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what is borderline personality disorder (BPD)?

What is Borderline Personality Disorder (BPD)?


Borderline Personality Disorder, or BPD, for short is one of the four main 'Cluster B' personality disorders defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM).


How is the diagnosis for BPD made?

The DSM sets out the following 9 criteria for Borderline Personality Disorder, and you'd have to meet at least 5 of them, to be considered as having BPD. The criteria used by mental health professionals are as follows:



APA Diagnostic Criteria: (I'll explain the gobbledy-gook in a minute, read on)


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 five (or more) of the following:

 
1) Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behaviour covered in criterion 5.


2) A pattern of unstable and intense interpersonal relationships, characterised by alternating between extremes of idealisation and devaluation.


3) Identity disturbance: markedly and persistently unstable self-image or sense of self.

 
4) Impulsivity in at least two areas that are potentially self-damaging (eg, spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behaviour covered in criterion 5.


5) Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour.

 
6) Affective instability due to a marked reactivity of mood (eg, intense episodic dysphoria, irritability, or anxiety usually lasting a few hours, and only rarely more than a few days.)

 
7) Chronic feelings of emptiness.

 
8) Inappropriate, intense anger or difficulty controlling anger (eg, frequent displays of temper, constant anger, recurrent physical fights.)


9) Transient, stress-related paranoid ideation or severe dissociative symptoms.

 
The essential feature of Borderline Personality Disorder (BPD) is a pervasive pattern of instability or interpersonal relationships, self-image and affects, and marked impulsivity that begins by early adulthood and is present in a variety of contexts.

 
Phew!


What the gobbledy-gook actually means:


To make broad, sweeping generalisations that are 99% accurate but still don't capture the true reality of BPD, if you're dealing with the following things, or acting in the following ways, you may get diagnosed with BPD:

  • Self-harming behaviours like cutting etc
  • Frequent thoughts of suicide, or actual attempts at suicide (10% of the patients diagnosed with BPD actually do kill themselves, God forbid.)
  • Impulsive behaviour - overspending, shopaholic, over-eating, binge eating, one night stands, lashing out at others verbally and otherwise, actually sending the nasty, disturbing email you just wrote instead of deleting it…
  • Living a life of extremes - and this comes through in your relationships and beliefs about yourself, others and life. Either it's all fantastic, wonderful and brilliant, or it's the dumps, terrible awful. There's an obvious lack of balance.
  • Frequent, uncontrollable rage fits
  • Take offence / get hurt very easily, and are hyper-sensitive to implied or actual criticism and rejection (more on this in a moment.)
  • Difficult relationships with others; rely on other people to solve your problems for you, but then can turn on them and reject them for not being caring enough, understanding enough or interested enough. Don't take responsibility for solving your own issues and blame others a lot.
  • Ungrounded emotions - get swept away by negative emotions and reactions very easily, and find it hard to regain your balance and sense of stability again.
  • Don't like yourself very much; find it hard to form an accurate judgement of who the 'real you' actually is.
  • A tendency to reject others before they reject you, ie, you'll provoke a fight, or overreact to something, or act unreasonably, or sabotage your relationship in some way, to 'test' how much the other person really cares for you.
  • Over-reliance on other people for support, sense of self and 'soothing', which can cause others to feel suffocated in the relationship. This sets up the paradigm where you want more from others than they can reasonably be expected to give, it gets 'too intense', and they back away, reinforcing your feeling of being rejected, uncared for, and misunderstood. Unfortunately, the more you try to 'keep hold' of people, the faster they run away from you.



What causes BPD?

 
Ah, the question of question.


I'll give you the current scientific answer, but then we're going to leave that paradigm behind, and dive into the God-based holistic paradigm of mental health, to look at what's REALLY happening at the level of body, mind and soul.


