Autoimmune Disease and Borderline Personality Link

After the post about Overreactions to Illness and Hysteria with Borderline Personality, I have received many emails and comments about how their Borderline Personality Disorder (BPD) mothers have auto-immune diseases. Specifically, one reader wrote,  "I find it interesting that your mother was diagnosed with an autoimmune disorder, as my mother is also (she is diagnosed with rheumatoid arthritis and psoriasis). Although I know there is nothing that can be done to prevent an autoimmune disorder, I can't help but wonder why so many BPD individuals are diagnosed with them. A friend's BPD sister was recently diagnosed with an autoimmune disorder as well. Now, this could be pure coincidence, but I was wondering if you had any thoughts on this topic or knew of any related research."

After this email, I thought researching this correlation further (BPD correlating with autoimmune diseases) would be interesting and revealing. And it sure was!

1. Individuals who have BPD or any of the other Axis II Cluster B's (BPD, NPD, ASPD, HPD) often suffer from autoimmune illness due to the stress and elevated cortisol levels which  induce a cascade of autoimmune issues. 
2. Autoimmune-related inflammation may exacerbate BPD symptoms or vice versa.
3. Present data demonstrate a clinically significant, longitudinal correlation between fluctuating antithyroid antibody titers and symptoms of BPD psychopathology.

Further, keep in mind that BPD is also associated with less healthy lifestyle choices (e.g., smoking, alcohol use, lack of regular exercise) which can cause a myriad of health challenges, problems, and diseases.  With this article, however, we are focused on the connection between BPD and autoimmune disease specifically.

First off,  BPD can have a major impact on physical health. BPD individuals often endure chronic medical conditions and pain disorders such as fibromyalgia, chronic fatigue syndrome, obesity, diabetes, hypertension, arthritis, and back pain (Psyche Solve). Additionally, individuals who have BPD or any of the other Axis II Cluster B's (BPD, NPD, ASPD, HPD) often suffer from autoimmune illness due to the stress and elevated cortisol levels which  induce a cascade of autoimmune issues. In normal circumstances, cortisol keeps the immune system in homeostasis, preventing inflammation from going out of control. In many patients with autoimmune diseases, this cortisol response and the cascade of brain hormones that stimulates its release are impaired, so there is no shutoff valve to end inflammation when it is no longer needed. In other patients, the cortisol response may be intact but immune cells are resistant to the anti-inflammatory effects of cortisol due to abnormalities in the cortisol receptor. In both circumstances, inflammation goes on unchecked without the dampening effect of the body own cortisol (American Autoimmune).

Next, in the book, "Sometimes I Act Crazy: Living with Borderline Personality Disorder" by Jerold J. Kreisman M.D. and Hal Stras, the authors draw a connection between autoimmune disorders and BPD. The following is an excerpt: Some researchers have investigated the connection of BPD to autoimmune disorders, in which the body has a kind of allergic reaction to itself and produces antibodies to its own organs. One example, rheumatoid arthritis, is associated with an unusually high prevalence of BPD. One study followed a woman with fluctuating BPD symptoms over a period of nine months while measuring her antithyroid antibodies. These investigators discovered significantly lower levels of the antibodies during periods when her depression and psychosis ratings were low, and higher levels when her symptoms increased. This finding suggests that autoimmune-related inflammation may exacerbate BPD symptoms or vice versa.

The following abstract is focused on the same issue, that BPD and autoimmune disease are correlated. And the conclusion is that a relationship between thyroid hormones / autoimmunity and BPD exists. Before reading, understand that antithyroid antibodies are antibodies directed against the thyroid gland (a gland which produces thyroid hormones). Antithyroid antibodies can be associated with inflammation of the thyroid gland and affect its function. Testing for antithyroid antibodies in the blood is useful in the diagnosis of some thyroid and other disorders including: Hashimoto thyroiditis (an autoimmune thyroid disease), Graves disease (overactivity of the thyroid), hypothyroidism (underactivity of the thyroid), thyroid cancer, Lupus, rheumatoid arthritis, autoimmune hemolytic anemia and Sjogren syndrome. Now to that abstract... deep breath and read on:

