Topic: Borderline Personality Disorders
Question: I was previously diagnosed with borderline personality disorder when I was in college. I don't want to share with anyone my past but I am starting to have major problems in my current relationship. What should I do?
Michelle's Take: Borderline Personality Disorder (BPD) is less talked about then bi-polar personality disorder but effects twice as many people. Close to 10 million Americans suffer from BPD with woman over three times as likely to be diagnosed as men.
Key components of the disorder include: unstable relationships (partners are originally seen as perfect but later are deemed worthless), reactive behaviors (outbursts and verbal tirades are common), impulsive behaviors (ex: sex, spending, binge eating, substance use), fear of being alone (hence the title of an older book on BPD entitled I Hate You, Don't Leave Me), feelings of emptiness/depression and no sense of self.
I frequently see couples enter counseling for relational problems and it soon becomes apparent that one has BPD. Unfortunately, the client with BPD frequently chooses to put the focus of the counseling on their partner who they see as the source of all their problems. The client with BPD feels like the victim and has learned how to distort reality to paint themselves in an positive light while demonizing their partner. This can apply to other categories as well. Think: boss vs employee or parent vs child. The pattern of polarized thinking, people are either good or bad, is a hallmark of borderline thinking.
BPD causes strong defense mechanisms. A single word or phrase can trigger a hostile response that is not proportionate to the offense. Individuals interacting with someone suffering from BPD feel like they have to walk on eggshells. This is because the person suffering from BPD has never learned coping mechanisms to help them detach and not take things personally.
That said, I have seen amazing success when working with clients who have BPD. This requires a very nurturing therapeutic relationship and a counselor who is comfortable and knowledgeable of BPD. The client must feel safe and the counselor must find the delicate balance between validating the client and challenging their distorted thinking that is causing harm.
Some professionals believe that BPD is not curable. I disagree. Clients suffering BPD are not the disorder. It will take time and work to shed the borderline traits. And it will require finding someone safe to let down defenses with. But when safe, nurtured and appropriately challenged, a client with BPD can replace old patterns with new healthier ones. Two great self help books on the topic include: Stop Walking on Eggshells by Mason and Kreger and Overcoming Borderline Personality Disorder by Valerie Porr.
