Borderline We-Space? The Phenomenology of the Background of Safety in Borderline Personality Disorder

2021 ◽  
pp. 1-11
Author(s):  
Zeno Van Duppen ◽  
Philipp Schmidt ◽  
Benedicte Lowyck

Borderline personality disorder (BPD) is a severe psychiatric condition characterized by instability in identity, relationships, and affect. Individuals, with BPD typically lack a coherent sense of self, are highly sensitive to interpersonal stressors, experience intense fluctuations in mood, and frequently engage in impulsive and self-destructive behaviors. Although both empirical research and development of effective psychotherapy have evidently progressed over the past years, many aspects regarding the structure of experience and the life-world typical for persons with BPD are not yet fully understood. Somewhat surprisingly, phenomenological psychopathology has only recently started to pay more attention to the disorder. A comprehensive elaboration of the phenomenology of BPD is therefore still lacking. This article aimed to contribute to such a phenomenological understanding by focusing on what we think is an essential aspect that has yet not been sufficiently addressed: the background of safety. To clarify what this means, we depart from Sandler’s [<i>Int J Psychoan</i>. 1960;41:352–6] psychoanalytic concept and elaborate on it phenomenologically. This leads us to argue that the development of a background of safety requires a particular embodied presence of others, which, in turn, contributes to the constitution of a safe we-space, a shared and familiar environment providing a matrix for the experience of a stable world. However, even when established, the background of safety remains in need of a continuous reconfirmation through corresponding experiences within a sufficiently reliable and controllable environment. The background of safety is vulnerable and open to (interpersonal) disruptions like trauma or neglect. In BPD, we suggest 3 aspects regarding the phenomenology of the background of the safety need to be considered: first, typically, patients with BPD did not develop a robust background of safety in infancy; second, weakening of the background of safety gives rise to symptoms and dynamics typical for BPD; third, these symptoms and dynamics further undermine the possible development of a background of safety in adult life and thus gravitate toward a petrification of the borderline condition, a “stable instability.” To conclude, we examine whether this concept should be understood as a <i>trouble générateur</i> and, last, consider its clinical implications.

2021 ◽  
pp. 003329412110006
Author(s):  
Stephanie Fagan ◽  
Suzanne Hodge ◽  
Charlotte Morris

The study explored experiences of compassion in adults with a diagnosis of Borderline Personality Disorder (BPD) to further the development of the construct of compassion in relation to BPD. Interpretative Phenomenological Analysis was used to develop themes from the narratives of six adults with a diagnosis of BPD. Five themes emerged: Emotional Connection to Suffering, Empathic Understanding, Prioritisation of Needs, A Model of Genuine Compassion and Developing Acceptance and Worth. Participants described the role of compassion in their difficulties, including the adverse impact of experiences of incompassion upon their sense of self. The themes were integrated into a model that highlighted a process of recovery through therapeutic encounters with others in which genuine compassion was modelled. In addition, barriers to compassion and factors facilitating the development of compassion emerged from the analysis and have implications for clinical practice.


2019 ◽  
Vol 33 (2) ◽  
pp. 249-261 ◽  
Author(s):  
Katharina Kolbeck ◽  
Steffen Moritz ◽  
Julia Bierbrodt ◽  
Christina Andreou

Ongoing research is shifting towards a dimensional understanding of borderline personality disorder (BPD). Aim of this study was to identify personality profiles in BPD that are predictive of self-destructive behaviors. Personality traits were assessed (n = 130) according to the five-factor model of personality (i.e., Neuroticism, Extraversion, Openness to Experience, Agreeableness, Conscientiousness) and an additional factor called Risk Preference. Self-destructive behavior parameters such as non-suicidal self-injury (NSSI) and other borderline typical dyscontrolled behaviors (e.g., drug abuse) were assessed by self-report measures. Canonical correlation analyses demonstrated that Neuroticism, Extraversion, and Conscientiousness are predictors of NSSI. Further, Neuroticism, Agreeableness, and Risk Preference were associated with dyscontrolled behaviors. Our results add further support on personality-relevant self-destructive behaviors in BPD. A combined diagnostic assessment could offer clinically meaningful insights about the causes of self-destruction in BPD to expand current therapeutic repertoires.


