How to Deal with Someone who has a Personality Disorder

Dr. Daniel Amen: Welcome to The Brain Warrior's Way Podcast. I'm Dr. Daniel Amen.

Tana Amen: And I'm Tana Amen. Here we teach you how to win the fight for your brain to defeat anxiety, depression, memory loss, ADHD and addictions.

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Dr. Daniel Amen: Welcome back. Today, we're going to talk about a very controversial subject and one that has tormented a lot of people, both from people who struggle with this and people who love them. We're going to talk about borderline personality disorder, often people who really struggle in relationships.

Tana Amen: I have a story about this actually. I actually didn't know anything about borderline personality, and long before I met you, I went out with someone who I thought I kind of liked. It didn't go very far though because this person was so traumatized by someone that he went out with who he said was borderline and he didn't know she was borderline and he began to tell me all about how crazy this person was and this person made his life just like hell and crazy. He asked me, he's like, "Are you borderline?" I'm like, "How do you even answer that?" I was so stunned.

But I realized he was so traumatized and he had such PTSD from this whole experience that nothing was ever going to come of this situation, so we just sort of ended before it started. He just couldn't trust anybody. Is that normal for someone who's ever gone out with someone with borderline personality?

Dr. Daniel Amen: It's a nightmare. Dating them, living with them, having them work with you is a nightmare for them, but it's also a nightmare for the people who are around them.

Tana Amen: Now, I'm assuming-

Dr. Daniel Amen: Let me talk about the 10 most common signs of borderline personality. One is impulsive and risky behavior such as risky driving, unsafe sex, gambling sprees or illegal drug abuse. That's just one. Impulsivity and risky behavior, two. Awareness of self-destructive behavior, including self-injury but often feeling unable to change it.

Tana Amen: So a self-injury like cutting?

Dr. Daniel Amen: Like cutting.

Tana Amen: Okay.

Dr. Daniel Amen: Burning yourself, asphyxiation, choking yourself. Wide mood swings is number three. Four is short but intense episodes of anxiety or depression. Five, very common, inappropriate anger and then antagonistic behavior sometimes escalating into physical fights not associated with drugs or alcohol. Six, difficulty controlling emotions. Seven, suicidal behavior. Eight, feeling misunderstood, neglected, alone, empty, very common or hopeless. Nine, fear of being alone. I hate you. Please don't leave me.

Tana Amen: Right.

Dr. Daniel Amen: 10, feelings of self-hate and self-loathing. I often will begin to suspect it in the office if someone tells me after meeting me for 20 minutes, "You're the best psychiatrist that ever lived," because I know usually in about three sessions, they're going to say, "You're the worst,"

Tana Amen: You're the worst.

Dr. Daniel Amen: " ... Psychiatrist that ever lived." They tend to overvalue ...

Tana Amen: And then undervalue.

Dr. Daniel Amen: And then undervalue.

Tana Amen: I have a question. I'm assuming there's also a continuum. Not everyone is a 10 on this scale and not everyone is a zero.

Dr. Daniel Amen: Right. Just so people know, the term "borderline" actually came because psychiatrists were having trouble. Is this a psychotic disorder where people lose touch with reality or is this a personality disorder? It's sort of on the border of those where sometimes their behavior is so irrational that you wonder if they're not going to a place of-

Tana Amen: Well, I've known someone who has, in my mind, all 10 of those traits, and it's really hard to get through to someone when they're in one of their episodes. What causes it?

Dr. Daniel Amen: There are a lot of theories about it, that early abandonment, very early trauma, sexual trauma-

Tana Amen: So emotional or ... Okay.

Dr. Daniel Amen: Physical trauma, almost always early either abandonment or trauma. I actually don't like giving people this diagnosis. I do it very rarely because for therapists, when they're dealing with someone who has borderline personality disorder, they'll often give people that diagnosis when they know they're not going to get better and so they justify,

Tana Amen: It makes them hopeless.

Dr. Daniel Amen: ... That, "Well, it's not my fault as a therapist if you're not getting better. It's your fault because it's your character. It's your personality."

Here at Amen Clinics, we actually very rarely give people personality disorder diagnoses because that doesn't really honor the brain.

Tana Amen: But what does that mean when you say you rarely give it? Is that because you're saying that personality disorders rarely get better?

Dr. Daniel Amen: That I would much rather see this from a brain perspective.

Tana Amen: Okay.

Dr. Daniel Amen: What I often is they have abnormalities in their left temporal lobe which go along with violence and the irritability and the dark, negative thoughts. They often have low frontal lobe function which goes with the impulsivity and the risky, excitement seeking behavior and they often have high activity in their cingulate gyrus which we've talked about.

Tana Amen: Get stuck.

Dr. Daniel Amen: It's where they get stuck. You're the best person.

Tana Amen: And they're inflexible.

Dr. Daniel Amen: And now you're the worst person and these people can actually become stalkers. I modeled them, thinking-

Tana Amen: The couple I've known ... The couple that I've known of also like sex addiction was huge. Is that a common thing?

Dr. Daniel Amen: Common.

