EMOTIONALLY UNSTABLE PERSONALITY

A personality-trait disturbance characterized by immaturity and lack of control over emotional reactions.In unstable persons minor obstacles or irritations produce major outbursts of anger, obstinacy, and general excitement, and they may shout, threaten, or assault others. At all other times, however, they may be amiable and pleasant.Most of these individuals show poor tolerance for frustration and defeat; they tend to sulk like children, lapse into despair, threaten or even attempt suicide. Their relationships with other people are constantly interrupted by displays of temper, jealousy, and quarrelsomeness. Under stress their judgment is undependable and their actions unpredictable.Behavior patterns of emotionally unstable personalities are outward attempts to compensate for inner weaknesses. If they are continually faced with situations they cannot cope with, they usually do not retreat into psychosis, but regress to more pronounced infantile reactions along the same lines they have always followed. They simply become more excitable, more stubborn, more aggressive, and the periods of amiability become shorter and shorter.Illustrative Case:Rosemary, an only child, lived with her father and stepmother, her own mother having died at the time Rosemary was bom.Her first five years, until her father remarried, were spent with her father in the home of her paternal grandparents, elderly people who indulged her greatly. When she was five, Rosemary’s father married her stepmother and established a home for them. From the outset Rosemary resented the intrusion of her new mother on the relationship she had with her father, a man described as being quiet but steady and understanding. Rosemary’s stepmother did not make things easy for the youngster, because she was a finicky person who lived according to a fixed routine which failed to make room for an active child. When things did not work out as she planned them, she tended to become highly emotional and required special attention. Crises were very upsetting for her and on many occasions Rosemary saw her stepmother become completely helpless in the face of such stresses. Because of this situation Rosemary found little real companionship in the home and frequently returned to her grandmother for the attention and affection she needed. Her grandmother’s death when Rosemary was twelve was therefore an inconsolable loss and marked the beginning of a very unstable and rebellious existence for her.At school Rosemary was able to do well when she applied herself, but more often than not she shirked her homework in open rebellion against the authority of her teachers. She was in frequent conflict with other girls over the attentions of favored boys in the school and was not above becoming engaged in physical conflict at times. She persisted in dating boys of poor reputation and, when rebuked by her parents, often responded with such an attack of hysterics and screaming that they were all disturbed for days. When she was sixteen, Rosemary decided to leave school, after having been chided by a teacher for smoking in the rest room. All efforts by her family to dissuade her failed, and she took a job as a salesgirl.Rosemary’s work history from the time she left school to the time she was sent to a psychiatrist was a checkered one. She failed to stay at a job for more than a few months, and she either left in fury or was fired for having committed gross errors of judgment when faced with relatively minor pressures.The incident leading up to Rosemary’s psychiatric referral involved a young man she had been seeing steadily for some months. Her parents had tried to discourage the relationship because of the young man’s unsavory reputation and because they feared Rosemary might consider marrying him. When their more oblique efforts to break the couple up failed, they confronted Rosemary directly with their concerns and insisted that she stop seeing the boy. A stormy scene followed, climaxed by Rosemary’s abortive attempt at suicide.When she was interviewed by the psychiatrist to whom she was referred, Rosemary was tense and hesitant initially, but as she grew to feel that she would not be punished or rebuked she relaxed considerably. After two sessions she was able to talk freely and openly. Without displaying any deep insight, she showed some awareness of her difficulties and sincerely seemed to desire help in finding a way out of them. It was felt that she was an immature, impulse-ridden girl who had used the suicide attempt to punish her parents and to extort attention and affection from them. It was also felt that she might respond well to a warm, supportive figure and that her parents too might profit from counseling with respect to developing a better understanding of Rosemary’s needs and the effects their relationships had on her.Rosemary was seen in weekly therapy sessions for a period of about nine months. During this time she decided to give up the boy friend about whom she and her parents had quarreled. Furthermore, she met a more acceptable man, and they were considering marriage at the time treatment ended. The relationship with her parents also improved greatly over the course of treatment which was concluded at the mutual agreement of Rosemary and her therapist. (Zax and Strieker, 1963).