Borderline Personality Disorder and Experiential Treatment

When Julie swallowed the painkillers, it was her mother who found her and called the paramedics. Julie’s father arrived as his daughter was fighting with the paramedics. In an attempt to save his child, Julie’­s dad removed the belt from his waist, looped it around one of her arms and helped the paramedics tie her to the gurney. He would later tell me that the look in her eyes as he strapped her down with his own belt still haunted him.

In treatment, Julie described the family difficulties that she had struggled with over the years. Her father had been unfaithful to her mother and distant from the rest of the family during Julie’s formative years. Her father and mother had separated for a year when Julie was nine years old. Julie’s mother had contracted cancer during that same year. As a doctor, Dad was away from home for long periods of time; when he was home, he was emotionally distant and critical. Dealing with the fear of death caused by her cancer diagnosis, Mom would draw close to her children; bouts of depression, however, would make her emotionally unavailable. This family system was extremely difficult for a highly sensitive, drama-prone child like Julie to navigate.

One of the hallmarks of borderline personality traits is a fear of real or imagined abandonment. The result of living with this constant fear is a feeling of perpetual emptiness and what I call the “borderline drowning reflex.” Julie thrashed about emotionally, as if anchorless in a sea of abandonment. A string of poor relationships with boyfriends as she grew into adolescence further confirmed what she feared: everyone she loved would leave her eventually. She was unlovable and destined to be lonely her entire life. If that was the case, she reasoned, why not be done with it and end life now? If she left them before they left her, maybe it wouldn’­t hurt so badly.

Several months into treatment, Julie, her parents, and her therapist huddled around a bonfire for a special ceremony designed to symbolize the cleansing of the past and to celebrate the beginning of a hopeful future. The group watched in silence as Julie burned her black clothing, short skirts, CDs of dark-themed music and the straight-edged razors with which she’­d cut her skin. The symbols of her abandonment were consumed by the flames.

Julie’­s mother spontaneously reached into her pocket and pulled out an empty bottle of painkillers; the same bottle that had held the pills Julie used in her suicide attempt. She raised the bottle and held it over the flames. Her eyes shone with tears but her voice was strong and clear. “I’m burning this because I finally have confidence that Julie will never attempt suicide again,” she said.

When his wife had finished, Julie’s dad slowly removed the belt from around his waist, wound it around his fist then thrust it over the fire. He said that he was burning the “horror” of being forced to strap his oldest daughter to a gurney with his own belt. “I’m moving on,” he said, looking at Julie, “and I invite you to do the same.” Then he threw his belt into the burning cherry logs. Julie ran to embrace her father.

The bonfire was a powerful, positive bonding experience which could never be taken away from Julie and her parents because they had lived it together. The burning ceremony and other therapeutic experiences like it addressed the issue of abandonment at the core of Julie’s borderline traits; these experiences were central to her healing process. At a recent four year follow-up, Julie’s parents report that they are happily married and that Julie is successfully completing a bachelor’­s degree.

Dustin Tibbitts, LMFT, has been a therapist at InnerChange for fifteen years and is the executive director for New Haven RTC, a treatment center for adolescent girls with two campuses in Utah. You can contact Dustin at [email protected].