Circulating thyroid autoantibodies are more prevalent in patients with mood disorders than in the general population, but longitudinal clinical data that establish a relationship between thyroid antibody status and the course of any psychiatric syndrome have been lacking. In addition, scant attention has been paid to thyroid hormones and autoimmunity in borderline personality disorder (BPD). We report a case of a patient with classic BPD whose fluctuating mood and, especially, psychotic symptoms-rated using a double-blind method-were directly linked to antithyroglobulin antibody titers serially determined over an inpatient period of 275 d. Significantly lower psychosis and depression ratings were seen during a 4-wk period of relatively low antithyroid antibody titers, during blinded treatment with carbamazepine, than were observed during two high autoantibody epochs. The significant positive correlations between nurse- and patient-rated depression and thyroid autoantibodies over the entire period of inpatient study were similar to those also observed between urinary free cortisol levels and depression; the positive correlation between antithyroglubulin antibody titers and psychotic symptoms was stronger (r = +0.544; p < 0.002). Although this patient had biochemical indices of primary hypothyroidism, she showed only marginal improvement to triiodothyronine (T3) and no apparent clinical response to sustained levorotatory thyroxine (T4) administration; neither were antithyroid antibody titers significantly associated with changes in T3, free T4, or thyroid-stimulating hormone concentrations. She clinically deteriorated during a 50-d fluoxetine trial. The present data demonstrate a clinically significant, longitudinal correlation between fluctuating antithyroid antibody titers and symptoms of borderline psychopathology in our patient. It will be of interest to determine the prevalence, pathophysiologic mechanisms, and treatment implications of this putative autoimmune- BPD link.

Another interesting observation is that medical conditions which cause organic behavioral function may result in a clinical picture that mimics to some degree BPD. Hormonal dysfunction over a long period, or brain dysfunction (e.g. the encephalopathy caused by lyme disease) can result in identity disturbance and mood lability, as can many other chronic medical conditions such as Lupus. These conditions may isolate the patient socially and emotionally, and/or cause limbic damage to the brain. However, this is not BPD which results, but rather a reaction to the isolating circumstances caused by a medical condition and the possibly coincident struggles of the patient to control his or her mood given damage to the brain's limbic system (Wikipedia).

So, with the reports coming from Kreisman and Stras as well as scientific exploration into the correlation between autoimmune diseases and BPD, we may be closer to finding out if indeed a direct link exists. At this point, the assumption seems pretty strong that a link does exist-- and solid research has already been conducted and concluded in regard to bipolar and autoimmune diseases. With BPD gaining more attention, more studies will be conducted. I will be very interested to see the results. A link exists as high levels of stress have been proven to trigger autoimmune diseases; however, does the reverse apply? Does an autoimmune disease bring about BPD?

Overreactions to Illness and Hysteria with Borderline Personality

Borderline Personality Disordered (BPD) individuals may display dramatic or hysterical behavior as well as overreact to illness and accidents. These behaviors leave family members "sucked in and emotionally depleted" (Lawson, p 15).  Although all BPD's are prone to hysterical reactions when stressed, the Hermit BPD feels particularly threatened by illness. She is intolerant of discomfort, inconvenience, and pain. She may moan and groan, scream and cry primarily out of fear, not pain. When frightened, she becomes hostile. Her exaggerated responses confuse those who care for her. Family members may be unable to distinguish minor injuries from major emergencies (Lawson, p 93). Additionally, the BPD Waif may suffer from chronic or recurrent illnesses with frequent medical visits (Lawson, p 64).

Each of these statements above depicts very clearly my BPD mother and her ever expanding list of illnesses and ailments and her dramatic and hysterical reactions to them. To be fair, she has been diagnosed with an auto-immune disease in 1995. However, besides my mother, I know many people with her type of autoimmune disease, and my mother is the only one who is as crippled mentally and physically as she. She has claimed to be effected by a host of diseases, conditions, and illnesses in addition to the autoimmune disease; however, most of them have never come to fruition. She scours the Internet and the PDR (Physician's Desk Reference) in order to self-diagnose herself. Then she dreams up these horrible possibilities which she then communicates to family and friends. As Lawson mentioned, family members have a challenging time distinguishing between fabricated, minor, and major health claims.

