Borderline Personality Disorder

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

So, borderline personality disorder (PRL) is a set of behavioral reactions, feelings and thoughts of a person that maladjust the personality and significantly reduce the quality of life.

This is a fairly common disorder. They are mainly affected by individuals whose life in the period from 1 to 3 years is characterized by abandonment, lack of satisfaction of basic needs, lack of response from parents (mainly to the mother or an object replacing her) to the child's requests (to the child's smile, his cry, requests, need for attention and care). This period of life is important for the subsequent formation of growth and development of the personality. Unfortunately, neglect during this period often leads to tragedy in the adult life of such people.

What are the characteristics of a person with BPD?

Hypersensitivity

People with BPD are particularly sensitive. M. Linehan writes in his work that such sensitivity is similar to that if a person does not have "skin".

Sensitivity to criticism and separation can even provoke suicide attempts. These are difficult experiences. A person who feels everything deeply is also capable of deep, stable strong feelings. When it comes to stress, feelings can be so strong that sometimes they can destroy and, as it were, tear a person apart. This is also a special emotional pain. People with BPD often complain of heart pain. Because of their sensitivity, health often suffers (headaches, heart pains, sleep disturbances). These people feel everything literally with their "bones", that is, very deeply. What is common for other people can be a disaster for people with BPD. For example, a broken cup or the loss of a personal item, a broken phone literally turn into a tragedy. In other words, a person with BPD lives as if the psyche is naked.

Particular sensitivity to parting

Such people do not tolerate any parting very well. Sometimes it becomes so unbearable for them that they commit suicidal attempts. For them, parting is stressful. During this period, their behavior may change. They can become aggressive, angry, distrustful. They are acutely worried when a spiritually close person leaves them, rejects them, does not express love and gratitude.

For individuals with BPD, loyalty is very important. They are so attached even to things, for example, to a cell phone, that they can be very sad when they lose this thing and acquire a new one. Any parting is accompanied by sadness, anger, tearfulness and intense suffering.

Loneliness and boredom accompany the life of people with BPD

It seems to people that life goes on in a circle, there is nothing particularly interesting, everything has faded and became commonplace. Such people are often alone. They find it difficult to trust, and therefore they suffer from loneliness. They are afraid of intimacy, afraid of being used and absorbed by others. There is a particular fear and tension. People are afraid that the other will harm them or take something from them. They can only trust themselves.

But, at the same time, they have a special sensitivity to ignorance, they cannot tolerate indifference. Thus, there is a desire to communicate, because people feel lonely, but at the same time there is a fear of this communication due to distrust and fear of being used in a relationship. That is, there is a kind of "vicious circle" with the desire for communication, loneliness, boredom and at the same time fears, which can arise in the process of close contact.

Ambivalence

During times of stress, people with BPD may love at the same time and, after a few hours or minutes, hate. Feelings are characterized by strength and antagonism. One person can become both a friend and an enemy for the "borderline". In a stressful situation, there is a sharp change in tenderness and anger, like on a swing. That is, there is polarity, contact at the border.

Idealization and depreciation

The tendency to idealize people, see in them the height of perfection and after a while devalue everything that once seemed good. These are also ambivalent feelings. Adequate understanding of people and oneself is absent or diminished.

Shame

Shame is inherent in people with BPD. They are often ashamed of their inappropriate behavior, and often of suicidal behavior, behavior that they cannot control. They often say, "I'm ashamed of myself."

Lack of control over behavior

People with BPD have poor emotional control and a low level of self-regulation, impulsivity. Often they cannot control anger, rage, love, affection, needs. Such deregulation becomes a real problem for an adult and can contribute to hospitalization due to inappropriate behavior.

Lack of the ability to be in a long-term permanent relationship with another person

People with BPD cannot be in long-term relationships. They feel anxious or panicky and try to leave, and sometimes even run away from the relationship. They tend to change the object or be in a relationship with a chaotic nature (changing communication partners).

Love and trust in animals

People with BPD often find it difficult to trust others. They consider animals to be reliable in "relationships". They interact well with pets, love them, but at the same time, they may tease or take little care of them.

Respect for authorities

Respect for authority is associated with idealization. If someone with BPD likes someone due to their competence, knowledge, they remember such a person. They have more confidence in him. Such authority can last a lifetime.

And on the contrary, if an authoritative person once suppressed with his power, then this, too, is usually remembered. Anger at the abuser and distrust can persist for a significant portion of the time.

