It has been known for some time that some of those suffering from borderline personality disorder (BPD), a very serious condition strongly associated with childhood trauma, may sometimes experience hallucinations, particularly at times of high stress.
Hallucinations can be visual (seeing things that aren’t there), auditory (hearing things that aren’t there), tactile (feeling things that aren’t there e.g. the sensation of insects crawling over the skin), gustatory (tasting things in the absence of a stimulus), and olfactory (smelling things in the absence of a stimulus).
Amongst BPD sufferers who experience hallucinations, a particularly common type is auditory hallucinations and a study conducted by Hayward et al. (2022) has found that 93% experience the voices they hear as talking to them directly, 78% said the voices instruct them on what they should do and 29% said they acted on these instructions. Furthermore, 69% said that they found the experience of auditory hallucinations the most distressing and incapacitating of all their borderline personality disorder (BPD) symptoms.
HALLUCINATIONS INSTRUCTING BPD SUFFERERS TO HURT THEMSELVES OR OTHERS:
According to this particular study, 76% of the BPD sufferers who experienced auditory hallucinations said they had experienced voices telling them to harm themselves and 33% had experienced voices instructing them to cause harm to other people.
THE LINK BETWEEN SYMPTOMS OF DEREALIZATION AND THE EXPERIENCE OF AUDITORY HALLUCINATIONS IN BORDERLINE PERSONALITY DISORDER (BPD) PATIENTS:
A major symptom of borderline personality disorder (BPD) is a form of dissociation known as derealization (a condition involving feeling cut off from one’s surroundings together with a sense that objects and people around one are not real) and the study found, perhaps unsurprisingly, that 23% of the sample said that their auditory hallucinations tended to occur when they were experiencing a state of derealization.
Research has demonstrated that those with borderline personality disorder are at particular risk of self-harm, including suicide (according to studies about 10% of borderline personality disorder sufferers die by suicide, and a far greater percentage attempt suicide at least once. According to this study, then, if a person with borderline personality disorder (BPD) is suffering auditory hallucinations, this may increase his or her risk of self-harm even further particularly as the majority of the sample said the voices they ‘heard’ felt very real to them.
On the question of borderline personality disorder sufferers harming others (as stated above, some of the samples ‘heard’ voices instructing them to harm others) a study carried out in 2016 by Gonzalez et al.found it to be unclear as to whether borderline personality disorder (BPD) contributes to acts of violence towards others or whether a propensity towards such violence is better explained by comorbidities the borderline personality disorder (BPD) person might suffer from such as antisocial personality disorder, anxiety, and substance abuse.
González, R.A., Igoumenou, A., Kallis, C. et al. Borderline personality disorder and violence in the UK population: categorical and dimensional trait assessment. BMC Psychiatry 16, 180 (2016). https://doi.org/10.1186/s12888-016-0885-7
2022). A cross-sectional study of auditory verbal hallucinations experienced by people with a diagnosis of borderline personality disorder. Clinical Psychology & Psychotherapy, 29( 2), 631– 641. https://doi.org/10.1002/cpp.2655, , , , , , , , , , & (