The focus of Margalis Fjelstad´s self-help book, Stop Caretaking the Borderline or Narcissist: How to End the Drama and Get On with Life, are the caretakers of those with borderline (BP) or narcissistic personality (NP) disorders. Fjelstad discusses how and why people become caretakers and what can be done to break the cycle of caretaking.

Fjelstad generally describes both disorders together as there are many similarities in behavior of those with the disorders, but sometimes speaks only of the BP or only of the NP (as she abbreviates the disorder names). Typically the borderline personality is marked with instability in relationships, mood, affects and strong impulsivity. Borderline behavior should include at least five of the following: frantic efforts to avoid real or imagined abandonment, a pattern of unstable and intense interpersonal relationships, unstable self-image or sense of self, impulsivity, recurrent suicidal behavior, gestures, or threats of self-mutilation, mood instability, reactivity, depression, anxiety, rage and despair, chronic feelings of emptiness, inappropriate intense anger or difficulty controlling anger, transient, stress-related paranoid ideas or severe dissociative symptoms. The narcissistic personality is in many ways similar to the BP but also behaves in ways that display an increased sense of importance, preoccupations with fantasies of success, wealth, beauty, and talent, a strong sense of being unique and special, a sense of entitlement of being treated better than others, exploitation of others, an unwillingness to notice or understand the feelings of others, and displays of envy and arrogance. It is not uncommon for the NP to outwardly display such behaviors but a more or less hidden pattern of self-loathing, fear of rejection, and inner anxiety is also very common in the NP.

Fjelstad also illustrates the classical caretaker which is a person that is low in self-esteem, has high levels of sympathy and is empathetic, is avoidant and scared of conflict, likes to please others and “do a good job” as well as being easy to get along with and very peacemaking, to name some characteristics. Fjelstad means that people often become caretakers because they have grown up with or been close to another BP or NP, this is what they know. Caretakers tend to remain in the caretaker role because of shame, fear and guilt and caretakers believe that is is up to them to fix and help the BP or NP, a job that is impossible, according to Fjelstad. On the other hand, Fjelstad is careful to point out that the caretaker often also enjoy feeling deeply needed and important; they are very responsible for letting the BP or NP harass them into doing whatever the BP or NP wants.     

Fjelstad describes different scenarios, sometimes with the help of client stories, to demonstrate to the caretaker that the BP or NP are mentally ill and cannot easily be fixed and that the behaviors that the BP and NP display are not valid or logical. Fjelstad offers a caretakers test along with plenty of advice on how to break away from the BP or NP and stop caretaking them. Fjelstad agrees that it is a long and hard road in front of the person trying to break with the BP or NP because these personalities tend not to respond well to logic but instead are very oriented towards feelings and whatever they are feeling at the very moment. The BP and NP also dominate families and rule over its members. The punishment for not doing what the BP or NP wants can be devastating for the caretaker who feels guilty for not being able to make the BP or NP happy. Fjelstad means that it is utterly important for the caretaker to realize that the BP and NP are unwilling or unable to make changes and that the disorders are real and permanent.

I thoroughly enjoyed reading Fjelstad´s book and I found it informative, exciting, and above all very well written. Fjelstad is truly honest and frank about the fact that the borderline and narcissist are mentally ill and unwilling to change. She is open about tha fact that caretakers too get something from the situation and that it is up to them to break the cycle of caretaking since the BP or NP is not going to change their ways. Fjelstad’s advice is well thought out and practical which makes them easier to follow and she provides the reader with specific ideas and examples to how the caretaker can make the changes needed to rid themselves of the power that the BP or NP has over them. I do have one critique and it is that I wish that Fjelstad would have included more examples from clients and additional stories. The stories included are interesting and can help the caretaker understand what types of behaviors that are considered typical of the BP or NP and compare them to their own experiences. Besides that, the book is excellent material for anyone that is living with or has any involvement with a BP or a NP, close or distant, since the book fosters understanding of the disorders and the need of the caretaker. The book can be of great use to psychology student, especially those in clinical psychology or those focusing on personality disorders.  

© 2015 Elin Weiss

Elin Weiss has a Bachelor´s Degree in Psychology and a Master´s Degree in Women´s Studies from University College Dublin.