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Anger and Borderline Personality Disorder


No More, I promised myself

One of the worst, most dangerous stigmatising myths about BPD is that we are dangerous due to our problems with ANGER. Now I’m not denying that anger management issues are a key factor in the diagnosis of BPD or saying that we don’t have anger problems, it is in fact a criteria for diagnosis –

“8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)”  (source – http://www.borderlinepersonalitytoday.com/main/dsmiv.htm)

Heck; as with the rest of the population we all get angry at times, and yes as with any other person who gets angry there is a chance that anger could be physically taken out against another person. Some BP’s are violent, but not any more so than the rest of the population; more likely the proportion of violent BP’s is probably lower than violent people who do NOT have BPD…

So why then does the criterion state anger in the terms it does? As this clearly paints a picture of someone who is likely to cause physical harm to others! This is a question I cannot answer, as I didn’t write the criteria, but I can tell you what I know to be facts about BP’s and anger, and use my own experiences to help you understand how this fits into the reality of living with anger as a BP…

The reality of anger and BPD is that it is closely linked to another of the criteria – self harm. The reason for this is that most BP’s are so scared of anger that they direct any anger they feel inwards, towards and against themselves rather than outwards, towards and against others.  It is this inward direction of anger that distinguishes BPD from Anti Social Personality Disorder (ASPD) another personality disorder which is characterised by antisocial behaviour and anger directed at others; to the point of a greater risk of violence towards others. In summary –

Anger in BPD – internalized, leading to self-harm

Anger in ASPD – externalized, leading to risk of harming others.

Back to BPD… many (but not all) people with BPD will have witnessed of been victims of violent, abusive, expressions of anger themselves, either as children or on going into adulthood.  Experiencing such things first hand, witnessing/feeling the damage and devastation of physically expressed anger, can have numerous effects on a person and for the majority of BP’s the effect is that they fear anger, to the point they cannot express it, avoiding letting their anger out at all costs. They fear the damage they would cause to others, they fear the harm they may suffer from others, they fear everything about anger, instead choosing to close the door on it, dissociate from it and refuse to outwardly express anger at all. But this anger has to go somewhere…

Let me give you a few examples from my own life…

As a youngster in primary school playground ‘fights’ were the norm, part and parcel of establishing the pecking order, not even really related to anger most f the time. I wasn’t a tough cookie, I had my fair share of fights, but I wasn’t a fair fighter as I was small, weak and had no fighting skills (no brothers/play fighting with dad) so I used the only thing I could. I was a biter. Several kids who picked a fight with me ended up needing a tetanus jab, it wasn’t until my headmaster pressed his own teeth against my arm and warned that if I bit another child he would bite me that I stopped this phase. Kicking led to standing in the hallway all day holding your shoes and the other children calling you ‘donkey’ as they walked past. My last ‘fight’ involved me dragging another girl round the playground by her hair. I never witnessed any violence at home; I was never hit and had NO experience of anger being expressed at all. You might think this is a good thing, but imagine having NO examples of how to deal with anger…  how would you know what you were feeling when that ‘anger’ did appear? How would you know how to deal with it? This was my problem, the opposite of those who witness and suffer at the hands of people who express their anger the complete lack of expression of anger in my life meant I was unprepared to understand and deal with it when I felt it.

I can’t tell you the first time I really felt anger, but I’m pretty sure it wasn’t in those young years of fighting, they were just reactions when under attack (as I wasn’t one to ‘start’ a fight). When I was older I must have started feeling anger, but I clearly didn’t know ‘what’ I was feeling (and I often struggle to understand ‘what’ I am feeling now – all I know is they are intense emotions, I don’t understand and I don’t like them!).

