Why are people with Personality Disorder so manipulative?

Keir is a Lead Therapist in an NHS Specialist Service and provides training, consultation and therapy around complex mental health problems through beamconsultancy.co.uk

Those diagnosed with personality disorder are manipulative.  This is a fact.  At least, you would think it was a fact if you heard it as many times as I have coming from the mouths of people in the caring professions.  Whenever I’m doing training on personality disorder, there is rarely a session where this fact isn’t voiced at some point.  When it does come out, it isn’t spoken in a timid, tentative way, but with the full throated confidence of someone speaking a truth universally acknowledged.  It is a fact as certain as death and taxes, and because people are so assured that it is a fact, the presence of a service user with a diagnosis of personality disorder in the room does nothing to encourage them to censor their views.

I’m going to spend some time thinking about manipulation, what we might mean by it and whether this is another way of interpreting behaviour in a way that might help carers keep caring.

 Most definitions of manipulation use the terms like clever, skilful or artful, implying a conscious use of talent on behalf of the manipulator. Based on this definition, we all manipulate the people in our lives in that we consciously try to get them to do what we want.  Being good manipulators, we hope to do this while keeping people liking us.  This is the skill.  It is not the forcing of our will onto others but being able influence people while keeping them on our side.  The problem that people with personality disorders have is that they are awful manipulators. Very often in my life women who are older than me tend to mother me.  If I look a bit flustered or helpless, they will frequently step in and do things for me that I’m perfectly capable of doing myself.  At the end of it, we all tend to like each other a bit more.  I’m in their debt and they feel they’ve been useful.  You can argue that this is a skilful bit of interaction, but based on the definition above, you could also argue that I’m manipulating people.  Let’s contrast this with me walking into the office and shouting “If someone doesn’t give me a lift into town, I’m going to fucking kill myself and it will be your fault.”  I have no doubt that the people in the office would indeed take me into town.  Whether they would ever want anything to do with me in the future is another matter.  Again, lets have a think about what might be the actions of a skilful arch manipulator, and what might be someone with really ineffective ways of getting their needs met.  A good manipulator gets what they want and people like them.  A bad manipulator gets what they want and people resent them.

It wasn’t a million years ago that I shared the ‘personality disorder = arch manipulator’ view. I used to work in a team where at least once a week a man would phone to tell us he was suicidal.  What followed would invariably be a 30 minute phone call where I desperately tried to get him to tell me he would be ok.  He rarely did.  Every suggestion of what to do had already been tried.  Every option had been explored and found wanting.  It said on his careplan to phone when he was suicidal and here he was phoning.  Now what was I going to do about it?  The answer was always nothing particularly useful.  While I was being berated for my incompetence I tended to feel powerless, useless and for someone who came to work to make people better, pretty bad at my job.  It would be fair to say that I hated the way he ‘made’ me feel and I know that many of my responses on the phone were far more about me trying to ‘win’ than they were about trying to provide care.  Because he had phoned weekly for years, I knew the actual risk of him committing suicide was pretty static and that the phone calls didn’t reflect a significant change.  In my head this guy was sat at home planning different ways that he could torture me.  I saw him rejoicing in my discomfort, raising his fist in the air (as I did) when he felt he’d refuted an argument and hanging up the phone after a particularly vitriolic exchange happy with a job well done.  My team were very helpful in supporting me with my view of him and we would have many conversations that built up a picture of someone whose sole pleasure in life was my misery.

It’s hard to be particularly caring to someone who at best, I wished would leave me alone.  Because I took the majority of his phone calls, I sought out some supervision to help me manage what I viewed as a cruel individual.  The supervision was not an enjoyable experience as rather than help me to manage a trouble maker, the supervisor started pulling apart the foundations of the power crazed manipulator I had built up.  He asked me what the service user was looking for when he called and what in his life might explain the way he interacted the way he did.  He got me to see how unhelpful the picture I had of the client was and even worse, how I might be exacerbating and maintaining some of the very things that did my head in.  That was the first time that everything I thought I knew about ‘personality disorder’ had been challenged and now I reflect on it, the first step towards me choosing this area for my career.

The point of the above is that I can sympathise with the view that people diagnosed with personality disorder are manipulators and it’s a view that I’ve held myself.  Now let’s try a different way of looking at things.

