provide conceptions th a t are useful in u nderstanding individuals who experience difficulties associated w ith problematic self-relations, such theories also inform our knowledge of self relations in general. The literatu re surrounding BPD provides descriptions of
self-structure th a t have been very useful for the purposes of this research study. Such descriptions, which are generally in agreem ent w ith each oth er, have provided a consistent reference point in the exploration of what is a n ab stract construction, th a t is, self-relations.
Although I have found the criteria th a t describe borderline personality disorder useful in identifying a population of clients and, therefore,
th erap ists who struggle with, and work toward in teg ra tin g self-states, I hav e considerable reservations regarding the practice of attach in g a psychiatric label to a n individual [see Assumptions Regarding Borderline Personality Disorder for further discussion].
Studying self-relations and problems with self-integration in order to gain a more thorough an d useful understanding of se lf and self in therapy is necessary and im portant. Few resources provide a description of the
experience of self-relations and there are fewer still th a t attem p t to explain exactly w hat occurs in term s of self-relations when a n individual experiences dissociation. Kroll (1993) claims th a t “there is a dim ensional quality to th e components of the borderline personality and th a t we all can be located somewhere on these dim ensions” (p. 214). Building on his argum ents, it is my belief th a t the behaviors and underlying factors th a t contribute to a diagnosis of borderline personality disorder are a m a tte r of degree in
comparison to other individuals, ra th e r th a n unique to th is disorder. Thus, i t is also my contention th a t th e study of relations an d problematic
self-10 relations will resu lt in inform ation th a t m utually inform s o u r knowledge of both.
To gain g re a te r understanding the read er is encouraged to engage in a process of describing h is or her own self-relations in order to have the
experience of p u ttin g into words th a t which is all-fam iliar a n d yet quite likely has never been discussed. The purpose o f encouraging th e reader to engage in th is process is twofold: the first is to allow for a richer, contextual understanding of th e dom ain of this study; the second is to b rin g to the reader's aw areness th a t w ithin W estern culture th ere is little opportunity to converse w ith others about the experience of being a self.
Review of th e L iteratu re Overview
The following lite ra tu re review is included in order to provide relevant, contextual inform ation about th e components of this study. T he inclusion of borderline personality disorder in th is study is due to its function a s a
descriptor of individuals who experience difficulties w ith self-integration. As well, th e body of litera tu re th a t h as been built firom the concept of
“borderline” psychology contributes definitions an d descriptions of influences on th e development and experience of self-relations, for example, such
lite ra tu re provides a working definition of self-structure and its developm ent. The history and contentious issues surrounding th e term “borderline” are presented with th e in tention of providing th e context firom which th e term arises.
Splitting, otherw ise known as dissociation, an aspect of borderline
personality disorder in particu lar, an d a recognized psychological event in general, is defined and described in th e following literatu re review. Such behavior is of specific in te re st to this research study.
Another key theoretical dom ain of th is study is th a t of se lf theory. Accordingly, a b rief orientation to a selected range of postulations an d research concerning th e concept of self h as been included.
Preparation of th e following review of th e literatu re preceded th e interview ing of participants an d subsequent d a ta analysis. An additional
12 litera tu re review was undertaken consequent to the emergence of unforeseen them es and concepts. The la tte r lite ratu re review is woven into the text throughout the dissertation.
Borderline Personality Disorder Definition of Borderline Personality Disorder
The fourth edition of th e Diagnostic and Statistical Manual o f M ental
Disorders, a publication by th e Am erican Psychiatric Association (1994)
suggests nine criteria in diagnosing Borderline Personality Disorder [BPD]: A pervasive p attern of instability of interpersonal relationships, self- image, and affects, and m arked im pulsivity beginning by early
adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
(1)
fi'antic efforts to avoid real or im agined abandonment.Note:
Do not include suicidal or self-m utilating behavior covered in Criterion 5.(2) a pattern of unstable and intense interpersonal relationships
characterized by altern atin g between extrem es of idealization and devaluation
(3) identity disturbance: m arkedly and persistently unstable self-image or sense of self
(4) impulsivity in a t least two areas th a t are potentially self-dam aging (e.g., spending, sex, substance abuse, reckless driving, binge eating).
Note:
Do not include suicidal or self-mutilating behavior covered in Criterion 5.(5) recurrent suicidal behavior, gestures, or threats, or self-m utilating behavior
(6) affective instability due to a m arked reactivity of mood (e.g.,
few hours an d only rarely more than a few days) (7) chronic feeling of em ptiness
(8) inappropriate, intense anger or difiBcnlty controlling a n g er (e.g., frequent displays of tem per, constant anger, recurrent physical fights)
(9) tran sien t, stress-related paranoid ideation or severe dissociative symptoms
cu ltu ral: DSM-IV states th a t BPD has been identified in m any
settings around the world.
gen d er: 75% female
p rev a len ce: 2% of general population, 10% of individuals in m ental
h ealth clinics, 20% among psychiatric inpatients.