Later, one incident stands out in my memory. My husband stormed into the kitchen and was raging at me over something (not uncommon – he spent a lot of time shouting about something). I was cooking the dinner, his friend chatting to me in the kitchen as I cooked. Something in me snapped at the nasty things I was hearing and I calmly walked away from the cooker towards the door where my husband stood. Next to the door was the fridge, on top empty glass milk bottles, as I passed the fridge I instinctively grabbed one of the bottles and swung it at my husband viciously causing him to back out of the door, slamming it shut behind him. He slammed it with such force he broke the handle and could not open it from the other side. Inside the kitchen I had replaced the bottle and returned to my cooking – still no emotion at all, other than relief he was no longer in the room, I felt the ‘threat’ was gone. He was still raging, now for me to open the door. I just kept replying calmly ‘No, I’m cooking’ and his friend just sat silent not knowing what to do… My husband was often verbally aggressive, he only ever actually hit me once – and I called the police on him. Many a time I had thrown things at him or lunged at him myself only to be pinned down until I stopped trashing around – so I guess in this phase I did let my anger ‘out’ to a degree, but still the main aim was always to get him to go away so I could avoid the feelings rather than any intention to hurt/harm him – I just wanted him to leave me alone and stop being aggressive towards me, or our children…

I do know sometimes now that I am angry, or at least I have strong emotions that I call ‘anger’ – I may still have it wrong, I don’t know. I think that the lack of introduction to anger as a child made me fear it when I did ‘feel’ it because I did not understand what it was and then when my husband was prone out outwardly expressing his anger, mainly verbally, I was not used to this and responded with the childhood ‘reactions’ of the playground fights – not anger but a desire to make the ‘attack’ on me stop. Thus, the way I see it I have a ‘self-defence’ mode, but I don’t know much about anger. I have never really had the opportunity to learn what it is or how to express it – and yes I still fear it…

What about you? How do you deal with feelings of anger? How did you learn these ways of dealing with it? Or do you struggle t understand and cope with your feelings like I do?

 

Thank you for reading!  If you have enjoyed reading this post please share it with others who may be interested and I always enjoy receiving feedback and comments :)



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34 comments on “Anger and Borderline Personality Disorder

  1. Anger is such a difficult emotion. I agree that sometimes all I know is I feel an intense emotion and I don’t like it either. I sometimes feel I am gonna explode from the emotion within me and that is often when I self harm. When I feel like this my voice changes and the kids know it! They recognise a line has been crossed and they need to stay out my way for a bit, I just wish I could say my husband was that intuitive!

  2. Thank you for the post.

    I find this subject to be very confusing.

    I have been hospitalised for 9 months now. Before I came in to hospital, both my psychologist and psychiatrist said that I had BPD. They both said that there are often different types of BPD, an ‘inward acting’ Borderline and an ‘outward acting’ one. Meaning that the inward acting one turns the anger in on themselves in the form of self-harming or simply negative self-talk. They then said that there is an outward acting Borderline where s/he argues and fights with those around him/her. They said that I am an inward acting ‘one’.

    Now I’m in hospital, they refuse to recognise the BPD and say that I just have Major Depression and Anxiety. They say that if I had BPD then they would be able to see it in the form of me 1. Refusing treatment and 2. Arguing with the nurses and staff.

    So it’s left me very confused as to what I have and how I need to be treated for what I have. i.e. When (and if!) I get out of the hospital, do I find a therapist that specialises in BPD and DBT?

    Anyway, thank you again for the post. You’re doing great work to fight the stigmas!

    The Quiet Borderline
    http://quietbpd.wordpress.com/

    • Indeed there are inward and outward types of BPD but the outward is much rarer, and more likely to have co-morbid conditions.

      In some ways not being classed as BPD might be good for you, due to the stigma professionals themselves attach to the label (such as those you describe of ‘resistance’ to treatment and difficulty with staff) but I know what you mean at the same time about it then meaning you may not be able to access DBT if you are no longer classed as BPD! :/ (Tbh I don’t get the whole resistant & argumentative thing as its not a criteria for diagnosis, yet they seem to be classifying it as one here!?)

      Thank you for the support, hope things get better for you soon! xx

      • Showard, I just wanted to thank you for your openness, and I believe that your bravery in sharing from the perspective of the BPD is invaluable. I respect your point of view and opinion, but as you have stated in your blogs, it appears that you are basing your opinion/statement on your own experience.

