Shrink Rap News: Brandon Marshall, the NFL, and borderline personality disorder

I am what you’d call an unwilling sports fan – and then just barely – in that I reside in a family where everyone else is riveted by sports, and by football in particular. The National Football League is the backdrop to my home life on Sundays, Mondays, and Thursdays, with Saturday reserved for college football, all the more so since both of my children have attended Big 10 universities. With that as a background, I was delighted when the Sept. 19 episode of the NFL’s “A Football Life,” focused on Brandon Marshall, the Chicago Bears wide receiver who has talked publicly about his personal struggles with borderline personality disorder.

While many psychiatric disorders are stigmatized by people who are unfamiliar with them, borderline personality disorder is likely the illness that gets most stigmatized within our profession. “Borderline” or “Cluster B” are sometimes uttered as code, to mean that a patient is difficult to work with, unlikeable, or perhaps even manipulative. We often blame patients for their behaviors in ways that we don’t when a patient is ill with an Axis I disorder, and few psychiatrists relish the opportunity to work with patients who have borderline personality disorder.

The television episode focused on Marshall’s football career, his legal struggles, and his interpersonal relationships both on and off the playing field. There were spotlights on many of the people who were affected by his troubling behavior. Marshall described his relationship with his best friend and quarterback, Jay Cutler, as, “We’re the couple that really love each other but shouldn’t be together.”

Cutler was interviewed. He described Marshall as an emotional man who loved media attention and who would lose his temper and hang on to grudges. They first played together for the Denver Broncos, and now both men play for the Chicago Bears.

Marshall’s agent was interviewed and made the point that Marshall had “…personally destroyed maybe five of my vacations.” Marshall’s former coach; his wife; his mother; and his psychiatrist, Dr. John Gunderson of McLean Hospital in Belmont, Mass., were all interviewed on the show.

The narrator for “A Football Life” described Marshall’s behavior as erratic, both on and off the field. Film clips were shown of Marshall losing his temper, kicking the ball off the field during a penalty, and celebrating excessively. His mother referred to his outbursts as “hissy fits,” and she noted, “We were all under the impression Brandon could control this.”

Despite his talent as a wide receiver – while playing for the Broncos, Marshall caught more than 100 passes in each of three consecutive seasons – the Broncos traded him to the Miami Dolphins. His career with the Broncos had been marked by a brief suspension for charges of drunk driving and domestic violence, and Marshall had had numerous arrests over the years. He finally was required to have a psychiatric assessment, and Marshall flew to Massachusetts for a day-long evaluation with Dr. Gunderson. Dr. Gunderson described Marshall at that meeting as “hostile and nondisclosing.”

In Miami, Marshall’s behavior continued to be a source of contention. His girlfriend, Michi, described him as remote and withdrawn. After a domestic dispute in which she was charged with stabbing him – charges that both denied and were later dropped – Marshall returned to see Dr. Gunderson and dedicated 3 months of his off-season to getting treatment.

Dr. Gunderson noted that on his return visit, “He was troubled enough by his behaviors and the difficulties they were causing for him.”

With a diagnosis of borderline personality disorder, Marshall became invested in learning about the disorder and devoted his days to intensive treatment, which included group therapy. He discussed the difficulties he has regulating his emotions and noted that he now had strategies to help him maintain control. Cutler noted that Marshall still loses his cool, but he quickly regains his composure, while in the past he could stay angry for days.

The rest of the show went on to document Marshall’s successes. He gained better control of his temper and became less difficult to work with. Coach Tony Sparano was interviewed, and both he and Marshall talked of Sparano’s role in providing emotional support to the football player. He was offered a $30 million contract extension with the Bears. He and Michi married, started the Brandon Marshall Foundation to support mental health education and treatment, and the couple announced in September that they are expecting twins.

Dr. Gunderson noted that Brandon Marshall’s openness about his disorder does a great deal to alleviate the stigma associated with borderline personality disorder.

“He’s an articulate and charismatic male football player,” he said. “This takes it out of the realm of something that’s about weak people.”

