This monograph, originally presented as three papers to the Association for Transpersonal Psychology titled The Abandoned Heart, describes an alternative model for understanding the borderline personality disorder.
Included in the monograph is a paper describing the theoretical foundations for this "energy-shift" model, and the energetic relationship between BPD and co-dependency.
Finally, a theory is offered that describes and explains the developmental functions of the soul in space and time and how these processes relate to normal and abnormal human development.
5. Preface
To the
The Abandoned Heart
A Dynamic Energy-Shift Model
of the Borderline Personality Syndrome
Robert M. Lewis, Ph.D
Behavioral Science Applications
San Diego, California
3
6. Preface
Revised and Abridged Edition
Version 2000
In its original form, The Abandoned Heart monograph is a collection of three papers presented to the
Association for Transpersonal Psychology at annual conferences during the summers of 1982, 1983 and
1984 held at Asilomar near Pacific Grove, California.
These papers have gained a degree of recognition that could not have been anticipated. Inquiries for
reprints have been requested throughout the 50 states as well as Canada and Europe. These continue to be
received as of this writing, nearly twenty years since the first paper was presented. In several instances,
one or more of the papers have been placed on required reading lists in graduate psychology departments
that introduce their students to transpersonal issues.
Although the original monograph included several additional papers that address peripheral issues, the
majority of requests have been for the first two papers, which specifically discuss issues of onset and
recovery of the borderline personality phenomenon.
In order to meet this need, the revised edition is being made available in this abridged format.
Nevertheless, since the first papers were presented, there has been a natural progression of research and
understanding, which has led me to the following conclusions: 1) The original premise is correct, 2) there
are many who suffer from an abandoned heart who do not display the full extent of the syndrome, and 3)
the personal, interpersonal and transactional processes of human nature are imbedded far more deeply in
man’s spiritual nature than I had originally assumed. These conclusions support the original assumptions,
but extend them far beyond what is presented here.
It is my hope that those who suffer from an abandoned heart, or who know and love them on a personal
level as well as those who work professionally with these issues, will continue to explore their own
spiritual nature ever more deeply. The rewards are worth the journey.
Although I am presently retired from my private practice, I remain open, as I have in the past, to receiving
inquires and calls from those who wish to discuss these important issues. I can be reached at the address
and numbers listed below.
If you wish to order additional copies of this abridged version, the cost is USD $29.95, which includes
shipping and handing.
San Diego, California
January 20, 2000
Robert M. Lewis, Ph.D.
Founding Director
Behavioral Science Applications
4869 70th Street, Suite 8
San Diego, California 92115-3061
Phone 619-463-5350 / 619-750-7290
rmlewisphd@cox.net
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7. The Abandoned Heart
A Dynamic Energy-Shift Model
of the Borderline Personality Syndrome
Robert M. Lewis, Ph.D.
Edited and Abridged
Version 2000
Table of Contents
Preface to Version 2000…………………………………………………. 4
Introduction……………………………………………………………… 6 -13
The Model………………………………………………………………... 14 - 21
Borderline Pathogenic Development…………………………………… 21 - 32
Energy Dynamics and Symptom Formation…………………………... 33 - 36
Recovery: Initial Considerations.………………………………………. 37 - 42
Initial Summary and Conclusions……………………………………… 42 - 49
Onset and Breakdown: Setting the Stage for Recovery………………. 49 - 55
The Recovery Process…………………………………………………… 49 - 55
Psychotherapy and the Recovery Process……………………………... 56 - 59
Technological Advances: Hemispheric Synchronization……………... 59 - 62
Altered States of Consciousness and Recovery………………………... 62 - 65
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8. The Abandoned Heart
A Dynamic Energy-Shift Model
of the Borderline Personality Syndrome
Robert M. Lewis, Ph.D.
Founding Director
Behavioral Science Applications
San Diego, California
Introduction
Historical Perspective
The borderline personality syndrome is one of the more puzzling, complex, and
difficult to differentially diagnose of the major personality disorders. It is also not without
its special challenges in treatment.
Historically, the borderline syndrome has been surrounded with controversy and a
certain skepticism. Although the clinical picture had been formally described in 1911 by
Bleuler, who used latent schizophrenia as the diagnosis, and while the terms borderland
and borderline were utilized in 1918 by Englishman L. Pierce Clark, it was not until 1938
that the term borderline was introduced formally in American journals by Stern.
Following a paper by Hoch and Polatin on pseudoneurotic schizophrenia in 1949, and
two papers in 1953 by Knight, who used borderline as the descriptive term, the diagnosis
of a discrete clinical entity became more common. The diagnosis has only recently been
given permanent clinical status by the American Psychiatric Association, which has for
the first time included the borderline personality as a diagnostic classification in the
DSM-III.
6
9. Clinical Picture of the Borderline Personality 1
Much has been written concerning the clinical picture presented by the borderline
personality. Although a comprehensive review is beyond this paper’s scope, a brief
description will be useful. The text of the disorder, as presented in the DSM-III manual,
is reproduced below:
The essential feature is a Personality Disorder in which there is instability in a
variety of areas, including interpersonal behavior, mood and self-image. No
single feature is invariably present. Interpersonal relations are often intense and
unstable, with marked shifts of attitude over time. Frequently there is impulsive
and unpredictable behavior that is potentially physically self-damaging. Mood is
often unstable, with marked shifts from a normal mood to a dysphoric mood or
with inappropriate, intense anger or lack of control of anger. A profound identity
disturbance may be manifested by uncertainty about several issues relating to
identity, such as self-image, gender identity, or long-term goals or values. There
may be problems tolerating being alone, and chronic feelings of emptiness or
boredom.
Some conceptualize this condition as a level of personality organization,
rather than as a specific Personality Disorder.
Quite often social contrariness and a generally pessimistic outlook are seen.
Alternation between dependency and self-assertion is common. During periods of
extreme stress transient psychotic symptoms of insufficient severity or duration to
warrant an additional diagnosis may occur (pp. 321-322). 2
The symptoms presented by the borderline are varied, and overlap with other
disorders. The most important of these are:
(1) Absence of a centered sense of self-identity;
(2) Strong approach-avoidance, or vacillation, in relationships;
(3) Depression of significant duration; cyclothymic mood swings;
(4) Anger as a primary affect, often explosively or inappropriately expressed;
(5) Somatic complaints and/or hypochondrias;
1
The contributions of Vincenzo G. Adragna to the development of this model are gratefully acknowledged.
2
It is now interesting to note that the current DSM-IV includes abandonment issues as an essential feature of the
borderline personality diagnosis.
7
10. (6) Anxiety, phobias, and panic anxiety states;
(7) Dependency and fear of dependency;
(8) Feeling of being empty, unfulfilled, bored, with difficulty being alone;
(9) Inconsistent work habits, and faltering long-term career patterns;
(10) Difficulty being in touch with true affect, or lack of congruence between
thoughts or feelings and their expression;
(11) Fear of separation from or abandonment by others;
(12) Self-condemnatory thoughts, with high risk of self-mutilation or suicide;
(13) Possibility of psychotic-like states of limited duration;
(14) Obsessive-compulsive tendencies.
Disagreement among clinicians and therapists regarding the borderline
personality as a discrete syndrome stems from the fleeting and cyclical nature of the
symptoms, and the not uncommon shift from neurotic patterns, to the loss of ego
boundaries associated with psychotic-like episodes of relatively short duration, and back
again. In addition, many borderline patients function within normal ranges a good portion
of the time, and may be quite successful in their careers.
It is the complexity of these processes, which shift and recycle between neurotic,
normal, and psychotic-like episodes, and the observation that many symptoms of the
borderline are shared with other diagnostic categories, which have contributed to the
clinical controversy, and have delayed its acceptance as a diagnostic category. Even now
there is disagreement concerning “borderline” as an appropriate term for this syndrome.
Questions such as the following continue to be asked: What is the person afflicted with
this disorder borderline to? Is it primarily a thought disorder, associated with the
psychotic states of schizophrenic processes? Or is it more closely aligned with the
rigidity and internal constraints of the neuroses? Is it primarily an affective disorder,
8
11. manifesting as depression, countered by explosive episodes of anger? Is its onset
triggered by abnormal developmental patterns, and is it therefore a learned behavior? Or
is it more closely tied to genetic and constitutional factors?
This paper is the initial attempt to present an alternative, yet integrative, approach
to understanding the development, symptoms, and recovery of the borderline personality.
The approach may be considered unorthodox by some, perhaps radical by others.
However, it is not an attempt to dispute or to replace the current ideas of others. It is,
rather, an attempt to further explain the puzzling dynamics of the borderline, using a
frame of reference uncommon to Western psychology and psychiatry, and to suggest
some alternate means for therapeutic recovery.