(If you're not into God, then I'll give you some secular sources of help later on, but be warned: secular treatment for BPD has had a lousy track record, and until the arrival of Dialectical Behaviour Therapy (DBT), there wasn't really anything much therapy could do for people diagnosed with BPD. And when it comes to other Cluster 'B' personality disorders like AntiSocial Behaviour Disorder (ASBD) and Narcissism, secular therapy is still stumped about how to tackle the problem. More on this shortly.)


The scientific explanation:

 
Again in a nutshell, the most recent theory is that people with BPD have a biological issue that causes them to experience heightened fear responses, while at the same time having a reduced ability to regulate their emotional response.


See this article for more details: Grey Matter Changes Linked to Runaway Fear Hub


To put it another way, people diagnosed with BPD have a natural tendency to be more emotionally sensitive than other people, and find it naturally harder to control their emotional responses.


But that's only one part of the equation.


According to Marsha Linehan, the developer of the DBT technique mentioned above, people who have this natural biological tendency to hypersensitivity and extreme emotional responses won't automatically go on to actually develop BPD, unless they're also raised in what she terms an 'emotionally invalidating environment'.


(See this article on DBT, for more details and to hear it from the horse's mouth.)


To cut through the gobbledy-gook, emotionally invalidating environments are when the parents, or main care givers, don't acknowledge and validate the child's feelings and emotions; don't help the child to work their feelings through in a healthy way; don't teach their child the tools they need to manage their emotions properly, and make the child feel like they're 'wrong', 'mistaken' 'incompetent' etc etc, for feeling the way they do, or reacting the way they react.


(And let's remember that these kids ARE much more sensitive than other people, and much more overwhelmed by their emotions to begin with.)


To win acceptance and curry favour, the child tries to suppress, hide and disassociate from their feelings (one extreme…), but can't continue doing this for ever, so they explode out into the open via rage fits, self-harming behaviours, intense 'over sharing', manipulative attempts to keep people close and attentive at all costs, and all the other stuff you just read about (the other extreme…)


If this pattern continues for any length of time, it sets the stage for BPD to flourish, God forbid.


Is BPD hereditary?


Part of the problem is that people with BPD, and other personality-disordered type traits, make very bad parents.


This website, Light's house, excels in painting vivid pictures of what it's like to grow up in a home where one or both of your parents have a personality disorder. It's an excellent, informative resource, but it can make quite harsh, unsympathetic reading for people who suspect they may have BPD (or another personality disorder) themselves! So caveat emptor.


We'll look at the parenting from a slightly different angle when we get to the God-based holistic health stuff a little later on, but let's conclude this section with this:


Studies have shown that BDP might be 'inherited' in nearly 70% of cases.

In the same vein, narcissism appears to be inherited in 64% of cases.

 
To put this differently, if you have a personality disorder, the chances are very high that it runs in the family, and at least one of your parents also has the same sort of problems.


It doesn't take a genius to figure out that when a parent has a personality disorder, it's very unlikely they'll be able to provide a 'validating' emotional environment for their child.


If a child has a biological tendency towards hypersensitivity and extreme emotional responses (as outlined above), PLUS has personality-disordered parents who raise their family in an emotionally abusive, invalidating environment, the chances of a personality disorder getting passed on to the next generation are much, much higher.


By contrast, when a child with the biological predisposition to BDP is raised in a nurturing environment, the chances that they'll actually go on to develop BDP are much less.


The God-based holistic view

 
Every human being is made up of three distinct elements:

  • Body
  • Mind and Emotions
  • Soul


All three of these elements affect, and are affected by, the other.


If a person's body isn't functioning properly, this can have a number of affects on their mind, emotions and soul - and vice versa.


(See this article, where it talks about how serious injuries to the front of the head, aka the frontal lobe, often caused victims to develop negative emotional tendencies and responses that are very similar to those identified in Anti-Social Behaviour Disorder, and violent and criminal behaviour.)


