Borderline Personality Disorder & Sexual Compulsivity | Sex Addiction, Hypersexuality, & Promiscuity

welcome to my scientifically informed insider look at mental health topics if you find this video to be interesting or helpful please like it and subscribe to my channel well this is dr. grande today's question is can I examine the relationship between borderline personality disorder BPD and sexual behavior and specifically one of the questions I received on this was looking at this idea of sexual compulsive 'ti sometimes called hyper sexuality so I'll be looking at this from the point of view of the research and from my clinical experience so let's first start with the construct of borderline personality disorder we know this is a cluster B personality it's in the dramatic erratic cluster along with antisocial narcissistic and histrionic Personality Riya and the definition for warlike person is order and v had to be met for a diagnosis and of course the diagnosis can only be provided by a licensed and qualified clinician so looking at the nine symptom criteria we see frantic efforts to avoid abandonment an unstable relationship pattern identity disturbance which means difficulties with self image we see impulsivity in at least two areas that are potentially self damaging so this one has an obvious potential relationship to sexual compulsive 'ti and we see suicidal behavior affective instability which is emotional dysregulation a chronic feeling of emptiness inappropriate or intense anger and paranoid ideation or severe dissociation so now moving to the construct of sexual compulsive 'ti we see here that this is really defined in a few different ways it has a few different components we see a lack of control of sexual behavior but also using sexual behavior to cope with emotions you could add a third component here in terms of how we measure sexual compulsive 'ti which would be the consequences of this type of behavior I mentioned before that sexual compulsive it is sometimes referred to as hyper sexuality it's also referred to sometimes as sexual addiction and even promiscuity a lot of times we see all these terms are really used entered changeably although they can mean different things and this is one of the problems with sexual compulsive 'ti there's no single agreed upon definition this is not a mental disorder that's currently listed in the Diagnostic and Statistical Manual although it seems likely that it will be at some point in the future but it's not really clear how it'll fit in will it be considered an addictive disorder like substance use disorder we don't really know right now if it's going to be in the DSM and if it is in the future what it's going to look like there but either way we know that there are harmful consequences associated with sexually compulsive behavior a risk of sexually transmitted infections which is increased and also we know it is disruptive in people's lives and it consumes a lot of time and energy so using those pieces that kind of looks more like an addiction the disruptive piece and consuming a lot of energy we see that with addiction so as we consider the symptom criteria for borderline personality disorder it's pretty clear how some of these symptoms could align with sexually compulsive behavior so for example if we look at the impulsive 'ti symptom criterion this one seems to have a clear connection potentially at least to being sexually compulsive if somebody's impulsive and they don't think things through and they tend to rush into these decisions then it makes sense that sexual compulsive 'ti might line up with that now affective instability the emotional dysregulation piece it's not as clear how this relates to sexual compulsive 'ti but if you think of somebody's mood as moving from one extreme to the other it would make sense that all types of relational factors would move along with that including the potential to engage in more risky sexual behavior and again it kind of relates back to impulsive eating away there's some overlap here between the symptom criteria if somebody has extreme mood swings they may be more prone to being impulsive now the next one frantic efforts to avoid abandonment this one I think has a fairly strong connection to sexual compulsive 'ti one of the frantic efforts could be to engage in sex more often to try to keep a partner engaged so somebody with borderline personality sorter may engage sex just to keep a partner connected just to make sure that a partner won't leave now interestingly the symptom criterion that's tied most closely to sexual compulsive 'ti is usually the chronic feeling of emptiness and there's really two theories behind this and why this has the strong Association one is that the feeling of emptiness is really about boredom and of course sex could be one way to address boredom but the other theory is the chronic feeling of emptiness is really about a lack of feeling emotions and if you can feel connected to another person it could satisfy that feeling of emptiness so sex here in this conceptualization is really used to increase connectedness to a partner or at least the feeling of connectedness so what is the research literature tell us about the relationship between borderline personality and sexual behavior well overall we see a positive association between BPD and sexual compulsive 'ti and this is really not a surprising finding we also see that BPD has been associated with increased sexual assertiveness and increased preoccupation with sex and increased dissatisfaction with sexual activity and we see that the first sexual experience tends to be at a younger age when we're talking about somebody who has borderline personality disorder or borderline personality features we see a higher probability of being the victim of sexual abuse we see increased risky sexual behavior and having a greater number of sexual partners in particular a greater number of casual sexual partners we see a lot of different estimates in terms of how much greater the number is but if we look at all the available evidence the most accurate number appears to be that somebody with borderline personality one average would have two times the number of sexual partners as compared to somebody without borderline personality we also see that with a specific question of number of partners and borderline personality it appears that sexual compulsive 'ti mediates the relationship between borderline personality disorder and borderline personality features and the number of partners and what this means as it tends to explain the relationship between BPD and the increased number of partners so we see borderline personality disorder and borderline personality traits this appears to lead to sexual compulsive 'ti and sexual compulsive 'ti tends to lead to an increased number of partners so again that's what's meant here by the term mediation we see that sexual compulsive 'ti mediates the relationship between BPD and the number of partners it explains why or how that relationship occurs something else interesting we see in the research literature about the number of partners and about risky sexual behavior with borderline personality is that substance use combined with BPD tends to worsen these specific characteristics again the risky sexual behavior and the number of partners both tend to increase we see more risky behavior and a greater number of partners when substances are combined with borderline personality so you may be thinking about the findings from the research and then kind of aligning that with borderline personality sorter and sexual compulsive 'ti and it really kind of points in this direction that somebody