notoriously difficult to treat. They are difficult to keep in therapy, frequently fail to respond to our therapeutic efforts, and make considerable demands on the emotional resources of the therapist, particularly when suicidal and parasuicidal behaviors are prominent.”
According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, “. . . to be diagnosed with borderline personality disorder, a person must show an enduring pattern of behavior that includes at least five of the following symptoms:
- Extreme reactions—including panic, depression, rage, or frantic actions—to abandonment, whether real or perceived
- A pattern of intense and stormy relationships with family, friends, and loved ones, often veering from extreme closeness and love (idealization) to extreme dislike or anger (devaluation)
- Distorted and unstable self-image or sense of self, which can result in sudden changes in feelings, opinions, values, or plans and goals for the future (such as school or career choices)
- Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating
- Recurring suicidal behaviors or threats or self-harming behavior, such as cutting
- Intense and highly changeable moods, with each episode lasting from a few hours to a few days
- Chronic feelings of emptiness and/or boredom
- Inappropriate, intense anger or problems controlling anger
- Having stress-related paranoid thoughts or severe dissociative symptoms, such as feeling cut off from oneself, observing oneself from outside the body, or losing touch with reality.”
My son has at least seven, if not all nine enduring symptoms of this disorder.
It is not necessarily important to label any illness, but it gives you an idea of how to treat it and for some reason it gives you a sense of peace to have a name for it.
According to the Skills Training Manual for Treating Borderline Personality Disorder by Marsh M. Linehan, “. . . the core disorder in BPD is emotion dysregulation . . . borderline individuals have difficulties in regulating several, if not all, emotions.” They have . . . “an emotional response system that is oversensitive and overreactive . . . Researchers have estimated that up to 75% of individuals with BPD have experienced some sort of sexual abuse in childhood . . . It is unclear, however, whether the abuse in and of itself facilitates the development of borderline patterns, or whether the
abuse and the development of the disorder both result from the extent of the familial dysfunction and invalidation.”
Are you born with BPD?
Does it develop because of a dysfunctional family and invalidation as a child?
Or does someone develop it because of a sexual abuse?
These are questions no one can answer completely.
According to an article by Barry Kiehn and Michaela Swales, “The disorder is a consequence of an ‘emotionally vulnerable’ individual growing up within a particular set of environmental circumstances which M. Linehan refers to as the ‘invalidating environment’ . . . An ‘emotionally vulnerable’ person in
this sense is someone whose autonomic nervous system reacts excessively to relatively low levels of stress and takes longer than normal to return to baseline once the stress is removed . . . The term ‘invalidating environment’ refers essentially to a situation in which the personal experiences and
responses of the growing child are disqualified or ‘invalidated’ by the significant others in his/her life . . . an Invalidating Environment is characterized by a tendency to place a high value on self-control and self-reliance.”
Matthew’s personality is described almost perfectly in the next part of this article.
“They are aware of their difficulty coping with stress and may blame others for having unrealistic expectations and making unreasonable demands . . . They invalidate their own responses and have unrealistic goals and expectations, feeling ashamed and angry with themselves when they experience difficulty or fail to achieve their goals. Next, they tend to experience frequent traumatic environmental events . . . This results in what Linehan refers to as a pattern of ‘unrelenting crisis’ . . . Patients with BPD are active in finding other people who will solve their problems for them but are
passive in relation to solving their own problems . . . they may indeed be competent, but their skills do not generalize across different situations and are dependent on the mood state of the moment. A pattern of self-mutilation tends to develop as a means of coping with the intense and painful feelings
experienced by these patients and suicide attempts may be seen as an expression of the fact that life at times simply does not seem worth living.”
When I found this article I couldn’t believe how accurately it described my son. He was a quiet, sensitive child who grew up with a father that expected him to be tough and not show his emotions or weakness, but instead control them. He was emotionally vulnerable and he witnessed frequent traumatic events in his household as a child.
The next part of the article also described Matthew well. He was passive in solving his problems and he let others assume the role of caretaker and activist for him, and I was excellent at assuming that role.
The last part of the article told about the pattern of self-harm entering the picture to help the person deal with the intense emotional feelings they have. When Matthew started self harming, he truly was not sure if life was worth living.
Validation, it is so incredibly important. Learn what it is and use it with your children and teens.