The concepts herein are presented in terms of a model, rather than to prematurely
elevate them to the level of theory. In addition, the idea of a model more adequately
encompasses the dynamics of energy flow central to this presentation, although many of
the concepts lend themselves readily to the generation of testable hypotheses required of
theory construction. The rigors of hypothetico-deductive thinking and empirical
procedures must await the prerequisite of more intensive clinical observation, from which
the ideas contained herein were initially obtained.
The model to be presented has had its own historical development. Although
covering a relatively brief time span, it has evolved through certain stages, each one
having a bearing on understanding the model.
The author made the initial observations and tentative hypotheses in the clinical
setting of his private practice in individual and family psychotherapy. As the clinical
model crystallized, and there began to be evidence of its application in psychotherapy,
these observations were shared and explored with research associate Vincenzo Adragna
during weekly discussions. It was during these discussions that many of the spiritual
implications began to unfold.
9
12. Stage I was a period of exploring the dynamics of reactive (functional, uni-polar)
depression with clients responding to some form of situational loss, great or small, and its
relationship to anger.
Stage II, a closely related and natural extension of the first, involved the complex
reactions, dynamics and symptom development of clients working through the grieving
process of separation, death, or their own terminal illness. It was during this period that a
most interesting observation was made. Each of these clients was able to describe a
certain set of somatic complaints, primarily involving deep visceral pain, in the region of
the lower thorax, heart, and upper abdomen. Also experienced was a great emptiness, or
void in the same region, accompanied by a sense of personal powerlessness. This
symptom was more commonly expressed during periods of depression, and was often
accompanied by intense separation or death anxiety.
As this observation was pursued, it was noticed, consistent with object relations
theory, that the symptoms disappeared when a strong emotional connection was made.
This fact in itself is not surprising. It has always been a part of the human condition.
However, we began to ask the question “why?” Why did the symptoms disappear? Were
they related to an inner process, perhaps an energy dynamic, which could, if understood,
be helpful in the recovery phase of loss and grieving? Was the feeling of emptiness or
void a literal subjective interpretation, rather than a psychological metaphor? If so, what
“disappeared” to produce the void and pain, and what “returned” to provide the feeling of
fullness?
Sometimes the fullness was associated with love, and a yearning to give of
oneself. In these moments, the pain disappeared, replaced by a sense of warmth and
contentment, as well as increased excitation and body tone, accompanied by a lessening
of depression. At other times, the emotional response was fully experienced anger, in
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13. which the pain temporarily disappeared, and a sense of personal power returned, but
which was often accompanied by increased anxiety, sometimes reaching panic
proportions following awareness of the anger.
Stage III was a period of working with clients experiencing phobias, a large
proportion of whom were diagnosed as agoraphobic. It was during this period that an
understanding developed of the complex dynamics between intense separation anxiety,
dependency, deep visceral pain, emptiness, depression, anger, panic responses and the
fugue states of ego boundary dissolution, which were key to recycling and perpetuating
the process. Later, similar processes were to be seen again and again in the borderline
personality.
Stage IV was a period of contemplation and integration. What did these
observations mean? The most important observation seemed focused on clients who were
experiencing intense loss of an important emotional relationship. For these clients, there
seemed to be genuinely something we could describe as a “broken heart.” But what was it
that was “broken?” Certainly it was not the physical heart. Besides, the symptoms were
not necessarily located in the left lower thorax, but were in a broader, although still
circumscribed, region. And rather than broken, it was more as if something vitally
important was temporarily missing. It was, as some clients would describe, as if there
were a deep hole in their very center, a hole which, when present, produced such a deep
ache or pain that it seemed at times unbearable, and which prompted many of them to
first seek medical attention, before being referred for psychotherapy when all diagnostic
tests proved negative.
An assumption about human nature, which had gradually been evolving into
acceptance over the years, was the eastern religious philosophy of an energy matrix or
system contiguous to and interactive with the structural system of the physical body. Was
it possible that the broken heart and the symptoms, which corresponded to it, were
11
14. actually the predictable outcome of a vital energy depletion of the Heart Center, or Fourth
Chakra? It was recalled that Shafica Karagula had reported observations by certain
sensitives concerning swirling energy vortexes, or “holes”, receding into the body
structure, which seemed to be correlated with physical or psychological pathology. Was
the pain of a broken heart associated with a “negative” energy vortex, and the fullness of
being in love associated with a “positive” energy vortex which extended outward beyond
the boundary of the physical body to make a literal energy connection with the loved
one?
Tentatively at first, this idea was advanced to clients experiencing these
symptoms. With very few exceptions, there was a subjective response in which the idea
made intuitive sense to them. In some instances, simply the idea itself seemed helpful. If
nothing else, it “explained” to them something that had been so puzzling. Some clients
also began to consciously attempt to “move” the energy outward, resulting in the
alleviation of symptoms.
Was there an important therapeutic principle hidden here? It remained for a
concentrated period of work with borderline patients for the answer to become clearer.
The movement of energy outward from the Heart Center to make a
connection with a loved one was later to be viewed as an ultimate act of giving, but
presented a basic paradox. Energy extending outward from the Heart Center produced
more fullness, whereas attempts to “take in” energy from someone else from a state of
neediness eventually produced a greater emptiness. Teaching the nature of this paradox,
the flip side of our normal world view, became a basic task in psychotherapy with
patients experiencing the pain of a broken heart.
Stage V extended further the processes of observation, contemplation,
integration, and application, with some surprising results. An increasing number of
borderline patients were being seen in therapy during this phase. Gradually, some basic
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15. patterns began to emerge, which drew quite naturally upon the experiences and
understandings of the previous four stages. In fact, the symptoms and dynamics of the
borderline seemed a composite of these stages, with the addition of certain unique
characteristics that presented a picture of greater complexity, variability, and difficulty.
First, there emerged a consistent pattern of characteristics or traits, which
suggested a predisposition or constitutional factor.
Second, there seemed to be a typical set of developmental variables, which
interacted with the predisposition-constitutional factors.
Third, from this genesis arose a reasonably predictable set of dynamics which,
when set into motion, could be viewed as accounting for the fleeting, cyclical, and
unstable patterns of the borderline personality.
Finally, as a cognitive model of the borderline syndrome emerged, opportunities
arose to apply some unique therapeutic interventions derived directly from the model.
The results were far beyond expectations. Indeed, for some patients recovery came so
swiftly and so completely that one had to wonder if these patients were in fact borderline,
even though they fit well the clinical picture. We were reminded of the medical
“problem” of spontaneous remission, and were tempted to dismiss the event as
misdiagnosis. However, since instances of spontaneous remission were being observed in
case after case, it was felt that there might be value in sharing the model. The validity of
these observations must of necessity await further corroboration by others.
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16. 1.0
The Model
Borderline Predisposition,
Basic Assumptions,
and Healthy Development
The progressive stages of observation described above became the building
blocks from which this model evolved.
The most significant observation, which will be detailed as we progress, was this:
The dynamics of the borderline personality appeared to be a derivative of the broken
heart pattern, but with some fundamental differences. The basic symptoms of deep
visceral pain, emptiness, and depression were the same. However, the symptoms of the
broken heart were temporary, being the acute stage of response to intense loss.
In the borderline personality, the symptoms of loss had become chronic. There
had, for whatever reasons, developed a certain permanency to the depletion of energy in
the Heart Center. Although it could, and often did, return temporarily, resulting in illusive
feelings of euphoria, there eventually came to be an expectancy of the emptiness, void,
and pain, which contributed to an ongoing dread and hopelessness.
Although the depletion and void was the result of inner dynamics and processes,
the emptiness and pain so often felt was not experienced as such, but was instead attached
to the presence or absence of a loved one, or nurturer, which contributed to the feeling of
helplessness and dependency: It was others who were perceived as ultimately in control
of the borderline’s sense of well-being on the one hand, or vast emptiness and pain on the
other, resulting in the constant dread of separation or abandonment.
Thus the defense of projection developed and was maintained, and prevented the
borderline from seeing the singular truth that would ultimately set them free. At a critical
point in their development, the borderline had made a most crucial decision. Out of an
agonizing sense of survival and self-protection, the decision was made to prevent the
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17. possibility of any further pain from abandonment. This was accomplished, in one
intuitive leap, by removing awareness from the locus of pain, from their own Heart. With
the removal of awareness, the energy of the Heart Center became increasingly depleted,
numbing the pain through denial, but with ever so costly results.
The borderline had made the decision that began the process of their own
pathology. They had made the decision -- to abandon their own Heart.
