Borderline Personality Disorder (BDP)
Borderline Personality Disorder (BPD) is a controversial name for an enduring mental health problem that can be debilitating. Borderline Personality Disorder is also known as emotional regulation disorder and emotionally unstable personality disorder. The term ‘personality disorder’ is often frowned upon and disputed because of the negative connotations it carries with it.
Borderline Personality Disorder refers to people who experience problems with self-regulation. This means that a person can have feelings that are overwhelming, out of control, and rapidly changing. These symptoms often go hand-in-hand with a deep sense of emptiness. BDP is a mental health problem that can be found on a continuum. A significant number of people within society experience milder symptoms of Borderline Personality Disorder. However, to be diagnosed with this mental health issue the symptoms need to be severe enough to impact how you function day-to-day and your overall quality of life.
People who fall on the higher ends of the Borderline Personality Disorder continuum are often engulfed with intense and powerful emotions that consume their mind, body and soul.
Many people I have worked with feel lost and confused, they do not understand why they experience such emotional instability and emotional extremes. One client said to me “I do not know why I overreacted that day”. That day refers to my client feeling suicidal and locking herself away from the world in her bedroom for 7 hours. Why had she been so upset? Her 11-year-old daughter had said something to her in a flippant tone in the school playground. This had caused intense feelings of failure, abandonment and rejection.
It is not unusual for people with Borderline Personality Disorder to feel hypersensitive to abandonment and rejection cues (perceived or real) in the environment. This is because perceived abandonment or rejection confirms their sense of unworthiness and reopens past trauma wounds. Borderline Personality Disorder is of course complex. However, it is widely recognised that a significant number of sufferers experience early life trauma and abuse, particularly sexual abuse. They may also have experienced a lack of emotional attunement and validation from primary care providers. The lack of validation, or/and trauma and abuse often creates a sense of insecurity, self-doubt and uncertainty.
The severity and frequency of symptoms and how long they last will vary depending on the individual and their illness. However, often symptoms can be triggered by seemingly everyday events. For example, people with Borderline Personality Disorder may feel angry and/or distressed over short separations or perceived rejections from people to whom they feel close.
Often people with Borderline Personality Disorder hold extreme views of the world and place people in good or bad categories. They sometimes idealise a person, adore them, admire them and love them, yet their opinions can change suddenly based on imagined or real rejection or abandonment. A person who is a friend may turn into an enemy or traitor. The constant shift in feelings and states can lead to intense and unstable relationships.
Other signs/ symptoms of borderline Personality Disorder may include:
- Efforts to avoid real or imagined abandonment, such as rapidly initiating intimate (physical or emotional) relationships or cutting off communication with someone in anticipation of being abandoned
- A pattern of intense and unstable relationships with family, friends, and loved ones, often swinging from extreme closeness and love (idealization) to extreme dislike or anger (devaluation)
- Distorted and unstable self-image or sense of self
- Impulsive and often dangerous behaviours, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating. Please note: If these behaviours occur primarily during a period of elevated mood or energy, they may be signs of a mood disorder—not borderline personality disorder
- Self-harming behaviour, such as cutting
- Recurring thoughts of suicidal behaviours or threats
- Intense and highly changeable moods, with each episode lasting from a few hours to a few days
- Chronic feelings of emptiness
- Inappropriate, intense anger or problems controlling anger
- Difficulty trusting, which is sometimes accompanied by irrational fear of other people’s intentions
- Feelings of dissociation, such as feeling cut off from oneself, seeing oneself from outside one’s body, or feelings of unreality
Not everyone with Borderline Personality Disorder experiences every symptom. Some individuals experience only a few symptoms, while others have many.
Dialectical Behaviour Therapy (DBT)
Dialectical Behaviour Therapy is a skills based psychological therapy created by Marsh Linehan. It focuses on individual therapy as well as four central modules taught during individual sessions and group work.
Mindfulness
Emotional regulation
Interpersonal effectiveness
Distress tolerance
Therapy involves one-to-one weekly sessions with a counsellor or psychologist and weekly group sessions. The main aim of the psychologist or counsellor is to help reveal or create a ‘life worth living’.
Being emotionally charged for extended periods leaves people with Borderline Personality Disorder feeling emotionally drained and in the long-term the stress of such intense emotional states may lead to more serious health concerns. Working on the skill sets detailed above helps clients diagnosed with Borderline Personality Disorder develop appropriate self-care/compassion strategies and ultimately helps them effectively manage, protect and conserve their emotional energy.
During Dialectical Behaviour Therapy treatment a ‘chain analysis’ is also deployed. Chain analysis is atherapeutic method that is used to meticulously break down a triggering event on a timeline. This method demonstrates to clients the events and triggers prior, during and after that help create and maintain emotional surges.
I believe that as much as people with Borderline Personality Disorder are fragile they are strong because after all, they are survivors. They have survived a lifetime of pain and suffering . Many of my clients, despite all this pain, are filled with determination, hope and love. I know and have seen how with the right guidance and support people diagnosed with Borderline Personality Disorder can learn how to invest their emotional energy in activities that enrich their lives . However, this can only be achieved once they have had the opportunity to get reacquainted with their emotions and process the sorrow/despair of their past. I believe people who experience such extreme emotions have so much to offer themselves and society, if only they have the opportunity to discocver the ‘self’ that hides beneath all of the pain.
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