The special did not talk about whether Marshall was taking medications – it was implied that he wasn’t – or if he has continued in treatment. We think of borderline personality disorder as being resistant to treatments, and certainly not as a disorder that can be fixed with 3 months of treatment. It was noted that Marshall has some unusual assets in addition to his charismatic personality: He has a vocation he loves and is good at, and he has supportive relationships. A clip was shown of an appearance he and Michi had made on “The View,” where he credited her support as being key to his success.

As psychiatrists, there is a delicate balance when treating patients with personality disorders. On the one hand, we want them to take ownership for their behaviors in the hopes that they will be able to gain some control over them. To balance this, however, personality disorders can be as crippling as any illness we treat in psychiatry, and the prognosis for some people is dismal. While it may be helpful to have a diagnosis and an explanation, it’s not beneficial if the patient sees himself as the victim of an untreatable condition. The television special on Brandon Marshall did a wonderful job of presenting this disorder with a balance – as a problem that happens to people, perhaps because of their difficult childhoods – but one that the individual can learn to take control of in an empowering way.

We might imagine this remains an ongoing struggle for Marshall, not one that was treated and fixed. I, however, enjoyed watching an NFL production with a positive spin on what we think of as being such a devastating psychiatric disorder.

Dr. Miller is a coauthor of “Shrink Rap: Three Psychiatrists Explain Their Work” (Baltimore: Johns Hopkins University Press, 2011).

I am what you’d call an unwilling sports fan – and then just barely – in that I reside in a family where everyone else is riveted by sports, and by football in particular. The National Football League is the backdrop to my home life on Sundays, Mondays, and Thursdays, with Saturday reserved for college football, all the more so since both of my children have attended Big 10 universities. With that as a background, I was delighted when the Sept. 19 episode of the NFL’s “A Football Life,” focused on Brandon Marshall, the Chicago Bears wide receiver who has talked publicly about his personal struggles with borderline personality disorder.

While many psychiatric disorders are stigmatized by people who are unfamiliar with them, borderline personality disorder is likely the illness that gets most stigmatized within our profession. “Borderline” or “Cluster B” are sometimes uttered as code, to mean that a patient is difficult to work with, unlikeable, or perhaps even manipulative. We often blame patients for their behaviors in ways that we don’t when a patient is ill with an Axis I disorder, and few psychiatrists relish the opportunity to work with patients who have borderline personality disorder.

The television episode focused on Marshall’s football career, his legal struggles, and his interpersonal relationships both on and off the playing field. There were spotlights on many of the people who were affected by his troubling behavior. Marshall described his relationship with his best friend and quarterback, Jay Cutler, as, “We’re the couple that really love each other but shouldn’t be together.”

Cutler was interviewed. He described Marshall as an emotional man who loved media attention and who would lose his temper and hang on to grudges. They first played together for the Denver Broncos, and now both men play for the Chicago Bears.

Marshall’s agent was interviewed and made the point that Marshall had “…personally destroyed maybe five of my vacations.” Marshall’s former coach; his wife; his mother; and his psychiatrist, Dr. John Gunderson of McLean Hospital in Belmont, Mass., were all interviewed on the show.

The narrator for “A Football Life” described Marshall’s behavior as erratic, both on and off the field. Film clips were shown of Marshall losing his temper, kicking the ball off the field during a penalty, and celebrating excessively. His mother referred to his outbursts as “hissy fits,” and she noted, “We were all under the impression Brandon could control this.”

Despite his talent as a wide receiver – while playing for the Broncos, Marshall caught more than 100 passes in each of three consecutive seasons – the Broncos traded him to the Miami Dolphins. His career with the Broncos had been marked by a brief suspension for charges of drunk driving and domestic violence, and Marshall had had numerous arrests over the years. He finally was required to have a psychiatric assessment, and Marshall flew to Massachusetts for a day-long evaluation with Dr. Gunderson. Dr. Gunderson described Marshall at that meeting as “hostile and nondisclosing.”