From this point onward, the constellation of personal beliefs, feelings, and
behaviors symptomatic of the borderline personality progressed in a fairly predictable
manner. However, the predictability that was observed was not simply the end result of
mutually interactive dynamic processes. Further, developmental variables were not
enough to account for the disorder. Gradually it became more and more evident that
persons with the disorder had certain general characteristics in common, characteristics
which, if isolated within normal development, were certainly not pathological. As these
characteristics were identified, we came to view them as borderline-predisposed
individuals.
1.1 The Borderline-Predisposed Individual
Certain individuals seem more prone to the borderline syndrome than others. We
believe there are three primary predisposing characteristics. These are: (1) A highly
sensate body, (2) a capacity for high emotional intensity, and (3) a naturally creative
intelligence. A fourth, involving the possibility of a constitutional factor, will be
discussed in a following section.
1.1.1 Sensate body.
Borderlines have a highly sensate body, with lower than usual sensory input
thresholds of pain and touch. Their bodies are very responsive to external stimuli, and
15
18. therefore the environment, especially other people. They are also unusually aware of
inner body states. As a result, they tend to be sensual and pleasure seeking, as well as
pain sensitive and pain avoiding.
The borderline’s low thresholds involve the peripheral nervous system. This is
not the same as the inadequate CNS filtering of information input hypothesized to
account for some schizophrenic processes. They, therefore, have the capacity for
accurately “mapping” the external world, sometimes in great detail, which seems not to
be true of the schizophrenic.
1.1.2 Emotional intensity.
Borderline’s have a higher than usual capacity for emotional intensity. The
intensity of their emotional energy makes them inherently responsive to relationships. In
its natural, undistorted state, we might view this as a love-giving, love-receiving trait, that
is, having a “full heart.” When distorted, it will shift to a deficiency state of neediness,
and may become a preoccupation with sexuality, perversions, or gender identity, often
expressed only in fantasies, which act as substitutes for the fulfilling emotional
connection and expression in love-giving, love-receiving relationships.
Under the strain of repeated separation, loss of important emotional relationships,
or physical abandonment, this emotional intensity will eventually provide the fuel for the
pain-generated anger and later, when insulated from awareness, will account for much of
the depression experienced by the borderline.
1.1.3 Creative intelligence.
Borderline’s have a naturally creative intelligence. Although not necessarily
associated with a high measured IQ., the borderline-prone individual is intellectually-
cognitively responsive. Paradoxically, this quality, as we will see later, is necessary for
the development of the disorder. Their minds are often constantly active, and they
frequently report difficulty shutting off their thoughts. An obsessive-compulsive quality
16
19. develops from attempting to avoid pain and find fulfillment.
To use the colloquial, their minds are “sharp,” with a quick wit, and “fluid,” being
able to make cognitive associations easily. These quick and fluid qualities also make their
cognitive processes slippery,’’ being unable to maintain certain cognitive sets required
for a consistent self-identity, and making long-range goal-setting and attainment difficult.
These qualities may also make them prone to using dry humor, often to a degree that
becomes annoying to others. Although eventually counter-productive, humor is an
attempt to spontaneously bring relief to the pain or emptiness they are experiencing.
Although they are able to put cognitive constructs together in unusual ways, this
creativity may be for better or for worse. While it allows them to problem solve
productively, it also provides the mechanisms for developing intricate defensive patterns,
the cornerstones of which are projection and denial, which eventually become their
undoing.
These three predisposing factors, each of which in their positive forms are
potentially enhancing of the self, have a negative side if distorted. In Abraham Maslow’s
terms, they can become Deficiency-needs rather than Being-needs, with predictable
adverse consequences.
In combination, these three factors can account for the tripartite essence of the
borderline personality: (1) A thought disorder, giving it pseudo-psychotic characteristics,
combined with (2) an affective disorder, involving both a preoccupation with sensation
and a denial of true affect, resulting in (3) relationship difficulties, which not only
provide the primary genesis, but serve to perpetuate the disorder as well. These factors
intertwine to form the relatively predictable dynamics, which are the predominant
subjective experience of the borderline.
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20. 1.2 Constitutional Factors: A Tentative Hypothesis
Individuals with a borderline disorder often report somatic complaints in the
general region of the throat, thorax and upper abdomen. These generally include vague
aches, pain, and neuromuscular tensions of varying intensities.
We believe it may be of heuristic value to note that this is the region served by the
Tenth Cranial (Vagus) Nerve, an autonomic efferent and afferent system, with motor
fibers to the larynx, pharynx, lungs, esophagus, heart and stomach. It has lesser branches
to several abdominal organs, and sensory fibers to the larynx and lungs (see Figure 2).
We have noted, for example, that upper thoracic and laryngeal tension increases
as primary emotional energy moves upward, away from the Heart Center, and decreases
as the energy returns to the Heart Center. Voice register, an indication of laryngeal
tension, also seems to rise and fall in correlation to the upward and downward energy
movement.
Other tentative observations include peritonitis, gall bladder disorders, nausea,
upper respiratory ailments, heart and chest pain associated with the chronic nature of an
abandoned Heart.
Is it possible there is some causal or mutually causal relationship between Tenth
Cranial Nerve activity (e.g., inhibition; dis-inhibition) and the instability of primary
emotional energy of the Heart Center in borderline prone individuals? The question
seems worth pursuing further.
1.3 Basic Assumptions of the Model
Several assumptions are basic to the model. These are treated “as if” true for purposes of
hypothesizing certain processes and dynamics. Consequently, there is no attempt to
support the validity of these assumptions with empirical evidence for, in fact, there is
none. It is a theoretical procedure familiar to the physical sciences in which an unknown
18
21. energy state, process or dynamic is advanced to account for an observable event. This has
been particularly valuable to theoreticians concerned with developing a more unified
theory.
Assumption 1: The Heart Center, or Fourth Chakra, consists of out-flowing
energy, which remains immeasurable and therefore unobservable to contemporary
Western science. Only its effects are objectively observable.
Assumption 2: This energy we shall call Primary Emotional Energy, and is the
basis for the emotional connection between persons in a relationship. It is,
therefore, the “energy of relationships.”
Assumption 3: In its natural state, primary emotional energy ‘fills” the region of
the lower thorax or chest area, producing the subjective experience of
contentment, warmth, openness to others, trust, and giving of self (love).
Assumption 4: Under certain conditions, primary emotional energy can shift
away from the Heart Center, resulting in the subjective experience of a “hole” in
the center of one’s self, producing either undifferentiated or specific somatic
complaints of vague or unknown origin.
Assumption 5: Primary emotional energy follows the “Law of Awareness” which
states : (a) Awareness activates the energy; (b) The energy follows awareness;
therefore, by shifting awareness, the energy will shift to the new locus of
awareness; (c) Withdrawal of awareness de-activates the energy; it is potentially
available, but latent; and (d) Reactivation of awareness reactivates the energy.
Assumption 6: The natural state of the energy is without limit or constraint, and
establishes connection (i.e., relationships) in an undifferentiated manner. That is,
it “gives to all.”
Assumption 7: Thoughts give form to (produce constraints upon) the natural
state of the energy. Thinking (i.e., information processing) results in the formless
energy being in-form-ation.
Assumption 8: Thinking directs the locus of awareness. That is, one’s thoughts
are responsible for shifting the locus of primary emotional energy.
Assumption 9: Specific emotions are the result of thoughts (i.e., constraints)
applied to the formless primary emotional energy.
9.1: Every thought (i.e., a constraint, producing a form) applied to
primary emotional energy will to some degree shift energy away from the Heart
Center, which is it natural “home”.
Assumption 10: Primary emotional energy can be returned to its natural state
(i.e., its “home”), and to formlessness, by redirecting an emotion, through the
vehicle of awareness, to the region of the Heart Center.
Assumption 11: Having redirected an emotion (e.g., guilt, anger, love, hate) back
19
22. to the Heart Center, it will undergo a natural transformation analogous to
biological metabolism, making the energy more readily available to the self and
others.
11.1: This natural transformation will change the emotion from a state of
constraint (form) to a state of undifferentiation. This is analogous to the
change that occurs when H20 is transformed from ice, to water, to vapor.
The process allows the new thought-energy to re-fill the void once created
by its shift away from the Heart Center.
Assumption 12: The steady state of the return of all primary emotional energy to
the Heart Center will produce a state of internal integration, and the subjective
experience of fullness and wholeness, resulting in a natural, spontaneous giving of
self: A parable’s parable of the Prodigal Son.
1.4. Normal (Ideal) Childhood Development
Normal childhood development is discussed briefly to provide a backdrop for
understanding the pathogenic processes that contribute to the borderline disorder.
