Borderline Personality Disorder (BPD) has been a disability surrounded by stigma and confusion for a long time, and the time to bring awareness and public understanding to this disability is long overdue. The disability itself often gets misdiagnosed as an other disability since the symptoms overlap with many other disabilities (NIMH, n.d, para 16), or worse case scenario, a medical professional refuses to diagnose or treat the disability due to the belief that these people are untreatable because of a negative schema about the disability and clinical controversies on whether BPD is a legitimate diagnosis (Hoffman, 2007) . However, after nearly three decades of research, it has come to light that BPD does indeed exist, does have a good prognosis for remission with treatment (BPD Overview, n.d, para 3), and that there are many treatment options available such as three different types of psychotherapy (Dialectical Behavior Therapy, Cognitive Behavioral Therapy, and Schema-focused therapy), omega-3 fatty acid supplements, and/or medications (NIMH, n.d, para 29, 30, 31, and 39, 41). Even though the disability started as a psychoanalytic colloquialism for untreatable neurotics (Gunderson, 2009), BPD is very treatable and doesn’t deserve the stigma it currently carries throughout society. Symptoms, Comorbidity, and Risk Factors In order for someone to be diagnosed with Borderline Personality Disorder, they must experience at least five of the following symptoms: 1) fear of abandonment, 2) a history of intense and unstable relationships with family, friends, and loved ones, which often go back and forth between idealization (which includes love and extreme closeness) to devaluation (which includes extreme hatred or anger), 3) a disto... ... middle of paper ... ...were fewer in individuals who received DBT compared to those in the control group. Additionally, individuals who received DBT retained individual therapy and had an attrition rate of 16.7 percent compared to the control group, who had an attrition rate of 50 percent. DBT varies from CBT because it seeks a balance between changing and accepting behaviors and beliefs (NIMH, n.d, para 23). Additionally to CBT and DBT, Schema-focused therapy is a type of therapy that combines elements of CBT with other forms of psychotherapy that focuses on reassessing an individual 's schemas about themselves. This therapy is based on the theory that BPD stems from a dysfunctional self-image that affects how an individual reacts to others, their environment, and how they cope with problems or stress, whether it originates from negative childhood experiences or not (NIMH, n.d, para 23).
An estimated 1.6%-5.9% of the adult population in the United States has BPD, with nearly 75% of the people who are diagnosed being women. Symptoms of Borderline Personality Disorder include Frantic efforts to avoid being abandoned by friends and family, Unstable personal relationships that alternate between idealizations, Distorted and unstable self-image, Impulsive behaviors that can have dangerous outcomes, Suicidal and self-harming behavior, Periods of intense depressed mood, irritability or anxiety lasting a couple hours/days, Chronic feelings of boredom or emptiness, Inappropriate, intense or uncontrollable anger - often followed by shame and guilt, and Dissociative feelings. The three main factors that could cause this mental illness are Genetics, Environmental factors, and Brain function. This illness can only be diagnosed by a mental health professional after a series of interviews with the patient and family/friends of the patient. The patient must also have at least five of the nine symptoms of this illness in order to be diagnosed. The most common treatment for this illness is some form of psychotherapy. Some other treatment options are to prescribe medications and if needed a short-term
Borderline Personality Disorder in “Girl Interrupted” The movie, “Girl Interrupted,”is about a teenage girl named Susanna Kaysen who has been diagnosed with Borderline Personality Disorder. People with Borderline Personality Disorder “are often emotionally unstable, impulsive, unpredictable, irritable, and anxious. They are also prone to boredom. Their behavior is similar to that of individuals with schizotypal personality disorder, but they are not as consistently withdrawn and bizarre” (Santrock, 2003).
In the past, BPD was believed to be a set of symptoms between problems associated with mood and schizophrenia. These symptoms were believed to be comprised of distortions of reality and mood problems. A closer look at this disorder has resulted in the realization that even though the symptoms of this disorder reveal emotional complexity, this disorder is more closer to other personality disorders, on the basis of the manner in which it develops and occurs in families, than to schizophrenia (Hoffman, Fruzzetti, Buteau &ump; Neiditch, 2005). The use of the term borderline has however, resulted in a heated controversy between the health care fraternity and patients. Patients argue that this term appears to be somehow discriminatory and that it should be removed and the disorder renamed. Patients point out that an alternative name, such as emotionally unstable personality disorder, should be adopted instead of borderline personality disorder. Clinicians, on the other hand, argue that there is nothing wrong with the use of the term borderline. Opponents of this term argue that the terms used to describe persons suffering from this disorder, such as demanding, treatment resistant, and difficult among others, are discriminatory. These terms may create a negative feeling of health professionals towards patients, an aspect that may lead to adoption of negative responses that may trigger self-destructive behavior (Giesen-Bloo et al, 2006). The fact however, is that the term borderline has been misunderstood and misused so much that any attempt to redefine it is pointless leaving scrapping the term as the only option.
