Borderline Personality Disorder in the Field of Psychology

This paper will discuss the psychological illness Borderline Personality Disorder, and seek to understand its many facets. By understanding its symptoms, the definition of this malady can be made clear in a psychological format. Also, the study of what is being done to help this illness will be sought after in the treatments available for it. In realizing all of these objectives, this paper will collect a comprehensive analysis of this illness.

This paper will discuss the psychological illness Borderline Personality Disorder, and seek to understand its many facets. By understanding its symptoms, the definition of this malady can be made clear in a psychological format. Also, the study of what is being done to help this illness will be sought after in the treatments available for it. In realizing all of these objectives, this paper will collect a comprehensive analysis of this illness.

In beginning this paper, there are many facets of the illness that can describe symptoms of the illness in many patients. By understanding these, we can see the affects they have on the people that are diagnosed with the illness. The relationship between many factors can lead up to the symptoms of BPD and how they can relate to a person’s life. The defining criteria of Borderline Personality Disorder (BPD) is a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity that begins by early adulthood and is 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; or sense of long-term goals; or career choices, types of friends desired or values preferred.
4. Impulsivity in at least two areas that are potentially self-damaging: for example; spending, sex, substance abuse, and binge eating.
5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
6. Affective instability: marked shifts from baseline mood to depression, 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; frequent displays of temper.
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.” (Bockian p.77)

In these symptoms, we can see how a doctor would diagnose a patient with such an illness. The many angles in the symptomatic process can reveal the nature of the person with BPD, and can usually merit some sort of treatment for the individual. The main ideas of the symptoms can tell us much about the different kinds of BPD that are present in today’s psychological world. The notion that there are simply a one-answer presentation to this complex illness, can tell us how wrong we can be, “for the disease has many dimensions in the fields of psychological research.” (Linehan p.45) In some ways as doctors can say:

“Borderlines often feel both dependent and hostile which in most cases makes for tumultuous interpersonal relationships. They can be very dependent on those to whom they are close and they can express enormous anger at those close, around them in times of frustration. Borderlines have a very low frustration tolerance level as well.” (Thorton p.166)

The idea of rage, being a part of the illness, can be seen as a way for BPD to take out their frustrations on people who may seem to be in a close proximity to himself or herself to the patient. By realizing this angle, this can be seen as symptoms of BPD in the judging of one’s character and their behavioral attributes.

The depth to which most Borderlines feel their pain is for the most part not understandable to non-borderline individuals. This deep intrapsychic pain is “often the pain of a traumatic childhood.” (Moscovitz p.66) Borderlines live in constant fear, terror of having to deal with real or often imagined abandonment. Attachments and bonds are very difficult for borderlines to develop because there are many control and trust issues with which they do not cope well. They have a strong need to protect themselves from anymore pain which sees most borderlines basically being incapable of dealing with their own vulnerabilities or the vulnerabilities and emotions of others. Borderline individuals may not seem it to the outside world around them but they are very sensitive people in a great deal of pain. The very unfortunate reality of this personality disorder is that when they need something the most Borderlines often are compelled by impulse to push away, to sabotage in order to protect themselves from the agony increasing that is ever present inside.

Borderlines, not unlike anyone often project, to a greater degree, greater than the average person. It is this projection out onto others of all that is essentially reality inside of the borderline themselves that leads them to often be so abusive to those around them. Borderlines struggle very much “with image of self and identity and in so doing often have no clear definable understanding of where they end and the next person begins.” (Moscovitz p.144) This is a boundary issue that has its roots most often in the way in which these individuals were raised. The blurring of boundaries between self and other causes the borderline to act out what is often their own self-hatred and disdain for self onto others. At times it seems as though there is an “average collective reality in the world and then there is the reality of the Borderline Disordered individual.” (Bockian p.134) Disordered dysfunction (inter-personally and or in others areas of life) is the basis of this lifestyle. It is a life that for any Borderline living it is often entrenched in chaos and marred by virtually inescapable feelings of helplessness and victimization. For more information go to PhDify.com

In the treatment that can be given to a patient that has this illness, we can see that there is hope for the suffering person with BPD. By organizing the major traits of the illness, the scope of its solutions can also open up into a variety of options for getting well. Treatment includes psychotherapy, which allows the patient to talk about both present difficulties and past experiences in the presence of an empathetic, accepting, and non-judgmental therapist. The therapy “needs to be structured, consistent and regular, with the patient encouraged to talk about his or her feelings rather than to discharge them in his or her usual self- defeating ways.” (Thornton p.133)

Another aspect of help is sometimes medications such as antidepressants, lithium carbonate, or antipsychotic medication are useful for certain patients or during certain times in the treatment of individual patients. Treatment of any alcohol or drug abuse problems is often mandatory if the therapy is to be able to continue. By using medications, we can see the nature of the brain, and how chemicals are processed within it. The observation of this in the study of medication can certainly help to also shed some light on the illness and its cure.

In some cases, brief hospitalization may sometimes be necessary during acutely stressful episodes or if suicide or other self-destructive behavior threatens to erupt. Hospitalization may provide a temporary removal from external stress. Outpatient treatment “is usually difficult and long-term – sometimes over a number of years.” (Linehan p.23) The goals of treatment in a hospital situation could include increased selfawareness with greater impulse control and increased stability of relationships. A positive result would be in one's increased tolerance of anxiety. Therapy should help to alleviate psychotic or mood-disturbance symptoms and generally integrate the whole personality. With this increased awareness and capacity for self-observation and introspection, it is hoped the patient will be able to change the rigid patterns tragically set earlier in life and prevent the pattern from repeating itself in the next generational cycle. In essence, these are the many aspects of treatment that are used to help the patient alleviate some of the stress associated with the illness, and may even help to adjust brain chemicals that play a part in the person’s way of thinking.

In conclusion, we can see the symptoms and the treatments that are so much a part of the psychological world today in realizing this very serious illness. By making efforts to come to terms with the neurotic elements of this disease, we can see the factors that contribute to the person’s behavior patterns from an earlier education in how to deal with life, in other words, how they use their coping skills in life. By seeing this in the patterns it appears that there are many ways that the patient can learn to deal with BPD, and can take advantage of the great amount of information that is out in the field presently. In the factors that go into making the symptoms, there are just as many ways for a patient to readjust his or her life accordingly to the information that is out there. Perhaps this paper, has shed some light on this psychological illness, and maybe ha taught a thing or to about the nature of this malady.

Bibliography:

• Bockian, Neil, New Hope for People with Borderline Personality Disorder, Prima Communications, Inc., June 2002.
• Linehan, Marsha, Skills Training Manual for Treating Borderline Personality Disorder, Guilford Publications, Inc., May 1993.
• Moscovitz, Richard, Lost in the Mirror: An Inside Look at Borderline Personality Disorder, Taylor Publishing Company, March 2001.
• Thornton, Melissa, Eclipses: Behind the Borderline Personality Disorder, Monte Sano Publishing, November 1997.