Individuals with BPD have
severe difficulty in regulating negative emotions --
including sensitivity to negative emotional stimuli,
emotional intensity, and a slow return to an emotional
baseline.
Individuals with BPD have
unrealistically high standards and expectations for self with
a tendency to invalidate or fail to recognize emotional
responses, thoughts, beliefs, and behaviors.
Individuals with BPD often
engage in "parasuicidal" behavior, i.e., nonfatal,
intentional self-injurious behavior that results in actual
tissue damage, self-mutilation, and self-inflicted burns,
with little or no intent to cause death.
Individuals with BPD are often
unable to cry or express strong sadness appropriately.
Individuals with BPD fail to
engage actively in solving their own life problems while
actively soliciting problem solving from others.
Individuals with BPD often
appear more competent than can be demonstrated through their
behavior or accomplishments.
This common clinical test looks for these four clusters of
symptoms:
Chronic/major depression, helplessness, hopelessness,
worthlessness, guilt, anger (including frequent expressions
of anger), anxiety, loneliness, boredom, emptiness
Odd thinking, unusual perceptions, nondelusional paranoia,
quasipsychosis
Substance
abuse/dependence, sexual deviance, manipulative suicide
gestures, other impulsive behaviors
Intolerance of
aloneness, abandonment, engulfment, annihilation fears,
counterdependency, stormy relationships, manipulativeness,
dependency, devaluation, masochism/sadism, demandingness,
entitlement
This test, developed by the major German researchers of BPD, focuses on
seven "BPD factors":
This is a brand-new test specifically designed for clinicians to administer in order to assess changes in BPD symptomatology, developed by Dr. Mary Zanarini, a prominent BPD researcher.
This questionnaire (not in general use, but highly interesting) provides 6 sets of 20 "Assumptions" held by those suffering from the various personality disorders.
The following 20 have been the most commonly affirmed by those diagnosed with BPD:
You can also see my
write-up of the key BPD-related behavioral and cognitive patterns, below, or check out the cognitive dysfunctions listed in:
Cognitive Therapy of Personality Disorders by A.T. Beck and A. Freeman, Guilford Press, New York (1990).
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Annotated DSM-IV-TR Diagnostic Criteria for Borderline Personality Disorder
These annotations are provided as an informational service only, and should
not be viewed as conclusive; for specifics on your individual situation, please consult your mental
health professional.
To diagnose a patient as suffering from Borderline
Personality Disorder, the
Diagnostic and Statistical Manual of
the American Psychological Association IV-TR
[revised
edition, 2000]
requires that clinicians follow the following diagnostic
criteria:
(Scroll down just a bit to see links to my detailed notes on each
criterion, plus a listing of some key behavioral traits and cognitive patterns.)
[*In the following annotations, I use the term "Borderline"
to refer to sufferers of this disorder sheerly for the sake of brevity; a human being obviously
cannot be defined by a mental disorder alone.]
Diagnostic criteria for DSM-IV 301.83: Borderline
Personality Disorder
A pervasive pattern of instability of interpersonal
relationships, self-image, and affects, and marked
impulsivity beginning by early adulthood and present in
a variety of contexts, as indicated by five (or more)
of the following:
(1) frantic
efforts to avoid real or imagined
abandonment.
(2) a pattern
of unstable and intense interpersonal relationships
characterized by alternating between extremes of
idealization and devaluation.
(3) identity
disturbance: markedly and persistently unstable
self-image or sense of self.
(4) impulsivity in at least two areas that are
potentially self-damaging (e.g., spending, sex, Substance
Abuse, reckless driving, binge eating).
(5) recurrent
suicidal behavior, gestures, or threats, or
self-mutilating behavior.
(6) affective
instability due to a marked reactivity of mood (e.g.,
intense episodic dysphoria, irritability, or anxiety
usually lasting a few hours and only rarely more than a
few days).
(7) chronic
feelings of emptiness.
