I know you are addicted to my introject.
I know you want videos to be as long as humanly possible. One hour, two hours, six hours.
But being the sadistic gnosis that I am, I'm going to give you today a 10-minute video.
It will whet your appetite.
I'm challenging myself.
Can I encapsulate everything known about borderline personality disorder in less, in fewer than 10 minutes. Let's see if I make it. Verbose as I am, mind you.
Borderline personality disorder in 10 minutes and 10 questions.
Number one.
Borderline personality disorder involves an identity disturbance, an unstable identity, a fragile sense of self.
The borderline changes from one day to the next. She or he is unrecognizable. Her values, her beliefs, her behaviors, her traits, her preferences, her dreams, her wishes, her plans, everything changes.
And it's like witnessing multiple personality disorder in action.
Indeed, some scholars suggest that borderline personality disorder is a form of dissociative identity disorder known as OSDD.
Look it up. I have a video on this.
Number two, borderline personality disorder and borderline personality organization involve emptiness at the core of the borderline personality organization involve emptiness.
At the core of the borderline, there's a void, a black hole, very reminiscent of the narcissist.
Exactly like the narcissist, the borderline has a false self. And identical to the narcissist, she has a fantasy defense.
It's historical, today half of all borderlines are men.
So, emptiness, false self, fantasy defense, in this sense, borderline and narcissism are indistinguishable from each other.
Indeed, scholars such as Otto Kernberg have suggested that borderline is merely a reaction to narcissism, and that both of them as character or personality disorders are on the verge of psychosis.
We'll come to it.
Number three, external regulation.
The narcissist uses other people to regulate his or her sense of self-worth.
The borderline uses other people, a special friend, favorite person, an intimate partner. She uses other people to regulate her emotions, to stabilize her moods. She outsources her inner landscape, her mind to agents in the outside whose job it is, to keep her on the level, balanced. They function as what is known as secure bases.
Number four, the borderline, again like the narcissist, has impaired reality testing.
She misperceives reality. She misattributes and mislabels emotions and cognitions. She projects, she splits, she engages in primitive defense mechanisms.
So, borderlines are very prone to paranoia, for example. Their paranoid ideation is very common in borderline personality disorder.
Borderlines also overestimate the level of intimacy, love, and commitment in relationships.
And in this sense, borderlines resemble and are reminiscent of histrionics.
People, including clinicians and even scholars, often confuse and conflate borderline personality disorder with histrionic personality disorder, and as we shall see, borderline personality disorder with histrionic personality disorder and as we shall see borderline personality disorder with bipolar disorder.
Borderlines, when pushed to the limit under stress, rejection, duress, humiliation, endure and experience psychotic microepisodes.
For a brief moment, for a few hours, maximum for a few days, their reality testing is so short and so destrudo and so ruin that they become psychotic. They're unable to tell the difference between internal voices, internal images, and internal events, and external ones.
Number five, borderlines are prone to self-harm suicide ideation, actual suicide. 11% of all people diagnosed with borderline personality disorder end up taking their own lives. Suicide is the leading cause of death among people diagnosed with borderline personality disorder.
The borderline has self-destructive cognitions and engages in self-destructive actions, including self-mutilating, reckless behaviors, impulsive behaviors, dangerous and risky behaviors.
Now all these forms of self-harm, and self-harm could be something like promiscuity even, or unprotected sex, or consumption of substances, abuse of substances. So all these self-harming and self-mutilation behaviors have four functions. They fulfill four functions.
Number one, this self-punitive. The borderline has inside her an internalized bad object, also known as a primitive superego. It is a constellation, a coalition of voices that inform the borderline, that she's unworthy, she's unlovable, she's hateful, she's aggressive, she is wrong, she is stupid, she is ugly, etc. This is known as the internalized bad object.
And then she punishes herself, she hates herself, she loathes herself to the extent of punishing herself through self-harming and self-mutilation.
But self-harming and self-mutilation have other functions.
For example, they silence the inner turmoil, inner tumult and internal voices that torment the borderline. They create a distraction, the physical pain or the physical circumstances divert the attention of the borderline away from the chaos that is taking over her internally.
Of course, self-harm, suicidal ideation, self-destructiveness also constitute a call for help.