Within DBT (Linehan 1993) manipulation would be viewed as poor interpersonal effectiveness.  Most of us come from a background that helped us to be effective.  We know how to get our needs met while keeping people on our side.  We know that when we raise the intensity of our communication by being more assertive or even hostile and rude, we run the risk of damaging the relationship with that person.  We generally know that if we need help someone will do something and that we can say no to requests that are unreasonable.  People who tend to be diagnosed with personality disorder haven’t come from the same background and as a result, they don’t have the same skill set as the average person in the street.  They might have come from a background where your needs were only met if you screamed blue murder.  They might have come from a background where people modelled that threats and violence were the only way to get people to do what you want.  They might have only been cared for when they were physically hurt or they might never have been taught to put their feelings into words.  They might….and on and on.  The gist of this is that we will see peoples past relationships in their present ones if we look for them.  If we look hard enough, we can see how people have been taught to interact the way we do.  If we’re being brutally honest with ourselves we might see how what we do keeps some of these problems going.  If we only spend time with people when they’re in crisis, if we only increase input when they self harm or we reduce our contact as soon as they’re ‘doing well’,  we can be playing a big part in keeping some of the more difficult to manage behaviours going.

It might also be worth thinking about splitting, where “people with personality disorder ‘play staff off against each other’ and form special relationships with particular carers”.  Splitting in teams certainly happens but I wonder if us staff ignore the part we play.  Instead we blame the client and think of them as an evil puppet master, pulling strings that ‘make’ us act.    Now I come from a background that taught me I was loved and valued.  Despite this I tend to gravitate towards people I perceive as warm, friendly and interested in me.  People labelled with personality disorder have the same tendency.  When in a frightening place it makes sense for them to particularly attach to staff who show the most warmth or have some characteristic that feels safe.  It makes more sense to strengthen that relationship by giving gifts, telling secrets and ‘being good’ for them.  Those staff care.  They need to be hung on to.  The relationship can also be strengthened by distancing yourself from people who are more cold, apathetic, hostile or just different.  By being difficult for the ‘other’ ones or only working with the special ones the special relationship is emphasised . This isn’t a cold, calculated endeavour to cause chaos, but a natural response from someone whose early experience of carers was different to our own.  In The Ailment, Tom Main (1957) gives the example of a baby crying in a room full of people.  They will compete to sooth it and some will succeed.  In an innocent way the baby evokes some rivalries in the people around it.  It might become distressed by these rivalries and might even make them worse in the quest for comfort.  While the baby hasn’t caused the rivalry (or split), its behaviour which draws in some while pushing away other inflames them.  The baby (fairly understandably) is pretty poor at managing the people around him but he does the best with what he has.  The split isn’t his fault. 

We can also think about what gets called personality disorder as a difficulty in managing strong emotions.  Often people with this label were never taught to manage their emotions, they had people in their lives who modelled ineffective ways of coping or they learned that only intense expressions were effective.  When on the receiving end of these powerful emotional communications it’s important to remember how well we are able to think when we are at our most frightened and angry.  When working with those who have been taught that the world is out to hurt them or those who are terrified at the prospect of being left alone, it is understandable that strong emotional responses will be a part of many of our interactions.  When angry or afraid we all want to manage the immediate threat and pay less attention to what happens in the long term.  If we can view people as feeling threatened or terrified, if we can understand why they might do all they can to achieve a short term goal again, it is harder to keep that picture of a skilful arch manipulator. 

We started with a picture of people diagnosed with personality disorder as calculating master manipulators.  We’re now at a place where we might see that some behaviours are exaggerated natural responses while others are the product of poor interpersonal skills.  We might substitute the idea of people intentionally causing chaos with people doing the best they can with what they’ve got.  Holding this in mind is essential for keeping some care in the caring professions.  It is nigh on impossible to care for someone who you think is deliberately trying to hurt you simply for the pleasure it will give them.  If we can ask ourselves why the client communicates in this way and find an explanation in their past then we can keep empathy.  While we have empathy, we can show compassion.

We live and work in busy times.  There is little time to search peoples records for clues from their past.  Action is valued, reflection looks a lot like doing nothing.  We do little good for our clientele when we act without empathy and yet the pressure to act on what is in front of us is immense.  Perhaps next time we feel that pressure to act we might do it with a person who has missed out on some of the skills we have in mind.  We can notice the sense that we’re being manipulated and wonder what that might mean in the context of an unskilful person trying to get their needs met.  It doesn’t mean that our actions will be different but it might mean we might communicate in a more caring way.