(8) inappropriate, intense anger or difficulty
controlling anger (e.g., frequent displays of temper,
constant anger, recurrent physical fights).
(9) transient, stress-related paranoid ideation or
severe dissociative symptoms.
[For non-USA contexts, also see the World Health
Organization's
International Classification of Mental
Health and Behavioural Disorders -- ICD-10, F60.31:
Emotionally Unstable Personality Disorder, Borderline
Type]
And here are two personal write-ups of what each DSM criterion
feels like to someone who suffers from BPD:
A Personal Reflectionand
Shadowlands
Borderline Personality Disorder
A pervasive pattern of instability of interpersonal
relationships, self-image, and affects, and marked
impulsivity beginning by early adulthood and present in a
variety of contexts, as indicated by five (or more) of
the following
Only 5 of the following 9 criteria are technically
required for a clinical diagnosis. Some patients
demonstrate 5, some demonstrate all 9. Because of the
relative looseness of this schema, it is possible for
the symptoms to vary quite a bit from person to person. A
Borderline who "acts in" by turning their anger onto themself in the form of self-injury
(cutting etc) can "quack" very differently from a high-functioning Borderline
on the narcissistic end of the spectrum who takes out these aggressions on
those around them.
This makes diagnosis extremely difficult, especially
given the tendency of those with the disorder to
dissimulate in therapy or focus on the symptoms
(depression, addiction, etc) rather than on the underlying
disorder as causal.
This "5 of 9" standard was set by the DSM-III in 1980,
although it has its strong critics, and
other
diagnostic models are competing for the next release of
the DSM, including an
adaptation of the
"five-factor" model of personality.
It is very important to note that each of these
criteria represents a behavior or cognitive pattern
shared to some extent by all of us; the pathological nature of these criteria
lies in their life-long presence, influence on the sufferer's perception of quality of
life, rigidity in the face of all rational counterexplanation, resistance to change,
the self-perpetuating nature of the traits, and their
effect on the overall functionality of the person in
relationships and society.
BPD is a severe mental health disorder with a
completed suicide rate of 10 - 12%, one of the highest of
all psychiatric diagnoses. An estimated
2% of the general population,
27.6% of all psychiatric patients,
25 - 50% of spousal batterers,
and an unknown but estimated 25% of prison inmates in the United States suffer from BPD.
1. frantic efforts to avoid real or imagined
abandonment.
[Note: Do not include suicidal or self-mutilating
behavior covered in Criterion 5]
These "frantic efforts" can include:
verbal violence
sudden exaggeration of physical maladies requiring
caretaking
accusations of abuse
physical blocking of exit pathways to the
partner
threats to children or intimate bystanders
suicidal intimations or blatant threats of
self-harm
threats to expose actual damaging information
shared in confidence
threats to expose fictitious damaging
information
threats to destroy, or actual destruction of
cherished possessions
threats of sexual infidelity
threats of divorce
compulsive revelation of sexual infidelities
threats of legal retribution
physical attack/abuse
The feared abandonment can be
imaginary; that
is, virtually anything at all can and may be
interpreted as abandonment or 'intent to abandon'
by someone with BPD. Borderlines appear to have
a hair-trigger response to what they perceive as 'invalidation' of any kind.
This becomes extremely
frustrating for those who interact with the
Borderline, since at times every single word or
action (real or referential) may be interpreted as
secretly harboring malicious abandonment (it is not
coincidental that many partners of Borderlines first
wonder whether their loved one suffers from clinical
paranoia).
In layman's terms, the Borderline brain is
hard-wired for rejection, and someone with untreated
BPD may be virtually incapable of perceiving any
other outcome to an emotional attachment, despite all
rational evidence to the contrary. Tragically, the
off-kilter behaviors that accompany this foregone
conclusion in their minds are very often the sole
cause of relationships and interpersonal attachments
falling apart.
