With Love, BPD
Borderline Personality Disorder (BPD) is a pervasive pattern of instability of interpersonal relationships, self-image, affects, and marked impulsivity. Individuals with BPD make frenzied efforts to avoid real, or imagined abandonment. Their perception of impending separation, or rejection can lead to dramatic changes in the perception of self, affect, cognition and behavior. This being said, diagnosed individuals are very sensitive to environmental circumstances, and have a pattern of unstable and intense relationships. These intense relationships can be chaotic and complex, but can be especially so in romantic relationships.
The DSM-V describes features of the disorder, claiming individuals may “idealize potential caregivers or lovers at the first or second meeting, demand to spend a lot of time together, and share the most intimate details early in a relationship. However, they may switch quickly from idealizing other people to devaluing them, feeling that the other person does not care enough, does not give enough, or is not ‘there’ enough.” This becomes detrimental, however, as individuals can empathize with and nurture other people, but only with the expectation that the other person will “be there” in return to meet their own needs on demand. The DSM goes on to state that these individuals are prone to sudden and dramatic shifts in their view of others, who may alternatively be seen as beneficial supports or as cruelly punitive. These shifts are commonly “disillusioned with a caregiver, or another individual whose nurturing qualities had been idealized or whose rejection or abandonment is expected.”
Dr. Barbara Greenberg, a clinical psychologist who treats patients with Borderline Personality Disorder explains that people with BPD “feel empty, and are always trying to fight off what they perceive as rejection and abandonment, so they see rejection and abandonment where it doesn’t necessarily exist.” Often, this is the result of early childhood trauma, due to lacking healthy, and secure attachments. This overwhelming fear can deeply disrupt their relationships later on in life, and can result in pushing partners away rather than pulling them closer.
“When they are in relationships they get very intensely involved way too quickly. [People] tend to really like [people with BPD] at first, because they are very intense, and very passionate. But then what comes along with it, a couple of weeks later, is: “Why didn’t you call me back immediately?” “Are you out with somebody else?” So [people with BPD] get attached very quickly, give [the relationship] their all, but then get disappointed very quickly. They start out thinking, “I love this guy, he’s the greatest,” but if he does a minor thing that disappoints them, they get deeply disturbed. Everything is done with passion, but it goes from being very happy and passionate to very disappointed and rageful.”
Those with BPD will have symptoms that include frequent fluctuations between sudden withdrawal, and strong clinginess and dependency. In addition, some symptoms of the disorder, including suicidal gestures and extremely impulsive behaviors, can create fear and tension between romantic partners, and establish additional stress in the relationship.
Research on romantic BPD relationships confirms the difficulty of maintaining a healthy relationship. One study demonstrated that women with BPD symptoms report higher levels of chronic relationship stress and frequent conflicts with their partner, resulting in partners reporting less satisfaction in the relationship, the more severe a person’s BPD symptoms are. One woman with BPD explained her actions in a romantic relationship, “I’ll be the first to step up to the confessional and admit that what I do is irrational,” she says. “It’s funny that my non-borderline partners think I am attacking them because I feel the same way. Most of my actions are done in self-defense to protect myself from some perceived threat. Here are several behaviors I have displayed in romantic relationships and the reasoning behind them.” The individual then goes on to describe instances in her romantic relationships that were the result of BPD, as she looks back and tries to analyze the root of the action.
She discusses where she purposely broke a gift given to her by her partner. With Valentine’s day having just past, we can imagine the pain this would cause to either party as they try to maintain control of their feelings, but also take their significant other’s feelings into account. She also goes on to discuss how BPD comes with emotional “Dr. Jekyll and Mr. Hyde” type symptoms:
“I did this because sometimes I get filled with rage that is hard to control. You may have hurt my feelings, and when I’m upset I get destructive. Weird as it sounds, destroying things you have given me hurts my feelings too. I may have felt a strong sense of self-hatred and may have wanted to inflict some emotional pain on myself too. At times people with borderline personality disorder can become masochistic due to repetition compulsion, a desire to repeat previous experiences of emotional pain in hopes they can be resolved on a conscious level…I have rapid mood swings, and with them come sudden and unpredictable personality changes. Often I experience emotional amnesia and my perspective on life oscillates with my constant mood swings. I need some more therapy, so there is little you can do about this right now beyond offering me a little validation.”
