{"id":1126,"date":"2024-06-25T13:42:30","date_gmt":"2024-06-25T13:42:30","guid":{"rendered":"http:\/\/www.mjtacc.com\/?page_id=1126"},"modified":"2024-08-10T15:45:18","modified_gmt":"2024-08-10T15:45:18","slug":"borderline-personality-disorder-information","status":"publish","type":"page","link":"https:\/\/www.mjtacc.com\/borderline-personality-disorder-information\/","title":{"rendered":"Borderline Personality Disorder Information"},"content":{"rendered":"\n

Borderline UK <\/a>has been a national user-led network of people within the United Kingdom who meet the criteria, or who have been diagnosed with Borderline Personality Disorder (BPD) or, as it is often known in the UK, Emotionally Unstable Personality Disorder (Borderline Type)<\/em>. It has now become a part of The Shack (Mjtacc)<\/a>.<\/p>\n\n\n\n

Here we aim to provide information on all aspects of BPD – how it is defined, current theories of what may cause it, treatment options and details of the latest news, conferences and initiatives in the field. It also contains information from Borderline UK original website.<\/p>\n\n\n\n

We believe that those of us diagnosed BPD are experts through our own experience and are able to articulate our views and opinions in a constructive manner. We believe that we have the ability to use our experiences and knowledge in partnership with other professionals and services to bring about real, sustainable change that will benefit us all. Members of Borderline UK Ltd were involved with a number of projects nationally and locally – the impact of which are beginning to be felt across the country.<\/p>\n\n\n\n

We feel that those of us diagnosed with BPD have the ability to provide a vast amount of support for one another. To this end Borderline UK Ltd had run Yahoo Groups in the past that allowed people diagnosed with BPD to communicate regularly through e-mail. These boards not only enable the isolation that so many of us have experienced to be reduced but also provided members with access to a wealth of information and support. Some experts are also part of other online communities like BPD<\/a> or BrainGains<\/a>.<\/p>\n\n\n\n

Borderline Personality Disorder Information<\/h3>\n\n\n\n


This section of the site is designed to give a brief overview of Borderline Personality Disorder, how it is diagnosed, suggested causes and some of the available treatments. If you’ve just been diagnosed BPD (or just found out!) or if you’ve just come across those three wonderful letters and want to discover more, this is the section to start with.<\/p>\n\n\n\n

BPD is not only a controversial diagnosis, but the arguments as to what causes it, how it is best treated etc. provoke heated debate all over the world. The only thing one can say with any certainty is that there is no consensus amongst MH professionals, researchers, carers or even BPs themselves. It’s easy to be overwhelmed by the amount of information out there, so the information on this section is very basic and very brief.<\/p>\n\n\n\n

Please feel free to distribute the leaflet. If you would like us to send a leaflet out through the post then please email us at admin@borderlineuk.co.uk<\/a>. Single copies are free. Anyone requiring multiple copies will be asked for a small contribution towards the cost of production and postage.<\/p>\n\n\n\n

Causes<\/h3>\n\n\n\n

There is still a great deal of debate concerning the causes of Borderline Personality Disorder. It is perhaps more meaningful to talk of the factors that shape Borderline Personality, about which there is increasing agreement and research. Broadly speaking there are two schools of thought on the processes that lead to the development of BPD.<\/p>\n\n\n\n

Attachment Theories<\/strong><\/p>\n\n\n\n

These models of the development of BPD emphasis the psychobiological and neurophysiological processes that influence personality. During the first five years of life, and in particular during the first two, a child’s brain is still growing and developing at a substantial rate. All the experiences that child has are directly influencing how various parts of the brain develop. Of prime importance in this process is the child’s interaction with its mother or primary care giver. Separation from the mother, or poor or negative nurturing (eg abuse, violence), can have a dramatic effect on the development on areas of the brain, especially those which handle emotions and social functioning.<\/p>\n\n\n\n

“traumatic experiences, especially if severe, sustained and repetitive, lead to cell damage and premature death in key centers [of the brain] and wiring patterns that evoke unmodulated and maladaptive responses to the ordinary events of life.”<\/em>
Kernberg et al, “Borderline Patients: Extending the Limits of Treatability”<\/p>\n\n\n\n

It is perhaps this ‘hard-wiring’ that makes BPD and other PDs resistant to treatment. Whilst the brain is in a state of constant flux throughout adult life, it is harder to change the wiring pattern in later life. However, it is possible to learn to manage the behavioural difficulties that a differently wired brain may produce.<\/p>\n\n\n\n

