BORDERLINE PERSONALITY DISORDER

Running head: BORDERLINE PERSONALITY DISORDER
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1 Borderline Personality Disorder
Elizabeth Kucera
Liberty University
June 25, 2017 FAMILY SYSTEMS AND ACCOUNTABILITY
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Abstract
Borderline personality disorder is a severe mental illness. Unfortunately, this disorder is
commonly controversial in diagnoses in any age below 18 which means that diagnoses usually
comes latter with many destructive behaviors in grained in the individual. Treatment is long and
takes a lot of commitment and time. Because of the behaviors associated with borderline,
therapist and the public have issues dealing with people who have BPD. Borderline personality
disorder is developed differently in each individual based on environmental factors, genetics, and
culture. With more education in the social and mental health fields, this illness can be taken for
what it is and hopefully take away the negative stigma that has followed the people affected by
it. FAMILY SYSTEMS AND ACCOUNTABILITY
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Introduction
According to the DSM-5, borderline personality disorder is a cluster b personality disorder.
Borderline symptoms consist of a pattern of instability of social relationships, self- image,
marked impulsivity beginning by early adulthood and present in different ways for each person
such as: Frantic efforts to avoid real or imagined abandonment, pattern of unstable and intense
interpersonal relationships characterized by alternating between extremes such as I hate you I
love you, multiply sex partners, over spending, self-mutilation behavior, substance abuse, and so
on. It also impairs self-direction is goals, values, career path and desires. Has issues showing
empathy towards others and has issues keeping relationships. They have chronic feelings of
emptiness and also intense anger without being able to control it. FAMILY SYSTEMS AND ACCOUNTABILITY
4 Cause of Borderline Personality Disorder
Borderline personality disorder has been a presence in mental health for over 30 years. This
disorder was used to categorize patients who are hopeless. The term borderline came into
actuality because these individuals were believed to lie on the borderline between psychosis and
neurosis (Omar, 2008). This term was first used by Adolph Stern in 1938 even though the
beginning of this disorder was in 1938 (Omar, 2008). It was not until 1980 when this term was
accepted as a psychological term and therefore included in the Diagnostic and Statistical Manual
III (Omar, 2008). Within the DSM, it became a cluster B personality disorder. Borderline
personality disorder was frequently disordered amid histrionic personality disorder, paranoid
personality disorder, antisocial personality disorder, and dependent personality disorder (Omar,
2008). Histrionic personality disorder and borderline personality disorder are similar in that the
patient is attention seeking, manipulative, and ever changing emotions (Omar, 2008). The
biggest variance in histrionic personality disorder and borderline personality disorder is that
borderline patients have symptoms of self-destructiveness, angry disruptions in intimate
relationships, and lingering feelings of deep emptiness and loneliness (Omar, 2008). There are
two different descriptions of borderline. Kernberg gives a general description while Gunderson
gives a more scientific one. Gunderson, along with Kolb and Zanari, developed a diagnostic
interview for borderline personality disorder (Omar, 2008). However, the most utilized view and
studies todays day and age originate from Marsha Linehan (Omar, 2008). Borderline personality
disorder is said to be the most controversial diagnose. Its similarities among other personality
disorders makes the diagnoses difficult and finding a therapist who can work with the individual
is challenging as well. This disorder plagues three percent of the population (Omar, 2008). FAMILY SYSTEMS AND ACCOUNTABILITY
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Further research and new treatments would be a welcomed relief to the individuals who suffer
with this debilitating personality disorder.
