What is the Core of Borderline Personality Disorder?

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 closest doctor grande in today's video I'm gonna answer a question from a subscriber and this question was inspired for another video I did and that video was was the core of narcissism and this question is what is the core of borderline personality so by core I mean what's the most basic central concept that we can link tube or line person is or if we only had one term to use to try to capture the essence of that disorder what would that term be now help answer this question I'll be using an article published in 2010 by mirrors and colleagues and in this article they really try to answer this question now its first important to understand what the symptom criteria are for borderline personality because a lot of the conceptualization is about what's at the core of that disorder come from our understanding from the symptom criteria so the symptom criteria we see for borderline personally have frantic efforts to avoid abandonment we see unstable relationships is this unstable relationship pattern where there's idealization and devaluation so sometimes this is called the love-hate cycle we see identity disturbance so somebody with Boylan personalities who could have a poor sense of self they don't really have necessarily a clear identity we also see impulsivity and at least two areas that could be self damaging suicidal behavior threats gestures we also see affective instability this is also known as emotional dysregulation we see a chronic feeling of emptiness inappropriate intense anger and the last symptom criterion is paranoid ideation or severe dissociation so those are the nine symptom criteria we see with poor line personality sweater somebody doesn't need to have all nine to have the disorder they can just meet five and of course a diagnosis of that disorder come from a licensed and qualified Commission now this article is really interesting they went about trying to identify the core of war line person is order and I thought a pretty interesting way they looked at the definition of personality sorter in general and it's an enduring pattern of inter experience that's part of the definition so what they looked at here is what component of borderline personality is enduring if one of the components is enduring and the other components are not maybe that enduring aspect is that the core of the disorder so in order to see if there wasn't enduring aspect they first had to divide the disorder into factors so these are building blocks elements of a disorder and there are many many models out there about the factors of bored life personality have models that divide it into all these different factors they used a model of divided boiling person a sorter into three factors so the first factor is identity self disturbance so this includes conceptually symptoms like I'd a disturbance from the symptom criteria and that chronic feeling of empty is the next factor is affective dysregulation so this would be affective instability that emotional dysregulation come out I talked about and the last factor is impulsivity so this would include of course the impulsivity symptom criterion and also probably the suicidal behavior symptom criterion so with these three factors in mind they wanted to see if given treatment if individuals with borderline personality disorder would improve with some of these factors and not improve in others again looking for this evidence that maybe one or more of these factors was enduring so what they found here is over a period of a year that individuals tended to improve individuals of borland person I sorter tended to improve in the area of affective dysregulation they call effect dysregulation they tended to improve impulsivity and these improvements for these two factors were significant but they did not improve for that first factor identity self disturbance so this is the factor that seems to be at the core of war line person is where now it gets a little more confusing though because if you look at the symptom criteria of course you're going to tie it to that identity disturbance symptom criterion that's on the stable sense of self the difficulty here is that identity is not the same thing as self so really the symptom criterion might be tapping into the core of borderline personality but it's not a good symptom criterion it's not broken down in a way that really appreciates that important difference between identity and self so what is that difference well with identity this is a public reality this is somebody's career family religion social groups it's who you are in relation to other people so it's an outward facing construct now self is an interfacing construct it's private experience sensations memories feelings images these things make you unique a lot of people can share your career a lot of people can be in the same social groups but those sensations memories feelings and images are uniquely yours now of course what someone who doesn't have board line person is order in theory the identity in the self are going to go together in a way where they help each other where they're consistent where they're congruent they work together to help you meet your goals with borderline personality disorder the identity the self don't match they don't work well together that's really the core of that symptom criterion identity disturbance and again maybe the core of borderline personality altogether it might be really at the essence of this disorder now another interesting thing here is they looked at earlier research and they found that you can take this identity self disturbance factor and break it down even further into role absorption painful incoherence inconsistency and lack of commitment what they found here is that in terms of predicting vorlon person is order only that painful incoherence part of that factor identity self disturbance only that painful incoherence really predicted or like person is or that's the only one that had a strong relationship with the disorder and with painful incoherence we see a feeling of emptiness we see this idea that someone's existence could come to an end if they lose a close relationship and we also see a fragmentation of self which sounds a lot like dissociation which of course is part of the ninth symptom criterion paranoid ideation or severe dissociation so it seems like we're not just looking at the identity disturbance symptom criterion we're also looking at that chronic feeling of emptiness of course that loads on that same factor but also the dissociation component and I find this particularly interesting because if you look at the literature and you look at the controversy around the definition of borderline personality see researchers targeting that ninth symptom criterion specifically the dissociation not so much the paranoid ideation and I say targeting meaning they're conducting research and they're looking at that criterion and they're saying it doesn't really add up with the rest of it doesn't really match it shouldn't be there and I think one of the reasons we've seen this is because dissociative identity disorder kind of wanders into the territory of borderline personality or conceptually a lot of times because of that dissociative component of world line person is where it makes those two disorders difficult to separate it's interesting that this is occurring when it does actually look like dissociation is a key part of or line person is order it might be part of the core of this order so it's just an interesting look I think at borderline personality and what could be at the for now of course I've heard all different explanations and all different theories about what could be at the core of borderline personality this is just one and if I look at this this actually does make a lot of sense based on my experience working with individuals who have boil and person I swear I've heard other arguments that the anger component is at the core and I understand these arguments but I think anger is one of those symptoms that we can see very easily a lot of people could easily observe that with an individual who has boil and personality sorter so I think that gets thought of as a core feature when it's really I think an important symptom but I don't think it really speaks to the core of the disorder I've also heard that the frantic efforts to avoid abandonment that's a core feature I think one of the reasons that we see this argument is because it's the first symptom criterion now a lot of times we look at a disorder the first symptom criterion we do think of that is the most important of all the symptom criteria even though that's not necessarily the case now I've also seen a pretty good argument made for the unstable relationship pattern but that's really the core of borderline personality but if you think about this really relates to the identity disturbance a bit if someone doesn't have a strong sense of self that they have a fragmented sense of self it would make sense that they have unstable relationships so that unstable relationship pattern could be at the core but I really think it's more related to the identity service I think that comes first then we see the unstable relationship pattern but again this is just one paper and even though I happen to agree with the finding there are a lot of different opinions about what's at the core board line person is order just as was the case with the video I did on narcissism and the core of narcissism I would be interested to see your comments about what's at the core of poor line person is order we all have different experiences with the disorder in terms of working with disorder from a clinical perspective of course some people watching this video may know someone who has disorder or have this or themselves might be interest to see your opinion about what's at the core of borderline personality what's the most basic and central component of that disorder I hope you found in this video on the core of war line personnel order to be interesting thanks for watching

Channel: Dr. Todd Grande

Views: 133,760

Keywords: borderline personality disorder, core, central concept, essence, borderline, personality disorder, Diagnostic and Statistical Manual, DSM, Cluster B, dramatic, erratic, emotional, antisocial, narcissistic, histrionic, abandonment, identity disturbance, impulsivity, suicidal behavior, affective instability, emptiness; anger; paranoid ideation, dissociation, self, identity vs. self

Id: w7dQUiKSNWs

Length: 11min 17sec (677 seconds)

Published: Tue Dec 11 2018