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Copyright 2002 Chicago Tribune Company

Chicago Tribune

May 22, 2002 Wednesday, NORTH SPORTS FINAL EDITION

SECTION: Woman News; Pg. 7; ZONE: C

LENGTH: 1115 words

HEADLINE: Coping with borderline personality disorder

BYLINE: By Barbara B. Buchholz. Special to the Tribune.

BODY:

Imagine a person believing they love someone romantically one moment; then

hating that person several hours later. Many of us flip-flop occasionally

in our feelings, depending on stress, anger, or unrelated factors. But,

others have emotions so intense that they frequently interact erratically

and also self-mutilate, through burning or cutting, or even commit

suicide.

Between 2 and 4 percent of the general population fall into this category,

classified as a borderline personality disorder. The vast majority are

women. Although their emotions wax and wane, the good news is that they

can learn to manage their disorder if they get proper treatment. A

downside: It may take several years.

First discussed in medical literature in the 1930s, BPD did not gain its

official classification as a mental disorder until 1980, when it was added

to the Diagnostic and Statistical Manual of Mental Disorders. Many lay

people still had not heard of it until greater strides were made and an

educational organization was formed, The National Education Alliance for

Borderline Personality Disorder.

More needs to be done. " We're 20 years behind in terms of research,

medication and family support, " says D. Hoffman, coordinator of the

dialectical behavior therapy day treatment program at New York

Presbyterian Hospital's Westchester, N.Y., division, in which 95 percent

of the patients are female.

Moreover, there's no definite agreement about the origin of the disorder

and appropriate treatments, says Randee Levitt, a clinical nurse and

colleague of 's.

For example, ph Santoro, a psychologist who helped found a residential

treatment facility for personality disorders in Brewster, N.Y., and who

authored " The Angry Heart: Overcoming Borderline and Addictive Disorders "

(New Harbinger Publications, $14.95), believes that the roots of BPD are

environmental rather than genetic. He recently spoke about BPD and its

ramifications for the patient and family. Following are his edited

responses:

Q. Can you be more specific in defining BPD?

A. It's somebody who does not possess a clear idea about their identity,

so that their attitudes and moods shift abruptly. They may not be certain

of their sexual orientation. They reveal extremes in their cognitive

thought processes regarding perceptions of themselves and others. The

" borderline " name is somewhat of a misnomer since the disorder occurs not

along a line between neurosis and psychosis but as a separate problem.

Q. How does it differ from schizophrenia and bipolar disorder?

A. In schizophrenia, there are psychotic symptoms, such as delusions,

hallucinations, paranoia. With bipolar, the main feature is a defined

episode of extreme mood swing.

Q. What are some reasons for the behavior?

A. Because we believe it has more of an environmental component, we think

it is due primarily to neglect and childhood abuse, including a

psychotraumatic series of physical or sexual events from before age 18. A

parent may not have wanted a child; a parent may have belittled a child

routinely. It's not due to one event but reflects a pattern so that the

BPD person feels inferior, unsafe and unable to take care of [herself] or

move forward. Their development gets interrupted.

Q. Why is it more associated with females than males, who are diagnosed

with narcissistic personality disorder?

A. Both BPD and NPD are similar in that they're part of the same family of

personality disorders. Women, however, are viewed as more emotionally

intense and tend to turn on themselves, sometimes through self-mutilation.

There's also a tendency among younger females to let men exploit them

sexually since they want to be loved. In contrast, men tend to act out

more with reckless driving, fighting, substance abuse. When you're

narcissistic, you have an easier time establishing relationships with

others and being charming.

Q. Why do women often go undiagnosed or are misdiagnosed?

A. Part of a successful diagnosis depends on the phase of the illness.

They may go to a psychiatrist and if they're also depressed that may

become the primary diagnosis. Or, if they exhibit great irritability, they

may be diagnosed as bipolar.

Borderline people may have some of those symptoms but also others. Intense

evaluation is needed to make a diagnosis, which is complicated by the fact

that it's hard to do so before age 18 when the human personality is still

being formed.

Q. What specific behaviors reveal BPD?

A. They are good at manipulating others. To cope, they may pick out one

person who they think is their savior and consider everyone else bad. In

doing so, they pit people against one another since they don't trust

anyone. When manipulation fails to produce desired results, they get angry

and may act self-destructively, frequently argue, threaten suicide or

commit suicide. In general, the American Psychiatric Association requires

that five or more of certain symptoms be present.

