Friday, September 25, 2009

What is Borderline Personality Disorder

One of my favorite critics told me that the post below isn't clear, that people don't realize how hard it is to have this disorder, and how hard it is, sometimes, maybe even most of the time, to live with someone who has the disorder.

Rather than go through the DSM checklist (I think it's in a post in a link at the end of yesterday's post) let me quote Randi Kreger. She defines Borderline Personality Disorder as follows in her book, The Essential Family Guide to Borderline Personality Disorder (italics are mine):
Borderline Personality Disorder is a serious mental illness that causes those who have it to see people and situations as all good or all bad; to feel empty and without an identity; and to have extreme, blink-of-an-eye mood swings. People with BPD act impulsively; their self-loathing and extreme fear of abandonment can cause them to lash out at others with baseless criticism and blame. Some practice self-harm or see no other option than suicide as a way to end their pain.

People with BPD experience the world much differently than most people. For reasons we don't entirely understand, the disorder distorts critical thought processes, resulting in emotions and actions that are out of the norm.
There you go. Now maybe the post below will make more sense :)

Thanks for your opinion, MK.



Isle Dance said...

Well shared. Perfectly said. Thanks so much.

Harriet said...

Interesting - can one be a little bit borderline personality disordered, or is it like being pregnant, you either are or you're not.

therapydoc said...

I like to say, we have features. And if we're aware of them we can work on them.

rabbi neil fleischmann said...

This post, like the one that preceded it, was quite meaningful for me. I have one friend who has the diagnosis and has neen through group and one on one therapy and and and. It's not easy. I have several other friends that I think fit this bill (and a friend that hinted that his/her spouse is borderline).

Wishing you and yours a meaningfulful and good fast and year.

Leslie said...

Thank you for this succinct explanation of BPD. I have a friend with a daughter just diagnosed, and also know someone in a 12 step program just diagnosed. This quote is much clearer than some of the explanations I've found via googling.

Finding that the 2 folks I mentioned above received this diagnosis explains a lot of what I've observed and wondered about in them for years.

I found this blog from Friend of the Bear giving you an "Honest Scrapper" award. Congratulations on the award. Your blog looks interesting. I'll be checking it out from time to time. Thanks!

Dr. Deb said...

I never have trouble diagnosing BPD. Probably bc I grew up with a parent who had it.

Anonymous said...

Are you going to talk about Mackenzie Phillips book and announcement? I hear all this and see the backlash of her family and media's response.
Over 30 years ago my brother raped me and my family basically ignored it and dismissed it as "drugs and alcoholism" had caused it and in some ways blamed me with indirect comments.
My story isn't hers . . . but its out there and it stirs it all up. Not that I still don't have night mares and flash backs.

therapydoc said...

Thanks Leslie, and Dr. Deb. I don't think it's possible to grow up without something.

And yes, I'll get to the Mama's and the Pappa's. Maybe. I can tell you right now, incest is taboo-- internationally. It'll be hard to hum California Dreaming now.

jumpinginpuddles said...

id also like to say that there is a fine line between BPD and D.I.D and often one is given only to find many session later D.I.D is the actual diagnosis

Anonymous said...

Randi Kreger also has discussed what she sees as two kinds of Borderline Personality Disorder, one that would easily be recognized as illness because the afflicted people resort to cutting and other self-destructive behaviors, are unable to hold a job, etc., and another version in which people are people are high functioning in the sense that they hold jobs, often very responsible positions and their illness manifests almost exclusively in ways that are seen by family but not much by others. This latter version, according to Randi Kreger, is much more problematic for family because others, including mental health personnel, don't recognize or even see the problems. Perhaps that's what you mean by someone with borderline traits or features. I think it would be pretty destructive, even without the most extreme behaviors, if it were limited to inappropriately expressed anger, and other impulsive acts like overspending or possibly binge-eating. I guess I can see why a therapist may want to avoid labels but seems like it can be helpful for people to know what they are dealing with, at least for other family members. What would it be like if someone had cancer but no one was willing to say that's the illness a person had, only treating the symptoms but never letting the individual or the family know.

therapydoc said...

I don't find anyone with BPD easy, no matter the category. And you're right, it's much easier for everyone if the goals of treatment are the same.

That said, I think that if you label people when they're not ready for a label, you won't see them for much longer. They may not be able to handle the shame of the diagnosis or the stigma.

And believe it or not, that can be a healthy thing, avoiding shame and stigma. The therapeutic directive is to work with a person whereever- whoever- he or she is, not to impose what we want, insist that someone "accept" reality.

I would much rather a person become acceptable, edge forward toward positive change, than have to own a diagnosis that feels reprehensible and increases self-loathing.

Dreaming again said...

"That said, I think that if you label people when they're not ready for a label, you won't see them for much longer. They may not be able to handle the shame of the diagnosis or the stigma."

So true. I went to 3 psychologists at my neurologists request to help me deal with chronic illness and having 2 kids with OCD/TS (amoung other dx's)

The first told me:
"It's not your health that is the issue, or having children with disabilities. You have an eating disorder that is at the crux of your stress. We deal with that first"

I got angry and left. I did NOT have an ED (yes, I did but I hadn't told anyone and how dare he?)

Second saw me 2 times before she began telling me I had an ED, third one told me he was referring out to an ED clinic because he didn't deal with eating disorders.

I was livid and not ready to even attempt to get help. 2 years later, my PCP gently took my hands in his and with teary eyes said that he couldn't watch me destroy myself any longer. I either got help, or I'd need to find a new PCP. I could accept it from him. (but I fully believed I'd go to the evaluation and be sent on my merry way ..instead got a regular appt with therapist, nutritionist and psychiatrist)

therapydoc said...

Thanks for that.

Jew Wishes said...

Thank you for all of your posts, all of the information, insight and inspiration you give to others. I know from reading your blog, that you have helped many, in ways you probably are not aware of (or maybe you are). It matters not...the point is that you have comforted and consoled, and helped humankind.

Chag Sameach!

Syd said...

Some days I think that I may be BPD.

therapydoc said...

No way, Syd, at least probably not. Everyone gets a symptom now and then of just about everything.

therapydoc said...

No way, Syd, at least probably not. Everyone gets a symptom now and then of just about everything.

Anonymous said...

Dear Doc..... this is off topic from your post, but I wonder if you can help.

My kids father is a real bully. He has a good heart, and he means well, but he pressures the kids into doing things that HE thinks they should be doing... such as teasing my 16 year old son that he should be dating (when my son is nowhere near ready to start dating). My son is a sensitive, kind-hearted, gentle soul. His father is a bull-in-a-china-shop.

How can I deal with this problem? I want to make my son feel good about himself, but it's pretty hard when the father is always on his back, and the father has absolutely no idea that words of abuse hurt and destroy.

Any tips?
I've spent the entire day crying, worrying what to do....

thanks Doc, I'd really appreciate any help you can offer me.


therapydoc said...

I don't give direct advice but read the stuff on assertiveness vs aggression and passivity.