Borderline Personality Disorder

At the heart of borderline personality disorder lies a fractured self-image and a disorganized attachment style rooted in a bone-deep fear of abandonment and rejection.


What is a Disorganized Attachment Style?


Attachment styles are formed early in life. As infants and young children, we learn our worth and value by the responses we receive from our primary caregivers. Ideally, caregivers provide responses that validate us and teach us how to identify and regulate our emotions, creating an internal structure of security.


However, we are invalidated in cases of abuse (psychological, emotional, physical, or sexual), neglect, and abandonment. Our desires and needs become irrelevant as the abuser’s desires and needs take precedence. When “parents are both the ‘source of and solution to’ their fear and anxiety,” there is no security for the children (Clinton & Sibcy, 2002).


As children, disorganized attachment develops when we seek to cope with the fluctuating demands, assurances, and punishments of abusive caregivers, cognitive distortions set in, and external regulation is required because there is no internal locus of control. Truth and reality provide no defense, thus becoming malleable constructs (Childress, 2015). Dissociation, “the ability to psychologically cleave off thoughts, feelings, and even physical pain, and shift the experiences to some other part of the consciousness” (Clinton & Sibcy, 2002), is a common response.


In a nutshell, people with a disorganized attachment style do not feel worthy of love, yet they crave it. They do not believe their needs are valid, yet they desire to meet them. They do not believe others are trustworthy or safe and yet fiercely need relationships to provide external emotional structure and validation.


What is Borderline Personality Disorder?


Borderline Personality Disorder (BPD) is a damaging condition that profoundly affects the

person with the condition and often destroys their relationships. The successive dissolution of

relationships creates a self-defeating cycle that reinforces the BPD characteristics.

BPD impacts approximately 76 million people and their loved ones (Juanmarti & Lizeretti,

2017). According to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.;

DSM-5, American Psychiatric Association, 2013), a person who exhibits five or more of the

following qualities meet the diagnostic criteria for BPD:

· “frantic efforts” to avoid rejection/abandonment

· alternately idealizing and demonizing those with whom they are in a personal

relationship

· “unstable self-image”

· self-damaging impulsivity

· self-harm/suicidal behavior

· emotional volatility

· “chronic feelings of emptiness”

· inappropriate angry outbursts

· short-term stress-related paranoia

· “severe dissociative symptoms.” (Startz, 2017).


Living with Borderline Personality Disorder


The effects of BPD are most pronounced in the lives of people associated with persons who

have BPD, as those with BPD are frequently blind to their actions.


Externally, BPD manifests itself through relational volatility often caused by irrational fears of

rejection and abandonment, manipulation, emotional polarity, and disproportional angry

outbursts. When confronted with behavioral patterns, persons with BPD believe they are being

persecuted for actions that are appropriate responses to the offenses (real or imagined) that

they have suffered (Arterburn & Wise, 2017).

One of the more personal, internal effects of BPD is a fractured self-image. This unstable sense

of self leads to fundamental changes in core values, e.g., sexual preferences or marriage and

family, and goals, e.g., career ambitions (Tahirovic & Bajric, 2016). Persons with BPD are

known to have little self-worth. The devaluation of self leads to varying degrees of self-harm.

Unhealthy choices such as unprotected sex, drug use, eating disorders, self-mutilation, and

suicide ideation and attempts are often what drive one with BPD into therapy (Startz, 2017).


Treatment Options


Research conducted by Juanmarti and Lizeretti (2017) demonstrated that pharmaceutical treatments alone are ineffective BPD treatments. Although, they may provide some help when used in conjunction with talk therapy. As Harville Hendrix (2007) stated, “we are born in relationship, we are wounded in relationship, and we can be healed in relationship” (p. 35).


The therapeutic relationship provides unconditional positive regard, removing the threat of abandonment and rejection and providing a safe space for persons with BPD to learn to build an internal structure for coping with strong emotions and adverse circumstances. “Dialectical and mentalization-based therapies have the most ‘empirically validated’ success” (Startz, 2017). Both approaches focus on present-day manifestations of BPD symptoms and maladaptive coping strategies instead of the original soul wound, decreasing the probability of re-traumatization.



Biblical Integration

Regardless of the therapeutic approach, it is imperative to attack the foundation of fear upon

which BPD is built. Profound fear of rejection and abandonment damages all aspects of life

for persons with BPD. God provides many reassurances of His love and faithfulness.

Reframing childhood traumas and present-day conflicts through the lens of scripture helps to

renew the mind (Rom. 12:2). The BPD patient who embraces the adoption offered through

Jesus (Ps. 27:10) need not fear losing the love of family. Feelings of hopelessness and

helplessness are addressed in Hebrews 13:5b,

“for He [God] Himself has said, I will not in any way fail you nor give you up nor leave

you without support. [I will] not, [I will] not, [I will] not in any degree leave you helpless

nor forsake nor let [you] down (relax My hold on you)! [Assuredly not!]

Replacing fear-based reactions with faith-based responses is an achievable goal with

supportive therapy and the help of the Holy Spirit (Startz, 2017).


Angela W Startz, MAHSC, CCLC

Mental Health Coach

Called2Rise LLC

HopeWorks Counseling



References

American Psychiatric Association. (2013). Personality disorders. In Diagnostic and statistical manual of mental disorders (5th ed.).

Arterburn, S., & Wise, R. (2017). Understanding and loving a person with borderline personality disorder: Biblical and practical wisdom to build empathy, preserve boundaries, and show compassion. Colorado Springs, CO: David C Cook. [Kindle Edition].

Clinton, T. & Sibcy, G. (2002). Attachments: Why you love, feel, and act the way you do. Integrity.

Hendrix, H. (2007). Getting the love you want, 20th-anniversary edition: A guide for couples. Macmillan.

Juanmarti, F. B., & Lizeretti, N. P. (2017). The efficacy of psychotherapy for borderline personality disorder: A review. Papeles del Psicologo / Psychologist Papers, 38(2), 148-156. http://dx.doi.org/10.23923/pap.psicol2017.2832

Startz, A. W. (2017). Borderline personality disorder [Unpublished manuscript]. School of Behavioral Sciences, Liberty University.

Tahirovic, S., & Bajric, A. (2016). Child-parent attachment styles and borderline personality disorder relationship. Mediterranean Journal of Clinical Psychology MJCP, 4(2), 1-27.

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