Ideal development for the borderline-prone infant and child (i.e., childhood
interactions that will prevent development of the disorder) focus primarily on qualities of
the nurturing parent. Although we will often use the term “mother,” this denotes function
rather than gender, and could just as easily be provided by an appropriate male or
significant non-biological surrogate parent.
Proposition 1.1: The ideal mother (of a borderline-predisposed infant) has a full
Heart. That is, her own primary emotional energy is strong and stabilized in her
Heart Center. She is therefore centered within herself.
Proposition 1.2: Because she is centered in the Heart, the mother experiences
herself as full and whole, and is therefore able to give freely.
Proposition 1.3: Being centered in the fullness and wholeness of her own Heart,
the mother is free from projection. There is no need to attribute her internal state
to those around her, including her infant.
Proposition 1.4: Being integrated and whole, the mother is free from denial.
There is no pain of unfulfillment, and therefore no need to withdraw awareness
from any portion of herself, including thoughts, feelings, or actions.
Proposition 1.5: Being free from projection and denial, the mother can maintain
full awareness of her child’s essence and needs, including the infant’s needs for
fusion and oneness, and later the child’s needs for separation and individuation.
Neither oneness nor separation are cause for anxiety, either for the mother or her
20
23. child.
Proposition 1.6: The strong, stable primary emotional energy of the mother
establishes and maintains connection with the infant’s Heart Center.
1.6.1: The stability and consistency of this connection gradually serve to
anchor the child’s primary emotional energy.
1.6.2: The child’s subjective experience is warmth, contentment, trust,
openness, and freedom to explore fully their own nature. The experience
of fullness allows for the development of their own capacity for giving to
others.
Proposition 1.7: The stability and consistency of the primary emotional energy
connection between mother and child continues through both the separation-
individuation (going away from mother), and the rapprochement (coming home to
mother) sub-phases of development. This further reinforces the strength and
stability of the child’s primary emotional energy, thus setting the stage for normal
and fully adaptive adolescent and adult development.
2.0
Borderline Pathogenic Development
The idea that developmental factors contribute to the borderline disorder is not
new. Masterson (1981), for example, argues well for this viewpoint.
This model does not differ greatly from others regarding what is objectively
observed about the borderline disorder. Where the model departs is the level of
explanation, by hypothesizing an energy dynamic rather than a psychodynamic as the
primary moving force. This may account for the difficulty traditional clinicians have
experienced in circumscribing the phenomena. Even so, psychoanalytic writings are not
discounted, having proven quite useful in understanding the borderline personality.
Developmentally, we believe there are four primary stages in the pathogenesis of
the borderline. The first is the infant stage, from birth to 18 months. The second is the
toddler stage, from 18 to 36 months. The third stage occurs around age seven, plus or
minus one year (6 to 8 years), and is the critical turning point of the disorder. The fourth
stage occurs during puberty at approximately age 12, plus or minus two years (10 to 14
years), and signals the onset of a prolonged period of formalizing and rigidifying the
21
24. personality infrastructure. This is the period, from adolescence through adulthood, in
which the social consequences of endogenous factors reinforce and perpetuate the
syndrome.
2.1. Infant Stage (birth to 18 months): “The Empty Heart.”
The borderline-prone infant, paradoxically, has the potential (perhaps even more
so than other infants), for a strong, intense Heart Center. However, as described above,
the infant requires a nurturing parent with a strong, stable Heart Center to ensure the
anchoring and stabilization of their own primary emotional energy.
Proposition 2.1.1: Developmentally, the disorder begins when the borderline-
prone infant is nurtured by a parent with “an Empty Heart” who, through
predisposition, physical or emotional illness, has weak or unstable primary
emotional energy, and is therefore unable to establish a consistent connection
with the infants Heart Center.
Proposition 2.1.2: During periods in which the infant does not experience the
stable primary emotional energy connection with the parent, there will begin to
occur a dissipation, shift or “drift” of energy away from the infant’s Heart Center.
Proposition 2.1.3: In the infant this will be recognized to be a generalized
irritability and/or crying, as if in discomfort or pain, but with no identifiable
physical source.
Proposition 2.1.4: Over prolonged periods, this drift of primary emotional energy
away from the infant’s Heart Center will eventually produce a deeper ache of
emptiness and unfilled “hunger.”
2.1.4.1: The infant may begin to show symptoms of eating difficulties or
digestive problems. Behaviorally, there may begin to be signs of either
passivity or hyperactive movement, and may be difficult to hold, console,
or put to sleep.
Proposition 2.1.5: Because (1) the natural tendency of the infant is for a strong
Heart Center, (2) and because the infant has not yet developed a cognitive
understanding of the source of its vague, internal discomfort (i.e., a parent with an
Empty Heart), and (3) because there may be other children, family members or
part-time surrogate parents who nurture the infant’s Heart Center, the drift of
energy may occur slowly, and may in fact return to fullness for periods of time,
only to drift again if not anchored by the mother’s primary emotional energy.
It is during the toddler stage, without a “change of Heart” occurring within the
22
25. mother, that the developmental process and symptom formation will become more
ominous.
2.2. Toddler Stage (18 to 36 months): “The Broken Heart.”
A critical period of the child’s development is the “toddler stage.”
It is between 18 and 36 months that the child begins the important process of
moving away from its mother, establishing separation and mdividuation, and then
returning to re-experience her presence. Both the sub-phases of separation-individuation,
and the complimentary sub-phase of rapprochement, are necessary for healthy
development.
The borderline-prone child experiences difficulty, even a sense of trauma, with
one or both of these sub-phases.
It is during the toddler stage that projection becomes established as a cornerstone
of the eventual pathology.
Proposition 2.2.1: It is during the active process of moving away from mother
that the child establishes the ability to separate self from the parent, and develops
a sense of self, or individuation.
2.2.1.1: At first, this may cause little difficulty or anxiety for the child.
Since the mother has an Empty Heart, it may even provide a sense of relief
from the discomfort, or energy drain, it experiences in her presence.
Proposition 2.2.2: The critical event for the child is its return “home,” for its
need is to reestablish the connection with mother’s primary emotional energy.
2.2.2.1: In the early stages, the child is ever hopeful that, upon return, he
will experience the warmth, the fulfillment, the contentment and the
oneness associated with being-in-connection with her Heart Center.
Proposition 2.2.3: When the borderline-prone child returns, he finds “no one
home,” for he returns to a parent with an Empty Heart.
2.2.3.1: Again and again, the child experiences the emptiness, the hunger,
the ache of having hopeful expectations broken.
2.2.3.2: Although separation is being accomplished successfully, there is a
gradual erosion of a sense of self, as the pattern of emptiness, hunger, and
unfulfillment is re-experienced upon each return, for the true self-identity
23
26. of the borderline-prone child is in its awareness of its own Heart Center.
Proposition 2.2.4: Gradually, as the pattern of returning home to an Empty Heart
continues, the child will experience a deeper and more persistent pain in the
region of the Heart Center. He will be experiencing the initial stages of a Broken
Heart.
2.2.4.1: Crying may be more frequent. Sleeping patterns may be disrupted
with nightmares, and anxiety about death, couched in the symbolism of a
child’s mind, may be noticeable. Normal eating patterns may be altered by
“tummy aches” or overeating.
2.2.4.2: Enuresis may be a signal that anger and depression are present.
2.2.4.3: Communication difficulties, involving articulation or dysfluency
may appear.
2.2.4.4: As the child grows older, the tension, somatic discomfort, and
visceral pain associated with a Broken Heart may reach intolerable limits,
prompting irritability, angry outbursts, and acting out behaviors, or
withdrawal.
2.2.4.5: Separation anxiety and fears of abandonment may increase.
Proposition 2.2.5: It is during this period that the child is earning a significant
lesson: Other people seem to be directly responsible for either the fleeting feeling
of fulfillment, or the increasingly familiar awareness of somatic discomfort and
visceral pain. Thus is born the defense of projection.
Proposition 2.2.6: Projection as a primary defense.
The borderline-prone child is highly sensitive to two major loci of awareness
simultaneously, a combination that leads directly to projection as a primary mechanism,
and which eventually serves to perpetuate the borderline disorder.
First, the highly sensate nature of the child makes them acutely aware of their
own body states. They are natural bedfellows to both pleasure and discomfort, and may
be unusually sensual as well as pain avoiding. These two qualities may predispose them
later to hypochondrias, and to avoidance patterns.
Second, their capacity for high emotional intensity and responsiveness to primary
emotional energy connections with others which, when present, provide them with
fulfillment or, when absent, are associated with emptiness and pain, make them acutely
aware of human relationships, and to the movement of people in and out of their life.
