Borderline Personality Disorder (known as BPD) is a little-known mental health condition that affects approximately 1% of people in the UK. Sufferers feel emotions more intensely than those around them, and can swing from feeling dependent to feeling smothered. They are also very likely to self-harm or attempt suicide as a way of coping with these emotions. People newly diagnosed with BPD can find the condition confusing, as there is comparatively little information available online, and it isn’t regularly discussed by the media.
However, BPD is treatable and is mainly managed with a specific type of talking therapy called Dialectical Behaviour Therapy, which teaches more robust and healthy coping skills and behaviour management, either in a group setting or individually.
Symptoms of BPD
- Inability to regulate your emotions
- Frequent self-harm and suicidal ideation, often leading to suicide attempts
- Intense relationships with friends, family, colleagues and partners; a fear of being abandoned by them even for short periods, driving you to co-dependent behaviour, but also a fear of being smothered or controlled by them, driving you to confrontation. These contrasts are commonly referred to as ‘go away/please don’t go’
- Emotional outbursts and uncontrollable anger (sometimes leading to physical violence)
- Mood swings across several hours
- Feelings of emptiness
- Low self-esteem and poor self-image
- Risk-taking behaviour, such as substance abuse, gambling or unsafe sex
- Disturbed thought patterns, like hallucinations, or a feeling you don’t exist
BPD isn’t usually diagnosed in childhood, but its symptoms can appear in or be traced back to teenage years or early adulthood.
The symptoms may affect your life in many different ways: for example, you might have trouble holding down jobs or relationships, or you might become driven to use alcohol and drugs to conceal low self-esteem and feeling chronically empty.
Dialectical Behaviour Therapy: The Main Treatment for BPD
Dialectical Behaviour Therapy is a long-term commitment, but a very effective strategy for managing BPD. You will learn to analyse your behaviour and reset your goals, moving away from feelings of anger, low mood and emptiness to be able to survive and then thrive again.
DBT can involve ‘homework’, so it can’t be entered into lightly, but every bit of work you put in will lead you towards a sustainable way of life, where you feel in control of your emotions and your life decisions. It will add much-needed stability after months or years of turbulence. For more on DBT and how it works, click here.
Other approaches like Cognitive Analytical Therapy (CAT), schema therapy and psychodynamic psychotherapy can also be used where appropriate.
Marsha Linehan, PhD: BPD Patient and the Godmother of Dialectical Behaviour Therapy (DBT)
Though the doctor who invented Dialectical Behaviour Therapy has personally experienced Borderline Personality Disorder, she didn’t publicly reveal this connection until 2011. Aged just 17, Marsha Linehan was admitted to a mental health hospital, the Institute of Living, in 1961, due to ‘social withdrawal’. She spent over two years as an inpatient, often on the secure ward, having been misdiagnosed with schizophrenia (there was no BPD diagnosis in those days); she was even given electroconvulsive therapy (ECT).
Once back in the community, Linehan struggled to deal with the outside world but simultaneously trained in psychology, determined to help others like her. She noticed that patients with chronic suicidal ideation and self-harm history often disengaged from traditional Cognitive Behavioural Therapy (CBT). They became angry and defensive, particularly when asked to make major life changes, or they became too dependent on their therapist.
Linehan was determined not to invalidate her patients’ feelings, but to lead them to a state of acceptance that the life they envisaged was not the life they had; this conflict between hopes and plans versus reality was often resulting in low mood and the urge to self-harm.
Her pioneering work to develop DBT has helped countless patients around the world, as DBT is now recognised as the best option for someone diagnosed with BPD. If you’d like to discuss DBT treatment with Christine Tizzard Psychology, get in touch today.
Written by guest contributor Vikram Das for Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk).