the ‘BPD’ LABEL
''It is increasingly being recognised that many individuals who receive the diagnosis of BPD are naturally highly intuitive and perceptive. What was previously thought of as a genetic vulnerability may actually reflect an innate talent. ''
People who were born emotionally intense, sensitive and are gifted with heightened perceptivity are like powerful sports cars.
It is as if they have an extremely powerful engine that requires a special fuel and a specific kind of care. In the right condition and with the right keeping, they can be one of the most high-performing machines in the world and win many races. The problem is, however, that they may not have been taught how to run this powerful machine. To borrow a metaphor from Psychologist Dr Hallowell (Additudemag.com), it is like having a Ferrari with bicycle brakes, and these brakes are simply not strong enough to control such a powerful engine.
Many emotionally intense people are diagnosed or misdiagnosed with various mental disorders throughout their lives, some of the most common ones are mood disorders, including Bipolar disorder, ADHD, eating disorders and personality disorders. Whilst these conditions are real and extremely painful, we should not immediately assume that they are signs of a defect.
“Self-destructiveness may be a primary form of communication for those who do not yet have ways to tame their excruciating inner conflicts and feelings and who cannot yet turn to others for support.”
― James A. Chu
what is bpd ?
One of the most common labels given to emotionally intense people is Borderline Personality Disorder, also known as Emotional Dysregulation Disorder or Emotionally Unstable Personality Disorder (World Health Organization, 1992).
Despite being referred to as a ‘personality disorder’, BPD is not a personality defect, but is best understood as a limitation in a person’s capacity to regulate emotions. This means that you can sometimes experience emotions as overwhelming, spiralling out of control, and rapidly changing. These symptoms sometimes go alongside impulsive behaviours and a chronic sense of internal hollowness. I emphasis ‘traits of’ because psychological disorders are nothing but extreme expressions of a continuum of normality. We all have traits and personality tendencies, it only becomes a ‘disorder’ when our way of thinking, feeling and acting severely impair our daily functioning.
Some of the BPD traits are:
Fearing abandonment and rejection
Having series of intense and unstable relationships
Not having a strong sense of self-identity, not knowing 'Who I am'
Impulsive behaviours that are self damaging e.g. spending, substance abuse, sex, reckless driving, binge eating
Recurrent suicidal thoughts and behaviour
Severe mood swings
Chronic feelings of emptiness
Sudden and uncontrollable rage
Feeling dissociated from reality during times of stress
These symptoms may manifest themselves in various ways. For some people 'frantic effort to avoid feeling abandoned' means not being able to be alone and becoming clingy, whilst for others it is about chronically isolating themselves altogether to avoid disappointment or hurt.
Sometimes people with BPD seem to view the world in a black-or-white, ‘all good or all bad’ fashion. This can be confusing and frustrating to the people around you, but it may be the only way you can safely experience the world at a certain point in time.
Often, the most painful part of being labelled as having BPD is being misunderstood by and isolated from those close to you. Unfortunately, you may eventually push away or sabotage what you actually need and desire most – real closeness and stable relationships. Although it may not seem like that to the outside world, people who identify with BPD are often extremely sensitive and intuitive. If the traits are not well managed, you can appear to be both dependent and hostile, which in most cases makes for turbulent relationships.
the giftS inside bpd
A ‘diagnosis’ in psychiatry simply represents a cluster of symptoms, which are manifestations of internal conflicts and dis-ease. In reality, the distinction from one disorder to another is unclear. The purpose of having these arbitrary categories is so that clinicians can fall back on a standardised framework to do research and to prescribe medication. With the dominance of the medical model, we tend to pathologize, and overlook the possibility that the distress may be a result of us not honouring our utterly unique make-up as individuals. Due of the lack of awareness, even amongst mental health professionals, of ‘neuro-typical’ traits such as high sensitivity and giftedness, many emotionally intense people have been wrongly pathologized.
It is increasingly being recognised that many individuals who receive the diagnosis of BPD are endowed with heightened sensitivity and perceptivity, and what was previously thought of as a genetic vulnerability may actually be a form of giftedness. Drawing on psychological research and theories, we see that many people who struggle with BPD do so as a result of two combing factors:
A) their innate intuitive talents, and the specific developmental requirements that go along with it, and
B) a childhood environment that fails to meet their emotions needs.