Origins of the Term “Borderline”
There is a su b stan tial body of literature on borderline personality disorder th a t details such areas as diagnostic criteria, treatm en t approaches, developmental difficulties, and psychodynamic structures. There is also a range of understandings on the origin and m eaning of the term “borderline”. The textbook. Abnorm al Psychology and Modern Life (Carson, B utcher & Coleman, 1988) explains th a t individuals with borderline personality
disorder show a p atte rn of behavior th a t is recognized as not only containing features of the personality disorders but also of the more severe psychological disorders, particularly th e affective disorders. Therefore, the term borderline indicates a diagnostic distinction between two types of disorders.
14 A nother viewpoint on the origin of the te rm borderline personality disorder comes from H erm an (1992). She contends th a t som atization
disorder, borderline personality disorder, and m ultiple personality disorder were once subsum ed under the now obsolete te rm “h y ste ria ”. The prom inent features of these th ree disorders, nam ely the physioneurosis characteristic of som atization disorder, the deformation of consciousness prom inent in
m ultiple personality disorder, and the disturbance in identity and
relationship common in borderline personality disorder, are “descriptive fragm ents of the condition th a t was once called h y ste ria ” (p. 126).
Langley (1994) credits Adolph Stem , a psychoanalyst, w ith first using th e term borderline in 1938. According to Langley, th e diagnosis developed from th e lim itations of psychotherapeutic tre a tm e n t a t th a t tim e. T hat is, if a p atien t could not tolerate the stress associated w ith psychoanalysis then he or she was labelled “borderline”; originally this te rm m ean t “borderline schizophrenic”. The problem lay in th e fact th a t th e psychoanalytic reliance on technical n eu tra lity and transference was fundam entally inappropriate for a client population whose m ain issues were abandonm ent and engulfinent fears. R ath er th a n acknowledge the lim itations of psychoanalytic treatm ent, th e “p atien t” was held responsible for the failure of th e therapy. Thus was th e beginning of a situation th a t exists to this day - clients w ith the label of “borderline” are considered “difficult” and u n treatab le.
The Pejorative Label “Borderline”
The pejorative n a tu re of th e b o rd erlin e" label can be understood to arise from a num ber of sources, th ese include: historical a ttitu d e s,
misogynistic tendencies, and th e effect of the borderline client’s defense system in combination w ith the th e ra p ist’s own issues.
From the 1930s through th e 1960s psychoanalysts focused on attem pting to increase the ego stren g th s of th eir “borderline clients” who, overwhelmed by th e ir difficulties in m anaging day to day life, would actually degenerate w ith treatm en t. Such a focus, in combination w ith the
psychoanalytic reliance on the therap eu tic relationship, g u aran teed the continuing lack of progress in tre a tin g borderline clients. T h erap ists who were experiencing disrupted and counterproductive th erap y w ith their borderline clients communicated w ith other therapists experiencing sim ilar problems; thereby the stereotype an d legend of the “difficult borderline client” was bom and perpetrated (Langley, 1994).
To this day the term “borderline” is used as a pejorative label, denoting an uncooperative and hostile client. H erm an (1992) states, “Some clinicians have argued th a t th e term ^borderline’ has become so prejudicial th a t it
should be abandoned altogether, ju s t as its predecessor term , hysteria, had to be abandoned (p. 123).”
It is likely not coincidental th a t the label “borderline” is most
16 percent of those diagnosed w ith borderline personality disorder are female (Carson et al., 1988). Langley (1994) suggesting th a t iatrogenic factors account for the preponderance of women being diagnosed with BPD, adds th a t it is possible th a t women raised in the U nited S tate s “are more subject to traum atic or BPD-inducing experiences th a n are m en” (p. 29).
A possible factor in the preponderance of women being diagnosed with BPD is th a t certain behaviors are considered more pathological in women th an in men. W aites (1993) suggests th a t women who dem onstrate
characteristics th a t a re considered particularly undesirable in fem ales are diagnosed with BPD far more often than m ales displaying the sam e
behaviors, e.g., difBculties w ith impulse control, being excessively dem anding ra th e r than self-effacing.
