Testing the Waters: Borderline Personality Disorder and Therapy

Borderline Personality Disorder often presents as a pattern complex and damaging thought processes and behaviors. People with this disorder are emotionally dependent, which means that their emotions have adverse affects on their day-to-day living because they can overwhelm regular cognitive functioning. (Grohol, 20213) These individuals will find it more difficult to distinguish between reality from their own perceptions of the world and their surrounding environment.

People with BPD have very heightened emotional responses to everyday situations. Recall the last bad day you had, maybe you had gotten sick during a busy week, or fought with a best friend, or had a significant other break up with you. The emotions you feel in those moments may be intense enough for you to not pay attention to much else. Now imagine, experiencing this not only during times of crisis, but on a daily (sometimes even on a more frequent) basis. A small disagreement with someone can make a person with BPD extremely angry, irritable, and impulsive, or an offhanded remark can result in a depressive state, loss of motivation, and hopelessness. While a person without a mental illness may feel this way from time to time, a person with BPD will act on these emotions and every time they encounter them. Worse yet, because of their intense fear and frantic efforts to avoid abandonment, perceived neglect by a loved one can cause a person with BPD to engage in self-damaging behaviors and suicide ideation.

The most common form of psychotherapy used to treat borderline personality disorder works to differentiate between emotion and behavior, and is called Dialectical Behavior Therapy (DBT). Research conducted on this treatment have shown it to be more effective than most other psychotherapeutic and medical approaches to helping a person to better cope with this disorder. DBT helps patients take control of their emotions and themselves through self-knowledge, emotion regulation, and cognitive restructuring. It is a comprehensive approach that is most often conducted within a group setting. (Linehan, 1999)

Other psychological treatments that have been used, to lesser effectiveness, to treat this disorder include those which focus on conflict resolution. People with BPD are often deemed as a source of drama and never-ending crises, shown through numerous derisive book titles to help other people ‘deal’ with someone close to them who have BPD. These often reinforce the stigma around people with BPD that they are just attention seekers or drama makers who live off of negative energy. Solution-focused therapies neglect the core problem of people who suffer from this disorder — difficulty in expressing appropriate emotions and subsequent behaviors to significant people in their lives.

Because people with this disorder often try and “test the limits” of the therapist or professional when in treatment, boundaries must be set between the patient and therapist. Individuals with borderline personality disorder are often unfairly discriminated against because their problematic impulsive behaviors, but it is the job of the clinician to maintain professionalism and work through their own biases in order to help the patient. While individuals with BPD may need more care than other patients, their behavior is caused by their disorder.  Discriminating against them, especially during treatment, is detrimental to their mental health.

Works cited:

Grohol, J. (2013). Borderline Personality Disorder Treatment. Psych Central. Retrieved on November 20, 2015, from http://psychcentral.com/lib/borderline-personality-disorder-treatment/

Linehan, M. M., Schmidt, H., Dimeff, L. A., Kanter, J. W., Craft, J. C., Comtois, K. A., & Recknor, K. L. (1999). Dialectical Behavior Therapy for Patients with Borderline Personality Disorder and Drug-Dependence. American Journal on Addiction, 8, 279-292.

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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