Borderline Personality Disorder

The Borderline Personality Disorder (BPD) it is a mental condition in which the patient has persistent complications in terms of personal relationships, self-image and his reaction to situations. You have overreactions and lose impulse control. He tends to appreciate people who take care of him one moment, and despise them the next.

According to Diagnostic and Statistical Manual of Mental Disorders "DSM IV", the main characteristic of Borderline Personality Disorder is a general pattern of instability in relationships interpersonal relationships, the image that the patient has of himself, and the affectivity that he shows, in addition to an evident impulsiveness. These characteristics begin to manifest in early adulthood.

The TLP in the face of interpersonal relationships

Individuals who suffer from it come to realize great efforts to avoid abandonment, whether real or imagined. They are sensitive to the circumstances of the environment. The perception of a latent separation, rejection or loss of external stability can cause profound changes in self-image, affectivity, cognition and behavior.

People with BPD often feel dependent and hostile, so their relationships are conflictive and turbulent. You can depend a lot on close people and show tremendous anger or rage towards them in times of frustration.

They present a pattern of unstable and intense relationships. They can idealize those who care for them. However, they quickly change their way of thinking and can go from idealizing others to devaluing them, thinking that they do not pay enough attention to them.

They have a huge need to lead a normal life and have good relationships, but at the same time, they have very afraid of privacy. The tension between this need and fear causes anxiety, guilt, and anger.

TLP to Individual Reactions and Self-Image

Present sudden and dramatic changes in self-image; changes characterized by modification of personal goals, values ​​and professional aspirations. They get bored easily and are always looking for something to do.

The basic dysphoric type of mood, that is, melancholy or depressive, of subjects with Borderline Personality Disorder, is usually interrupted by periods of anger, anguish, or despair, and the occasions in which a state of well-being or satisfaction comes to replace them are rare.

Most subjects with BPD experience great discomfort when they are alone, even for very short periods of time.

They have a low level of frustration tolerance, and great difficulty in channeling it properly. There are subjects born with a biological predisposition to react more intensely to lower levels of stress than other people, and take longer to recover, so this predisposition may be a factor in causing the disorder.

Have unpredictable responses, which consist of sudden mood swings or sudden emotional outbursts. They may display extreme sarcasm, persistent bitterness, or verbal outbursts. This behavior is harmful to the person with this disorder and to those close to him, who are not always know how to act and may think that no matter what they do or say, it will be turned around and used in their against.

Feelings vary dramatically in quality and intensity, from one moment to another, and can be so intense that they distort the perception of reality.

They alternate between feeling full of feelings or blocking themselves giving an image of total and absolute apathy. With these intense feelings or thoughts of the polarized type, that is, black / white, disappointment often turns into anger, which can be directed towards others, in verbal or physical attacks, or directed towards oneself in suicide attempts or behavior of self-violence.

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It is common for subjects with Borderline Personality Disorder to express Inappropriate and pronounced anger, or having trouble controlling it. These expressions of anger are often followed by Grief and Guilt, and contribute to the feeling of being "evil" or "outcast."

Outbursts of anger can generate the strongest impressions that the individual is out of control, impulsive, and inattentive to the consequences of his behavior. Although he is aware of his way of acting, it is inevitable, because he already sees the other person as someone who wants to hurt him, as an enemy.

It is relevant to understand that they usually don't try to hurt. They are acting out of great pain, fear, or shame, and are using primitive defenses that they may have learned long ago.

Criteria for the Diagnosis of BPD

According to the Diagnostic and Statistical Manual of Mental Disorders, there are the following criteria for the Diagnosis of Borderline Personality Disorder. With five or more of them being fulfilled, it is already a fact:

1.- Great efforts to avoid real or imagined abandonment

2.- Pattern of unstable and intense interpersonal relationships characterized by the alternation between idealization and devaluation.

3.- Alteration of identity, in terms of the image they have of themselves, accused and persistently unstable.

4.- Impulsiveness in at least two potentially harmful areas for your body or well-being, such as spending, sex, substance abuse, food.

5.- Intense behaviors or recurrent suicidal threats, or self-mutilating behavior.

6.- Affective instability due to a notable reactivity of the mood, such as irritability, anxiety, which usually last from hours to days.

7.- Chronic feelings of emptiness.

8.- Intense anger and difficulties to control it.

9.- Transitory paranoid ideation, related to stress or severe dissociative symptoms.

Treatment of Borderline Personality Disorder

For the treatment to be successful and progressive, it is essential to ensure two factors: Patient motivation and getting a good Therapist.

The treatment to be applied is very complex, since it is necessary to combine elements of different therapies, to adequately respond to the complexity of the painting and adapt to the particular characteristics of each person.

It depends on the work of a multidisciplinary team, as well as the help of the family.

Therapy will consist of two main aspects:

The Establishment of Behavioral Limits, that is, to moderate the time and frequency in which there are approaches with the subject in therapy.

The Maintenance of the patient's independence, so you have a faster and more solid progress, and learn to calibrate.