THE ‘BORDERLINE EMPATHY PARADOX’
It has long been recognised that individuals with BPD seem to possess an uncanny sensitivity to other people’s subconscious mental content - thoughts, feelings and even physical sensations. They also seem to have a talent in involving and influencing others (Park, Imboden, Park, Hulse, and Unger, 1992, p. 227).
In the first study that explicitly investigate this observation, Frank and Hoffman (1986) found that individuals with BPD showed a heightened sensitivity to nonverbal cues when compared with people without BPD. This finding has been validated through other follow-up research (Domes, Schulze, and Herpertz, 2009). A well-known study, for instance, compared the way people with BPD react to photographs of people’s eyes to those without BPD. The researchers found that the BPD group was more able to correctly guess what emotions these eyes expressed, which showed their enhanced sensitivity to the mental states of others (Fertuck et al., 2012).
At their best, these highly intuitive individuals’ ability would constitute what giftedness psychologists call “Personal Intelligence” (Gardner,1985) . This kind of giftedness consists of two components: ‘Interpersonal intelligence’— the capacity to understand the intentions, motivations and desires of other people, and ‘Intrapersonal intelligence’ — the capacity to understand oneself, to appreciate one’s feelings, fears and motivations.
Despite their enhanced empathic ability, however, many people with BPD have difficulties navigating social and interpersonal situations. Without the ability to regulate their emotions and manage attachment relationships, their hypersensitivity may end up showing up as emotional storms and mood swings (Fonagy, Luyten, & Strathearn, 2011), being easily triggered by stressful situations, and a constant fear abandonment and rejection (Fertuck et al., 2009). This phenomenon is known as the ‘Borderline Empathy Paradox’(Franzen et al., 2011; Krohn, 1974).
IS IT BECAUSE OF MY CHILDHOOD?
It is true that high empathy may be an outcome of growing up in a traumatic and unpredictable childhood environment. Indeed, many people with BPD have a history of abuse, neglect or prolonged separation as children. As a response to confusing or neglectful parenting, these children had to ‘amp up’ their empathic functioning in order to protect themselves. They were trained by their environment to become highly attuned to the subconscious cues given out by their parents so that they can be prepared for their unpredictable behaviours.
Environmental factors alone, however, do not explain why many siblings who grow up in the same household are not affected in the same way. Thus, we must also consider the biological and innate temperament-based factors that affect people’s distinctive reactions to traumatic events. As psychologist Bockian (2002) suggested: “It is extremely unlikely that someone with a placid, passive, unengaged, aloof temperament would ever develop borderline personality disorder.”
Child psychologists have found that there is a subset of children who has ‘heightened sensitivity to the social world’, whose developmental and emotional outcomes are critically dependent upon their early childhood conditions. (Boyce, Chesney, Kaiser, Alkon-Leonard and Tschann, 1991)
In most cases, serious difficulties in emotional regulation, or BPD, is a result of two combing factors: A) being born with heightened sensitivity and a gift in perceptivity, and B) a deficient or vicarious childhood environment that fails to meet these children’s emotions needs.
But what if you simply don't have a solid self to return to—if the way you are is seen as basically broken? And what if you can't conceive of "normal" or "healthy" because pain and loneliness are all you remember?”
― Kiera Van Gelder
IF IT IS A GIFT, WHY IS IT SO PAINFUL ?
Under favourable, 'good enough' circumstances, a child who is born with a gift in perceptivity would not grow up to have serious emotional regulation issues or BPD. However, if the primary caretakers did not have the capacity to attune to their child, or even resented or were threatened by their unusually perceptive child, they may consciously or subconsciously sabotage the child’s healthy development. The nature of the psychological abuse may differ, but it always includes an assault on the child’s perceptions and the development of their autonomy.
For gifted children, ongoing negative feedback towards their intuitive perception is ‘particularly damaging’(Park et al., 1992, p.228).
Attachment theories have us know that children will do all they can in order to preserve a good image of their parents. Even when their parents are incompetent, abusive or neglectful, children naturally blame themselves because it is not safe to think of the people they depend on as ‘bad’ (Winnicott, 1960). This scenario is complex if the child is naturally intuitive; many emotionally gifted children have strong feelings of love and responsibility for their parents, and often feel compelled by a need or desire to take care of them.
