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What is BPD?

Borderline Personality Disorder (BPD) is a mental health difficulty that can be hugely impacting for the person who has been diagnosed.  For a diagnosis to be given symptoms will often have been present in varying degrees for at least five years and they will not be explained by any other mental health difficulties.  BPD can often be misdiagnosed as treatment resistant depression, Bi-polar disorder, eating disorders and chronic anxiety.  The symptoms of BPD are below:

•Feelings of chronic emptiness and depression.

•Marked fluctuations in emotional state that can be easily triggered and difficulties recovering from these changes.


•Having a fragile self image – seeing yourself than less than other people and feeling like you have to over-adapt to fit in.

•A pattern of difficulty maintaining relationships.

•Fears of being rejected and abandoned

•Harmful behavioural patterns including, impulsivity, including addictive behaviours, eating difficulties and promiscuity.

•Frequent suicidal thoughts.

•Desires to self harm.

What causes BPD?

A combination of our biology and the environment that we grow up in are believed to be causal factors of BPD.

Some individuals are born with temperaments that mean they feel more than other people, if their emotional needs are not met, this causes a greater impact in how their personality develops.  We are not born empty vessels that are purely shaped by our external environment, we are born with some pre-determined personality traits, such as being more attuned to the feelings of others, or having a need for consistency or being more laid back.

The environment we grow up in is just as important in how our personality develops, an emotionally invalidating environment is believed to be crucial in the development of BPD.

Let me explain an invalidating environment – imagine a child grows up in a home which consistently denies them of their experience of thirst; when they are thirsty, they’re not given water, they might be to told that they’re not really thirsty, they’re just making a fuss. On some occasions they might ask for water and be told they’re not thirsty they’re just cold and be given a jumper, other times they’re told they can’t possibly be thirsty because their siblings aren’t thirsty.  The child knows they need water and begins to act out to get water but also begins to resent water because the thirst causes them so much discomfort. This child is going to grow into an adult who has really confused feelings about thirst and a really difficult relationship with water.

If we swap water for emotions we can begin to imagine an invalidating environment.  An invalidating environment does not give us the opportunity to naturally learn to experience our emotions as a part of ourself which is normal, we never learn that emotions can be big or small, that they can be attended to, that they pass. We begin to view them as silly, bad, scary, unnecessary or shameful.  But just like thirst, experiencing emotions are part of the human existence.

With appropriate nurturing and care individuals born with temperaments that are more centred around emotions might never develop BPD.  Similarly, someone with a less emotionally centred temperament may be less scathed by an invalidating environment.  BPD is caused by a combination of temperament and environment, BPD is not a case of someone simply being “overly emotional and sensitive.”

How does BPD impact people?

BPD can effect different people, differently, I always say, if you’ve met one person with BPD, then you’ve met one person with BPD but there are some commonalities.

You might find that your emotional life can feel like a rollercoaster, when you feel, you feel big.  Feelings can range from anger and rage, to depression and scare and your self esteem can experience highs and lows, the highs tend to depend on the quality of your relationships and the lows tend to be triggered by relationship issues and fears of abandonment.

BPD can be very visible, some people may find themselves in emergency mental health crises regularly, finding themselves in and out of hospital due to self harm and suicidality other people may live in quiet despair where they feel like they are able to function but just below the surface barely able to hold it together.

The behaviours associated with BPD tend to develop as coping mechanisms to manage the big feelings, addiction, food issues, body image issues and inappropriate partner choices are all ways of escaping or trying to control difficult emotions that feel overwhelming.

What can help BPD?

Schema Therapy and DBT both have an evidence base for reducing the symptoms of BPD.  Both therapies help individuals gain a better understanding of themselves, their emotions and whilst helping develop newer and more adaptive coping behaviours.
Picture of Geraldine Osowska Therapist

If you want support to help you begin coping with your BPD symptoms contact Geraldine today for a free telephone consultation. Geraldine offers face to face therapy in Wilmslow which is easily accessible from Manchester, Macclesfield and Cheshire.


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