Recently the reports have gotten more and more dramatic per emails that my brother has forwarded to me from my mother. Just this year, she has claimed to be losing her kidneys and may need a kidney transplant (even went so far as to ask my brother if he would donate one of his), claimed to have polymyositis (widespread inflammation, loss of, and weakness of the muscles which she stated would ultimately effect her heart and be terminal), and claimed to have heart disease. Each of these claims did not get diagnosed after tests by her doctors. She has always been the victim-- whether she's the victim of something one of her friends did to her or something that one of her family did to her (ie: me, her sister, my brother, her father) or with these medical issues.

In regard to her health, she always had a weak fortitude since as far back as I can remember. She has always been tired and rarely physically active. She smoked a lot, never exercised, and was always sedentary. But above all-- she was always fatigued. Additionally, she has displayed the inability to handle discomfort, inconvenience, or pain. She would tell me stories of the dentist, gynecologist, and other medical visits from her childhood to present that were uncomfortable, inconvenient, or painful. And now, through experiences of my own with the same procedures, I have not felt the same. In fact, each of the experiences has been built up with anxiety due to what she had said, and then to my surprise, the experience was pleasant and comfortable.

In regard to her health, she had strange ailments pop up through the years such as 2nd degree burns at the beach in 1976 and toe nails falling off in the 1980's. Then starting at the end of the 1980's, she started to gain weight and hurt when moving. By the early 1990's she was diagnosed with fibromyalgia.  By 1995, she had surgery (hysterectomy). 

While she was in the hospital, she had fits of extreme hysteria. Her behavior was completely erratic, wild, and, well, crazy. She would say one thing, scream another, cry & plead, and was out of control. "Borderlines are prone to hysterical reactions. She is intolerant of discomfort, inconvenience, and pain. She may moan and groan, scream and cry primarily out of fear, not pain. When frightened, she becomes hostile. Her exaggerated responses confuse those who care for her" p 93 Lawson. I definitely didn't know what to do. I was confused and looked to my step-father for guidance. He seemed as bewildered as I was.

When she first came out of surgery, she asked for and looked to her friend for comfort. She rejected my affection, including holding my hand, having me caress her, and merely sitting next to her. I was ignored and eye-contact was avoided. I was puzzled as to what I had done to deserve this treatment. And then when it came to the evening, although I was supposed to stay the night in the room, she asked her friend to stay. I gathered my things and began to leave with my step-father. That's when the hysteria peaked. 

She went completely hysterical with yelling, screaming, and crying. I truly didn't know what to do as she was irrational and seemingly psychotic. My step-father had her friend and myself step out of the room so he could talk with her. We could hear her screaming, bawling, and freaking-out at him. Her behavior was bizarre. When he emerged from the room, he advised me to leave with him and for my mother's friend to stay.  I was still completely baffled as to why she was pushing me away but upset that I was leaving. My step-father was equally confused as we spoke about it on our way out to our cars. "Overreaction to pain or illness is a consequence of the inability to sooth or comfort herself. When she feels vulnerable, she is incapable of containing anxiety" p 93 Lawson.

I had observed this type of behavior when I was a child. When she had sun-burn at  the beach, I found her crawling on the floor, hysterical and yelling at my father (1976). When she went to the hospital when I was in high-school (1983), she was irrational and confusing: requesting one thing then scolding you for doing that, insisting she meant something else. The worst was the incident in 1995 mentioned above, but her behavior in 1999 was equally as scarring to me (mentioned below). Her hysteria was not limited to illnesses / ailments. A few examples are when she went hysterical when my Dad went on business trips (throughout the 1970's), went ballistic in the house (tearing it apart with my Dad ultimately restraining her on the living room floor- mid-70's), and threw herself down (hysterically crying) on the door-step of a family's home that I was babysitting (my Dad was awarded custody at the time- early 80's).

Now back to the mid-90's: I was very frustrated with my mother during the years of finding a diagnosis, as well as after the autoimmune disease diagnosis (1995). She wasn't doing anything to help her cause. Equally dysfunctional is the BPD completely neglecting her health as my mother did during these years (Lawson, p 64). My mother remained sedentary. She ate terribly. Although she had claimed to have stopped smoking, she was sneaking cigarettes whenever she could. She was very negative and not finding the positive in life. I would try to motivate her to exercise-- walk, stretch, get out-- but my ideas were always greeted with excuses. During this time, she would actually avoid going to the doctor and dentist. She was skipping follow-up treatments and taking herself off of her medications. She completely neglected her health.

