On the Use of the Term Manipulation
Can or should we refer to our relative’s behavior as manipulative?
FC Position: No! While we all attempt to change other people’s behavior from time to time, the word “manipulative” generally has negative connotations. In fact, there are other words in the English language that do not have such negative connotations, such as “persuade,” “convince,” and “sway.” So, as I will demonstrate below, using this term is objectively wrong and, for this very reason, ineffective. Most importantly, it misinterprets what BPD sufferers are trying to accomplish, only serving to further stigmatize and invalidate them!
Several Arguments for this Position:
(1) Dr. Blaise Aguirre (https://www.youtube.com/watch?v=q4KjxxPp3Ls):
(a) Their behavior is a classic example of “learned behavior” (When I do X, I receive y, so I will continue to do X). For example, I threaten suicide when someone tries to abandon me and then they don’t leave; this response–a type of reinforcement–increases suicidality, so at 3East we forbid parents from visiting their kids in the hospital after a suicide attempt. After one or two times, the attempts stop. [The parents protest, “But I always visit my kid in the hospital”; We reply “How is that working for you?” ]. Briefly put, they are not trying to manipulate you. They are merely doing what they have learned is the most effective way to stop their pain.
[“Reframe their behavior as the product of a ‘problematic learning history’ rather than mental illness or innate evil.” (Katy Butler, “Revolution on the Horizon” Psychotherapy Networker May/June 2001)]
(b) Family members may feel very manipulated but they need to realize that their relatives may not intend to be manipulative. How family members experience their loved ones behavior may not mirror how they experience it. The sufferers may very well be acting out of intense pain and have no conscious desire to manipulate others. They just want the pain to stop. So, by definition, they cannot be termed manipulative.
(2) The characterizing of an act as manipulative means that the “manipulator” has carefully thought out a plan to get what he or she wants. Someone who is in as much pain as BPD sufferers, who are overwhelmed and in emotion mind, cannot be manipulative by definition. They cannot think that clearly.
(3) Marsha Linehan points out the following: “If they are so good at manipulating, why do they end up in therapy and hospitalized? They must be very lousy manipulators, or that is not what they are trying to do!”
She is also described in the following way: “Never willing to ascribe intents she could not verify, she theorized that cutting and suicide attempts were problem-solving devices and sometimes ‘communication behaviors,’ but not manipulations. She assumed that self-punishing responses were learned, and could be unlearned.” (Katy Butler, “Revolution on the Horizon” Psychotherapy Networker May/June 2001)
Or stated conversationally:
Q: But, BPD sufferers are manipulative….!
A: (1) “As to manipulation, two weeks ago at the BT training we attended in Florida, the trainer emphasized that ‘manipulation is the skillful use of means to get what you want’. So, echoing what Alan says, our loved ones with the disorder or symptoms simply cannot manipulate. [They are emotionally dysregulated. Their] threats are not skillful [not mindful, not rational, and, therefore,], not manipulation—but desperation.” (Matt Costello, Veteran Family Connections Leader in private correspondence)
(2) Furthermore, since manipulation, by definition, is intentionally causing someone else to act in a certain way, if our loved ones are acting out of desperation, they are only really acting on their pain and their need to assuage it. Their effect on others is incidental, not intentional.
(3) “I feel very strongly that it does everyone a disservice to call these statements manipulative. How are we supposed to validate them well if in the back of our mind we are thinking we are being manipulated – vs. this is an expression of awful, miserable, unbearable pain? Aren’t we in a better position to help someone we love when we see their need than when we feel used???” ( Marie-Paul de Valdivia, LCSW, MBA, Executive Vice President and Family Connections Leader, National Education Alliance for Borderline Personality Disorder, in private correspondence).
Some therapists are aghast when Linehan describes DBT’s “24-hour rule”: if a client injures herself or attempts suicide, there will be no extra client-therapist contact for 24 hours so as not to unwittingly reinforce the behavior. “Are you going to get into the ethics of DBT?” one social worker asks her hotly. “It’s always ethical to do the most effective treatment,” Linehan replies without flinching. “And for the moment, DBT has the most data as effective treatment for this disorder.” (Katy Butler, “Revolution on the Horizon” Psychotherapy Networker May/June 2001)