This is the third in a four-part series in honor of Mental Health Awareness and Borderline Personality Disorder (BPD) Awareness Month. The first part is here and the second part is here.
As someone with the diagnosis of BPD, I’m writing this four-part series in hopes of raising awareness and destigmatizing perhaps the most misunderstood diagnoses in all of psychology. In the daunting list of symptoms of the disorder, I’ve struggled with them all and wouldn’t want to pick a “favorite child” from the list, though I wouldn’t mind if “fear of abandonment” got a damn apartment in another state.
There’s a symptom that’s not on the main menu we concentrate most therapy effort on, that for me and many others is often a dragon we also have to spend a lot of time trying to repeatedly slay: it’s what’s generally referred to as dichotomous or black-white thinking or in the casual vernacular as “splitting.” Also often referred to as extreme valuation/devaluation, it means the perception of others in interactions can either be all good or all bad. It’s caused by a lack of consistent object constancy and chaotic and unstable relationship patterns in the early childhood of BPD sufferers that can lead to “splitting” challenges in later relationships.
Emotional instability and insecurity lead to fear and shame which then cause splitting on oneself—a belief that if one can’t be all good, one must be all bad; therefore, self-hatred, self-loathing and feelings of worthlessness (particularly with regard to lack of success in relationships) can be common in BPD patients, hence the high rates of suicidal ideation and rates of suicide. Because we often feel we’re worthless, BPD individuals often choose relationships with others who are also struggling or vulnerable in some way, an unconscious effort to find someone who understands our flaws and can co-exist with us in some form of peaceful imperfection. But inevitably the issues the other person is facing cause them to often become just another person abandoning us, and the self-fulfilling prophecy continues.
What are some of the coping mechanisms for learning to embrace middle ground in order to avoid the cognitive distortion of black-white thinking? Although with BPD it’s a daily struggle to control emotions and behavior, learning dialectical thinking, that two things can be true at the same time (we can allow ourselves to feel a powerful emotion and also learn to control our behavior) can be helpful if that type of thinking is practiced often.
In addition to DBT therapy, one of the most helpful treatment methods for BPD is mindfulness practice.
When we slow down to notice our breathing and let ourselves be curious, we allow our thoughts to settle. As we detect our thoughts, we can choose to engage or let them go. By letting go of thoughts and returning attention to the experience of mindful breathing, we regain autonomy over our feelings. We’re no longer driven by our emotions and can choose what to think about.
Anything we can do to get outside of our own heads and overly emotional hearts and submerge ourselves in the world around us—for me, gardening, candlemaking, a gratitude journal, working on miniatures, and simple stretching/yoga on my dock overlooking the Chesapeake. There are many small mindfulness techniques that help me get through another day and stay grounded as I try to survive in a world where there are so many jagged edges inside me and not many people in the world who can understand them.