        So, I must whole-heartedly disagree with your statement regarding BPD’s not being dangerous and that the outward BPD type is rare. That really does not appear to be the case. It is just that those High Functioning (or “outward”) BPD types don’t get diagnosed. The mental health profession refers to them as the “Invisible BPD’s.” The Outward BPD doesn’t seek help and acts out their anger on their families and those close to them. Even if they do seek help, they are rarely diagnosed as they don’t stay in treatment very long. Either the therapist believes their lies/manipulations or they recognize the BPD and choose not to diagnose it. Or, they try to diagnose BPD and it doesn’t go well and the outward BPD drops out of therapy and rejects the diagnosis (they believe that there is nothing wrong with them and that everyone else is the problem). Also, for the few outward BPD’s that actually accept their diagnosis and seek treatment, it is far less successful and effective than the inward BPD’s. DBT is the leading treatment for BPD, but it is more effective for the inward BPD’s. The damage done to those receiving their “anger” is immeasurable. The “non-BPD’s” are the ones that end up seeking help for all of the damage done.

        I have two of these “rare” BPD types in my own family and both are undiagnosed. My outward BP sis violently attacked/beat me from age 2 to 30. Following the last beating, it was my “last straw” trauma, and I ended up with full-blown PTSD. My behavior and my traits are NOTHING like my outward BPD sis or mother. She also committed other unspeakable acts of cruelty and abuse. Our “mother” was BPD too, but she acted her anger out on us with neglect, emotional and severe psychological abuse. I am also in two non-BPD support groups (tens of thousands of members) where most have the High Functioning/outward BPD type relative/spouse who has not been diagnosed.

        I must add that my outward BPD sis is extremely violent and she has been acting out her anger on others with physical violence since she was 4 years old. It started with me being the primary target for her “anger” but when she started dating, she began beating her boyfriends, stalking and attacking her exes new girlfriends. She has also acted out her “anger” in a violent physically abusive manner with other people and animals too. She has even physically attacked people while they were in their cars and done body damage. When she was out at sea on a yacht while working as a chef, she was fired. The real abandonment brought on the stress, which lead to the paranoia that led to the full-blown psychotic episode. I had been her “lifeline” for years, and I ended up spending hours with her on the phone trying to convince her not to poison everyone on the yacht. She actually had the poison in her hands ready to use it. I stayed on the phone with her until after the episode passed.

        Yes, people with BPD CAN be extremely dangerous, but yes, I can appreciate and understand that the inward BPD is more of a danger to themselves than to others. My sis is not the most extreme case by far, but Dr. Drew did use the same description for Jodi Arias that my therapist used to describe my sis. BPD (high functioning/acting outward) with psychotic episodes. There are thousands just in my group that have experienced violent/physical abuse “acting out” anger from their BPD spouse/family member. Many much worse than mine.

        I just really felt it was imperative to express my opposing point of view/experience. I appreciate your point of view, as for me, the inward BPD is the rare one. I do agree with you though that those Inward BPD’s are likely not often dangerous/violent/physically abusive to others and they are more likely to physically harm themselves as opposed to others..

        I really like your use of Inward vs. Outward and think it is much more accurate and descriptive then the High vs. Low Functioning I am used to.

      • Hi Kris, apologies for the delay replying and publishing your comment due to work I don’t get much time to keep up with the comments on here :(

        Yes, indeed I have always tried to be clear about the fact that my writing about BPD is only based on my experiences of living with it and the people I have met who also have it, and I recognise there are whole parts (and people/experiences) that will be very different from my own better and worse.

        Sorry to hear about your suffering at the hands of your sister and mom (I take it they were officially diagnosed BPD then? – if not how can you be sure it is not ASPD or

        I am high functioning, inward BPD, myself and agree that it is the high-functioning types that are less frequently diagnosed – and while I didn’t know as much about the outward types when I wrote this piece I have since found out that it would seem you are either right or maybe we meet in the middle, as there are a lot more of them than I had learned of – having now spoken with people who work in the UK prison system, where a lot of the women are low-functioning, outward BPD (although a lot of therapists argue that these are misdiagnosed because they are female and it is actually ASPD which tends to be the label given to men who may actually be more BPD, there is a real gender bias in diagnosis – but, I guess we will never know for sure) and are a danger to others, and in contrast women in medical mental health facilities are more likely to be low-functioning, inward types who are a danger to themselves but rarely others. Then as you state there are the high-functioning, outward types who (again query is it actually ASPD? but regardless of that…) who due to their higher intelligence manage to ‘cover-up’ the damage (violence, abuse, etc) they are doing to family (etc) and as you say either won’t seek treatment as they do not see they have a problem (as with many domestic abusers I guess?) or they don’t stick with it. (BTW Jodie Arias was not diagnosed with BPD in the end, and many other labels were thrown out about her, the one that actually seemed to fit best was psychopath). I wonder if that sort of thing is actually the real problem here, with many overlapping symptoms between what are actually very different conditions, and even within BPD alone over 200 ways to meet the criteria for diagnosis (In DSM IV – looking at DSM V I think the number may have grown!) it does feel like either people may not be getting the right diagnosis to explain their symptoms or the ‘spectrum’ of BPD is much closer to the kind of spread you see in the Autism spectrum – from the lowest functioning to the highest and lots more in between…?

