Borderline Personality Disorder (BPD)
The clinical word borderline personality disorder originated to describe continuing, long-lasting dysfunctional actions in people who did not have a complete psychosis, such as schizophrenia, but who also were considerably more dysfunctional than persons with difficulties of anxiety and depression. Borderline Personality Disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) (DSM-IV) as a “pervasive pattern of instability of interpersonal relationships, self-image and affects or moods, and marked impulsivity, beginning by early adulthood and present in a variety of contexts,” with at least five of the following:
- Desperate struggles to evade real or imagined abandonment. People with Borderline Personality Disorder may not be willing or able to do much at all alone. The patient, or BP, can become desperate over events such as having lunch alone or to be at home alone at night. Borderline Personalities may drink, call loved ones dozens of times an hour, go out and pick up an outsider for sex, have desperate fits, or cut themselves to avoid being alone. The more histrionic, intense, and self-destructive the BP’s behaviors, the more dysfunctional the person typically is.
- A form of unstable and forceful interpersonal relationships. This refers to the pattern of the BP working from intense love and admiration to intense hate, rage, and anger over and over in love relationships. BPs are recognized for being happy one minute and threatening divorce a few minutes later. They split up with loved ones, only to get back and break up over and over.
- Unstable self-image or perception of self. The Borderline Personality may not trust that he or she exists in the mind of others except the other person is in through contact and giving direct reaction to the BP. The BP can receive a loving mention and in the same discussion state that she considers she is not loved or even being thought well of by the other person. The BP consecutively sees himself as all good or all bad, superior or inferior, kind or detestable. The BP catches it hard to hold in mind different moods and different qualities of personality together at the same time.
- Impulsivity. Because the Borderline Personality has robust, violently fluctuating sentiments that are extremely powerful, he or she frequently acts thoughtlessly and may reply suddenly with extremely adverse or extremely positive emotions. He may toss things, walk out of an anniversary dinner, yell swearwords in public, or send dozens of red roses or propose to a new love he’s just met. Frequently the BP reacts quite differently to the same situation at different times. This makes it very hard to guess how a BP may act in any given moment.
- Repeated suicidal behavior, motions, or threats of self-mutilation. The Borderline Personality’s emotional responses to dissatisfaction, loss, fear, anxiety, or abandonment can be dangerous. He can trust that the present feeling will, literally, never leave, so suicide can seem to be the only answer. Cutting or burning herself with cigarettes may be used by the BP to reduce his consciousness of her emotional pain by concentrating on a real bodily pain.
- Mood instability, anxiety, reactivity, depression, rage, and despair. This is a symbol of Borderline Personality Disorder. The person with Borderline Personality Disorder is very vulnerable to dwindling into negative moods instantaneously and is frequently very fast to change moods, occasionally within seconds or minutes, and these emotions can alter rapidly back and forth. These emotions are frequently tremendously strong, and the BP is at a loss as to how to handle them alone.
- Chronic sensations of emptiness. The person with Borderline Personality Disorder may sense invisible and frequently does not trust that anyone remembers him when he is not in that person’s attendance. He may suppose others to not think about him when he is gone but at the same time may be furious by not having his desires predicted. He may have no logic of who he is, what he desires in life, or what his skills, ideals, or beliefs are, but he may also anticipate a loved one to recognize these things for him.
- Unsuitable powerful rage or trouble controlling anger. The power of the BP’s anger can be dreadful to others around him. The BP might behave physically abusive, striking out by beating, throwing things, screaming, threatening to harm, or, in extreme circumstances, killing the loved one. She can similarly act in emotionally abusive conducts through accusing, put-downs, impossible demands, and ultimatums. The BP cannot appear to let go of such powerful anger even with the care of a loved one. If the BP senses an emotion, whatever it is, that feeling is unconditionally true to the BP and cannot be altered by logic. Since the person with BPD cannot figure out how the feeling came about, he or she frequently accuses someone else for triggering the feeling.
- Temporary, stress-related paranoid thoughts or severe dissociative symptoms. This is the most puzzling symptom shown by the person with Borderline Personality Disorder. The BP can rapidly change from seeing a loved one as valuable and supportive person to recognizing the same loved one as a hostile enemy. Consequently, the BP can say things and act to her spouse and child in ways that she would do only to her nastiest, most despicable enemy. Furthermore, the BP characteristically forgets what he said and did a few hours or a day later, and he practically never comprehends the emotional impact of his surge on his loved ones. Although the cruel words and actions still wound the other person, the person with BPD perceives no reason to make an apology or even discuss what happened since as far as the BP is concerned, it never even occurred or is in the past.
The following instances of daily behaviors, opinions, and feelings of the person with Borderline Personality Disorder may appear clearer than the therapeutic explanations by the DSM-IV.
- Powerful emotional poverty, which may be covered up by a concealment of independence.
- Unexpected emotional surges of anger and despair that seem random.
- Faith that the emotions of the moment are completely precise and will last forever.
- Mistaken remembrance of emotional events, even altering the meaning of the events after the fact.
- Seeing their feelings as being caused by others or by events outside themselves, with no trust that they have any sort of control over their own feelings.
- Considering that the only way to alter how they feel is to get other people or events to change.
- Continuing, powerful anxiety and fear.
- All-or-nothing thinking.
- Powerful acceptance in their own perceptions in spite of facts to the contrary.
- Their version of events is the only truth.
- Continuously searching for the negative unseen meaning in conversations and events.
- Cannot be convinced by fact or logic.
- Do not see the consequence of their own behavior on others.
- Refute the views of others.
- Blame others of saying and doing things they didn’t say or do.
- Reject negative or positive events from the past that clash with current emotional state.
- Thoughtless and impulsive behavior.
- Bodily, sexually, or emotionally abusive to others.
- May cut, burn, or injure themselves.
- Frequently have obsessions to alcohol, prescription or street drugs, eating disorders, spending money, or other compulsive behaviors.
- Generate calamities and disorder continuously.
- Frequently rapidly go to suicidal considerations when dissatisfied or disagreed with.
Instability of a Sense of Self
- Powerful fear or paranoia about being excluded, even to the extent that they need to be accepted by persons they don’t like.
- Frequently change their persona, thoughts, or beliefs, conditional on who they are with.
- Absence of a reliable sense of who they are or may have an excessively inflexible picture of the self.
- Frequently present a cover-up. May be fearful of being seen for who he really is. Repeatedly supposing that they will be excluded or criticized.
- May never have formed any real thoughts, ideas, or interests of their own.
- Act unsuitably or outrageously to get attention.
- Have difficulty fine-tuning to changes in the appearances of loved ones
- Out of sight, out of mind. Trouble recognizing that they or others exist when not together.
- Simultaneously see herself as both inferior and superior to others.
- Suddenly fall in love or instantaneously end a relationship with no rational justification.
- Aggressive, devaluing verbal assaults on loved ones while being attractive and enjoyable to strangers.
- Over-idealization of others.
- Have concern being alone even for short episodes of time however also drive people away by picking fights.
- Accusing and attacking loved ones for small, even unimportant mistakes or accidents.
- Might try to evade predicted rejection by denying the other person first.
- Trouble feeling loved if the other person is not nearby.
- Extremely controlling and demanding of others.
- Reluctant to recognize and respect the boundaries of others.
- Demand rights, commitments, and manners from others that they are not willing or able to share.