Many folks ask why, if a person with BPD is so
afraid of abandonment, they are so often the one to
terminate the relationship and flee voluntarily. This
"first strike" behavior is actually quite logical
from the Borderline's perspective:
abandon or be
abandoned. This subjective sense of personal
'control' over intimate circumstances appears to be
very appealing to many with this disorder, all the
more so because of a general tendency to perceive so
many other life factors as beyond their control.
Another trigger for abandonment fear can be real or
imaginary illness on the part of a loved one or partner.
Borderlines appear to have an extremely difficult time with the
mere possibility of the loss of a loved one, and will often flee (rather than offer support)
when confronted with this scenario.
2. a pattern of unstable and intense interpersonal
relationships characterized by alternating between
extremes of idealization and devaluation.
Folks with BPD appear to have been deeply damaged in
their early emotional attachment ("bonding") processes;
this finds its expression in the inability to
realistically assess the limits and boundaries of
interpersonal relationships.
A black-and-white pattern of relating to others --
often called the
abandonment/engulfment cycle --
results in the premature idealization of a new friend
or partner. This idealization is akin to a kind of
juvenile symbiosis unconsciously intended to replace an
absent or damaged relationship to a parental caretaker
figure. Adults with BPD can move extremely quickly into revelations of a
very personal nature and soon become extremely demanding of the time, resources and loyalty
of new partners or acquaintances.
As reality sets in, the Borderline is often extremely
disappointed and discouraged that this new relationship
does not (and cannot) replace their subconscious ideal of parental
unconditional love.
Additionally, intimacy and trust
have an inversely proportional relationship in BPD; this is the least intuitively rational
aspect of the disorder. As personal closeness grows, so does the irrational fear that the
new loved one/friend will reject the "real" person underneath the complex of BPD. The Borderline
begins placing demands of loyalty on the other that get increasingly irrational -- all in the
semi-conscious attempt to "prove" that the other will inevitably reject them.
These incredibly deep-rooted fears, alas, too often wind up becoming a self-fulfilling prophecy.
Unable to retain a balanced view of the other person (and frightened by the encroaching
intimacy they are not emotionally equipped to handle),
the Borderline then "splits" the other person into an all-evil
representation and demonizes them as utterly uncaring,
disappointing, abusive, etc. Often this results in the
Borderline completely and arbitrarily severing the
relationship (which in turn is extremely hurtful to the
person on the receiving end of the dynamic).
When another person is split 'bad', they can do no right.
All arguments begin and end with an assignment of blame to the other participant(s).
This can reach irrational levels quite quickly -- a Borderline can
be so invested (consciously or not) in their self-image as "abandoned victim" that they literally re-write
personal history to place themselves in this role. Whereas this tendency is irritating enough in most
normal scenarios, it can reach the level of actual legal damage to the other, as in false accusations of abusive or criminal acts.
There are many documented instances of this mechanism invoked in
disputed custody cases,
for instance.
See this page for more on the "rescripting of memory" in BPD.
This splitting can reverse itself with surprising
speed. There is no predicting when or how a partner or
friend will be "split back" to sainthood; often this
happens when the Borderline has left for another
idealized relationship, only to return begging
forgiveness when the new person inevitably
disappoints. Unfortunately, the cycle is ongoing and, without appropriate
treatment intervention, will last as long as the relationship is able to.
American culture places inordinate value on so-called "true
romance", which is well simulated by the jealously exclusive
Borderline idealization process. This can make it very difficult
to distinguish its pathological dimensions at first
blush. As the relationship proceeds, many
non-Borderline partners who have failed to register the
early warning signs of emotional dysfunction are caught
very unhappily by surprise in this dynamic when their
partner begins cruelly devaluing or abusing them, engages in
infidelities, or sometimes suddenly vanishes.
Many non-Borderlines have noticed this idealization
pattern quite markedly in the Borderline's relationship
to family members and close friends, who may be idealized
beyond reason one moment and utterly discarded the
next. Possessions, places, pets, philosophies,
politics, religious or political beliefs can also be
"split" good or evil.