        Sharon

      • Sharon,

        Actually Jodi Arias WAS diagnosed with BPD as discussed at trial by Dr. Janeen DeMarte:

        showard, we have both been the target of BPD anger. Would you find it offensive if a person who never even met you suggested that your diagnosis was wrong? That it was not BPD that causes you to hurt yourself, but instead you must just be depressed. Well, I too have been the target of BPD anger, and it has caused me great pain and injury. Yes, people with BPD CAN be violent and dangerous to others. That does not make them a sociopath (APD).

        Yes, there are similarities and overlaps with the Axis 2, Cluster B personality disorders. However, it is misleading and inaccurate to assume that all those that express their anger outwards towards others in a violent manner can NOT be BPD and are automatically categorized as APD. That is why we have mental health professionals and the DSM.

        I believe there is some confusion over High vs. Low Functioning. These are not judgements and are in no way related to intelligence, but these are the sub-categories of BPD that I am familiar with. It is likely similar to your Inward/Outward BPD subtypes. High Functioning BPD’s generally target their anger “outward” onto other people and cause them pain. Low Functioning BPD’s generally target their anger “inward” onto themselves and cause themselves pain. High Functioning BPD’s are considered “invisible” to mental health profession because they go undiagnosed and often do not seek or accept help. The Low Functioning BPD’s are considered “conventional” to the mental health profession because this is the type that is often hospitalized for self-harm/suicide, and they DO seek help.
        http://www.bpdcentral.com/borderline-disorder/subcategories-bpd/

        No, neither my sister or mother have been officially diagnosed with BPD. Why? Because they are the High Functioning type. I recognize them as “BPD” because that is how I (and other family members and friends) have experienced them. If you read the above link you will see that it is common for this type of BPD to only be recognized through the non-BPD (me) seeking treatment for the damage done by the expressed “anger” of the BPD. For example, when I sought help for myself (PTSD), my therapist recognized the BPD traits and characteristics in these family members. Other family members have also sought professional help for the damage done by their “anger”,and their therapist independently also came to the same conclusion of BPD. Like I said before, I am in a support group with tens of thousands of members, and we all have similar experiences and have all suffered similar abuse mostly by the High Functioning, undiagnosed, outward, invisible BPD.

        No, neither my sister or mother meet the criteria for APD, but I guess I should thank you(?) for your attempt to diagnose them. While yes, my sister can be very violent, this is not random. It is generally only those in close intimate relationships (family, boyfriends, husbands, etc.) who witness and experience her outward, innapropriate, violent, dangerous expression of anger.

        While I must whole-heartedly disagree with the notion that outward expressed anger and violence (dangerous) means APD, I do agree that their is an issue in the mental health profession with gender bias in diagnosing and recognizing traits. Often NPD women are misdiagnosed as BPD (though they often are co-existing). Often BPD men are misdiagnosed as NPD. I have read studies showing that APD is often misdiagnosed in BPD men due to gender bias. I would assume too that it is possible that APD women might be misdiagnosed as BPD due to gender bias.
        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3115767/
        http://www.psychologytoday.com/blog/stop-walking-eggshells/201104/borderline-personality-disorder-in-men-overlooked-misdiagnosed

        It does appear to me that you are trying to categorize people as not being BPD and being APD based on their violent, dangerous behavior. The defining point I believe in this instance is not “what” they do, but “why” they do it. For example, often the violent outward expression of anger is because the BPD believes they are being rejected or abandoned which triggered their attack. The NPD might unleash their violent narcissistic rage because they believe they were criticized which triggered their attack. I guess I feel that it is dangerous to assume that a violent outward dangerous expression of anger equals APD. I would think that it would be more pertinent to identify “WHY” or “WHAT” triggers the violent, outward, dangerous expression of anger.