The words of a woman diagnosed w ith borderline personality disorder speak to the suffering experienced by those subject to the prejudice
surrounding this diagnosis:
I know th a t th in g s are getting better about borderlines and stuff. Having th a t diagnosis resulted in my g ettin g trea ted exactly th e way I was treated a t home. The m inute I got th a t diagnosis people stopped treating me as though w hat I was doing had a reason. All th a t
psychiatric tre a tm e n t was ju st as destructive as w hat happened before.
harm ful. Not being able to tru s t anyone was the most serious e ffe c t... I know I acted in ways th a t were despicable. But I w asn’t crazy. Some people go around acting like th a t because they feel hopeless. Finally I found a few people along the way who have been able to feel OK about m e even though I bad severe problems. Good therapists were those who really validated my experience. (H erm an, 1992, p. 128)
A nother m anner in which the term borderline has engendered negative reactions by psychotherapists is through the actual relationship between client and therapist. M asterson (1981) hypothesized th a t unresolved depressive feelings in th erap ists could facilitate countertransference
reactions to borderline clients. A recent study (Rosenkrantz & Morrison,
1992) found th a t “certain dim ensions of th erap ist personality, including type of depressive experience and preference for m aintaining personal boundaries, would influence therapists’ perceptions of them selves and patients ...” (p. 550). T herapists who had th e ir own issues w ith dependency, neediness, feelings of loneliness, and fear of abandonm ent tended to react negatively to their borderline clients who struggle with these very issues.
Etiologv of Borderline Personalitv Disorder
A review of the literatu re on BPD and causation finds agreem ent th a t negative experiences contribute to the development of this disorder. Some sources include social factors (W aites, 1993), others focus strictly on early development (before th ree years) as the window period for the development of
18 BPD (M asterson, 1978). C urrently m any sources link a BPD diagnosis w ith childhood tra u m a (Briere, 1992; R eiker & Carmen, 1986; Zivney, N a sh & H ulsey, 1988) and some theorists contend th a t BPD is associated w ith post tra u m a tic stress disorder (Herm an, 1992, Langley, 1994) [definition to follow],
M asterson (1978), perhaps th e m ost well known Object R elations [OR] psychoanalyst who has w ritten on th is subject, claimed th a t th e developm ent of BPD was due strictly to the influences of a mother w ith BPD a n d th a t th e dam age occurred before the age of three. Over tim e M asterson h a s m od erated h is position to include the possibility of other (pathological) m o thering factors th a t m ay contribute to the development of BPD (Langley, 1994).
According to M asterson (1978) it is during the separation (locomotion)- individuation (communication) process, w hen the toddler is stru g g lin g w ith th e developm ental ta sk of dependency vs autonomy, th a t the m other
dam ages th e child by w ithdraw ing h er support. When tension develops around th e toddler’s efforts to be autonom ous in thought, speech, feelings, a n d actions th e integration of opposing qualities, e.g., all-good self im age an d all-bad self image, cannot occur. W ithout th is integration the child
experiences feelings of abandonm ent and shame. A false self, one th a t will not identify or activate individuated thoughts, is created to avoid trig g erin g th e m other’s rejection or punishm ent for self expression.
M asterson (1978) asserts th a t the BPD-inducing developm ental a rrests cannot be reversed or neutralized. The child develops into an ad u lt who reacts intensely to any loss or separation, h as profound difBculty w ith rejection, and is extrem ely defensive.
In contrast to M asterson’s explanation of the etiology of BPD, current sources claim th a t borderline personality disorder is traum a-based and th a t all individuals diagnosed w ith BPD have unresolved p o sttrau m atic stress disorder [PTSD] in th eir background (Herm an, 1992; Langley, 1994). PTSD is diagnostically defined by the DSM-IV (American P sychiatric Association,
1994) as:
A- The person has been exposed to a trau m atic event in which both of the
following were present:
(1) th e person experienced, witnessed, or was confi'onted w ith an event or events th a t involved actual or th reaten ed death or serious injury, or a th re a t to the physical integrity of self or others
(2) th e person’s response involved intense fear, helplessness, or horror.
N ote: In children, this may be expressed instead by disorganized or
ag itated behavior
B. The traum atic event is persistently reexperienced in one (or more) of
the following ways:
(1) recu rren t and intrusive distressing recollections of th e event, including im ages, thoughts, or perceptions. Note: In young children, repetitive play m ay occur in which themes or aspects of th e tra u m a are expressed.
(2) recu rren t distressing dreams of the event. N ote: In children, there may
be frightening dream s without recognizable content.
(3) acting or feeling as if the traum atic event were recu rrin g (includes a sense of reliving the experience, illusions, hallucinations, and
20 dissociative flashback episodes, including those th a t occur on
aw akening or when intoxicated). N ote: In young children, trau m a- specific reenactm ent may occur.
(4) intense psychological distress a t exposure to internal or external cues th a t symbolize or resemble an aspect of th e traum atic event
(5) physiological reactivity on exposure to in te rn a l or external cues th a t symbolize or resemble an aspect of th e trau m a tic event
C. P ersistent avoidance of stim uli associated w ith the traum a and num bing of general responsiveness (not present before traum a), as indicated by th ree (or more) of th e following:
(1) efforts to avoid thoughts, feelings, or conversations associated w ith the trau m a
(2) efforts to avoid activities, places, or people th a t arouse recollections of th e traum a
(3) inability to recall an im portant aspect of the trau m a
(4) m arkedly dim inished interest or participation in significant activities (5) feeling of detachm ent or estrangem ent from others
(6) restricted range of affect (e.g., unable to have loving feelings)
(7) sense of a foreshortened future (e.g., does not expect to have a career, m arriage, children, or a norm al life span)
D.
