The term borderline has a long and confusing history. Originally, it was used to describe a condition at the border of neurosis and psychosis. Today’s definition of borderline personality disorder no longer assumes a “relationship” to schizophrenia.
The diagnosis Borderline is a completely separate mental disorder with many different symptoms. The original meaning of the word is no longer valid. Concerned persons can, however, identify themselves very well with the meaning of the word: on the border go between normality and illness, between closeness and distance, between exalted and distressed to death. Many borderliners have experienced borderline injuries, they can hardly set limits.
Borderline Personality Disorder Diagnostics
The ICD-10 uses the term “Emotionally Unstable Personality” and then differentiates once again between the Impulsive Type and the Borderline Type. For the diagnosis of “Emotionally Unstable Personality Disorder” certain criteria have been defined.
The Impulsive type must have at least three of the following five characteristics. The first feature, however, must be there:
- Inclination to quarrels and conflicts, above all because of impulsive and unexpected actions;
- Inclination to unexpected actions without consideration of consequences;
- Inclination to anger or outbreaks of violence and inability to control explosive behavior,
- Difficulties in maintaining actions that are not immediately rewarded;
- Impermanence and unpredictability of mood.
For the diagnosis of the borderline type, there must be at least three of the above characteristics plus at least two of the following five characteristics:
- Uncertainties in self-image or in one’s own identity, uncertainties in one’s own goals and preferences;
- Tendency to intense but unstable relationships;
- Exaggerated efforts not to be abandoned;
- Repeated threat or execution of self-injurious behavior;
- Persistent feelings of emptiness.
The disorder affects the feelings and behavior of those affected. It changes how sufferers experience the world around them, and it changes their identity. It is a very complex disorder with many different appearances.
Borderline Personality Disorder Effects
Effects on the feeling
- Mood swings : borderline sufferers experience quick mood changes. In addition, they are very receptive to the moods of their fellow human beings.
- Anger : Those affected often have a great anger that they can not control. Their anger can be directed against people, objects or their own person.
- Emptiness and boredom : This feeling is part of the elemental experience of borderline sufferers.
- Loneliness and abandonment : People with Borderline Personality Disorder desperately strive to avoid being alone, loneliness seems existentially threatening to them.
Impact on impulses and behavior
- Impulsivity : Affected sometimes think of the consequences of an action, they give their impulses directly after.
- Suicidality : Suicidal and parasuicidal behavior, ie acts that harm one’s self but do not kill, are typical.
- Self-injurious behavior : The characteristic behavior of people with Borderline Personality Disorder is self-injurious behavior. It is often used to relieve anxiety or tension.
Effects on the experience
Dissociation : When their emotional world is unbearable for those affected, they sometimes completely separate the experience from their consciousness. Right now they have no access to things. Some feel as though they were floating, as if they were looking at the situation like an uninvolved observer.
Impact on the identity
Many people with borderline personality disorder suffer from not having their own sense of identity. They are somehow alien to themselves and orient themselves very much to the expectations of the environment. For friends, they are ready to do almost anything, regardless of their own feelings and needs. Some measure their own self-esteem only on the praise from outside. Many sufferers do not know exactly what they want. You need to be guided to find out.
Nearly 2 percent of the population meets the diagnostic criteria of borderline personality disorder. In young people, however, over 6 percent are affected, while in the group of over 40-year-olds only about 0.7 percent suffer from the disorder.
Most researchers and therapists adopt a biopsychosocial origin model of borderline personality disorder that takes into account an interaction between genetic factors, traumatic experiences, and negative learning processes or behaviors.
What helps in everyday life?
Since many sufferers have been cut down, devalued or rejected by others over the course of their lives, it is especially important to treat them with benevolence. Try to develop understanding of their emotional fluctuations. Those affected can often barely tolerate and understand their mood swings themselves. If the environment reacts with rejection or devaluation, the negative feelings are only amplified.
A benevolent, calm reaction on the part of the employees, on the other hand, has a calming effect. Borders and rules make a relationship calculable, you know what you can expect.
However, experiencing limits is also associated with frustration, especially when expectations are disappointed. At the same time, borders create security for all concerned. When there are no limits, sufferers tend to continually test boundaries. Some borderline people have a veritable aptitude for unclear structures or information gaps. You can set boundaries in an empathetic way by not only perceiving the feelings and disappointment, but also addressing them.
Helping people help themselves
Borderliners are usually very interested in learning about borderline. For many, there is a great need to understand oneself better. There are many ways for those affected to obtain information: psychoeducational groups, one-to-one interviews or self-help literature.
Those affected can learn to control themselves better in everyday situations. It is primarily about building good habits, such as not to do everything at once with complete exhaustion in professional activities. They learn to use their powers to house and take breaks. Those affected learn to reduce their perfectionist aspirations and to admit that they are making mistakes. They can be aware that they are not responsible for everything and are not immediately responsible if something is not done on time.
In relationships – love relationships, but also in friendships – and in their leisure behavior, borderline people tend to extremes. Sometimes they spend too much and too much on an intense relationship or they retire desperately. Then they suffer from loneliness and may even plunge into the next relationship.
Another area of self-regulation is health-promoting diet, drinking, sleep and exercise habits. Many sufferers suffer from eating disorders or have great difficulty in drinking enough.
As part of psychotherapeutic treatments, various strategies (skills) have been developed to improve self-control, which are recommended and used by many affected people. Below is a brief overview: Skills are understood in the dialectical-behavioral therapy skills that help to reduce the tension and find out without self-harm from crisis situations. These skills are usually practiced in “skill groups”. Skills groups are often offered as part of inpatient or outpatient treatment. The practiced skills refer to six areas:
- Stress tolerance,
- Dealing with emotions,
- interpersonal skills,
- physical health,
- Solve problems.
In times of crisis, those affected do not always remember what they can do, how to get rid of their tension without harming themselves. Self-help strategies are more present when they are packed in an emergency kit. The idea implies that those affected always have their personal crisis assistance with them.
Self-injurious behavior in borderline people is one of the most difficult issues: when people cut or burn themselves, it creates a lot of uncertainty. For those affected, it is helpful if their distress is seen and at the same time an objective handling of self-injury is possible. Specifically, this means that wounds are adequately treated. In the case of deeper injuries, this can also mean visiting a doctor together with the affected person.