Hello Blogosphere :)
This being my first post, I thought I’d spend some time explaining my intention and hopes for this blog. My wish for this blog is to be an informative resource geared towards Mental Health. Through a whimsical and compassionate approach it is my intent to shed light on some of the most common Mental Health disorders.
In exploring a new disorder each month, I plan to not only provide insight but resources that will help within the context of each monthly topic. As a strong believer in education it is also my plan to help educate in order to provide a healthier pathway towards understanding these specific issues and the people who struggle with them.
Strengthening emotional intelligence is not hard; it just takes some awareness and effort. In writing this blog it is my sincere hope for this to be a resource that helps others cultivate greater emotional intelligence and acceptance towards those who suffer from Mental Illness.
Firstly please know that I have been a practicing Licensed Clinical Social Worker (LCSW) for over 6 years providing Individual and Family Therapy throughout Chicago. I have worked in a variety of settings and been exposed to many different Mental Health conditions. As a clinician in private practice I treat many disorders including, depression, anxiety, anger, among others.
I treat each client of mine with compassion and respect, looking at their internal strengths while helping incorporate healthier patterns and self-determination skills. I consider myself a generalist in regards to my practice, and am always looking to enhance and further my clinical skills. I don’t claim to be an expert in Mental Health, just someone who has been working in the trenches and has built a small but growing private practice.
My passion is working with people who are feeling stuck or wanting to improve their lives. We all have some form of connection to Mental Illness whether we have struggled ourselves or know someone struggling. Mental Health is highly stigmatized within our society, and we have a long history of it being this way. I say we change this, by opening our hearts and awareness towards those who are in pain and are challenged in ways we might not understand. In part of this blog and dialogue, I also hope to provide ways we can cope with not always understanding the complexities of these different Illnesses.
This month and for my first post, I have decided to explore the broad spectrum of characteristics and behavior patterns regarding people who struggle with Borderline Personality Disorder (BPD). BPD is a complex and dynamic pathology that inhibits a person’s ability towards building and maintaining meaningful and peaceful relationships.
Within my experience most of us know someone who suffers from BPD or who hold certain characteristics that resemble BPD. Understanding how to approach and cope with someone with BPD is a valuable skill in today’s world because unfortunately, this is a growing disorder within our society. Having awareness and acceptance towards people who struggle with BPD helps us live less chaotic lives while not feeling victimized by their inability to live peacefully.
BPD is a broad disorder, and like most Mental Health conditions each person’s diagnosis and struggle can range throughout the spectrum. Although each person may have their own experience it is my goal to discuss the most common characteristics and features of BPD while shedding insight towards how to cope and recognize these key characteristics.
If you go to the main source of how Therapists and Psychiatrist’s diagnosis people with mental illness, we look at the DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) It is through the work of many Psychiatrists and other Mental Health Professionals that we are able to access this manual to reference and see the criteria of all mental health disorders. (Basically we see this manual as a dictionary for all mental health, conditions where we find the information needed best to diagnosis someone.)
BPD has become one of the most pervasive and common of Personality Disorders that are a group of disorders that range from Narcissistic Personality Disorder to Histrionic Personality Disorder.
Personality disorders are different from other Mental Health Disorders, in that it has its roots in a person’s impairment towards having a healthy self-image. It is in this rooted impairment that makes it hard for them to create meaningful and healthy relationships whether it is with themselves or others.
The criterion for diagnosing individuals with Borderline Personality Disorder has not been changed dramatically since the updated version of DSM 5 came out in 2011. The diagnostic code for those wanting to read more about BPD is 301.83.
According to the “DSM 5,” Borderline Personality Disorder, is defined as:
“a pervasive pattern of instability of interpersonal relationships, self image, and affects and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by 5 of the following (if not more)"
Frantic efforts to avoid real or imagined abandonment. (This often is a self-constructed story of abandonment although there might not have been any in place, in some situations true abandonment can be a reality of those living with BPD.
A pattern of unstable and intense interpersonal relationships characterized by alternating extremes of idealization and devaluation.(This is often considered splitting in terms of looking at someone with BPD; you are either the villain or the hero depending on how the person with BPD is feeling.)
Identify disturbance:Markedly and persistently unstable self-image or sense of self. (This has to do with how a person with possible BPD feels about them and how their self-image is reflected by the relationships in their lives.)
Impulsivity in at least two areas that are potentially self damaging(spending, sex, substance abuse, reckless driving, binge eating)
Recurrent suicidal behavior, gestures, or threats, or self mutilating behaviors such as cutting
Affective instability due to a marked reactivity of mood (intense mood swings, irritability, or anxiety lasting a few hours and only rare for a few days.(We often see people with BPD have acute and constant explosivity within their behaviors and arguments within this criterion.)
Chronic feelings of emptiness
Inappropriate intense anger ie difficulty controlling anger (e.g. frequent displays of temper, constant anger, recurrent physical fights
Transient stress related paranoid ideation or severe dissociative symptoms.
In understanding BPD it is important to know that a person can have Borderline features and characteristics and not be fully Borderline. Thinking about BPD in a broader context and seeing it within its many elements is helpful because not everyone will meet all 9 of these features, however it is still possible for them to be on the spectrum. The spectrum is not small and there are many complexities that are apart of this disorder.
Thinking about it this way might be helpful. We can have a cold, but if we don’t have a fever over 98.6 degrees that doesn’t mean we aren’t sick or don’t have symptoms. The same is true with people with BPD, they might not meet all of the criteria, however can still show characteristics and thinking which are on the spectrum.
