Psychological Characteristics Of People With Borderline Personality Disorder

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

The life stories of people with borderline personality disorder (BPD) are like a roller coaster ride. Only this is not at all fun entertainment. Some people call borderline disorder "the apocalypse." The fates of people with BPD are reminiscent of a series of crises, abrupt changes in events, succession of ups and downs, disappointments and delights, rapidly changing emotions and lack of control. People with BPD are characterized by sensitivity, emotional pain, idealization and devaluation of other people or situations, dysregulation in the cognitive, emotional and behavioral spheres in situations of stress, inertia of affect (stability, sticking of emotions). All this and much more leads to a decrease in the quality of life and often suicide in people with borderline mental pathology.

There are 151 different combinations of symptoms in the clinical picture of patients diagnosed with BPD (some authors cite 256 as a possible number of combinations of symptoms in BPD) (Bateman, Fonagy, 2003) [1, 13-14].

The variety of symptoms and their manifestations often leads to the fact that people with BPD are seen by a doctor and specialists make various diagnoses, including, often found in people with BPD and the diagnosis of schizophrenia. Numerous hospitalizations and illiterately formulated diagnosis further maladjust and stigmatize people with BPD. In this regard, a detailed study of the structure of the psyche in BPD becomes relevant.

Analyzing the history of the term "borderline" it is worth noting that "this term has long been popular among the representatives of psychoanalysis. It was first used by Adolf Stern in 1938 to describe patients undergoing outpatient treatment who did not benefit from classical psychoanalysis and who clearly did not fit into the categories of the then standard psychiatric categories of "neurotic" or "psychotic" patients [2, 8-9] …

Considering the transformation of the term and its meaningful basis, we present the first definitions and connections between them.

So, A. Stern (Stern, 1938) noted that the content of BPD includes:

1. Narcissism is both idealization and contemptuous demeaning of the analyst, as well as of other significant persons in the past.

2. Mental bleeding - powerlessness in crisis situations; lethargy; a tendency to give in and give up.

3. Severe hypersensitivity - an aggravated response to moderate criticism or rejection, so strong that it resembles paranoia, but not sufficient for an obvious delusional disorder.

4. Mental and bodily rigidity - tension and numbness, clearly noticeable to an outside observer.

5. Negative therapeutic reactions - some of the analyst's interpretations that should facilitate the therapeutic process are perceived negatively or as manifestations of indifference and disrespect. Depression, outbursts of rage are possible; sometimes there are suicidal gestures.

6. Constitutional feelings of inferiority - there is melancholy or infantile personality type.

7. Masochism, often accompanied by deep depression.

8. Organic insecurity - a clearly constitutional inability to endure severe stress, especially in the interpersonal sphere.

9. Projective mechanisms - a pronounced tendency towards exteriorization, which sometimes puts the individual on the brink of delusional ideas.

10. Difficulties in checking reality - the empathic mechanisms of perception of other individuals are damaged. The ability to create an adequate and realistic holistic image of another individual on the basis of partial representations is impaired [2].

Another researcher H. Deutsch (Deutsch, 1942) identifies the following features in people with BPD:

1. Depersonalization, which is not hostile to the patient's “I” and does not bother him.

2. Narcissistic identification with other individuals, which is not assimilated by the “I”, but periodically manifests itself through “acting out”.

3. Completely intact perception of reality.

4. Poverty of object relations and the tendency to borrow the qualities of another person as a means of maintaining love.

5. Disguise of all aggressive tendencies by passivity, feigned friendliness, which is easily replaced by malicious intent.

6. The inner void that the patient wants to fill by joining various social or religious groups - regardless of whether the principles and doctrines of these groups are close or not [2].

