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DSM-IV Criteria
for Borderline Personality Disorder
Traits involving
emotions:
Quite frequently people
with BPD have a very hard time controlling their emotions.
They may feel ruled by them. One researcher (Marsha
Linehan) said, "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."
1. Shifts in mood lasting
only a few hours.
2. Anger that is
inappropriate, intense or uncontrollable.
Traits involving
behavior:
3. Self-destructive acts,
such as self-mutilation or suicidal threats and gestures
that happen more than once
4. Two potentially
self-damaging impulsive behaviors. These could include
alcohol and other drug abuse, compulsive spending,
gambling, eating disorders, shoplifting, reckless driving,
compulsive sexual behavior.
Traits involving
identity
5. Marked, persistent
identity disturbance shown by uncertainty in at least two
areas. These areas can include self-image, sexual
orientation, career choice or other long-term goals,
friendships, values. People with BPD may not feel like they
know who they are, or what they think, or what their
opinions are, or what religion they should be. Instead,
they may try to be what they think other people want them
to be. Someone with BPD said, "I have a hard time figuring
out my personality. I tend to be whomever I'm with."
6. Chronic feelings of
emptiness or boredom. Someone with BPD said, "I remember
describing the feeling of having a deep hole in my stomach.
An emptiness that I didn't know how to fill. My therapist
told me that was from almost a "lack of a life". The more
things you get into your life, the more relationships you
get involved in, all of that fills that hole. As a
borderline, I had no life. There were times when I couldn't
stay in the same room with other people. It almost felt
like what I think a panic attack would feel like."
Traits involving
relationships
7. Unstable, chaotic
intense relationships characterized by splitting (see
below).
8. Frantic efforts
to avoid real or imagined abandonment
- Splitting: the self
and others are viewed as "all good" or "all bad." Someone
with BPD said, "One day I would think my doctor was the
best and I loved her, but if she challenged me in any way
I hated her. There was no middle ground as in like. In my
world, people were either the best or the worst. I
couldn't understand the concept of middle ground."
- Alternating clinging
and distancing behaviors (I Hate You, Don't Leave Me).
Sometimes you want to be close to someone. But when you
get close it feels TOO close and you feel like you have
to get some space. This happens often.
- Great difficulty
trusting people and themselves. Early trust may have been
shattered by people who were close to you.
- Sensitivity to
criticism or rejection.
- Feeling of "needing"
someone else to survive
- Heavy need for
affection and reassurance
- Some people with BPD
may have an unusually high degree of interpersonal
sensitivity, insight and empathy
9. Transient,
stress-related paranoid ideation or severe dissociative
symptoms
This means feeling "out
of it," or not being able to remember what you said or did.
This mostly happens in times of severe stress.
Miscellaneous
attributes of people with BPD:
- People with BPD are
often bright, witty, funny, life of the party.
- They may have problems
with object constancy. When a person leaves (even
temporarily), they may have a problem recreating or
remembering feelings of love that were present between
themselves and the other. Often, BPD patients want to
keep something belonging to the loved one around during
separations.
- They frequently have
difficulty tolerating aloneness, even for short periods
of time.
- Their lives may be a
chaotic landscape of job losses, interrupted educational
pursuits, broken engagements, hospitalizations.
- Many have a background
of childhood physical, sexual, or emotional abuse or
physical/emotional neglect.
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