We all manipulate.  People who tend to be diagnosed with personality disorder are just particularly bad at it. 

Keir is a Lead Therapist in an NHS Specialist Service and provides training, consultation and therapy around complex mental health problems through beamconsultancy.co.uk

Linehan, M. M. (1993). Cognitive Behavioral Treatmentof Borderline Personality Disorder. New York: Guilford Press.

Main TF. The Ailment. Br J Med Psychol. 1957; 30:129-45.

 

As ever, all of the above is just an idea to play with.  Don’t take it as fact.  Other ideas are available...

 

59 thoughts on “Why are people with Personality Disorder so manipulative?

  1. This is going to fly in the direction of as many mental health professionals as I can get it too especially my crisis team. Too often I encounter these attitudes from professionals when all I’m doing is asking for help when that’s what they’ve told me to do. Thank you for writing this.

    Liked by 1 person

      1. Oh for sure it will upset quite a few I expect. I found it hard to read having been on the receiving end of similar attitudes. I got a lot of flak for one of my posts and needed to take cover for a while. I’ve been incensed at how I’ve been treated over the years and try v hard (with some staff on side too) to dispel the myths of PD’s

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      2. Having Ben. Married to a Woman with an undiagnosed Narcissistic PD who had an emotionally distant mother, this makes sense. However, I am not sure it explains the gaslighting and outright cruelty she inflicted on my Son, who died by suicide two and a half years ago. While I remember, please could you remove the term ” committed” from your text. Suicide is no longer a crime, and it is considered by parents bereaved by the suicide of a child to be an outmoded and cruel term. Thank you in anticipation. It might be that my Son’s mother was treated cruelly by her own mother in not having her emotional needs met, but her ability to project her own failings onto people , the emotional damage she has caused both in my late Son and my daughter, who is at risk of inheriting or developing her mother’s traits is not explained by her own mother’s failings. She is passive but not actively cruel like her daughter. My ex wife has her whole family scared of her, I have no contact with her, and I prepared months in advance of my Son’s inquest with counselling to equip me with the psychological armourI knew I would need at that hearing. I was right. She blames me for My Sons death, even though he had turned his back on her two years previously. He never mentioned her in either of two suicide notes, and had already come to an independent view and realisation of his mother’s condition. In one note he pleaded with his sister to get out of the situation, leave home, reconnect with me in order to have some happiness. Manipulative behaviour sometimes borders on evil intent, it goes beyond a need to be emotionally fulfilled, it strays into very harmful actions. Not everyone with an emotionally distant parent develops manipulative behaviour, they can and do break the chain and lead normal loving relationships. When does bad manipulative skills become evil skills, because there is frankly no other word that conveys the intent of someone who deliberately witholds love from their child as a mother and destroys that life quite literally.

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    1. who are created by 1st placing these vunerable selected persons in an induced consistent Stockholm syndrome, where a consistent disruption to the schedule of routine daily life, than they destalize sense of self worth, than they sever the primary emotional bond-the suicide bombers are triggered via clinical hypnosis and drugs, as they are initially selected through their low impulse control, which flags aggression, all these procedure steps have been used in projects like MLK ULTRA, to train and trigger assets, where victims are selected for their warrior genes with mild kinetic abnormalities-MAL 2R Gene

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    1. Thank you Judy. I suppose its worth saying its not all professionals and even then, attitudes are based on not being able to understand rather than people being deliberately mean.

      I’m glad you liked it and really appreciate the feedback, Keir.

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    1. Thank you so much. It seems great to get feedback from people, especially when it’s positive. Do feel free to share it around. My fear is that it’s only ‘the converted’ who will see it.

      Thanks again, Keir

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  2. Thank you for such a thought provoking article. It made me pause and think, and will definitely challenge mine and my colleagues attitudes more often. I recognise the bit about action valued more than reflection, yet only through reflection I would argue can we start to appreciate where someone is coming from. Three years in Forensic mental health and I can count number of team reflections on one hand.

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    1. Gosh I’m late replying to this. I suppose it gives m the chance to ask how the challenging got on. It’s hard to get time to reflect but the first step is to let people know you value it. You can be the change!
      Thanks you so much for taking the time to comment. It is so appreciated.