She wielded the guilt-trip weapon during this time too. I was offered a position at a company across the country from where we both resided. She was dramatic, firm, and clear when she stated, "You wouldn't think of moving away when your mother is this sick... would you?" I ended up not taking the job. Ironically, we ended up estranged shortly after that due to  a package I recieved in the mail from my Dad that she went bonkers over: Here We Go Again 

By May of 1999, my brother and I decided to break the silence between our mother and us. We called her on Mother's Day. She carried on as if nothing ever happened. In July 1999, she ended up in the hospital for a pulmonary embolism. The condition was truly serious, and she wanted to see my brother. So I flew him down, got him from the airport, and had him stay with me. My mother wanted him to spend the night in the hospital with her, but he didn't feel comfortable with that. I don't blame him (it had been 9 years since they had seen each other and only a few months into the reconciliation). 

My mother, again, exhibited inappropriate and aggressive behavior while she was in the hospital. Keep in mind that this was the first time that my brother, mother, and me were all together in the same room in almost FIFTEEN years. My mother was acting like Mr. Hyde. I don't know what got into her, but there she was in the hospital bed, being very boisterous, pushy, and rotten. She became angered with my brother for not staying at her bedside day and night. She ranted that she didn't leave her mother's side when she was in the hospital- so she expected the same treatment. She was so angered with my brother that they ended up estranged again shortly after she was out of the hospital. Additionally, a topic that was never brought up in the past that she brought up out-of-the-blue was that I have a different father than my brother. She kept emphasizing that my brother "is ONLY" my half brother. Her behavior was not only dramatic but also inappropriate and out-of-place and with purpose. But what was that purpose? More about this period of time: In Through the Out Door

In regard to overreacting to illnesses: since her diagnosis of an autoimmune disease in 1995, my mother has claimed to have Rheumatoid Arthritis (inflammation of joints / tissues), Cushing's Disease (pituitary gland releases too much adrenocorticotropic hormone), Hashimoto's Disease (thyroid gland inflammation), Raynaud's Syndrome (vasospastic disorder causing discoloration of the fingers / toes), Sjogren's Syndrome (immune cells attack and destroy the exocrine glands that produce tears / saliva), chronic heart failure, polymyositis (weakness and/or loss of muscle mass in the proximal musculature, particularly in the shoulder and pelvic girdle), bladder dysfunction (went through an extensive battery of tests), kidney failure, heart failure, and more. Again, I have to stress that she DOES have an autoimmune disease; however, these other claims are above and beyond the autoimmune disease diagnosis and haven't been diagnosed by her doctors although she claims to be suffering from each. 

"Sucked-in and emotionally depleted" is how Lawson described the family of a BPD who overreacts and is dramatic with illness and accidents. Indeed, caring for a BPD mother who is ill yet lashes out and is purposefully hurtful and rejecting is challenging: on one hand, you feel sympathy and empathy, and then on the other hand, you feel the need to protect yourself from the abuse. The irrational behavior is incomprehensible, and the bizarre and hysterical behavior is frightening. All the way around, being a child of a BPD mother who exhibits these behaviors is terribly confusing, perplexing, and disorienting.

In Through the Out Door (1997 - 1999)

I guess you can figure out what happened next. Now that my mother and I were estranged, my Dad and I started up our relationship again. I went for a visit in 1997 at his house and was struck by how the years hadn't been kind to him. He had aged, but he was still the same Dad-- loud, controlling, and conditional. He still had some sort of power over me, where I had a hard time standing up for myself, I allowed him to interrupt me when I was talking, accepted that he never asked about what was going on in my life, and treated me like I wasn't there at times. See subsequent posts: My Dad, the Narcissistic King and What Makes my Narcissistic Dad Tick. Other times, he seemed like he was happy that I was with him, and at those times, I was thrilled. I have always wanted my Daddy back-- the one before he met & married my step-mother. He changed after he met her. He changed, and he changed for good. It was just hard to accept.

