How Borderline Personality Symptoms Reinforce
One of the greatest difficulties of managing borderline personality disorder
(BPD) is that the symptoms it creates tend to feed off, and intensify, each
other; often this will end in a crisis point at which the affected individual
will become suicidal and/or require hospitalization.
Until the disorder is properly treated with the relevant therapy, the individual is likely to keep
experiencing such crisis points throughout his/her life.
In this article, I want to look at how the symptoms of BPD can keep
reinforcing and worsening each other, leading to a downward spiral from
which the majority will find it impossible to break free without professional
intervention. In order to do this, it is worth revisiting the main symptoms of
– almost always full of painful and distressing emotions
– becomes intensely attached to others very quickly, leading to feelings for,
and expectations of, others that are not warranted given the context and/or
history of the relationship
– expects to be rejected by those s/he forms an emotional attachment to
– is simultaneously deeply needy of, and rejecting towards, others; feels
deep need of emotional intimacy with, and caring from, others but then will
tend to reject it when it is offered
– interpersonal relationships become unstable and chaotic
– experiences great difficulty in controlling (regulating) emotions which
quickly become powerful and overwhelming; these frequent powerful,
intense, uncontrollable emotions frequently spiral out of control and then
have a very adverse effect upon normal functioning
– inability to self-soothe (it is theorized that this is due to damage to the area
of the brain known as the AMYGDALA, thought to be caused by severe
trauma and high levels of stress during childhood)
– suffers from impulsivity and recklessness
– frequently, or continuously, prone to severe depression and anxiety
– feels, and almost always is (by non-experts), misunderstood
– tends to constantly expect utter and devastating calamity (a mind-set
referred to by psychologists as CATASTROPHIZING, a state of mind
cognitive behavioural therapy, and other types of therapy for BPD, seek to
HOW SUCH SYMPTOMS INTERACT AND INTENSIFY ONE
Because the symptoms of BPD trap the sufferer in a downward spiral, as I
shall illustrate below, it is just about impossible for individuals to cope
with, let alone manage, the condition on their own. Professional
intervention is therefore imperative. Because BPD is frequently
misdiagnosed, it is worth noting down relevant symptoms and presenting
them to the relevant professional in advance of an appointment.
Also, there is nothing to prevent one seeking a second (or even third!) opinion. It is
important to seek out a therapist who is expert in the condition and one is,
of course, free to ask any potential therapist what experience s/he has of the
disorder, together with their views about treatments (eg medication, talk
therapy, a combination?) What is your own instinct on this? Let the
Let’s now look at how the symptoms of BPD may become so mutually,
Because the person who suffers from BPD can be in such continuous,
painful emotional distress it is very common for him/her to turn to alcohol
or drugs in an attempt to numb these intolerable feelings.
The individual may well then castigate him/herself about this alcohol/drug use, seeing
him/herself as an alcoholic or drug addict which lowers even further his/her
already greatly damaged self-esteem.
S/he may then seek psychologically support from a friend, but, as a consequence of his/her distress, become
clingy and demanding. In response to this, the friend may set down
boundaries which the BPD sufferer interprets as rejection, thus further
lowering his/her self-esteem and causing further painful emotions leading to
yet more excessive drinking or drug taking…
Of course, this is just one example of how symptoms of BPD may
unhelpfully feed off each other, though an almost infinite variety of harmful
interactions between other symptoms can be easily imagined.
Essentially, the BPD sufferer LACKS INTERNAL RESOURCES TO COPE WITH
MENTAL PAIN AND STRESS so will turn, with depressing regularity, to
DESTRUCTIVE EXTERNAL RESOURCES such as one-sided
relationships or activities which allow temporary, psychological
DISSOCIATION from the emotional distress being experienced, such as
ALCOHOL, DRUGS, PROMISCUOUS SEX or GAMBLING in other
words, maladaptive (unhelpful) coping mechanisms.
As these maladaptive coping strategies continue to aggravate and worsen
one another, the BPD sufferer is likely to become increasingly desperate
and to undertake increasingly self-destructive behaviours.
How can s/he break free from this vicious cycle? Sometimes, as I said in the opening
paragraph of this post, hospitalization may be required to interrupt the
cycle; however, this has its negative side: being placed in a psychiatric
hospital can significantly worsen, yet further, damaged self-esteem, making
the sufferer feel like a pariah – stigmatized, demeaned, humiliated, and on
the bottom rung of society’s ladder.
S/he will also be burdened with the often acute worry of how s/he will now be perceived by others for having
being placed in a psychiatric ward, making him/her less capable still of
finding the confidence to interact successfully with acquaintances, friends
and society in general. In extreme cases (eg when the sufferer is actively
suicidal), however, there may, sadly, be little alternative
David Hosier BSc Hons; MSc; PGDE(FAHE).