Borderline Personality Disorder: Causes, Symptoms, and Treatment

the Borderline personality disorder O TLP it is considered one of the more serious personality disorders, along with Paranoid Personality Disorder and Schizotypal Disorder, as many experts view them as more pronounced versions of the rest.

In this sense, the TLP can share many features with other personality disorders, Such as addict, histrionic, avoidant or anti-social.

Borderline personality disorder

Different doubts and characteristics have arisen around the concept of borderline personality disorder which have been debated within the academic community. However, according to the DSM-V, we may already know the symptoms, causes and the most effective treatments for this disease.

symptoms

The diagnostic criteria for DSM include:

  • Frantic efforts to avoid abandonment, real or imagined;
  • Alternation between the extremes of idealization and devaluation in interpersonal relationships;
  • Clearly unstable self-image;
  • Potentially dangerous impulsivity, for example in relation to money, sex, drug addiction or binge eating;
  • Threats or attempted self-harm or suicide;
  • Mood instability due to marked emotional reactivity;
  • Chronic feelings of emptiness;
  • Intense and inappropriate anger or difficulty controlling anger;
  • Paranoid thoughts or severe, transient, stress-related dissociative symptoms.

the causes

Borderline personality disorder is currently thought to be it is the result of the combination of the biological predisposition to feel a strong emotional reactivity, Which would lead to particularly frequent and intense episodes of impulsivity or irritability and to a disabling environment.

Marsha Linehan, creator of this concept and expert in borderline personality disorder, defines the disabling environment as an environment in which caregivers project their own emotions and motivations onto the child rather than acknowledging and approving those of the child. child, without tolerating them samples of negative emotions. In this way, the child’s analysis of his experiences would be trivialized (for example, saying “You are angry but you do not want to admit-“) and it would be transmitted to him that these are caused by a personality. characterized as negative traits, which would be summed up in messages like “You are bad”. Without proper validation of their own experiences, children cannot learn to correctly label their emotions or take their reactions as natural, making it difficult to develop an identity.

childhood trauma

Borderline personality disorder it has also been frequently associated with childhood trauma; risk factors for developing the disorder include neglect and emotional abuse, witnessing domestic violence, parental crime and substance abuse and, in particular, repeated sexual abuse. It has been hypothesized that this type of chronic victimization leads the child to believe that he is vulnerable and helpless and that others are dangerous and therefore affects his ability to form secure and satisfying bonds of affection.

According to Pretzer (1996), people with borderline personality disorder view the world in dichotomous terms, that is, their views about themselves, the world, and the future tend to be either completely positive or completely negative. This way of thinking would lead to emotions that are always intense and rapidly changing from start to finish, with no possibility of intermediate terms. As a natural consequence, others perceive these changes as irrational and random.

self-injurious behaviors

The tendency of people with borderline personality disorder to experience negative emotions more intensely and more frequently than most people partly explains their propensity to use drugs, Binge eating – and therefore bulimia nervosa – or unsafe sex.

All of these behaviors are done with the intention of reducing discomfort, as is sometimes the case with self-injurious behaviors, which are used to temporarily distract attention from negative emotions. Many people with borderline personality disorder who engage in this type of behavior report feeling little or no pain during these episodes, most often between the ages of 18 and 24.

Relationship with emotional dependence

The self-devaluation inherent in borderline personality disorder is related to the intense need to have an intimate relationship with another person, whether romantic or not. These relationships reduce feelings of emptiness and lack of self-worth and make the person with borderline personality disorder feel protected in a world that, as has been said, is conceived as dangerous. Being so strong in their need to be attached to the significant other, it’s no surprise that people with borderline personality disorder are extremely sensitive to the possibility of being abandoned; the trivial acts of others are often interpreted as signs of impending abandonment.

Thus, not only do frequent outbursts of desperation and anger at others occur as a result, but self-injurious behaviors can be used in an attempt to manipulate others into stopping them or as a means of revenge if they feel that they are. they were abandoned. Symptoms of BPD tend to decrease with age, including self-injurious behaviors. However, in older people these can manifest themselves in slightly different ways, for example by neglecting diet or drug treatments.

However, and paradoxically, a strong union with the other can also lead to the fear that his own identity, fragile and unstable, is absorbed. There are also fears that the abandonment perceived as inevitable will be all the more painful the more intimate the relationship is. This is why the chaotic interpersonal behavior of people with borderline personality disorder can in some ways be seen as an unconscious strategy to avoid a stability that can be feared as much as feelings of emptiness.

This way, many people with BPD fluctuate between fear of loneliness and fear of addiction, keeping their relationships in an unstable and pathological equilibrium for a time. Others, frustrated and exasperated, tend to shy away from them, which reinforces their belief that they deserve to be abandoned, creating a vicious cycle in which the person with BPD causes the same thing as they do. feared.

BPD and depression

TLP involves a strong predisposition to depressive episodes, Because it relates to low self-esteem, feelings of guilt, hopelessness and hostility towards others. In fact, some experts claim that TLP could be considered mood disorderAnd the emotional instability characteristic of TLP has even been linked to bipolar disorder, which is defined as the alternation between periods of weeks or months of depression and others of pathologically elevated mood.

treatments

It is probably the sheer severity of borderline personality disorder that has led to more research into its treatment than any other personality disorder, so it is currently the only one for which is known to be an effective treatment. We refer to Dialectical Behavior Therapy, devised in the 1990s by the aforementioned Linehan (1993), who, to the surprise of the scientific community, recently revealed that she herself had been diagnosed with BPD.

the Dialectical behavior therapy it is based on the apparent paradox which, according to Linehan, led her to improve and motivated her to develop her therapy: to change, radical self-acceptance is necessary. Among other strategies, this treatment includes strategies for emotional regulation, Social skills training and belief modification.

Bibliographical references:

  • Carey, B. Mental Illness Expert Reveals His Own Struggle. The New York Times online. June 23, 2011. Retrieved from http: //www.nytimes.com/2011/06/23/health/23lives.h …
  • Linehan, MM (1993). Cognitive-behavioral therapy for borderline personality disorder. New York: Guilford Presse.
  • Millon, T .; Grossman, S .; Millon, C .; Meagher, S .; Ramnath, R. (2004). Personality Disorders in Modern Life, 2nd ed. (Pp. 493-535). Hoboken, New Jersey: John Wiley & Sons.
  • Pretzer, JL and Beck, AT (1996). A cognitive theory of personality disorders. In JF Clarkin and MF Lenzenweger (Eds.), Main Theories of Personality Disorder (pp. 36-105). New York: Guilford Press.
  • Stone, MH (1981). Borderline syndromes: a review of subtypes and an overview, research guidelines. Psychiatric Clinics of North America, 4, 3-24.

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