        While I can understand that you can’t relate to a BPD acting outward in a violent abusive manner as you are the inward/conventional type, but please know that it is dangerous to apply this to ALL people with BPD. I can appreciate that you are an inward BPD and not likely to direct your anger outwards onto others in a violent, dangerous manner. Just because you are not dangerous though, does not mean that ALL people with BPD are NOT dangerous.

      • That was just one of the expert witnesses bought forward others claimed PTSD or that she was a sociopath, but the final decision was that no single diagnosis could explain her behaviour as discussed in Psychology Today – http://www.psychologytoday.com/blog/reading-between-the-headlines/201305/jodi-arias-guilty-murder-1-psychiatric-analysis

        I would not be offended if someone suggested my diagnosis was wrong, why should I be? And as you state your family members have not been diagnosed so you are also just diagnosing them based on your knowledge – you are not qualified to do this, just as I am not qualified to diagnose either, I was merely pointing out that without a formal diagnosis other possibilities do exist – no offence intended. Our perceptions of other peoples behaviour described to our own therapists are not enough for a diagnosis as while our experiences are very real and true we still (everyone) add our own ‘spin’ to how we describe this to other people, the only true picture is first hand witness, a diagnosis cannot be made third party, yes your therapists may be right but they also may not, even working directly with people misdiagnosis occurs…

        While it is not normally explained in this way I (as I believe I said previously) consider BPD to be more of a spectrum than an either or, with over 250 combinations of meeting the diagnosis it can not just be divided into high/low functioning or in/outward acting. I was also not saying that outward anger ‘has’ to be APD only that due to the overlaps it is often a misdiagnosis which does occur. And no I am not trying to categorize people based on the level of violence, I have stated that I agree that not all BPD’s are incapable of this, I think your point about it being ‘why’ not ‘what’ triggers violence is very valid.

        I agree, not all BPD’s are not dangerous, but not all BPD’s are dangerous either…

  3. My mom has borderline personality disorder clearly and her anger used to be directed at us and others. But I think it depends on a person. Some borderlines direct their anger inward so they engage in self-harm and even attempt a suicide while others physically and mentally abuse others. Some borderlines might do both, so we can’ really say people suffering from this mental disorder would always harm themselves instead of harming others. I grew up in an environment, which was filled with so much anger and tensions, so I started to fear upsetting people (well, mainly mom), and even as an adult, I have trouble upsetting others because of a fear that they can retaliate against me.

    • I’m sorry to hear about your difficulties. Yes, it sounds like your mom is an ‘outward’ expressing BPD as discussed in the comment and reply with The Quiet Borderline above. It does depend on the person, but inward expression is far more common in BPD. I hope you and your mom are getting help :)

  4. This topic could not of come at a better time – I have a terrible time with anger. As I have only discovered my BPD I am only just figuring what makes me the way I am. The anger can start over anything, its usually starts over something I am anxious about something and when I feel I can’t control a situation I am trying to deal with. I try to stay calm but I can feel it festering inside and no matter how I try I cannot manage the anger and keep it in , I will literally explode. It will result in me hurting myself. Last week I had a particulary bad day and it ended up in a&e as I bang my arm so bad and my partner thought I had fractured it . I feel so ashamed of myself , my poor boyfriend has to put up with me, I never hurt anyone else just myself. When the anger comes I have a mixture of emotions so I cannot makes sense of things. I wonder if my anger comes from when I was a child I was very supressed by my sister and mother, my sister was very controlling and bullying, and if I got upset I told to stop. I was never able show any emotions , if I was happy she (my sister) would find someway to squash that happy moment and if I was upset I was told to stop crying and that I was just attention seeking,so maybe now as an adult I cannot deal with my emotions in a healthy way. Maybe I am not sure :(

    • Sorry to hear you are having such a difficult time. I think you may be right that lack of emotional expression as a child contributes to difficulties expressing emotion as an adult, especially with BPD. :(

  5. Am a little foggy on it and a part of me doubts just how accurate these ideas are but I’m just going to write it down anyway.

