Department of Psychiatry
Penn Behavioral Health

PAH Outpatient Behavioral Health Clinic

subpage feature

Newsletter: June 2011

A Brief Introduction to Borderline Personality Disorder

Robert Riordan, BA

A personality disorder is a psychological disorder characterized by an adult’s chronic use of certain coping mechanisms in an inappropriate, rigid, and maladaptive manner. To this end, personality disorders are considered enduring and persistent styles of thought and behavior. Borderline Personality Disorder refers to a psychological disorder where the sufferer exhibits, among other things, an overreliance on splitting (specifically, splitting the world into all good aspects and all bad aspects), which often results in unstable interpersonal relationships.  Individuals who split can exhibit intense, positive attachments to others in one moment.  However, if the sufferer is angered, slighted or stressed, he or she can then quickly shift from idealization to devaluation, where negative feelings toward others predominate. While there are many aspects to Borderline Personality Disorder not addressed here, the hallmark symptom of the disorder is emotional instability. When an individual with Borderline Personality Disorder becomes overwhelmed with emotion, he or she often loses the ability to think clearly and may become unpredictable in his or her behavior. Surprisingly, such extreme behavior is often exhibited in an effort to maintain relationships, rather than to disrupt them (as often occurs).

The sufferer’s strong emotionality can affect his or her self-image, mood and/or behavior, as well as negatively impact his or her long-term personal and professional growth. People who have this disorder are often intelligent, sociable, and very competent. Unfortunately, as with people who suffer from any personality disorder, individuals who have Borderline Personality Disorder rely too heavily on familiar behaviors, even if they are chaotic, in an effort to increase their comfort when they feel as though the fulfillment of their needs is threatened.

Individuals with Borderline Personality Disorder can improve with treatment.  While psychotropic medications can be used to help stabilize the sufferer’s mood and improve their reality testing, lasting change can only occur through intensive psychotherapy (both through individual and group therapy). Therapists trained to work with individuals with Borderline Personality Disorder can help these patients to regulate their emotional states and to find more adaptive ways to respond to conflict or threat. In particular, therapy can help the patient to curb splitting behaviors and to learn to tolerate, at the same time, both the good and bad aspects of others or situations.

Unfortunately, there are barriers to treatment.  The psychological term borderline has made its way into everyday language; and, it is frequently misused. The term was originally adopted in order to denote the level of an individual’s psychological functioning. Today, however, as opposed to being descriptive, the term when used in isolation has become pejorative, and it is often indiscriminately used to summarily explain the behavior of individuals (most often, females) who display strong, uncontrolled emotion. There may be several causes underlying a show of strong emotion, and the thoughtless application of this term has led to a degree of stigma surrounding the diagnosis of Borderline Personality Disorder. 

It is important for the sufferer and his or her family to appreciate that maladaptive thoughts and behaviors are learned and, as such, they can be altered to a certain degree.  The first step is for the sufferer to acknowledge that his or her coping style is not developmentally appropriate and that his or her daily functioning can be improved by taking the time to learn more adaptive responses to conflict or threat. Successful treatment holds the promise of offering the sufferer less rigid ways of functioning and more stable interpersonal relationships.