The core disorder in BPD is emotional dysregulation. Emotional
dysregulation is viewed as a joint outcome of biological disposition,
environmental context, and the transaction between the two during
development. The theory asserts that borderline individuals have
difficulties in regulating several, if not all, emotions. This systemic
dysregulation is produced by emotional vulnerability and by maladaptive
and inadequate emotion modulation strategies. From: Skills Training
Manual for Treating Borderline Personality Disorder. By Marsha Linehan.
The symptoms of borderline patients are similar to those for which most
people seek psychiatric help: depression, mood swings, the use and abuse
of drugs and alcohol as a means of trying to feel better; obsessions,
phobias, feelings of emptiness and loneliness, inability to tolerate
being alone, problems about eating.
Borderline people also show great difficulties in controlling
ragefulness; they are unusually impulsive, they fall in and out of love
suddenly; they tend to idealize other people and then abruptly despise
them. A consequence of all this was that they typically look for help
from a therapist and then suddenly quit in terrible disappointment and
anger. Underneath all these symptoms, therapists see in borderline people
an inability to tolerate the levels of anxiety, frustration, rejection
and loss that most people are able to put up with, an inability to soothe
and comfort themselves when they become upset, and an inability to
control the impulses toward the expression, through action, of love and
hate that most people are able to hold in check. What best defines the
"borderline" personality, is great difficulty in holding on to a stable,
consistent sense of one's self: "What am I?" these people ask. "My life
is in chaos; sometimes I feel like I can do anything--other times I want
to die because I feel so incompetent, helpless and loathsome. I'm a lot
of different people instead of being just one person."
The one word that best characterizes borderline personality is
"instability." Their emotions are unstable, fluctuating wildly for no
discernible reason. Their thinking is unstable--rational and clear at
times, quite psychotic at other times. Their behavior is unstable, often
with periods of excellent conduct, high efficiency and trustworthiness
alternating with outbreaks of babyishness, suddenly quitting a job,
withdrawing into isolation, failing.
Their self control is unstable -- ranging from the extreme self denial
of anorexia to being at the mercy of impulses. And their relationships
are unstable. They may sacrifice themselves for others, only to reach
their limit suddenly and fly into rageful reproaches, or they may curry
favor with obedient submission only to rebel, out of the blue, in a
Associated with this instability is terrible anxiety, guilt and
self-loathing for which relief is sought at any cost -- medicine, drugs.
The effect upon others of all this trouble is profound: family members
never know what to expect from their volatile child, siblings, or spouse,
except they know they can expect trouble: suicide threats and attempts,
self-inflicted injuries, outbursts of rage and recrimination, impulsive
marriages, divorces, pregnancies and abortions; repeated starting and
stopping of jobs and school careers, and a pervasive sense, on the part
of the family, of being unable to help.
And, of course, the effect of the illness upon the life of the patient is
equally profound: jobs are lost, successes are spoiled, relationships
shattered, families alienated. The end result is all too often the
failure of a promising life, or a tragic suicide.
I found the most straightforward discussion of the effect of childhood abuse in a book about poverty. I discovered snippets of information about BPD throughout the book, although the term BPD was never mentioned in the book.
Sexual abuse is one reason, among others, for the failure to create healthy partnerships. An abused child’s sense of powerlessness may lead to surrender and to a method of escape that psychiatrists term “dissociation”, in which the victim mentally stands aside watching the assault occur. The same phenomenon has been observed in victims of other trauma including war. The out-of-body experience generates protective feelings of indifference and emotional detachment that can remain for years after the event, even for a lifetime. Children are especially vulnerable. “Repeated trauma in adult life erodes the structure of the personality already formed,” notes Dr. Judith Lewis Herman, a psychiatrist at Harvard Medical School, “but repeated trauma in childhood forms and deforms the personality.”
The survivor’s intimate relationships are driven by hunger for protection and care and are haunted by the fear of abandonment or exploitation. In a quest for rescue, she may seek out powerful authority figures who seem to offer the promise of a special caretaking relationship. By idealizing the person to who she becomes attached, she attempts to keep at bay the constant fear of being either dominated or betrayed.
Inevitably, however, the person fails to live up to her fantastic expectations. When disappointed, she may furiously denigrate the same person whom she so recently adored. Ordinary interpersonal may provoke intense anxiety, depression, or rage. In the mind of he survivor, even minor hurts evoke past experiences of deliberate cruelty… Thus the survivor develops a pattern of intense, unstable relationships, repeatedly enacting drams of rescue, injustice and betrayal.
John Gunderson wrote a book called
Borderline Personality Disorder
(see review). One point I identified with immediately
3 levels of Borderline emotions. As he puts it, "manifest
psychopathology in terms of relationships to major objects".
A while ago I did a survey and found that 70% of the people with Borderline Personality Disorder surveyed came from an alcoholic home. I took two books, one BPD and one ACOA, and made a comparison of the similar BPD and ACOA symptoms.
If you're looking for a BPD mail group here they are:
Here is a very good
transcript of an online discussion on the subject of Borderline
Personality Disorder featuring Melissa Ford Thornton, author of the book:
Eclipses: Behind the Borderline Personality Disorder. Melissa has
Borderline Personality Disorder.
Here are some
comments about Borderline Personality Disorder that I am collecting from
newsgroups and maillists. The information discussed is not not
necessarily professional. I included them here to give people in
investigating BPD more than textbook explanations of the disorder.
In my PERSONAL STORY story I speak frankly about my experience with
Borderline Personality Disorder based on the DSM criteria.
If you are critical, or tend to find fault with people with disabilities, read no further.
