What is borderline personality disorder?

Borderline Personality? What Is that?

Borderline Personality Disorder is a disorder that is most recognized by the pattern of unstable relationships where the individual shifts between those periods of representing the person as perfect or better than in reality, and then represents the person as completely flawed, worthless, or having exaggerated negative qualities.

People may make repeated attempts to avoid real or imagined situations of abandonment. It is most recognized by the emotional turmoil it causes. People who have it feel intense emotions and struggle with the ability to regulate for long periods of time, and it is harder for them to return to a stable baseline after an emotionally intense event. Suicide threats and attempts are very common for people with BPD. Self-harming acts, such as cutting and burning, are also common.

When working with clients, the first step is to gather the childhood history, and the reason I focus on this is that what we experience from our time in the womb to adulthood determines the struggles we experience as adults. Personal trauma is a known factor that can contribute to BPD, Broken attachments with parental figures (mother, father, grandparents, foster parents, adoptive parents, etc.) also are a contributing factor as we learn how to develop trust in our caregivers, our ability to self-soothe (regulate emotions) and create our self-image (worthiness, loved, needed, etc)

There are notable gender differences in BPD with regard to personality traits, comorbidities, and treatment utilization between men and women.Men with BPD are more likely to demonstrate an explosive temperament and higher levels of novelty seeking than women who have BPD1. Men with BPD have been recognized to struggle more with substance use disorders while women are more likely to develop eating disorders and mood conditions, while both can identify with anxiety and post-traumatic stress disorder. When working with BPD clients, the first thing to share is that it is treatable, it does not define who the client is, but rather explains the cause of the behaviors and symptoms of distress they are experiencing.  We are all born with biological emotional response mechanisms and throughout this journey of life, this biological part gets altered by the social environments in which we encounter from birth to adulthood. (parents, educators, peer groups, friendships, colleagues, romantic relationships.}I provide Dialectical Behavioral Therapy (DBT) which teaches the client how to regulate emotions, develop effective communication skills when interacting with others in their life, develop and maintain a satisfying life, to focus on the present using mindfulness and other coping skills they can use when faced with stress rather than self-harm, using substances, or other reckless behaviors to dissociate or numb the distress they are experiencing.I also utilize ACT to assist with getting beyond the thoughts and learning to use acceptance rather than resistance to things that occur in life that are beyond one's control.  I introduce Schema therapy to look at one's childhood to identify what core needs were not met and what coping mechanisms were learned and are yet in place as an adult. 1) Tadić A, Wagner S, Hoch J, Başkaya Ö, von Cube R, Skaletz C, Lieb K, Dahmen N: Gender Differences in Axis I and Axis II Comorbidity in Patients with Borderline Personality Disorder. Psychopathology 2009;42:257-263. doi: 10.1159/000224149