Blog 34: Borderline Personality Disorder

Written by Jim Sheehy

 

BPD or Insecure Relational Attachment affects between 1 and 2 people in every 100.  40% of adolescents under psychiatric care have this condition.  Its main symptoms are: anxiety, depression, difficulty with intimacy and indecisiveness.

Why does a young person experience this condition?  Usually when growing up, their highly sensitive self loses their essential attachment bond with parents.  Very often, the parents are not aware of what’s going on until their teenager explodes or implodes in their behaviours.  Initially, there can be a clingy / hostile ambivalence in relating to parents.  These teens experience confusion and frustration because they themselves can’t understand what lies beneath their moods: sad, angry, anxious, depressed.

So, in therapy, teenagers or even children speak of their inner world being ‘an empty hole, a maze or a tangled knot’.  Telling their story, they reveal a self that became ashamed for a host of different reasons.  They keep this shame secret from everyone, even parents.  When they become a teenager, they learn to survive by adapting a ‘pride’ front because they can’t be going around with shame written on their forehead.  So, they can be very needy inside but don’t believe they are loveable and, instead, become the shoulder that everyone cries on – the caretaker.  To parents at home, however, they come across as deceitful and sometimes arrogant, doing their own thing, seemingly oblivious that their moods and behaviours impact the family atmosphere very negatively.  What I say to these clients is: both the shame and pride identities are false and where we need to begin is develop a new identity based on evidence: the good parts in personality, family and friendship history, their own resilience in trying to live a contented life.  I compare it to planting a new sapling and nourishing it with the evidence the client themselves come up with.  They don’t do compliments from others.  Compliments work for folks solid in who they believe they are and what they’re worth.  For folk with BPD, the compliments from parents, teachers, friends, etc. get lost in the inner emptiness.  What does work is evidence the client can’t dispute.  It would stand up in a court of law: academic grades, sporting or creative achievements etc.  Remember, these are highly sensitive and will often excel in anything they’re passionate about.  But nourishing this new identity also involves shedding overused and outdated attitudes and behaviours, masks and defences that hurt confused loved ones.

BPD clients want to ‘attack’ me when I tell them their condition is life-long.  However, I offer them hope - each decade we live through is very different and more positive in experiencing and managing the condition. In the teens, the young person can be seen as high maintenance in the family setting. They have an intensity of mood that can implode or explode by isolating in their room or ‘flying off the handle’ at the least challenge. They realise that they struggle with boyfriend or girlfriend. 3 approaches they can find helpful in providing a platform on which to build self-worth and build healthy relationships: finding an activity like sport or studying academic subjects; expressing their moods in art, writing, music, drama or dance; finding a therapist or adult mentor they like and trust and they feel ‘get them’. In their twenties, work that absorbs them for 30-40 hours a week provides time-out from self-absorption at home; In their thirties, they are better at managing moods and are sufficiently self-contained to seek and commit to adult partnership and raising children. In later life, they compose a philosophy of life based on what reasons they have to stay alive and feel alive.

The life of the BPD child, teenager and adult is far from easy but it can be relatively happy and fulfilling.   They may on occasion have to take prescribed drugs to take the edge off depression and anxiety.   What they need to learn are ways to develop interpersonal effectiveness, regulate emotions, communicate skilfully and learn strategies to tolerate distress.  I say to the client: the empty, confused tangle is part of who you are.  No point in denying, hiding or running away from that reality.  But you can reach and grab what you plant on the bank: trees, shrubs, flowers.  These will see you through life.  Trees are the one or two trust figures who get you and chat to you on brighter days and darkest nights.  Shrubs are what absorbs you and are activities that keep you from self-absorbing in too much thinking and feeling: work, interests and hobbies.  Flowers are treats, important because the life of someone with BPD can be intense, even exhausting.  Flowers can be travel, eating out, beauty and massage treatments. 

What can be very frustrating is the search for the right friend or partner.  The friend or partner needs to be patient, compassionate, strong and firm – quite a shopping list.  This friend or partner accepts the positive qualities. and the occasional ‘slumps’ of someone with BPD.  There will be periods of dependency when the moods prove overwhelming but this passes and what emerges are friends and partners, Mums and Dads who are inspirational and become leaders in helping others in distress,


If you enjoy the material, please get the word out there among those you care for.  You can contact me with comment or suggestion via Facebook at Jim Sheehy Therapy and on Twitter @jimsheehy2017

Take care,

Clarifying Disclaimer:  While the material I am presenting is well-researched and suitable for the general population, I believe each person’s issues and needs are unique.  I encourage you to seek medical and/or therapeutic support if you struggle with an issue or condition that negatively and seriously impacts your life.

 

Contact

Contact me:

Jim Sheehy M.Ed. MIACP
Leitir
Kilcar
Co Donegal 
F94 WV99

087 2137922

jsheehy@hotmail.co.uk

 

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