Borderline ‘Personality Disorder’

Thanks to Hollywood and general negative press, individuals with BPD tend to get a pretty rough time. A quick Google search on dating someone with BPD brought up these nuggets of wisdom:

“Ultimately no matter how attractive she is, dealing with this type of crazy is not worth it.”

 “I would never date a girl with BPD,
they’re way too clingy and needy.” 

“Walk (RUN) away!”

According to the most recent Diagnostic and Statistical Manual of Mental Disorders (DSM-5), someone with BPD is said to have ‘significant impairments in personality functioning’ including instability of goals and aspirations, compromised empathy for others, problems with intimacy, anxiety, depression, takes excessive risks and is persistently antagonistic and hostile.

In both my personal and professional life I have encountered many incredible people dealing with this diagnosis, many of whom feel as though they have been labelled as having a ‘bad’ personality.

One particular individual I know could be considered highly-functioning and works within the field of psychotherapy. She uses her tools of intuition, insight and sensitivity to support others, and has a tremendous capacity for compassion because she can directly relate to complex and powerful emotions. From this perspective, I would deeply argue that people with BPD lack empathy.

It is however true that people with BPD are exquisitely sensitive which goes some way to explaining why certain accompanying behaviours may manifest as negative characteristics. Imagine that you had burns all over your skin. The slightest gust of wind or drop of rain would hurt you. And in a world full of people with ‘thick skins’ you might begin to think that you were impaired in some way. You’re battling with old emotional wounds and have a core belief that you will be rejected or abandoned by those you get close to, so frightened in fact that it feels safer to push them away in order that you feel less vulnerable.

Sophie* (32) tells us how it feels in her relationship with Jamie*.

“I hate the way it makes me feel about myself, like I’m a bad person. Although I work really hard to remember that people aren’t all good or all bad, my mind feels like it’s breaking when I try to find the middle ground. I love Jamie so much – he’s amazing, kind and so supportive. But it could be a little thing, not kissing me before going to work as an example. Rationally, I know it isn’t the end of the world – and he might have been in a rush, or stressed or whatever, but the feeling – the gut response which is separate to my intellect – can suddenly change my perception of him.

The inner feeling grows into anger, and all I can see are his lesser strengths until the positive traits he has completely vanish. So when I’m in this place, I feel like we’re not right for each other, that he is this or that, and lose sight of the wonderful and amazing man he is.

It can drag me down into depressive episodes, because the negative feelings are so strong and seemingly real. Then he can do something, perhaps look at me in a certain way – which pierces and breaks the spell – then I’m back in the room and everything is fine again.”

What Sophie is referring to is the BPD phenomenon known as splitting. In her case, we discussed how the trigger of Jamie not kissing her was being internalised at a chain-reaction emotional level. When we react to something, the processing can be so quick that we don’t really understand why we’ve responded in such a way until much later. Sophie was able to explore her interpretative chain reaction.

He doesn’t want to kiss me >
There’s no intimacy or connection >
He must have gone off me>
He doesn’t find me attractive>
I feel angry at him >
The relationship is doomed >
We’re not right for each other anyway >
We’re so different >
I can’t stand these attributes of his >
I don’t like him and don’t want to be with him.

Now let’s break this down a bit further and try to understand this.

Stage 1: activating trigger perceived as a rejection/ abandonment
He doesn’t want to kiss me

Stage 2: false negative assumptions made
There’s no intimacy or connection > He must have gone off me > He doesn’t find me attractive (projection of poor self-image onto another)

Stage 3: emotional reaction
I feel angry at him

Stage 4: reconstructing thought processes to protect against perceived abandonment
The relationship is doomed > We’re not right for each other anyway > We’re so different

Stage 5: new perception reached
I can’t stand these attributes of his > I don’t like him and don’t want to be with him

In breaking down these stages, we can see that Sophie’s processing and subsequent vilifying of Jamie is all based around a fear of loss. The mind constructs a new version of reality to replace the old view (I love Jamie and want to be with him) in order to protect her from feelings of pain and vulnerability. For many borderline sufferers, there is often a sixth stage which involves acting out on feelings (causing a row, getting into a fight, turning to self-harm/ drugs/ alcohol).

She explains:

“When I try to re-balance the thoughts and feelings, it’s just so hard to get back. To put it into perspective, imagine if I asked you to hate the person you loved the most. You’d find it impossible. That’s why you can’t just ‘think’ your way back.
The feelings seem to just generate negative thoughts and convinces me they are the truth. If I’m feeling depressed or numb, my mind can trick me into believing he is the source of my bad feelings.”

People with BPD can learn to catch these triggers and neutralise them before they snowball out of control but it’s a challenging process and takes hard work and dedication. One of the things I recommend is that people learn to communicate openly with their partners, in real time if they can. And whilst it might feel tough to start a type of conversation such as: Jamie, when you didn’t kiss me then, it made me feel that you don’t love me – the results can be profound in terms of deepening the connection and reaching a higher level of understanding.

The other key area for overcoming BPD is to learn to sit with the negative feelings without acting out. For someone with BPD, stage 6 can feel almost compulsive – to get relief from the bad feeling – but in reality this doesn’t actually help. Sitting with the emotional pain and distress can feel overwhelming but paradoxically this is where emotional growth and resilience comes from.

So for the ill-informed out there who view people with BPD as stroppy, irrational and ‘crazy’ perhaps try to exercise a little compassion and understanding as to what drives people’s behaviour. Behind every angry outburst lies a deeper pain or a need for protection.

 

* Names have been changed to protect identities

 

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