PSYCH66 - Borderline Personality Disorder

Borderline Personality Disorder definition

pervasive pattern of instability in interpersonal relationships, self-image, and affects (emotions/expression of emotion)

General characteristics of BPD

• significant impulsivity

• everything is ALL or NOTHING

• need to be with others, can’t be alone

• hate themselves

• lots of power struggle

• frantic attempts to avoid abandonment

• 75% diagnosed are female

• struggle with substance abuse + maintaining a job

• violent, complicated, abusive, stormy relationships

• use attempted suicide for manipulation

What is the biggest fear of people with BPD?

abandonment

they think that abandonment (even perceived abandonment) means they are bad

What is the Borderline tango?

1. Idealize another person - put them on a pedestal

2. share intimate details way too early

3. sudden shift in mood/view of person

4. Person is devalued, not ENOUGH, RAGE

What is the main characteristic of people with BPD?

Usually have a lot of stormy, romantic relationships and lots of romantic relationship jumping

they don’t understand:

• healthy boundaries

• manipulative

• deep self-hate

• very judgmental

• critical of others

Diagnostic criteria of BPD

5 or more of the following

• frantic effort to avoid real/imagine abandonment

• alternating between extremes of idealization to devaluation in relationships

• unstable self-image (always changing)

• impulsivity in at least two damaging areas (sex, drugs, money, etc.)

• recurrent suicidal behavior

• intense anxiety or irritability

• chronic feelings of emptiness

• difficulty controlling anger

• paranoid ideation or disassociation

Treatment of BPD

• no specific meds prescribed - usually just for targeting symptoms

• Transference-focused psychotherapy

• Dialectical Behavior Therapy (DBT)

Why are there no specific medications prescribed for those with BPD?

Because it can not change their personality

Focuses on targeting symptoms instead

Transference-focused psychotherapy

therapist takes a supportive posture and focuses largely on issues that occur within therapist-patient relationship

Dialectical Behavior Therapy (DBT)

Treatment of choice

• lots of therapy

• teaches coping skills - manage emotions + not act on impulse

• reduces impulsiveness

• focuses on a lot of eastern medicinal treatments