Borderline Personality: Life in Black and White

In the world of psychology, there are various categories of mental and emotional conditions people can suffer from. The more common ones, such as depression, ADHD, anxiety, and bipolar disorder get a lot of attention in our society. One category of conditions, personality disorders, aren’t talked about as much; however, they can be very debilitating disorders to have. A personality disorder is “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment” (DSM-5; APA, 2013).

One personality disorder in particular, Borderline Personality Disorder, is a disorder clinicians often see in therapy. People who have this disorder experience extreme instability in their interpersonal relationships (family, romantic, friendships), impulsivity (drug or alcohol use, spending money, binge eating), recurrent suicidal behavior and threats, and self-mutilation. Additionally, someone with Borderline Personality Disorder may have chronic feelings of emptiness, intense and inappropriate anger outbursts, and an unstable sense of self or identity. This disorder is most commonly seen in young women, and tends to improve somewhat with age.

People who are in relationships with those who have Borderline Personality disorders may feel like they are walking on eggshells around the person or feel that they are being manipulated by the person. For example, a young woman with this disorder may meet someone and become quickly attached, idealizing this new person in her life, only to shortly thereafter feel that the new person is not giving enough in the relationship. The young woman may threaten to hurt herself if the new person in her life does not stay in the relationship/spend more time with her, etc. She may experience multiple job losses due to interpersonal difficulties at work or due to dramatic shifts in her opinions and sense of identity. There is little room for grey area in their life as things shift from one extreme to another.

Typically, people with Borderline Personality Disorder come from childhoods where there was little stability in their attachments and bonds with parents or caregivers who may have been abusive, neglectful, or alternated dramatically between being loving and abusive.

Until somewhat recently, Borderline Personality Disordered was considered untreatable, but we now know that with specific types of therapy and medication the disorder can improve greatly. The therapy that is now most recognized for treating Borderline Personality Disorder is Dialectical Behavioral Therapy, which is a very structured therapy that focuses on improving interpersonal skills, coping with distress and intense emotions, and learning how to use mindfulness to stay aware of thoughts and feelings that may trigger a person’s anger or suicidal behavior. This therapy is useful for many people, but is particularly helpful to those with Borderline Personality Disorder as it addresses the personality traits and behaviors that cause so much distress and impairment in their everyday lives.


Suggested reading/resources:

“Sometimes I Act Crazy: Living with Borderline Personality Disorder” by Jerold J. Kreisman and Hal Straus.

“I Hate You, Don’t Leave Me” also by Jerold J. Kreisman and Hal Straus.