Q. How does someone get better?

A. With extended help that may require several years. We think the best

help is dialectical behavior therapy, which involves managing one's

actions and thoughts. At our facility, we work to gain trust, develop a

rapport, teach skills to identify what triggers the behavior, explore

alternatives, and treat the original trauma that may have occurred.

Q. Can people with BPD develop meaningful relationships?

A. Yes, but there may be a strong element of conflict because they

misperceive motives and intentions and fear abandonment. The reasons the

illness is so hard for families are the suicide threats and attempts and

the self-injury. With a cutback in mental health care services, families

must expect more emergency room visits and multiple crises.

Q. Are there medications that help?

A. No one medication does the trick, but several are recommended that

stabilize mood and outlook, such as lithium.

Q. Can you suggest books or Web sites?

A. A good book is " I Hate You, Don't Leave Me " by Jerold Kreisman (Avon,

$6.99). Web sites include health.com with a test for BPD and

borderlinepersonalitydisorder.com.

Identifying signs of the disorder

Here are some of the official diagnostic criteria from the American

Psychiatric Association:

- Frantic efforts to avoid real or imagined abandonment

- A pattern of unstable and intense interpersonal relationships

- Unstable sense of self and identity

- Impulsive actions that are ultimately self-damaging, such as drug abuse,

excessive spending, reckless driving, or unsafe sex

- Unstable, intense moods or emotions that can be triggered by events and

may last hours or days

- Inappropriate or intense anger

-- Barbara B. Buchholz

LOAD-DATE: May 22, 2002

Copyright 2002 Associated Newspapers Ltd.

The Evening Standard (London)

May 17, 2002

SECTION: Pg. 29

LENGTH: 1094 words

HEADLINE: Why I tried to hurt myself;

Life & Style: At 21, novelist Emma Forrest was the toast of London. Life

should

have been great. But she had a terrible secret. As she reveals here for the

first time, manic depression was making her mutilate herself

BYLINE: Liz

BODY:

WHEN reading about a 25-year-old who is publishing her second novel, is

working on a screenplay, lives in a West Village apartment in New York where

she

writes for Vanity Fair, and has Weisz and Minnie Driver as best

friends,

the initial impulse is to dismiss her as yet another spoilt brat with more

hype

than talent. But Emma Forrest's new novel, Thin Skin, has been described as

" the

best study of a breakdown since The Bell Jar " . The heroine, Ruby, is a film

star

who cuts her arms, legs and belly with knives.

She eats doughnuts for breakfast and then vomits before her close-up.

What

gives the writing such stomach-churning clarity is that Emma Forrest cut

herself

and suffered from bulimia as a teenager, and was diagnosed with manic

depression

three years ago.

" The desperate feeling of unhappiness has been there for as long as I can

remember, " says Emma, " but I didn't know that what I was experiencing was

worse

than what any other 12 or 13-year-old was feeling. I would go to sleep and

pray

not to be alive. "

Emma's father is a solicitor, her American mother a writer. She attended

Godolphin and Latymer school in west London, and won a writing competition

aged

13. She interviewed Nigella Lawson, an old girl, for her school magazine.

Lawson was so impressed she recommended Emma to the Evening Standard,

which

commissioned her to review Madonna's Erotica album. Aged 16, she was writing

a

column for The Sunday Times, although she can't remember what she did with

the

money - " I think I spent it on Nikes " . She left school with one A-level, a

burgeoning career as a writer and Burchill as her mentor, but she felt

worthless and almost suicidal.

Emma had already started bingeing and vomiting, sometimes up to eight

times

a day. " I was an insane eater, I almost got food poisoning when I ate 20

packets

of salt and vinegar crisps in one go. I went to a very competitive school,

and

there were lots of anorexics being helped along the corridors, but I didn't

know

bulimia existed. I suppose I was trying to purge myself of misery. I was very

heavy at the time, so no one noticed.

" I had a disgusting rash on my face because I'd been sick so often, my

fingers were red from sticking them down my throat, my breath smelled of

vomit

all the time. I would look in the mirror after I'd been sick and the blood

vessels in my eyes were popped, I had vomit on my face, but people were still

saying, 'Oh, Emma's so young, Emma's so successful.' "

Emma says she always used to get home from school and draw all over her

face

and body with a pen, then wash it off in the shower. She says she had never

heard of anyone cutting their own flesh - or self-harming - but to her it

seemed

the logical next step. Women tend to turn their unhappiness against

themselves,

whereas men take their feelings out by being aggressive towards others.

