What is Borderline Personality Disorder? Find a psychotherapy treatment in Bangalore
What is borderline personality disorder?
The term “borderline” first appeared in the 1930s to describe a condition that stood between neurosis and psychosis. Object relations theorists believed “borderline personality organization” occurred as a result of fixation in the developmental phase of a child, specifically the developmental phase of separation-individuation.
Patients diagnosed with a borderline personality disorder often have intact reality testing, exhibit identity diffusion, use primitive defense mechanisms such as splitting and projective identification frequently, and are considered as those having ‘immature personalities’.
Helen Deutsch called it “ambulatory schizophrenia” (as-if personality), while Paul Hoch and Phillip Politan had coined the term “pseudoneurotic schizophrenia”. John Frosch used the term “psychotic character disorder” and the ICD-10 uses the term “Emotionally Unstable Personality Disorder (EUPD)” instead of borderline personality disorder.
In the latest version of the DSM-5, it appears under the section of Cluster B personality disorders (characterized by erratic and dramatic behavior) that includes Antisocial, Histrionic, Narcissistic personality disorder and appears under the section of Specific Personality Disorder F60-F60.9 in the International Classification of Disease (ICD-10).
The term ‘borderline personality organization or structure’ includes a wide range of personality types, impulse control disorders, mood disorders (especially bipolar disorder), and substance abuse disorders.
What are the common clinical characteristics of clients with borderline personality disorder?
The clinical features of borderline personality disorder are:
- These patients always seek out treatment during a crisis precipitated by difficulties in 4 areas of functioning, namely self-image, interpersonal relationships, affect, and behavior.
- Their interpersonal relationships are described as ‘volatile’ and ‘tumultuous’ with periods of extreme highs and lows. At times they idealize their partners or completely devalue them.
- They have disturbances in their ‘sense of self’ and ‘self-image’.
- They have an extreme ‘fear of abandonment’ and can go to great lengths to prevent any sort of abandonment (either real or imaginary).
- They frequently experience feelings such ‘emptiness’ ‘boredom’ and ‘loneliness’. In order to avoid these negative emotional states, they tend to develop relationships too quickly only to leave them in a matter of days or weeks.
- They tend to injure themselves by either cutting themselves, biting themselves, pulling their hair, banging their head to the wall, or over dosing on drugs (prescription and recreational) as a way of releasing intense emotional states. They also make frequent threats of self-harm to those around them.
- They engage in impulsive and high-risk behaviors, such as driving recklessly, going on shopping sprees and maxing out their credit cards, consuming excessive amounts of alcohol and drugs, engaging in sexual activities with multiple partners, and forming attachments too quickly with strangers they would have met online.
- Due to the doubtful, fleeting, and circumscribed in nature of their psychotic symptoms, they often undergo ‘micro psychotic’ episodes and experience dissociative and paranoia-like symptoms under intense stress.
- Although most of them are intelligent and gifted, however, due to their emotional instability, poor distress tolerance, and interpersonal relationship difficulties, they are unable to complete their academic courses, sustain in jobs for prolonged periods of time, have frequent changes in jobs, and hence, settle for jobs that pay them below their capabilities.
- They tend to have a bad reputation in the health care system as they are frequently rushed to emergency services after an attempt at self-harm or following intense anger outbursts.
- A large number of them suffer from comorbid AXIS I disorders such as mood disorders, anxiety disorders, substance abuse disorders, and PTSD.
How can borderline personality disorder be assessed?
Clinicians can use semi-structured interviews such as Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD) or the International Personality Disorder Examination (IPDE) to assess the presence of borderline personality disorder in patients, besides obtaining a detailed case history from the patient and their care-givers.
Does psychotherapy help in the treatment of borderline personality disorder? What are the most common psychotherapies recommended for the treatment of borderline personality disorder?
A combination of pharmacotherapy and psychotherapy is considered as the first line of treatment for borderline personality disorder. In severe cases, even inpatient care is recommended.
Dialectical Behavior Therapy (DBT) is an empirically supported therapy based on cognitive-behavioral principles and teaches clients healthier ways of coping through by 4 main skills of DBT 1. Core Mindfulness, 2. Distress Tolerance 3. Interpersonal Effectiveness and 4. Emotional Regulation, either imparted in individual therapy settings or group therapy setting have been effective in the treatment of borderline personality disorder.
Schema Therapy combines concepts and approaches from various other schools of therapy such as attachment theory, psychodynamic psychotherapy, gestalt therapy, and cognitive behavioral interventions. Schema therapy helps clients form a better match between their basic needs and the environment in which they are living. Schema therapy enables clients to shift from Early Maladaptive Schemas (EMS) which are nothing but self-defeating cognitive, affective and behavioral patterns and to more adaptive patterns of cognition, affect, and behaviors. Schema therapy also helps soothe and give in to the demands of the client’s vulnerable child mode, helps set limits on the angry-impulsive child mode, and fight the harsh messages of the “punitive-parent mode”.
Mentalization Based Therapy is an intervention that is based on the promotion and development of mentalizing capacities in borderline personality disorder clients. The term ‘Mentalization’ is a social construct which was first introduced in 1989 by Peter Fongy, and is considered as the capacity to implicitly or explicitly, make sense of ourselves and others, in terms of mental processes and subjective states.
You can contact the MPower center for treatment of Borderline Personality Disorder
MPower-The Bengaluru Center
2nd Floor, 2983, 12th Main, Indira Nagar, HAL, 2nd Stage, Bengaluru, Bangalore-560008, Karnataka
Mobile Number: 9702803210
MPOWER- THE CENTRE (MUMBAI)
1/155, 15, Nyaymurti Sitaram
Patkar Marg, Khareghat Colony,
Hughes Road, Mumbai - 400007
+91 22 23828133
+91 22 23856228
MPOWER - THE CENTRE (KOLKATA)
Unit N210A-211, 2nd Floor,
North Block, Ideal Plaza,
11/1, Sarat Bose Road
MPOWER - THE FOUNDATION (MUMBAI)22B, vasantrao N Naik Marg,
Opp. Bhatia Hospital, Tardeo,
Mumbai - 400 007.
+91 22 2386 8650
+91 22 2387 5147
+91 81087 99299
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