A Very interesting panel discussion at Yale, and one in which a lot of what is said matches my experience.

She seemed to be living in a bubble, to be out of touch with reality. She was aware and we had spoken about the fact that she was seemingly unaware of all of the kind things I had done and said to her. She was most definitely unable to interpret facial expression at very least most of the time. I had adapted by explaining my facial expressions, but she was dubious and more often than not would choose to believe her own first impression. She had a similar issue with voice tone, often when I was excited about something she would understand the voice tone to mean that I was dogmatic, or anxious and somewhat ironically would ask why I would never get excited about things. I can only imagine what level of despair this lead to, if I were consistently unable to recognize excitement in others I might come to believe that I was the cause of their lack of excitement. I might come to take it personally. She was always suspicious, I had to explain a lot of things that I did, and that became habitual. When asked a question she was unable to interpret voice tone and facial expression, so any question was usually dealt with rather than answered, and mostly was dealt with by avoiding any sort of direct answer. I might ask, “Are you going to Yoga today?”. She would interpret the question in a number of possible ways and struggled to answer the question if she couldn’t be certain “where I was going with this”. She might interpret the question as a passive aggressive attempt to get her out of the house or alternatively as a criticism of her state of health, the way she looked, or even an accusation of laziness leveled at her. The reality of course was that I wanted to know whether to arrange dinner at a later time than usual, and even though I would explain why I was asking she would often disbelieve what I had explained in favor of her misinterpretation. She seemed in several ways to be living in a reality which differed from reality. What it seemed from the outside was that she would have emotional responses to things which didn’t happen. To her, given her frame of mind, they most definitely did happen. About answering questions I used to say to her “Just take the question at face value” or “Just answer the question that’s asked” in most cases people aren’t being underhanded, in most cases they really just want a question answered, and often if one answers exactly what is asked people may rephrase their question. She was unable to this though, for the most part.

I can’t stress enough that the possibility exists to “cure” BPD, or at very least to improve the situation greatly. Something society seems to do is believe that a person with a mental disorder, such as a personality disorder, is fundamentally bad, fundamentally a cruel persona, an unkind person, an insensitive person, that the symptoms of the disorder are part of who the person is. I think more in terms of “Who would they be if the disorder were cured” which alludes to the disorder and the person’s identity not being one and the same.

Below is the video of the panel discussion which provides some insights into how these problems may arise.