I have a free course called 'Talk to God and Fix Your Health' on my website at www.jemi.website/courses that sets all this stuff out in detail, but in a nutshell, the following things will ALL affect a person's physical and mental health, and sense of wellbeing and happiness:


1) Having a strong connection to God (see the site for what this actually means in practise.)


2) The three foundations of emotional health need to be strong and balanced.

 
The three foundations are:

  • Healthy compassion
  • Sensible Accountability
  • Appropriate Kindness



(See this article for more details: 3 foundations of emotional health)

3) That the body's energy, and particularly the 14 main energy meridians, are healthy and strong.

 
Again, you'll find a lot more information on my site, and the following free guides are good places to start understanding the links between body, mind and soul:

Basic Guide to Strengthening Your Meridian Energy 

What Emotions are Related to Which Energy Meridian

And another good site that's packed full of 'Energy Medicine' resources is www.innersource.org, the site of author Donna Eden.



How does BDP fit into this paradigm?


It would take a whole book to really do this topic justice (and guess what, I'm working on one at the moment…) but to try to sum it up in an incredibly over-simplified way, we can say this:

1) Why belief in God / nourishing the soul helps with BPD


One of the things that characterise people diagnosed with BPD (and probably a few billion other people who haven't been diagnosed with anything, much) is a profound, overwhelming sense of loneliness and emptiness.


Back in the old days when believing in God was still somewhat acceptable, this was commonly referred to as 'existential angst'. People didn't know what the meaning of life was, what they were doing on the planet in the first place, why apparently 'bad' things happened to apparently 'good' people, why they have to suffer so much, and so acutely.


Plain, old-fashioned ideas that God exists, that people are first and foremost souls, not just bodies, and that we're all down here on a spiritual journey, and that everything that happens to us is somehow meaningful and for our higher good are the key to defusing these issues at their spiritual source.


And remember, BPD people are highly sensitive, so they naturally feel these questions, and the suffering, and the 'lack' in the world more acutely and deeply than other people, even when they've been raised in emotionally healthy, validating and warm environments.


When they haven't - and most of the people who have BPD haven't, as discussed above - then they've also experienced an enormous amount of suffering, pain and heartache in their own lives.


Believing in God enables you to cope with your suffering without getting smashed to pieces, for a few reasons:

  • You have someone to turn to, to share your pain with who won't find you 'too intense', clingy, deep or emotionally draining (BPD people: talk to God every single day about what's hurting you and upsetting you! More on this below.)
  • You have a spiritual framework to help you understand your suffering better. If you feel that everything you're going through is 'random' and purposeless, you'll sink into a black pit of despair and lose your will to live (which is why as much as 75% of BDP people try to kill themselves, at least once.) If you can believe that your suffering has purpose, is part of what's required to 'fix' your soul, and is part of a much bigger plan for you and your life - you'll have more strength, resilience and ability to acknowledge, cope with, and eventually overcome your difficulties.
  • If you believe that God's behind your difficulties, you also believe that He can stop all the 'craziness' in your life. If you don't, you'll feel that the difficulties, problems and issues will never end, and that you're powerless to do anything about it, which can make you feel even more desperate, panic stricken and overwhelmed. (As a side note, as well as feeling things more strongly, and reacting more extremely, BDP people also tend to have more than their fair share of crises and external 'problems' to deal with, which compounds the problem.)



2) Why working on the 3 foundations of emotional health can help BPD

It's all about BALANCE.


People with BPD need a lot of help to figure out what are appropriate, healthy emotional responses, and what aren't.


Yes, compassion is generally a good thing, but unlimited compassion that leads to you being treated like a doormat and being sucked dry is clearly not going to be very helpful.


The 3 foundations of emotional health that are set out in 'Talk to God and Fix Your Health' and not faddy ideas or pop-psychology; they're based on the timeless wisdom contained in the Torah, that's been proven as a blue-print for healthy humanity for more than 3 millenia.


They aren't going to change any time soon, and they WORK to help people feel more emotionally stable and grounded, and to have clarity about what a healthy emotional response actually should be, in any given situation.