P ersistent symptoms of increased arousal (not present before the traum a), as indicated by two (or more) of the following:(1) difficulty falling or staying asleep (2) irritability or outbursts of anger (3) difficulty concentrating
(4) hypervigilance
E. D uration of the disturbance (symptoms in C riteria B, C, and D) is more th a n 1 month.
F. The disturbance causes clinically significant distress or im pairm ent in
social, occupational, or other im portant areas of functioning.
Specify if:
Acute: if duration of symptoms is less th a n 3 m onths Chronic: if duration of symptoms is 3 months or m ore
Specify if:
With D ela y ed O nset: if onset of symptoms is a t le a st 6 m onths after the
stressor
Langley (1994) contends th a t all individuals w ith BPD have a co diagnosis of PTSD and th ere is no age lim it on w hen th e tra u m a has to have occurred. Langley’s model presented in Self-M anagem ent Therapy for
Borderline Personality D isorder m aintains th a t it is th e severity and
repetitiveness of the trau m a , not th e tim ing of it, th a t leads to the
development of BPD. Dissociation and damage to th e self-structure are the links between BPD and PTSD according to Langley, who relies upon
Kohut’s work to explicate concepts of the self and self-structure.
The work of Heinz Kohut, who during the 1960s an d 1970s developed the theory of self psychology, a post-Freudian version of psychoanalysis, describes the development of self out of self-object experiences (Langley, 1994).
Kohut describes th e “self” as it
22 constituents th a t emerge in to a coherent and enduring configuration during th e interplay of in h e rite d and environm ental factors w ith th e child’s experience of its e a rlie st selfobjects ... As a u n it th a t endures over tim e, [the self] develops in th e lawful gradual m an n er of
psychological structures. Among its core attributes, th e self is th e center o f initiative, recipient of im pressions, and repository of th a t individual’s particu lar constellation of nuclear am bitions, ideals, talen ts an d skills. These m otivate and perm it it to function as a self- propelling, self-directed a n d self-sustaining unit, which provides a central purpose to the personality and gives a sense of m eaning to th e person’s life. The p attern s o f am bitions, skills, and goals, th e tension between them , the program of action they create, and th e re su lta n t activities th a t shape the individual’s life are all experienced as
continuous in space and tim e and give th e person a sense of selfliood as an independent center of in itiativ e and independent center of im pressions. (Wolf, 1988, p. 182)
Selfobject is described as m eaning
...n eith er self nor object, b u t the subjective aspect of a self- su stain in g function perform ed by a relationship of self to objects who by th e ir presence or activity evoke and m aintain the self an d th e
experience of selfhood. As such, th e selfobject relationship refers to a n intrapsychic experience a n d does not describe the interpersonal
relationship betw een the self a n d other objects (Wolf, 1988, p. 184) T he diagnostic criteria for BPD include dissociative sym ptom s as a specific criterion [see DSM-IV Definition, #9]. Dissociation is a defense m echanism in th a t it is employed to protect the self stru c tu re fi*om traum a-induced vulnerability. “S tru ctu re” in the psychological sense m eans “p a tte rn based upon repetition”. The self structure re su lts firom consistent self-object experiences. W hen an individual experiences
overw helm ing situations of high em otional impact and a t odds w ith his or h er previous self-object m e a n in g s th e n the self structure m ay be “broken” either tem porarily or perm anently (Langley, 1994). It is th is “breaking” or dam age to th e self stru ctu re and th e re su ltan t use of dissociation or
sp littin g th a t Langley highlights as th e link between BPD a n d PTSD. B riere (1989) also rejects the psychoanalytic contention th a t BPD is a disorder due to inadequate or dysfunctional m aternal n u rtu ra n c e w ithin the first few years of life. Through h is cfinical practice an d research Briere (1989) h a s concluded th a t a history of childhood sexual abuse “m ay
predispose some individuals to behavior th a t satisfies borderline
diagnostic criteria” (p. 36). In a la te r book Briere (1992) expands on this connection betw een childhood abuse an d a diagnosis of BPD by statin g th a t it is likely th a t th e behaviors associated with BPD are chronic
reactions an d accommodations rela ted to early childhood ab u se including psychological, physical an d sexual abuse.
