Understanding Borderline Personality Disorder

By: Christine Hammond, LMHC

What does “Borderline” mean?  What are you a borderline to?  It is almost as if the author of Borderline Personality Disorder (BPD) came up with the most confusing name possible to express just how confusing it could be to deal with a BPD.  Whatever the reason, the name does not describe the disorder as a BPD is not a borderline to anything.  Rather it describes the almost daily “they love me” or “they hate me” responses a BPD can display in a relationship.

So what is BPD?  Here is the technical DSM-V definition:

·      Identity:  Unstable self-image with excessive self-criticism

·      Self-direction:  Instability in goals or career plans

·      Empathy:  Prone to feel slighted or insulted even when not true

·      Intimacy:  Relationships marked by mistrust, neediness, and preoccupation with real or imagined abandonment

·      Emotional liability:  Unstable emotional experiences and frequent mood changes

·      Anxiousness:  Intense feelings of panic, feeling fearful, fears of falling apart or losing control

·      Separation Insecurity:  Fears of rejection or separation from significant others

·      Depressivity:  Miserable, hopeless, thoughts of suicide and suicidal behavior

·      Impulsivity:  Acting on a momentary basis without a plan or consideration of outcomes

·      Risk Taking:  Engagement in dangerous, risky and self-damaging activities

·      Hostility:  Anger or irritability in response to minor slights and insults

 

The practical definition looks more like this:

·      Impulsive and risky behavior such as unsafe sex or gambling sprees

·      Threatens and often does self-harming behavior

·      Wide mood swings

·      Short but intense episodes of anxiety or depression

·      Inappropriate anger sometimes escalating into physical fights

·      Difficulty controlling emotions

·      Suicide attempts

·      Feels misunderstood, neglected, alone, empty or hopeless

·      Fears being alone

·      Feelings of self-hate

 

In real life, a BPD looks just like Winona Ryder who played Susanna in “Girl, Interrupted”.  Her parents were unable to help her following a suicide attempt so she was placed in a mental institute.  While this may or may not be the appropriate course of action for a BPD, the trail of destructive relationships and the large black cloud of doom and excessive drama that seems to follow them is very much characteristic of a BPD.  It is not uncommon for a BPD to have a long list of people they no longer talk to for no apparent reason.

So how do you deal with a person who might have BPD?  Here are a few suggestions:

·      One minute you are their best friend and the next you are the enemy, don’t trust either.

·      Establish and maintain firm unwavering boundaries; they constantly push the envelope.

·      If you find yourself wanting to rescue them, they are most likely a borderline.

·      They often play the victim to get others involved, don’t.

·      They frequently have a black cloud of destruction overhead; it is not your responsibility.

·      Remember the moon hung over the last person they now dislike, now look where they are.

·      Because they are emotionally driven, use emotions to convince them, don’t use logic.

·      Distraction works when all else fails.

True intimacy is hard for a BPD although on first glance they may seem to be very intimate as they often open up right away divulging what to everyone else would be a deep secret.  Don’t be fooled by the seduction of a close relationship as they pull away when you get too close and then blame you for the reason they pulled back.  Get some help for this relationship and set very firm boundaries.