Twice Hurt: Borderline Personality Disorder and Secondary Wounding

It hurts to have borderline personality disorder (BPD), especially when trauma is a factor. However, people can cause what's called secondary wounding--that is, they can hurt by a person by their reactions when he/she turns to them for help. In her book I Can't Get Over It, Dr. Aphrodite Matsakis writes "Some victims reported that their secondary wounding experiences were more painful and devastating than the original traumatic event."

Forms of secondary wounding

• Disbelief, denial, discounting. People will sometimes deny or disbelieve that the traumatic event happened, or downplay its significance. For example, my ex-fiance discounted my experience of being raped by telling me he could help me get over it by having sex with me.
• Blaming the victim. Some people blame the victim when a traumatic event happens, especially when sexual misconduct is involved. For example, when I was sexually assaulted, my mother told me I was "maybe not consciously" asking for it.
• Stigmatization. This occurs when people blame the survivor for their reactions to the trauma. This can include ridicule of the survivor; misinterpretation of the survivor's symptoms as a moral failure or mental deficiency; an implication or statement that the survivor's symptoms reflect a desire for sympathy, attention or financial gain; or punishment of the victim. For example, a nurse once asked me if I was self-injuring "for the attention".
• Denial of assistance. For example, I was promised that the state would reimburse me for STD testing. I never saw a dime.

Why people cause secondary wounding

• Ignorance. Some people just don't understand what it's like to suffer from a traumatic event. While training can improve the reactions of medical, legal, and mental health professionals, such training is not always required or available. I remember firing a psychiatrist who told me I should have seen my sexual assault coming.
• Burnout. This is a major cause of secondary wounding, according to Matsakis. In this case, the responder is simply overwhelmed.
• "Just world" philosophy. This philosophy teaches that everyone gets what they deserve. It assumes that if you are careful enough, intelligent enough, moral enough or competent enough, you can avoid misfortune. Therefore, people who suffer trauma are either at fault, weak, or immoral. An example is the common myth that "good girls don't get raped".
• Cultural influence. Our culture teaches hard work, self-sacrifice, and physical and emotional endurance can overcome any hardship. The sad thing is, while these are positive character traits, they do not always lead to success in overcoming obstacles. There are other factors--luck, for example.

Overcoming secondary wounding

"Secondary wounding experiences can be as painful and powerful as the original traumatic event," Matsakis writes. "Just as you need to heal from that event, you will need healing for any secondary wounding experiences."

So how do we heal from secondary wounding?

First, we identify what we experienced, then distance ourselves emotionally and mentally from it. This enables us to survive others' insensitivity--it may bother us, but it won't destroy us.

Second, we realize that as a general rule, the secondary wounding says more about the other person than us. This is often the result of a larger problem in society, such as the "just world" philosophy and the blame-the-victim attitudes. When you view it from this perspective, we have an argument against their assumptions.

Third, we learn positive self-talk. It is vital for us to have our arguments against secondary wounding experiences ready. We can counter that internal voice that repeats what we so often hear from others.

Secondary wounding is painful. The fear of rejection common in BPD makes it even more so. But we don't have to be victims all over again. We can overcome it.