Borderline Personality Disorder (BPD) is a complex diagnosis often stigmatizing and pathologizing.
Many therapist shy away from working with clients with BPD as a result of the complex nature of the diagnosis and the difficulty with clients.
BPD is a pervasive pattern of instability in relationships, a push pull of I love you I want to be close to you; get away from me, I hate you. Of course this is an overly simplistic view, but it can be a constant back and forth in relationships. Often, people with a diagnosis of BPD have had ACEs which have contributed to the diagnosis.
When a child grows up with instability within the relationships. especially with parents or caregivers or other close adults, the child internalizes negative messages about themselves that they carry into adulthood. These negative believes are hard to heal and so a person might act out their disbelief that anyone can love them the way the person with BPD wants, needs or deserves to be loved. They can’t imagine that this person they have such intense feelings for can possibly love them or have the same level of feelings.
When we look at attachment styles, an anxious attachment style and an avoidant attachment style come together to form a disorganized attachment style and that is what BPD really is…. a disorganized attachment style.
People with BPD might engage in some serious, unhealthy behaviors including alcohol, addictive, illegal drug use, over spending of money and impulsivity. Looking at BPD through an Internal Family Systems lens. we would look at those behaviors as “Firefighters” as they are there doing these behaviors to numb the emotional pain.
Using Polyvagal work to help BPD people to expand their window of tolerance is also helpful.
* I would like to note that DBT therapy is the Gold Standard of care for people with DBT. But EMDR. IFS and polyvagal can also help.