In Miami, Marshall’s behavior continued to be a source of contention. His girlfriend, Michi, described him as remote and withdrawn. After a domestic dispute in which she was charged with stabbing him – charges that both denied and were later dropped – Marshall returned to see Dr. Gunderson and dedicated 3 months of his off-season to getting treatment.

Dr. Gunderson noted that on his return visit, “He was troubled enough by his behaviors and the difficulties they were causing for him.”

With a diagnosis of borderline personality disorder, Marshall became invested in learning about the disorder and devoted his days to intensive treatment, which included group therapy. He discussed the difficulties he has regulating his emotions and noted that he now had strategies to help him maintain control. Cutler noted that Marshall still loses his cool, but he quickly regains his composure, while in the past he could stay angry for days.

The rest of the show went on to document Marshall’s successes. He gained better control of his temper and became less difficult to work with. Coach Tony Sparano was interviewed, and both he and Marshall talked of Sparano’s role in providing emotional support to the football player. He was offered a $30 million contract extension with the Bears. He and Michi married, started the Brandon Marshall Foundation to support mental health education and treatment, and the couple announced in September that they are expecting twins.

Dr. Gunderson noted that Brandon Marshall’s openness about his disorder does a great deal to alleviate the stigma associated with borderline personality disorder.

“He’s an articulate and charismatic male football player,” he said. “This takes it out of the realm of something that’s about weak people.”

The special did not talk about whether Marshall was taking medications – it was implied that he wasn’t – or if he has continued in treatment. We think of borderline personality disorder as being resistant to treatments, and certainly not as a disorder that can be fixed with 3 months of treatment. It was noted that Marshall has some unusual assets in addition to his charismatic personality: He has a vocation he loves and is good at, and he has supportive relationships. A clip was shown of an appearance he and Michi had made on “The View,” where he credited her support as being key to his success.

As psychiatrists, there is a delicate balance when treating patients with personality disorders. On the one hand, we want them to take ownership for their behaviors in the hopes that they will be able to gain some control over them. To balance this, however, personality disorders can be as crippling as any illness we treat in psychiatry, and the prognosis for some people is dismal. While it may be helpful to have a diagnosis and an explanation, it’s not beneficial if the patient sees himself as the victim of an untreatable condition. The television special on Brandon Marshall did a wonderful job of presenting this disorder with a balance – as a problem that happens to people, perhaps because of their difficult childhoods – but one that the individual can learn to take control of in an empowering way.

We might imagine this remains an ongoing struggle for Marshall, not one that was treated and fixed. I, however, enjoyed watching an NFL production with a positive spin on what we think of as being such a devastating psychiatric disorder.

Dr. Miller is a coauthor of “Shrink Rap: Three Psychiatrists Explain Their Work” (Baltimore: Johns Hopkins University Press, 2011).

I am what you’d call an unwilling sports fan – and then just barely – in that I reside in a family where everyone else is riveted by sports, and by football in particular. The National Football League is the backdrop to my home life on Sundays, Mondays, and Thursdays, with Saturday reserved for college football, all the more so since both of my children have attended Big 10 universities. With that as a background, I was delighted when the Sept. 19 episode of the NFL’s “A Football Life,” focused on Brandon Marshall, the Chicago Bears wide receiver who has talked publicly about his personal struggles with borderline personality disorder.

While many psychiatric disorders are stigmatized by people who are unfamiliar with them, borderline personality disorder is likely the illness that gets most stigmatized within our profession. “Borderline” or “Cluster B” are sometimes uttered as code, to mean that a patient is difficult to work with, unlikeable, or perhaps even manipulative. We often blame patients for their behaviors in ways that we don’t when a patient is ill with an Axis I disorder, and few psychiatrists relish the opportunity to work with patients who have borderline personality disorder.

The television episode focused on Marshall’s football career, his legal struggles, and his interpersonal relationships both on and off the playing field. There were spotlights on many of the people who were affected by his troubling behavior. Marshall described his relationship with his best friend and quarterback, Jay Cutler, as, “We’re the couple that really love each other but shouldn’t be together.”