3) Why bodywork / Energy Medicine / Energy Psychology stuff can help BPD

 
The scientific view brought above stated that the amydala, or 'fear hub' in the brain is overly-sensitive in people with BPD, while the frontal lobe is lacking the mechanism it needs to rein-in extreme emotional reactions.


Here's the good news: there are energetic techniques that can start to deal with this issue fast and effectively, including energy medicine techniques like holding the neurovasculars, and energy psychology techniques like Emotional Freedom Technique (EFT, or tapping) and the Tapas Acupressure Technique (TAT)


See here for the official page for EFT and how to do it.

See here for the official TAT page, and here for the free JEMI guide to doing TAT.


Post-Traumatic Stress Disorder (PTSD) is a big issue for people with BPD. As they feel so strongly and so deeply, it's VERY easy for them to be traumatised repeatedly, and to continue to hold that trauma physically, and to keep 'replaying' it at a subconscious level.


(I should say here that this can happen even when BPD people are raised in 'safe' home environments, which the vast majority of them are not. So they have trauma on top of trauma to try to deal with.)


Guess what happens when you're repeatedly traumatised and stressed-out? Yup, you're amygdala fires-up, sets off your body's stress response, you go into fight-flight-or-freeze, and 90% of the blood drains away from your frontal lobe, where you do your mature, adult processing and thinking.


Remember, BDP have a natural 'weakness' in this area in the first place, that trauma and stress only exacerbate.


If you go HERE, you'll find a video showing you the amazing results that tapping achieved with Vets suffering from PTSD as a result of their wartime experience.


What years of therapy and counselling couldn't shift, EFT managed in a couple of hours.


That's why approaching Borderline Personality Disorder just from the 'mind' perspective simply doesn't make sense. At least half the problem is energetic; start working on it there and the involuntary emotional reactions that characterise BPD can be defused in a very short amount of time, often providing instant relief.


Then, the BPD person can get on with the real work, of learning how to balance their emotions, and connecting all their experiences, depth, sensitivity and inner 'emptiness' back to God.


Can BDP be cured? - The Mainstream Mental Health View

 
Here's where the mainstream mental health view, and the holistic God-based view of how to treat personality disorders like BDP differ radically.


Mainstream secular science says broadly: no, but with one possible exception: Dialectical Behaviour Therapy (DBT), that's apparently had some notable success for treating BPD, and is being touted as a 'breakthrough'.


See THIS ARTICLE for more information and success stories about DBT.


Why I like DBT:


If you're going to go the Godless therapy route, DBT seems like your best bet by a long way, for the following reasons:

  • It works, at least more than any other secular therapy.
  • The founder, Marsha Linehan, is grounded, honest and realistic about the problems facing people diagnosed with BPD, as well as the limitations of the therapists trying to help them.
  • Linehan also has a healthy attitude to the way therapists should approach clients with BPD, to avoid exacerbating their feelings of invalidation, rejection and being 'not good enough' - in her own words: 'All therapists are jerks!'
  • But she also doesn't let BPD people off the hook for their own behaviour. The attitude promoted by DBT is one of BALANCE, acceptance of the client as they are now, with firm demands for change, improvement and growth.



But if you combined DBT with the God-based holistic approach outlined below, I believe you'd see tremendous, lasting results even faster.


Can BDP be cured? The God-based holistic health view


 
The God-based holistic health view for all illnesses, physical, mental or emotional, is that when God's in the picture, anything is possible.


This applies to terminal illnesses; chronic physical illnesses where the doctors have given up on finding a cure, or ameliorating the patient's condition; and especially for mental illnesses like personality disorders, which have a huge spiritual component to them that isn't usually even recognised by mainstream therapy and conventional medicine.


(I joked that I was writing a book on this subject, and I'm realizing that I've already half done it, in this post. So for the sake of brevity, I'm going to try to sum up the next points succinctly, and send you to other articles and references for further reading.)


