Understanding Borderline Personality Disorder
Updated: May 30
Borderline Personality Disorder (BPD) is one of the most stigmatized mental illnesses. People with BPD are often simply labeled as "crazy" or "too much to handle." Many mental health providers won't even work with people diagnosed with BPD for fear that it will be too difficult, emotionally draining, or even dangerous. Why dangerous? Because people with BPD at times can be punitive if there is a real or even perceived slight. It's also important to remember that a person can have Borderline traits and still not meet the criteria for a diagnosis of BPD. It's important to think about Borderline traits as being on a spectrum. The truth is that most people can and will exhibit some Borderline tendencies at one point or another, which is why the most important question for clinicians to ask when considering a BPD diagnosis is how much these traits are impacting their client's life.
People with BPD often struggle controlling the "volume" of their emotions. Things that most people might find irritating often feel like the end of the world to people with BPD. They constantly assume that everyone is trying to trick them, manipulate them, use them, etc. They live in constant fear of being abandoned and/or rejected, and this fear causes an intolerable amount of anxiety. The anxiety becomes so overwhelming that they often sabotage their relationships. When they inevitably drive their partners, friends, and family members away with their behavior, it reinforces their fear of being rejected and abandoned; they feel justified in their fear and it becomes an endless cycle of turmoil in relationships. An identifying characteristic of BPD is this chronic instability of relationships. Their best friend today is their mortal enemy tomorrow.
Some people with BPD truly don't know how to tell if someone cares about them so they will resort to using drastic measures to try and figure it out. The best example of this is they will do things to make the people in their lives worry about them. Something innate inside them says, "If they are worried about me I know they care." Eventually the people in their lives get sick of being on this merry-go-round, so they stop worrying...which again validates the fear of being abandoned. It is exhausting for both the person with BPD and their loved ones.
When I work with people with BPD, or even traits of BPD, I emphasize the importance of learning how to accurately identify who they can trust. Having a concrete way to evaluate trust helps people with BPD be more open to feedback and willing to consider alternative perspectives. Getting them to slow down and do the work to reality test when they feel slighted or wronged can really be life changing for them. This is what allows them to maintain relationships in a way that is sustainable, healthy, and free of manipulation...which is all people with BPD want anyway.