24
27. In combination, these two qualities create projection, which is the process of
attributing the cause of their own internal states to the thoughts, feelings, or actions of
others.
2.3. The Critical Age Seven--Plus or Minus One:
“The Abandoned Heart.”
Up to the age of seven, plus or minus a year, the constitutional, pre-dispositional,
and developmental factors associated with the borderline condition have not yet solidified
to produce the borderline personality.
Proposition 2.3.1: At the approximate age of seven, if the nurturing parent is still
not capable of “being home” in the Heart Center (thus providing connection and
stabilization of the child’s primary emotional energy) a situational crisis may
occur, which will precipitate a decision by the child that will take them a critical
step closer to becoming borderline.
2.3.1.1: The crisis may be either major (e.g., a death), or minor (one more
rejection, or emotional abandonment) in objective terms. However, it will
be perceived as irrevocably traumatic by the child, thus by definition
producing the crisis.
Proposition 2.3.2.: Because of the now intolerable pain associated with a sudden
shift of energy away from the Heart Center, the child makes the self-protective
decision to withdraw awareness from the locus of pain, creating a chronic state of
void or emptiness.
2.3.2.1: Not realizing that to withdraw awareness from the pain in their
Heart Center is to unavoidably create more emptiness, the child
unwittingly makes the decision to abandon their own Heart. Thus,
motivated by a sense of self-preservation, the child initiates a process
which eventually leads to their down-fall.
Proposition 2.3.3: The child has now firmly established the defense of denial,
which is temporarily helpful, for through it the pain is dampened. It results in the
denial of awareness, but also the denial of self. Self-identity thus becomes an on-
going issue as the disorder progresses.
Proposition 2.3.4: Although the child has made the decision to abandon their own
Heart, this is protected from awareness and therefore self-responsibility through
the defense of projection, already firmly established from the preceding stage. In
the eyes of the child, others still remain the cause of their emptiness and pain.
25
28. Proposition 2.3.5: This stage is critical in the development of the borderline
dynamics because the child is now actively directing the energy shift.
2.3.5.1: This is made possible by the maturation of the child’s creative
intelligence. He is now in control of logical processes, which, inevitably,
given his nature, dictate an upward shift of energy to the region of his
“mind” (i.e., his head). At the moment of decision, his mind has been
given the role of savior, rather than his heart. Self-protection has taken the
place of love.
2.3.5.2: This shift could (and eventually will) also be made downward to
the sex center. But at age seven, the child is entering into the latency
period, reducing awareness of genitals and sexual energy. Further, school
is serving to give heightened attention to the mind, adding to the logical
choice of shifting energy upward to the head region.
Proposition 2.3.6: As the energy is shifted upward, it may accumulate
inappropriately and excessively in various body parts along the midline, including
upper thorax, neck, larynx, pharynx, tongue and lips, creating tension and
awareness of discomfort, resulting in various possibilities for communicative
disorders.
2.4. The Critical Age Twelve--Plus or Minus Two:
“The Split Heart.”
It is a paradox of the disorder that the borderline-prone child has a higher than
average capacity for love-giving, while those in advanced stages are often viewed as
excessively selfish, needing to take from others and, in fact, seeming to have little to give
in return. They can be a continual drain on those around them, and may receive more than
their share of social rejection as a result. When in a state of excessive need, the borderline
may actually draw primary emotional energy from others, quickly raising the discomfort
level of those around them, without others consciously knowing why they are
uncomfortable. When this occurs, there can be the feeling of simply wanting to escape
the presence of the borderline.
As people consistently withdraw from them they may react in socially
inappropriate ways, which serves only to create more distance and fewer opportunities
for social contact. They may have few true friends.
They may not only feel lonely, they may in fact be socially isolated for extended
26
29. periods. As a result, they often have a delayed social and sexual development.
It is not uncommon for the borderline disorder to be complicated by sexual issues
and concerns, sometimes of a pathological nature, which may have an obsessive-
compulsive quality. These may include unusual sexual practices, excessive masturbation,
questions of gender identity, and masochism, to suggest the more common. These may
exist primarily or solely at the fantasy level for long periods, or may break forth into
episodes of acting out during the reduction of impulse control following periods of
excessive stress.
Many of these dynamics have their genesis during and following the onset of
puberty, and occur as a function of their predispositional qualities in combination with a
second major energy shift, this time downward to the genitals.
Proposition 2.4. 1: The borderline-prone adolescent, following the essence of
their predispositional nature, are innately sensate and sensual, emotionally intense
and responsive to relationships, and creatively intelligent.
2.4.1.1: When found in conjunction with a full Heart, these qualities will
manifest as unusual capacities for nurturing, empathy, love-giving, and
problem-solving, and they may prove to be unusually strong candidates
for the healing professions.
2.4.1.2: However, when present in conjunction with an abandoned Heart,
an unfortunate distortion of these qualities is likely to result.
Proposition 2.4.2: During the pre-adolescent years, the borderline-prone child
has made a uni-polar vertical shift of energy to the head region.
2.4.2.1: As sexual awareness increases during puberty, a portion of the
primary emotional energy may be shifted downward to the genitals,
creating a bi-polar shift, or “Split Heart,” with excessive energy
accumulating both above and below the Heart Center.
Proposition 2.4.3: The essence of the Heart Center is the natural, spontaneous
love-giving that comes from awareness of one’s wholeness. It is a feeling of
“fullness to overflowing.” It has no need to take; only to give.
2.4.3.1: The shift to the head region is essentially the shift from love-
giving to self-protection. Indeed, the shift was precipitated by the vast
feeling of emptiness and pain.
Proposition 2.4.4: As energy and awareness become split between the head and
genitals, a distortion occurs. Without the mediating awareness of the Heart
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30. Center, sexuality becomes a means of “getting” fulfillment, rather than giving it.
Sexuality becomes a substitute for love, rather than love’s expression.
Proposition 2.4.5: Sexual perversions, in the true sense, are acts of taking rather
than giving. It is therefore not the act itself, but its motivation, coming as it does
from the deepest form of confusion about the nature of one’s self, which is the
perversion.
The sexual pathologies of the borderline are precipitated by the bi-polar energy shifts
of the Split Heart. This dynamic results inevitably in confusion about self-identity, and
the identity of self-in-relation-to others as sexual beings. It is compounded by the
obsessive-compulsive tendencies that result from the never-ending cycle of attempting to
substitute sexuality for self-fulfillment, love-taking for love-giving.
3.0
Energy Dynamics and Symptom Formation
The symptoms manifested by the borderline personality tend to group naturally
into symptom constellations. However, they will change and fluctuate cyclically,
appearing to give a fluid, unpredictable quality to the borderline disorder.
In this section, we have organized the symptoms into groupings, which correlate
with directional energy shifts. Here we suggest tentative hypotheses of energy-symptom
relationships in order to provide some coherence and predictability to changing patterns
of the borderline.
Six major energy shift patterns are hypothesized. They tend to occur in time-
sequential phases, suggesting a relationship to developmental events.
Each energy pattern is presented in two parts: First, a description of the energy
dynamics, followed by the symptoms which correlate with the shift.
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31. 3. 1 Phase I: The Upward Vertical Shift
Description
As a pain avoidance response, awareness is withdrawn from the Heart
Center. Awareness is focused on thinking processes, which are then defined as
the essence of self. Primary emotional energy follows awareness in an upward
vertical shift. Primary emotional energy changes from its original
undifferentiated state, to the constraint of specific emotions, from formlessness to
form. Initially vitalizing the natural creative intelligence, it later serves to distort
reality as it is used for self-protection through the mechanisms of projection and
denial.
Symptom formation
3.1.1: Pain, emptiness, void, boredom
As primary emotional energy shifts away from the Heart Center, it
produces deep visceral ache or acute pain. The more quickly the shift occurs, the
sharper the pain.
The chronic state results in the subjective experience of emptiness
and void in the center of one’s self. Boredom is experienced when emptiness is
projected onto the current life situation.
3.1.2 Anxiety, panic states, phobias
Anxiety occurs when the shift of primary emotional energy away
from the Heart Center is anticipated.
Panic anxiety states, often associated with depression, occur when
a sudden, unexpected shift occurs. This is usually associated with a belief in the
lack of support for self by others. It is correlated with depression when slowed
motor, cognitive, and affective responses are subliminally recognized as being
inadequate to respond adaptively to a life situation.
Phobias (e.g., agoraphobia) are a learned pattern of response to a
belief in the absence of support for self, combining anxiety, panic states, and
depression.
3. 1.3 Obsessive-compulsive tendencies
Awareness of one’s thinking process increases as the energy moves
upward to the head region. Awareness, in turn, draws more energy. Excessive
reliance on thought processes to protect self and avoid pain, in conjunction with
anxiety, produces obsessive, repetitive, and circular thinking.