M. Schmideberg (1947) notes the following signs and features of interaction in therapy:

1. They cannot stand monotony and constancy.

2. They tend to break many traditional social rules.

3. They are often late for psychotherapy sessions, they pay inaccurately.

4. Are unable to switch to other topics during psychotherapy sessions.

5. Are characterized by low motivation for therapy.

6. Are unable to comprehend their problems.

7. Lead a disordered life in which terrible things happen all the time.

8. They commit petty crimes (if they do not have a significant fortune).

9. Experiencing difficulties in establishing emotional contacts [2].

S. Rado (Rado, 1956) designates BPD as an "extractive disorder" and distinguishes in patients:

1. Impatience and intolerance to frustration.

2. Outbursts of rage.

3. Irresponsibility.

4. Excitability.

5. Parasitism.

6. Hedonism.

7. Attacks of depression.

8. Affective hunger [2].

B. Esser and S. Lesser (Esser & Lesser, 1965) designate BPD as "hysteroid disorder", where there are:

1. Irresponsibility.

2. A messy professional employment history.

3. Chaotic and unsatisfactory relationships that never get deep or lasting.

4. A history of emotional problems in early childhood and a violation of habitual behavioral patterns (eg, bedwetting in adulthood).

5. Chaotic sexuality, often with a combination of frigidity and promiscuity [2].

R. Grinker, B. Werble and R. Dry (Grinker, Werble, & Drye, 1968) [2] identified

general characteristics for BPD:

1. Anger as the predominant or the only type of affect.

2. Defectiveness of affective (interpersonal) relationships.

3. Violation of self-identity.

4. Depression as a characteristic aspect of life [2].

Thus, people with BPD have a variety of psychological characteristics that have been noted by researchers at different times.

In addition, BPD is characterized by cognitive errors, distorted interpretations of real situations, impaired self-regulation, etc.

There are different types of borderline personality disorder. Subtypes are formulated taking into account adaptation indicators. Subtype 1 indicates the presence of low adaptive ability and insignificant personality resources. Subtype 4 indicates higher adaptation.

Let's present a more detailed description:

Subtype I: on the verge of psychosis:

• Inappropriate, maladaptive behavior.
• Inadequate sense of reality and self-identity.
• Negative behavior and unrestrained anger.
• Depression.

Subtype II: Basic Borderline Syndrome:

• Uneven interpersonal relationships.
• Unrestrained anger.
• Depression.
• Inconsistent self-identity.

Subtype III: adaptive, affectless, seemingly protected:

• The behavior is adaptive, adequate.
• Complementary interpersonal relationships.
• Low affect, lack of spontaneity.
• Defense mechanisms of alienation and intellectualization.

Subtype IV: on the verge of neurosis:

• Anaclytic depression.
• Anxiety.
• Closeness to neurotic, narcissistic character (Stone, 1980) [2, 10-11].

The classification makes it possible to understand at what level of adaptation an individual is. Thus, it can be seen that BPD includes different gradations of the manifestation of the disorder: from severe disorders with suicidal behavior to mild maladjustment in the interpersonal sphere (difficulties in relationships, lack of understanding in the family, a tendency to change jobs).

People with BPD have some behaviors.

M. Linehan identifies the following behavioral patterns in BPD:

1. Emotional vulnerability. A pattern of significant difficulties in regulating negative emotions, including a high sensitivity to negative emotional stimuli and a slow return to normal emotional state, as well as awareness and feeling of one's own emotional vulnerability. May include a tendency to blame the social environment for unrealistic expectations and demands.

2. Self-invalidation. A tendency to ignore or not acknowledge one's own emotional reactions, thoughts, beliefs, and behaviors. Unrealistically high standards and expectations are presented to themselves. May include intense shame, self-loathing, and self-directed anger.

3. The ongoing crisis. A model of frequent stressful, negative environmental events, disruptions and obstacles, some of which arise as a result of an individual's dysfunctional lifestyle, inadequate social environment or random circumstances.

4. Suppressed experiences. A tendency to suppress and over-control negative emotional responses - especially those associated with grief and loss, including sadness, anger, guilt, shame, anxiety, and panic.

