Borderline Disorder From The Inside

There is one study in the literature that provides an especially helpful perspective on borderline disorder that adds effectively to the information presented in the clinical description on this website.2 I believe that these reports from patients will help you to understand more completely what it feels like to suffer from borderline disorder.

Of course, there is no single view of borderline disorder that adequately captures all of your experiences. However, this material, directly quoted from my book, Borderline Personality Disorder Demystified, may be of help to you.

“In 1994, Sharon Glick Miller, a psychologist in the Department of Psychiatry at the University of Florida, published a study of 10 patients (8 women and 2 men) with borderline disorder from whom she obtained life-history narratives in a series of 90-minute interviews over a one-year period. After careful analysis of the data, she concluded that the self-reports of these patients were highly consistent, but differed significantly from typical clinical descriptions.While clinicians described these patients as having an impaired sense of self (an identity problem), they seemed to have a sense of themselves as impaired. They reported that the strategies they used, such as changes in appearance, might seem like an identity problem, but they were mainly attempts to feel better about themselves. They also indicated that they did not reveal themselves readily to therapists or to others because they anticipated disapproval, and would rather appear to be lacking in identity than have confirmed their perceptions of themselves as flawed.They did not see themselves as having an illness, but as leading a life in which they constantly struggled against feelings of despair. This was a central theme of how they perceived their fate in the world.Most patients reported feeling alone and inadequate, beginning in some as children, and in others as adolescents. This was so in spite of their achievements. For the most part, they did not know the origins of these feelings, though two identified family disturbances and another the discrimination she experienced because of obesity. The sense of emotional pain and despair they reported was overwhelming. They all expressed the wish not to be alive.

Coping Strategies.These patients each developed a number of coping strategies to lessen the sense of pain and despair, always with the hope that, just once, something would help. The main coping strategy was attempting to block out or dissociate themselves from these feelings as best they could. If that was not successful, many turned to alcohol and drugs.

Patients viewed their bedrooms or apartments as safe havens, except when they were depressed. At these times, some realized that it was dangerous to be alone because of the great impulse to hurt themselves. Social situations typically provoked anxiety and feelings of inadequacy. These feelings resulted in strategies either to push through the event, which exacted a high toll on their energy, or to escape from the situation.

One potential coping strategy was notable because of its relative absence, the use of social support. Patients consistently reported that they did not openly share their feelings with family, friends and even their therapists because of fears of rejection, and of being viewed as a burden. However, not sharing their struggles resulted in the worsening of their sense of isolation.

They also felt conflicted about sharing negative feelings with their therapist. To not do so could be perceived as not working in therapy, but doing so could reveal a lack of progress that might result in increased pressure to perform, or in hospitalization. Hospitalization was viewed primarily as a respite from the constant struggles with despair and the desire not to be in this world. Once the crisis was over, they then wished to be discharged. However, they learned they could not refer often to their constant thoughts of self-harm as this might result in an undesired hospitalization.

The Importance of Self-Disclosure. An important finding from this study was that patients felt more comfortable revealing information in the research setting than elsewhere, because no challenges were being made to their presentations. Subsequently, they believed the researchers understood them better than their families, friends and even some of their therapists. They perceived themselves to be collaborating with the researchers because they were the experts about themselves, which helped reduce their conflicts over dependency issues.”

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