I’m three years old when I meet Mrs. H for the first time. She has a soft brunette bob and warm eyes. She is a magnet, and I am a nickel. I trail close to her each day, passing up other children for the way she makes me feel warm and good inside.
When I’m in elementary school, it’s the teacher-librarian. In high school, it’s the dance instructor and the science teacher. I go out of my way to cross their paths, spend hours sitting beside them. There is a ferocity in me that propels me toward them.
Later, it becomes best friends and girlfriends. When it happens in a romantic relationship, the devastation is pronounced and profound. I will do anything to make them happy. Usually a strong-minded and independent person, I offer up my whole self for consumption. I lose my mind in the dance to please, the violence and forgiveness.
I do not learn of the term Favourite Person until I have lived through 23 years of the push-and-pull. Of the euphoria and despair. Suddenly, my experiences snap into focus. My mishmash of incongruent relationships fit a pattern that so many like me have experienced. It is like a blindfold lifted. A solution to the algebra.
Favourite Person (FP) is not a scientific term. In clinical science, we call this unstable relationships, idealization, or fear of abandonment. These terms are important, but nebulous. The symptoms that converge to form FPs are disjointed and the pattern is lost. Currently, there is no scientific work on the FP phenomenon. Perhaps it is seen as redundant, perhaps too colloquial. But for myself and the people I have worked with in peer support, the concept has been a game-changing tool in understanding ourselves and our relationships.
Qualities of a Favourite Person relationship & associated BPD symptoms
Attention, praise, or love from an FP results in intense feelings of pleasure, joy, comfort and attachment while perceived rejection, criticism, or disappointment causes intense dysphoria, self-injury or suicidal thoughts. The intense positive affect resulting from spending time with an FP can plummet into despair as soon as the meeting ends.
Associated Symptoms: 1) Affective instability due to a marked reactivity of mood, 2) A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation, 3) Recurrent suicidal behaviour
Research: Chapman et al. (2014) found individuals with BPD showed heightened emotional reactivity, distress, shame and irritability following a social rejection task, but not following a negative academic evaluation, whereas the opposite was true for non-BPD comparisons. Speaking to the split between intense positive and intense negative experience of an FP, Coifman et al. (2012) found significantly greater polarity in the daily emotional and interpersonal experiences of participants with BPD across 21 compared to healthy controls. With relevance to favourite persons, increased interpersonal stress predicted increased polarity.
Sensitivity to perceived rejection or possible abandonment
Insecurity and anxiety about maintaining the relationship results in paranoid ideation, distinguished from paranoid delusions of psychosis in that the individual with BPD partially maintains contact with reality, but struggles as distress intensifies. The individual may perceive rejection from benign cues, or be limited in the capacity for imagining complexly the feelings of the other person. It is hard for the patient to imagine the life of the FP existing separately from their relationship.
Associated Symptoms: 1) Anxious preoccupation with real or imagined abandonment 2) transient dissociation and paranoid ideation under stress
Research: Staebler et al. (2011) found patients with BPD score significantly higher on the Rejection Sensitivity Questionnaire (RSQ) than healthy controls, patients with anxiety, social phobia, avoidant personality disorder and mood disorders. Increased BPD-specific cognitions were related to increased scores on the RSQ in all patient groups. Lazarus et al. (2018) found individuals with BPD reported more frequent experiences of rejection and less frequent acceptance across 21 days than individuals without BPD. This study also reported more hostile responses to rejection by a romantic partner in those with BPD during the 21-day study.
Loss of identity, goals, and values
Individuals with BPD have difficulty forming and maintaining a cohesive sense of self. This results in profound emptiness. Often, external stimuli will fill this emptiness and provide temporary identity structure. This stimulus might be a hobby, a job, a friend, a book or a movie. An FP is a particularly salient stimulus for this identity formation. An individual might idealize their FP to the extent that they emulate their behaviours, identity, career, and values. This can be particularly devastating when the relationship with an FP ends and the person with BPD “splits”: removing themselves from everything associated with the FP and once again becoming overwhelmed with emptiness and lack of meaning in life.
Associated Symptoms: 1) Markedly impoverished, poorly developed, or unstable self-image, 2) Chronic feelings of emptiness.
Research: De Meulemeester et al. (2017) described identity diffusion as poor boundaries between the self and others and extreme positive or negative thinking of the self and others. Mentalizing is described as the ability to a) feel a sense of cohesiveness and agency over the goals and intentions that drive our behaviour, and b) conceptualize the goals and intentions of others as separate from our own, resulting in strong boundaries between the self and others (De Meulemeester, 2017). From this perspective, identity and social cognition are inextricably linked.