It is very common for Borderlines to express their emotional
ambivalence via withholding or rationing of affection, sexual activity, financial
support, or other sensitive components of a relationship. There is a specific form of
"Borderline Sulk" known among non-Borderline spouses that manifests as an age-inappropriate, aggressive
walling-off from all communication with loved ones.
Yet when the other is split 'good' again,
no one can be a more generous, supportive or understanding partner than a Borderline.
This leads loved ones to frequently comment on the Dr. Jekyll/Mr. Hyde persona of folks with BPD.
Perhaps most importantly of all, Borderlines primarily
split themselves. This fundamentally shaky
relationship to self is the backbone of many clearly
identifiable BPD behaviors and feelings. A person with
BPD often finds it near-impossible to take
accountability for small errors without vilifying
themself completely and risking utter self-hatred. They
tend to hold themselves to a standard of inhuman
perfection -- and to fail in even the smallest way, in
their minds, is to court justified self-annihilation.
The often-noted inability of those with BPD to
apologize for (or even acknowledge) mistakes they've
made can be related back to this splitting
mechanism.
3. identity disturbance: markedly and persistently
unstable self-image or sense of self
Some Borderlines have an almost eery chameleon-like
quality to their social interactions: voice, gestures,
clothing, opinions can change according to the person
or group being idealized at the moment.
Lacking a stable relationship to self, it is common
for folks with this disorder to exhaustively question
every fundamental belief others may take for granted:
their religious convictions, sexual orientation or
preferences, moral precepts, goals and purpose in life.
Unable to provide it for themselves, Borderlines
consistently seek external validation of their
self-value. Often, the assimilation into a group with
strict guidelines and principles (military, religious
or even cultist organizations) can substitute for this
acceptance.
Another facet of this lack of identity is an observed tendency on the part
of those with BPD to frequently quit jobs and/or change careers. In many ways,
even an older person with BPD can be much like a teenager fresh out of high-school,
unsure of their future goals and plans and reluctant to commit to one career path.
Many loved ones wonder whether the person with BPD in
their life suffers from Multiple Personality Disorder
(now known as Dissociative Identity Disorder), because
their self-presentation can shift so radically from
situation to situation. This has many causes, one of
them being a tendency of those with BPD to dissociate under stress
[see criterion 9, below].
4. impulsivity in at least two areas that are
potentially self-damaging (e.g., spending, sex,
substance abuse, reckless driving, binge eating).
[Note: Do not include suicidal or
self-mutilating behavior covered in Criterion 5]
Some studies have found that over 60% of those with
addictive problems also suffer comorbid personality
disorders. This status of "dual diagnosis" makes
treatment much harder; causality can be very difficult
to pinpoint in these cases. Mind-altering and
escape-promising substances and habits are extremely
tempting to those suffering the constant emotional pain
of this disorder.
There is some biochemical evidence that the same
neural pathways damaged by the disorder are also those
which can render a person prone to addictions of all
kinds. Certainly alcoholism, sexual addiction, and
substance abuse are commonly found in this clinical
population.
See these links for more on addictions and BPD.
Life-threatening road rage and a yen for aggressive public confrontation with service
persons or strangers can be displayed by folks of both sexes with BPD.
This appears to relate to an extremely short fuse for tolerating delay or
apparent dismissal, and may be related more closely to Criterion 2.
Eating disorders (in particular) and impulsive behaviors such as spending
sprees, shoplifting, gambling or hair-pulling are often comorbid with BPD.
Compulsive behaviors such as situation-inappropriate hoarding of food or clothing,
extreme skin-picking or Body Dysmorphic Disorder (an unrealistically negative image of one's body) are
commonly co-diagnosed as well.
See these links for more on Impulse Control Disorders, Compulsive Disorders, Eating Disorders and BPD.
