Borderline Personality - A View From Inside

"I am borderline" is a short film staring Danielle Keaton about borderline personality disorder from the inside. This short film (4:35 minutes) was written and directed Betsy Usher in Los Angles. The film offers a realistic portrayal of the internal conflict of a person with borderline personality disorder or traits traits of worldwide slots. The film opens with the voice over; 



"It feels like you aren't living at all, or you're possibly too alive. You're a person that feels the highest of highs and the lowest of low. You're usually triggered by small things, the way a person looks to watch..."

The film is part of a campaign created By Betsy Usher (pictured at the bottom) to help reduce misconceptions and the stigma of BPD. Another part if this campaign asks individuals who identify with the BPD diagnosis to post pictures of themselves online showing all of the other talents, labels, and thoughts about who they are (e.g. "I am a teacher").

Usher has her doctorate in clinical psychology (PsyD). She studied Borderline Personality Disorder at California School of Professional Psychology at Alliant University. She also attended California State University, Northridge and CSPP/Alliant International University at Alliant University.

The film finished first place in the month of June 2016, winning the monthly "Art with Impact" given by artwithimpact.org, a non-profit organization encouraging the production of short films based on mental health issues. The organization is sponsored under the California Mental Health Services Act, and by The National Endowment for the Arts (NEA) , Pacific Blue Cross Community Connection Health Foundation, and others.

The Importance of Empathy Skills when Supporting a Person with BPD

Empathy is the experience of understanding another person's condition from their perspective. You effectively place yourself in their shoes and feel what they are feeling.

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When someone asks what is the most important tool for supporting a loved one with borderline personality disorder, I say "empathy". I typically follow with "and many of us over estimate our own empathy skills".

What is empathy?

It is often confused with sympathy. Empathy it is distinctly different. Empathy is the experience of understanding another person's condition from their perspective. You effectively place yourself in their shoes and feel what they are feeling. Seeing things from another person's perspective isn't simply understanding their point

of view -- it extends to understanding, without disclaimers, why they feel their point of view is just and appropriate and honest.

So, when your child returns from a therapy appointment and proclaims "I really like this one", it's most likely related to the therapist's ability to empathize and communicate it. We will not be able to motivate, coach, lead or redirect anyone without having this knowledge, too.

When Perry Hoffman (Harvard) conducted a study to determine the predictors of BPD patient recovery, the researchers found the #1 predictor to be the presence of a caring and empathetic person in the patient's life. They were surprised with this #1 rating.

It is also interesting that the architects of the DSM 5 proposed that a personality disorder be diagnosed when a person has diminished skills in two of the following -- either "empathy or intimacy" and either "identity or self direction". This raises two practical issues for us. First, our loved one may very well have impaired empathy skills and so we don't want to mirror that back as a way to "teach them a lesson".  Secondly, if we are supporting a BPD child, it is important to remember that BPD traits tend to run in families and we may have had a parent that wasn't very empathetic and in turn, we didn't develop effective empathy skills ourselves. As such, we may have to become very deliberate in developing empathy skills now and seek the advice of others to help us to better "step in the shoes" of our child.

The five levels of empathy proposed by the DSM 5 architects are listed here. Want to know where you stand? Ask someone very close to you - ask your children - don't make a self-assessment.

Helping each other to grow to be more empathetic is one very important way we help each other at BPDFamily.com.

Author: Skip
Video Short: Scott Peck

Scott Peck earned his Masters Degree in Education and Doctorate in Divinity and has worked professionally as an educator, national advertising manager, reporter, photographer, copywriter, & real estate broker.

What Does Recovery Look Like?

Trying to determine if someone in your life suffers from Borderline Personality Disorder and what can be done about it? You will soon find out that this is a complex question.

When in the midst of a relationship with the person who may be suffering from Borderline Personality Disorder, it can feel like there are more questions then there are answers.

This documentary video takes an in-depth look at the disorder. It not only includes three individual sufferers perspective, including Kiera Van Gelder author of The Buddha and the Borderline, but also from their family members as well. They discuss an array of issues including the confusion within the symptoms, angry outbursts, isolation, cutting, suicidal ideation, self destructiveness, and the misconceptions surrounding the behaviors in response to the intense emotions. 

