Borderline Personality Disorder is one of the most difficult personality disorders to diagnosis and treat. BPD is a bio/social disease that arises when a sensitive person is placed in a non-validating environment. The person can begin to feel that what he or she perceives or fee is wrong or not real because others in the environment tell him or her so. This can lead to serious problems.
Characteristics of the Disorder
BPD as a disorder is characterized by some very specific behaviors. Usually the person has a terrible fear of abandonment and will do anything to prevent that whether it is real or imagined. A sufferer has an unstable self image, and often acts impulsively in self damaging areas. There is intense episodic depression, irritability or anxiety as well as intense anger. Often the person will make recurring suicide attempts, develop dissociative symptoms and will engage in acts of self mutilation. Many who suffer from BPD report lacking a sense of self and having chronic feelings of emptiness.
These symptoms manifest themselves in a variety of ways. Borderline Personality Disordered folks can be very manipulative, especially if they perceive being abandoned. They can also be extremely self-destructive, engaging in acts like substance abuse, cutting, impulse buying and random sex. Many experts, including psychiatrists and psychologists have found that those who suffer from the illness can be some of the most difficult patients to work with. They are generally inconsistent in their response to treatment, often failing to show up, take meds and be honest with their caregivers. In addition Borderlines have a high rate of suicide ideation and attempt. Although only ten percent of Borderline sufferers are successful in this attempt, this can make them a very draining population to treat.
Treatment Options
Yet, this illness can be treated. In recent years many behavioral treatments have developed that help borderlines understand and correct the behaviors and the distorted thinking that leads them to make poor choices. One treatment especially has been seen to be radically successful with Borderlines. The treatment, Dialectical Behavioral Therapy, developed by a psychologist Marsha Linehan involves making behavior changes, despite being in the grips of the illness. It requires that the people hold in tension their borderline behaviors with possible changes to those behaviors through a set of skills. These skills are designed to make people more aware of how and what they communicate. The skills require that the patients become mindful of each action in their life and that they hit a pause button before acting. The skills include challenging distorted thinking, benign interpretation and mediation.
Using these skills allows people with Borderline Personality Disorder to stop for a moment and ask if the impulse they feel to act in a specific way is going to make a situation worse. The clients are thus required to pay attention to the details of their lives, avoid maladaptive behavior, and act opposite to their initial impulses. In addition to the skills, one on one and group therapy as well as medication is used to help in the process.
Linehan claims a high rate of success with this method of treatment, suggesting that there is less reoccurrence of bad behaviors, lowered suicidal ideation and attempts, as well as lowered amounts of hospitalizations for those who suffer from the illness.