I was working in a much better environment now, and I was enjoying life again. I was deeply conflicted about my mother, and I spent time trying to talk out the situation with friends. "Children of borderlines search for validation, for others who might confirm their reality" p 157 Lawson. Knowing only the basics of the workings of my mother and my relationship, however, didn't do the analysis any justice, so only a few select friends were able to actually give valuable and insightful advice. The situation with my mother and Dad was so convoluted, toxic, and in depth, that any isolated incident didn't capture the true nature of the dysfunction, so at times, painstaking effort had to be made to create the proper background before getting started with the issue at hand, such as I miss my mother, so should I try to make the relationship work; or what part of what happened my fault; or is my mother out of her mind?

I would try to talk to my Dad but he flat out told me, "If your mother died tomorrow, I wouldn't shed a tear". How compassionate!?!? How supportive!?!?! My goodness, how harsh! He also said, "I divorced that lady 17 years ago, and I want to leave it that way. She's out of my life". Again, what a terrible thing to say to your child, who still has this person as his / her mother. See subsequent post: Adult Children of Parental Alienation Syndrome.

Trying to get any knowledge or understand from him was a big fat dead-end, which was AND IS a shame as he could help to heal wounds and give his children some peace of mind. Instead, he perpetuates the confusion, emptiness, and feelings of loss. Just as my mother feels that one's childhood has very little to do with one's success or failure in life, my Dad thinks all the events from the past should be deep-sixed. Neither parent's viewpoint helps the child who has been searching for answers and understanding. Neither parent, also, wants to claim any responsibility for the rubble left from the divorce bomb and the premature remarriages with ready made families.

My Dad's mother passed away from lung cancer in 1999. My Dad flew my brother out to the funeral but didn't offer to fly me out. I didn't understand why I wasn't offered, but I couldn't afford the flight across country compounded by missing work, so I sadly was unable to attend the funeral with my Dad and brother.

During some of the visits in 1999, my Dad would pull me aside and slip some money into my pocket. He would say, "Keep this quiet, this is between you and me". The sums of money were rather large: $500 here, $1000 there. Years later I found out through my brother that my grandmother (Dad's mother) had left all the grandchildren money, and lo & behold, that money my Dad was slipping me under the pretense it was from him, was from my GRANDMOTHER. Remember how he had me sign over my inheritance from my great-grandmother back in the early 1980's!? Here we go again. The trust factor is zilch with my Dad, but the hopes of having a trusting relationship, of having him accept me, of having him love me were high. Why!?

So, Mother's Day 1999 rolls around, and my brother and I were talking. We decided that we'd give our mother a call, out of the blue, and see what happens. He hadn't talked to her in 9 year, and it had been 3 for me. He called her first, and after they spoke, he called me to report all went smoothly-- almost like nothing had ever happened. My mother and I spoke after that, and sure enough, all was like nothing had happened.

My mother and I visited, and then we started to hang-out again on Monday nights. Her illness was progressing, and she was on high levels of steroids and other medications (placquinil for example). By July she ended up in the hospital for a pulmonary embolism. The condition was serious, and she wanted to see my brother, so I flew him down, got him from the airport, and had him stay with me.

I had to work during this time (4pm- 4am) so trying to get him to the hospital and back to my house before I had to be at work was quite the feat. My mother could have loaned him her car while she was in the hospital to make matters easier, but she wanted him to spend the night in the hospital with her. He didn't feel comfortable with that, and I don't blame him (it had been 9 years since they had seen each other and only a few months into the reconciliation). I went out of my way with friends picking him up and taking him around as my mother and step-father didn't offer up any assistance.

My brother's stay was WONDERFUL for me. I had the BEST time seeing him (we had visited the year before up his way), and we made some long-lasting and precious memories. He saw my mother in the hospital when we could get him there (the distance between my job and home and the hospital were all scattered and far), and she seemed happy.

To my surprise when I was at work, I got an abrupt and angry call from my Dad. He drilled me about my brother, his whereabouts, and what he was up to. I didn't want to get in the middle of anything, and since I didn't know what he had told our Dad about his visit, I didn't want to say anything at all. I continued to tell my Dad to talk to my brother and ask him the questions. My Dad didn't like my responses at all, and eventually I was able to get off the phone because I was at work. My Dad ultimately was angry with my brother for coming into town and not spending time with him, but my brother explained the circumstances for the visit. Our Dad didn't understand, but my brother had a good visit anyway.