The documentary also features leading experts in the field of Borderline Personality Disorder, Dr. John Gunderson, Dr. Marsha Linehan, and Dr. Perry Hoffman, discussing behaviors, clinical diagnosis, and treatments. Their commentary bringing a greater understanding of the disorder but also a message of hope. There is treatment. There are tools out there for family members. There are answers and solutions. The first step is knowing that what is going on in a Borderline Personality Disorder sufferer's mind and how they are acting can be two entirely different things.  There are no simple behavioral checklists; no definitive tests. Identifying Borderline Personality Disorder requires having a working knowledge of the disorder and some insight into the past life of the person in question.

Borderline Personality Disorder is a disorder of the emotions. Imagine a person who is extremely sensitive to rejection (fearful of even perceived or anticipated rejection) and has a limited ability to regulate their emotional impulses (love, fear, anger, grief, etc.). To protect themselves from their own feelings, they are prone to adopt a multitude of dysfunctional rationalizations and cover-ups.

For example, a person suffering from BPD may so fear rejection in a new relationship that they recreate themselves in the image of a person they believe would be lovable. When the negative emotions for making such a sacrifice surface - and not having the ability to modulate them, they lash out at the target of their affections for "making them do it" - rather than face their own feelings of inadequacy / fear of rejection, ultimately damaging the relationship they so fear losing, and reinforcing their feelings of inadequacy / fear of rejection.

For more information or to register, please click here. www.bpdfamily.com

Author: DreamGirl

Adolescence and Borderline Personality

What is the difference between otherwise normal adolescence behavior and adolescence behavior associated with Borderline Personality Disorder?

Borderline Personality Disorder is not often diagnosed in adolescence, however adult patients with this diagnosis often explain that symptoms began in early childhood. 

The behavior can include extreme sexual activity, utilizing drugs, engaging in impulsive and risky activities (i.e. driving too fast, stealing) – according to Dr. Blaise Aguirre the difference lies in the functionality of the behavior, being that the function of one is typical and the other’s function is mostly to help regulate the emotion(s) of the child in the moment [suffering from BPD].

Blaisse Aguirre, M.D.,  discusses in this video how to recognize the difference and how to better understand the purpose behind it.  He addresses in depth the criteria needed to diagnose BPD according to the current DSM and uses specific examples for younger children that gives a better understanding to the behavior that leads to diagnosis. It is a must see for any parent or family member who  is raising a child who may (or may not be) suffering from BPD.

 Dr. Aguirre is an expert in child, adolescent and adult psychotherapy, including dialectical behavior therapy (DBT), and psychopharmacology. He is the founding medical director of 3East at Harvard - affiliated McLean Hospital, a unique, residential DBT program for young women exhibiting self-endangering behaviors and borderline personality traits (BPD). Dr. Aguirre has been a staff psychiatrist at McLean since 2000 and is nationally and internationally recognized for his extensive work in the treatment of mood and personality disorders in adolescents. He lectures regularly in Europe, Africa and The Middle East on BPD and DBT.

Author: DreamGirl

Avoid Creating an Invalidating Home

In his talk on October 18, 2008 in Minneapolis, MN, Alan Fruzzetti, Ph.D. explores what it means to give someone a validating response rather than an invalidating response and how validating responses can be used to help a person with high levels of emotional arousal more constructively process their feelings, emotional dysregulation or personal chaos.

In this video, Dr. Fruzzetti explains the fine art of "validating" and shows us how easy it is to be invalidating.  He explains that invalidation is not necessarily abusive, mean, neglectful, uncaring or dyfunctional - it can be caring and well intended - but painful nonetheless. 

Dr. Fruzzetti recommends that families of a person with BPD also be in therapy as (1) it’s very stressful to have a loved one in emotional chaos and (2) it benefits the person with BPD when the family is part of the solution.