Whilst more is becoming known about what processes influence the development of BPD, far less is known about why certain individuals seem more prone to develop BPD (and other psychiatric problems) than others. It increasingly appears that there may be a genetic predisposition, given an adverse environment, for certain individuals to develop BPD.<\/p>\n\n\n\n

Poor nurturing and an adverse environment is not guaranteed to result in a child experiencing psychiatric problems in later life; equally, good nurturing in a positive environment is no guarantee that a child will be free from psychiatric difficulties as an adult. However, a genetic predisposition towards psychiatric problems coupled with poor nurturing is far more likely to result in problems later in life.<\/p>\n\n\n\n

Physical Causes<\/strong><\/p>\n\n\n\n

As research expands, more and more theories regarding the cause of BPD are being developed. Some of these theories suggest that BPD is a \u201cneurological\u201d illness \u2013 having little or nothing to do with environmental factors. Other recent research has suggested an interaction between a person\u2019s early environment and their neurological development which may precipitate the onset of BPD. Of course, there are also those people who refute any neurological involvement at all.<\/p>\n\n\n\n

Diagnosis<\/h3>\n\n\n\n

A WORD OF CAUTION: The personality traits described below are usually experienced by most people from time to time, especially adolescents. For these traits to be indicative of a personality disorder they must be long-standing, intense and persistent. Personality disorders are a notoriously controversial diagnosis, and making a self-diagnosis based on information on a web-page or in a book is not to be recommended. If you are at all concerned about your mental health, then seek professional help urgently.<\/p>\n\n\n\n

As there are no physical or biochemical tests that can be made to establish whether someone does or doesn’t have BPD, clinicians use the criteria given in one of two psychiatric manuals. In Europe and the UK, most clinicians will use the ICD-10 Classification of Mental and Behavioural Disorders (World Health Organisation, 1992), whereas in America clinicians use the Diagnostic and Statistical Manual of Mental Disorders -DSM IV (American Psychiatric Association, 2000). Just to add to the confusion, the official label for BPD within Europe is Emotionally Unstable Personality Disorder (Borderline Type).<\/p>\n\n\n\n

Misdiagnosis does, unfortunately, happen. Within the NHS you are entitled to request a second opinion – though there is no compulsion for such a request to be granted.<\/p>\n\n\n\n

ICD-10 Diagnostic Criteria for Emotionally Unstable Personality Disorder<\/strong><\/p>\n\n\n\n

Impulsive Type<\/em><\/p>\n\n\n\n

At least three of the following must be present, one of which must be (2)<\/p>\n\n\n\n

    \n
  1. Marked tendency to act unexpectedly and without consideration of the consequences<\/li>\n\n\n\n
  2. Marked tendency to quarrelsome behaviour and to conflict with others, especially when impulsive acts are thwarted or criticised<\/li>\n\n\n\n
  3. Liability to outburst of anger or violence, with inability to control the resulting behavioural explosions<\/li>\n\n\n\n
  4. Difficulty in maintaining any course of action that offers no immediate reward<\/li>\n\n\n\n
  5. Unstable and capricious mood<\/li>\n<\/ol>\n\n\n\n

    Borderline Type<\/em><\/p>\n\n\n\n

    At least three of the “Impulsive Type” criteria must be present, accompanied by at least two of the following:<\/p>\n\n\n\n

      \n
    1. Disturbances in and uncertainty about self-image, aims and internal preferences (including sexual)<\/li>\n\n\n\n
    2. Liability to become involved in intense and unstable relationships, often leading to emotional crises<\/li>\n\n\n\n
    3. Excessive efforts to avoid abandonment<\/li>\n\n\n\n
    4. Recurrent threats or acts of self-harm<\/li>\n\n\n\n
    5. Chronic feelings of emptiness<\/li>\n<\/ol>\n\n\n\n

      DSM-IV Diagnostic Criteria for Borderline Personality Disorder<\/strong><\/p>\n\n\n\n