According to the DSM-5, Personality Disorders are characterized by “impairments in personality functioning and the presence of pathological personality traits”. Borderline Personality Disorder is one of ten personality disorders listed in the DSM-5. The DSM-5 lists several criteria that must be met in order for someone to be diagnosed with Borderline Personality Disorder. They are quoted as follows:
Borderline Personality Disorder (BPD) hinders people’s security, makes interpersonal and interpersonal relationships difficult, worsens the person suffering from the disorder’s life and those around them, effects their affect and self-image, and generally makes a person even more unstable (Davidon et al., 2007). This disorder is a personality disorder which effects the people’s emotions, personality, and daily living including relationships with other and job stability. People with BPD may experience a variation of symptoms including but not limited to: intense contradictory emotions involving sadness, anger, and anxiety, feelings of emptiness, loneliness, and isolations (Biskin & Paris, 2012). This disorder makes it hard for the person with the disorder to maintain relationships since they have tendentious believe that people are either strictly good or bad. Also, they are sensitive to other people’s actions and words and are all over the place with their emotions so those in their life never know which side to expect. (Biskin & Paris, 2012)
reduce instances of self-harm, self-injury, or suicidal behaviors. Though it integrates characteristics from CBT, it differs in that it also teaches the concepts of mindfulness (living in and accepting the here-and-now moment) and acceptance along with teaching the individual techniques to help them improve their ability to tolerate stress and regulate strong, intense emotions. DBT recognizes the tension caused by the need for acceptance of beliefs accompanied by the need for changes in behaviors.
The most successful treatments for Borderline Personality Disorder range from Dialectical Behavioral Therapy (DBT), Cognitive Behavioral Therapy, Psychoeducation and medications consisting of antipsychotics such as Zyprexa or selective serotonin reuptake inhibitors (SSRI’s) including Fluoxetine (Prozac) or Paroxetine (Paxil) to reduce the occurrences of mood swings, depression, boredom, agitation, and emptiness. Cognitive Behavioral Therapy can benefit Evie Zamora because it can help her identify and change her core beliefs and behaviors to her negative self-image or insecurities. Evie Zamora falls into two types of borderline, the petulant and impulsive. However, the most effective and useful therapy for Evie is DBT because it focuses on
Dialectical Behavior Therapy (DBT) is a comprehensive cognitive-behavioral treatment developed by Marsha M. Linehan for the treatment of complex, difficult-to-treat mental disorders. Originally, DBT was developed to treat individuals diagnosed with borderline personality disorder (BPD; Carson-Wong, Rizvi, & Steffel, 2013; Scheel, 2000). However, DBT has evolved into a treatment for multi-disordered individuals with BPD. In addition, DBT has been adapted for the treatment of other behavioral disorders involving emotional dysregulation, for example, substance abuse, binge eating, and for settings, such as inpatient and partial hospitalization. Dimeff and Linehan (2001) described five functions involved in comprehensive DBT treatment. The first function DBT serves is enhancing behavioral capabilities. Secondly, it improves motivation to change by modifying inhibitions and reinforcement. Third, it assures that new capabilities can be generalize to the natural environment. Fourth, DBT structures the treatment environment in the ways essential to support client and therapist capabilities. Finally, DBT enhances therapist capabilities and motivation to treat clients effectively. In standard DBT, these functions are divided into modes for treatment (Dimeff & Linehan, Dialectical behavior therapy in a nutshell, 2001).
The history of BPD can be traced back to 1938 when Adolph Stern first described the symptoms of the disorder as neither being psychotic nor psychoneurotic; hence, the term ‘borderline’ was introduced (National Collaborating Centre for Mental Health, 2009, p. 15). Then in 1960, Otto Kernberg coined the term ‘borderline personality organization’ to describe persistent patterns of behavior and functioning consisting of instability, and distressed psychological self-organization (National Collaborating Centre for Mental Health, 2009, p. 15).