5. recurrent suicidal behavior, gestures, or
threats, or self-mutilating behavior
Once upon a time, when a person received a diagnosis
of self-injurious behavior (cutting, self-harm,
self-mutilation), the diagnosis of BPD followed right
behind. Although modern psychology has learned to
distinguish between the two, a general rule of thumb is
that whereas not all self-injurers have BPD, many folks
with BPD -- although not all! -- self-injure in
some fashion.
Cutting or burning one's own skin with knives, pins,
razors, cigarettes or cigarette lighters are the most
commonly known expressions of self-injury. Abuse of alcohol and
controlled substances or street drugs could also be considered self-injury,
as could the reckless practice of unprotected sex with strangers of
dubious status vis-a-vis sexually transmitted diseases. A marked tendency
to neglect physical self-care, to the point of often becoming physically ill when
easily preventable, also points in the direction of a self-destructive mind-set.
The secret habit of literally inducing illness in oneself is a
separately diagnosed disorder known as Munchausen's Syndrome. Here, folks
deliberately harm their bodies by breaking their own limbs, insisting upon unnecessary
invasive surgery, or ingesting or injecting toxins. While not technically the same disorder, Munchausen's shares a
large diagnostic overlap with BPD.
Extreme amounts of tattoos or piercings, constant
skin-picking or extreme shaving, severe restriction of
diet or sleep according to arbitrary rules, fanaticism
for the questionable "quick-results" promises of
non-mainstream health fads -- these may all be
indicative of self-injurious tendencies when observed
in the presence of other diagnostic criteria for
BPD.
For more on self-injury and eating disorders, see these
links.
6. affective instability due to a marked
reactivity of mood (e.g., intense episodic dysphoria,
irritability, or anxiety usually lasting a few hours
and only rarely more than a few days)
There is a big debate in the mental health community
over whether BPD can be viewed as a subset of Bipolar
Disorder, and I address this debate elsewhere on this site. As mental health professionals
continue to research the topic, the salient point for diagnostic purposes is that a
person with BPD is subject to extreme and sometimes
astonishingly rapid shifts of mood.
It is quite common for someone with BPD to feel
literally suicidal one moment, and an hour later feel
"fine" and wonder what all the fuss is about.
Technically speaking, even rapid-cycling Bipolar
Disorder (known as Bipolar II) does not cycle that rapidly.
These mood shifts may occur many times a day in someone
with BPD. There is a marked tendency towards
drama and chaos -- Borderlines often lead themselves
into crisis situations as though they can't control it.
This "addiction to crisis" may have both learned and
biochemical roots.
These mood shifts
appear to be triggered both by internal
as well as by external sources or triggers -- sources, however,
which the person with BPD is not often capable of identifying on their own.
Standard soothing techniques used with people suffering from depression,
while sometimes helpful in the short run, are ineffective in changing
the course of these Borderline moods. It remains unclear what part of
these BPD up- and down-swings are due to actual affective disturbance
(a possible genetic component) and what part to self-destructive cognitive
patterns.
7. chronic feelings of emptiness
Borderline "emptiness" is often confused with boredom
or depression. Lacking a sufficiently mature sense of
self, or identity, a person with BPD is highly likely
to fall into a lethargic, painful dysphoric state in
which nothing and no one seems appealing.
[dysphoria="a feeling or spell of dismally low spirits", constant low-grade misery]
This is most
often encountered when the Borderline has no intimate
relationship or during cycles of long-term committed
relationships after the idealization period has worn
off. Most apparent here is the Borderline's seeming
inability to relax, to enjoy peaceful down-time
(without crisis!) in the company of friends and loved
ones, to occupy oneself alone with hobbies or interests
for any extended length of time.
For more information on BPD & depression, see
these links.
Borderline "emptiness" is often frantically assuaged
with the acquisition of material possessions or money,
adrenalin-seeking behaviors and addictions.
Hoarding/collecting behaviors and a tendency towards
addictive substances are both subjectively intended to
combat these extremely unpleasant sensations of diffuse
"lack."