" The first time I started cutting myself I was 17. I was in love with

someone who didn't love me back, and so when I knew I was going to see him I

would cut my body so I wouldn't be able to take my clothes off. "

Nobody in her family realised there was anything wrong - she admits she

was

a hyperactive kid, but her behaviour was put down to food additives, then

adolescent angst. In fact, she would eventually be diagnosed not only with

depression, but with a borderline personality disorder.

" I'm very close to my mum, but she had no idea; we were in Topshop one

day

when she saw my arms, and she started crying.

I'd never drunk alcohol or taken drugs, and so I suppose everyone thought

I

was OK. I could see how blessed I was, yet I was profoundly unhappy, and so

by

cutting myself I could pinpoint the pain, I could see the blood. "

EMMA decided to move to New York when she was 21, partly because her first

novel, Namedropper, had just come out over there to critical acclaim, partly

to

try to escape, to leave the depression, the cutting and the bulimia behind

her.

She was the cool new kid in town, invited to all the best parties, mixing

with

trust-fund kids and expat models but, if anything, the illness started to get

worse.

" I was obnoxious. It came to a boiling point when I hit my 20s and a lot

of

friends dropped me. I was, like, 'a bummer'. The upside of manic depression

was

that I felt like a superhero, it was an amazing feeling; I would do

life-endangering things like walk in front of speeding cars - I did that all

the

time. I would put my hand on a boiling radiator and I couldn't feel it. I was

afraid of confrontation, but when I was manic I would scream at people in the

street. When I was down, I would sleep all day. " She finally realised she

needed

professional help when she read the notes that would become Thin Skin, and

they

didn't make sense.

" A big part of me loves insanity - I'm obsessed with the turmoil of being

a

young woman, I love Buffy - and it has been hard to let go. It took a couple

of

attempts to find the right therapist, but now I have someone I can talk to.

I've

been on mood-stabilising drugs for two years, and the medication makes the

pendulum swing less. I now have volume control. " She also has what she calls

a

" blood-stabilising boyfriend " - a 6ft 4in carpenter. " I told him

everything, and it's a big step not to want to be around insane men.

He isn't someone who thinks Betty Blue is sexy.

If I ever slip, start to act crazy, he'll call me on it. I used to think

I

would never be able to have a normal relationship, or be well enough to have

kids.

" I'm now mentoring a girl who cuts herself, and I keep telling her, you

are

going to stop. The scars on my arms are fading, and even the nasty ones on my

leg aren't so bad. My friend Barbara says I look like an African tribe lady.

I'm still scared that I might have a relapse, I worry about what would

happen if the medicine stops working. I don't mind that I might have to take

drugs for the rest of my life; I'm happy now for the very first time. "

Emma regrets all those years not knowing what was wrong with her, and

thinks

that by speaking out, she can help others to get advice much sooner.

" What made writing the book so difficult was that I didn't want my

parents

to think it was their fault - I think my mum still blames herself. But

they've

been great, incredibly supportive. Manic depression is an illness, it's

nobody's

fault. "

Thin Skin is published on Monday (Bloomsbury, L6.99).

The National Self-Harm Network, PO Box 16190 London NW1 3WW.

Self-Harm Alliance, 01242 57 88 20, Wednesday to Sunday, 7-8pm.

Love and Hitler have/had BPD?

2 of 42 DOCUMENTS

Copyright 2002 The Washington Post

The Washington Post

May 20, 2002, Monday, Final Edition

SECTION: STYLE; Pg. C04; BOOK WORLD

LENGTH: 967 words

HEADLINE: The Promise of a Man

BYLINE: Gavin McNett,, a nonfiction writer and semi-professional musician

BODY:

SHAKEY

Neil Young's Biography

By Jimmy McDonough

Random House. 786 pp. $ 29.95Consider the people who become rock stars.

You

can pretty much assign them one by one, I submit, to the Cluster B of

personality disorders in the DSM-IV -- the diagnostic manual for

mental-health

practitioners. " Personality disorder " means that mental functioning is pretty

much all there, but warped in some basic way -- generally having to do with

not

having gotten enough attention as a child, or retaining childish mental

processes, or something of the sort. Because who else would want to be a rock

star as a life's career, really? Would you? I wouldn't.

