What is Borderline Personality Disorder?

November 12, 2012

What is Borderline Personality Disorder?

Diagnosis of borderline personality disorder (BPD) is fraught with ambiguity because of the difficulty of describing and measuring the symptoms of the condition. Many psychoanalysts, psychiatrists and psychologists all have differing views of just what BPD is and how it manifests itself. The reason or reasons for it are equally vague and open to discussion. Some researchers believe that it is a form of post traumatic stress disorder (PTSD) others think that it may be a label which is worthless because it is so vague which leads to misunderstandings amongst the medical community. The causes of borderline personality disorder are also open to debate amongst the mental health community however one expert, Linehan, believes that it is caused when a person has a tendency to act in response to lower stress levels and take longer return to the stable state. Kernberg, on the other hand initially identifies that no psychosis is present and an impaired ego integration is seen and then says,”Borderlines can describe themselves for five hours without your getting a realistic picture of what they’re like”. It’s also believed that those with the disorder may have been brought up where they and their views were continually put down. The result is an individual whose behavior and inner feelings routinely swings from extremes such as showing an ability to cope outwardly yet things could be breaking down internally. Or going from one crisis to another whilst always feeling grief which is being inhibited. Another feature of borderline personality disorder is the individual’s inability to enjoy pastimes or work in a meaningful manner, having a low tolerance to anxiety and inability to control impulsive behavior. The combination of these factors is known as ‘nonspecific signs’. It is also seen that those with BPD tend to swing from one extreme to another when assessing others. People are seen as all of one thing, good or bad and one person can be seen as totally good one day when compared with others, yet the next day that same person is seen as all bad. Another symptom shows itself by the person’s inability to understand that actions take place because of other actions. A BPD sufferer judges a person on that one action not all of the surrounding issues which have led to the action. This means that the borderline personality disorder sufferer judges the person totally subject to the last meeting with that person.

Other views of what defines borderline personality disorder include having symptoms where self destructive behavior is repeated, there is a chronic fear of panic when alone or feeling of abandonment. In other cases the BPD sufferer may behave impulsively and then be embarrassed by their behavior afterwards and the borderline may have difficulty understanding rules within society, perhaps at work, which everyone else tends to understand clearly.

When someone is suffering from borderline personality disorder they cannot sense what it is like to feel in another mood. For example when they are stressed then they cannot imagine any other way of thinking, if they are happy then that is the only way that they can understand.

How to assess the symptoms associated with Borderline Personality Disorder

Experts in the field have drawn up a diagnostic interview to assess for borderline personality disorder. The symptoms covered in this interview to evaluate the patient include affect, cognition, interpersonal relationships and impulse action patterns. Each area is broken down into sub areas, where affect may include anger, guilt, worthlessness, helplessness, emptiness and chronic depression. Cognition is understood by unusual perceptions, quasipsychosis, peculiar thinking and non delusional paranoia. Interpersonal relationships investigate issues of engulfment, abandonment, counter dependency, entitlement, dependency and fiery relationships. Impulse action patterns deals with substance abuse, manipulative gestures of suicide, sexual deviance or other impulsive behaviors. This interview is the most commonly used measure of BPD and has directed medical professionals to four behavioral factors believed to be found in BPD: fears of annihilation, abandonment, engulfment and a feeling of demandingness and entitlement. Standard methods which are advocated to deal with borderline personality disorder include instructing patients on interpersonal skills, learning mindfulness, controlling emotions, understanding distress tolerance and developing interpersonal balance.

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