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  3. Brilliant post. I’m a student mental health nurse, one of those who had a view of people with personality disorder as “manipulator”. Certainly this view is shared among many mental health professionals I have worked. This blog Was so helpful in challenging my views about them and I hope I can translate this to my practice

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    1. I was talking to someone today about the value of shouting into the echo chamber that is twitter and only hearing people who agree with you. I really appreciate you taking the time to let me know how this impacted on you. Now you have to pick up the torch and spread the light. Thank you ☺

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  4. Fantastic & thank you for offering a different perspective of manipulation. When well I teach staff about self-harm & suicide; I offer a flippant example of manipulation to hopefully help staff understand that we all at times manipulate (usually along lines of I have will go home after teaching today, sit on sofa [should just add I live with chronic pain & poor mobility] & tell my husband how much I love him, any chance of a coffee or bottle of Stella!) to get our needs met, it’s what as human beings we have evolved to do. As you can imagine staff can offer relate to this example. I want to encourage staff to move away from the manipulative label, take a step back, what is really happening in that persons life, either now, in the past or possibly fear for the future.
    The sad thing is I’m not well at present & am ODing worse than I have for many, many years. Yesterday I was told “it’s your choice …”

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    1. Thanks for you kind words Sam. I try to get staff to move away from that label too. It’s good that most want to and can see a more empathic way of interpreting things. Let’s keep challenging. Thanks for taking the time to comment. ☺

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  5. The article implies a PD is all learnt behaviour, having a grown up daughter with a PD and most of her manipulative presentation was their from early onset and I’m 100% sure inherited from her absent father, who had the same traits. I do feel for some sufferers there is a generic heritage.
    Interesting read, thank you 😊

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    1. Thanks for commenting Mandy. There’s an argument to be made that our personality is made up of biological, social and psychological elements and which each having more or less influence than others in different individuals. I suppose those in the behaviourist camp would argue that ways of interacting only develop in a particular way if they’re working. It’s all very complex. Glad you found it interesting 🙂

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  6. Hi Kier.
    I wish different pd diagnoses were not lumped together when people talk about them. Someone with an inate psychopathic thinking style has different needs to an individual with borderline pd, who benefits from a therapist helping them to identify and use better emotional coping strategies. They both may use manipulation but for different reasons. I have found the pd label used by certain staff to justify their own lack of compassion, and to justify not meeting a patient’s needs in a timely way. Compassionate staff tend to ask why a person is distressed or being demanding, not to use it as a reason not to help them. Culture is so important in mental health settings and strong compassionate leadership of the service. Compassion, or lack of it, is learned as new staff join and model the staff around them. There can be one culture during office hours – but another during nights and weekends and an OT can’t help this. Training (and lots of it) is so important in helping people to be more understanding. Maybe also changing the name BPD… It sounds so much worse than it is.

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    1. Thanks for commenting Anthea. You’re not going to like ICD 11. That gets rid of the classifications and just rates people on severity. I agree with pretty much all you said but I think the organisation can also influence how compassionate we are. If we have time to be useful to people then we can be, if people are just units to be processed then it’s harder to keep the empathy…Thanks for reading 🙂

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  7. Nearly 20 years ago i worked in a homeless hostel with 30 residents staying for up to a year, with wide and varying needs. One client with a ‘personality disorder’ was ‘the most difficult one’ – she would threaten suicide or ‘kick off’ 3 to 4 times a week causing big issues for other staff and clients. As her key worker i offered to spend a 1-2-1 session with her 3 times a week, regardless of whether there was an incident and she agreed- Just me and her in a room talking for an hour three times a week (this was before such key work sessions became common like they are today). I got to know and like her very much during this time- i had previously found her irritating and manipulative like the rest of the staff. We met like this for several weeks, sometimes she would tell me really difficult and awful memories, othertimes we would just chat about what she was watching on TV- after a month it was noticable the number of hostel ‘incidents’ recorded about her had dropped dramatically. I counted them up one day & estimated my 3 hrs spent with her per week was reducing at least 6 hours of ‘incident’ time. However in our next team meeting other staff and management decided i was spending too much time and ‘rewarding’ her previous ‘bad’ behaviour- so after a couple of months i was told to stop. Guess what happened… yep her ‘incidents’ hit the roof and she felt really let down by me. I left shortly after but always remember that experience. As a young, unqualified support worker i never challenged the decision (even though i thought it was the wrong one) and often wondered what became of her after i left. Thanks for publishing this- it makes sense of that experience for me and is a good reminder of how important professional compassion is when working with people in crisis.

