Borderline Personality Disorder

 

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The fact that the Borderline personality disorder is often found among women makes it a controversial mental health diagnosis. Some scholars say that it is a culture-bound pseudo-syndrome invented by men to serve a patriarchal and misogynistic society. Others point to the fact the lives of patients diagnosed with the disorder are chaotic and that the relationships they form are stormy, short-lived, and unstable. Moreover, not unlike compensatory narcissists, people with the Borderline Personality Disorder often display labile (wildly fluctuating) sense of self-worth, self-image and affect (expressed emotions).

Like both narcissists and psychopaths, borderlines are impulsive and reckless. Like histrionics, their sexual conduct is promiscuous, driven, and unsafe. Many borderlines binge eat, gamble, drive, and shop carelessly, and are substance abusers. Lack of impulse control is joined with self-destructive and self-defeating behaviors, such as suicidal ideation, suicide attempts, gestures, or threats, and self-mutilation or self-injury.

The main dynamic in the Borderline Personality Disorder is abandonment anxiety. Like codependents, borderlines attempt to preempt or prevent abandonment (both real and imagined) by their nearest and dearest. They cling frantically and counterproductively to their partners, mates, spouses, friends, children, or even neighbors. This fierce attachment is coupled with idealization and then swift and merciless devaluation of the borderline's target.

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Exactly like the narcissist, the borderline patient elicits constant narcissistic supply (attention, affirmation, adulation, approval) to regulate her gyrating sense of self-worth and her chaotic self-image, to shore up serious, marked, persistent, and ubiquitous deficits in self-esteem and Ego functions, and to counter the gnawing emptiness at her core.

The Borderline Personality Disorder is often co-diagnosed (is comorbid) with mood and affect disorders. But all borderlines suffer from mood reactivity.

From an entry I wrote for the Open Site Encyclopedia:

"(Borderlines) shift dizzyingly between dysphoria (sadness or depression) and euphoria, manic self-confidence and paralyzing anxiety, irritability and indifference. This is reminiscent of the mood swings of Bipolar Disorder patients. But Borderlines are much angrier and more violent. They usually get into physical fights, throw temper tantrums, and have frightening rage attacks.

When stressed, many Borderlines become psychotic, though only briefly (psychotic micro-episodes), or develop transient paranoid ideation and ideas of reference (the erroneous conviction that one is the focus of derision and malicious gossip). Dissociative symptoms are not uncommon ("losing" stretches of time, or objects, and forgetting events or facts with emotional content)."

Hence the term "borderline" (first coined by Otto F. Kernberg). The Borderline Personality Disorder is on the thin (border) line separating neurosis from psychosis.

Read Notes from the therapy of a Borderline Patient

The Three Voices: Histrionic, Psychopathic, Borderline

Borderline Personality Disorder (BPD) is often diagnosed together (comorbid) with other personality disorders: histrionic, narcissistic, and antisocial (psychopathy). The majority of persons diagnosed with these comorbidities of personality disorders are women.

Borderline Personality Disorder is a post-traumatic state which is repeatedly triggered by neglect, abandonment, withholding of sex and intimacy, verbal and psychological abuse and by life’s circumstances, dangers and chaos.

When Borderline PD is comorbid with Histrionic PD, such women react by seeking comfort, acceptance, validation, sex, and intimacy from other men.

But the comorbidity creates conflicting inner voices:

Histrionic: Men will make you feel better, restore your self-esteem.   

Antisocial: Don't feel guilty about cheating and being a "whore". It is fun, you deserve it, it is not your fault, no one gets hurt if you keep it a secret - so go for it.

Borderline: Your Sexuality is bad, mad, and dangerous. Don't take it too far or it will end calamitously.

When such a woman experiences a narcissistic crisis or injury – when she is hurt, humiliated, or frustrated and when her femininity is doubted or challenged - her histrionic side forces her to reach out to men to make her feel better by ameliorating her frustration. Flings with men restore her self-esteem and self-confidence and regulate her labile sense of self-worth. She contacts men with the intention of having intimacy and sex with them.

Her antisocial (psychopathic) voice legitimizes her histrionic behavior: "Don't feel guilty about cheating and being a 'whore'. It is fun, you deserve it, it is not your fault, no one gets hurt if you keep it a secret - so go for it."

Her borderline aspect feels stressed and panics. When she is faced with a man's expectation to have sex and with her own sexual desire, she freaks out. Sex is perceived as traumatic: it is associated with pain and hurt, a kind of punishment. The following negative thoughts prevail:

(a) Sex is "dirty";

(b) Men are evil, dangerous, one-track minded (they want only sex and then they will discard you);

(c) Sex inevitably results in pain and hurt;

(d) You should feel guilty about cheating;

(e) You should feel ashamed for being so "whorish".

So, when faced with the prospect of sex, borderline patients panic because of these negative thoughts. The panic leads to depersonalization ("splitting" from oneself in a paralyzing trance, going “auto-pilot”, or lapsing into a dream-like state).

If such a woman crosses the line and has full-fledged sex, she experiences dissociation: she forgets sexual acts that conflict with her values and boundaries, especially if she finds them enjoyable.


Many additional Frequently Asked Questions (FAQs) about Personality Disorders - click HERE!


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