Borderline Personality Disorder (BPD)

BPD is often experienced as a pervasive negative pattern in one’s emotions, relationships, and behaviors. Individuals with BPD have intense emotions that often feel near impossible to regulate and manage which can lead to difficulty in creating and maintaining healthy relationships. Due to the experience of highly intense, difficult to manage emotions, individuals will understandably turn to problematic behaviors in order to find some kind of relief from their emotional pain. This can take the form of suicidality, self harm, substance use, and many other behaviors that have negative consequences on the individual’s well being. The DSM cites the following as signs and symptoms of BPD:

• An intense fear of abandonment, even going to extreme measures to avoid real or imagined separation or rejection

• A pattern of unstable intense relationships, such as idealizing someone one moment and then suddenly believing the person doesn't care enough or is cruel

• Rapid changes in self-identity and self-image that include shifting goals and values, and seeing yourself as bad or as if you don't exist at all

• Periods of stress-related paranoia and loss of contact with reality, lasting from a few minutes to a few hours

• Impulsive and risky behavior, such as gambling, reckless driving, unsafe sex, spending sprees, binge eating or drug abuse, or sabotaging success by suddenly quitting a good job or ending a positive relationship

• Suicidal threats or behavior or self-injury, often in response to fear of separation or rejection

• Wide mood swings lasting from a few hours to a few days, which can include intense happiness, irritability, shame or anxiety

• Ongoing feelings of emptiness

• Inappropriate, intense anger, such as frequently losing your temper, being sarcastic or bitter, or having physical fights

In DBT, we often look at BPD as a result of a person’s biology transacting with an invalidating environment in a pattern that repeats throughout a person’s life.