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    1. It is so rude of me to leave it this long before replying! Services can be so fixated on being right they can loose all sense of what they are there for. To improve outcomes to people or enforce rules. It’s difficult to work in an environment where people can’t think, especially if you’re capable of reflection yourself.
      I hope you’re holding onto your compassion, and thank you for taking the time to share your experience.

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  8. Hi Keir, great post! Loved reading it. Can I push you to go a bit further with it though? I think there is only a couple of things missing from your post. At no point do you make it clear that 1) none of what us BPDs do that could be considered in any way ‘manipulative’ (whether we are good at it or not) is actually consciously done 2) plenty of people with mood disorders can be considered manipulative (it’s not just a label that can apply to PDs) and 3) what about treating clients as individuals rather than just walking diagnoses?

    People forget that severe emotional neglect/abuse is often a component of BPD. Part of that is not only calling a child names, but trying to get the child to shut down emotionally. I was told repeatedly ‘crying is manipulation… stop it, it won’t work, I won’t give you what you want’ all I wanted was a hug because I’d grazed my knee or something. It is stuff like that. Demonising of emotion. When not dealt with in a healthy way, when kids are not shown how to handle big emotions, later, when the emotions get too much, they get out of hand. After a lifetime of living in an emotional pressure cooker, it explodes. The intensity of emotion blinds any conscious, rational thought so in the moment, no, we are not thinking about how we can get you to do what we want. We feel abandoned for whatever reason, our emotions go haywire, the pressure cooker explodes and we self-harm or attempt suicide because we cannot cope. Without any hope you will not abandon us. It’s not manipulative (whether we are bad or good at it is irrelevant), it’s just an inability to cope with emotions we cannot handle. Often I feel like people who label me as manipulative are asking ME to be self-aware but actually missing that deep inside them is something that I’ve rubbed up the wrong way. When I began to see that when people called me manipulative they were actually saying ‘you want something I don’t want to give you’ I began to see it a little differently. It is less about what I want and more about what they DON’T WANT TO GIVE ME. So that begs the question…. why don’t they? Does my pain resonate with them? Are they afraid of emotion themselves? Are their emotional boundaries not strong enough and if they are professionals, is it their problem for taking on more than they should have? IF your emotional boundaries are secure, you have the right help and support (supervision, therapy for yourself maybe and a loving group of friends and family), the right experience and qualifications and you take good care of yourself… then actually the chances of labelling clients negatively is less. I’m constantly surprised that my therapist can handle me. She allows me to contact her between sessions, she tells me she genuinely cares and likes me and thinks about me between sessions. I thought that meant she was going to burn out and blame me. She told me ‘no! That’s why I have good emotional boundaries, good support structures and I take good care of myself. I cannot pour effectively from an empty cup’

    Also, the incident you described with the guy who kept ringing to say he felt suicidal then telling you he’d tried all your suggestions… that could also be depression. The number of people with depression who also do that is high as well. Using their illness like a blanket they don’t want to give up… that could count for any number of mood disorders, not just PDs. Only the other day, I met one woman with depression who had recently decided to come off her drugs ‘oh I feel awful’ she said. I empathised. ‘the drugs just don’t work’ she said, I validated and empathised ‘therapy just doesn’t work either’ she said. ‘I’ve tried everything’. When I asked more questions, turned out she’d tried 1 drug and 1 therapist using 1 model of therapy. When I said ‘there are lots of kinds of drugs, don’t give up, you might not have found the right one and there’s hundreds of models of therapy, again you might not have found the one that works’ ‘oh no, it’s me… I cannot be cured, thank you for trying though’. She had depression, not BPD.

    Obviously, not all people with depression are like that. Not all people with BPD are how I suggested either and not all therapists are like mine nor are all OTs like you. Even though we carry a label… that is not all there is to our personalities. We are not just diagnoses. We behave, think and feel differently to each other because we are (bizarre concept I know) unique individuals. Diagnoses are a lazy man’s way of understanding someone. Like all labels; black, white, Christian, Muslim, gay, straight, man, woman etc… if we know someone’s ‘label’ we can quickly make assumptions about what they are like (stereotypes) and assess their ‘danger’ to us (psychology 101). How about… not doing that and taking each individual case as they are and treating them as such?