Dialectical Behavior Therapy (DBT) is a comprehensive cognitive-behavioral treatment developed by Marsha M. Linehan for the treatment of complex, difficult-to-treat mental disorders. Originally, DBT was developed to treat individuals diagnosed with borderline personality disorder (BPD; Carson-Wong, Rizvi, & Steffel, 2013; Scheel, 2000). However, DBT has evolved into a treatment for multi-disordered individuals with BPD. In addition, DBT has been adapted for the treatment of other behavioral disorders involving emotional dysregulation, for example, substance abuse, binge eating, and for settings, such as inpatient and partial hospitalization. Dimeff and Linehan (2001) described five functions involved in comprehensive DBT treatment. The first function DBT serves is enhancing behavioral capabilities. Secondly, it improves motivation to change by modifying inhibitions and reinforcement. Third, it assures that new capabilities can be generalize to the natural environment. Fourth, DBT structures the treatment environment in the ways essential to support client and therapist capabilities. Finally, DBT enhances therapist capabilities and motivation to treat clients effectively. In standard DBT, these functions are divided into modes for treatment (Dimeff & Linehan, Dialectical behavior therapy in a nutshell, 2001).
In it's simplest form, Cognitive Behavioral Therapy, (or CBT as it will be referred to from here on out), refers to the approach of changing dysfunctional behaviors and thoughts to realistic and healthy ones. CBT encompasses several types of therapy focusing on the impact of an individual's thinking as it relates to expressed behaviors. Such models include rational emotive therapy (RET), rational emotive behavioral therapy (REBT), behavior therapy (BT), Rational Behavior Therapy (RBT), Schema Focused Therapy, Cognitive therapy (CT). Most recently a few other variations have been linked to CBT such as acceptance and commitment therapy (ACT), dialectic behavioral therapy (DBT), and Mindfulness-Based Cognitive Therapy (MBCT) (Harrington and Pickles, 2009). The main aspect that all of these branches of therapy share, is that our thoughts relate to our external behaviors. External events and individuals do not cause the negative thoughts or feelings, but, instead the perception of events and situations is the root cause (National Association of Cognitive Behavioral Therapists, 2010).
There has been no change in the diagnostic criteria from the DSM-IV to the DSM-5 with regards to diagnostic criteria for borderline personality disorder. Borderline personality disorder is defined by the American Psychiatric Association in the DSM-5 (2013) as “a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts” (Borderline Personality Disorder). There are nine criteria listed in the DSM-5 (2013) that are utilized as indicators that the individual meets the diagnostic definition of BPD. The individual must meet a minimum of five of the criteria
These treatments can be divided in 2 categories, therapist and/or medicine. PBS 's website on BPD states that therapy “involves learning about your condition, and thinking and talking about how you feel, think and behave”.The website also lists 3 different therapies that are effectively improving the symptoms of BPD. First of all, transference-focused psychotherapy helps individuals with BPD to understand about emotions and difficulties in a relationship. And through conferences, therapist would “walk them through” the relationship in order for individuals with BPD knowing what to do to maintain an healthy relationship. Second of all, Dialectical behavioral therapy (DBT) focus on “developing skills for handling stress, regulation emotions, tolerating negative emotions and improving relationships. DBT has been proven as one of the most effective treatment of BPD as one of the interviewee in Border _ | A compassionate documentary on BPD ,directed by Sattler, mentions that DBT has helped her a lot to understand herself and able to start developing the sense of true self. She also says that DBT has helped her to be able to associate with her negative thoughts and use it to improve herself. Last but not least, Schema therapy helps “to recognize and switch out self-defeating schema modes as quick as
Borderline personality disorder is a cluster b type of disorder. This type of disorder is characterized by unpredictable and dramatic behavior. It is also included with antisocial, narcissistic, and histrionic personality disorder. The DSM 5 states that the diagnosis must include, frantic efforts to avoid imagined or real abandonment, intense and unstable relationships, identity disturbance, impulsive decisions in two or more areas (excessive spending, promiscuity, eating disorders, substance abuse, or reckless driving), reoccurring suicidal behavior or self mutilation, mood swings that last as little as a few minutes or a few days, numbness or emptiness, inappropriate displays of anger or inability to restrain anger, dissociation or paranoia.
My friend shows patterns of behavior of someone that has a borderline personality disorder. First and for most she is the type of girl that can never be single. She always needs the love and affection of a boy in her life. Although, she tends to be involved in long-term relationships she breaks up and makes up with her significant other more than once in a given year. She has stated in many occasions that she does not like being alone, in other words doesn’t like the feeling of emptiness. In addition, she stresses over the smallest things in her relationship. She appears to be very clingy with her boyfriend and can’t do anything without him. If I were to invite her out for a girl’s night she would ask if her boyfriend could come along. If he