Sam Vaknin

Borderline Personality Disorder

The fact that the Borderline personality disorder is often found among women makes it a controversial mental health diagnosis.

Some scholars say that it is a culture-bound pseudo-syndrome invented by men to serve a patriarchal and misogynistic society. Others point to the fact the lives of patients diagnosed with the disorder are chaotic and that the relationships they form are stormy, short-lived, and unstable. Moreover, not unlike compensatory narcissists, people with the Borderline Personality Disorder often display labile (wildly fluctuating) sense of self-worth, self-image and affect (expressed emotions).

Like both narcissists and psychopaths, borderlines are impulsive and reckless. Like histrionics, their sexual conduct is promiscuous, driven, and unsafe. Many borderlines binge eat, gamble, drive, and shop carelessly, and are substance abusers. Lack of impulse control is joined with self-destructive and self-defeating behaviors, such as suicidal ideation, suicide attempts, gestures, or threats, and self-mutilation or self-injury.

The main dynamic in the Borderline Personality Disorder is abandonment anxiety. Like codependents, borderlines attempt to preempt or prevent abandonment (both real and imagined) by their nearest and dearest. They cling frantically and counterproductively to their partners, mates, spouses, friends, children, or even neighbors. This fierce attachment is coupled with idealization and then swift and merciless devaluation of the borderline's target.

Exactly like the narcissist, the borderline patient elicits constant narcissistic supply (attention, affirmation, adulation, approval) to regulate her gyrating sense of self-worth and her chaotic self-image, to shore up serious, marked, persistent, and ubiquitous deficits in self-esteem and Ego functions, and to counter the gnawing emptiness at her core.

The Borderline Personality Disorder is often co-diagnosed (is comorbid) with mood and affect disorders. But all borderlines suffer from mood reactivity.

From an entry I wrote for the Open Site Encyclopedia:

"(Borderlines) shift dizzyingly between dysphoria (sadness or depression) and euphoria, manic self-confidence and paralyzing anxiety, irritability and indifference. This is reminiscent of the mood swings of Bipolar Disorder patients. But Borderlines are much angrier and more violent. They usually get into physical fights, throw temper tantrums, and have frightening rage attacks.

When stressed, many Borderlines become psychotic, though only briefly (psychotic micro-episodes), or develop transient paranoid ideation and ideas of reference (the erroneous conviction that one is the focus of derision and malicious gossip). Dissociative symptoms are not uncommon ("losing" stretches of time, or objects, and forgetting events or facts with emotional content)."

Hence the term "borderline" (first coined by Otto F. Kernberg). The Borderline Personality Disorder is on the thin (border) line separating neurosis from psychosis.

Article Tags: Borderline Personality Disorder, Borderline Personality, Personality Disorder

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