    Bit radical of me, I know and I apologise if your blog in other places has already dealt with the issues I raised and you already agree with me wholeheartedly (I’d be surprised if you didn’t, judging by your open and non-judgemental attitude displayed on Twitter and in this post). I just wanted to add a BPD perspective to the mix.

    All we want, all any human really wants, is to be appreciated and validated for who we uniquely are. Forget labels, look to the individual for the definition of themselves.

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    1. Sorry for taking so long to reply. To address your 1st point, I hope I make it clear that EVERYONE manipulates people. That’s how we get people to meet our needs and keep liking us. We all do it, but people who tend to have a BPD label aren’t particularly good at it, based on their early learning and (often traumatic) experiences.
      2- You’re right, anyone can have a relationship with staff where they perceive the person as manipulative, but regardless of the diagnosis, if it happens too often someone will stroke their chin and suggest BPD might be a better label.
      3- If I was writing this now I’d use “people labelled with PD” rather than focusing on the diagnosis.

      Thank you so much for letting me know your thoughts and encouraging me to write more. If you ever fancied writing a response id happily publish it. Thanks again,

      Keir

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  9. Loved your article! Your depth of understanding is awesome to see in writing. Unbeknownst to me I married (now divorced 2 years after 20 year marriage) a lady that was diagnosed with a PD during our marriage counseling near the end of our marriage. I began to understand what/why things happened as they had. Only after I began to understand could I go from anger to forgiveness. Her particular love/zeal of manipulation is still frightening to me. Her ability to long term plan to meet her amazingly selfish needs is the most frightening in hindsight. Having someone you’ve loved 20+ years basically stand over you and laugh (and gathering her flying monkeys around to laugh too) as you’re lying on the floor in pieces it’s hard to understand at that moment but in the end it can help understand what they must have experienced as a child. To understand misdirected anger and revenge is helpful but it still hurts like hell. Weird, or maybe not at all, how the abused becomes the abuser. The cycle continues.

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  10. Interesting read, uncertain which personality Disorder you were referring too as Emotional Intensity Disorder would not lend itself to the Manipulation definition in your blog as it is a deliberate thought process not behaviour thus Cognition. I am trying to understand the similarities and differences around and within each of the 3 clusters of Personality Disorders.

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  11. This is a great post, but I am also shocked that people who work in mental health teams are so unsophisticated that they believe clients are being manipulative like masked villains. Surely personalizing like this is a sign of emotional and psychological immaturity?
    This is my beef with services. Cant they employ people who don’t actually resemble some of the diagnostic criteria for personality disorder themselves? I mean borderlines are supposed to have ‘rudimentary and expediently devised coping skills’ according to arch guru theorist Theodore Millon. Sounds a bit like a crisis team response or indeed mental health services themselves given the implications of severe underfunding.

    I think there may be a number of reasons someone might make a suicide threat based on my own experiences as someone who was diagnosed with emotionally unstable pd:

    Fearing a sudden wave of unpredictable negative emotion, this follows a deeply intuitive knowledge that the threat level must remain high for I know that in the future I might suddenly experience a kind of planetary alignment where all the destructive forces come together and I would follow through on the destructive effects. When I see people recording my emotions as completely healthy I feel fear because it is as if a white light were guiding them – and I can see that I am not going to get the help I need.

    When I am in a crisis, if it is a bad one I don’t want help,-there is an unstoppable momentum- so there is something proactive in calling. But then call too often and it has the effect of making you appear less distressed than you are. I am aware of this paradox and I feel tormented that this private truth is not communicable to anyone else, and am bitter and tired and inured to its perseverance, so that self harm is a totally private act and a conceited commentary known only to myself.

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  12. A psychologist I saw talked about schema chemistry, which is the chemistry between people, in this context the sufferer and the helper. ‘Acting out’ and ‘kicking off’ are broad labels that do not really describe much. My psychologist kept asking me ‘what were you thinking before?’ and ‘avoid getting into a battle of wills.’

    ‘Kicking off’ sounds like a thermostat, but is it anger or anxiety? Yes it might be dangerous, but what dangers does the person experience within?

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  13. The problem with being a good manipulator is that you can manipulate things you don’t really understand, so you could ‘validate’ a perspective without really having any idea what it is that the person is experiencing.

