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Borderline Personality Disorder: Chaos, Confusion And Hope
More women than men suffer from Borderline Personality Disorder, an alienating, bewildering condition. Learn the symptoms and how you can help yourself or a loved one.
by Java Solis
May 1, 2006
A pproximately 6 million people in North America suffer from Borderline Personality Disorder (BPD), of which 4.5 million are estimated to be women. Yet this pervasive mental illness which is often diagnosed in high functioning people and impacts family members, partners, friends and coworkers, has garnered little public attention. Improved treatment options and a new awareness within the healthcare community are bringing hope to both those who suffer from the disease and those who know and love them.
What is BPD?
People with BPD feel the same emotions as others, however
their feelings, reactions and perceptions are experienced to the extreme. Their illness stems
primarily from an inability to regulate emotion. “People with BPD have very rapid and intense
emotional reactions and difficulty calming down once emotions have been stirred,” explains Katrina
Davino, PhD, an Atlanta-area therapist who specializes in treating patients with BPD. “People with
BPD often are successful in careers and school, but under emotional stress, particularly stress
related to conflict in intimate friendship or family relationships, they find that their coping
abilities are inadequate.”
Those with BPD live within a world of incredible devastation, many surviving horrific pasts that may include sexual, physical or emotional abuse. “In an attempt to cope with their pain, people with BPD tend to go to extremes,” says Dr. Davino. Self-injurious behaviors, including cutting and burning, are a hallmark of the disorder. Sufferers may also make suicide attempts and suffer from depression and overwhelming fears of abandonment.
People with BPD tend to think in terms of ‘all black or all white’, causing chaos in their interpersonal relationships as they alternately deem those around them as deplorable or in a state of grace. Their interpretation of events and other's actions often leaves them feeling victimized and thus justified to follow any response to soothe their perceived hurt. Other traits common to people with BPD include unstable self-perceptions, undefined boundaries, control issues, aptitude for reading others’ social and nonverbal cues, ability to regulate themselves in some social contexts (e.g., at work) and continual self-involved demands.
To others, high functioning individuals with BPD may not look or sound like they have a mental disorder, leaving their loved ones, who witness the disease and suffer many of the consequences, to wonder how someone so charming, intelligent and accomplished can act so irrational and hurtful at home. Those in relationships with someone with BPD (including friends, relatives, partners and spouses), often called “nons”, frequently describe their relationship as “walking on eggshells.” In an attempt to calm the chaos, nons may keep thoughts, feelings, and opinions to themselves, ultimately finding no room for their authentic self in their relationship. Many nons report that their actions and comments are misinterpreted and used against them, that the relationship expectations constantly change and that it is difficult to plan events due to the loved one's unpredictable behaviors and moods. When nons try to leave the relationship, the loved one with BPD often goes to extreme measures to keep the relationship intact, resulting in a continual and chaotic push-pull.
Women And BPD
“Approximately 80 percent of my patients with BPD are women,” reports Dr. Davino. The reason for the disproportion has not been identified. “Factors as diverse as biological predisposition and gender bias on the part of the professional may play a part. The factor that I tend to consider most important is how we are socialized differently as girls and boys.” While girls are more likely to be taught to be emotional or ‘needy’ to cope with unmet needs, boys are more like to be taught to push people away and externalize their anger. “If these patterns continue in to adulthood, the girls would be more likely diagnosed with BPD while the boys might be diagnosed with Narcissistic or Antisocial personality disorder,” says Dr. Davino.
Treating BPD
In the past, options for treating BPD were limited and many mental healthcare professionals viewed those with BPD as difficult to treat and slow to improve, if at all. Most treatment protocols included a combination of intensive therapy and medication. Dialectical Behavior Therapy (DBT), developed by Marsha Linehan, PhD is a comprehensive program for people with BPD and offers something other treatments have lacked -- hope.
“There is help for families and loved ones of people with BPD,” says Minal Shah, MS, NCC, LPC, clinical director of the Atlanta DBT Center, one of the few certified DBT clinics in the Southeast. “Therapists trained in DBT are able to balance complete acceptance of the patient as they are, with the ability to help the patient recognize and implement change to become who they want to be and to build the life that they want,” explains Shah.
Identifying that your loved one suffers from BPD may bring a new understanding to your relationship, provide much needed insight into hurtful behaviors and pave the way for a positive relationship. A relationship with someone with BPD requires a commitment to taking care of your needs. This may include looking outside of the relationship for ways to meet your needs, understanding that the actions of your loved one are not about you, finding support and validation, vigilantly ensuring you are living your own life, exploring which of your needs the relationship meets, developing healthy coping skills and boundaries, knowing your limits and believing in your own self worth.
BPD can be devastating, but it can also be treated. Both for people with BPD and their loved ones, it is important to know there is help, there is hope.
Local Resources
• TARA Association for Personality Disorder, Atlanta Chapter, 404.403.6894, dbtsarah@yahoo.com
• Atlanta DBT Center, www.atlantadbt.com, 770.833.0227, atlantadbt@hotmail.com
• Katrina Davino, PhD, In private practice in Midtown, 404.668.9893
Other Resources
• BPD Central – www.BPDCentral.com
• Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder by Paul T. Mason, MS and Randi Kreger
• Love and Loathing: Protecting Your Mental Health and Legal Rights When Your Partner Has Borderline Personality Disorder by Kim Williams-Justesen and Randi Kreger
• Understanding the Borderline Mother: Helping Her Children Transcend the Intense, Unpredictable and Volatile Relationship by Christine Lawson
• The Angry Heart: A Self-Help Guide for Borderline and Addictive Personality Disorder by Joseph Santoro and Ronald Jay Cohen
• Skills Training Manual for Treating Borderline Personality Disorder by Marsha M Linehan