Development of Borderline
It is an established understanding that personality disorders have their origins in childhood and
adolescence and yet it is controversial to give such a diagnosis prior to the child becoming 18
(Chanen A. M., 2012). Borderline personality disorder is progressively understood as a lifespan
developmental disorder (Chanen A. M., 2012). Developmental psychopathology perspective is
one theory around the cause of borderline. It observes the developmental pathways studying
the dynamic interface of normal and abnormal biological, psychological, and sociocultural
factors and systems over important developmental periods throughout the progression of life
(Chanen A. M., 2012). Neurobiological research in adults implies that abnormalities in
frontolimbic networks are connected with numerous of the characteristics of borderline
(Chanen A. M., 2012). These discoveries, however, are undistinguishable between a cause or
an effect, or a secondary effect that arises from borderline and may not influence the process
(Chanen A. M., 2012). Borderline in adults are perplexed by influences connected with the
extent of illness, including persistent co-occurring Axis I disorders, deliberate self-harm,
cumulative traumatic events, and treatment (Chanen A. M., 2012). In order to demonstrate that
abnormalities found in late-stage BPD are associated in the cause, they have to be existing
initially in the course of borderline. Environmental risk factors have been shown to play a role
in the development of BBD. Numerous studies of negative childhood experiences and BPD
coincide. Relations among BPD and unfavorable childhood experiences have been discovered
in clinical and nationally representative samples of adults (Chanen A. M., 2012) Nevertheless,
there is still no clear-cut responsibility of childhood hardship in the cause of BPD (Chanen A. FAMILY SYSTEMS AND ACCOUNTABILITY
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M., 2012). It seems that even today we cannot disclose one genetic or environmental cause for
BBD. There has been desperate research and studies the past decade for borderline
personality disorder. The hope is to enlighten on the development, prevention, early detection,
and timely intervention for BPD (Chanen A. M., 2012).
Treating Borderline
Borderline personality disorder is difficult to treat because of its complexity and controversy.
Also, the symptoms suggest deep-rooted behavior and thinking patterns (Treating borderline
personality disorder, 2010). Borderline is diverse in what symptoms may plague an individual.
Most patients have a subsequent mental disorder such as post-traumatic stress disorder or
mood disorder. One notion for treating borderline are pharmaceuticals. They can help with
certain symptoms like depression or anxiety however, they do not rid the individual of person ality traits and behaviors (Treating borderline personality disorder, 2010). Psychotherapy has
proven to be successful in treating borderline personality disorder and is the foundation of treatment for those who suffer with borderline (Treating borderline personality disorder, 2010). With
psychotherapy, there is a significant time commitment to generate results (Treating borderline
personality disorder, 2010). One of the more common psychotherapy is dialectical behavior
therapy which was created by Dr. Marsha Linehan. This method has an approach that helps to
resolve evident inconsistencies in a patient’s perspective and encouraging change at the same
time (Treating borderline personality disorder, 2010). With Dialectical behavior therapy, the sessions go for about a year and involve both group and individual sessions. Group therapy helps
patients learn more constructive behaviors and reactions by partaking in sessions on problem
solving, mindfulness meditation, muscle relaxation, and breath training (Treating borderline personality disorder, 2010). Individual sessions help with incorporating what is learned in group FAMILY SYSTEMS AND ACCOUNTABILITY
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into daily life, this can involve phone coaching as well (Treating borderline personality disorder,
2010). It is evident that borderline has a major impact in not only the individual suffering with it
but also on the family. Getting treatment is paramount if the sufferer wants to have a functioning
life.
Preventing Borderline
With any disease or mental health issue, researchers and clinicians want not only a way of
treating the problem but also a way of preventing it as well. Borderline personality disorder is no
different. Most of the time, borderline personality disorder is found later in an individual’s life.
This is because it is controversial, frowned upon, to diagnose someone with borderline before the
age of 18. So, one way of a proposed prevention method would be to diagnose borderline when
DSM-5 criteria are met regardless of age (Chanen A. S., 2017). In doing this, behaviors that
come about because of borderline would not be so ingrained as in late intervention. Training and
teaching both the mental health services and public could help in the image of what borderline
really is and get the individual the help they so desperately need (Chanen A. S., 2017). People
who have borderline are very hard to work with on a clinician’s side and in the family. If
borderline was taken seriously and not an inconvenience that could help with the recovery side
of borderline. Another way to help with prevention is to change the health care system. Making
it known that borderline is just as serious as other mental conditions and not giving someone a
set amount of sessions to recover (Chanen A. S., 2017). It costs a lot of money to seek mental
help and if the health care system changes people could actually afford the help they need.
Prevention is hard with borderline. Because it is a development over years, it can be hard to FAMILY SYSTEMS AND ACCOUNTABILITY
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catch in the beginning. It seems that if we attack the social barrier of borderline and provide a
method of brining awareness to the illness, it could make all the difference in the world.
Cross-cultural Differences in Borderline Cross-cultural differences lie with borderline personality disorder. For instance, Great Britain
and the United States differ in things such as drug abuse and drug-related psychoses, counter
dependency, and derealization/depersonalization symptoms (Jani, 2016). In Japan, they
compared 33 Americans and 19 Japanese females who had been diagnosed with borderline.