In order to 'cure' BDP, you first have to have a full and honest assessment of the problem. Let's see if we can go back to the 9 criteria set out in the DSM for diagnosing BPD, and see how a God-based holistic approach could help to tackle each aspect of the problem.



RECAP: APA Diagnostic Criteria:


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 five (or more) of the following:


1) Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behaviour covered in criterion 5.


2) A pattern of unstable and intense interpersonal relationships, characterised by alternating between extremes of idealisation and devaluation.

 
3) Identity disturbance: markedly and persistently unstable self-image or sense of self.

 
4) Impulsivity in at least two areas that are potentially self-damaging (eg, spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behaviour covered in criterion 5.


5) Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour.


6) Affective instability due to a marked reactivity of mood (eg, intense episodic dysphoria, irritability, or anxiety usually lasting a few hours, and only rarely more than a few days.)


7) Chronic feelings of emptiness.


8) Inappropriate, intense anger or difficulty controlling anger (eg, frequent displays of temper, constant anger, recurrent physical fights.)


9) Transient, stress-related paranoid ideation or severe dissociative symptoms.

 
The essential feature of Borderline Personality Disorder (BPD) is a pervasive pattern of instability or interpersonal relationships, self-image and affects, and marked impulsivity that begins by early adulthood and is present in a variety of contexts.

A STRONG CONNECTION TO GOD AND WORKING ON THE SPIRITUAL ASPECTS OF THE PROBLEM WOULD HELP TO RESOLVE THE FOLLOWING:


1) EFFORTS TO AVOID ABANDONMENT - when you've got God to fall back on, to talk to, to rely on for comfort, you feel hugely less lonely even when you're completely alone. Which means you get much less desperate for 'people' to fill the loneliness gap.


5) RECURRENT SUICIDAL BEHAVIOUR - As mentioned earlier, BPD have had their fair share of suffering, and experience it much more deeply than others. Knowing that life, and even suffering, is purposeful and meaningful makes it much easier to deal with and cope with, and reduces the likelihood that a person will fall into despair and seek to kill themselves. When God's in the picture, there's always hope, because even if we ourselves can't 'fix' the problems we face (and that's a recurring theme for BPD people who are frequently overwhelmed by their life) - God can. And that thought is profoundly reassuring.

 
7) CHRONIC FEELINGS OF EMPTINESS - as explained above, this stems from existential angst, loneliness and a spiritual 'depth' and need for meaning in life that is felt much more strongly by people with BPD tendencies.


GENERALLY: God can help with all of the above, but first you need to ask Him to get involved. How? Talk to Him, and tell Him what's going on, and what you need, and why it hurts, and how you're really feeling.

For more details on how to do this, you can get a free e-copy of my pocket guide called: 'The How, What and Why of Talking to God' here: www.talktogod.today/ebook

WORKING ON STRENGTHENING AND BALANCING THE THREE FOUNDATIONS OF EMOTIONAL HEALTH (OR DBT) WOULD HELP TO RESOLVE THE FOLLOWING:

 

2) UNSTABLE AND INTENSE INTERPERSONAL RELATIONSHIPS WHERE YOU FLIP BETWEEN LOVING OR HATING PEOPLE - All three foundations come into play here, but particularly Healthy Compassion, where you learn how to empathise more with the other person's point of view, and see things a little less black-and-white.


3) IDENTITY DISTURBANCE  - Particularly focussing on the area of Appropriate Kindnesses, which teaches you to differentiate between WANT and SHOULD, and helps you to develop your own free choice about what YOU really want and believe.


4) IMPULSIVITY - Particularly focussing on the area of Sensible Accountability, which encourages you to recognise behaviours that are destructive, without letting yourself off the hook (and consequently ignoring the consequences of your behaviour), OR excessively beating yourself up over it (which guarantees that you'll repeat the behaviour again in the future - more on this in the energy section, below.)


