Borderline Personality Disorder Is Not A Choice

Borderline Personality Disorder Is Not A Choice

 

Nobody chooses to suffer from borderline personality disorder ; this is obvious.

Borderline personality disorder (BPD) is probably the most tormenting and agonizing psychiatric condition known to man. One in ten sufferers end up killing themselves after years, or even decades, of appalling mental suffering. Due to the disturbed behavior that accompanies BPD,  sufferers may become social pariahs and/or be rejected by their families – in the latter case, often by the very family member/s who have played a major role in causing the disorder ; I have said elsewhere that this is rather like somebody cutting off all your limbs and then blaming you for bleeding for over them. Or injecting you with a cancer causing agent and then blaming you for wasting away and dying.

One of the great torments of BPD sufferers is a belief that they are bad and that their behavior is due to some fundamental character flaw rather than due to a desperately serious psychiatric condition. It is this false belief (frequently caused by internalizing parental negative views of them whilst growing up) that contributes to many of the suicides and, as such, is a belief which is in urgent need of correcting.

On what grounds do I make this assertion? I summarize them below :

  • DAMAGE DONE TO THE PHYSICAL DEVELOPMENT OF THE BRAIN:

The physical development of the following three brain regions is affected by our upbringing in early life and this physical development may be adversely affected if that upbringing is significantly dysfunctional.

  • AMYGDALA
  • HIPPOCAMPUS
  • ORBITOFRONTAK CORTEX

 

Let’s look at each in turn:

AMYGDALA : This part of the brain controls emotions and, especially, negative emotions like fear, anxiety and aggression. It follows that because the amygdala has developed abnormally in BPD sufferers, they will be prone to experiencing abnormal levels of fear, anxiety and aggression.

HIPPOCAMPUS : This part of the brain plays a significant role in our ability to exert self-control. Again, it follows that because the hippocampus has developed abnormally in BPD sufferers, they will have difficulties with self-control, leading to impulsive and self-destructive behaviors.

ORBITOFRONTAL CORTEX : This part of the brain is involved with planning and decision making. Yet again, it follows that because the orbitofrontal cortex has developed abnormally in BPD sufferers, they will have problems planning ahead (including poor ability to consider future implications of behaviors or to act in a premeditated or carefully deliberated manner) and be prone to irrational and illogical decision-making.

Furthermore, these three brain areas play a very significant role in mood regulation / our ability to control how we feel. As these three areas have developed abnormally in BPD sufferers, this helps to explain why their moods can fluctuate so dramatically, in turn leading to extensive problems both forming and maintaining healthy relationships with others.

Now, consider this : If a person was hit on the head with a hammer, causing brain damage which, in turn, affected how s/he felt and behaved, should s/he (the person hit) be blamed for this change in behavior? No, of course not. So, why should a different view be taken in the case of BPD sufferers? Indeed, to take a different view would seem suspiciously like discrimination against mental illness and a failure of imagination in regard to how devastating the infliction of emotional suffering can be.

Types Of Dysfunctional Upbringing That May Damage These Brain Regions :

These include :

  • suffering abuse from parent/primary carer
  • being neglected by parent/primary carer
  • being brought up by a parent with a significant mental health problem
  • being brought up by a parent/primary carer who is an alcoholic
  • being brought up by a parent/primary carer who is a drug addict

What About The Role Of Genes?

There is NOT a gene for BPD.

However, some may be born with a greater vulnerability to being adversely affected by stressful environments due to high levels of sensitivity.

 

Are Those With BPD Manipulative?

Sadly, many individuals suffering from borderline personality disorder (BPD) are stigmatized by others and, amongst other perjorative terms, are frequently described as ‘manipulative’.

However, in recent years, it has been increasingly recognized that intentionally manipulative behavior is, in fact, NOT a defining characteristic of BPD sufferers after all ; this shift in attitude is best exemplified by the fact that the Diagnostic And Statistical Manual Of Mental Illness, Fifth Edition, or DSM-V (sometimes informally referred to as the ‘psychiatrists’ bible’), has ceased to list ‘manipulative’ as one of the personality traits associated with borderline personality disorder.

However, this begs the question : ‘Why has it been so common for those suffering from BPD to be scornfully dismissed as manipulative in the past?

According to the psychologist, Marsha Lineham (well known for having developed Dialectical Behavior Therapy (DBT) for the treatment of BPD), this mis-labelling of BPD sufferers as manipulative has been based on a MISINTERPRETATION of certain types of their behavior.

Lineham puts forward the view that, often, some of the behaviors of BPD patients are wrongly perceived as being  manipulative whereas, in fact, they are desperate manifestations of intense psychological and emotional pain.

Indeed, borderline personality disorder (BPD) is generally accepted as being the most excruciatingly, psychologically and emotionally, painful of all mental health conditions ; as I have stated elsewhere on this site, approximately one in ten of those suffering from BPD end their lives by suicide. (To read my article, Living With Mental Agony, click here, or to read my article, Anger May Operate To Soothe Emotional Pain, click here.)

Sometimes, an example some people may give of so-called ‘manipulative’ behavior from BPD sufferers is the threat of suicide. For example, someone with BPD may take an overdose of tablets but then phone a friend or family member to say what they have done. Lineham points out, however, that this is unlikely to be a coldly calculated ploy but, rather, a desperate and confused expression of inner mental turmoil (the intensity of which the individual may not have the words to convey) and ambivalence – ambivalence in the sense that a part of the BPD sufferer may genuinely want to die whilst another (say, instinctual) part may be driven to survive.

Indeed, the fact that, as stated above, one in ten BPD sufferers eventually die by suicide suggests that any threat to do so should be treated extremely seriously.

 

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David Hosier BSc Hons; MSc; PGDE(FAHE).

 

About David Hosier MSc

Holder of MSc and post graduate teaching diploma in psychology. Highly experienced in education. Founder of childhoodtraumarecovery.com. Survivor of severe childhood trauma.

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