Compulsive behaviors can result from the impossible dilemma of
attempting to experience fulfillment through activities, rather than a return of
awareness to the Heart Center.
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32. 3.1.5 Avoidance patterns
The essential formula is: “A void produces avoid.” The void in the
Heart Center produces pain. A consistent motivation of the borderline is pain-
avoidance. Social avoidance is the response to anticipated pain of eventual
abandonment in relationships.
3.2 Phase II: The Upward-Downward Cyclical Shift
Description
In the borderline, primary emotional energy can return to the Heart
Center if certain, usually situational, conditions are met. However, this is
temporary and the upward vertical shift will again occur, usually in response to a
life stress.
Symptom formation
3.2.1 Euphoria, cyclothymic mood swings
Many borderlines retain hope, sometimes against seemingly great
odds, of eventually finding a “perfect” love relationship in which they will never
be abandoned. Consequently, they may “fall in love” many times in their lifetime.
Each time a potential love relationship exists, their primary
emotional energy may temporarily return to their Heart Center, producing
euphoria.
However, since they still rely on projection, which is the belief that
one’s fulfillment or pain is caused by someone else, they eventually lose trust or
faith. They then re-experience the pain and depression, and fall out of love, only to
keep searching and repeat the pattern, thus vacillating between hope and
hopelessness, euphoria and depressive mood swings. Some, however, may give up
and withdraw from meaningful social contact for long periods.
3.2.2 Approach-avoidance and vacillation in relationships
The above patterns will eventually result in an approach-avoidance
in relationships. Because they retain their underlying belief that others are
responsible for their inner states, they seek dependence, yet fear it at the same
time, producing pronounced vacillation.
3.3 Phase Ill: The Inward-Outward Shift.
Description
Usually in response to a love relationship, in which primary
emotional energy has temporarily returned to the Heart Center, a quick shift of
energy may occur in either an outward, or inward, direction, rather than upward or
downward.
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33. Symptom Formation
3.3.1 Sadness crying, joy crying
The quick shift of energy outward from the Heart Center, which
makes a connection with a loved one, will often produce a crying response of
sheer joy.
The opposite, a quick shift inward, signaling a disconnection from
loss or pain in a relationship, may also produce the crying response, this time as
sadness.
This dynamic may also be similar to a “flutter,” in which the shift
occurs in and out quickly, producing a crying response, in which the person is not
sure whether they are happy or sad.
3.4 Phase IV: The Split Shift.
Description
This dynamic involves the bi-polar vertical shift of energy upward
to the head region, and downward to the genitals, leaving a void in the Heart
Center. It has been discussed at some length in a preceding section.
3. 5 Phase V: The Pendulum Shift.
Description
This energy dynamic results from a cyclical vacillation between
projection and denial, anger and depression, as self-protective mechanisms.
Although purely symbolic, the imagery of a pendulum swinging
from one apex of its arc to another, with depression (denial) at one end, and anger
(projection) at the other, has proven useful in therapy. These two affective
responses are connected psycho-dynamically, being mutually interactive in the
borderline, which swings from one end of the pendulum to the other and back
again, in a cyclical pattern.
Recovery requires stopping this cyclical pattern. This is
accomplished by stopping the pendulum swing. The technique is to bring
awareness of the energy in anger, and the energy in depression, back to the
midline of the body, and “dropping” the energy, through the mediating process of
awareness, to the Heart Center. Once awareness returns, it undergoes the natural
transformation from emotion to primary emotional energy.
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34. Symptom formation
3. 5. 1 Explosive anger
Intense anger is generated in response to the pain, emptiness and
personal powerlessness experienced from the Abandoned Heart.
Projection maintains the delusion that the cause of the anger lies
outside of oneself.
Anger is withheld for long periods, since the anger is usually felt
toward those whom the borderline feels most dependent upon. Therefore, to
express anger directly might lead to driving away the very person upon whom the
borderline relies for love, support and caring. Anger is experienced as threatening
to oneself, since adverse social consequences may follow.
When anger is expressed, a duality is experienced. First, there is a
temporary shift of energy to the Heart Center, helping to create a feeling of
strength and the return of personal power. However, guilt will often follow as
awareness is gained of the social consequences, along with a renewed feeling of
threat to self.
3.5.2 Depression
In response to the guilt and threat, the energy of anger is
encapsulated through denial and the withdrawal of awareness, which temporarily
deactivates the energy, eventually producing, through the mechanism of
depression, the slowing of motor, affective and cognitive responses.
The borderline then becomes less effective, adversely influencing
social, self-expressive, and career patterns.
Gradually, as the energy of anger is added to the dynamics of the
depression, tension builds beyond the capacity of the protective encasement of
depression to contain it.
The energy of anger, fed by projection, is finally forced into
awareness by the disequilibrium, and the cycle repeats.
Helpless to stop the pattern, hopelessness seeps in, undermining
self-worth.
3.5.3 Suicide risk
Awareness of depression, dependency, helplessness, sense of loss,
emptiness, lack of self-worth and hopelessness combine with the energy of anger,
guilt, and awareness of social threat to produce high suicide risk.
32
35. 3.6 Phase VI: The Up and Out Shift
Description
In response to a severe life stress, often involving separation,
primary emotional energy is depleted almost completely from the Heart Center as
it is directed upward and “compressed” into the head region during a panic anxiety
state.
Symptom formation
3.6.1 Pseudo-psychotic episodes
Activated by the energy, an information processing over load stress
occurs, which creates intolerable subjective experiences of tension, obsessive,
circular and redundant thinking.
Since the borderline does not have the healing strategy of returning
energy to the Heart Center, there may be one further last-ditch attempt to push the
energy upward, as a response to the intense stress.
With no other directional options, the energy is expelled upward
and “outward,” away from the “self,” producing an energy under load stress which
creates the additional feeling of void in the head region, resulting in the feeling of
non-being and unreality. Temporary fugue states may occur, in there are short-
term memory lapses, and short-term hospitalization may be required.
4.0
Recovery
Initial Considerations
The borderline personality syndrome is the clinical manifestation of an
abandoned Heart. An abandoned Heart is the chronic phase of a broken Heart. A broken
Heart is the disintegration of the energy matrix or subsystem known as the Fourth
Chakra, or Heart Center.
Puzzling in its complexity, the borderline syndrome is often viewed as presenting
special challenges to both the individual and the therapist. Because of the inherent change
and flux of the symptoms which may produce a sense of hopelessness and fear of
abandonment, the recovery process has been viewed as a therapeutic mine-field for
patient and therapist, both of whom can experience frustration and despair.
The model of the borderline personality as an abandoned Heart, derived from
clinical experience, suggests hope. In this section we will outline the basic principles of
33
36. recovery. Derivations of the model, they are straightforward, and essentially simple to
understand and implement.
The emphasis, in therapeutic terms, is always on the basic principles underlying
the development of this disorder, rather than on the symptoms. The symptoms, however,
are useful therapeutically, for they signpost the underlying energy dynamics, and their
disappearance in the course of therapy will be viewed as great cause for hope, something
the borderline desperately needs. Further, knowing the symptom constellations, and how
they interact, can be used sensitively and caringly by the therapist to communicate
empathic understanding of the client’s disorder, and thereby engender the trust so
necessary for successful recovery. The client is hopelessly confused by the internal
disorder they subjectively experience. The therapist need not be.
4.1 The Basic Principles
The basic principle, for both understanding the disorder, and implementing
therapeutic processes and techniques, is the “Law of Awareness,” discussed earlier under
the section on Basic Assumptions.
Principle 4.1.1
A cognitive map of the disorder, including predisposition, development, and
energy-symptom dynamics, has proven useful to clients. This should follow an
intense period of exploring the unique subjective experience of the client.
Because of the natural creative intelligence of the borderline, they often can take
this information and make it work for them at a conscious level, reversing the
unconscious decision they earlier made to abandon their own Heart.
Principle 4.1.2
In therapeutic use of the model, the therapist should feel free to continue using all
the therapeutic skills acquired through training and experience. Nothing about this
model implies discarding the old for the new.
Principle 4.1.3
The overriding purpose of therapy is to return primary emotional energy to its
home, the Heart Center or Fourth Chakra.
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37. Principle 4.1.4
The only guideline for the implementation of any therapeutic skill, process or
technique should be the question: Does this action help return primary emotional
energy to the individual’s Heart Center?
Principle 4.1.5
Primary emotional energy follows awareness. To return this energy to its home,
one first returns awareness to the Heart Center. Concentrated, focused awareness
on the Heart Center will transform an emotion, or emotional state (e.g., anger,
guilt, sadness, anxiety, depression, and sexuality) into the subjective experience of
warmth, peace, contentment, fullness, and desire for love-giving.