    I was made to feel guilty about feeling angry when I was a child. Because my parents didn’t want me to be my own person – in that they believed their preferences were more important than my own – they disabled the tool (anger) that helped me to get what I wanted.

    As such, it became harder and harder for me to set boundaries, because I thought that having anger made me bad. This has led me feel very vulnerable as an adult as abusive people can see what buttons to press in me. The result has been me going into situations where I have experienced significant levels of humiliation (essentially just a recreation of being humiliated as a child).

    Now I have a hard time feeling and expressing anger. If I do ever express my anger, the vulnerability I feel is somewhat excruciating. I often worry that I’m being abusive, and also a part of me expect to get attacked.

    • Thank you for sharing. I think anger is such a personal and confusing emotion that while what I have written in this post is true for me, others experiences may be very different and clearly are from the comments that are being made! As with catnip I think you are right that the difficulties you experienced as a child have influenced your ability to cope with your emotions (particularly anger) now that you are an adult. And yes, anger does make us feel vulnerable! :(

      • “And yes, anger does makes us feel vulnerable!”

        I wonder what it would be like to have a healthy relationship with anger. I seem to imagine that if that was the case, I would experience my general feelings of vulnerability as more comfortable instead of excruciating. This idea here is that having a healthy relationship with my anger would give me more confidence in protecting myself, and thus I would feel safer.

      • That sounds very plausible to me, I think one of the key healing steps for those with BPD (and other conditions which affect your emotional stability) is learning to have a healthy relationship with your emotions, including anger, so that they are not so disturbing and overwhelming – but it is a long hard road to get to that point and it is something we need help to achieve, we can’t do it alone – if we could we would not be in this position in the first place! :/

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  7. Ola! Showard76,
    I take your point Like a balloon with skin fully stretched out by hot air, people diagnosed with borderline personality disorder easily burst up with the slightest touch of a piercing object. They are vessels bobbing through a turbulent sea of emotions, periodically facing the chance of drowning.
    Kindest Regards

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  15. I dont understand. If you wanted your husband to leave you alone, why didnt you just tell him you needed some space. Your action of locking someone out of the house is a form of communication in of itself. I think BPD sounds like an excuse to be cruel. Anyone would go bananas.

    • I agree, I don’t think you understood the situation properly Julie – my husband was the one being aggressive while I was just minding my own business cooking the dinner, his abuse made me snap, he slammed the door locking himself out of the room, I was not about to let someone being so violent and aggressive back in! How can I tell someone who is verbally threatening me that I need space, I was fine until he came in having an outburst for no apparent reason! BPD is not an excuse to be cruel, it is the result of how many cruel mistreatments I have suffered myself…

  16. When I was little I used to share my room with my sister and she was really the only person I ever talked to really in my family. Whenever I would get mad she would tell me to shut up because if I started yelling mom would yell at us. She never even let me rant quietly. So instead I would just cry. So now whenever I’m mad I don’t know how to release it so it just builds up and start getting mad about every little thing. And then I start crying instead of letting my feelings out. I also have misophonia so I get angry about noises a lot. I’m very inward I constantly find myself digging my nails into my skin or reaching for scissors and rubbing the blade against my finger or leg. My sister also forced a lot of stress on me with the help of my cousin. She would threaten to kill herself. Once she tied her head to the pillow and told me she was going to hold her breath until she died. Or I would walk into her room and she would be sitting on the windowsill with the window open and threatening to jump if mom yelled one more time. My cousin would go to court a lot and one time when I was at his house me and my female cousin were watching tv and he started to yell at us and tell my other cousin he was going to kill her with a kitchen knife. She ran upstairs and my aunt said she was going to put him in juvvy but she never did. This is kind of wordy but anyway the point is that I hate myself so much that I wish that I could just argue with people and tell them how much I hate them but I can’t. I’ve tried writing it out but it doesn’t sound angry enough. I’ve tried getting into fights but I find them stupid when there is really no reason. I always rehearse what I’m going to say when I start an argument but then I talk to the person I’m mad at and they either counter everything back at me like my sister which makes me hate myself more than them or I can’t sound mad enough.

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