What is BPD and why the bad rap?

All any person is ever trying to do in, well, life is to get their needs met. We have social, professional, intimate, collegial needs in addition to personal, emotional, spiritual and physical needs. The popularity of the self-help industry indicates that a lot of us aren’t getting all of those needs met, but arguably everyone is doing the best that they can and most people have a somewhat organized way to connect with others and feel okay. Borderline personality disorder is the diagnosis used to describe someone who is overwhelmed by their emotions, struggles to get their needs met, and is emotionally unregulated.

A full description of the criteria for borderline personality disorder is here. When taken as a whole, the symptoms describe a person who struggles managing emotions and relationships. To someone who experienced attachment trauma, other people can be either idealized or vilified, much time and attention is spent avoiding abandonment, and most relationships are short and intense. There can be a feeling of chronic emptiness, and perhaps a lack of sense of identity or self-concept. The individual can be impulsive, quick to anger, dissociative and do self-harm and sometimes have a history of suicide attempts.

Interestingly, the same dysregulation graph that showed trauma dysregulation applies to emotional patterns in folks with BPD, except that instead of representing the fight-or-flight response, this applies to the emotional experience in general. That is, folks with BPD follow the red line for happiness, sadness, love, despair, etc. They are extra sensitive, peak higher, and return to baseline more slowly than folks who are more regulated.

What’s BPD’s connection to trauma?

Marsha Linehan describes the etiology of the borderline personality disorder as both biological and environmental, and either one can be more important depending on the person. One idea is that folks with BPD experienced attachment trauma when they were very young.

When we’re infants and toddlers we learn how the world will respond to us. If our world, or caregivers, respond in an inconsistent, or cold, or highly anxious manner, then we don’t learn to care for ourselves, and we often internalize that we deserve to be treated badly because there is something wrong with us.

So it’s the mother’s fault? No, not necessarily! Someone can have the most wonderful parents, but maybe an illness or something causes an absence that can’t be explained to a baby. That could be experienced as rejection or abandonment by some babies, and not others, depending on their temperament, environment, etc.

The good news is that there is treatment for both attachment trauma and borderline personality disorder. That’s another post in itself, but if you’re wondering whether you have BPD, or just think you might benefit from some help with regulation, therapy is a great place to start.