She goes on to discuss suicide; specifically, talking about suicide with her partner even though she knew it would hurt them. Seventy percent of individuals living with Borderline Personality Disorder attempt suicide, and ten percent of those with the diagnosis complete suicide. This makes the suicide rate is several times higher than that of any other mental illness:
“I have so much angst and depression that sometimes it seems like the only option. It’s nothing personal, and most things you’ll try do to cheer me up simply won’t work. I often cannot comprehend the profound impact my actions will have upon those around me. I may even feel like my death will be a relief to you so you will no longer need to deal with my disorder. Guilt, intense self loathing, emptiness and chronic inability to experience pleasure often cause my prolonged thoughts of suicide.”
Treatment is available to those diagnosed with BPD, and has shown results when looking at individuals in romantic relationships. It is largely a misconception that relationships with those who suffer from BPD are doomed to fail. While uniquely challenging, there are ways to reduce symptoms dramatically. The most important thing to remember is that with the proper treatment, individuals with BPD can learn to manage their symptoms, and establish inner tranquility. Along with individualized therapy, couples therapy is often an essential part of healing as both individuals and as a team. Dialectic behavior therapy (DBT), a cognitive-behavioral approach, stresses the psychosocial aspects of treatment- looking at the individual’s arousal (reactions) in emotional situations and how they increase dramatically quicker, and take much longer to return to an emotional homeostatic state than those without the disorder. DBT along with other clinical and holistic therapies have allowed a substantial number of individuals to achieve remission to a point where afterwards they no longer meet the diagnostic criteria for Borderline Personality Disorder. Dr. Greenberg says, “I’ve seen a lot of [people with BPD] get so much better, I love working with borderlines. Because their emotion is all there, and acting that way is all they know, and then when you show them an easier way to be, and to act, they see how much easier life can be. Absolutely. There’s hope.”
References
BPD Symptoms: Suicidal Behaviors. (2016, November 02). Retrieved from https://www.clearviewwomenscenter.com/borderline-personality-disorder-symptoms-suicide.html
Diagnostic and statistical manual of mental disorders: DSM-5. (2013). Washington, D.C.: American Psychiatric Association.
Grohol, J. (2016, July 17). An Overview of Dialectical Behavior Therapy. Retrieved from https://psychcentral.com/lib/an-overview-of-dialectical-behavior-therapy/
Hill, J., Stepp, S. D., Wan, M. W., Hope, H., Morse, J. Q., Steele, M., . . . Pilkonis, P. A. (2011). Attachment, Borderline Personality, and Romantic Relationship Dysfunction. Journal of Personality Disorders,25(6), 789–805. doi:10.1521/pedi.2011.25.6.789
It’s Nothing Personal: A Woman With BPD Explains Her Actions in Romantic Relationships. (n.d.). Retrieved February 11, 2017, from https://www.bpdcentral.com/help-for-families/bpd-articles/?It-s-Nothing-Personal-A-Woman-With-BPD-Explains-Her-Actions-in-Romantic-Relationships-1
Salters-Pedneault, K., Dr. (2016, November 17). Understanding Romantic BPD Relationships. Retrieved from https://www.verywell.com/understanding-romantic-bpd-relationships-425217
What You Need to Know When Dating Someone With Borderline Personality Disorder. (2016, November 22). Retrieved from https://www.bridgestorecovery.com/blog/what-you-need-to-know-when-dating-someone-with-borderline-personality-disorder/
