A Love Unconditional

Space

Wanted: open hearts to hold space over borderline personality disorder

From ‘Dappled Light’ by Rana Begum showing till September 2022 at Ptizhanger Manor and Gallery

If there’s a subject in mental health that’s lively as psychedelics, it’s borderline personality disorder or BPD. Things got even stormier when the two got together. 

Or rather, didn’t. Psychedelic hierophant, Imperial College’s Dr Robin Carharrt Harris ruled personality disorder sufferers out of psilocybin trials in the earliest stages of reporting. Interpersonal relationship issues might prevent these voyagers achieving a necessarily productive therapeutic relationship with their guides, hindering ‘letting go’ to the experience. 

Asked about respite for personality disorder sufferers in the Vital Q&A about her work at Imperial College with psilocybin, Ashleigh declares she certainly hopes so. She highlights a courageous academic appeal by Toronto’s Rick Zeifman, and Anne Wagner of the city’s Remedy clinic, on the subject.

The paper notes how clinically-proven effects of psychedelics, like increased mindfulness, a clearer sense of identity and behaviour, healing addictions and a reduction in suicidal tendencies line up neatly with BPD’s issues. The impressive doc proposes possible treatment angles including dialectal behaviour therapy (DBT) a socratic method invented for BPD, plus transference-based therapy (big up the space holders there). It also cites a bunch of examples where BPD symptoms were markedly improved by psychedelic treatment: MDMA looks like the front-runner for medical modality, but Swiss researchers say many came to them seeking LSD treatment for narcissistic personality disorder (NPD) in the late 80s and 90s with no major reported issues. Say what you like about them, but anyone turning up for LSD therapy saying “I’m a massive abusive narcissist, please help me” has done their shadow work. Moreover, just recently doctors in Basel claimed success when treating a complex personality disorder with LSD and MDMA. “This decision was not taken lightly,” reads the abstract.

There’s currently no medication for BPD but sufferers can be prescribed for co-morbidities. Savage psychological wounds, acute trauma, prompt intense abandonment fear in BPD sufferers, possibly leading to volatile and self-sabotaging behaviour. In a thoughtful article on BPD from multiple award-winning UK Cosmopolitan mag, expert Dr Dawn Starley levels it all out by reminding smartphone shrinks that by no means all personality disorder sufferers are disruptive. Moreover, any perceived cruelty, mind games or violence come from a place of terror rather than sadism. Words like ‘guilty’ and ‘innocent’ are perhaps not nuanced enough (sync!) to describe a BPD court defendant (certainly a diagnosed one). And neither is, for example, ‘manipulation’, says BPD specialist Dr Susan Heitler.

Equally, "[Partners, friends and family members] can experience feeling abused or gaslighted themselves. The negative experience for some is substantial,” she says. It’s natural to want to help a loved one in trouble. Selfishly wishing your lover would just get better is forgivable too. But the two of you are often better served by staying apart. This is non-dual acceptance at its starkest.