Borderline Personality Disorder Is Serious But Treatable
Written By: Mark Smith
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It is estimated that as many as 14% of women suffers from this disorder. The diagnostic manual or DSM IV gives 9 criteria for this disorder.
1. Frantic efforts to avoid real or imagined abandonment. People who have BPD have a really strong intolerance of being alone. Examples of abandonment issues here would be jealously grilling a spouse as to their whereabouts, accusing them of flirting with the waitress, getting highly reactive if a significant other is just a few minutes late, becoming intensely jealous and competitive of a third party in their spouse's life, continuing to pine for and obsess about a relationship that is over. It is almost as if the person becomes instantly and temporarily intoxicated and unable to see things in a rational manner. These reactions are almost always rooted in some form of parental abandonment. The stronger the abandonment by a parent, the stronger the frantic efforts to avoid real or imagined abandonment in the relationship.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. In the early stages of their relationships, borderlines tend to place the objects of their love on an extremely high pedestal. Many times the new man in the borderline's life has ridden in on a white horse to heroically rescue them. However, when the walls of denial start the crack it opens the floodgates to months or even years of unexpressed criticisms. Borderlines then become masters at devaluing everything about the object of their wrath/desire. The relationship becomes a love/hate relationship that is stormy and unstable.
3. Identity disturbance: markedly and persistently unstable self-image or sense of self. These identity disturbances might include confusion about life goals, values, career choices, sexual identity, or the type of friends that are desired.
4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Borderlines tend to have addictive personalities. They are in pain a lot and when they are in pain they tend to do things that medicate their pain. They are extremely emotionally needy and when their relationship evolves into the devaluing stage they frequently turn their attention to another, more idealized lover.
5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. For many lower functioning borderlines do attempt suicide, mainly as a way of either communicating anger or as an attempt to get attention. Tragically, at times these suicidal attempts are successful. Self-punishment is common in lower functioning borderlines. This can take the form of an eating disorder, excessive exercise or cutting or dying one's own hair in an unflattering manner.
6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). Living with a borderline is like riding a rolling coaster ride - there are a lot of ups and downs. They can shift moods on a dime. They can be exhilarated one minute, then anxious, then full of rage, and then deeply saddened. This leaves their more stoic partners highly confused as they attempt to fix things. Borderlines are missing the anchor in their souls of a solid and consistent sense of themselves. They are like feathers blowing in the wind.
7. Chronic feelings of emptiness. There is just a big empty hole in the borderline's soul and they attempt to fill that hole with external objects or people. This tremendous chasm in their souls is the thing that fuels their desperate efforts to capture, control and then cling to their treasured and yet hated object of affection.
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights). Borderlines can be scary from time to time. Although they generally are extremely loyal, emotionally connected, creative, and really quite wonderful people, they certainly have their dark sides. As they progress in their therapy, we frequently see strengths and positive qualities remaining while the rough edges are taken off their destructive sides.
9. Transient, stress-related paranoid ideation or severe dissociative symptoms. This last one is a broken down in two parts. Stress-related paranoid ideation is basically just that - being paranoid, questioning the motives of safe and well- meaning people. During childhood they learned that there was not a consistently safe place in the world for them. They were abandoned, abused, neglected, controlled, criticized, unloved and not given what they needed to grow up healthy and happy. The final piece of the puzzle is the severe dissociative symptoms. This is a unique ability to stick their pain away for weeks, months and years at a time. They just sort of go bye-bye. This coping mechanism helps borderlines stay in very dysfunctional and painful relationships for way too long. They have an ability to cut and run that seems very cold and calculated. They needed that defense mechanism during their childhoods and they end up being sort of stuck with it. It is like a breaker switch in your electrical box - when there is too much current, it trips the switch.
The therapeutic process is about re-parenting that little child who lives inside that adult body. If you feel as if you might have borderline personality disorder or that your spouse, friend, or family member might have it then you really need to seek some help for them and for yourself. With time, hard work, trust, patience, genuine care, and even more time you can have many of the wonderful things in life that we all want - a stable loving relatively healthy relationship and a fulfilling rewarding self-defining career. See you next week.
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