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Understanding borderline personality disorder: myths and reality in BPD

Do we really know what borderline personality disorder is? Do we know what kind of symptoms these people experience? Have you ever stopped to understand the suffering of people with this disorder beyond what is observed in their behaviour?

MYTH: There is no cure

Certainly, this disorder is treatable.

There are treatments with proven efficacy. From pharmacological to rehabilitative treatments, including psychological treatments.

Pharmacological treatment aims to reduce some symptoms, such as distress and impulsivity, and to improve mood.

Psychological treatment aims to address symptoms, trauma through the patient’s life story or to improve interpersonal skills. We also work at the family level to improve the dynamics, conflicts and relationships that may exist due to attachment and bonding. Identity and self-concept work is also done to improve self-awareness and self-regulation.

MYTH: Limitations must be set

Patients with BPD are not the only ones who need restrictions. All children and adolescents need to learn how to set boundaries.

We should not forget the difference between boundaries and rules. Boundaries help to create our identity, help us to distinguish ourselves and to protect and take care of ourselves. Rules are often imposed by society, family, school and are the same for everyone.

MYTH: They don’t do something because they don’t want to do it.

The reality is that BPD is a disorder and patients have a number of problems because of it. It’s not that they don’t have the will or the desire. The reality is that they don’t do or succeed because they don’t feel fulfilled, capable or confident. We cannot deny the disorder, we have to work on the difficulties, and to do that we have to identify them, see where they came from and where they learned them. Here we have to work with the image that each person has of themselves in relation to their capabilities and value.

Myth: It’s for life

Just as other illnesses do not shape us, so mental illness does not shape us. We need to be clear that it is not a way of being, but a punctual condition. These patients do not suffer from BPD, but have BPD. This distinction is important because it implies and implies a lot about treatment and the progression and development of the disorder.

MYTH: People with BPD harm themselves for the sake of attention

People with borderline personality disorder self-harm as a way of self-regulation, expression of their emotions or even as a form of self-punishment. The inner distress they feel causes them to regulate themselves in ways that are maladaptive and harmful to themselves. Often in this behaviour they seek help, understanding and support from people close to them, but this does not mean that they want inordinate attention, as they often think.

Myth: They are dangerous people

Impulsive personality traits and even the fact that they experience emotions very intensely can lead to the idea that they are dangerous. They are unpredictable people and cause some discomfort to the other person, but that does not mean that they are dangerous. This emotional intensity makes them more dangerous to themselves than to others. Over their history, they have internalised a way of relating, behaving and self-regulating that can be striking and, above all, not very effective because they have not developed the resources of self-control.

MYTH: BPD is of the mixed type

Although it is true that it shares symptoms with other psychiatric disorders such as dissociative or trauma-related disorders or even other personality disorders, BPD should only be diagnosed if diagnostic criteria are met and a good differential diagnosis is made through a comprehensive assessment and personality study.