This is a complex disorder where the person often has a distorted perception of themselves; they are impulsive and self harm. About 75% of people diagnosed with Borderline Personality Disorder are women. The individual is emotionally unstable, especially when it comes to interpersonal relationships. The BPD person fears abandonment and displays emotional outbursts if a relationship ends or in a minority of cases if a doctor is late for an appointment etc. They perceive abandonment as meaning that they are a bad person. This disorder usually presents itself in early adulthood.
A personality disorder is viewed as a person’s behaviour and inner experience differing from the norm. The areas affected are: cognition, interpersonal functioning and impulse control. This can lead to problems in both social and work situations. Psychologists or psychiatrists diagnose the condition. Psychiatrists are unsure as to what causes BPD but they presume it is due to biological, social or genetic factors. They take into account the way the person socialised with their family and friends in early childhood, and how they coped with stress.
They often feel like they are bad people, but sometimes they question if they exist at all. This usually occurs in relationships where they feel unsupported or unloved. They are very sensitive to their surroundings. They can switch to idolising a friend or partner to devaluing them and feeling as if they are not ‘there’ for them. People with BPD are extremely emotionally vulnerable and sensitive. They feel emotions to an intense extent. A person without BPD experiences sadness in an upsetting situation, whereas a person with BPD who experiences the same situation, will experience that sadness as despair. Their emotional baseline is much higher than the average person, and it can take them a long time to return to a normal baseline after they are upset.
Dialectical behavioural therapy
Dialectical Behavioural Therapy (DBT) is a type of talk therapy developed by American psychologist Dr. Marsha Linehan. Dr. Linehan suffered for years with BPD herself and she created DBT specifically to meet the needs of people who experience emotions very intensely. She explains that the person with BPD is lacking emotional skin so she is deeply affected by anything emotional.
The difference between CBT and DBT is that CBT helps the person to change unhelpful ways of thinking and behaving. Whereas DBT is effective for focusing on accepting yourself with who you are, but also shows you constructive ways of dealing with your distressed emotions. DBT incorporates mindfulness, distress tolerance, interpersonal effectiveness and emotional regulation.
Symptoms of BPD
• Frantic efforts to avoid real or imagined abandonment
• Unstable and intense relationships
• Identity disturbance
• Impulsivity (substance abuse, binge/purging, spending sprees, reckless driving)
• Suicidal behaviour/self harm
• Emotional instability
• Feeling of emptiness
• Inappropriate and intense anger
• Paranoid thoughts
Treatment Centres for BPD in Ireland
