The detached protector
When the patient is in the detached protector mode, the patient seems relatively mature and calm. A therapist could assume the patient is doing well. In fact, the patient uses this protective mode in order to avoid experiencing or revealing her feelings of fear (abandoned child), inferiority (punishing parent) or anger (impulsive child). Underlying assumptions that play important roles here are those of: it is dangerous to show your feelings and/or desires and to express your opinion. The patient fears losing control of her feelings. She attempts to protect herself from the alleged abuse or abandonment. This becomes particularly evident as she becomes attached to others. The protector keeps other people at a distance either by not engaging in contact or by pushing them away. Should others discover her weaknesses, the patient would face potential humiliation, punishment and/or abandonment. Therefore, for her it is better to not feel anything at all and keep others from getting too close to her.
Sample dialogue with a patient in the protector m ode
(In this example and following dialogues, ‘ t ’ is therapist and ‘p ’ is patient.)
t : How are you doing?
p : (with no emotion) Good.
: How was your week, did anything happen that you would like to talk about?
p : (looks away and yawns) No, not really.
t : So, everything ’ s OK?
p : Yeah, everything ’ s OK. Maybe we could have a short session today?
BPD patients often describe this mode as an empty space or a cold feeling. They report feeling distanced from all experiences while in this mode, including therapy.
Should simple methods of avoiding painful emotions prove ineffective, she may attempt other manners of escape, such as substance abuse, self - injury (physical pain can sometimes numb psychological pain), staying in bed, disassociation or attempting to end her life.If the patient is not successful at keeping people at a distance, she can become angry and cynical in an attempt to keep people away from her. It is important for the therapist to recognize these behaviours as forms of protection and not be put off by them. If this angry state is very pronounced, it can be distinguished as a separate ‘ angry protector ’ mode.
It is difficult to distinguish the angry protector from the punitive parent, especially during the initial stages of the therapy. One manner of distinction is to observe the direction of the patient ’ s anger. While the angry protector ’ s rage is directed towards the therapist (or someone else), the punitive parent ’ s anger is directed towards the patient herself. If the therapist is unsure of the mode he is presented with, he can simply ask the patient if she is able to disclose which ‘ side ’ of her personality is currently active.
Sample dialogue with patient in the angry protector and the punitive parent mode
Response from angry protector:
p : Oh No! We're going to have another lecture about that stupid borderline model of yours? You couldn't wait, could you? Can't think of anything better can you?
Response from punitive parent:
p : I don ’ t know which ‘ side ’ of me this is. I only know that I must have been a complete idiot to trust you and that is one mistake I won ’ t make again. It doesn ’ t matter anyway, I ’ ll never get better.
In the beginning of the therapy, the subtle differences between the angry protector and the angry child can also be difficult to distinguish.
These examples involve the protector expressing herself in a demonstrable, interactive manner.
The completely opposite form in which the protector may express herself is by exhibiting tired or sleepy behaviour. In this case the therapist must assess whether or not the patient is actually tired or whether she is in the protector mode.
There is the risk that while in the protector mode, the patient may avoid therapy and not work on her problems with a serious chance of her stopping therapy all together. The patient can also have problems with dissociative symptoms, self - injury, addiction to numbing substances (e.g. drugs or alcohol) or may attempt suicide. Because of this, it is important to identify when the protector role is present and circumvent it. This will give the patient an opportunity to work on her actual problems.
Treatment Methods for the Detached Protector
Therapeutic relationship
In the beginning of the therapy the therapist must often deal with the detached protector. The patient is frightened by the strong emotions of the abandoned or angry child. She also fears punishment and/or humiliation from the punitive parent. The therapist must regularly reassure the detached protector that he will support his patient when this happens and help her deal with these strong and often unpleasant emotions. He encourages her to express her emotions. He speaks to the detached protector in a friendly yet firm voice. During each session, the therapist must continually try to bypass the detached protector even if this takes a great deal of effort. While the patient is in her detached protector mode, it is not possible for the therapist to reach the abandoned child with limited reparenting (see Chapter 4 ). At times the protector can even become aggressive, often as a result of the patient not having enough trust in her therapist. Because of this, the protector is prepared to do, and does, anything and everything to ensure the therapist does not get near the abandoned child. The protector does this with the aim of protecting the patient from further abuse. This means that the therapist must have patience and continue to earn the patient\\\'s trust in him. If the patient is mistrusting, her therapist must make it clear that the fact that she does not trust him is evidence that she is in the protector mode and he must show understanding for her inability to trust. He must express empathy with her, let her know that learning to trust someone takes time, particularly if one has a past of putting their trust in untrustworthy individuals. The therapist can choose to increase the frequency and/or length of the sessions in trying to bypass the protector because usually the protector will back down in this situation. Outside of the session the protector can show their side by means of self - injury or suicide attempts. To an extent, physical pain protects the patient from emotional pain. In this case, all attention must first focus on putting an end to self - injury and/or suicide attempts. The therapist must ensure that he is easily accessible to the patient in this situation and that a crisis centre is available when he is not.
Feeling