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Personality Disorders

Stop Calling it Drama: Misconceptions and Borderline Personality Disorder

Borderline personality disorder has a long history shrouded in misconceptions. The term ‘borderline’ itself originated from an old psychiatric convention, as some categorized patients with the disorder as being on the ‘border’ of psychosis and neurosis since they overlapping symptoms of both. 

By Vidya Koesmahargyo

Borderline personality disorder has a long history shrouded in misconceptions. The term ‘borderline’ itself originated from an old psychiatric convention, as some categorized patients with the disorder as being on the ‘border’ of psychosis and neurosis since they overlapping symptoms of both (Gunderson, 2008). Over the years, however, borderline personality disorder gained its own diagnostic criteria, and is no longer only characterized as being on the border of two neurological symptoms. Though many efforts have been made to change the name, so far none have been successful despite the term’s inaccuracy. Valerie Porr, president of Treatment and Research Advancement Association for Personality Disorders states that, “the name BPD is confusing, imparts no relevant or descriptive information, and reinforces existing stigma. (Porr, 2001)

According to Psych Central, borderline personality disorder is characterized by pervasive patterns of instability in interpersonal relationships, self-image and emotions. Although these patterns are the diagnostic criteria for this disorder, they might manifest themselves in different ways for each individual, and each experience is unique.

An example of a symptom of this disorder is emotional instability. A person with borderline personality disorder may feel intense episodic dysphoria, anxiety, mania and anger in the span of a few hours or days. This is where the label ‘drama queen’ stems from, which effectively invalidates the experiences of people with BPD.

Because of their cyclic and intense moods, people with BPD are often impulsive in an effort to relieve their distress. These periods of anxiety or anger may be so extreme as to cause transient, stress-related paranoid thoughts and even brief psychosis. (Psych Central, 2014)

Another symptom is a lack of self-identity or identity disturbance. People with BPD typically do not feel as if they have a base identity, and instead adopt temporarily meaningful personalities that they observe in other people. Their intense mood shifts also play a role: during periods of mania, a person might display extreme confidence and recklessness, while in extreme anger they might say nasty remarks or act out in aggression.  These shifts may include drastic changes in beliefs and morals, making it even harder for the individual to build a stable sense of self.

Another symptom among people with BPD is the concept of ‘splitting,’ which is the act of constantly idealizing and devaluing something. Due to their severe moods, people with BPD often fall into a ‘black’ or ‘white’ mindset. According to Goin, splitting is a primitive defense characterized by a polarization of good feelings and bad feelings, of love and hate, of attachment and rejection. Splitting, acts as an unconscious force to protect against dangerous anxiety. If a person with BPD suddenly feels good or bad about a particular person or situation, they can instantly modify their opinions, memories or attitudes to be consistent those feelings, regardless of any apparent contradictions. (Goin, 1998)

Many believe that people with the disorder and manipulative, attention seeking, and even abusive. Even psychiatric professionals often dismiss their clients with BPD in the same manner. While emotional and identity instability may cause some to extreme actions, these actions are not deliberate. In the same way individuals with depression cannot change their mood on a whim, individuals with BPD are unable to regulate their emotions in a healthy way. It is important to remember these individuals deserve respect and compassion, not to be treated condescendingly or vilified.

 

Works Cited:

Gunderson, J.G., Links, P.S. Borderline Personality Disorder: A Clinical Guide. Washington, DC, American Psychiatric Publishing, 2008, 1-9.

Porr, V. (2001). How Advocacy is Bringing Borderline Personality Disorder Into the Light. Retrieved November 22, 2015, from http://www.tara4bpd.org/how-advocacy-is-bringing-borderline-personality-disorder-into-the-light/

Psych Central. (2014). Borderline Personality Disorder Symptoms. Psych Central. Retrieved on November 21, 2015, from http://psychcentral.com/disorders/borderline-personality-disorder-symptoms/

Goin, M. (1998, November 1). Borderline Personality Disorder: Splitting Countertransference. Retrieved November 22, 2015, from http://www.psychiatrictimes.com/borderline-personality/borderline-personality-disorder-splitting-countertransference-0/page/0/1

 

By Vidya Koesmahargyo

Although my interest in working in medicine predates the start of my college career, it was only recently that I developed an affinity for medical research. I was part of the Carl Sagan Program in my high school, where we took classes on how to successfully conduct our own research projects and present them. After conducting my own at the end of my senior year, I felt that research was certainly a field I’d like to pursue.
I have struggled with mental health issues myself, so it was both a personal and academic curiosity that led me to the Humanology Project. I hope to shed some light on the gritty topics that still struggle to be included in the discourse on public health.
In my spare hours, I consume copious amounts of poetry, ambient music, and embark on the occasional urban exploration.

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