Borderline Personality Disorder

This gif is totally unrelated to the material below. It just entertains me.


Some of you may know that some time ago- when I was completing the first part of my Master degree- I was diagnosed with Borderline Personality Disorder. It's not something I write about often, or talk about often, or really want to. Not because I am ashamed of it. If someone asked me if I have it, I would not be ashamed to say that I do. It's just that it's not something I would go around introducing myself with. I know that, by definition, personality disorders- of which there are 14 according to the newest publication of the Diagnostic and Statistical Manual of Disorders- are a specific class of mental disorders unlike sleep disorders, anxiety disorders, eating disorders, somatic disorders, mood disorders etc., characterised by patterns of maladaptive behaviour, cognition, affect and inner experience that are enduring and exhibited across may contexts. These patterns are said to develop early and remain inflexible. Some say that they are associated with disability and significant distress. This is where I, personally, deviate. I will never say that I 'suffer from borderline'. I do not suffer. I made my parents suffer for a long time. I am still learning to regulate my emotional responses in certain situations where they deviate from what is acceptable because I am aware that my behaviour can cause suffering, especially for those who care about me. I am very lucky to have people who care about me. All I can say is that, disorder or not,  my actions are never intentionally carried out to cause anyone else harm. I am not going to whine about how I hate myself so much it's punishment enough. I am finished with my days of wallowing.

Now I'll just run through them briefly, for education purposes. The personality disorders are organised into clusters. This makes them a little more interesting, I guess, at least if you play it out in your head like a bunch of crazy characters with idiosyncratic off-the-wall ways of existing and bouncing off one another. Cluster A (the odd types) is comprised of these 3. Let's imagine them as characters.
Paranoid: irrationally suspicious, mistrusting of everybody, interprets people's motivations as generally malevolent.
Schizoid: not interested in social stuff, detached from others, no relationships, apathetic, doesn't express emotions.
Schizotypal: very uncomfortable with social interactions, does not like them at all.

Cluster B is where my diagnosis falls in. They are the erratic, emotional types. There are four types in Cluster B. The characters:
Antisocial: no regard for the rights of others, lacking in empathy, overblown self-image, manipulative, impulsive (sounds lovely)
Narcissistic: needs admiration, thinks that they are above all the rest and deserving/entitled to all, lacking in empathy too
Histrionic: attention-seeker, excessive displays of emotion
Borderline: pervasively unstable all over in terms of relationships, self-image, identity, behaviour and affect, often leading to impulsive behaviour and self-harm

Then there's Cluster C, the anxious and fearful types.
Avoidant: feeling socially inhibited all the time and feeling inadequate, extremely sensitive to being evaluated negatively
Dependent: pathalogically needy, basically
Obsessive-compulsive: rigidly conforms to rules, perfectionist, needs control to the point that they are excluded from friendships and other ways of having fun.

Anyway, after that short and informative digression, I guess I just wanted to write about it this once because it's not important for people to know about because of me, but it's important for people to know about personality disorders. I don't want to raise awareness or start claiming I get any special treatment. I didn't bring this upon myself and neither did anyone else. The causes are thought to be a mixture of genetic heritable factors and mainly averse early events. It was heartbreaking when I was in treatment because the majority of women in the group, myself included, had experienced traumatic events that had critically altered our lives. I am not about raising awareness or trying to claim it's something I should wear proudly. What I think is important is education.

When I started treatment- it's a very, very effective treatment called mentalisation based treatment- I was lucky enough to know how it works. It's not a talking cure and you don't have to sit there talking about the past and what it was that damaged you. For all anyone knows, it could be one thing, it could be a million things, or it could actually be nothing at all. Whatever it is or not, you have problems fitting in. You're making mistakes. You don't know why. You don't feel like a person so you act like a person but you're terrible at acting so you try and make your surroundings respond to you, to give you something to mirror yourself against. I happened to take a lecture in BPD and mentalisation based treatment as part of my neuroscience module as an undergraduate at UCL. I actually didn't think it had anything to do with me. Weirdly enough, I'd been sent to the university counsellor who had said the word 'borderline' to me, given me some numbers and books, and sent me away saying he could only provide 6 sessions and I needed long-term help. I laughed it off at the time. It wasn't until I was put into a mental health institution that someone wrote borderline on my health notes, which so far had been riddled with eating disorders and PTSDs. I still didn't get it. When I started the treatment, I was reluctant at first but soon I found myself in a room full of women who were speaking a language I understood and had been trying to communicate with my whole life, and nobody else I'd known could understand me. I was diagnosed with BPD so completed the full 18 months of treatment, and the reason I think education about such treatment is so important is because they work- if you understand them.

Mentalisation isn't a psychobabble word. It's also the name for a neural network in the brain that, among most people, operates automatically and without any problems at all. It allows them to infer the mental states of others, without assuming that they are absolutely correct and can read minds, without always assuming the worst, without taking their assumptions and turning them into their own destructive actions, and without neglecting them entirely either. People with BPD have a dysfunctioning mentalisation process. My whole life my mother had been saying, You are putting words in my mouth, and she had been right. The assumptions I was making were due to my lack of ability to naturally infer the mental states of others. I just can't get people by looking at them, basically. Isn't that almost tragically simple? When someone smiles at me, I think they are laughing at me. I take things too personally and I know it is irrational. I know these assumptions are not the truth. Now I know. Thanks to the treatment. I was taught what my problem was. I was taught how to see from other angles. It still takes effort and I 'mentalise' every day but it stops me from hurting myself so badly I end up in the funny farm.

Borderline personality disorder isn't something that I was diagnosed with and grew into. I have known people take on symptom, get worse, act out, use it as an excuse, claim disability funding. I am not going to turn into the diagnosis I'm given. I have made mistakes and maybe this explains some of them but it sure doesn't excuse them. 

The way I see personality disorders is that there is a societal order- some people are a few standard deviations away from the norm. We are the abnormal ones. The disordered, out of the order. In a few centuries, maybe, the order will have changed. Maybe we'll be the ones who are the norm. That's just an idea, but I just wanted to write positively, because I may have a few screws loose, but I spend time screwing them back in, and I will probably have to my whole life. A good description is as follows: "People with BPD are often exceptionally idealistic, joyful and loving. However they may feel overwhelmed by negative emotions, experiencing intense grief instead of sadness, shame and humiliation instead of mild embarrassment, rage instead of annoyance and panic instead of nervousness. People with BPD are especially sensitive to feelings of rejection, isolation and perceived failure. Before learning other coping mechanisms, their efforts to manage or escape from their intense negative emotions may lead to self-injury or suicidal behavior. They are often aware of the intensity of their negative emotional reactions and, since they cannot regulate them, they shut them down entirely This can be harmful to people with BPD, since negative emotions alert people to the presence of a problematic situation and move them to address it."

Now I am not saying I wanted to be treated differently. Ever. It is my personality. It is not an aspect of it or a problem I can solve. It's not all I am but it's mixed up in the sum of my parts. I just thought I'd write a little about it since I haven't done so before. If you'd like to read a good scholarly article, click below my hysterical laughter

Borderline Personality Disorder