Borderline Personality Disorder For Dummies

Charles H. Elliott, Laura L. Smith

• Editorial: For Dummies
• Año: 2020
• ISBN:
  9781119714354
• Edición: 2
• Categoría: Medicine
• Categoría: Psychiatry & Mental Health

Get to know the ins and outs of BPD—and make the choice to change!

Borderline personality disorder (BPD) is an extremely serious—and often seriously neglected—condition. Despite around 4 million diagnoses in the USA, BPD has attracted lower funding and levels of clinical concern than more "popular" conditions such as bipolar disorder. But there's no need to lose hope! Borderline Personality Disorder For Dummies, 2nd Edition was written to bridge this gap and help sufferers learn how to break the cycle to lead a full and happy life.

BPD impacts the way you think and feel about yourself and others and can cause long-term patterns of disruptive relationships and difficulties with self-control. It often results from childhood abuse or neglect, as well as from genetic or brain abnormalities—particularly in areas of the brain that regulate emotion, impulsivity, and aggression. Knowing how it works means we know how to manage it, and Borderline Personality Disorder For Dummies —written in a friendly, easy-to-follow style by two leading clinical psychologists—is packed with useful techniques to do just that: from identifying triggers to finding the right care provider.

• Get a compassionate, actionable understanding of the symptoms and history of BPD
• Acquire techniques to identify and halt damaging behaviors
• Evaluate providers and the latest therapies and treatments
• Set goals and habits to overcome problems step-by-step

BPD should never be allowed to dictate anyone's existence. This reference gives you the tools to take your life back and is a must-have for sufferers and their loved ones alike.

Part 1

Mapping the Boundaries of Borderline Personality Disorder

IN THIS PART …

Discover the ins and outs of Borderline Personality Disorder.

Find out the characteristics of a healthy personality.

Take a closer look at BPD symptoms.

Understand the multiple causes of BPD and how they interact.

Chapter 1

Exploring Borderline Personality Disorder

IN THIS CHAPTER

Taking a look at the characteristics of BPD

Searching for BPD’s causes

Calculating the costs of BPD

Seeking help for BPD through psychotherapy and medication

Knowing how to help someone who has BPD

A charming, exciting, intimate, intelligent, fun person suddenly turns mean, sluggish, angry, self-defeating, and dismal — a radical change for no obvious reason. What causes the unpredictable ups and downs from fear to rage, intimate intensity to distance, and euphoria to despair that some people experience on a daily basis? Borderline personality disorder (BPD), arguably the most common and debilitating of all the personality disorders, causes chaos and anguish for both the people who suffer from the disorder and those who care about them.

This book takes you inside the world of BPD and shows you what living with this disorder is really like. Unlike some books and articles about BPD, we strive to maintain a compassionate, kind perspective of those people who are afflicted with BPD. You may be reading this book because you know or suspect you have BPD or some of its major symptoms. If so, expect to find a wealth of information about BPD and its causes. Discover hope as you read about effective treatments.

Perhaps you are a reader who cares about or loves someone who has BPD. By reading this book, you can discover why people with BPD do what they do as well as see how you can better relate to them. Finally, even if you’re not in a close relationship with someone with BPD, you no doubt have a co-worker, neighbor, supervisor, or acquaintance who suffers from BPD, or at the very least, a few of its prominent symptoms. Even superficial relationships with people who have BPD can pose surprising challenges. This book can help you better understand what’s going on and how to deal with the problems BPD creates for you.

If you’re a therapist, you can use this book to expand your understanding of BPD. You can see how to deal with difficult therapeutic issues. You can also figure out how to set better boundaries while you simultaneously take care of both yourself and your clients.

In this chapter, we describe the basics of BPD in terms of how the disorder affects both the people who have it and the people who have relationships with them. We present what’s known about the causes of BPD. We also tally up the costs of BPD for both the people who have it and the society they live in. Finally, we overview the major treatment options for BPD and show those of you who care about someone with BPD what you can do to help.

Breaking Down Borderline Personality Disorder

Personalities are the relatively consistent ways in which people feel, behave, think, and relate to others. Your personality reflects the ways in which other people generally describe you — such as calm, anxious, easily angered, mellow, thoughtful, impulsive, inquisitive, or standoffish. All people differ from their usual personalities from time to time, but, for the most part, personalities remain fairly stable over time. (Check out Chapter 2 for more on personality.)

For example, consider someone who has a generally jolly personality; this person enjoys life and people. However, when this person experiences a tragedy, you expect to see normal grief and sadness in this generally jolly person. On the other hand, someone with a personality disorder, such as BPD, experiences pervasive, ongoing trouble with emotions, behaviors, thoughts, and/or relationships. The following sections describe the core problems that people with BPD frequently experience.

The American Psychiatric Association has a manual that describes specific symptoms of BPD. The manual groups these symptoms into nine categories. In Chapter 3, we describe those nine symptoms in some detail. In this chapter, we condense these nine symptom categories into four larger arenas of life functioning that are easier to digest.