De Meulemeester et al. found the processes of mentalizing, identity diffusion and interpersonal functioning were highly correlated, and that identity diffusion mediated the relationship between interpersonal functioning and mentalizing.
Attachment to FP is outside of conscious control
This is often the most distressing aspect of an FP. The individual with BPD does not choose who they would like their FP to be, rather, they might attach to very different individuals with very different roles. An FP might be a teacher, a friend, a celebrity, or a romantic partner. To the individual with BPD, this lack of control worsens their sense of autonomy and deepens their sense of emptiness. It feels as though we are riding a rollercoaster of our attachments, at the mercy of the highs and lows. This element increases risk of abusive relationships, as it is extremely difficult for an individual with BPD to effortfully end a relationship with their FP even if they are experiencing abuse.
Associated Symptoms: 1) A pattern of unstable and intense interpersonal relationships characterized by alternation between extremes of idealization and devaluation.
Research: Attachment styles are persistent patterns of engaging in close relationships, and are closely related to neurobiology and early life stress. Attachment in children and adults can be classified as secure, avoidant, ambivalent, and disorganized. Patients with BPD are most likely to exhibit ambivalent or disorganized attachment. Ambivalent attachment presents as intense, persistent separation anxiety and a paradoxical inability to be comforted by the object of attachment. Ambivalently-attached infants are distressed when separated and when reunited with their caregivers. Disorganized attachment often results from abusive, neglectful, or inconsistent parental care. Disorganized attachment presents with conflicting fear of and love for the caregiver, and can be conceptualized as an evolutionary mechanism. Humans are hardwired for attachment to ensure survival in infancy, as we are born unable to care for ourselves. Thus, survivors of early childhood abuse often maintain strong attachments despite fear and trauma related to their attachment figure. For a review of attachment and BPD, see Levy (2005) and Agrawal et al. (2004).
Treatment for Maladaptive Attachment
A number of therapies designed for DBT can be helpful in managing strong, maladaptive, or Favourite Person attachment. Dialectical Behaviour Therapy (DBT) contains an Interpersonal Effectiveness module that teaches communication, empathy, and perspective-taking. Transference-focused therapy works on improving the relationship between the patient, others and the self by observing how the patient constructs a relationship with the therapist and using this relationship as a template for change. Mentalization-based therapy treats difficulty conceptualizing the self and others as independent beings with complex goals, thoughts, and feelings.
What are your experiences with attachment?
Agrawal, H. R., Gunderson, J., Holmes, B. M., & Lyons-Ruth, K. (2004). Attachment Studies with Borderline Patients: A Review. Harvard Review of Psychiatry, 12(2), 94–104. https://doi.org/10.1080/10673220490447218
Chapman, A. L., Walters, K. N., & Gordon, K. L. D. (2014). Emotional Reactivity to Social Rejection and Negative Evaluation Among Persons With Borderline Personality Features. Journal of Personality Disorders, 28(5), 720–733. https://doi.org/10.1521/pedi_2012_26_068
Coifman, K. G., Berenson, K. R., Rafaeli, E., & Downey, G. (2012). From negative to positive and back again: Polarized affective and relational experience in borderline personality disorder. Journal of Abnormal Psychology, 121(3), 668–679. https://doi.org/10.1037/a0028502
De Meulemeester, C., Lowyck, B., Vermote, R., Verhaest, Y., & Luyten, P. (2017). Mentalizing and interpersonal problems in borderline personality disorder: The mediating role of identity diffusion. Psychiatry Research, 258(December 2016), 141–144. https://doi.org/10.1016/j.psychres.2017.09.061
Lazarus, S. A., Scott, L. N., Beeney, J. E., Wright, A. G. C., Stepp, S. D., & Pilkonis, P. A. (2018). Borderline personality disorder symptoms and affective responding to perceptions of rejection and acceptance from romantic versus nonromantic partners. Personality Disorders: Theory, Research, and Treatment, 9(3), 197–206. https://doi.org/10.1037/per0000289
Levy, K. N. (2005). The implications of attachment theory and research for understanding borderline personality disorder. Development and Psychopathology, 17(04). https://doi.org/10.1017/S0954579405050455
Staebler, K., Helbing, E., Rosenbach, C., & Renneberg, B. (2011). Rejection sensitivity and borderline personality disorder. Clinical Psychology and Psychotherapy, 18(4), 275–283. https://doi.org/10.1002/cpp.705