We have music running through our heads constantly. Many are sensitive
to sunlight, and many have low blood pressure. We like rocking chairs,
sometimes rocking even when we don't have a rocking chair, and we often
lay in bed and rock ourselves to sleep. Borderline people are usually
notably intelligent and talented.
There are two kinds of Borderlines; acting-in and acting-out. It is usually the acting-in borderlines who communicate on the internet. It is usually the spouses and friends of acting-out borderlines who come to the web looking for insight and understanding. Acting-in borderlines recognize their disorder and seek help while acting-out borderlines act as if their problems are caused by others and they are out to get even through a myriad of mean and destructive actions.
Acting-in borderlines often appear deceivingly competent. When the spouse of an acting-in borderline tries to explain feeling frustrated and abused to friends and acquaintances, the spouse may be perceived as exaggerating and overly-sensitive. But while the borderline may act quite competent and normal to the general public, behind the scenes the borderline is splitting, projecting, manipulating, and self abusing, creating a situation where the spouse feels he/she is "walking on eggshells" always in fear of disturbing the delicate balance of emotions the borderline is constantly battling.
Sometimes my own thoughts are so overpowering I forget that someone is talking to me. This happens frequently when my husband is explaining something to me, and suddenly I realize I have no idea what he's been talking about, so I pretend I've been listening, and try to catch up with the discussion. Once in a while he will say something like "you haven't heard a word I've said, have you?" When we're listening to an ' audio book in the car, as hard as I try to follow the story, my mind drifts and I haven't a clue of what's been happening in the story.
When I am feeling abandoned, angry, anxious, whatever, I mow the lawn or rake leaves. When I mow the noise of the mower helps tame the voices in my head. I harness the bad feeling by exerting energy, while I am mesmerized by the appearance of the differences I create.
Borderlines naturally sort of "hang on the periphery;" close enough so
they still see themselves as part of the human race, but not so far away
that the cut themselves off from all contact. One little bump could be
enough to send a borderline over the edge
Borderlines hate being misunderstood, having all our actions (anger sadness, ect.) attributed to our BP diagnosis for their benefit, and having people tell us we dwell too much on the subject, that we should just "knock it off" or that we have "no right to feel that way."
Here I bring up emotional blackmail, and I have to admit that I feel sort of a traitor here, because when I first read about this I saw I was extremely guilty of it. Emotional blackmail is certainly not exclusively a tool of borderlines, but every time a person with BPD threatens to self harm if somebody doesn't do something, or threatens to do anything in an attempt to manipulate somebody else, it is called emotional blackmail. Emotional blackmail is a leading contributor of things that lead to divorce. My Emotional Blackmail page is written for the person BEING emotionally blackmailed, not the person doing it. I saw no nice way of sticking up for the borderline here. Being borderline myself, I know how difficult it is to abandon the practice of emotionally blackmailing others. I have a lifetime of practice.
"It seems that there are two pathways by which one may develop BPD. The
first is by way of early life abuse/neglect and the second is by way of
having a bipolar disorder. Of course some of the people diagnosed with
BPD have a history of both."
"When there is a significant degree of bipolarity in the makeup of
someone with BPD, mood stabilizers and antidepressants can be very useful
therapeutic modalities. When there is a history of neglect/ abuse without
a personal or family history of bipolarity, medications have less to
offer and psychotherapy becomes the primary treatment."
Depression in the borderline personality may represent expression of
character, a reactive mood, or independent affective disorder. Research
indicates it has both a core biologic dysregulation and a pathological
personality organization. This requires the use of both medical and
psychological therapy for comprehensive treatment.
Most would cry
Thoughts of Revenge
strong enough to kill
and beat against my brain
and tear apart my insides
And I can't help but think
that someday they will.
|I'm trapped here with this feeling
determined never to enter so freely again
friendship so innocent turned uninnocently strong...
ended so quickly -- like death
|Internal screams that cry no tears
No outward proof that I'm even real
Click here to search for more borderline personality disorder sites
Click here to search for site sites about Social Security Disability (SSI)
On June 12 1998 I applied for SSI, On August 10, 1998 I saw a therapist,
and on 13 August I started attending a local anger management/abuse
therapy group three nights a week that I thought included borderlines.
It didn't, and it wasn't helping, so on Oct 9 I started seeing an
individual intern therapist. That ended Nov 24 and now I have no one.
On January 22, 1999, I was awarded SSI.
12.08 Personality Disorders: A personality disorder exists when
personality traits are inflexible and maladaptive and cause either
significant impairment in social or occupational functioning or
subjective distress. Characteristic features are typical of the
individual's long-term functioning and are not limited to discrete
episodes of illness.
The required level of severity for these disorders is met when the
requirements in both A and B are satisfied.
A. Deeply ingrained, maladaptive patterns of behavior associated with one of the
1. Seclusiveness or autistic thinking; or
2. Pathologically inappropriate suspiciousness or hostility; or
3. Oddities of thought, perception, speech and behavior; or
4. Persistent disturbances of mood or affect; or
5. Pathological dependence, passivity, or aggressivity; or
6. Intense and unstable interpersonal relationships and impulsive and damaging behavior;
1. Marked restriction of activities of daily living; or
2. Marked difficulties in maintaining social functioning; or
3. Deficiencies of concentration, persistence or pace resulting in frequent failure to complete tasks in a timely manner (in work settings or elsewhere); or
4. Repeated episodes of deterioration or decompensation in work or work-like settings which cause the individual to withdraw from that situation or to experience exacerbation of signs and symptoms (which may include deterioration of adaptive behaviors).
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This page was updated 13 Apr 2003