Understanding and Treating Borderline Personality Disorder
By Gina Cipriano
Sometimes, people have a way of relating to others that seems to continue to cause harmful patterns to reappear in their lives. Everyone has a personality style; however, when that style starts to cause considerable harm, it may indicate that a person meets criteria for a personality disorder. One such personality disorder is borderline personality disorder (BPD). The American Psychiatric Association’s (APA, 2013) Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) outlines some of the following symptoms of borderline personality disorder:
• A person with BPD may intensely fear being abandoned. This can result in a person emotionally reacting to any perceptions of with intense anger and panic.• A person with BPD may vacillate between idealizing then devaluing relationships within their life.• A person with BPD may alter their identity often • A person with BPD may have difficulties managing impulses which can result in substance use, alcohol use, eating disorder pathology, and other self-harmful behaviors• A person with BPD may feel their mood shifts frequently and easily based on their environment • A person with BPD may experience dissociative symptoms which may entail having a detached feeling from themselves that they cannot quite explain
People with BPD who did not understand their symptoms may feel validated to learn that there are potential explanations for why these symptoms start to occur. One such theory is that a person with BPD had increased emotional sensitivity as a child and grew up in an environment that was invalidating (Choi-Kain et al., 2017). Also, it is encouraging to know that borderline personality disorder is treatable!
Dialectical Behavioral Therapy (DBT) was created specifically to treat BPD and assists people in recognizing that two things can be true at the same time. For instance, it can help someone think, “I can be disappointed at my partner and understand their viewpoints.” For someone with BPD, this can assist them in better regulating their emotions and making sense of a situation. DBT also assists people with BPD manage intense emotions through distress tolerance skills (Choi-Kain et al., 2017). Distress tolerance skills help someone who has BPD better regulate their emotions. One distress tolerance skill can include radically accepting a situation for what it is. Another examples of a distress tolerance skill can include self-soothing through utilizing the five senses.
Further, DBT assists people in understanding how their reason mind (logical mind) and emotion mind (emotional mind) influence their thoughts and behaviors (Gelder, 2010). DBT assists people in utilizing their wise mind, which is the interaction of the reason and emotion mind, so people can behave in a way that honors both their emotions and intellect (Gelder, 2010).
References American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders(5th ed.). https://doi.org/10.1176/appi.books.9780890425787Choi-Kain, L. W., Finch, E. F., Masland, S. R., Jenkins, J. A., & Unruh, B. T. (2017). What works in the treatment of borderline personality disorder. Current behavioral neuroscience reports, 4(1), 21-30.Gelder, K. V. (2010). The Buddha and the borderline: My recovery from borderline personality disorder through dialectical behavior therapy, Buddhism, and. New Harbinger Publications.
