Tag Archives: Accountability

The BPD Behavior Double Bind

Attention-seeking, manipulation. Many borderline personality disorder patients are accused of these, and I struggle as I come to terms with the fact that, indeed, a lot of my behavior at least comes across like this. For example, a few weeks ago, my crisis prevention plan was changed to the effect that staff no longer need to make me come back if I run off. It’s up to me to decide whether to run off and, if I do, what to do about it. After trying to communicate my discomfort with this change and being told off with references to choices and responsibility a few times, I ran off and wandered for about an hour until the staff eventually decided to find me.

I can see in a way how this can be interpreted as manipulative. The staff also said I have tremendous power when deciding to run off, because there is no way the staff can responsibly not take care of me eventually.

To my defense, I find myself in situations many times where I communicate in a normal way that I need support and am not being heard because other patiets, with different diagnoses, are acting out more. For example, today I asked the staff to take me on a walk because I was feeling irritable. They couldn’t, because there are several patients in a psychotic break right now. I rationally understand that my needs need to go on the back burner when people are in more severe conditions, but at the same time, this feels like a double bind. If I act out, I’m attention-seeking, manipulating and it’s my responsibility, but if I ask for support in a normal way, I’m obviously not sick enough to need it. In this situation, how am I supposed to show that I’m genuinely not coping?