    You can contrast a response based on knowing with one that is facile – one that explains away problems. With facile validation there is obviously the risk that the therapist is doing therapy for themselves, for their own benefit and not for the client. Whether people can really do therapy at all with disturbed clients without having experienced any of the problems the patient experiences is one area of concern. Linehan later disclosed her experience which must have formed some of the insights.

    DBT is basically an attempt to train people to validate experiences they have never had personally, and as this post captures in the title, the mindset is invariably hostile.

    When I was a small child my father had his leg amputated, as a result of rugby, and this was quite a major event. It would be extremely unlikely that a mental health professional would have any idea of the difficulties this would cause, which are substantial, not least because they are very unlikely to be employed in a role with such a disability anyway, and the frequency of this type of injury is low. So I think we can cross off anything serious off the validation claim list and instead put it on the facile list.
    However DBT professionals, being good manipulators, would they know when to stop manipulating? Most DBT professionals are able bodied and although their work is stressful, they are still quite a long way from being in contact with traumatic events,

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    1. In terms of keeping real, NICE had 3 service users/carers when the BPD Clinical Guidelines were updated in 2014, Co-production and Co-designing is required at all universities where undergraduates train to become Nurses, Social Workers, OT’s, and many more professions,
      Of course lived experience should not be confused with Professional experience on its own, Person Centre Care when undertaken in partnership and collaboration with the needs of the individual would promote positive well being.
      Radically Open DBT offers a different approach to standard DBT where over control is present.
      I provide a link to a research study that I was involved with which finished last year which maybe of interest.

      http://www.southampton.ac.uk/psychology/research/projects/reframed.page#project_overview

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  14. When I was two months past my 18th birthday I began harming myself and got admitted. I am now in my 40’s. I am continuing to learn how to describe my experiences to people to try and improve my quality of life and I would like to get to a position where I know something which would have helped me a bit when I was younger as I experienced distress then which I believe morphed into something more destructive ultimately with long admissions.
    Now when I was distressed when I was younger I would be on a short timer (punishment pending) and then I would be threatened with a beating or got one if I didn’t behave myself. I became very frustrated and sometimes I would smash my head against the wall. I grew up alone most of the time and didn’t say very much with ‘silent and enigmatic’ being repeated about me, or just simply beaten up for being different.
    I wonder how a severe negative life event can change the parental style and whether this change in the pattern of punishment and reward could shape the terminal, repeating patterns of emotional dysregulation ‘a stably unstable’ pattern as I saw Theodore Milllon refer to it. When a person is treated with threat when they are upset they would learn not to express it unless it built up too much, then perhaps cutting, and they would also feel anxious when they were upset. In the end they might end up appearing unemotional.
    I think one thing specific to amputation is that my father and perhaps this can be generalized, does not like displays of negative emotion (sadness, crying, resignation.) and becomes a bit panoptic about ending displays of negative feelings. Being unrelentingly positive is quite negative.

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  15. People who trash every idea about how people should behave need to be pathologized so that helpers can enact their narcissistic power fantasies for their own gratification. The health service is full of such individuals. It is not as altruistic as many suppose.

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  16. I think self harm is a revulsion of my own docility where I allowed myself to be taken advantage of and did not protect my self esteem because of fear (if I did it would have resulted in someone else getting seriously hurt); of the intrusive thoughts of killing members of my family as a result of seeing someone I knew well dead, then the death of my sisters baby. This gave me the courage to hurt myself, I saw it as a good thing actually because I am a good person in a hopeless world when I bleed but an evil person when I survive.

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  17. I’ve only just stumbled across this piece, but thank you for describing bravely and powerfully the conflicting and complex emotional responses very familiar to my own experience as a volunteer on a MH helpline. Many of our ‘frequent’ callers were those diagnosed with BPD/EUPD, usually in highly distressed states, and I felt both desperate to ‘help’ and communicate my genuine care/compassion for people who I felt had been all too often re-traumatized by services and pathologizing professionals – as well as finding myself feeling somehow manipulated…and then driven into a self-doubting/ashamed/’bad helper’ cycle in my own head.
    I’m not explaining myself very well perhaps, but I guess that is a sign of the complicated reaction I used to have. Your writing is thought-provoking and helpful to read. Thank you.

