Borderline Personality Disorder (also known as BPD) is listed in the DSM V as being a Cluster B Disorder, characterised by a pervasive pattern of instability of interpersonal relationships, self-image, affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five or more of the following:

• Frantic efforts to avoid real or imagined abandonment.
• A pattern of unstable and intense interpersonal relationships characterised by alternating between extremes of idealisation and devaluation
• Identity disturbance: unstable sense of self.
• Impulsivity in at least two areas that are potentially self-damaging e.g., spending, sex, substance abuse, reckless driving, binge eating).
• Recurrent suicidal behaviour, gestures, threats or self-mutilating behaviour
• Affective instability due to a marked reactivity of mood
• Chronic feelings of emptiness.
• Inappropriate, intense anger or difficulty regulating emotions
• Transient, stress related paranoid ideation or severe dissociative symptoms

In nutshell, people with Borderline Personality Disorder will make frantic efforts to avoid real or imagined abandonment, they are very sensitive to environmental circumstances, and they from time-to-time experience inappropriate levels of anger to real or perceived rejection.

BPD can be a very painful and at times debilitating condition.

It stems from a biological predisposition and can be triggered by trauma. People with BPD often engage in risky behaviours, thus making them more vulnerable to trauma.

People with Borderline Personality Disorder can also be very intelligent, fun loving, loyal and charismatic people. I like to think of Borderline Personality Disorder as a spectrum. Some individuals are very high functioning, can contain their emotions, have families and successful careers. Whilst some turn to drugs and alcohol to ease their pain, form “trauma bonds” with others that are likely to continue the downward cycle.

What makes one person able to be high functioning and the other not?

Great question!

Researchers indicate that individuals that have grown up with stable and secure attachments with primary caregivers, received an education and sought psychological help for their troubles are more likely to live a fully functioning and happier existence.

Early attachments matter

Alternatively, individuals who have had anxious and insecure attachment experiences with early caregivers, dropped out of school and did not receive any psychological support are more likely to struggle with this disorder.

 

Why do people self-harm?

Individuals with Borderline Personality Disorder experience very intense, overwhelming emotions that often leave them feeling vulnerable and desperate. During these moments, some will turn to self-harm in the way of cutting, burning, head banging etc. This in psych terms is what we call Maladaptive Coping Mechanisms. In other words, they serve a purpose but there are better ways of managing it.

Individuals with BPD experience very intense, overwhelming emotions

One of my clients who has Borderline Personality Disorder expressed that self-harming helps to divert attention away from the distressing feelings and creates a new focus – therefore bringing her out of her head and into her body. This provides her a sense of relief and much needed peace.

From a biological perspective, cutting and other forms of self-harm cause the body to release endorphins (the feel-good hormone). Another reason that people choose to use this a method of self-soothing. There are however, inherent dangers with self-harming and is therefore viewed as problematic.

Self-harming is dangerous

To someone who does not have Borderline Personality Disorder, seeing someone who has self-harmed can be a very frightening and messy experience. They often mistake it as being a suicide attempt, instead of what it really is, a desperate attempt to feel better.

Suicide

Individuals with Borderline Personality Disorder may sometimes experience Suicidal Ideation (thoughts about dying) and make attempts on their life.

Rarely are they successful.

Rather, they are attempting to shut out the noise and are a cry for help. They are sometimes used to highlight to a significant other the immense pain and anguish they are feeling. Rarely are they wanting to die. Rather, they want to be HEARD.

How to support someone with BPD

Therapy

Dialectical Behavioural Therapy (DBT) is the first line of therapy for Borderline Personality Disorder. A psychologist, social worker or counsellor trained in DBT can work with the individual in two ways. It’s important to have one-on-one therapy as well as attending a skill-based program.

DBT uses a four-pronged approach to work with the core issues people with DBT experience:

1. Mindfulness-based strategies
2. Emotional Regulation Skills
3. Distress Tolerance, and
4. Interpersonal Effectiveness

It’s important to highlight that DBT is not a ‘quick fix’. Treatment occurs over weeks, months and sometimes years depending on the individual needs of the client.

 

If you wish to book in for DBT Therapy with Sonja you can do so HERE 

 

Alternatively, you can check out Psychology Today for other Social Workers, Psychologists and Counsellors who specialise in DBT therapy and trauma.

DBT Emotional Regulation Cards

If therapy is not an option right now and you need some strategies for some instant relief. Then DBT Emotional Rescue Cards  are the go. They also work well as an adjunct to therapy.

DBT Emotional Regulation Cards offer 40 different emotions that create overwhelm, along with a huge selection of evidence-based psychological strategies proven to alleviate suffering.

 

 

 

These cards are a definite Go To. You can order yours HERE