And finally, when the borderline mutilates herself, self-trashes and so on, she feels alive. Usually she experiences herself as dead, a walking, talking corpse, dead inside. Self-harming and self-mutilation, suicide ideation, make her come alive.
Next, the borderline is reckless and impulsive. When confronted with stress, duress, criticism, rejection, abandonment and humiliation, she may become a secondary psychopath, an impulsive psychopath, but she never loses her empathy, her positive emotions, and her sense of remorse and guilt for her acting out and dysregulation.
The borderline is emotionally volatile. She has affective lability. She is emotionally dysregulated. It's a term borrowed from dialectic behavior therapy. She's mostly angry. Anger is a predominant hue, predominant color of the borderline's emotion. She has reactive moods and mood swings and mood shifts and changes. Whenever she is confronted with real or anticipated or impending doom and gloom, rejection, abandonment and humiliation, her moods change. She may become depressive. Her emotions take over her, drown her, dysregulate her. Most of them are negative. I mentioned anger and rage. She's affectively labile.
The borderline maintains intense interpersonal relationships, which involve exactly like the narcissists, involve idealization and devaluation.
Borderline, therefore, is a relational disorder. Indeed, some scholars such as Gunderson suggest that borderline personality disorder is all about relationships.
And finally, the borderline has twin anxieties, abandonment, rejection, anxiety, also known as separation insecurity, and the opposing diametrically opposed, engulfment and intimacy anxiety.
So you can't win with a borderline. I hate you, don't leave me. She approaches you and then she avoids you.
When she approaches you, she demands that you act as a secure base, a stable rock. Never abandon her. Never let her go.
But then when you do as an intimate partner, when you become caring and intimate and loving and embracing, she feels suffocated. She feels consumed. She feelsocated. She feels consumed. She feels assimilated. She feels dead. And she wants to run away. She panics.
This is approach avoidance. Repetition compulsion.
She's terrified of abandonment and rejection. Repetition compulsion. She's terrified of abandonment and rejection. Repetition compulsion. She is terrified of abandonment and rejection.
She approaches, and then she is terrified of the resulting intimacy, and engulfment, so she avoids.
Borderline personality disorder has been blamed on brain malfunctions, genetics, inadequate upbringing, social and cultural conditions, you name it.
The truth is that the diagnosis of borderline personality disorder is 40 to 50 percent heritable. In other words, according to twin studies and adoption studies, heredity accounts for anything between 40 to 50% of individual differences in susceptibility to the disorder.
What is inherited is described as temperament or character or disposition and it affects mood and activity levels, attention spans, responses to simulation and so on so forth.
The other 50% is the environment, nurture and nature collude in the case of borderline personality disorder, and this is why it can be safely diagnosed as early as age 12, as distinct from narcissism, which cannot be safely diagnosed before age 18.
Borderline personality disorder is a challenge, but it is treatable, unlike narcissism.
It is heterogeneous, and there are different clusters of symptoms in different people.
But everyone who has borderline personality disorder, who suffers from it, shares the same components, a fragile self, impairment of relationships, impulsiveness, emotional volatility and dysregulation.
Psychotherapy is actually pretty effective in the case of borderline personality disorder, especially cognitive behavioral approaches, including dialectical behavioral therapy and psychodynamic therapies.
So, borderline is treatable, and psychotherapy is the mainstay of treatment, but sometimes medication is given to take care of certain manifestations or aspects of the disorder.
Borderline personality disorder is still, after 80 years, still being studied, still a work in progress, the knowledge is still evolving.
The borderline is difficult to work with and difficult to study and difficult to be in a relationship with. Her moods are erratic. Her personal relationships are turbulent, she is unable to control anger, she has anger management problems, she's destructive, she's chronically angry, quick to take offense, she's suddenly depressed, irritable, anxious or enrage for reasons which are beyond anyone.
So it's quite a roller coaster.
Drama is an integral part of borderline personality disorder and actually it's a regulatory mechanism and inevitable accompaniment to the pleasures of being with the borderline.
Because on top of all this, the borderline typically is highly emotional, highly involved, highly empathic, loves like no one else, highly sexual, and all in all, a committed partner if you know how to be with her and work with her.