What is Borderline Personality Disorder?
Photo by Rad Pozniakov
Borderline personality disorder is often misunderstood. The stereotype of someone with borderline personality disorder is typically a young female with volatile mood swings who engages in self-injurious behaviors. But that is just a stereotype. The reality is, men can be diagnosed with borderline personality disorder as well, and not everyone with this disorder engages in self-harm. Unfortunately, many people are discouraged from seeking help because of the stigma. Some may even assume that nobody can hope to achieve progress, let alone recovery, if the core issue has to do with one’s personality. But is that true?
To understand borderline personality disorder, we have to start with the definition of a personality disorder. A personality disorder suggests an enduring pattern of inner experience — perception, self-image, world view, boundaries, impulse control — that is consistent across different situations and relationships. It implies a persistent way of thinking, feeling, and behaving that deviates from cultural expectations and often results in difficulties. Like any other health condition, personality disorders can be affected by a host of factors — external stressors, support system, access to care, etc. When a person is in crisis, the emotional strain may worsen the symptoms of a personality disorder, just as it would for any other medical diagnosis with physical symptoms.
People with borderline personality disorder often struggle with a range of significant symptoms — impulsive or risky behaviors; intense and unstable relationships; frantic efforts to avoid abandonment; highly changeable moods; chronic feelings of emptiness; inappropriate anger outbursts; self-harming behaviors or suicidal gestures; even transient paranoid ideation and dissociative episodes. These symptoms can interfere with day-to-day activities, especially interpersonal dynamics.
Among the symptoms of borderline personality disorder, anger is often the issue that loved ones struggle with the most. Because the anger displayed can be so inappropriate and intense, the loved ones often feel blindsided by the outburst. If this pattern persists, they become hypervigilant and start to walk on eggshells. They may communicate less and less, fearing that any innocent comments or gestures might set off another storm.
It is not hard to imagine the damage such a dynamic can do to a relationship. When we are tense and worried, or second-guess ourselves constantly, or feel we must always think ahead in order to prevent a disaster, the relationship becomes something we dread rather than enjoy. Not surprisingly, many people in this situation may choose to pull away from the volatility. Ironically, this outcome is the worst-case scenario for the individual with borderline personality disorder, even though he or she is largely responsible for bringing it about.
The baffling dichotomy between outward rage and inward need is often misleading. Most people are quick to register the impact of one or the other, but slow to see the intricate connection between the two. For people with borderline personality disorder, the need for a strong and immediate connection with the ones they esteem is so paramount that they spiral downward and lash out if there is any hint of losing that connection. But for those around them, the only thing that is crystal clear is the anger; everything else is drowned out. Because of the emotional intensity in these encounters, most people shy away from reopening old wounds once the calm has set in. However, in therapy, acknowledging this dichotomy and understanding the underlying mechanism is inevitably where one needs to begin.