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  18. Fantastic article, lots of really interesting points. I have Bipolar with Borderline Traits, I have always felt really fearful of being classed as ‘manipulative’, or ‘attention seeking’ going out of my way to not be viewed as such and as such putting off seeking help for suicidal ideation or telling anyone how I felt out of fear of judgment. (Perhaps that is a form of manipulation in itself?) Most of the other people I know diagnosed with a PD tend to be ‘loud’ in their quest for help, but they are often ignored and passed off as frustrating and attention seeking by MH professionals – perhaps if they were granted “attention” & time to work on the deeper issues outside of a crisis situation they would have less need to be combative and form better relationships with carers giving them a chance to actually heal?
    More support being available for mental health outside of crisis would generally make a huge difference, but unfortunately until we can grow money trees that is just a pipe dream.

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  19. If you want to know what borderline personality disorder feels like, just as you sit down to comfortably discuss people who are manipulative I would grab you by the hair and drag you to another room where people would kick you around the floor, laugh and spit on you and perhaps set you on fire. And guess what, most staff would go off sick for 6 months. If this is you, then don’t bother coming because you cant hack it.

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  20. I find this perspective interesting, our reptilian aspect is concerned with needs, food, sex, fight, social hierarchies these are for survival, apart from poor family of origin we can also get addicted to certain emotional states which can make the individuals needs far beyond the normal or healthy amount. I think we can all be manipulative to get our needs met, but we can also be honest with ourselves and others to achieve those needs without manipulation, this is much more difficult and takes alot of development and awareness sometimes. What you find is that the other person is quite happy to satisfy those needs and will be more confident in voicing similar needs due to the courage of that honesty. “I FEEL SAD AND I DONT KNOW WHY CAN I HAVE A HUG AND SOME COMPANY FOR A WHILE” the answer will usually be yes without manipulation.

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  21. Just had this linked by a colleague in EM on Twitter.

    Really good article helping us to reframe a behaviour that we see as being a person’s ‘fault’ to being about how that person might need understanding.

    Love it.

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  22. Thank you for the interesting article. I am not a healthcare professional, but I had a bpd friend who after the initial love bombing, left me with my head spinning. Your article gives a good picture of where the bdp person is coming from and why she acts in a certain way when she wants her needs met. Still, I can’t help this overwhelming feeling of me being used by her in the course of our friendship. I understand that my people-pleasing attitude and having no friends in a different country played a crucial role in she being able to use me, but retrospectively I now realize that she was manipulating me all this time. Of course she wanted to have her needs met, but her needs were unreasonable, selfish and never-ending. Yet, she was able to manipulate me around, so much so that I ran around fixing some food for her every time she came over (sometimes several times a week) or hosting her and her husband for dinner when we were just supposed to watch a film with popcorn. I was flexible and understanding of her emotional struggles every time she cancelled and re-arranged meetings, while ignoring my own needs and asking for minimal respect of my time. I didn’t even notice that I stopped making plans with new friends so that I could have enough free time for her, just to have her half of our plans cancelled in the last minute anyway.
    My efforts for this friendship were not reciprocated in actions and her promises were mostly forgotten. She never invited me over. I only went to her place when she asked me to help her organize her stuff or to take care of her dog while she was away. She gave me some used clothes a couple of times to make me feel like I owe her. I could have done without these old tops with stains or faded color. She asked me to buy her all sort of small things in return. She was able to turn me into a complete pushover by playing into my motherly instincts (even though she was 10 years older than me) with stories of her abusive mother or through love-bombing.
    Now, that I am in no contact, I can see it from a clearer perspective how manipulative she was. She was quite skilled to get her needs (of being in the center of attention, getting free food, other items and entertainment) met without or with minimal reciprocation and not lose me as a friend in the meantime. We can describe this with different words, but essentially that is manipulation. I get it that this is how she learnt to exist and getting what she wants, but shall we really give a different definition for manipulation if it is coming from a borderline? From this aspect maybe we should re-define manipulation if it is coming from a narcissist or from a spoilt, little entitled child as well. Yes, there are different levels and types of manipulations, for different reasons, but that doesn’t change the very core meaning of the word “manipulation”. I do, however understand that the reasons behind it could be different than a narcissistic person’s reasons.
    I appreciate the compassionate and caring way you look at borderlines. But please, do not underestimate their manipulative skills. They are very good at reading people and they can even wrap some healthcare professionals around their fingers.

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