Once my brother was back at home, my mother voiced her disappointment with my brother not spending the night in the hospital and how she was upset that he didn't spend longer time periods with her. I explained that some of the issues were with logistics while some had to do with feeling comfortable with the situation (after all they were just getting to know each other again). She was very harsh with her opinions and was rather angry at the outcome. I expressed to her that she was expecting too much too soon and to be happy that she saw him. I was also surprised to hear how unsatisfied she was with the visit-- AND the fact that she didn't acknowledge how difficult the time was for me, worrying about her health while trying to work & accommodate the trips to the hospital. All the times that are like this, where she's lashing out at my brother or my step-father, I am always wondering when it will be me... when is it my turn to be the whipping post?

That Thanksgiving and Christmas, I was back to the juggling of holidays again-- trying to see both sets of parents, trying not to disappoint anyone, and trying to appease all. Which of course, all the efforts meant I didn't enjoy my holidays. I was happy, however, that I had a job that required me to work holidays because I could always fall back on that I had to work.

Years with my Mother (1990 - 1995)

As my relationship with my Dad came to a screeching halt after finding out that I was dangerously and illegally driving around with no car insurance, my relationship with my mother progressively grew. She was involved in my life, she seemed sincerely interested in what I was doing, and reciprocated in the relationship-- aspects I didn't feel I had in the past.

I was carefree at this point in my life, having loads of fun working, going out with friends, and being myself. She seemed to vicariously live through my experiences, making comments when I had something fun planned that I am lucky or that she wished she could have done these things when she was younger. "The borderline mother lives vicariously through the child and seeks validation through the child's accomplishments" p 162 Lawson. I graduated from college Summa Cum Laude and started paying on the $20K school loans. I would get aggravated through the years when she told people about me graduating from college, as if she was the one responsible for my achievement.

I often met my mother for dinner on Monday nights, and we had a good time shopping. Although we seemingly had a close relationship, we never talked about my Dad. That was a hot button that wasn't pushed, and she seemed to be completely irrational and irritated when his name was brought up. I was awaiting the next occurrence when the bottom was going to fall out of our relationship again. I didn't trust the fabric of the relationship and knew that it could blow at any time. "Things weren't the way they were supposed to be when I was a child. Now, I am suspicious whenever things are going well" p 157 Lawson.

Although I was sad about not having a relationship with my Dad, it was nice to not have to worry about juggling parents at holidays as I had been doing. As a note, my whole life has been either having neither one of them in my life -or- having one or the other. Having BOTH in my life has always been virtually impossible as both demand your attention, don't understand a commitment with the other, and toss a massive heaping of guilt.

In regard to the verbal and emotional abuse I endured as a child and teenager, I somewhat deep-sixed it and charged forward in life full force. My main goal in life was to make wonderful memories. I used to tell people that all the time-- and that's why I took so many pictures. This point (making memories) is significant since I have never able to talk to about my memories from my past with my mother or Dad. My mother either doesn't remember, doesn't remember that way, or doesn't want to talk about it, and my Dad doesn't want to remember because he 'doesn't want to'. Both ways, emotional experiences aren't validated, and the past isn't dealt with so that I could come to peace with it. "Rather than arguing about the accuracy of each other's memories, adult children need to trust their own experience. Children of all ages find it extremely disturbing when their mother does not validate their emotional experiences" p 207 Lawson.

1990 and 1991 were spent graduating from college and working long hours. 1992 - 1993 were characterized by moving up the corporate ladder of management. By 1994, I changed jobs and my Dad made an appearance in my life. He randomly and unannounced showed up at my place of work in order to tell me information about my step-sister and her drinking problem. I found this visit very strange as I hadn't been in contact with her for some time, and I hadn't been in contact with my Dad for some time. The visit seemed very disconnected and meaningless. We didn't see each other again for a couple of years.

1995 was focused on my career, having a wonderful time with friends, and Monday visits with my mother. Those Monday visits had become a routine at this point, and if I ever tried to cancel, my mother would get VERY upset. She felt she owned Monday nights with me, and her feelings were hurt if I had something else to do. Separation on the phone was a tough one too. She wanted to talk often and for long periods of times. She had begun to be confrontational about issues such as my career, her health, and more.

