An Inside Look at Borderline Personality Disorder

Troy Prouty, Yahoo! Contributor Network
Oct 1, 2008 "Share your voice on Yahoo! websites. Start Here."

Borderline Personality also known as BPD affects one out of every ten women and fewer amounts of men, however some people believe a higher number of males might have BPD, but are often diagnosed incorrectly stating they are Anti-Social.

Despite the high figure of people who have BPD, many therapists will not usually diagnose clients with BPD right away. Many of those Diagnosed with BPD experienced some sort of childhood abuse; sexual, physical, and verbal. Therapists often confuse Borderline Personality Disorder with Post Traumatic Stress Syndrome or Bi-Polar, however that being said, many patients that have BPD can also have Bi-Polar and Post Traumatic Stress Syndrome. I believe this leads to the confusion surrounding BPD. Many therapists actually will put BPD deferred, meaning that the characteristics found in BPD could actually be from other mental illness or alcohol and drugs.

Earlier in life many therapists turned away clients that had BPD, it was said that BPD was not treatable. But over the last fifteen years, certain treatments were developed to help treat this illness. It is believed that one out of every four that are getting psychiatric treatment may have BPD. It is also said that ten percent of those suffering from BPD will commit suicide. There is a strong movement from therapists to change the name Borderline Personality Disorder to Emotion Regulation Disorder in 2012.

BPD is extremely difficult to understand, one minute the person seems one way; possibly loving and kind, they may even put you on a pedestal, but their mood can change rapidly and they can turn aggressive, verbally or even physically. For someone that is not borderline it becomes a real nightmare and roller coaster ride. It is difficult to understand where these emotions and behaviors come from which leads spouses, children, and co-workers confused.

According to the DSM IV, the diagnosis for Borderline Personality Disorder is the following.

1. Identity disturbance: Self-image or sense of self persistently and markedly disturbed, distorted, or unstable.

2. Chronic feelings of emptiness.

3. Frantic efforts to avoid real or imagined abandonment.

4. Affective (emotional) instability due to marked reactivity of mood. Intense, episodic dysphoria (depressed mood), irritability, or anxiety usually lasting a few hours and only rarely more than a few days.

5. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

6. Inappropriate, intense anger or lack of control of anger.

7. Frequent display of temper.

8. Constant anger.

9. Recurrent physical fights.

10. Transient, stress related paranoid ideation. (Feelings of persecution) or severe dissociative symptoms (discontinuity of experience).

11. Impulsiveness in at least two areas that are potentially self damaging.

A. Spending

B. Sex

C. Substance Abuse

D. Reckless Driving

E. Binge Eating

F. Recurrent suicidal behavior, gestures or threats.

G. Self-Mutilating behavior.

Being borderline wrecks the world around the borderline, relationships become chaos in the life's of those around them. It is hard for those with BPD, they want the relationships to work; and yet they are often the cause of destroying them.

Joseph Santoro and Ronald Cohen from the book "The Angry Heart" Described it like this: "How can people who want to be liked by others abuse those whose acceptances they want until relationships with them are dismantled? This paradox puzzles those who must live out its curious logic. "I want to be accepted by you. I want you to like me. I don't know what it feels like to be accepted and loved. Everyone that loved me hurt me. I don't want to be hurt. I must survive somehow. No one can love me because I hate myself. I don't trust you. If you say you love me you are lying to me so you can exploit me. I'll exploit you first. I hate you because I believe that you will treat me the way my family treated me, but I need you to survive. I'm confused".

"These thoughts make up the borderline twister or swirling thoughts and accompanying emotions. It pushes its sufferers toward any and all actions that will help them escape from its deadly path. Its logic can be brain numbing in its twist and turns. An understanding of it might go like this:

"If I look for your acceptance while subconsciously fearing that you will not accept me and will in fact use me, I will pick up on even the slightest signs of non-acceptance or use of me. I will then react with anger and misuse our relationship. My anger and use of you will confuse and anger you and you will eventually reject or use me. After this happens time and time again, I learn to take what I can from my relationships because I have come to expect that they will all end badly for me""

"The borderline twister creates a cycle of failure. Failed relationships, jobs, and living situations increase mental agony and the need to escape suicidal thinking and actions, which produces further lifestyle failure. The borderline cycle of failure, crisis, agony, escape, and failure continues until help is sought and accepted".

Melissa Thornton described her experience with BPD this way. "You suffer from BPD and you hurt inside, so you begin to hurt yourself outside to match those powerful hidden emotions".

