Emma Lauer, LCSW
It’s Possible to Recover from Borderline Personality Disorder
Updated: Jun 21, 2021
In my work with students and clients, I’ve noticed a lot of misconceptions around the diagnosis of Borderline Personality Disorder (also known as BPD). Some people confuse it for “multiple personality disorder” (which nowadays is known as Dissociative Identity Disorder, or DID), and others have told me they think BPD and Bipolar Disorder are the same thing. BPD may share some things in common with those diagnoses, but it is separate and distinct. Even when people recognize that BPD isn’t the same as “being bipolar” or having “multiple personalities,” it is still often misunderstood. I frequently hear people throwing around the word or weaponizing “borderline” to describe everything from expressions of anger or sadness, to perceived manipulation.
BPD can be an isolating diagnosis, and it’s deeply stigmatized, so it’s worth taking some time to shine a light on what BPD is exactly, and the ways that people can overcome it. BPD doesn’t have to be a life-sentence, and it doesn’t have to be something we shy away from talking about.
BPD is defined as: “a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning in early adulthood and present in a variety of contexts, as indicated by 5 or more of the following (American Psychiatric Association, 2013):
1. Frantic efforts to avoid real or imagined abandonment
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
3. Persistently unstable self-image or sense of self
4. Impulsivity in two areas that are potentially self-damaging
5. Recurrent suicidal behavior, gestures, or threats
6. Instability due to reactivity of mood (e.g. intense irritability or anxiety)
7. Chronic feelings of emptiness
8. Inappropriate, intense anger or difficulty controlling anger
9. Transient, stress-related paranoid ideation or severe dissociative symptoms
That’s a lot of clinical jargon to sort through, and a lot of symptoms happening all at once. In a nutshell, BPD is usually recognizable as trouble controlling intense emotions and instability in relationships. And, like other diagnoses, BPD exists on a spectrum, with some people having less intense symptoms and strong insight to what they’re experiencing, while others have more extreme symptoms and little to no insight.
Experiencing intense emotions may feel like a weakness at times, but it can be a gift and a strength if you learn how to work with your emotions, instead of letting them work against you. DBT (Dialectical Behavior Therapy) teaches that emotionally sensitive people tend to be intuitive, creative, and make for great leaders.
DBT was developed with BPD in mind, and research backs DBT as the gold-standard treatment for BPD. The creator herself, Dr. Marsha Linehan, spent years figuring out how to overcome her struggles related to BPD. Dr. Linehan was hospitalized, had multiple suicide attempts, and self-harmed for years. In the 1980s, she developed DBT to pass her lessons on to others. I highly recommend her memoir, “Building a Life Worth Living.” Through learning DBT skills and working with a DBT therapist, you can learn how to tolerate intense emotions and increase emotional stability, improve relationships, learn mindfulness, and learn how to think about difficult situations in a more balanced light.
We haven’t pinned down exactly why some people develop BPD. It is thought that these symptoms arise due to a combination of both biological factors (such as an inherent predisposition to emotional sensitivity) and environmental factors, such as childhood trauma and chronic invalidation from attachment figures. “Chronic invalidation” may look like being told that you were too sensitive, “too much,” or being told (directly or indirectly) that your emotions weren’t important. While these kinds of childhood experiences can have a big impact on people, there are ways to heal from them in therapy. Eye Movement Desensitization and Reprocessing (EMDR), Trauma-Focused Cognitive Behavior Therapy (TF-CBT) and Cognitive Processing Therapy (CPT) are some example of evidence-based trauma therapies that have helped people heal from all kinds of childhood trauma, both big and small. When you pair DBT with trauma therapy, you can have some relief from BPD.
Famously, one of Dr. Linehan’s patients once asked her, “are you one of us?” while looking at the welts, burns, and scars on her arms (Carey, 2011). Dr. Linehan chose to share her personal struggles with the world so that she could pass hope on to others. Indeed, there is hope for those struggling with BPD. You deserve to be heard and validated, to be given the proper coping skills, to heal from your trauma, and to build “a life worth living.”
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental
disorders (5th ed.)
Carey, B. (2011, June 24). Expert on Mental Illness Reveals Her Own Struggle. The New York Times. https://www.nytimes.com/2011/06/23/health/23lives.html