What is Borderline Personality Disorder… with Self-Destructive Features?

Friday, January 5, 2024. Can a culture suffer from Borderline Personality Disorder?

What is Borderline Personality Disorder… with Self-Destructive Features?

By now you already know that Borderline Personality Disorder (BPD) is a complicated, hard-to-diagnose, and often misunderstood mental health condition.

The most obvious signs of BPD are pervasive patterns of instability in interpersonal relationships, self-image, and affect, as well as marked impulsivity.

Within the spectrum of BPD, the final distinct subtype that I want to discuss requires the most gravita

It’s the Self-Destructive subtype…

• This subtype is marked by a heightened propensity for engaging in behaviors that pose significant risks to their physical, emotional, and social well-being.

• Understanding the volatile nature and velocity of Self-Destructive behaviors in humans suffering from this subtype is essential for effective diagnosis, treatment, and support.

How to spot the Self-Destructive Subtype:

Impulsive and Reckless Behavior: Humans expressing the self-destructive subtype of BPD often exhibit impulsive and reckless behaviors, such as substance abuse, unsafe sexual practices, reckless driving, or binge eating. These actions are driven by an overwhelming desire to escape emotional pain or to feel a momentary sense of control.

Self-Harm and Suicidal Ideation: Self-harm, including cutting, burning, or other forms of self-injury, is a prevalent manifestation of self-destructive behavior in this subtype. Suicidal ideation is also common, as individuals grapple with intense emotional distress and a distorted perception of their self-worth.

Chaotic and Intense Relationships: The self-destructive subtype often experiences tumultuous relationships marked by extreme highs and lows. The fear of abandonment and intense emotions can lead to impulsive decisions, such as engaging in destructive conflicts or abruptly ending relationships.

Identity Disturbance: Individuals with the self-destructive subtype often struggle with a fragmented self-identity, experiencing an unstable sense of who they are. This identity disturbance can contribute to a pervasive sense of emptiness, driving them to engage in self-destructive behaviors to cope with the inner turmoil.

Factors Contributing to Self-Destructive Behaviors:

Emotional Dysregulation: One of the core features of BPD, emotional dysregulation, plays a significant role in the self-destructive subtype. Difficulty managing intense and rapidly shifting emotions can lead individuals to seek impulsive and maladaptive coping mechanisms.

Fear of Abandonment: The fear of abandonment, a central theme in BPD, is particularly heightened in the self-destructive subtype. This fear can trigger desperate attempts to maintain relationships, even if it means resorting to self-destructive behaviors to keep others close.

Traumatic Experiences: Many humans with the self-destructive subtype have a history of trauma, especially such heart-breaking experiences as childhood abuse or neglect. Traumatic experiences are understood to contribute to the development of maladaptive coping strategies, including self-destructive behaviors, as a means of managing profound emotional pain.

Here are the Self-Destructive BPD symptoms that are often in evidence:

• The Self-Destructive subtype is characterized by angry, unstable emotions turned inward.

• Intense feelings of self-loathing (self-hatred)

• Prone to self-harm, or discussing self-harm.

• Often listless and depressed.

• Feelings of envy, spite, and/or bitterness.

• Tendency to seek comfort through attracting attention from other humans.

• Suicidal behavior and ideation.

• Serial Self-injurious behavior.

• Substance abuse.

• Tendency to engage in reckless behaviors out of lack of self-care, but not to impress others.

• Tendency to sabotage their happiness and sense of well-being due to intrusive feelings of being undeserving and unworthy.

• Unstable self-image (lack of identity), vague sense of self.

• Existential despair is a felt sense that no one cares about them, and so consequently, they rationalize self-destructive behavior by also not caring about themselves.

Treatment and Support:

Effective treatment for the self-destructive subtype of BPD requires a comprehensive approach that addresses both the underlying emotional dysregulation and the specifics of the self-destructive behaviors.

As usual, Dialectical Behavior Therapy (DBT) is a go-to protocol for helping humans with BPD to develop healthier coping mechanisms and emotional regulation skills.

Additionally, therapy approaches that focus on trauma resolution may be beneficial for those with a history of traumatic experiences being evidenced by self-destructive behaviors.

Final thoughts

Understanding the nature of self-destructive behaviors in the Self-Destructive subtype of Borderline Personality Disorder is crucial for mental health professionals, caregivers, the humans themselves, as well as their immediate family circle.

All of BPD is fraught with clinical peril. But I’m struck by the vagueness of just how much BPD is out there.

So why did I write this series?

I’m positing that 2024 will be incredibly stressful on a multitude of fronts, which, I suspect will activate otherwise dormant personality disorders throughout the year and beyond.

I’m hoping that as a community of practice, we can become more cognizant of the interconnectedness of impulsive actions, emotional dysregulation, and a distorted self-identity, perhaps from a dislocation caused by living in history.

I’m talking the about the biblical four horsemen here. War..Famine…Pestilence , and Death.

In other words, because political, social, public health, and economic institutions are teetering… will Borderline behaviors come to characterize our culture?

A more targeted and effective approach to diagnosis and treatment is what we all ardently desire.

Marriage and Family Therapists, as well as other talk therapy professionals, may need to build bridges with other helping professionals to up our collective game during a time of profound upheaval. We have a narrow role to play, but we can’t avert our eyes if and when public mental health declines because of inexorable external stressors.

I hope that we will soon be entering an age of technological assistance in crafting optimal intervention and treatment plans.

But until that Golden Age, humans enduring the self-destructive subtype can work towards healing and developing healthier ways of coping with their emotional challenges by choosing the evidence-based protocol that is best suited for their personal history while they are living through history.

Be well, Stay Kind, and Godspeed.