Alan E. Fruzzetti, Ph.D. is associate professor of psychology and director of the DBT Therapy and Research Program at the University of Nevada and Research Advisor Member of the Board of Directors of the National Education Alliance for Borderline Personality Disorder (NEA-BPD). 

Author: Vivekananda

Untangling the Internal Struggles of Borderline Personality Disorder

In this 12 minute audio Amy Tibbitts, LSCSW discusses the day to day struggles of a person with Borderline Personality Disorder (pwBPD) and the basic principles behind Dialectical Behavioral Therapy. This is a very helpful presentation for anyone trying to understand the mindset and behavior of someone suffering with Borderline Personality Disorder.  It also helps with the understanding of how we, as family members, affect pwBPD.

Tibbitts explains that family members without mood disorders themselves  know that emotions are simply emotions and that they do not need to  responded to them. This is not so clear to a person with a mood disorder.

The speaker goes on to explain that family members also know that when they want to fulfill a goal, emotional responses need to be "put on the shelf" so they can continue with the task at hand. For someone with Borderline Personality Disorder this can be extremely challenging.

Listen to the audio program   Wisemind.mp3

The Dialectal Dilemma - logic in the face of emotion is not helpful

Tibbitts describes what she calls the "dialectal dilemma". The dialectal dilemma is the invading feeling that results when applying logical thought to emotional responses at the time of the response. When this is done by the person having the response or by others it results in a very invalidating and very upsetting experience.

An alternative and the principle behind dialectical behavioral therapy is for the pwBPD to have cognition (recognition when an emotional reaction is in the extreme) and then substitute an alternate behavior - doing something different and more constructive with the emotional reaction.  The emotion is not denied.  The reaction to others is altered.

Three Characteristics Common with Borderline Personality Disorder

Three characteristics are common in people suffering with Borderline Personality Disorder are heightened sensitivity, extreme reaction/arousal, and slow return to baseline.

Heightened sensitivity - A person with Borderline Personality Disorder has a high sensitivity to emotions and feelings - both their own and of others.

Extreme reaction and high arousal - Extreme reactions and high arousal often makes it difficult to think through issues and act in an appropriate way.

Slow return to baseline - These reactions last longer and this in turn can the heighten the reaction to subsequent events and stimuli.

Biosocial Theory

The struggles with Borderline Personality Disorder are impacted by both biology and by the social environment.

Biological factors - Being tired, hungry, stressed, or under the influence are all conditions that exacerbate the struggles of Borderline Personality Disorder. This is why people with the disorder do not do well in crisis situations.

Social factors - Being in an environment that denies or minimizes emotional experiences (independent of whether they are valid or not) adds to the difficulties. Specific examples include indiscriminately rejecting the validity of feelings, punishing the pwBPD for their emotions, escalation of emotional situations, or oversimplification of the task of solving problems at hand.

When these factors become extreme it often leads to suicidal ideation, or parasuicidal ventures, or even suicide.

BPDFamily.com provides support, education, tools, and perspective to individuals with a loved one affected by Borderline Personality Disorder. BPFamily is a non-profit, co-op of over 50,000 volunteer members and alumni formed in 1994. We invite you to join with us to explore these and other aspects of having a person with Borderline Personality Disorder in your life.

Amy Tibbitts, LSCSW, is the founder and director of the Lilac Center in Kansas City, MO. She has been providing Dialectical Behavioral Therapy (DBT) in a private practice setting since October of 2000. Ms. Tibbitts is a 1997 graduate of the University of Kansas and holds a master’s degree in social welfare. She underwent clinical training at Wyandot Mental Health Center. Prior to opening her private practice, Amy provided clinical services at Johnson County Mental Health Center. She is currently authoring a book on Dialectical Behavioral Therapy.

Author: Skip

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BPDFamily.com provides support, education, tools, and perspective to individuals with a loved one affected by Borderline Personality Disorder. BPFamily is a non-profit, co-op of nearly 75,000 volunteer members and alumni formed in 1998. We welcome you to join our free 24 hour on-line support community with its nearly 3 million postings and grow with us as we learn to live better lives in the shadow of this disorder. For more information or to register, please click here. www.bpdfamily.com