People with BPD often have trouble owning or accepting accountability for their bad behaviors. Instead of looking inward towards what the problem might be, they often become explosive and project onto others some form of their emotional chaos. We often see that people with BPD will be explosive with their moods, which can often and easily escalate towards intense arguments and lack of permanent relationships.
The BPD behavior that triggers non-BPD individuals the most usually is centered on their often-irrational explosive emotional outbursts coupled with there shifting moods about others. It is within this space however where we can become more empowered by the awareness of their efforts at emotional manipulation while learning not to give away our own emotional awareness and power.
When educating clients about possible BPD elements I often hear,
“I know someone, like that…
“I have tried so hard to understand them…
“It feels like I never know what version I will get and what will happen.
“I often feel like I am walking on eggshells.”
Part of the diagnostic criteria for BPD is the concept of splitting. This might seem like a hard concept to understand, but in the end it models exactly how many Borderlines think, which we can refer to as “Black and White thinking”.
In a Borderline person’s mind its comparable to how Heidi Klum tells contestants on Project Runway if they have made it to the next round.... “You are either, in or out!!”
This might seem comical however signifies a true thinking which borderlines live by. In many accounts you are either in or out of their lives. Either the villain or the hero. A true quality of someone who has the potential of a Borderline diagnosis is an unmanageable way of incorporating “Gray Thinking.”
Since people with BPD are 99.9% automated towards “Black and White” thinking the “Gray” is somewhere they show very little interest in visiting. It is their lack of the acceptance that there is A LOT of gray in life, which makes it hard for people with BPD to navigate healthy and lasting relationships.
When you are being adored by someone who may potentially have BPD it is often charismatic, fun, and validating. However this attention, can often be fleeting and not authentic, due to the inevitable fact that it will often switch towards some form of explosive disconnection which leads towards “devaluation” (meaning they switch towards seeing you as the villain.) When this happens, it can feel devastating and heartbreaking leaving us wondering what we have done, and often feeling victimized by their irrational emotional change in how they see us.
Within my experience, boundaries are the best way towards navigating a relationship, with someone with BPD or who might be on the spectrum. Knowing that the thinking behind someone with BPD is very Black and White helps us also know that we can embrace the “Gray”, while they may not be capable.
In conclusion, I want us to understand that people who might have BPD or who are on the spectrum are not bad people, they just often trigger bad feelings and reactions within ourselves. The way we react to how we are treated by someone with BPD is the only control we hold in these form of relationships.
In my experience, “Hurt people, Hurt People. “ Although it can often be hard to negotiate a healthy relationship with someone with BPD it can be done with awareness and compassion.
Although some relationships may prove to be too toxic, it is within our judgment to see if the relationship serves us or hurts us. If there is a history of the relationship not serving us, we have the prerogative to step back with acceptance of their inability to sustain healthy authentic relationships. We also can release ourselves knowing we tried many times to connect with them.
Acceptance is important because like someone who has cancer, you can’t wish away this disease. The same is true regarding how someone with BPD treats us. They will see you the way they see you, and it is our job to investigate whether we agree with their ideology and if it benefits our own Mental Health
Borderline Personality Disorder is beyond multifaceted and is a Mental Health topic that requires further awareness and education on. My hope is to have shared some of the key characteristics on how to recognize BPD while also promoting compassion and acceptance towards this illness. Having compassion for people who have BPD as well as people who are in a relationship with someone with BPD is beyond valuable because it helps us to instill and execute our personal boundaries.
For everyone’s sake, I think I will end this month’s blog/PSA on Borderline Personality Disorder. Although I could go on and on, I am trying to keep it simple in order, to not make this topic seem more intimidating or overwhelming than it is.
There is much more to be said about this disorder, and we have to continue towards being aware of BPD. Below are some helpful book resources to help your further empower yourself on understanding BPD. I hope this month’s blog has been informative and insightful. BPD is a heavy subject that I feel I was able too barely tap the surface on. This is why I hope these additional resources will be utilized.
By my own detriment and simultaneous enjoyment I’ve watched endless hours of Real Housewives, which has given me many personalities and examples to see how Borderline Personality lives and ruminates within our society.
Anyways till next time, stay happy, stay positive and stay emotionally aware out there :)
-Hillary Schoninger LCSW
Book Recommendations/ Resources on Borderline Personality Disorder:
Here are a few books that are great resources in learning more about BPD and its broad range of symptoms and behaviors. For your convenience I have also supplied links to these books listed on Amazon. As a clinician I often incorporate bibliotherapy with my clients, and find that reading about different Mental Health topics can be both empowering and insightful.
1) I Hate You--Don't Leave Me: Understanding the Borderline Personality
2) Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder
3) The Buddha and the Borderline: My Recovery from Borderline Personality Disorder through Dialectical Behavior Therapy, Buddhism, and Online Dating
4) The Monster Inside of Me: Life with Borderline Personality Disorder
5) The Essential Family Guide to Borderline Personality Disorder: New Tools and Techniques to Stop Walking on Eggshells
6) The Good Karma Divorce: Avoid Litigation, Turn Negative Emotions into Positive Actions, and Get On with the Rest of Your Life
This is also a great resource for those who are going through a divorce or have. It may not be a real focus on people with BPD however it is an amazing resource on how to navigate divorce more peacefully. Since people who are on the BPD spectrum often have trouble living peacefully, I find this to be a valuable resource for people facing a divorce where there is potential emotional conflict.
I am proud to say that I have heard Judge Michele Lowrance, speak numerous times where she helps people see how they can be more peaceful and accepting about their divorce. She is a true resource and someone I am fortunate to call a mentor.