Borderline Personality Disorder (BPD)

Borderline personality disorder (BPD) is a developmental disorder of the self. It is characterised by extreme emotional reactions, impulsivity, difficulty of properly engaging in relationships and diminished sense of self. Individuals with borderline personality disorder have difficulties with their sense of self, their self-esteem and self-worth. Relationships are a measure of gaining their sense of self and that is why they put great importance onto others, which is why they may often come across as overly pleasing sometimes.

Characteristics and symptoms of borderline personality disorder (BPD)

Similar to other personality disorders, one does not need to meet all diagnostic criteria for a formal diagnosis in order to be considered borderline. There are many individuals that do not meet all criteria and are hence never diagnosed, but nonetheless have difficulties in life and relationships because of the borderline personality traits they have.

Borderline personality disorder (BPD) is predominantly characterised by the following characteristics. They are predominantly connected to the person’s behaviour, sense of self and how they perceive themselves in light of how others see them and act towards them.

Impulsivity of person’s behaviour

This can often include self-harming and self-damaging behaviour, such as reckless driving, impulsive and promiscuous sexual behaviour, sado-masochistic sex, gambling, drugs and alcohol consumption—often in the form of binging, eating disorders etc.

Intensive emotional reactions

Individuals with borderline personality disorder or borderline personality traits have difficulty managing their emotions. They will tend to get overwhelmed by their feelings and will also perceive reality by how they feel it, rather than what they think of it. This will usually be strongly related how they manage and engage in relationships.

Periods of anxiety and/or depression

These periods will usually signify abandonment depression caused by a rupture in their relationships. Because they identify themselves with the relationships they engage in, they will perceive the loss of other as loss of themselves—as though they are “all bad”. BPD individuals will hence also frantically look to avoid real or imagined abandonment. Because they often seek therapy at the time of distress—i.e. abandonment depression—this can often be misdiagnosed for generalised anxiety or “regular” depression or even bipolar.

Intense interpersonal relationships

Because of the importance and significance relationships play in the perception of the sense of self for a BPD individual, they will tend to be intense—predominantly because of fear of abandonment and the emotional pain that abandonment brings to them. Individuals with borderline personality disorder (BPD) traits will tend to please others in order for them not to reject them, however, they will expect the same from others. When they do not get the response they hoped for, they will usually act out by distancing and rejecting that person as “bad”.

The lack of sense of self

Because BPD individuals have poor sense of self, the main way of how they gain it is by engaging in relationships with others and through the eyes of others. They will hence think of themselves in whatever way they see others think of them or perceive how they think of them. This is why they will see themselves as “bad” when others reject them or just seemingly reject them.

It is not uncommon for them to feel a sense of void or even as sense that they actually do not even exist. Developmentally, they never managed to work through the symbiotic stage and this is what they are struggling with also today. Borderline personality disorder individuals will, therefore, tend to be pleasing towards others in order to preserve attachment and avoid the “bad feeling” of abandonment depression.

Borderline personality disorder in relationships

Because of the nature of borderline personality disorder and the importance of attachment to others, the disorder will impact and manifest itself on multiple levels when it comes to either intimate, platonic, work or business relationships.

The same will be true of their sexual relationships where they might engage in sado-masochistic behaviour. Sado-masochism may also come out in their other interpersonal interactions and not only during sexual activity. This is mainly by either provoking sadistic reactions in others or by themselves acting in a sadistic manner.

You can find more about how borderline personality disorder affects intimate and other relationships here: Borderline Personality Disorder and Relationships.

Borderline personality disorder from perspective of interpersonal and intra-psychic dynamics

Borderline individuals have a dynamic of clinging and distancing in their relationships. This is actually one of the most pervasive dynamics presented by individuals with borderline personality disorder traits. It is actually an interpersonal behaviour that has origin in intra-psychic dynamics. Because relationships and the acknowledgement they get from others is the essence of borderline’s sense of self, they will tend to be clinging in order to avoid abandonment.

They will enter symbiosis to get recognition and the sense of “goodness”. Once they get too close and the feelings of potential abandonment become too overwhelming, they will seek reassurance from their partners and look for potential signs of their partner’s distancing, which might be a bit smothering to the partner and in itself cause partner’s distancing.

Once they get too close, it might become uncomfortable for them—they will try to protect themselves from negative and painful feelings of abandonment and the only think they can do is by distancing themselves, which is when anger, hate, rage and other “nasty” parts of themselves come out.

Borderline personality disorder individuals will see the world in black and white, good or bad. There is no middle ground for them. “If you don’t like one thing about me, that means you don’t love me and that means I’m a bad person.”—is their way of rationalising. BPD individuals will have trouble seeing people as multi-layered individuals—as someone that can be a good person but make mistakes that might hurt at the same time.

Self-harm and suicidal behaviour often accompanies borderline personality disorder. When they are distancing or abandoned, they may perceive themselves as “all bad”. Self-harm gives them a sense of being, sense of materialisation and bodily form, it releases emotional overcharge and gives them a sense of recognition. This is where masochism and the need for control blend in. They will sometimes also use threats of self-harm and suicide as a desperate measure to control the other and avoid expected abandonment. Because in their childhood they were used to potentially abusive, violent, neglected behaviour of their parents, they will learn to equate love with such behaviour. This is why BPD individuals may take the masochistic position to feel recognised and loved.

Borderline personality disorder and psychotherapy

When dealing with borderline personality disorder in psychotherapy, it is important to understand that the way they engage into relationships will also come out in therapy room—acting out, rage, anger, clinging, distancing will also manifest themselves in relationship with the therapist. Because borderline personality disorder is a developmental impairment of the self that originates in the loss and disruption of early relationships and also manifests itself in current relationships, psychotherapy of BPD will only reach full potency when done in a relational manner.

Individuals with BPD traits will tend to act out their intra-psychic conflict in the relationship with the therapist. They might want to be a special client to the therapist and will want the therapist to go out of their way accommodating them. Because they are used to engaging in relationship by pleasing others, they will also expect the same from others.

Similarly they will assess the attachment they have to the therapist by how much the therapist is prepared to go out of their way for them. They might be putting strain on the therapeutic relationship by cancelling or postponing sessions at the last minute, by not paying for the sessions and asking for the rules of therapy to change all the time. If the therapist does not do what they want them to do, they will perceive the therapist as rejecting and bad.

Their main concern will be around controlling the therapist in order to not get abandoned or rejected. If this kind of manipulation does not work with the therapist, they may resort to more extreme measures, as are suicide threats or threats of self-harm or any other threats to the therapist—all in the attempt to gain control of the therapist. Sometimes the attachment to the therapist or perceived rejection from the therapist will not be at the core of this process, but rather their internal conflict between what they perceive as good or bad and their effort to maintain others’ view of them as good. If the therapist is successful in not falling for the manipulation, the therapist might become the bad object for the client, which will in turn result in anger and distancing.

Because this is the behaviour they learned throughout their developmental history and because it is actually the sign of their intra-psychic issues, it is important that such behaviour is subject to boundaries and addressed in order to be dealt with. Such ruptures are actually the sign of progress in therapy and can be used successfully in further treatment—provided the client does not leave therapy at such point.