Borderline personality disorder (BPD) is, fundamentally, a disorder of mood and emotion. People with the disorder struggle to be alone, they crave the company of others, but find it very difficult to manage relationships. People with BPD tend to use other people to help them regulate their intense and rapidly shifting emotions, which is why they can become so dependent on others and so terrified of even brief and expected separations.
Borderline personality disorder is a mental health disorder, currently classified in the Diagnostic and Statistical Manual of Mental Disorder (DSM) -5. To meet the clinical threshold to be diagnosed with the disorder you must fulfil five of the following criteria:
- Frantic efforts to avoid real or imagined abandonment.
- A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
- Identity disturbance: markedly and persistently unstable self-image or sense of self.
- Impulsivity in at least two areas that are potentially self-damaging (e.g. spending, sex, substance abuse, reckless driving, binge eating).
- Recurrent suicidal behaviour, gestures, threats, or self-mutilating behaviour.
- 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).
- Chronic feelings of emptiness.
- Inappropriate, intense anger or difficulty controlling anger.
- Transient, stress-related paranoid ideation or severe dissociative symptoms.
People with bpd often struggle with interpersonal relationships, finding it hard to feel secure due to their underlying fear of abandonment. They deeply fear that their partner will leave them, which can lead to hyper-vigilance. The person with BPD is on high alert to signs that their partner might reject them. Perhaps a partner texts to say they are going for drinks after work, or will be home late due to an over-run meeting. The BPD partner may become very upset and feel rejected, they may suspect their partner is having or seeking an affair, or simply no longer enjoys their company and plans to leave them. For most of us this is an extreme reaction, but for the BPD partner, the idea that their partner will abandon them is always hovering just below the surface. It doesn’t take much for these feelings to bubble up and create panic in the bpd sufferer.
Relationships with a person suffering from BPD will most likely be unstable due to their tendency to idealize and then subsequently devalue people. This pattern may become more obvious in romantic relationships, but can also be present in other relationships as well. In the early stages of a relationship people with BPD put their partner on a pedestal, they might admire them excessively and uncritically. This, of course, cannot possibly last and it doesn’t, but rather than evaluating the other person more reasonably and understanding and accepting their flaws, the BPD partner will begin to devalue their partner in the extreme. The partner of the person with BPD will experience a massive fall from grace. Because people with BPD have very black and white thinking, they often overlook the nuance, they move quickly from an ‘all good’ perspective to an ‘all bad’ one. And so the partner of the BPD sufferer is often perceived as either ‘all good’ or ‘all bad’, rather than being seen as their whole selves, with both good traits and human flaws.
Another difficulty commonly experienced by those with BPD is their intense experience of anger. They will lose it pretty quickly, going from 0 – 60 in a matter of seconds. People with BPD have unstable emotions and so they are very unpredictable to the people in their lives, because they also often react to situations with intense anger they can be quite scary to be around. Because of their emotional instability and their tendency to lose their temper, the borderline person can create an intense or stressful environment, with everyone around them walking on eggshells, trying not to set them off. They may also get very upset, very easily, thereby creating a situation where the people around them feel they must be careful not to upset them. This environment can create habits of hyper-vigilance in those around the BPD sufferer and a tendency for over responsibility-taking, or parentification. This means that partners or family members may develop unhealthy patterns of interacting that they learn through the everyday dysfunctional dynamics of the relationship with the BPD sufferer.
People with BPD have real difficulty regulating their emotions. This tends to show up in their sensitivity to their environment and to other people, their lack of coping skills in stressful situations and their tendency to crumble under pressure. The person with BPD may also be quite impulsive, this combination of emotional instability and impulsivity can result in reckless, dangerous and other self-damaging behaviour. This can be very hard to be around for the partner or family member of the person suffering. Impulsivity in combination with feelings of self-loathing or low self-worth can also result in suicide attempts or self-harming behaviours.
People with BPD also experience chronic feelings of emptiness and a lack of stable identity, which gives the BPD sufferer very little to grab hold of in a crises. It is difficult to ground yourself when your identity and sense of self feels like sand slipping through your hands. The person with BPD can work on these difficulties in therapy, they can build a sense of self, and develop coping mechanisms that help them to regulate their emotions and stabilise their relationships. For more information about BPD see the NHS website. To see if you fit the criteria for BPD fill out the online questionnaire.