I alluded to this in an earlier post, but I will add to it here: my mother has always been socially inappropriate. “The borderline can be inappropriately open, enticing others by too much self-disclosure, and then walking away with an air of indifference" p 58 Lawson. I mentioned in an earlier post, that in high school, she would flirt with my boy friends, talk about inappropriate topics with my friends, and even talk about lewd & crude things with me (things mothers and daughters shouldn't talk about). She always managed to talk about inappropriate things at the dinner table or in mixed company. She would gross out friends with medical talk, she embarrassed me terribly at a very fine dining restaurant by talking about her hysterectomy to a large group of people who were obviously taken back, and she would step in and say things when & where she shouldn't. I think she meant well, but I don't think she has a very effective or efficient filter. She always felt she HAD to entertain when in a social setting, which many times her loud and rambling chatter made the situation so uncomfortable. I think she tried too hard to be "cool", and she wanted to be funny but she often had people cringing at what she said.

She had opened a business in the retail industry. Being in business on her own caused her to brag about what she owned and how well her business was doing. "Attempting to evoke envy in others, the borderline speaks openly about expensive vacations and the price of possessions" p 109 Lawson. Well, once her illness progressed, she claimed she was too sick to operate it. She had a leasing agreement that stated she had to open specific hours on specific days. So, my step-father, working his typical Monday - Friday 8a - 5:30pm job, added on taking care of her business as well. She continued to push him, not giving him a break, and criticizing how he did this or that. She never went back to working after this. "The borderline is driven to excel and may be outstanding in her field but is sadly incapable of enjoying her success. If given the choice, however, she may not work at all" p 80 Lawson.

In regard to her health, she was always a weak person-- tired and not physically active (not including the massive housework she imposed on herself every day-- such as folding laundry impeccable and painstakingly perfect like at a department store). She had strange ailments pop up through the years (2nd degree burn at the beach in 1976, toe nails falling off in the 1980's), and starting at the end of the 1980's, she started to gain weight and hurt when moving. By the early 1990's she was diagnosed with fibromyalgia. Then she started to have uncontrollable and endless female bleeding along with bladder and urethra challenges. By 1995, the decision was a hysterectomy, rectocele, and cystocele which ended up being a huge mistake. Shortly after this surgery, she was diagnosed with an autoimmune disease. The autoimmune disease was the reason for these odd symptoms, and having the surgery only made matters worse because she couldn't have the estrogen replacement as its lethal to this type of autoimmune disease sufferers.

While she was in the hospital, she had fits of hysteria. Her behavior was completely erratic, wild, and, well, crazy. She would say one thing, scream another, cry & plead, and was out of control. "Borderlines are prone to hysterical reactions. She is intolerant of discomfort, inconvenience, and pain. She may moan and groan, scream and cry primarily out of fear, not pain. When frightened, she becomes hostile. Her exaggerated responses confuse those who care for her" p 93 Lawson. I definitely didn't know what to do. I was confused and looked to my step-father for guidance.

When she first came out of surgery, she asked for and looked to her friend for comfort. She rejected my affection (holding her hand, caressing her, sitting next to her). I was puzzled as to what I had done to deserve this treatment. And then when it came to the evening, she asked her friend to stay the night in the room, although I was supposed to stay. I gathered my things and began to leave with my step-father. That's when the hysteria peaked. We left after she calmed down, but I was still completely baffled as to why she was pushing me away but upset that I was leaving. "Overreaction to pain or illness is a consequence of the inability to sooth or comfort herself. When she feels vulnerable, she is incapable of containing anxiety" p 93 Lawson.

I was very frustrated with my mother during the years of finding a diagnosis, as well as after the diagnosis. She wasn't doing anything to help her cause. She became sedentary. She ate terribly. Although she had claimed to have stopped smoking, she was sneaking cigarettes whenever she could. She was very negative and not finding the positive in life. I would try to motivate her to exercise-- walk, stretch, get out-- but my ideas were always greeted with excuses.

She became angry and took it out on her husband. He started to confide in me, and I truly understood how he felt as I had been there many times myself-- the whipping post. I reassured him that I was there for him, so if he wanted to confront her or talk to her about her rude and hurtful behavior I would be there as support. The situation got so heightened that he actually left her for a period of time.