Many individuals use the term Borderline quite loosely and do not understand the burden that label contains. First of all, borderlines are not crazy, but individuals fraught with a personality disorder make it quite challenging to engage in a healthy and balanced manner with others. They struggle with others because they also have an internal dialogue of self-defend that disables their social engagement skills. Keep in mind that the BP individual is not trying to create difficulties or seek attention through their behavior, but instead, their patterns reflect internal challenges they face.
The DSM 5 refers to Borderline Personality as a personality disorder that falls under Class B disorders with features that impair a person’s ability to maintain healthy social interactions. Individuals with Borderline personalities struggle to maintain healthy relationships since they have enormous trust and boundary issues.
A person with borderline personality tends to fluctuate in their ability to form relationships, struggles with a poor self-image, impulse control, mood fluctuations, and reckless behaviors that may endanger their lives.
There are many symptoms connected to borderline personality disorder besides their ongoing struggles to form healthy relationships. The symptoms can include any of the following:
- Avoiding imagined or real abandonment by initiating relationships quickly as well as cutting off connections
- A tendency to get involved in an intense and unstable relationship that can range from extreme attachment or love (idealization) to extreme dislike or distrust (devaluation)
- Distorted sense of self-image or self
- Impulsive and risky behavior patterns that may include overspending, reckless thrill-seeking behaviors, unsafe sexual practices, drug or alcohol binges, or binge eating
- Harmful behaviors such as self-cutting behaviors triggered by feeling disconnected from the body or feeling unreal
- Chronically feeling empty
- Frequency episodes of suicidal ideation or thoughts
- Extreme mood swings that can last a few hours to a few days
- Inappropriate displays of anger
- Difficulty trusting others for fear of being harmed or abandoned
The number of symptoms varies from person to person as well as the duration. The severity of the BPD disorder is determined based on several symptoms experienced over time.
There is a tendency to go through extremes in personal and professional relationships; seeking and remaining in treatment is challenging. The borderline individual tends to over-idealize persons, placing them on a pedestal and often claiming that they are the only person in the world that they can trust. However, when the person on the pedestal disagrees with the individual, their reputation is devalued and turned into the worse person they ever encountered. In summary, the person’s reputation in the borderline individual’s eyes goes from hero to zero, often making them sever ties abruptly.
Types of Treatment
There is a tendency to go through extremes in personal and professional relationships; seeking and remaining in treatment is challenging. The borderline individual tends to over-idealize persons, placing them on a pedestal and often claiming that they are the only person in the world that they can trust. However, when the person on the pedestal disagrees with the individual, their reputation is devalued and turned into the worse person they ever encountered. In summary, the person’s reputation in the borderline individual’s eyes goes from hero to zero, often making them sever ties abruptly.
When working with borderlines, therapists need to establish immediately strong and clear boundaries around idealization to develop a strong therapeutic alliance. Also, treatment needs to focus on immediate pending conditions such as potential self-sabotaging behaviors, unhealthy coping defense mechanisms, manage moods, and working with personal boundary settings. Therapy techniques such as cognitive and interpersonal therapies are useful since they help individuals focus on behavior patterns and learn healthy coping skills. Some available treatments are the following:
- Dialectical Behavior Therapy (DBT) – uses mindfulness techniques to reduce self-destruction, manage emotional crisis and improve relationships
- Transference-Focused Therapy – focuses on developing emotional insight by using the patient and therapist relationship as a platform
- Mentalization-Based Therapy – talk therapy helps individuals identify core issues and gain insight.
- Self-care – develop self-care routines to improve the quality of life
- Medication Management – This is indicated when the client also struggles with depression, anxiety, or poor impulse management
- Psychiatric Management – utilized with patients that struggle with severe depression and anxiety as well as self-harm
The contributing factors to the development of the borderline personality are not entirely understood or concretely known. However, research indicates a strong link between genetic, brain function, environmental and social factors as playing a pivotal role in increasing the potentials for developing a borderline personality disorder. According to DSM 5, various symptoms contribute to the severity index and other co-morbid mood disorders such as depression, bipolar anxiety, or substance use. Typically, individuals with borderline personalities enter therapy due to a mood disorder, eating, or substance use disorder.
References
What are the symptoms of Borderline Personality Disorder? Retrieved from https://www.webmd.com/mental-health/symptoms-borderline-personality-disorder#1
Borderline Personality Disorder. Retrieved from https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml
Treatments for Borderline Personality Disorders. Retrieved from
https://www.borderlinepersonalitydisorder.org/what-is-bpd/treating-bpd/
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