24 H erm an (1992) found th a t 81% of women diagnosed w ith BPD had histories of severe childhood trau m a. She cites a number of stu d ies th a t confirm a relationship between sym ptom s of borderline personality disorder and a history of childhood tra u m a (Hermans, 1992). W aites (1993) also finds a direct relationship between childhood tra u m a and a la te r diagnosis of BPD. She states th a t “substance abuse, fa m ily violence, and social barriers to female individuation and independence also
probably contribute to the kinds of pathology diagnosed as borderline” (p. 17).
Splitting
A phenomenon of specific in te rest to th e research study is th a t of “splitting”. This next section will provide definitions of key concepts, and a n exploration of w hat is m eant by th e term splitting, and how it occurs.
Definitions of dissociative disorders, splitting and stru ctu re
C entral to the difficulties experienced by those individuals diagnosed w ith BPD is the concept of splitting. S plitting may be understood to be a type of dissociation (Grotstein, 1981). The DSM-IV describes th e essential featu re of the dissociative disorders as a “disruption in the usually
in teg rated functions of consciousness, memory, identity, or perception of the environm ent. The disturbance m ay be sudden or gradual, tra n s ie n t or chronic” (American Psychiatric Association, 1994, p. 477).
splitting have differing intellectual histories. However, they Eire simileir in their applied clinical meaning.
Object relations theory and splitting
Object Relations (OR) developed in th e 1960s as a post-Freudian
psychoanalytic theory and therapy model. A significEmt difference betw een previous psychoanalytic theories and OR w as th e inclusion of
psychologicsd and social psychologiceil forces in understanding h u m a n behavior. In th e late 1960s and early 1970s OR theory was responsible for defining th e development Eind describing th e behavior of th e borderline personality an d thereby removing th e nondescript m eaning of th e term borderline fi-om being n eith er a neurosis nor a psychosis (Langley, 1994).
Langley (1994) states th a t in 1967, K em berg, a psychoanalyst, identified “splitting” as a central process in th e development of a
borderline personality organization. S p littin g w as defined as “a ce rtain lack of integration of the ego” (Langley, 1994, p. 97). The term sp littin g had been discussed as esirly as 1950 by th e B ritish School of Object
Relations, describing it as a personeility defense mechEinism, b u t i t w as not recognized in the U nited S tates as clinically significant until K em b erg ’s work (LEingley, 1994).
How splitting occurs
Beginning w ith the infant, two sta te s m ay be assum ed to be
26 tim e th e in fan t is “fused” w ith th e prim ary caregiver in th e sense th a t the infant is not aw are th a t th e caregiver is separate from his or h er self, although th e in fan t will associate “feel good/feel b a d ” sta tes w ith w hat the caregiver/infant does. This dichotomous aw areness can be called
“regulatory splitting” and it is a n essential elem ent of healthy self development. It is during th is so-called “symbiotic p h ase” th a t the
formation of identity develops; satisfying experiences are th e beginnings of the positive self-identity and fru stra tin g experiences serve as th e initial traces of th e negative self-identity. Initially th e tw o p a rt self-identities (satisfying an d frustrating) are separate, w ith in teg ratio n occurring by age six or seven. T his unified self-identity is an exam ple of w hat object
relations theory refers to as “object constancy” (M asterson, 1978). W hen th e firustrating experiences are more p rev alen t th a n the satisfying ones th e infant is th o u g h t to develop a “false self” in order to please or placate the caretaker, thereby gaining th e in fan t more satisfying symbiotic experiences. According to OR theory it is during th e
development phase of separation-individuation (18-48 m onths) th a t the self-functions originate th a t a re absent or lacking in ad u lts w ith BPD, e.g., boundaries, autonomy (M asterson, 1978).
Simply pu t, it is the consistency and continuity of positive early experiences th a t enable an individual to develop a s a n integrated, independent self. Conversely, “experiences th a t a re too intense or too
unintelligible, th a t are too a t variance w ith the individual’s experience hase, or th a t occur too inconsistently, can fragm ent or split th e self” (Langley, 1994, p. 38).
An im portant concept in understanding the stru ctu re of self is the “interpenetration” of opposites. Beginning with the “feel good/feel had sta tes” of infancy, psychological experience tends to he a m ixture of opposite qualities, e.g., most experiences include both fru stratin g and satisfying dimensions. When opposite qualities are in terp en etrated an in teg rated self is structured which allows for a t least two self functions to develop. According to Langley (1994) these are: “F irst, th e self can provide its own check and balance function as a way to w ard off extrem e or “all-or- none” reactions. Second, the self can m odulate its own responses so th a t a more selective response or m eaning has a chance to occur” (p. 39). When interpenetration of opposites does not occur w ithin a se lf th en th a t self is split, leading to impulsive behaviors, either-or thinking, and distorted meaning-making.
A dynamic tension results from th e interpenetration or integration of opposites th a t provides a cohesion and stability to th e self. Individuals diagnosed with BPD are lim ited in th e ir ability to in te g rate the
oppositional aspects of experiences and therefore they ten d to have a distorted and “flat” perception of them selves and fu tu re possibilities (Langley, 1994).