Indeed, a sense of entitlement or insistence on the
"right" to make up for perceived discriminatory
withholding of resources (affection, material objects,
schooling, privilege, children, etc) -- despite factual
evidence to the contrary -- is a key BPD cognitive
pattern in this context.
8. inappropriate, intense anger or difficulty
controlling anger (e.g., frequent displays of temper,
constant anger, recurrent physical fights)
Only a few "primitive" emotions are easily accessible
to someone suffering from BPD -- and situationally inappropriate anger is chief among
them. Lacking a more differentiated
capacity for expressing (or even recognizing) intense emotion, a
person with BPD is easily triggered into towering,
inappropriate rage. Unfortunately, this rage is then
aimed at anyone in an intimate relationship with this
person, transforming it from merely regrettable emotional
underdevelopment into true interpersonal or domestic
violence. Rages can come on with astonishing speed and violence, and are
very difficult to explain to anyone who is only nominally acquainted with the person with BPD.
The person with BPD tends to dissociate during
periods of rage, during which they are not responding to the current surroundings and situation, but
rather to a traumatic incident in their past. This can
render them virtually oblivious to the effect of their rage on others, which can be highly
dangerous. A Borderline in a full-blown rage is not a person to be reasoned with or
otherwise tolerated -- if the rage is clearly out of control, it is appropriate
to remove oneself from the immediate area and notify the authorities.
Rages are in general brought on by a triggered suspicion of abandonment or
an intimation of criticism/invalidation, and can include (as in Criterion 1):
shouting
uncharacteristic cursing
harsh verbal abuse
physical abuse, domestic violence
threats to children or bystanders
the destruction of property
self-injurious episodes
Besides physical violence to their person, numerous non-Borderlines report having experienced
incidents such as holes punched in the walls, telephones ripped out, furnishings
destroyed, knife battles, gunplay, arson attempts, and other extremely
dangerous (even potentially deadly) incidents. It's the unpredictability of these rages, and the
seemingly innocuous events that precipitate them, that
are so very difficult for those in relationships with a
Borderline to tolerate.
[Note: if you find yourself in this situation with a loved one, remove any lethal weapons from the home and
please read these resources immediately.]
Although raging is certainly
one of the more universal hallmarks of the disorder,
some folks with BPD do not appear to rage as violently
or frequently as others. Some researchers characterize
these tendencies as "outward-acting" and
"inward-acting" -- the former taking their anger out on those around
them and the latter on themselves in the form of self-injury. Many cases appear to be a mix of
both, depending on the situation.
9. transient, stress-related paranoid ideation or
severe dissociative symptoms
Times of stress can bring anyone's most dysfunctional coping mechanisms
to the fore, and this is particularly true in someone suffering from BPD.
Chief among these is dissociation, or the subjective
re-playing of past traumas in present scenarios. A tone
of voice, sound, sight or smell may 'trigger' the
dissociation by stimulating the part of the brain keyed
to remember past injury. In self-defense, the
Borderline dissociates, removing themself emotionally
from the present source and responding to it as though
it were the past situation. Dissociation is
particularly common in survivors of childhood sexual
abuse.
For many more details on dissociation, see
these links.
Most Borderlines suffer from the belief that people are
fundmentally ill-willed towards them and will
ultimately betray and abandon them. (See this list for an excellent
summary of common beliefs held by people with BPD.)
Paranoid ideation
can include the temporary conviction that loved ones
are poisoning, illicitly harming, or (quite common)
committing infidelities behind the Borderline's back -- all
despite overwhelming objective evidence to the contrary. If the
paranoia extends beyond the belief that
intimate loved ones will ultimately abandon them (for
instance, if the person sees patterns of actual personal
persecution in random unrelated events, is abrasive with everyone,
seeks no friendships, often fears being spied or evesdropped upon,
or sees murderous intent in all
strangers), and appears long-lasting, an alternate diagnosis of
Paranoid Personality Disorder might be considered.
