"Splitting" & Bipolar Disorder
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Q:  "Splitting" & Bipolar Disorder


During a therapy session with a family member who is bi-polar with manic episodes, the therapist mentioned a bi-polar term called "splitting" in response to her behavior in telling one person one thing and another person something different regarding the same subject. (Like thanking person #1 for all of their help, then complaining to person #2 that she is so hurt and angry because person #1 is doing nothing to help.) Is that what splitting is?  And why do people with bi-polar disorder do it?  Thank you for anything you can tell me...I've had a lot of trouble finding out what this "splitting" is...and I just want to understand better!
 

Hello Karen-

The term you are describing here, "Splitting", belongs to a very large body of writing in reference to a different condition, very unfortunately called "borderline personality disorder" (unfortunate, because it reflects a remarkable arrogance on the part of psychiatry, labeling people thus). The term is not really a part of the literature on bipolar disorder

However, there is a striking overlap between these two conditions, as described in an essay about bipolar disorder and borderline personality disorder on my website. Nevertheless, the idea of "splitting", really belongs to the literature on borderline.

The example of the splitting that you have provided here is an appropriate one. In general, the idea is that the "patient" this play is a tendency to create a divide between people who would otherwise be united in their wish to help. One often hears the term "manipulation" as part of this story; i.e., the patient is thought to manipulate situations to his or her advantage through indirect means, often behaviors that force caregivers to respond. The classic example here is suicidal or self harm actions which are then rather openly disclosed.

However, one of the world's most foremost authorities on "borderline personality disorder", Dr. Marsha Linehan, has taken very strong issue with both of these terms (splitting and manipulation). In her model of explaining borderline personality disorder, both of these behaviors are described as the result of the behavior of the caregivers, more than the patient. The idea is that because more effective means of communication have not worked, the patient resorts to more indirect means, such as suicidal actions to communicate distress, which are then reinforced by caregivers and even institutions (emergency rooms and psychiatric inpatient units).

In my view, Dr. Linehan's explanations have great value. Therefore, I would suggest extreme caution in accepting this concept of "splitting" as something that you're a family member is doing. In general, another important way of looking at this would be to consider the possibility that these "splitting" behaviors reflect something going on in the family system, not just in that particular individual.

Bravo to you for "just wanting to understand better". That is very likely to be the best approach. Good luck with that.

Dr. Phelps
 


Published May, 2007
 
 

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