28 R egulatory splitting and self-defense sp littin g
It may easily be argued th a t splitting is an integral function in our processing o f psychological events, therefore it is necessary to distinguish between regulatory (helpful) sphtting and th e type of splitting th a t can occur in individuals w ith BPD - self-defense splitting (Langley, 1994).
Regulatory sp h ttin g allows us to order inform ation and form categories th a t are m u tu ally exclusive, A ristotelian logic operates in this m anner. When we sequence psychological events an d prioritize categories in order not be to overwhelm ed we are practicing regulatory sphtting. M aking choices and responding to one’s own preferences in an orderly m an n er are also products of regulatory sphtting. Being able to distinguish in te rn al events such a s feelings, thoughts, beliefs an d to distinguish these from others’ feelings, thoughts, beliefs etc., leads to an o th er outcome of regulatory sp littin g th a t is the ability to m a in tain a clear sense of self while relatin g interpersonally (Langley, 1994).
Self-defense sp h ttin g involves the ordering of psychological events contingent on the avoidance of painful reahzations or awarenesses. This distorting sp littin g leads to idiosyncratic behefs and m eanings about self, others, and relationships. Chaos ensues from self-defense sphtting since prioritizing, choicemaking, and preferencing are all based on the
individuals’ need to m aintain an illusory u n d erstan d in g of self and others. Isolation, a n d fu rth er effort are required in order to protect the self from
acknowledging th e distorted view (Langley, 1994).
It is ap p aren t th a t individuals who depend on self-defense sp littin g will experience a g reat deal of difBculty in th e ir day-to-day lives and indeed if we tu rn to th e DSM-IV diagnostic crite ria for BPD each crite ria m ay be understood to have splitting as its driving force.
A D escription of th e Problematic Life of Individuals w ith Borderline B ehaviors
W hile it has been acknowledged th a t some women are diagnosed w ith BPD not because of th e ir own sense of dissatisfaction w ith the quality of th e ir lives, b u t because of the a ttitu d e s of a cu ltu re th a t finds th eir
im pulsive and dem anding behaviors unacceptable, th ere are many
individuals diagnosed with BPD who are in g rea t distress and who w a n t a n improved quality of life. These individuals sh are common difficulties in achieving stable employment, lasting relationships, and an in teg rated sense of self.
The behaviors th a t are common to individuals who m eet the diagnostic crite ria of BPD stem largely firom an im paired, incomplete, shifting sense o f self. The experience of BPD is to feel em pty an d split. The DSM-IV
(1994) describes th e identity disturbances of BPD as “sudden and d ram atic sh ifts in self-image, characterized by shifting goals, values, and vocational asp ira tio n s” (p. 651). Sudden changes in types of fiiends, sexual id en tity , opinions an d plans a re common. Individuals m ay perceive events (in tern a l
30 and external), people, and relationships, in term s of “either-or”, m eaning th a t they do not m aintain a sense of th e “big picture” a n d therefore believe in th e m om ent th a t w hat is perceived is all there is. The individual who experiences th is kind of spht, “either-or” understanding of relationships will have difBculties m anaging conflict in relationship. F o r exam ple, she m ight beheve th a t an argum ent w ith a friend is an indictm ent of her whole self r a th e r th a n simply a difference of opinion. Com pounding the problems w ith integ ratin g conflict as a functional aspect of relationships, is the added difBculty she has in feeling close to others. D ue to h e r lack of an in teg ra ted identity and a poor sen se of boundaries she will ten d to feel either engulfed or abandoned by others.
The im pulsivity, addictive tendencies, emotional reactivity and lability, a n d shifting career and personal aspirations, th a t a re hallm arks of individuals diagnosed with BPD a rise firom a profound in ab ility to m ain tain a stab le sense of identity. T hese experiences of lack of self tend to occur w hen th e individual is feeling unsupported and w ithout a
connection to a m eaningful relationship. The loss of ex tern al stru ctu re th a t occurs w hen a relationship ends can precipitate profound changes in self-image. P ersons w ith BPD “are very sensitive to environm ental
circum stances” (American Psychiatric Association, p. 650).
Cohen & G ara (1992) assert th a t th e self-reference of those diagnosed with BPD consists of opposed clusters of self, rath er th a n th e more usual
me and not-me contrasts. T he individual w ards off the onset of a psychosis
by enacting th e opposing self. T his dichotomous self-structure hm its the ability of the individual diagnosed w ith BPD to rem ain in positive self sta tes for any length of tim e.
Given the problematic self-structure an d subsequent m aladaptive coping mechanisms of individuals m eeting diagnostic criteria for
borderline personahty disorder it is evident th a t integrated self-relations are a necessary aspect of psychological well-being.
The following studies investigate various aspects of the etiology and treatm en t of borderline personality disorder.