Criterion 9 can also include brief periods of
psychosis. This involves true unlinking from reality --
seeing headless angels descending, hearing voices
issuing dire commands, engaging in extreme self-injury
such as attempted auto-castration. Depending on the
severity and duration of the psychotic episode(s), the
person with BPD may carry an additional diagnosis of
"depression with psychotic features."
If the person with BPD exhibits episodes of manic behavior --
wild euphoria, delusions of personal invincibility, taking on the persona of
famous characters -- an alternate or comorbid diagnosis of Bipolar Disorder may be considered.
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Key BPD-Related Behavioral and Cognitive Patterns
'One law for me, another for everyone else'
This kind of blind universal self-exception is fundamental
to the cognitive distortions that underlie all personality
disorders. It is the entrenched rigidity of this belief
in the face of all rational counter-argument -- and many folks with BPD are above-average in intelligence -- that defines the very pathology of
BPD.
Common variations include "I'm allowed to have affairs but
my partner is not", "I'm not an addict but others using
these same drugs/substances are", or "I am a devout Christian [or
other religious or political adherent] and
nothing I do contradicts this."
Extreme Foreshortening of Emotional Horizons
Observers usually note that a person with BPD will retain an impressionistic emotional memory of
others based
solely on the most recent interaction with that person. Their
cognition and memory being impaired by a
noradrenalin-maintained hypervigilance, folks with BPD are
commonly unable to take a longer-term perspective on life events. Certainly this
factor plays into the impulsive
behaviors associated with this disorder -- stories are legion of Borderlines 'burning their bridges'
in many contexts.
Linked to this is the distorted cognitive principle that "Feelings Create Facts", next:
"Feelings Create Facts"
The deeply entrenched belief that the subjective, fleeting feelings of the moment
determine all reality forever ... or at least until the next impression sets in.
For complex reasons, Borderline pathology includes a relatively fast-and-loose relationship to historical
fact when the individual is emotionally aroused in some way. If a Borderline
feels abused,
in their mind, abuse
must have factually happened. For obvious reasons,
this is an extremely confusing world-view for others to comprehend; all the more so, given
the obvious intellectual clarity of the individual in other contexts.
For more on this, see:
Memory and BPD
"Attention is a Zero-Sum Game"
Many Borderlines are incapable of perceiving the limitless quality of
emotional affection or attention in general. If someone else receives praise or notice,
Borderlines fear that there will be less to go around for them. The recognition received by anyone else, the reasoning goes,
has the effect of personally dimishing the Borderline, and they immediately take a
hostile, defensive stance against this perceived new 'enemy.'
This apparent jealousy is not a
rational cognitive process, and many non-Borderlines have remarked on the highly age-inappropriate behavior of
Borderlines in contexts such as children's birthday parties, others' weddings, spouse's job promotions or similar
celebratory events that focus on others. (Imagine, for example, your consternation while attending
your law firm's celebration of your attaining full partnership after ten years,
to be called into the bathroom by your seething middle-aged spouse sobbing
that "you're getting
all the attention -- and you'll be sorry!" --
a scenario recently related to me by a site visitor).
In many cases, this jealousy is expressed via seemingly interminable
conversations (often in the dead of night) revolving endlessly
around one's supposed infideities or "betrayals" as a partner.
In some cases, a Borderline's pathological jealousy of a spouse
or partner can express itself in violence, suicide or even homicide; if you find yourself in
this situation, please notify the appropriate authorities, as this is an intolerable and potentially
very dangerous irrationality to live with. Folks freshly separated from a violent Borderline
relationship must take extra care to make use of all legal venues that ensure their own
self-protection. Many (possibly preventable) tragedies have resulted from this
"If I can't have you, nobody can!" mind-set.
