Borderline personality disorder
Borderline personality disorderBorderline Personality Disorder (BPD) is one of the most controversial diagnoses in psychology today. Ever since it was introduced in the DSM, psychologists and psychiatrists have been trying to give the concepts behind Borderline Personality Disorder a concrete form. Some researchers believe that BPD is a name given to the end result of Post-Traumatic Stress Disorder, and that the term BPD has been so misunderstood and misused that there is no point in trying to refine it, they would rather just eliminate the term completely.
There are many symptoms of BPD, but most are quite general. The most common symptoms of BPD are: Relationships with others are intense but stormy with marked shifts of feelings. The person may manipulate others and often has difficulty with trusting others. There is also emotional instability with marked and frequent shifts to an empty lonely depression or to irritability and anxiety. The person may show inappropriate and intense anger or rage with temper tantrums and resentment, and a loss of control or fear of loss of control over angry feelings. There is a feeling that one is flawed, defective, damaged or bad in some way, with a tendency to go to extremes in feeling, thinking, or behavior. The depression that accompanies this disorder can cause much suffering and lead to serious suicide attempts.
Borderline Personality Disorder is a common disorder, and it is estimated that 10-15% of the population has it. It is two to three times more common in women than in men. The increased amount of BPD among women is thought to be a result of the greater incidence of incestuous experiences during their childhood. This victimization can later result in impaired relationships and mistrust of men, and a seriously damaged self-image.
The main category of diagnosis of BPD is and impaired ego integration, which is a diffuse and internally contradictory concept of oneself. Kernberg is quoted as saying, “Borderlines can describe themselves for five hours without your getting a realistic picture of what they are like.” In I Hate You-Don’t Leave Me!, Jerold Kriesman and Hal Straus refer to BPD as “emotional hemophilia; [a borderline] lacks the clotting mechanism needed to moderate his spurts of feeling. Stimulate a passion, and the borderline emotionally bleeds to death.”
The treatment need for Borderlines includes psychotherapy which allows the patient to talk about both present difficulties and past experiences in the presence of an empathetic and non-judgmental therapist. The therapy must be structured and consistent. Sometimes medications such as anti-depressants, lithium carbonate, or anti-psychotic medications can be useful for some patients. Brief hospitalization may be necessary during extremely stressful episodes, and hospitalization may provide the temporary removal from external stress that is so strongly needed. Outpatient treatment can be difficult and long-term. A positive result from therapy would be a person’s increased tolerance of anxiety. Therapy should help to alleviate mood-disturbance symptoms and unite the whole personality. The goal of the therapy is for the patient to be able to change the rigid patterns set earlier in life, and prevent the pattern from repeating itself.