C urrent Research
Recent research (N ajavits & G underson, 1995) indicates th a t th ere is a tendency for erratic im provem ent over tim e w ith individuals diagnosed w ith BPD. The study followed 37 women (aged 17-35 yrs) for a three-year period and found significant im provem ents in several areas and no
significant deterioration. The DSM-IV (1994) also reports a tendency
tow ard improvement over tim e: “diiring th e ir 30's and 40's, the m ajority of individuals w ith this disorder a tta in g reater stability in th eir relationships and vocational functioning” (p. 653).
A number of current studies focus on th e etiology of borderline
personahty disorder, such as P atrick, Hobson, Castle and Howard’s (1994) exam ination of th e association betw een troubled interpersonal
32 relationships and p articu lar kinds of self-structuring. They found a
relationship between style of interpersonal relationship and m othering experience, e.g., low m atern al care, high m atern al overprotection. A study by Torgersen (1994) found a slight genetic influence in the developm ent of borderline personality disorder. The DSM-IV (1994) reports a fam ilial p attern in th a t a diagnosis of BPD is five tim es more common am ong first- degree biological relatives of those w ith the disorder th a n in the general population.
O ther recent research studies range fi'om a n exam ination of self
stru ctu re and self-states in borderline personality disorder (Cohen & G ara, 1992; Ryle & Marlowe, 1995) to reviews on th e efficacy of drug tre a tm e n t and the surrounding issues involved in determ ining efficacy (Soloff, 1994; Rosenberg, 1994).
P a m a s (1994) argues th a t research of “borderline conditions” h a s been severely limited due to an exaggerated em phasis on reliability an d not enough concern paid to validity issues. He suggests th a t methodological shortcomings could be overcome by the inclusion of phenomenological observation, prototypical approaches, and insights fi'om studying “n o rm al” populations.
Theories on th e N ature and C haracter of th e Self
Theories of the self m ay be broadly divided between those th a t support the W estern concept of a bounded, independent, u n ita ry self (Kohut, 1977;
M ahler, 1968) and the relatively recent focus on self as m ultiple, shifting, and discursively constructed (Gergen, 1991; W hite & Epson; 1990). A range of theoretical postulations concerning th e n a tu re of self-relations is briefly described in the following section. T he review of the literatu re will concentrate on th e more recent concepts of self.
The m anner in which self-reference can profoundly affect our future course is explored by M arkus and N urius (1986). They examine th e notion of possible selves (cognitive components of hopes, fears, goals, and th re a ts for th e future and of the past), their effect on self-concept, and th e link between self-concept and motivation.
C ultural differences are also identified as factors th a t affect self relations by M arkus and K itayam a (1991). T hey propose th a t Asian cultures foster an interdependent notion of th e self, w hereas W estern cultures em brace an independent notion of th e self. Therefore, differing cultural construals of the self and of others, will influence, and possibly determ ine, th e n atu re of individual experience.
In a discussion focusing on intrapersonal positioning, th a t is, “the process by which persons position them selves privately in internal discourse" (Tan & Moghaddam, 1995, p. 388), th e au th o rs argue th a t culture defines the boundaries of the self. T hey propose th a t the “dividing line between th e self and the social and/or n a tu ra l environm ent is not definite and m ay be draw n a t different places, varying w ith contexts and
34 cultures" (p. 397).
Another cross-cultural perspective comes from Ewing (1990) who m aintains th a t in all cultures people can be observed to project m ultiple, inconsistent self-representations th a t are context-dependent and may shift rapidly w ith or w ithout th e person’s awareness.
An interesting accounting for the notion of holding m ultiple “I”
positions comes from H eshusius (1994). She notes an elem ent of fear in the literature on m anaging one’s subjectivity, and th a t th ere is anxiety about merging, about m ain tain in g distance, and anxiety about th e necessity of rigorously accounting for one’s subjectivity. H eshusius suggests that;
as a consequence of such anxiety, we create th e idea of distinctly separate “I’s” w ithin one person: th e T th a t is doing th e restraining, and the “I’s” th a t need th e restraining. But are they separable in the first place? Or is th e separation an illusion, created by our
psychological need to be in control of something - if not our “objectivity” th en our “subjectivity? (p. 19)
Sampson (1985) tu rn s to nonequilibrium physics to explore his contention of a revised ideal of " ...personhood as a decentralized,
nonequilibrium stru ctu re, a pantheon of selves w ithin a single body ..." (p. 1210). He proposes th a t th e W estern reliance on th e concept of a u n itary self may lim it our understanding, our growth, and may be destructive in term s of our evolution.
Another use of th e physical sciences in hypothesizing about th e n atu re of the self is presented by Schwalbe (1991), who strives to cap tu re an understanding of th e self as a “dynamic whole” or “nonlinear dynam ical system ” (p. 269). He applies the concept of autogenesis, the process of self organizing in the physical world, to the development of self.