This extreme BPD egocentrism, based as it is on a foundation of anxiety and crippling self-loathing,
can lead to innumerable conflicts in life as the Borderline overpersonalizes each interaction
in this way -- and struggles resentfully to hang on to what is tragically felt to be a
limited quantity of love & attention in the world.
Situational Competency
The intense fear of abandonment, triggered by dysfunctional attachment perceptions,
usually
applies only to those with whom the Borderline is emotionally intimate, therefore the
'outside world' often sees no irrational behaviors. Someone with BPD who is relatively
high-functioning may exhibit little impairment on the job or in other non-familial contexts.
This trait makes it particularly difficult for spouses and family locked in a cycle of domestic
abuse to attain external validation of their experiences.
Lack of Object Constancy
"Object Constancy" is a term used in a field of psychology known as
Object Relations theory.
It denotes the learned ability of a young child to retain a
constant internal image of a thing in mind, despite its
shifting outward appearance (for instance, the accurate
size of a toy whether viewed from close up or from
afar. A classic child psychology experiment in this area is the demonstration of two
glasses of different sizes containing the same amount of liquid -- can the child perceive that the
amount of fluid remains constant when its physical shape changes?).
Folks with BPD have been theorized to possess an unstable object constancy in
regards to the loved ones in their lives: when that person
is not physically present, someone with BPD slowly
loses an emotionally consistent 'sense' of that person's existence. Many
non-Borderlines have noted the curious (and often
irritating, sometimes even abusive) tendency of Borderlines to telephone
excessively, to inappropriately "check up" on their loved one's
behaviors outside the home, to keep small physical mementos or photographs
of the loved one with them at all times, or to insist that
they physically see the partner in person at frequent intervals.
As one person with BPD put it, "It's as though the
outlines of the absent person, no matter how well I know
them, begin to fade and lose their clarity, leaving room
for all sorts of doubts and fears of my own to begin creeping
in."
Projection, Splitting, Displacement, Magical Thinking, Triangulation
Read
this for a description of some common ego defense mechanisms used by those with BPD.
After the 1944 film of the same name (
Gaslight), in which Ingrid Bergman plays a
Victorian newlywed who, through a devious series of manipulations (e.g., slowly dimming the gaslights) by her mentally ill husband,
is slowly persuaded that
she and not he is the unbalanced spouse.
Many folks
with BPD or BPD traits are
extremely invested in denying the level of their dysfunction -- personality disorders are "ego-syntonic",
or viewed by the individual as a natural and necessary way to think and be. Borderlines may wage a permanent war with all their loved ones as to "who is really the sick one here?"
Blatant denial of events or conversations that have occurred, endless circular conversations on
who-did-what-when, and actually changing or removing physical evidence of dysfunctional behaviors
are all gaslighting techniques.
It's a commonplace in the psychiatric community that
the spouse or partner of someone with BPD is usually the first to present clinically, worried
about "going mad" themself.
Interpersonal Manipulation
Quite a bit has been written on the topic of manipulative
behavior and BPD. Indeed, people with the disorder have
traditionally been stigmatized in the mental health
community for precisely this reason: "master manipulators",
"emotional vampires" or "users" are terms that
unfortunately still get lots of play in clinics and hospitals
around the country.
Certainly most of the dysfunctional behaviors expressed by
those with the disorder are perceived by others as blatant
attempts to sway others into fulfilling their immediate
wishes. Borderlines are experts at 'sideways fulfilment'
of their needs. Loved ones and others are often drawn
into highly complicated interpersonal games whose goals are
to provide the Borderline with things the Borderline is
seemingly unable (or perceives her/himself as unable) to
provide for her/himself -- or to fulfill a misplaced need for "safety."
Whether or not
this is a conscious
process is up for debate (albeit a debate with enormous
legal ramifications); what is certain is that
someone with Borderline Personality Disorder clearly lacks the
social/emotional skills to fulfill these needs in healthier
ways.
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This Page Last Updated: August 13, 2003
How do I know
if someone in my life has Borderline Personality
Disorder?