with this disorder is much more likely to be sexually compulsive and in general this is true but the research also has some different findings we see some contradictions and some of the research literature for example there's a study that indicates that 40% of people with borderline personality disorder actually actively avoid sexual contact so that of course seems much different than a strong relationship with sexual compulsive 'ti we also see that in a sample of people who had sexually compulsive behavior that less than 2% of that sample actually met the full criteria for borderline personality so these conditions BPD and sexual compulsive 'ti are separate constructs there's some overlap but the overlap may not be as strong as we think literature is really split on this particular issue so that covers the research component but what about my clinical experience I've worked with a lot of people who have borderline personality and I've supervised a large number of clinicians that treat clients that I've treated clients with borderline personality so here's what I think based on that clinical experience so the first thing here would be that a lot of mental health clinicians a great number of them tend to make a strong association between borderline personality and specifically hyper sexuality so again this is similar if not the same thing depending on how you define it a sexual compulsive 'ti so this is very strong association and the minds of many clinicians so we have to be careful about this as a mental health treatment community we don't want to treat somebody with borderline personality and see that person for the first time and automatically assume that they're going to engage in risky sexual behavior or have a greater number of partners than somebody without war line personality sorter so this seems to be again something that a lot of mental health clinicians believe and we have to exercise caution here another important element to remember here is that extreme examples tend to be more easily remembered and when you work with individuals with borderline personality if you work with a lot of people with this disorder you're going to run into certain presentations where there is distinct hypersexuality like having ten or more sexual partners in a week having 20 or 25 sexual encounters in a week and these kind of extreme examples really stand out and I think clinicians look at these examples and they start to apply it to everybody or at least many people with borderline personality order so we have to keep in mind when we see kind of extreme presentations that those are just isolated presentations that don't necessarily represent the behavior of an entire group and of course with borderline personality sorter we know that they are not representative we see all points on the continuum in terms of sexual behavior represented in people with borderline personality yes there will be extreme examples that will catch our attention but we have to remember keep thinking critically about these types of situations and keeping in mind that extreme examples stand out and that that potentially causes bias something else interesting I've noticed in my clinical experience is that individuals in a relationship with somebody who has borderline personality especially if that presentation involves sexual compulsive 'ti they tend to have a fairly strong reaction to the sexual behavior differences so what I mean by this is for some people let's divide this up into like a person a person B situation so person le would be an individual in a relationship with somebody with borderline personality just to kind of expedite this part of the video so from the point of view of person a this sexual behavior can really be quite attractive sometimes person a might feel unwanted lonely they might want to be the hero in a relationship and when somebody is sexually compulsive and person B is sexually compulsive they are going to be insecure and that could play into the hero part but they also this is person B they also approach sex with an intensity and a passion sometimes this is described as wild sex so they really bring just a lot of energy to that sexual relationship and again for person a this can be overwhelmingly attractive some people are really just attracted to that level of intensity and I see certain personality characteristics over represented in person a so to speak so again person B borderline personality what I'm talking about there person a have also seen characteristics that we see with other cluster B personality sorter specifically antisocial person and narcissistic person is order and the research generally supports this finding so the research is consistent with my clinical experience here now with antisocial personality disorder it may be the lack of empathy or the sensation-seeking that caused this tendency to be attracted to somebody who's sexually compulsive or who has borderline personality features and in terms of narcissistic personality disorder individuals with this disorder oftentimes want their self-esteem to be built up and they want admiration and having somebody person B be really attracted and really want to have sex often and be intense that can be very appealing for somebody with narcissistic characteristics so it kind of makes sense that somebody would borderline personalities Witter may be attracted to somebody with antisocial personalities or derp or narcissistic person I sorta and intern individuals with antisocial or narcissistic personality would be attracted to somebody with BPD and this is a pairing that I've seen many times in my clinical experience you'll see some of the BPD be with somebody who has antisocial personalities were or narcissistic person I sort these relationships tend to be powerful and intense in the beginning but in the long run at least in my experience don't work out too often they don't work out as often as people would help they tend to burn really brightly in the beginning and then kind of fade out as some of the other features of cluster B personality pathology kind of enter into the relationship some of the destructive relational aspects now of course they're going to be exceptions and I have seen exceptions to this I have seen people with borderline antisocial and narcissistic traits make the relationships work even for a very long time so we don't want to immediately look at those relationships and think they're doomed or anything that's not the case I think however there are certain challenges there that we need to be aware of and that needs perhaps to be the focus of treatment if that's what the client wants now I know whenever I talk about borderline personality disorder and sexual behavior they're gonna be strong opinions in different directions if you agree or disagree with any of the different things I mention in this video or have other opinions please put those in the comments as always I hope you found this description of borderline personality sorter and sexual behavior to be interesting thanks for watching

Channel: Dr. Todd Grande

Views: 125,097

Keywords: Borderline Personality Disorder, BPD, sexual compulsivity, sexually compulsive behavior, compulsive sexual behavior, sex addiction, hypersexuality, promiscuity, sexual behavior, sexually transmitted infection, Cluster B, personality disorder, antisocial, narcissistic, histrionic, frantic efforts to avoid abandonment, unstable relationships, identity disturbance, impulsivity, suicidal behavior, affective instability, chronic feelings of emptiness, anger, paranoid ideation, dissociation

Id: wzl-iZvsCtc

Length: 15min 5sec (905 seconds)

Published: Mon Feb 25 2019