Although BPD has an identifiable set of symptoms, the specific symptoms and the intensity of those symptoms varies greatly from person to person.

Unpredictable relationships

People with BPD desperately want to have good relationships, but they inadvertently sabotage their efforts to create and maintain positive relationships over and over again. You may be wondering how they continually end up in rocky relationships.

Well, the answer lies in the fact that their desire for relationships is fueled by an intense need to fill the bottomless hole that they feel inside themselves. People with BPD ache to fill this hole with a sense of who they are, a higher level of self-esteem, and high amounts of outside nurturance, unconditional love, and adoration. But no one can fill such a huge personal chasm. Partners and friends may be defeated soon after they enter the relationship. Their attempts to make their friends who have BPD happy too often fail. The people with BPD reflexively respond to their friends’ efforts with surprising disappointment, pain, and sometimes even anger.

This intense negative reaction confuses partners of people with BPD because people with BPD typically start out relationships with enthusiasm, warmth, and excitement. New partners may feel entirely enveloped by love and caring at the beginning of their relationships, but, repeatedly, things go terribly wrong.

What happens to turn a relationship so full of love and excitement into something full of pain and confusion? Well, many people with BPD fear abandonment above almost anything else. Yet, at the same time, they don’t believe they’re worthy of getting what they really want. They can hardly imagine that another person truly does love them. So, when their partners inevitably fail to fulfill their every need, they believe the next step is abandonment.

This conclusion simultaneously fuels the person with BPD with terror and rage. As a result, they push their partners away. Better to push someone away than to be pushed away, right? This series of reactions is extremely self-defeating, but it’s born out of fear, not malice. See Chapter 8 for more information about BPD relationships and Chapter 18 for how you can work to improve them.

Acting without thinking

Human brains have built-in braking systems, which, in theory, are a lot like the ones that five-ton trucks use to slow down as they roll downhill. These brake systems come in handy when the trucks drive down steep mountains, or, in terms of the human brain, when the intensity of emotions flares up in certain situations. Unfortunately, most people with BPD have brake systems that are adequate for golf carts — not five-ton trucks — which are hardly enough to handle the weighty emotions that often accompany BPD.

Brain brakes, as we like to call them, keep people from acting without first thinking about the consequences of their actions. Like rolling dice in a game of craps, behaving impulsively rarely results in winning in the long run. Common impulsive behaviors in people with BPD include the following:

• Impulsive spending
• Gambling
• Unsafe sex
• Reckless (but not wreckless) driving
• Excessive eating binges
• Alcohol or drug abuse
• Self-mutilation
• Suicidal behavior

See Chapter 5 for a tour of the dangerous, reckless world of people who have BPD and Chapter 15 for how to start inhibiting such impulsivity.

Volatile emotions

The emotional shifts of people with BPD are almost as unpredictable as earthquakes. They can also be just as shaky and attention grabbing. After people with BPD unleash their emotions, they usually don’t have the ability to regain steady ground.

The rapidly shifting emotional ground of people with BPD causes the people around them to walk warily. In the same day, or even the same hour, people with BPD can demonstrate serenity, rage, despair, and euphoria. See Chapter 6 for more information about this emotional drama and Chapter 16 for how to try to control it.

Confusing thoughts

People with BPD also think differently than most people do. They tend to see situations and people in all-or-nothing, black-and-white terms with few shades of gray. As a result, they consider events to be either wonderful or awful, people in their lives to be either angels or devils, and their life status to be either elevated or hopeless.

Sometimes the thoughts of people with BPD travel even closer to the edge of reality. For instance, they may start thinking that other people are plotting against them. They may also distort reality to such a degree that they may seem briefly incoherent or psychotic. Psychosis entails difficulty understanding what is real versus not, including obviously false beliefs and seeing or hearing things that others do not. Such departures from reality are usually brief.

People with BPD also sometimes perceive their bodies as being separate from themselves, which is called dissociation. They describe these occurrences as like looking down at what is happening to them from another vantage point. See Chapters 9 and 10 for more information about the thought processes of people who suffer from BPD and Chapter 19 for how to form more adaptive ways of thinking.

Exploring the Origins of BPD

If you trip over a log and hurt your leg, the cause of your pain is obvious. The doctor orders an X-Ray and discovers a fracture. She sets the leg and sends you home to rest. You know where the pain in your leg came from and what to do about it.

Similarly, if you plant a tomato seed in fertile soil, in a sunny spot, and then water regularly, you are likely to see tomatoes emerge after a few months. The origins of your tomatoes are obvious. You can be pretty sure that the seed, soil, sun, and care caused the tomatoes to grow.

In contrast, BPD doesn’t seem to have a clear-cut cause, a consistent pattern of symptoms, or even a consistently predictable response to treatment. Nevert...