Love would. She falls under borderline personality disorder:

enormous oversensitivity and insecurity, coupled with poor impulse control,

lots

of temper tantrums and selfishness, and a failure to see how one's actions

affect others. Bowie is histrionic personality disorder: overly

dramatic,

theatrical, attention-seeking; excessive concern with personal appearance.

Narcissistic personality disorder pretty much catches the bulk of them. But

what

about Neil Young?

Perhaps uniquely among frontmen and solo artists, Young is an avatar of

avoidant personality disorder. That's what Jimmy McDonough's book pegs him

as.

Its almost 800 pages chart a life in which the subject is always bugging out

on

situations, holing up, leaving people, not doing things and basically not

being

engaged whenever he's supposed to be -- and being engaging, as though

contrarily, when it's least expected.

The profile is classic. And it has made for a very interesting career.

Young

has always been an X-factor, doing beautiful acoustic albums and then

charcoal-smearing them with albums of blaring sludge; reaching pinnacles of

expectation and sales, and then turning out weirdo projects as though for

spite.

He hasn't always been good (or even just okay), but on the occasions when

Young's personal whims have crossed with the mainstream, he's often been the

most inspiring major artist in the running, and the best stylist and

songwriter

to match talent with sales and stardom. He's the only canonical '60s guy to

be

loved jealously by classic-rock shemps and hipsters alike.

McDonough's book is a 10-year project in which he followed the traces of

Young's career place by place and person by person, carrying on a decade-long

running interview with the man himself. It's a capital-W Work, the definitive

book on the subject, and it answers almost any question anyone would ever

want

to ask about the artist -- except for the most pertinent and difficult one,

the

bane of the biographer: Who is this man?

The man's career started in Winnipeg, Manitoba, in 1962, with a famous

father (Canadian author Young) and a mother, Rassy, who exhibited

enormous

oversensitivity and insecurity, coupled with poor impulse control, as it

were.

It began with pre-Beatles garage bands, and -- Hold on. A striking number of

charismatic famous people (and people with personality disorders) survived a

major childhood illness that kept them in bed and isolated for a long time,

drawing them inward and doing something odd to their psyches. ny Rotten

(narcissistic personality disorder?) had spinal meningitis; Adolf Hitler

(borderline?) had a bedridden period of that nature as well. Neil Young? He

had

childhood polio and, as McDonough quotes him, it was " scary. Couldn't move

very

well. Had to lay still for a long, long time. . . . If I close my eyes, my

left

side, I [still] don't really know where it is. "

After that, it was all just a little strange, and Neil was shy and sort

of

spacey -- and got into rock-and-roll via AM radio. He practiced guitar

constantly and joined garage bands, and never had much of a thought of a

normal

life again. Young left Canada in 1966 and ran into a carload of old friends

(including Stills) on an L.A. freeway and thereafter formed Buffalo

Springfield -- which he left soon after, then was coerced into rejoining,

then

left again to go solo. He rejoined again and left again, first going solo and

then being drawn into Crosby, Stills and Nash, which he soon left to go solo.

Says Young about his bestselling album, 1972's " Harvest " : " Seclusion was a

big

part of it. I liked the idea of bein' able to get away. Control that part of

it.

Not be on the frontlines all the time. " Toward the " control " end of it, as

McDonough details, Young early began using amateurs and small-potatoes

session

guys as musicians, and has always broken up and reformed his bands -- Crazy

Horse, the Stray Gators, combinations thereof -- with dizzying frequency,

always

keeping one leg out of the bed and on the floor.

McDonough follows Young's career past " Harvest, " past the mega-decibel

garage-rock of " Zuma " and (later) " Rust Never Sleeps, " and past all the

difficult weird periods in the '80s, where he explored rockabilly, country,

soul

and Euro-technopop. The next decade was a watershed, during which Young

essentially preempted grunge with the hit " Rockin' in the Free World. " He

hasn't

done a bad record since.

But the surprising thing about Young's late career, as McDonough shows,

is

that his metier isn't really music at all -- it's a far more solitary

pursuit.

Young has been a model-railroad enthusiast since childhood. He evolved into a

fanatic with a multi-thousand-square-foot train building as he grew older and

richer, and in 1995 he headed a consortium that bought the Lionel model-train

company. In the end, the shy, avoidant rock star is the same as the boy he

used

to be -- alone, insulated, and in suzerainty over his model-train domain.

McDonough asks Young about his entire career: " Why did you do all this? "

" Just

follow your dream, " Young answers. " That's what I did. "

LOAD-DATE: May 20, 2002

Randi Kreger

RandiBPD@...

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