      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:<\/p>\n\n\n\n

        \n
      1. Frantic efforts to avoid real or imagined abandonment. Do not include suicidal or self-mutilating behaviour covered in (5)<\/li>\n\n\n\n
      2. A pattern of unstable and intense interpersonal relationships characterised by alternating between extremes of idealization and devaluation.<\/li>\n\n\n\n
      3. Identity disturbance: markedly and persistently unstable self-image or sense of self.<\/li>\n\n\n\n
      4. Impulsivity in at least two areas that are potentially self-damaging (eg spending, sex, substance abuse, reckless driving, binge eating). Do not include suicidal or self-mutilating behaviour covered in (5)<\/li>\n\n\n\n
      5. Recurrent suicidal behaviour, gestures, threats or self-mutilating behaviour.<\/li>\n\n\n\n
      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).<\/li>\n\n\n\n
      7. Chronic feelings of emptiness.<\/li>\n\n\n\n
      8. Inappropriate, intense anger or difficulty controlling anger (eg frequent displays of temper, constant anger, recurrent physical fights).<\/li>\n\n\n\n
      9. Transient, stress-related paranoid ideation or severe dissociative symptoms.<\/li>\n<\/ol>\n\n\n\n

        Treatments<\/h3>\n\n\n\n

        Unfortunately, there are still health professionals in the world who regard personality disorders as basically untreatable. This extreme position is, of course nonsense, but there is no doubt that Personality Disorders constitute one of the greatest challenges facing mental health professionals today. Borderline Personality Disorder attracts an ever increasing amount of investigation and research, particularly in the United States.<\/p>\n\n\n\n

        Treatment includes psychotherapy and other ‘talking therapies’, in a one-to-one or group setting, that allows the patient to talk about both present difficulties and past experiences in the presence of an empathetic, accepting and non-judgemental therapist. Therapy needs to be structured, consistent and regular, with the patient encouraged to talk about his or her feelings rather than to discharge them in their usual self-defeating ways. Different therapists will adopt different treatment strategies depending upon their particular school of thought.<\/p>\n\n\n\n

        Medications such as anti-depressants or anti-psychotic drugs may be useful for certain patients or during certain times in the treatment of individual patients. For more information see Tyrer and Bateman: “Drug treatment for personality disorders”. <\/a>Treatment of any drug or alcohol problem is usually necessary if therapy is to be able to continue. Brief hospitalisation may be necessary during extreme stressful episodes, and, in the UK at least, you are likely to be hospitalised without your consent (‘sectioned’) if your therapist, GP or an Approved Social Worker believes you are a danger to yourself or to others. There is some research to suggest that long term hospitalisation for borderlines can be counter-productive.<\/p>\n\n\n\n

        Out-patient treatment is usually difficult and can sometimes take a number of years. Research suggests that borderlines being treated in an out-patient environment have an exceedingly high drop-out rate. Although recent research shows that psychosocial out-patient care can be highly effective if it immediately follows a brief in-patient stay in a therapeutic environment. Chiesa, “Time limited psychosocial intervention with patients with severe personality disorder following shorter inpatient stay.”<\/p>\n\n\n\n

        Effectiveness of Treatment<\/h3>\n\n\n\n

        As yet, there have been only a few studies conducted assessing the effectiveness of the various types of treatment. These would indicate that the short-term prognosis is usually poor. Chronic symptoms, high relapse rates, poor employment and poor psychosocial functioning are reported in the short-term following treatment. The long-term outlook for borderlines is more optimistic as research suggests that symptoms such as dysphoria, impulsiveness, disturbed relationships and micropsychotic symptoms decrease over time, and also indicates that 75% of cases no longer meet the criteria for BPD fifteen years after initial diagnosis. So, if we can keep ourselves alive then the chances are we’ll eventually get better!<\/p>\n\n\n\n

        Availability of Treatment<\/strong><\/p>\n\n\n\n

        The availability of treatment, particularly therapies, within the US & UK is far from adequate. Waiting lists are often very long, and the type of therapy available can vary considerably depending on your geographical location. Age can also play a part in that many health authorities and clinicians are unwilling to treat older people on the grounds that they respond less well to therapy. Long term therapy is expensive and it is worth remembering that cost effectiveness is usually the over-riding concern for Local Health Authorities.<\/p>\n\n\n\n

        Key Concepts<\/h3>\n\n\n\n

        There are quite a few concepts that you’ll come across in the literature on BPD that can be difficult to get your head around. This is our guide to some of them.<\/p>\n\n\n\n

        Depersonalisation<\/u><\/strong><\/p>\n\n\n\n

        Depersonalisation is the state in which an individual feels ‘unreal’ or detached from himself. This can include:<\/p>\n\n\n\n