I have already published many articles about the link between the experience of significant childhood trauma and the later development of borderline personality disorder (BPD) – click here to read one such article.
If we are unfortunate enough to develop BPD following a traumatic childhood, in some cases (NOT all) we may, especially during periods of acute stress, be prone to what psychologists and psychiatrists refer to as brief psychotic episodes.
Such brief psychotic episodes can entail experiencing, for periods of short duration, symptoms such as paranoid delusions and hallucinations. However, these are likely to be of relatively minor intensity compared to how they might be experienced by someone suffering from acute schizophrenia.
The above diagram shows that psychosis can involve not only hallucinations and delusions, but, also : poor self care, disjointed thoughts, agitation, pacing, and unusual mood changes.
Let’s look at the symptoms of paranoid delusions and hallucinations in a little more detail:
Paranoid delusions – these may involve suspecting one’s friends or associates are plotting against one when this is not the case and there is no evidence that it’s the case. It might also involve ‘reading threats into’ what others say to one when no such threats exist.
Paranoid delusions of a severe nature may involve imagining threats which clearly have no grounding in reality at all, such as believing there is a world plot, coordinated at the highest levels of power, being constructed against one. However, as I alluded to earlier, such extreme delusions are NOT usually experienced by those suffering from BPD.
Hallucinations – these involve the imagined perception of stimuli which, in reality, do not actually exist. These may include:
1) Imagining one can hear ‘voices’ – these are referred to as ‘auditory hallucinations’
2) Imagining one can see things which are not actually there – these are referred to as ‘visual hallucinations’
3) Imagining one can feel by touch something which is not there (eg one may imagine one can feel a hand on one’s shoulder) – these are referred to as ‘tactile hallucinations’
4) Imagining a taste in one’s mouth – imagining one can taste something when there is no corresponding stimulus is known as a ‘gustatory hallucination’
5) Imagining a smell – smelling something which is not there is known as an ‘olfactory hallucination’
6) Imagining a significant change in temperature
Whilst all of these hallucinations are figments of the mind the important point is that they can feel very real to the person who is suffering from them.
If the person who has the experience of hallucinations such as these is aware that the sounds, visions etc are not real but are being generated from his/her own mind then experts to not consider them to be suffering from full-blown psychosis. These kind of experiences are only classified as psychotic if the person is adamant that they are real. As stated already, psychosis of this nature, involving a complete departure from reality, is rare in those with BPD.
If a person with BPD is suffering from hallucinations which cause distress, a psychiatrist may prescribe a period of time on antipsychotic medication, until the symptoms are under control. Such medication should never be self-prescribed and only taken on the advice of a properly qualified expert.
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David Hosier BSc Hons; MSc; PGDE(FAHE).