Written by: Gregory Pulis
Edited by: Olivia Stanco
Borderline personality disorder (BPD)–also known as emotionally unstable personality disorder (EUPD) or emotional instability disorder (EID)–is shrouded with stigma, partially due to its characterization of instability in relationships and extremes in mood reactivity. It is important to understand not just the symptoms, but the context and background from which those symptoms could have developed. Due to the reactivity of someone with BPD, the people around them may be quick to frustration, but it may also help navigate potential conflicts by understanding why they react that way.
The disorder is defined as “a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts” (DSM-5-TR). Of the nine possible symptoms listed, some to note are: “frantic efforts” to avoid abandonment; extremes of idealization and devaluation within relationships; affective/emotional instability due to reactivity; difficulty controlling anger; and stress-related paranoid ideation. While the other symptoms are important and should be looked at holistically, these noted symptoms may relate to how people with BPD think about and treat their interpersonal relationships.
To better understand how these behaviors emerge, it helps to explore the underlying emotional patterns at play. Between the difficulty with emotional control and impulsivity, mixed with this sort of “everything or nothing” view on people (also known as “splitting”), and yet also fearing their abandonment can cultivate a difficult mindset. Let’s do our best to put ourselves into the mind of someone who would be experiencing these thought patterns: You start dating someone–we’ll name them Riley–and a month or so in, it’s not only going great with them–it’s amazing. Riley is your rock, your everything, possibly even the only person who understands you. You’re going to marry them, you just know it deep in your heart. So you thought. Last night, their phone died when they went out to eat with a friend. Clearly, they’re lying and they put someone else’s needs over yours. You dreaded that this would ever happen, and it stings deep, so you may lash out on them for their perceived betrayal and/or even internalize those feelings through the use of substances. Riley is just denying everything, claiming you are hurting them, so they text less. They’re drifting away, and a wave of panic floods your body–stomach to the floor. You text them all day, call them a million times, begging and pleading with them not to leave. Day by day they text less and less and it stings a hundred times over. (It is important to note that this is only a hypothetical, and certainly does not represent all experiences with BPD, nor is it a definite situation to occur).
Perhaps it may aid in understanding not only to look at a Day in the Life imagining, but to consider where do these thought patterns originate from in the first place? As Dr. Megan Anna Neff stated, “at the core of BPD is a very anxious-preoccupied attachment style” (Neff, M. A. 2019). This attachment style can be characterized by an individual’s strong desire for intimacy and belonging, along with a fear of abandonment. They often have low self-esteem that leads to a dependency on others for validation. In Dr. Neff’s attempt at simplifying and giving more context to the DSM diagnostic criteria, she gets at how people with the disorder are often overwhelmed by the anxiety of a relationship going wrong since they have a strong need to fit in with people. Because of that need, their minds are hyperfocusing on searching for any negative warning signs. This may make them more susceptible to quick reactions to slight changes in someone else’s behavior–especially since they have that anxious-preoccupied attachment style. In frantic efforts to repair any chance of rejection or abandonment, lashing out with outbursts or projections is a common response.
For a disorder in which relationship stability can be a struggle, building long-lasting romantic relationships has its challenges. Based on a study by Selby and colleagues (2008), they found that “the presence of BPD symptoms predicts current romantic relationship dysfunction, and it does so, at least in part, via self-reported childhood emotional invalidation by parents” (p. 890). This connects to Dr. Neff’s article where she claims BPD is connected to an anxious-preoccupied attachment style, in line with the idea that attachment styles are formed when we’re younger, based on relationships with our parents/caregivers. If those with with BPD symptoms are reporting this early parental invalidation, in relation to their anxious attachment styles, that possibly may explain why they are “more sensitive to emotional invalidation (perceived or real) within romantic relationships and respond with maladaptive behaviors such as verbal attacks and impulsive behaviors” (Selby et al., 2008, p. 891). Again, when looking at BPD, or most mental disorders for that matter, it should be through a holistic lens in which we consider all possible factors. The stance on parental invalidation shaping this anxious attachment style is only one dimension of a complex disorder that attempts to further understand the way that those with the disorder function.
As for future implications, Selby and Fincham’s study also implies that it’s important to implement “interventions to treat maladaptive beliefs, social problem-solving skills deficits, and splitting tendencies” (2008, p. 891). While this is an implication meant for those in the research and clinical fields, knowing where interventions are needed could contribute to understanding the areas in which people with Borderline Personality Disorder may be struggling. Arguably, it is inevitable for challenges to arise within their close relationships. But with all of this in mind, educating oneself on the struggles associated with the disorder–and approaching these issues with knowledged and open mind–can reduce the stigma, can reduce stigma and create room for healthier connections.
References
American Psychiatric Association, issuing body. (2022). Diagnostic and statistical manual of mental disorders : DSM-5-TR (5th edition, text revision.). American Psychiatric Association Publishing.
Neff, M. A. (2019). DSM-5 Criteria for Borderline Personality Disorder. Neurodivergent Insights. https://neurodivergentinsights.com/dsm-5-criteria-for-borderline-personality-disorder/
Selby, E. A., & Fincham, F. D. (2013). Relationship impairment with borderline personality disorder. Journal of Family Psychology, 27(1), 163–173. https://www.fincham.info/papers/Selby%20et%20al%20BPD%20J%20Fam%20Psy.pdf
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