Tana Amen: Okay.

Dr. Daniel Amen: If you think about sex addicts-

Tana Amen: And risky sex.

Dr. Daniel Amen: That they have compulsivity and impulsivity at the same time, so they're impulsive and compulsive. For me, I'll use either medicine or supplement to raise both serotonin and dopamine. Raising serotonin helps the compulsivity. Raising dopamine helps the impulsivity. I'll often use a mood stabilizer as well, something like Neurontin or Lamictal to help decrease the rages. To me, I found when I balance their brain and then teach them how to manage their stress and their relationships, they do so much better.

I actually got to debate Otto Kernberg who is probably ... People think of him as the founder of borderline personality disorder and psychoanalytic theory. I'm like, "We should be looking at their brains because how do you know they didn't have a brain injury or how do you know they don't have a Lyme disease?"

Tana Amen: Yeah, that's my question. How does it start?

Dr. Daniel Amen: Because if you have a brain injury, it can totally make you look ...

Tana Amen: That's my question.

Dr. Daniel Amen: We saw a movie last night that we love. I can only imagine about the,

Tana Amen: Yeah, so good.

Dr. Daniel Amen: ... Origin of this Christian song by MercyMe and the movie was just beautiful.

Tana Amen: But he lived in a lot of trauma.

Dr. Daniel Amen: But Bart was the main character was raised by a severely abusive father who beat him and whose mother left. Bart was abandoned. Bart was abused. Bart didn't have borderline personality disorder. He was traumatized. Then, as you look at the dad, the movie really early on centers around football, and the dad I guess played in college and was really good. I'm watching the movie going, "The dad has CTE."

Tana Amen: I know. I'm being mad at you.

Dr. Daniel Amen: The dad has chronic traumatic encephalopathy from the repetitive hits to his head which makes him ineffective at work, with his family, and Jesus ends up saving him and transforms his life. You're like, "How can Jesus fix CTE?"

Tana Amen: If he have ... No, no, no, no, no, no. That's not what I said. You said that. I said, "If it were CTE, he wouldn't, all of a sudden, for the last part of his life become this amazing person."

Dr. Daniel Amen: See, I went to Roberts University so I'm-

Tana Amen: I went to Loma Linda so same thing.

Dr. Daniel Amen: Totally believe in prayer.

Tana Amen: Same thing. I do, too.

Dr. Daniel Amen: And healing.

Tana Amen: I'm just saying CTE, you don't usually see reverse that radically.

Dr. Daniel Amen: But what do we always talk about? That there are four main circles of illness. They're biological so trauma. They're psychological, the trauma that Bart was raised in and probably the dad. Social, you're really struggling in your marriage or struggling at work. You're struggling to be a good dad or a good kid and spiritual. Often we find when people find their purpose, when they get connected to God, their community, their deepest sense of meaning and purpose, even if they have bad biology, it gets better.

One of my favorite stories is about Byron Katie who's a friend of ours, who-

Tana Amen: Oh, she certainly would have demonstrated a lot of this.

Dr. Daniel Amen: She was a rager. She would have totally demonstrated borderline personality. She was an addict. She was a rager. She had an eating disorder.

Tana Amen: Self-destructive behavior, right?

Dr. Daniel Amen: She was self-destructive, but she has this epiphany which is really a spiritual experience. She wakes up on the floor of a halfway house.

Tana Amen: With a cockroach crawling across her foot.

Dr. Daniel Amen: And realizes when she believes her thoughts, she suffers. When she doesn't believe her thoughts, she doesn't suffer.

Tana Amen: Because her thoughts were awful.

Dr. Daniel Amen: When we became friends because her book was so helpful to me, we're actually published by the same imprint of Random House, and so I got to meet her. She came and got scanned. She had the brain of a murderer. I said, "Oh, by the way, if you murder someone, I can help get you off."

Tana Amen: That's true.

Dr. Daniel Amen: But she was the most peaceful person.

Tana Amen: Yeah.

Dr. Daniel Amen: Right? When you think about the transformation, don't forget that having a deep sense of meaning and purpose can help you feel better.

Tana Amen: Okay. Let's just say you didn't experience all of that in childhood, but can experiencing like massive major stress later in life or some sort of emotional trauma later in life trigger that kind of behavior or can an infection or a head injury later in life?

Dr. Daniel Amen: Yes, especially if the stress is stacked.

Tana Amen: Which means that there is hope that you can be helped.

Dr. Daniel Amen: Absolutely. But if the stress is stacked, you lose your job, you lose your marriage.

Tana Amen: Your home.

Dr. Daniel Amen: You have a car accident. You have an autistic child. These start stacking, your behavior is much more likely to get out of ...

Tana Amen: Erratic and ...

Dr. Daniel Amen: More erratic and there is hope. You have to just deal with each of these ...

Tana Amen: Then you can balance that behavior.

Dr. Daniel Amen: Then you can balance your behavior.

Tana Amen: I would like to do another podcast on this because I think we should talk about people who love people with these personality issues.

Dr. Daniel Amen: Stay tuned.