I HATE YOU! DON’T LEAVE ME! Borderline Personality Disorder

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Borderline Personality Disorder (BPD) is a cross to bear for all who are within its range, including spouses, other immediate family, friends, and perhaps the sufferer of this condition most of all. Before 1980, this was not a recognized psychiatric term. But it was added in the Third Edition of The Diagnostic and Statistical Manual (DSM III) of the American Psychiatric Association.

Although BPD itself has been criticized as a-sometimes catch-all term that can describe or coexist with other conditions, its symptoms are highly disturbing, intense, and vexing. There can be severe mood swings, self-destructiveness, violent outbursts, and fears of abandonment. For those around the sufferer of BPD, there can be a feeling of walking over eggshells or facing a Jekyll-Hyde personality.

Many people have learned about BPD from the popular book I Love You Don’t Leave Me by Jerold Kreisman and Hal Straus. This book describes symptoms and offers strategies for dealing with BPD. These authors claim that over 10 million Americans suffer from BPD, and that most psychiatric hospitalizations involve a person with BPD: a significant claim, one that I have not seen verified by empirical studies.

Dr. Marsha Linehan, a graduate of Loyola University of Chicago, is considered by many to be the world’s leading expert on BPD. Her two books Cognitive Behavioral Treatment for Borderine Personality and Skills Training Manual for Treating Borderline Personality Disorder offer an integrative and structured approach that is backed by studies of clinical research.

Dr. Linehan’s Web site includes this description of her treatment approach: “The treatment she developed combines the technology of change derived from behavioral science, or ‘technology of acceptance,’ derived from both Eastern Zen practices and Western spirituality. The practice of mindfulness, willingness, and radical acceptance form an important part of the treatment approach.”

Another feature of her treatment approach is that it combines the psychoanalytic approach with cognitive behavior therapy. It is an approach the effectiveness of which has been empirically verified.

There are two components of dialectical behavioral therapy. In the first, the patient meets individually with the therapist each week and reviews a diary of behaviors. Any suicidal or self-destructive behaviors are reviewed first, and then more general issues and quality-of-life concerns are approached. The second component involves group therapy; with others, the patient develops mindfulness, interpersonal and emotional regulation, and distress tolerance skills.

I highly recommend Dr. Linehan’s work and books. A Web search will reveal a wealth of information about her approach.

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