They used the Diagnostic Interview for Borderline with the score for the American females being
considerably higher than that of the Japanese females especially in the affect and cognition
scores (Jani, 2016). The impulse action patterns or interpersonal relationships sections measured
about the same for both and American females had higher scores in the helpless- ness,
hopelessness, worthlessness, and guilt sections (Jani, 2016). However, the Japanese females had
greater scores for manipulative suicide efforts (Jani, 2016). What is curious about the
manipulative score is that it is a normal thought that Americans with borderline are more
impulsive and manipulative (Jani, 2016). The researchers believed that the suicide differences
were based on religious prohibitions such as Catholics believe you will go to hell if you kill
yourself (Jani, 2016). Borderline has various symptoms that seem to occur not only because of
predispositions and environmental factors. It seems that depending on what culture one is
associated with, borderline will develop accordingly and is also influenced on how the culture
itself views the illness (Jani, 2016). This is why as a clinician, it is paramount to take in the
whole picture of a patient including their culture.
Christian Worldview of Borderline FAMILY SYSTEMS AND ACCOUNTABILITY
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Individuals who is suffering from borderline personality disorder seem to have a screwed idea of
who God is that is a result from upbringing. In a study, it was found that the women found God’s
character to be undisputable, unavoidable, stationary, large (Gravitt, 2011). I would agree that
God is undisputable and unavoidable because Romans 14:11 says that every knee shall bow and
every tongue will confess he is God. There is no way to dispute a God that will make himself
known so that everyone will bow and every tongue will confess. However, I would say that God
is not stationary. Throughout the whole Bible, God is working. He created the heavens and the
earth, he created every living thing, and in Mark 2:28 Jesus says to the priesthood that the Son of
Man works on the Sabbath. These women also envisioned God as person that is magical,
inexplicable, and because of this, they believe God to be unreliable (Gravitt, 2011). To address
God as a person, he is not. He is a spiritual being. Nowhere in the Bible does it say what God
looks like. In 1 John 4:1-3, It talks of testing the Spirits. However, it is important to note that it
says Jesus Christ came in the flesh. If he came in the flesh then that was not his original form.
God is not magical in the idea that most would think such as fairytales. God is inexplicable and
this does not make him unreliable. Deuteronomy 31:6 says he will never leave us or forsake us even though he is beyond our own understanding Isaiah 55:8-9. Looking at how these women
perceive God, it is no wonder pease is hard to find. Especially with the behaviors of borderline
like manipulation, it can be hard as a Christian to deal with. If God takes root in the beginning of
a child’s life, I think it could eliminate borderline. Along with this, proper teaching of the Word
is an important factor.
Conclusion FAMILY SYSTEMS AND ACCOUNTABILITY
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In conclusion, borderline personality disorder is complex and varies among all patients. Cul ture, genetics, environmental factors and religion all play a factor. With this rigid mental
dieses, it is not to prevent with the controversial process of diagnosing someone before the age
of 18. At the same time, in preventing borderline, it is better to diagnose earlier than later just
like with cancer and other illnesses. With treatment being difficult for therapist, in dealing
with the patient’s moods, it is also difficult to change in grained behaviors taking a lot of com mitment and time. There is hope as more research is taking place and new treatments are be coming available. FAMILY SYSTEMS AND ACCOUNTABILITY
11 References
Chanen, A. M. (2012). Developmental pathways to borderline personality disorder. Current
Psychiatry Reports, 14(1), 45-53.
Chanen, A. S. (2017). Prevention and early intervention for borderline personality disorder: A
novel public health priority. . World Psychiatry, , 16(2), 215-216. .
Gravitt, W. J. (2011). God’s ruthless embrace: Religious belief in three women with borderline
personality disorder. . Issues in Mental Health Nursing, 32(5), 301-317.
Jani, S. J. (2016). Cross-cultural bias in the diagnosis of borderline personality disorder. Bulletin
of the Menninger Clinic, 80(2), 146-165.
Omar, L. A.-A. (2008). Borderline personality disorder: An overview of history, diagnosis and
treatment in adolescents. International Journal of Adolescent Medicine and Health, 395404.
Treating borderline personality disorder. (2010). the Harvard Mental Health Letter. FAMILY SYSTEMS AND ACCOUNTABILITY
12 ***This grading rubric must be included as that last page of your paper***
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