Borderline Personality Disorder

"People with BPD are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement."

Marsha Linehan

What is it like to have borderline personality disorder?

Borderline personality disorder is a multifaceted illness. It includes intense emotions and rapid mood swings; painful feelings of shame, worthlessness, or self-loathing; difficulty forming stable, healthy relationships; and impulsive behavior that might be harmful to your wellbeing. Other people in your life might not understand why you react to things the way you do -- contributing to a painful cycle of conflict, anxiety, anger, and shame. 

People with borderline personality disorder struggle a great deal in these areas:

The Self

• Chronic low self-esteem

• Sudden, extreme swings in self-esteem

• Confusion about identity; not knowing who you really are

• Being a "chameleon" -- changing your interests, behavior, and other aspects of identity depending on who you are with

• Difficulty spending time alone

• Feelings of emptiness

Relationships

• Intense fear of abandonment or rejection

• Intense feelings towards others -- either love and idealization, or rage and devaluation, with very little gray area in between

• Getting attached to people who are unavailable or not good for you

• Pushing others away before they can reject you

• Being passive and people-pleasing

• Sensitivity and mood swings contributing to challenges in relationships

Emotions and Impulses

• Rapid, extreme mood swings

• Chronic or recurring depression and anxiety

• Feelings of shame, anxiety, or rage that are easily triggered

• Occasional feelings of paranoia

• Feeling numb or empty

• Difficulty identifying your emotions

• Dissociation: "spacing out," feeling disconnected from your body, feeling like nothing is real (derealization) or you are not real (depersonalization), feeling as though your life is happening to someone else or you are watching it like a movie, episodes of "blacking out" when sober (especially during extreme stress or anger)

• Impulsive behavior that may provide temporary relief, such as self-injury, substance use, shopping, sexual behavior, eating behavior (e.g., binging or restricting), verbal aggression, etc.

How do you treat borderline personality disorder?

Every client is different, but treatment for borderline personality disorder generally involves:

• Safety and stabilization. As with treatment for trauma, treatment for BPD begins with addressing any urgent concerns: reducing or managing suicidal thoughts and other symptoms that put you at risk for serious harm; working to meet basic needs (e.g., financial resources, safety from abuse); and managing current depression and anxiety. (Treatment for BPD often includes treatment for trauma, depression, and anxiety; click the links to learn more.) 

• Exploring your feelings and how they DO make sense. People with BPD, in particular, often receive the message that they are overreacting, dramatic, or "crazy." But your feelings and reactions are always understandable. We will look closely together, with open-mindedness and compassion, to understand your feelings and reactions.

• Slowing down the "zero to one hundred" reaction. Whether it's relationship conflict, self-destructive behavior, or something else, there is probably an area of your life where "going from zero to one hundred" has made it difficult to change despite your best efforts. We will slow this down both by "zooming out" and "zooming in." Zooming out, we identify your triggers so you can prepare ahead of time (when possible) for situations that might trigger you. Zooming in, we identify specific thoughts, feelings, and impulses that show up when the "zero to one hundred" reaction begins. Noticing these will help you to catch yourself in the moment -- to realize that you are going from zero to one hundred -- which is the first step to change.

• Improving communication skills. We will explore your communication style and work on assertive communication skills.

• Enhancing overall wellbeing. From the basics like getting enough sleep, to recreation and social support, we will work on self-care strategies to help reduce the mood swings that come with BPD.

If this sounds helpful to you, reach out to me or request an appointment online. I would be honored to work with you.