"Make your arm bleed, bang your head on the headboard harder, harder! Scream at those you love until they slink off terrified of you, the traitors! Burn your fingers on the stove; prick your hand with a pin over and over".

"Scary? The world of the borderline is a scary place, where logic as most people know it is eclipsed. It's a place where emotions rage wildly, often with self- harmful if not fatal consequences. It's a place where there are either good or bad".

Here is what some family members of those who have BPD had to say:

"After thirty one years of marriage it's finally over. As odd as this may sound it is only in the last year or so that I have come to an understanding of the depth of my wife's mental illness. She was diagnosed with BPD over twenty years ago. She has always been difficult. However, things came to a head as our daughter entered adolescence. My wife has been unable to cope with normally difficult teenage behavior. We have a sixteen year old son and a thirteen year old daughter. My son has always been easy to deal with. He is quiet and well behaved. My daughter is wonderfully perceptive, smart, and a socially adept child, yet she is also quite feisty. As is typical for borderline, my wife engages in splitting (black and white thinking). My son is the good one and my daughter the bad one. Things began to get bad about one year ago when my son got angry at her. She had been emotionally and at times physically abusive to the children".

Anonymous

"The annoying thing about suicidal threats is that no one, not even the person expressing them, knows for certain if the next impulse will be to do it. Exactly how much does it matter if it's a manipulation tactic, a cry for help, or a sincere desire to bring end something - life or pain. A reasonable dilemma overwhelmed by irrational thoughts. When were faced with that sort of desperation. "Yes" we can empathize with their thoughts; we can validate their tremendous pain. We can tell them that we hope they don't choose this particular solution. But, during a violent rage or when someone feels so overwhelmed by helpless hopelessness, no one is in control".

Anonymous

"I could hear it now, "God dammit Alan get back here! There it was again, my mother going on one of her rampages. These happened often. My brother was hit several times in the face and was retreating in our room; mom chased after him and began the punishment again. My brother spent countless hours' daily working on models, he loved them and they were special to him. He had about twenty six or so. That day my mother would punish my brother some more by smashing every one of them. I don't know what, if anything my brother did to set mom off, it didn't take much".

Anonymous

A good video that described the life of a borderline is found here on you tube.

http://www.youtube.com/watch?v=TgUOch8uQPU

DR. Richard Moskovitz in his book "Lost In The Mirror" said that "people with BPD are among the most gratifying and most frustrating of his patients".

There are several treatments for Borderline Personality Disorder. The most successful is Dialetical Behavioral Therapy (often referred as DBT) developed from Marsha Linehan at the University of Washington. DBT is a combination of cognitive behavioral therapy with Eastern Zen practices. DBT is made up of three kinds of symptom treatment; emotions, behavior, and thinking. Often DBT is at least a six month to a year commitment, which includes group/class therapy weekly along with one therapy visit per week. Marsha Linehan describes BPD and DBT like this in her journal March 1^st 1997 vol 8/Iss.1

"DBT is based on a model suggesting that both the cause and the maintenance of BPD is rooted in biological disorder combined with environmental disorder. The fundamental biological disorder is in the emotion regulation system and may be due to genetics, intrauterine factors before birth, traumatic events in early development that permanently affect the brain, or some combination of these factors. The environmental disorder is any set of circumstances that pervasively punish, traumatize, or neglect this emotional vulnerability specifically, or the individual's emotional self generally, termed the invalidating environment".

Here is what one person had to say about DBT. "Without DBT I haven't a clue where I would be today. I learned a lot about me as well has many new skills to help me get through life".

To find a DBT program in the area you live in, here is a website that will help you locate a program:

http://www.behavioraltech.org

On-line DBT groups:

http://health.groups.yahoo.com/group/DBTSKILLS-DG/?v=1&t=search&ch=web&pub=groups&sec=group&slk=3

http://health.groups.yahoo.com/group/dbtclass/?v=1&t=search&ch=web&pub=groups&sec=group&slk=2

http://health.groups.yahoo.com/group/bordertown_dbt/?v=1&t=search&ch=web&pub=groups&sec=group&slk=1

There are also many books a person can buy to help them with BPD. These include workbooks or just getting an understanding about BPD.

"The Angry Heart" by Joseph Santoro and Ronald Cohen.

"Borderline and Beyond" Text and workbook by Laura Paxton

"The Prouty Guide to Healthy Family Living" by Troy Prouty

"I Hate You - Don't Leave Me" by Jerold Kreisman

"Lost In The Mirror" by Richard Moskovitz