Hermans, Rijks, and Kempen (1993) designed research methodology to support the theory th a t “th ere is no single ‘F as an agent of self
organization but several, relatively independent T positions th a t
complement and contradict each other in dialogical relationships” (p. 207). H erm ans (1992) adopts a constructionist perspective on self th a t he term s “dialogical”. His methodology relies on using narrative as a m eans to understand hum an experience.
A study th a t exam ines the m anner in which individuals m a in ta in multiple, role-specific, self-conceptions as well as a consistent sense of self was conducted by Roberts and Donahue (1994). They concluded th a t
“people see th eir self-concepts both differently and consistently across social roles” (p. 214).
Victor De Munck (1992) also developed a research design to study self. He uses this study to support his contention th a t there is no integrated, single self but only a self symbol th a t gives the illusion of a unified, coherent self.
36 pregnancy challenge assum ptions regarding the self s boundedness,
singularity, and integration. Johnson proposes th at th e self is b etter
characterized by non-integration and decentred agency. The experience of pregnancy entails a loosening of boundaries, both physical and psychic as a woman’s shape inexorably changes an d she struggles to do th e psychic work necessary to accommodate having a n internal, tem porary, guest.
A them e th a t emerged from my research on the experience of an alteration in psychology during pregnancy (Snell, 1992) is the notion th a t changes in self-relations m ight occur during pregnancy. The following is quoted from my M aster’s th esis (Snell, 1992);
As well as being responsible for forming and birthing a new being, a pregnant woman, p articularly w ith a first pregnancy, needs to crea te a self who has another being growing inside her, a self who is now
affecting someone else w ith everything she ingests and possibly w ith every thought, a self whose sta tu s in society changes abruptly and dram atically, a self who will give b irth and parent this new being. From the first knowledge th a t conception has taken place, a p reg n an t woman m ust incorporate into her self concept many new roles th a t may be in direct conflict w ith h er nonpregnant self. It could be said th a t a pregnant woman creates and gives birth to a new p a rt of h e rse lf as well as giving b irth to a baby. (p. 73)
conceptions of self by Glass (1993), the au th o r o i Shattered Selves:
M ultiple Personality in a Postmodern World. He captures th e profound dis
ease experienced by those individuals who do not enjoy a stable
subjectivity a n d contrasts th a t pain with th e postm odernists’ idealization of m ultiplicity or fragm entation of self. According to Glass (1993), the deconstractive practices of postmodernism, which advocates th e reduction of “self” to a F oucaultian concept th a t “th e re is no inner a n d o u ter self, m erely practices and ideologies th a t constitute the self as a consciousness in language” (p. xi) represent a gulf between theory and lived experience.
In his analysis of French theorists, philosophers, and psychoanalytic fem inists (he believes postmodernism to be “more complex” th a n w hat has been adapted to th e American context) Glass (1993) argues ag ain st the postm odernist theory of self. He notes th a t the fem inist th eo rists “often d ep a rt from those of the postmodernists, especially from those concerning th e sta tu s of th e self, the n atu re and construction of gender and identity, th e presence of suffering, and th e place of healing” (p. xiii).
H e com pares K risteva’s, a practising psychoanalyst, support of the necessity of a bounded and gendered self, to th e convictions of
postm odernists such as D errida, Lyotard, and B audrillard who “would leave th e self w ithout identity” (p. 19). Glass contends th a t th e
postm odem istic assertion th a t “th e self is simply a reflection of reality, or m etareality or hyperreality, therefore consciousness, if it chooses, is free to
38 deconstruct those realities an d assum e or internalize an infinite variety if identities” (p. 25), is callously simplistic in its blindness to hu m an
suffering.
Glass (1993) asserts th a t postmodernists “m istakenly confuse w h at a core self ‘is’ w ith th e lack of fireedom to reject the past, convention,
norm ality, and so on” (p. 126). He contends th a t a stable subjectivity is necessary in order to indulge in the deconstruction of identity.
Summarv
A review of th e literature h as been provided concerning (a) borderline personality disorder, and w ithin th a t area the psychological phenom enon of splitting, and; (b) current theories of the self, have been described.
The principal implications from the review of literatu re on borderline personality disorder are (a) th e definitions and descriptions of influences on the development and experience of self-structure provide working definitions and constructs for th is study on self-relations; (b) th e need for com passionate understanding and treatm ent for individuals diagnosed w ith BPD emerges fi'om this review and underscores the necessity of studying self-relations; and (c) the disordered lives of individuals m eeting diagnostic criteria for BPD serve as an extreme example of w h at likely occurs w ith less intensity or fi*equency in the lives of all individuals (Kroll, 1993), and therefore increases our understanding of the dynam ics of self- relations in general.
