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.
As partners will often agree, relationships with any personality disorder type are a challenge, but in the case of borderline personality disorder relationships are even more of a roller coaster. And, as we know, one does not have to have a formal personality disorder diagnoses to have the traits of one and bring those into their relationships—either with intimate partners, friends, work, or other kinds of social situations. Borderline personality disorder (BPD) can put a strain on any relationship, which makes the disorder even more important to understand if we are faced with a partner that poses with its traits.
A corporate executive that spent half of her life chasing her career, getting one promotion after the other and moving up the corporate ladder, only to find out—usually in her thirties—that she in fact never achieved what she wanted, whilst her life is slipping by. She wakes up anxious, not knowing what she is doing, where she is going and slightly doubting that she knows what she wants to achieve. She cannot take pleasure in fruits of her hard work although she can afford to. She sees younger generation as competition and starts wondering how long she can keep this up. And what then? When? She can no longer relate to the little girl that sat on her daddy’s shoulders, pulling his hair as they walked through the zoo.
Narcissism by nature of the personality structure manifestation makes it hard for a narcissist to engage in authentic and intimate relationships. People who engage in a relationship with a narcissist will often be subject to the lack of connection, empathy and intimacy. They may find themselves under fire of allegations that they are too controlling and smothering. Even though these accusations will be part of narcissist’s distorted reality, there will often also be some pathology related to why someone gets involved with a narcissist in the first place. Usually such pathology will be unconscious.
Avoiding conflict is one of the most prevalent issues I see my clients presenting in therapy room—regardless of whether I see them in NHS or privately. It is usually not the main issue they come in with, however, it does in one way or another often boil down to it. Whether they come in for anxiety, burnout, low self-esteem, or problems with relationship. Even narcissism—sometimes even more so than other disorders—can manifest itself in significant avoidance of conflict. But contrary to the fact that some pride themselves with the fact that they are not confrontational, this is hardly a good thing and is often symptomatic of disruptions in the sense of self-worth.
Psychotherapy still often remains a taboo and a topic that is insufficiently discussed. Many often wonder who needs psychotherapy, what it is and what the criteria for it are. Nonetheless, there is still a lot of reluctance to speak about it openly.
It is usually assumed that someone needs psychotherapy only when mental health issues get to the point of severe disturbance in their life. So, when does one need psychotherapy and in what cases?