Borderline syndrome is a personality disorder characterized by severe emotional instability and impulsivity. The clinical picture is extremely diverse and ranges from depression to drug, alcohol or sex addiction to massive identity problems, aggressiveness and suicide. For those affected, the disorder means a tremendous impact in dealing with others, but also in terms of their own feelings, moods and behaviors.
Borderline syndrome: causes
Borderline personality disorder (BPD) is characterized by severe emotional instability. The 1938 coined term means "borderline" goes back to the American psychoanalyst William Louis Stern. He saw the disorder in a transitional area between neurosis and psychosis, as in those affected symptoms from both areas showed.
Today Borderline disorders form an independent disease, the cause of which psychologists see in childhood, when important interpersonal relationships, such as the father or mother, were burdened in the broadest sense. These include sexual abuse, abuse and neglect. Especially in childhood, people learn to deal with their feelings, and also to trust this. If this development is permanently disturbed, the emotional instability arises.
Who is affected by borderline?
There are only estimates of the spread of Borderline Syndrome in the population, as many sufferers do not seek professional help. It is estimated that about two percent of the population is affected - most are younger than 30.
Only a quarter of the patients are male, mostly girls and women are on therapy. Nevertheless, it is believed that possibly as many men as women are affected. More than two-thirds of those affected have attempted suicide before.
Borderline and violence
"Sometimes I do not feel my body anymore, I hurt myself to feel myself again, anxiety, panic attacks, depression and relationship problems determine my life, I'm trapped in myself!" These and other descriptions can be found in the interviews and personal reports of borderline patients. As part of her diploma thesis as a graphic designer, Martina Schwarz has compiled many of these reports and created with them a "diary borderline - borderland".
Among other things, it becomes clear how much border liners are inclined to violence - against themselves and others. Mijailo Mijailovic, the murderer of Swedish Foreign Minister Anna Lindh, is said to be suffering from borderline syndrome, experts say. More common, however, are self-injuries with knives, razor blades, fire or needles, even suicide.
Between Madness and Normality - Borderliner and Relationships
Borderline diagnosis is difficult, it seems that many symptoms are related to the condition. Characteristic are strong emotional fluctuations that are unpredictable for those affected and their environment. Especially with regard to attraction and hatred, the attitude towards other people can quickly change from one extreme to another.
But not only the feelings towards other people are unstable, also the ego-feeling changes rapidly. For borderline patients, it is therefore often difficult to understand their own actions in hindsight. This leads to unbearable mental stress states.
Loneliness, but also proximity, they can not always endure, so living together with a Borderliner designed very difficult. Although it is usually not difficult for them to meet new people, they often have great difficulties to build a circle of friends and maintain. Often there is only one caregiver on whom the Borderliner projects everything.
Typical behavioral patterns in borderline
"Borderline, " Marie-Sissi Labrèche's autobiographical novel of the same name says, "is a great metaphor, the chance to transcend boundaries, to think differently, to let out all that is seething inside, a dance between insanity and normalcy I'm used to being on a track between the two. "
According to the Diagnostic and Statistical Manual IV (DSM-IV) - a worldwide classification system of mental disorders - nine behavioral patterns typical for borderline are described. If five of these behaviors are met, the diagnosis of borderline syndrome can be made.
- Desperate attempts to avoid actual or supposed abandonment - it feels like you can not survive without the partner.
- Patterns of intense and unstable interpersonal relationships that are characterized by a change between the extremes of idealization and devaluation - sometimes you get along well, sometimes the proximity to the partner is threatening.
- Identity disorder in the sense of a conspicuous and consistently unstable self-image or self-perception - some people have the feeling that their body is nothing but an empty shell.
- Impulsive, self-damaging behavior - drug and alcohol abuse, buying addiction, cravings or shoplifting are part of the appearance.
- Repeated suicidal acts, suicidal threats or self-injurious behavior - cutting, burning, nails, suicide threats and attempts.
- Affective instability - one can not control one's emotions, fluctuates between depression and happiness, sometimes fears come and one can not do anything about it.
- Chronic feeling of inner emptiness.
- Inappropriate, very violent anger or difficulty controlling anger. Some patients can not control themselves, attack objects or other people, are irritated for days.
- Temporary, stress-dependent paranoid ideas or clearly dissociative symptoms. Dissociation is a loss of the sense of reality, all sensory perception including pain is reduced. Some patients experience hallucinations or "flashbacks" - sudden onset of often traumatic experiences from the past.
Therapy - because without help it does not work
Borderline patients are part of psychotherapeutic treatment that can take place both on an outpatient and inpatient basis, as a group or individual therapy. A very commonly used therapy concept is Dialectic Behavioral Therapy (DBT), developed by the American psychiatrist Marsha Linehan. One begins with the symptoms of the illness: First of all therapist and patient together try to stop the suicide danger and the self-injuries.
In the group therapy it is especially about the guidance to an increased mindfulness for the own experience. Based on this, the patients learn how to handle feelings appropriately, that is, their early perception, non-judgmental description and appropriate expression. Also important is a competent behavior in interpersonal relationships.
Accompanying individual contingency plans are developed, which list, for example, how to calm down or distract. In group therapy, behavioral patterns should also be learned to help make social relationships more satisfying. Role-play and video recordings help to better understand one's own social behavior and to increase the safety in dealing with other people.
Goals include a more positive self-assessment, improved communication, showing oneself, getting involved in and delineating social relationships.
Therapy forms for borderline syndrome
Only at a later stage will the traumatic experiences of the past be worked up, followed by the integration phase, in which new perspectives for life will be developed. In numerous clinics there are special borderline therapy stations, which additionally use further therapy options such as design, music, dance and sports therapies, autogenic training and progressive muscle relaxation.
Movement therapy aims to get to know one's own bodily functions and abilities such as breathing, strength and movement better. By means of progressive muscle relaxation, patients learn to perceive and resolve states of tension, and to develop a relaxed and relaxed basic mood through regular practice. Within the sports group, self-initiative and integration into the group are promoted, which offers the opportunity to structure aggressive impulses.
However, a sad fact is that 75 percent of all therapies are discontinued - but the problems are not always with the patient, but also with the complexity of the condition for therapists.