Miss yew more!
Conceptualization of BPD Symptoms
Five Areas of Dysregulation
Emotional dysregulation is considered to be the primary area of dysregulation that drives the other four areas. This area of dysregulation is characterized by affective instability and marked mood reactivity. In addition, the DSM-IV-TR recognizes the over expression of anger as one of the criteria for BPD; however, it is important to note that individuals with BPD may also have trouble with the underexpression of anger. Thus, the reactions of people with BPD may vacillate between angry outbursts and quiet discontent. Another aspect of emtotional dysregulation is that individuals with BPD tend to have difficulty controlling positive and negative emotions.
As indicated in the DSM-IV-TR criteria, people with BPD have unstable and intense interpersonal relationships. The emotional dysregulation experienced by individuals with BPD often leads them to try and depend on others to regulate their emotions. Because of this, these people are often described as clingy. They also tend to engage in over the top efforts to avoid real or imagined abandonment. In fact, most individauls with BPD have a history of abandonment or are currently experiencing some form of abandonment. Unfortunately the constellation of symptoms exhibited by people with BPD, tend to drive people away. Thus, these individuals tend to have a strong need for, yet a marked absence of close interpersonal relationships. Another aspect of interpersonal dysregulation among people with BPD is the tendency to oscillate between the idealization and the devaluation of others. This issue is particularly relevant to client therapist relationship. Particularly since individuals with BPD idealize people who are helpful (like a therapist), but this opinion will probably not remain stable throughout the course of therapy.
Individuals with BPD tend to have an unstable sense of self, chronic feelings of emptiness, and uncertainty in their goals, direction, and values. The absense of clear sense of self is thought to be the consequence of extreme mood experiences and the associated extreme behaviors. Individuals with BPD are often confused by their dysregulation; however, one aspect of their self-image is always stable: the belief that they are bad or defective.
The behavioral dysregulation experienced by individuals with BPD is characterized by impulsivity that leads to negative consequences. These self damaging behaviors can include maxing out a credit card, having unsafe sex, abusing substances, driving recklessly, binge eating, or engaging in parasuidical behavior. These behaviors are often negatively reinforced, because they help people with BPD temporarily alleviate some of their negative emotions. This strong pattern of negative reinforcement makes it challenging to change these maladaptive coping behaviors.
Cognitive dysregulation is often experienced by individuals with BPD though transient, stress-related paranoid ideation or severe dissociative symptoms. Also, the extreme emotions experienced by people with BPD tend to lead to distorted cognitions such as fear of abandonment and a negative view of self.
Fed up with pretentious tools who care more about status and bragging rights than being a genuine human being. It’s always apparent to everyone but them.