Lack of clear ideas about yourself

People with BPD are often asked who are you? cannot accurately describe themselves. Their ideas about themselves are fractional. They are collected piece by piece from other people. For example, a part in a person from a boss, a subpersonality from a loved one, a subpersonality from an authoritative person. Other people's behaviors are copied by individuals with BPD. That is, figuratively, the personality is like "a pie with different pieces from other pies."

The ability to take on a lot of things and not finish to the end. Activity

Individuals with BPD have nebulization activity. They tend to take on a lot of things, wreak havoc, but rarely follow through with what they have begun. They don't have enough patience and everything quickly gets bored and boring, so they want to take on a lot of things. Developing consistency and the ability to follow through can help individuals with BPD. This is often helped by sports.

Low self-esteem and self-esteem

People with BPD tend to consider themselves unworthy, dirty, and humiliated. As children, they were often humiliated and ignored and, as adults, they believe that they did not deserve respect and good relations. Their self-esteem is inadequately low, they do not see something good in themselves, they often feel abomination and disgust for themselves and their actions. They can do a lot, but as a result of a lack of faith in themselves and their success, misinterpretation of what is happening, a low level of resources, such people may need support.

In general, individuals with BPD are characterized by impulsivity, lack of social skills, loneliness, distrust, feeling like a failure, boredom, emptiness, life-threatening behavior, addictions (alcoholism, drug addiction), harm to oneself and others, and strong feelings of stress.

For individuals with borderline disorder, competent psychotherapy with an experienced therapist is recommended. The duration of therapy should be from 5-10 years under the guidance of a competent psychotherapist, otherwise, mistakes may be made that can lead to serious trauma. It is important to remember that the therapy itself is stressful for borderline clients.

What is stressful for people with BPD?

The most acute stress is the situation of interpersonal breakup or when someone decides to leave a person with BPD.

Also, stress can be conflicts in the family and at work, a situation of threat of losing a job, a situation of unemployment, a situation where you need to make a choice or make a decision, as well as a situation of death of a loved one and other stresses.

How do individuals with BPD deal with stress?

Unfortunately, times of stress are the most difficult times for people with BPD. Loss of normal and productive functioning occurs. All those skills and knowledge that were once formed cannot be used during this period due to an extremely unstable state. All functions are mismatched. A person is conscious, he understands everything, understands what is happening around him, partly understands what is happening to him, but he cannot regulate his emotions and state. It turns out such a paradox: as if the head is located separately (thinking, consciousness), and emotions are located separately. That is, there is a violation of self-regulation.

Events in life are perceived catastrophically and thus, there is, as it were, crisis after crisis. Even an insignificant event (going to a doctor's appointment) is perceived as if the examination is associated with a serious fatal illness. All ordinary events are perceived as a crash.

During this period, people with BPD often suffer from colds, their reserves are worn out. It is during this period of chronic stress that PTSD can also escalate. When the events of the past are perceived as if they happened yesterday. They are so bright that a person can even be very scared to tears. Any slam of a bus door can be perceived as a shot or a threat to life.

Ego instability can be one of the facts of the influence of stress. Instability manifests itself in antagonistic ideas about myself (I am a bastard, I am a saint), in directly opposite ideas about others (I love you, I hate you), as well as in the instability of views of positions on current events, conformity.

Stress disorganizes the psyche, splits it. During this period, sleep, mood worsens, life becomes unbearable.

During and after periods of stress, cognitive errors or inadequate, misinterpretation of what is happening may occur. Often, their own feelings are projected onto another person, which often worsens the condition and leads to the breakdown of meaningful relationships.

Often, an individual with BPD seems to be "carried" and he would be glad, but he cannot stop expressing feelings (anger, rage, aggression).

Often, psychotherapy itself is a source of stress for people with BPD.

Thus, the condition of a person with BPD directly depends on their relationship with the environment.

The condition can return to a neurotic level in the absence of traumatic factors and with the use of low doses of antipsychotics and good REB psychotherapy, psychoeducation. Much also depends on the level of resources and human intelligence. The more social resources and the higher the intelligence, the better stress is tolerated and the faster the individual returns to an adapted life.

Sometimes it is important for the therapist to admit his incompetence and think about who could really really help the client.

Recommended areas of psychotherapy for treating clients with BPD:

1. Dialectical-behavioral psychotherapy.
2. Cognitive-behavioral psychotherapy + client-centered psychotherapy.
3. Psychoanalysis.

Literature on Borderline Personality Disorder:

1. O. Kernberg "Borderline Personality Disorder"
2. Marsha Lainen "Dialectical-Behavioral Psychotherapy for Borderline Personality Disorder"
3. Elionor Greenberg "Treating Borderline Disorder"
4. A. Beck "Borderline Personality Disorder"
5. Depatologization of the border client