4.2 Techniques
The techniques for recovery described below involve a reversal of the original
decisions and energy dynamics that led up to and perpetuated the borderline disorder.
Once this principle is understood, the therapist to suit the individual needs and
circumstances of the client can invent new techniques.
Technique 4.2.1: Resolving Anger
Anger is a product of projection. It is an attempt to place responsibility for an
unwanted state or condition in one’s life onto someone else. It is an attempt to reduce the
internal tension of misdirected primary emotional energy by expelling it, and projecting it
outward onto someone else, rather than to return the energy to its original home, the locus
of the Heart Center, which resides within oneself.
Alone, or with someone you trust, lie or sit down in a comfortable position.
Become aware of the anger, in all its intensity, with all the accompanying thoughts.
Become aware, but do not express your awareness verbally.
Next, “move” your awareness to the region of your Heart Center. This may
involve a spatial reorientation, bringing thoughts and imagery from outside of
yourself, back to your body’s centerline, and then downward to the Heart Center.
At first, there may be experienced a burning sensation in the throat or lungs,
and a strong desire to run, mentally, emotionally, or physically, from this
experience by shifting awareness.
However, by maintaining awareness of the anger at the location of the Heart
35
38. Center, within a short period (20-40 minutes) the burning will change to warmth,
and the Heart Center will be experienced as calm, strong, and full. This indicates
that the natural transformation of the emotion into primary emotional energy has
occurred. This can be repeated during each occurrence of anger, but each
successful attempt will reduce the total amount of anger, acquired during your life
time, until it is eventually eliminated, and replaced by compassion and a desire for
love-giving.
Technique 4.2.2: Dealing with depression
Depression results from denial of awareness of an unacceptable feeling. The
denial encapsulates the energy of the emotion by removing awareness from it. The energy
in therefore deactivated, and is temporarily unavailable for use, either for self-expression
or work.
Therapeutic paradox can be useful here. For example, “We accept your
depression. It is useful to you now, and you do not need to change. Therefore, we would
encourage you to be as depressed as you need to be. However, as you allow the
depression, become aware of it. Become aware of all the body states that accompany your
depression. Then, express to the fullest possible extent your awareness of the many body
states as they arise.”
At the point the client becomes aware of the unacceptable emotion (e.g., anger,
guilt) hidden within the depression, follow Technique 1 (Resolving Anger).
Technique 4.2.3: Pain, Emptiness and Void
Pain in the Heart Center is a signal that primary emotional energy has been
withdrawn. However, the borderline is unusually sensate, pleasure seeking, and pain
avoiding. Their natural tendency is to avoid pain. This is attempted by the strategy of
removing awareness. However, the result is the perpetuation of the pain. Pain is seen as
the natural “enemy” of the borderline.
This view can be reversed. Pain now can become the “friend,” since pain can now
tell the individual exactly where primary emotional energy is needed for recovery.
36
39. Therefore, when the pain of emptiness occurs, it can be used as the locus for
awareness. As awareness is maintained, the natural transformation will occur. The pain
will become warmth, strength, peace, contentment, the experience of fullness as the
primary emotional energy returns.
5.0
Initial Summary and Conclusions
5.1 Summary
The borderline personality disorder, recognized only recently by the American
Psychiatric Association as a discrete and diagnosable syndrome, is gaining clinical and
public attention. Increasing numbers of cases are being seen in both private and publicly
funded mental health clinics, suggesting we may be on the verge of a psycho-social
phenomenon approaching epidemic proportions.
It has been hypothesized, for example, that Vietnam veterans who have
experienced extreme difficulty adapting upon their return may include relatively large
numbers of borderline personalities. This is suggested by their susceptibility to
abandonment depression, low frustration tolerance, explosive anger and high suicide risk,
among other features. John Hinkley, the man who attempted to assassinate President
Reagan, fits many of the borderline criteria. However, there are many others in our
society, with less extreme public visibility, who suffer the constantly shifting emotional
anguish, relationship difficulties, and interrupted or delayed career patterns also
associated with the disorder.
Historically considered difficult to differentially diagnose due to its cyclical and
elusive characteristics, having both neurotic and pseudo-psychotic qualities with
37
40. pathological affective, cognitive, and behavioral-social components, it is confusing and
difficult for the patient to subjectively understand. It breeds hopelessness, despair, and
suicidal tendencies, among other symptoms. It has therefore been a most perplexing and
difficult phenomenon for psychotherapists as well, with treatment times averaging three
years. However, with increasing numbers being seen for therapy, length of treatment has
become a critical issue.
Traditionally, the borderline personality has been considered the primary clinical
domain of psychoanalytically oriented psychiatry. However, borderlines are now being
diagnosed and seen for treatment by psychologists, marriage and family therapists, and
clinical social workers who, although confronted with a patient in crisis and in need of
skilled professional assistance, may not have the orientation, resources or time to provide
a long-term psychoanalytic treatment program. Further, a three year time span in pursuit
of recovery has enormous costs to the patient, both economically and socially.
Confronted with these variables in my own clinical, consulting and supervisory
practice, I began a process, brought into focus through necessity, of reconceptualizing the
borderline disorder. This activity culminated in a paper (attached) which was presented to
the Association for Transpersonal Psychology (1982) and the California Association of
Marriage and Family Therapists (1983), with additional presentations and workshops
scheduled for professional organizations in 1983.
Although still in the early stages of development and refinement, clinical
observations have proven encouraging far beyond expectations. In some cases, recovery
time has been reduced to under three months, thus giving hope for addressing a present
need within both the mental health community and society-at-large.
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41. 5.2 Chronic Loss, Energy-Shift Patterns, and the Borderline
Syndrome
The original model was based on the observation that the borderline patient
displayed symptoms strikingly similar to people experiencing the intense pain, grief,
anger, and depression of a “broken heart.” However, rather than reflecting an acute, one-
time loss, the borderline had patterns suggesting their experience of loss had become
chronic. Furthermore, their experience was compounded by an almost constant feeling of
emptiness or void, which they invariably identified as being located in their lower chest
and closely surrounding area.
We began our clinical research with the assumption that, in addition to a bio-
psycho-social being, man is an energy-matrix system, the form of which responds
sensitively to awareness, thought, and choice.
Following this assumption, we explored with patients their subjective perceptions
of being “in love” and “in loss.” Invariably, with these patients, being in a love
relationship stimulated a feeling we called a “fullness of heart,” in which there was a
sense of connection with another, a feeling of expanding beyond the body’s physical
boundary, and a desire to fill or give completely to the loved one.
On the other hand, the experience of loss produced a profound and often
excruciatingly painful disconnection, with a feeling of contracting and becoming empty,
and a compulsive desire therefore to take into their own bodies something, anything,
which would reproduce a feeling of fullness, alleviate the pain and boredom of
emptiness, and recreate the experience of oneness sought for in their love relationships.
Drug, alcohol and eating dependencies are therefore not uncommon secondary features of
the disorder. In sum, our observations suggested that something (e.g., energy) was
“present” in the Heart Center during the love experience, and “absent” in loss.
Formulating these observations into a working hypothesis, we began searching for
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42. means with borderline patients to assist this energy to “return to its natural home,” i.e.,
the Fourth Chakra or Heart Center, even (and particularly) in the absence of a love
relationship which, if viewed as necessary for recovery, would unavoidably perpetuate
the defense of projection, well recognized as a cornerstone, along with denial, of the
borderline pathology.
Initially utilizing techniques which emphasized focusing awareness on the locus
of emptiness or pain in the Heart Center, we observed indications of symptom relief and
recovery. Although clinically hypothesized from the model, the speed with which the
patient began to experience recovery was surprising. Clinically we proceeded on the
following assumptions: (1) the pain and emptiness resulted from a void or breakdown in
the underlying energy-matrix system, (2) the energy-matrix system responds sensitively
to awareness, thought and choice, (3) returning awareness to the locus of pain produces a
return of primary emotional energy to that location, and (4) it is possible to eventually
anchor this energy by maintaining the new locus of awareness for a sufficient period of
time so that it no longer shifts erratically, thereby eliminating the cyclical, fluctuating
pain-avoidant patterns of the borderline. Although the exact process remains unknown,
permanence seems to require only that the energy be “anchored,” and the length of
therapy is determined largely by successes (or failures) in this energy stabilization. A
subjective result of this internal process, reported by clients, is the sensation of warmth
and fullness in the Heart Center usually associated with emotional connection in a love
relationship, but now occurring in the absence of such a relationship.