Cutler was interviewed. He described Marshall as an emotional man who loved media attention and who would lose his temper and hang on to grudges. They first played together for the Denver Broncos, and now both men play for the Chicago Bears.

Marshall’s agent was interviewed and made the point that Marshall had “…personally destroyed maybe five of my vacations.” Marshall’s former coach; his wife; his mother; and his psychiatrist, Dr. John Gunderson of McLean Hospital in Belmont, Mass., were all interviewed on the show.

The narrator for “A Football Life” described Marshall’s behavior as erratic, both on and off the field. Film clips were shown of Marshall losing his temper, kicking the ball off the field during a penalty, and celebrating excessively. His mother referred to his outbursts as “hissy fits,” and she noted, “We were all under the impression Brandon could control this.”

Despite his talent as a wide receiver – while playing for the Broncos, Marshall caught more than 100 passes in each of three consecutive seasons – the Broncos traded him to the Miami Dolphins. His career with the Broncos had been marked by a brief suspension for charges of drunk driving and domestic violence, and Marshall had had numerous arrests over the years. He finally was required to have a psychiatric assessment, and Marshall flew to Massachusetts for a day-long evaluation with Dr. Gunderson. Dr. Gunderson described Marshall at that meeting as “hostile and nondisclosing.”

In Miami, Marshall’s behavior continued to be a source of contention. His girlfriend, Michi, described him as remote and withdrawn. After a domestic dispute in which she was charged with stabbing him – charges that both denied and were later dropped – Marshall returned to see Dr. Gunderson and dedicated 3 months of his off-season to getting treatment.

Dr. Gunderson noted that on his return visit, “He was troubled enough by his behaviors and the difficulties they were causing for him.”

With a diagnosis of borderline personality disorder, Marshall became invested in learning about the disorder and devoted his days to intensive treatment, which included group therapy. He discussed the difficulties he has regulating his emotions and noted that he now had strategies to help him maintain control. Cutler noted that Marshall still loses his cool, but he quickly regains his composure, while in the past he could stay angry for days.

The rest of the show went on to document Marshall’s successes. He gained better control of his temper and became less difficult to work with. Coach Tony Sparano was interviewed, and both he and Marshall talked of Sparano’s role in providing emotional support to the football player. He was offered a $30 million contract extension with the Bears. He and Michi married, started the Brandon Marshall Foundation to support mental health education and treatment, and the couple announced in September that they are expecting twins.

Dr. Gunderson noted that Brandon Marshall’s openness about his disorder does a great deal to alleviate the stigma associated with borderline personality disorder.

“He’s an articulate and charismatic male football player,” he said. “This takes it out of the realm of something that’s about weak people.”

The special did not talk about whether Marshall was taking medications – it was implied that he wasn’t – or if he has continued in treatment. We think of borderline personality disorder as being resistant to treatments, and certainly not as a disorder that can be fixed with 3 months of treatment. It was noted that Marshall has some unusual assets in addition to his charismatic personality: He has a vocation he loves and is good at, and he has supportive relationships. A clip was shown of an appearance he and Michi had made on “The View,” where he credited her support as being key to his success.

As psychiatrists, there is a delicate balance when treating patients with personality disorders. On the one hand, we want them to take ownership for their behaviors in the hopes that they will be able to gain some control over them. To balance this, however, personality disorders can be as crippling as any illness we treat in psychiatry, and the prognosis for some people is dismal. While it may be helpful to have a diagnosis and an explanation, it’s not beneficial if the patient sees himself as the victim of an untreatable condition. The television special on Brandon Marshall did a wonderful job of presenting this disorder with a balance – as a problem that happens to people, perhaps because of their difficult childhoods – but one that the individual can learn to take control of in an empowering way.

We might imagine this remains an ongoing struggle for Marshall, not one that was treated and fixed. I, however, enjoyed watching an NFL production with a positive spin on what we think of as being such a devastating psychiatric disorder.

Dr. Miller is a coauthor of “Shrink Rap: Three Psychiatrists Explain Their Work” (Baltimore: Johns Hopkins University Press, 2011).