The BPD Diagnostic Criteria | JOHN GUNDERSON

definition involves with in psychiatric organ is called three different feet three different sectors of psychopathology the first most discriminating and most discriminating involves the interpersonal relationships borderline patients have intense unstable relationships marked by shifts between idealizing someone and devaluing someone and marked by over vacillation between over involvement and dismissal or under involvement they also have fears of abandonment which are more and fears of rejection which is an associated feature which are the phenomena reflecting a real fear about being alone some including myself feel that that is really the queer the core of this disorder is is in the interpersonal area a second major sector of psychopathology has to do with effective lay bility or emotional dysregulation as it's become identifiable through dialectical behavior therapy but this includes a tendency towards angry outbursts or inappropriate anger many patients will say that they're always angry or that they can't control their anger mood changes mood changes that you could say uh is something that might characterize people with bipolar disorder but in borderline patients is characteristically involves feelings of anger and it's characteristically very reactive to a social context it's not like the moods change because of some internal clock that is pushing the moods back and forth but is very responsive to the social context and in particular to adverse interpersonal events and a third part of that affective picture is emptiness not all borderline patients will describe it those who do this drive it it seems listening to life histories as if it's ace something that developed as a result of a long-standing sense of being neglected so that there's an inner emptiness like a hungry child who has not been fed enough the third sector of psychopathology is belongs to the behavioral problems and here deliberate self-harm recurrent suicidal ideation and/or acts is sort of the signal symptom of borderline personality for my patients often do hurt themselves and hurt themselves repeatedly the more they do that the more at the are to be suicidal self-harm acts are both something that are self punitive and a way of easing this dysphoric states of mind that they can't believe otherwise it also can become a call for help with so eliciting supportive responses from others the other behavioral symptom has to do with patterns of impulsivity the borderline patients typically have unsafe sex drive recklessly in addition are frequently bulimic or substance abusing so that's the behavioral room the last realm has to do with cognition and here are borderline patients and this is why they were originally thought maybe to be an atypical form of schizophrenia can have these lapses of reality testing for instance they can be like paranoid ideas the paranoid ideas usually occur when a borderline patient feels otherwise alone and the idea that somebody is watching them actually is a psychological way of not being alone that rather have somebody watching them than being alone they could also have sort of a loose energetic type phenomena when these are people who may have trouble going to sleep at night because they're alone and then I hear voices under those circumstances I say that not really psychotic because they reverse very quickly when you put the board on person in a social context where there's other people around paying attention to them so that's the definition more or less as it's been since 1978 in the diagnostic system since 1980 but one thing I haven't mentioned is it's a disturbed sense of self a sense that they're not really stable it changes it can a lot of borderline patient will say that I behave a lot depending on who I'm talking to or who I'm with and what I perceive they want or what they expect from me say it will form an unstable identity there's an argument could be built that that is a sort of blanket problem and everything else is subsumed within that and that's what one of the pioneers in this area Otto kernberg would suggest and I think that's a viable way to look at it

Channel: BorderlinerNotes

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Keywords: bpd, borderline personality disorder, borderline, john gunderson, gunderson, bpd relationship, dating someone with bpd, borderline personality disorder relationships, bpd and relationships, bpd definition, bpd criteria, emotional dysregulation

Id: h15OnmUqFj8

Length: 5min 51sec (351 seconds)

Published: Wed Apr 19 2017