If the parents either explicitly or implicitly reject the child— he or she will internalise the shame of being rejected, and experience him/ herself as being profoundly bad (toxic shame). As a result of their negative experience of themselves and those around them, these children’s natural gifts in perceptivity become ‘highjacked’ by negative bias and negative projections. Without an environment where they can learn to set healthy boundaries and experience secure attachment without exploitation, these children develop ’symptoms’ such as as an inability to self- soothe and regulate emotions, a fear of rejection, and a deep sense of internal hollowness.
Many emotionally intense adults have struggled all their lives feeling lonely, misunderstood, with the belief that there is something deeply wrong with them. If you are one of them, I hope that you can reconsider the potential gifts that are within you.
Whilst the history cannot be changed, you can re-write the story that you have been telling yourself. You are in no way ‘bad’. You are not ‘too much’. What you are, is a sensitive, intuitive, gifted individual, who were deprived of the right kind of nourishments you were growing up. Your high level of awareness and acuity to subtleties is not only unusual but also extremely precious.
Because of your innate perceptivity, you cannot ‘un-see’ or ‘un-feel’ things. Perhaps like a poppy that has outgrown his peers, you were being shamed and ‘chopped down’. Your struggles are not your fault, and the shame that you carry is a natural reaction to a childhood environment that has failed to support you.
Perhaps there is a little voice within you that has always known you were not fundamentally wrong. If you can begin to listen to that voice, you can liberate yourself to retrieve the long-forgotten gifts inside you.
Your psyche wants to heal. Once you can begin to recognise and trust your own fundamental goodness, restoration and integration would naturally happen.
“People with BPD are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement.”
― Marsha Linehan
BOUNCING BACK FROM BPD
After being diagnosed/ misdiagnosed, you might be passed from one service to another, from one diagnosis to another. This is not only unhelpful, but can erode your self-esteem and sense of agency, which is the last thing you need when you are seeking understanding, healing, and ways to fulfil your potential.
Using Google, you will be able to find a lot of information about BPD online. However, not all of them are up-to-date or accurate. It is important to identify trusted, affirmative sources for information.
The myth that BPD is ‘untreatable’ is an old, inaccurate and very dangerous myth within the mental health industry. While many doctors and mental health clinicians still feel personality disorders as untreatable, most recent evidence suggests otherwise.
Several new forms of treatment for BPD have been developed and found by evidence to be effective. These treatments designed specifically for BPD include Transference focused psychotherapy (Kernberg, 2001), Mentalisation-based therapy (MBT), Dialectical Behavioural Therapy (DBT) (Linehan, 1993), and Schema Therapy. Many of these new therapies for BPD share a theoretically coherent and manualised structure. Here are some therapeutic models found to be helpful with treating BPD traits:
An innovative and integrative approach: Combining cognitive, behavioural and experiential element.
Based on the assumption that many negative cognitions have their roots in past experiences
Therapists take a warm, supportive but active stance.
Not that commonly offered in the NHS
Dialectical Behaviour Therapy (DBT)
By Marshal Linehan in the US (Who recently told the public about her own struggle with BPD!)
Developed to treat chronically suicidal individuals with borderline personality disorder (BPD)
Main goal is to teach the clients skills to cope with stress, regulate emotions and improve relationships with others.
Motivation & Commitment, as well as skills training component are emphasised
Group skills training classes for four types of skills: mindfulness skills, emotion regulation skills, distress tolerance skills, and interpersonal effectiveness skills.
Some NHS Trusts only offer Emotional Regulation group without full treatment
Effective especially with managing suicidal feelings and self harm, but not for everyone.
Mentalisation- based Treatment (MBT)
Commonly offered by the NHS
offered to clients twice per week with sessions alternating between group therapy and individual treatment.
Psychodynamic-based, but more about here-and-now than digging up the past
Therapist takes a ‘curious, active’ stance
Some people’s feedback is that ‘Mentalisation’ as a concept is hard to grasp.
Other treatments offered by the NHS (UK) for BPD: Art Therapy, Structured Case Management, STEPP program, CBT.
You can identify with traits of BPD without being officially diagnosed; that does not mean what you experience is any less painful or valid. Borderline personality disorder is not uncommon. In England, it is estimated around one in every 20 people has a personality disorder, and many do seek and are being helped by suitable therapy.
If you identify with the traits of borderline personality disorder, seeking help and reaching out can help to overcome feelings of hopelessness and helplessness. There are certain things that you can’t do, but searching for help and support is one thing you can do.