Imi Lo, Clinical Psychotherapist & Art Therapist
Borderline Personality Disorder (BPD) is also known as Emotional Dysregulation Disorder or Emotionally Unstable Personality Disorder in Europe. Despite being referred to as a ‘personality disorder’ in the diagnostic manual, many have proposed that the term ‘personality disorder’ is best understood as a disorganisation of the capacity for regulating emotions. This means that a person can sometimes experience emotions as overwhelming, spiralling out of control, and rapidly changing.
The Diagnostic and Statistical Manual of Mental Disorders, D.S.M.5, defines borderline personality disorder as follow:
“A pervasive pattern of instability of interpersonal relationships, self-image, and emotions, and marked impulsivity beginning in early adulthood and present in a variety of contexts, as indicated by five or more of the following:
1. Frantic efforts to avoid real or imagined abandonment
2. A pattern of intense and unstable relationships
3. Persistently unstable self image (and attempts to control it)
4. Impulsivity in at least two areas that are self damaging e.g. spending, substance abuse, sex, reckless driving, binge eating
5. Recurrent suicidal behaviour, gestures, threats or self-mutilating behaviour
6. Affective instability, due to a marked reactivity of mood.
7. Chronic feelings of emptiness
8. Inappropriate, intense anger, or difficulty controlling anger
9. Transient, stress-related paranoid ideation, or severe dissociation
These symptoms may manifest themselves in various ways. For instance, for some people ‘frantic effort to avoid feeling abandoned’ means not being able to be alone and becoming clingy, whilst for others it is about chronically isolating themselves altogether to avoid disappointment or hurt.
Sometimes people with BPD seem to view the world in a black-or-white, ‘all good or all bad’ fashion. This can be confusing and frustrating to the people around , but it may be the only way the person can safely experience the world at a certain point in time.