6) AFFECTIVE INSTABILITY - Working across all three foundations of emotional health, to work out they underlying reasons WHY you are being triggered, WHO is contributing to the problem, and WHAT you are telling yourself subconsciously, that you then react to emotionally without being aware of what's really going on.


(NB: Talking to God can also help with all these issues, too, especially if you start to feel scared, overwhelmed, despairing or stuck.)


WORKING ON THE ENERGY PSYCHOLOGY / BODY / ENERGY MERIDIAN ASPECTS OF THE PROBLEM WOULD HELP TO RESOLVE THE FOLLOWING:


8) INAPPROPRIATE, INTENSE ANGER: This can't be done in a vacuum. You also have to work out WHO you're angry at, and why, and that's where the 'Talk to God and Fix Your Health' stuff comes in.


But to sum up a very long story in a nutshell, Borderline Personality Disorder people have an over-reactive Triple Warmer energy meridian, which is the meridian responsible for the 'fight-flight-or freeze' response.


Fight = you get angry.

Flight = you run away (or 'disassociate')

Freeze = when you don't do either fight or flight, sending your energy system into internal paralysis.


The more you can do to calm down Triple Warmer, the less reactive and angry you'll feel, and the easier it will be to keep your emotions in check.

See this article for more information about the Triple Warmer, and how it's affecting your mental and emotional health.


Again, let me state again that trauma, and PTSD, keeps Triple Warmer permanently switched 'on', and keep you permanently on edge and ready to tip over into fight-flight-or freeze.


But Meridian-based Energy Psychology techniques like EFT (tapping) and TAT can defuse PTSD and take the trauma out of your system very fast.


For more information about Energy Psychology and how it actually works, I highly recommend you pick up a copy of this book:


The Promise of Energy Psychology


For more general information about the body's 9 energy systems, including energy meridians, I highly recommend you read this book:

Energy Medicine, Donna Eden


You can also find a whole bunch of free resources about how energy meridians are connected to emotions, and how to work with them yourself using easy acupressure techniques on my website, here:


www.jemi.website/knowledgebase


9) PARANOIA, STRESS AND DISASSOCIATION


A lot of what I've written for number 8, above, also applies to this, with another addition, namely:


Holding the Neurovasculars.

The Neurovasculars govern what happens to blood and energy under stress. As well as being all over the head, they are also behind the knees, and in the centre of the throat.


Each neurovascular point is associated with a different meridian and its associated emotion). Gently holding the neurovasculars with the finger tips is a simple, but powerfully effective tool for lessening emotional intensity, and removing the 'charge' from negative emotional reactions.


Why this is particularly relevant to BPD people is that regularly holding the neurovasculars brings blood back to the frontal lobe, that regulates the emotional response.

 
To put it another way, it calms down the fight-flight-freeze response, and enables you to think instead of react.


You can find more information about holding the neurovasculars here, and also on my website, here.


PULLING IT ALL TOGETHER


 
By working across body, mind and soul, you can utilise a number of techniques to tackle BPD multilaterally, and every improvement you get in one area will automatically lead to further improvements in other areas.


I could carrying on writing about BPD for hours (clearly…) but I'm going to stop here and invite you to get in touch if you have any comments or questions. I'm figuring out a lot of this stuff as I go along, and I want to invite you to join me in this journey of discovery, and of looking at different ways to understand and overcome things like Borderline Personality Disorder.


Let me leave you with this: Don't despair! God loves you unconditionally, and He can help you to turnaround even the more dire circumstances, and most difficult problems.


Yes, BPD is a huge challenge, but by adopting a God-based holistic health approach, I believe you can see some dramatic improvements in your quality of life and outlook, and much faster than you might believe is possible.


From the spiritual perspective, mental health issues usually come about because a person's soul is too big for the body it's been squished into. Let that thought give you some comfort, and also, a lot of hope.

Rivka Levy

Jewish Emotional Health Institute

 

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