Nevertheless, we also observed that some patients were resistant to the elusive
nature of techniques which depended upon refocusing awareness, making it imperative
that other treatment modalities also be found. In general, we found that those who
experienced the most difficulty with awareness techniques (1) experienced more
emptiness than pain, (2) had not yet broken through major areas of denial, (3) had little
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43. experience differentiating between thought and awareness (e.g., had not previously
engaged in meditation) and (5) had a greater tendency to view the therapist as an expert
to whom they could look for solving their emotional and behavioral dilemmas.
5.3 Conclusions
The borderline personality syndrome is a composite disorder initiated by
constitutional, predispositional and developmental factors involving a dynamic cyclical
shift of primary emotional energy away from the Heart Center or Fourth Chakra. As the
energy moves away from the Heart Center, it accumulates in other energy centers and/or
body parts of the individual, producing several discrete sets of symptoms, which
correspond to the following processes:
5.1 Energy underload symptoms
Energy underload symptoms, which result from energy shifting away from
the Heart Center (e.g., emptiness, pain, anxiety, boredom, depression);
5.2 Energy overload symptoms
Energy overload symptoms, which result from the energy shift
accumulating inappropriately and excessively in other energy centers and/or body
parts (e.g., tension along vertical midline, communicative disorders, sexual
pathologies, panic states, and explosive anger);
5.3 Information underload symptoms
Information underload symptoms, which result from withdrawal of
awareness from self and/or one’s life situation, including social contact (e.g.,
interrupted career patterns, lack of reality testing, delayed emotional development
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44. and unrealistic appraisal of self);
5.4 Combined information overload/energy underload symptoms
Combined information overload/energy underload symptoms, which result
from panic response to intense life stress, such as separation (e.g., obsessive,
repetitive and circular thinking, with an attempt to forcefully expel excess energy
from the head region, producing a thought disorder and psuedo-psychotic
episodes); and
5.5 Behavioral changes
5.5.1 Behavioral changes producing relationship difficulties and occasional
social pathology, which serve to both trigger and perpetuate the disorder.
5.5.2 Puzzling and confusing to both the borderline and therapist due to the
intensity, complexity, and cyclical nature of the disorder, the individual
nevertheless is not without hope.
5.5.3 Recovery can come swiftly once the basic principle of therapy is
understood and implemented. The abandoned Heart of the borderline can be
returned to the wholeness and fullness of its natural state by following the Law of
Awareness: Reawaken awareness of the Heart Center, thereby allowing one’s
primary emotional energy to return to its natural home, producing peace, strength,
contentment, and a desire for giving of self.
The successful outcome of the recovery process is a spiritual transformation, in which
one can finally say:
I Am
Being
Within love
With you.
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45. 6.0
Onset and Breakdown:
Setting the Stage for Recovery
From onset to complete recovery, the borderline syndrome may be
viewed as occurring in seven stages, the progression of which moves through
several overriding phases, including onset, breakdown, crisis, recovery, and a
psycho-spiritual transformation. These seven stages are:
Onset and 1. The Broken Heart
Breakdown 2. The Abandoned Heart
Crisis and 3. The Awakening Heart
Recovery 4. The Heavy Heart
5. The Strong Heart
Interpersonal and 6. The Full Heart
Spiritual 7. The Light Heart
Transformation
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46. The Seven Stages of Onset and Recovery
6.1 Onset and Breakdown
The constitutional, developmental and psychological factors,
which, when occurring together and in sequence, comprise the borderline
personality syndrome, have been described in detail above. However, we shall
again summarize the essential elements here, hoping it will contribute to a
perspective of the disorder, from its onset to full recovery in its entirety.
Although the description of onset and breakdown is bleak, and the borderline’s
subjective experience filled with pain, turmoil and emotional anguish, the
essential message here is hope. Based on clinical observation to date, full
recovery is not only possible but can occur swiftly, changing a person’s life not
only in ways unforeseen, but (and I admit to editorial license here) awe-inspiring.
The transformations I have been privileged to observe have touched me, as deeply
as if they were my own.
6.1.1 Stage I: The Broken Heart
The essence of the borderline pathology is a broken heart. Most of us have
experienced an intense emotional loss, and with it the pain that we are often able
to locate in a particular area of our body, usually our chest or upper abdomen. The
pain may be so intense that we feel genuine concern for our physical and
emotional wellbeing. Physical symptoms may ensue, motivating us to seek
medical attention.
What we may not yet recognize is that a broken heart, far from being simply
another metaphor, is a valid subjective phenomenon. The pain and emptiness are
real, because something has been torn from us. Whereas before something was
present that provided a feeling of fullness and well being, that “something” is
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47. now absent. There is, in a literal sense, a hole in our middle. It is, if we are to
judge from our reaction to it, an invisible gaping ugly wound.
Although first occurring during infancy, and continuing periodically
throughout their lives until the final crisis which brings them to therapy, the
broken heart of the borderline patient is the same experienced by all who have
known catastrophic emotional loss. There is only one major difference. The
borderline has known this loss not once, but literally hundreds of times.
During the initial phases of treatment, it can be especially meaningful to the
patient if they sense the therapist has an intuitive and sympathetic understanding
of the subjective emotional significance of a broken heart. It is helpful for the
therapist to know their own emotional pain in this way. And it is useful to be
sympathetic to that special insanity that can follow loss: The grieving process,
profound depression, frustration and futility leading to rage, to helplessness in the
face of overwhelming emotional adversity, the undermining of self-worth from
nameless guilt, and hopelessness leading to suicidal ideation or action. It is
helpful for the therapist to intuitively know this, and more, for these comprise the
foundation of the borderline’s subjective experience and existential dilemma.
Often, however, the borderline’s walk through life is not met with empathy,
much less sympathy. They are in actuality quite disabled for lengthy periods in
their life, but appear to others to be very much the master of their own fate.
Expectations from others are often high, yet their own competencies, particularly
interpersonal ones, may be severely underdeveloped. Later in life, career patterns
may falter for these underlying, unseen reasons, thus leading to greater frustration
and eventual explosive rage.
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48. The pain of a broken heart leads to symptoms interpreted as physical. These
may range from appetite loss to nausea, from irregular heartbeat to symptoms
mimicking angina. Physical pain in other body parts is not uncommon. Although
medical attention is often sought, there usually is no basis for diagnosis.
Disenchanted and unconvinced, the borderline may drift from physician to
physician until a mental health referral is finally made. The psychotherapist who
can assess within the first session or so the presence of a borderline syndrome,
and then work immediately toward uncovering the multiple experiences of loss by
encouraging them to tell their life’s story, will often be rewarded by the
statement, “This is the first time I have ever felt understood.” Although payment
for therapy is always appreciated, it will never replace the feeling one receives
from a borderline’s gratitude.
For most of us, our first broken heart does not occur until adolescence, or later,
when we have a strong, usually sexually energized connection with another
person. Not so with the borderline patient, who through predisposition,
constitutional factors and family history, has lived through that experience
multiple times, usually hundreds if not literally thousands, since infancy.
6.1.2 Stage II: The Abandoned Heart
The child who is constitutionally prone to the pain of a broken heart is in
greater than usual need of consistent, stable emotional nurturing from a parent
well-grounded and secure in their own sense of self, and whose primary
fulfillment comes from resources not directly tied to the child. The nurturing
principle of empathic non-possessive, emotionally warm caring, provided by a
mother capable of emotional and non-erotic intimacy while encouraging
independence applies to this situation.
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49. So, imagine the child in vital need of this nurturing. Yet also imagine that each
time the child comes to the parent to fulfill this need, the parent is unable to
respond. The parent has an “empty heart,” unable to connect emotionally with the
child. For the child, the parent may be physically there. But emotionally, no one
is home. For the child, seeking merely to have their own Heart Center affirmed,
each time they approach the parent without the fulfillment of connection, their
primary emotional energy drifts. It moves away from its center. And each time it
drifts, each time it is not allowed to connect and to stabilize, there is an empty
ache. At first the ache may be but a gnawing hunger. But each time it becomes
stronger, more and more a dominant part of awareness, until finally it becomes
pain, the pain we know as a broken heart.
This process, for the borderline-prone child, occurs not once, but again and
again, a thousand times, uncountable times, until the pain reaches intolerable
limits.
Drastic measures for self-survival are necessary now, and the child responds.
The acute pain of a broken heart has multiplied once too often: It has become
chronic. And the child responds, attempting to forever remove awareness from
the pain’s locus. However, without recognition of the enormous implications, the
child has abandoned not their pain, but their own Heart. They have abandoned
awareness of their own essence. And thus doing, they have begun a process of
breakdown, which will lead them, step by anguished step, toward the syndrome
we now know as the borderline personality.
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