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Fear

Why Is Emotional Splitting So Hard to Deal With?

Three ways to respond when someone presents with an all-or-nothing attitude.

“I hate you,” my client screamed as she walked out the door. “You don’t know what the f**k you’re doing.” She had spent the session telling me what a bad therapist I was and assuring me that all of her friends, to whom she had described the terrible things I was doing, agreed with her.

As she left, slamming the door so hard that my office mates could surely hear, if they hadn’t already her the rageful tirade, I considered the possibility that this was the end of our work together. But, although some small part of me hoped that she might actually never return, I knew from experience that that wasn’t how things would pan out.

Following a pattern set months earlier, she would return for her next session as though nothing had happened between us. Or, equally possible, she would come in and tell me what a fabulous therapist I was. She would also add that her friends, to whom she had reported some brilliant comment I made in the previous session (yes, the one in which she told me I was a terrible therapist), were all envious of her for having such a wonderful therapist.

While I was left with a mix of unpleasant residual feelings from that appointment, she would have left all of her negativity behind — until the next time I said something that wasn’t exactly what she wanted to hear from me, when we would start the cycle again.

This client was often difficult to work with, in part because this behavior captured one of her major difficulties in life: She tended see things in either/or terms. For her, things, experiences, and people were either all bad or all good, totally wonderful or totally worthless, completely positive or completely negative. It was often almost impossible for her to recall what she had loved or hated about something or someone when she was viewing them from the other perspective.

This tendency to separate things into all good or all bad is called “splitting” and is often seen in people who are diagnosed with borderline personality disorder, or BPD. Splitting can sometimes occur quickly and without apparent cause. It is often accompanied by shifting and intense emotions, problems with impulse control, and intense but unstable relationships, all of which can make it difficult to live with someone with BPD. These same difficulties can also make it hard for them to make the best use of talk therapy.

Years ago, the psychoanalyst Gerald Adler wrote that individuals with BPD did not benefit from a traditional form of once-a-week therapy because they suffered not from hidden fears but from a very specific form of separation anxiety. They often need more contact with their therapist, because they feel alone and anxious when separated from someone else. This is because splitting interferes with what clinicians call “object permanence,” an ongoing sense that someone you love cares about you and is still part of your life even when they are not with you — or when you are mad at one another.

Thus, a person with BPD can feel connected to a person they care about when they have intense loving feelings toward that person. But when the feelings switch, they may fear a loss of a connection — a fear which is often borne out when they are rejected by people who can no longer tolerate the ups and downs of the relationship.

Interestingly, even rageful emotions can serve to connect to another person. Terrible loneliness occurs when the intense connection, whether loving or angry, idealizing or denigrating, disappears completely. Yet, as Adler pointed out, understanding and talking about this pain is not enough to heal a tendency to split. I have found it useful to integrate this understanding of splitting with the tools provided by dialectical behavioral therapy (DBT), a form of therapy developed by Marsha Linehan, Ph.D., to help individuals with BPD learn to manage their emotions and impulses. The belief is that as an individual learns to use these tools, they will also develop healthier relationships.

Because BPD often affects every corner of an individual’s life, it is not something that changes quickly. Therapists, clients, and family members have to recognize that change occurs not only slowly, but in small steps. This is not always easy for family members, who may have suffered the consequences of a client’s behavior for many years.

123rf 91521288 Marharyta Stoika
Source: 123rf 91521288 Marharyta Stoika

I, therefore, encourage clients with BPD to talk to their families about the work we are doing and to offer them some tools for dealing with the client’s behaviors and emotions. It’s important to understand that this does not mean taking responsibility for the client, who must learn to take responsibility for his or her own actions, which can be hurtful and can drive others away.

If you are dealing with a loved one, a friend, or even a colleague who tends to split, you might try these three techniques with them:

  1. Set boundaries. While you cannot stop them from splitting, you can let them know that you can’t listen to them when they are yelling or saying hurtful things. A simple statement can help. For example, you might say, “I’m sorry, but I can’t process what you’re saying to me when you’re speaking like that. I’m going to end this conversation now, and we can take it up another time.” Of course, this is easier said than done, especially with a senior colleague or a parent. But no one has the right to yell at you, and you do have the right to set a calm, but firm boundary with them. In such a case, you might try saying something like, “I want to hear what you’re saying because I think you have a point. But I can’t process it when you’re yelling at me.”
  2. Affirm that your relationship will continue. Because of the fear of loss and abandonment that often accompanies BPD, it is helpful to remind a person that your relationship will continue even though you are angry at one another. This isn’t easy in the heat of an argument or when a person is telling you, as my client did, that you don’t know what you’re doing. But it’s helpful to remember that their anger and difficult behavior is only one part of the connection. As my client walked out the door, I reminded her that I would be waiting for her for our next appointment. Years later, she told me that that reminder had meant more than she could say at the time. “You were letting me know that we had a connection that I wasn’t breaking,” she said. “I was always destroying relationships with my anger, but you were saying I hadn’t destroyed ours.”
  3. Make space for your own feelings. You are allowed to be angry, hurt, resentful, and even to want to end the relationship altogether. If you don’t give those feelings their space, you won’t be able to move forward in this relationship. It’s not always a good idea to express them in the heat of the moment, since it can sometimes only escalate the conflict; but it can be useful to acknowledge them to yourself. Owning up to myself that I might secretly wish that this client would not come back allowed me to process that emotion, and then to acknowledge how much pain she was in — and her fear that she would, in fact, drive me away.

Splitting is not healed by forcing someone to see your point of view or to integrate their own intolerable and/or conflicting feelings. But over time, it can be diminished in the face of a relationship that can survive in the face of these intense, distressing, and conflicted feelings. However, a relationship cannot survive if the person who splits is not willing to work on managing his or her impulses and emotions. Both tasks are difficult — and both are key to making change.

It is, in the end, a combination of learning to manage the emotions and trusting that another person will hang in with you while you do so that can gradually make a difference.

Copyright@fdbarth2020

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References

The Psychotherapy of Core Borderline Psychopathology by Gerald Adler , M.D.

Published Online:30 Apr 2018https://doi.org/10.1176/appi.psychotherapy.1993.47.2.194

DBT® Skills Training Handouts and Worksheets, Second Edition by Marsha M. Linehan, Guilford Publications.

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