There is a very strong link between the experience of severe and protracted childhood trauma and being diagnosed with borderline personality disorder (BPD) in later life. As we have seen in other articles I have published on this site, BPD is a very serious disorder that can lead to extreme difficulties in many important areas of our lives, not least our ability to function at work.
Some people with BPD may be so seriously affected by their condition that they are essentially too unwell to cope with work at all, others may be able to cope quite well and yet others will be somewhere in-between: just about managing to keep their heads above water but feeling perpetual, acute stress and constantly on the verge storming into our boss’s office and presenting him/her with a letter of resignation.
The reason some people are able to manage OK at work, or do well, despite their BPD whilst others can’t work at all and yet others lie somewhere in the middle of the spectrum is that the disorder affects individuals in a myriad of different ways and some jobs suit an individual’s particular type of borderline personality better than others. For example, someone with BPD who feels paranoid around authority is likely to do better in a job that involves little direct contact with the boss and someone with BPD who has severe difficulties with interpersonal relationships, in general, is likely to cope better in a job in which s/he is generally left to his/her own devices.
EXAMPLES OF SOME SPECIFIC SYMPTOMS OF BPD WHICH MAY SERIOUSLY UNDERMINE ABILITY TO FUNCTION AT WORK:
- The tendency to oscillate between idealization and devaluation: some people with BPD can fluctuate rapidly in terms of how they feel about other people, their circumstances etc., dramatically swinging, in the blink of an eye, from one polar opposite to the other. This is frequently referred to as ‘black and white’ thinking or ‘splitting’. In the workplace, this tendency may cause a variety of difficulties. For example, the person with BPD may initially be extremely excited about a new job, feeling that it’s the best thing that ever happened to him/her but, in a very short time, believing it to be the worst job ever and, in anger and disappointment, resigning (and possibly swearing at the boss for good measure thus irretrievably burning his/her bridges).
- The tendency to find interacting with authority figures problematic: many with BPD find interacting with authority figures highly stressful and may become preoccupied at work with the dread of the next interaction with such figures. Coupled with paranoid-like feelings and social anxiety, dealing with such stress can be extremely challenging. Also, the professional distance authority figures need to maintain when interacting with employees may be interpreted by the BPD sufferer as a sign of enmity.
- Addiction: Many people with BPD struggle with addiction which, of course, can cause enormous problems at work. Indeed, a BPD sufferer may turn to heavy drinking to try to cope with the stress of work only to compound the problem (e.g. going to work with a bad hangover, taking days off work or even resorting to drinking at work leading to dismissal).
- The tendency to perceive rejection when, objectively speaking, and by reasonable standards, there is no reason to do so: people with BPD are often hypersensitive to signs of rejection, whether real or imagined. (This is frequently linked to the perception of having been abandoned as a child’ by a primary carer.) Repeatedly feeling rejected may deepen feelings of depression, inadequacy and hopelessness or may result in inappropriate anger, rage and aggression.
- The tendency to find criticism difficult to tolerate: this is another hallmark feature of BPD and may mean the employee suffering from the condition finds even sensitive, diplomatic, constructive criticism highly threatening, reinforcing feelings of personal inadequacy and unacceptability.
- A tendency to have a frequently changing sense of identity: many BPD sufferers have a weak and ever-fluctuating sense of identity which may lead to frequent changes of mind as to which career suits him/her best resulting in frequent job changes after only short periods of employment in each particular ephemeral place of employment.
A STUDY EXAMINING HOW INDIVIDUALS WITH A DIAGNOSIS OF BPD INTERACT WITH THE WORKPLACE:
A study conducted by Dahl et al. (2017) examined factors which impair or enhance an individual with BPD’s functioning in the workplace.
The study looked at the following three workplace-related issues:
- How individuals with BPD integrated themselves into the workplace.
- How individuals with BPD coped with going back to work after a period of sick leave.
- Job tenure (i.e. how long individuals with BPD remain in their jobs).
The study found that, through a series of interviews (including interviews with the employees and their service providers), in relation to their effect on the above, personality traits of the employees with BPD that were found to be of particular importance were as follows:
- how they reacted to work-related pressure.
- how capable they were of controlling their emotions (emotional dysregulation is one of the main hallmarks of BPD).
Other factors of importance were found to relate to stakeholders and insurance-related procedures – in relation to these, the authors of the study provide the example of ‘poor communication between stakeholders, work accommodations and natural support in the workplace’ as having a significant effect on ‘work participation issues of individuals with BPD.’
WHAT CONCLUSION WERE DERIVED FROM THE STUDY?
The author of the study suggested that, in light of their findings, current rehabilitation programs used by employers to reintegrate individuals with psychological difficulties into the workplace need to be better adapted to the needs of the employee with BPD in order to help him/her address participation issues at work. They also suggest that such rehabilitation programs need to be better integrated and ‘joined-up’ with any separate psychotherapy that the employee with BPD is undergoing.
POTENTIAL BENEFITS OF EMPLOYMENT FOR INDIVIDUALS SUFFERING FROM BPD:
A good job can help the BPD sufferer improve his/her sense of self-worth, add a dimension of stability to his/her life, help to alleviate feelings that life is empty and meaningless, and help him/her develop a stronger sense of personal identity.
EXAMPLES OF WAYS IN WHICH EMPLOYERS CAN SUPPORT EMPLOYEES SUFFERING FROM BPD:
- validating the employee’s emotions even if the employee’s point of view is disagreed with.
- maintaining clear boundaries
- allowing working hours that are flexible, if possible
- if possible, allowing the employee to work from home if s/he prefers it
- providing a private space in the workplace for the employee to work in, if required
- providing appropriate positive reinforcement wherever possible for things the employee does well
- allowing the employee to speak to his/her therapist by telephone if necessary and reasonable
- allowing the employee ‘time out’ breaks at work, if necessary, to reduce stress and intense emotions
- providing the employee with both short-term and long-term goals
- scheduling of regular private meetings with the employee with BPD to discuss keeping the stress of work under control and other relevant workplace issues
Dahl, Kathy & Lariviere, Nadine & Corbière, Marc. (2017). Work participation of individuals with borderline personality disorder: A multiple case study. Journal of Vocational Rehabilitation. 46. 377-388. 10.3233/JVR-170874.