5. Active passivity. A tendency towards a passive style of interpersonal problem solving, including an inability to actively overcome the difficulties of life, often in combination with vigorous attempts to involve members of their environment in solving their own problems; learned helplessness, hopelessness.

6. Perceived competence. The individual's tendency to appear more competent than he really is; usually explained by an inability to generalize the characteristics of mood, situation and time; also the inability to demonstrate adequate non-verbal signals of emotional distress [2].

Reactions in a stressful situation are “indicators” for determining the presence of borderline disorder. In situations of stress, people with BPD can experience disruptions in adaptation, destabilization in the emotional, cognitive and behavioral spheres.

One of the central concerns in people with BPD is the fear of breaking up a meaningful close relationship. Individuals with BPD are unable to maintain and maintain stable relationships, and their whole life, like a merry-go-round that has lost control, revolves in a frenzied whirlwind around an axis set by two poles: meeting and parting with partners. They are terribly afraid of being left alone, while, as a rule, they completely lack the understanding that desperate and dramatic attempts to retain partners in relationships most often only alienate loved ones. Often, it is in solitude that they experience strongly pronounced dissociative states of depersonalization / derealization, switching between dissociative states (Bateman and Fonagy, 2003; Howell, 2005; Zanarini et al., 2000) [1]. Breakdowns in relationships lead to overwhelming emotions, including anxiety, shame, self-deprecation, depression, and involvement in self-destructive behaviors such as drug and substance abuse, impulsive behavior, and promiscuity [1]. In general, it is worth noting that parting with a significant object in interpersonal relationships is a huge stress for individuals with BPD. In addition, sudden events that reflect offenses, humiliation, betrayal, insults in any form, even moderate criticism, are also stressful. All this disorganizes their psyche. In a state of stress, it is difficult for a person to understand what he did and what the other did, who he is and who the other is. Sharp changes in affect (from love and tenderness to hate) exhaust the psyche and destroy the real factual ideas about what is happening in a given situation.

Borderline personality disorder is a complex and severe psychiatric disorder (ICDA10, 1994; DSMAV, 2013) characterized by a persistent pattern of dysregulation of affect and impulse control, as well as a lack of stability in relationships with others and in one's own identity, in internal the image of your person. The circle of borderline pathology also includes dissociative symptoms: derealization and depersonalization, flashback effects, psychogenic amnesia, symptoms of somatoform dissociation, etc. In addition, individuals with BPD are characterized by the use of primitive defense mechanisms such as splitting and projective identification, one of the links which is dissociation (Bateman, Fonagy, 2003) [1, 11].

One of the greatest injustices in life is that a large number of people who are traumatized in childhood are re-traumatized again and again throughout their lives because the initial trauma made them extremely vulnerable, unprotected and prone to reactive reactions. Borderline clients will inevitably, from time to time, serve as triggers for their therapists, provoke them, causing them to feel fear, resentment and despair. Many borderline clients have suffered from a lack of recognition in their lives. Usually, when they found themselves in a conflict situation, they were shamed and rejected for their increased sensitivity, emotionality or impulsiveness. As a result, they often live with the feeling that they are condemned to be alone [3]. By their behavior, they are able to alienate people, although in reality they really need others, as well as acceptance, security and relationships. Strong social bonds make relationships viable and help people with BPD cope with crises.

Some of the psychological characteristics of people with BPD considered in the article make it possible to better understand the structure of the disorder with the aim of competent psychotherapeutic interaction. These features must be taken into account in the treatment of these rather complex personality disorders, which in their extreme manifestations can be fatal.

Literature

1. Agarkov V. A. Dissociation and borderline personality disorder // Counseling psychology and psychotherapy. 2014. T.22. No. 2.

2. Lainen, M. Cognitive-behavioral therapy for borderline personality disorder / Marsha M. Lainen. - M.: "Williams", 2007. - 1040s.

3. Richard Schwartz. Depathologizing The Borderline Client.