2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Dova Yovenescha ◽  
Desvalini Anwar

The purpose of this analysis is to expose the issue of Borderline Personality Disordere which is represented by the main character and to know the contribution of the plot, setting, and character in revealing the Borderline Personality Disorder. This analysis is related to the concept neurosis by Freud that is supported by the text-based interpretation. The result of this analysis shows the main character has Borderline Personality Disorder that can be seen from the main character’s inappropriate emotional reactions and highly self-destructive behaviors.


2020 ◽  
Vol 20 (1) ◽  
pp. 56-74
Author(s):  
Giampaolo Salvatore ◽  
Lorena Bianchi ◽  
Luisa Buonocore ◽  
Nadia Disturco ◽  
Angus Macbeth ◽  
...  

Borderline personality disorder (BPD) is a severe disease, characterized by severe instabilities in identity, affect and relationships. Clinical improvement of BPD can be facilitated by psychotherapy aimed at tackling multiple specific cross-modality impairments and their patterns of interaction: impaired sense of self, maladaptive interpersonal schemas, impaired metacognition, emotion dysregulation and impulsivity. Herein, we describe the steps in the treatment of a young woman meeting the criteria for with BPD with paranoid traits, successfully treated with Metacognitive Interpersonal Therapy, a treatment based on comprehensive assessment of domains. In the initial phase, treatment focused on promoting emotion regulation, integrating opposing patient representations of the therapist, enhancing metacognition, and increasing focus on the maladaptive schema that elicited dysregulated behaviors. Later in therapy, treatment focused on supporting the patient to realize her ideas about self and others were schema-driven; and improving metacognitive capacity to understand others’ minds. General implications for psychotherapy of BPD are discussed.


2014 ◽  
Vol 16 (3) ◽  
pp. 228-240 ◽  
Author(s):  
Lucy Jade Lovell ◽  
Gillian Hardy

Purpose – The purpose of this paper is to explore the lived experience of having a diagnosis of Borderline Personality Disorder (BPD) in a forensic setting. Design/methodology/approach – Semi-structured interviews were conducted with eight women with a diagnosis of BPD in private secure units. The interview data were analysed using interpretative phenomenological analysis (IPA). Findings – Four main themes emerged: identity, power, protection and containment, and confusion. The themes of identity, power and protection and containment represented polarised positions which in turn contributed to the theme of confusion. Research limitations/implications – There are limitations to this study mainly the heterogeneous nature of the sample. However, good quality control and the similarities with previous findings indicate that this study makes a valuable contribution to the understanding of BPD in a forensic setting. In addition it has implications for further research; exploring sense of self and the differences between a sample from a community and a sample from a forensic setting with a diagnosis of BPD. Practical implications – For practitioners to acknowledge power dynamics and to be able to formulate and address these with patients with a diagnosis of BPD. Originality/value – This is the first IPA study to ask women with a diagnosis of BPD in a forensic setting what their experience is. It is a qualitative study due to the need to genuinely explore the topic and to provide a basis for others to conduct further research.


2020 ◽  
Author(s):  
Celine De Meulemeester ◽  
Benedicte Lowyck ◽  
Patrick Luyten

Impairments in maintaining a differentiated sense of “self” and “other” are thought to be a central feature of borderline personality disorder (BPD). However, studies directly focusing on self–other distinction (SOD) in BPD are scarce, and these findings have not yet been integrated with novel insights into the neural mechanism involved in SOD. Here, we present a narrative review of recent behavioral and neuroimaging findings focusing on impairments in SOD in BPD. Behavioral findings of SOD at the embodied level provide preliminary evidence for impairments in multisensory integration in BPD. Furthermore, both behavioral and neuroscientific data converge to suggest that SOD impairments in BPD reflect an inability to shift between self and other representations according to task demands. Research also suggests that disruptions in infant–caregiver synchrony may play a role in the development of these impairments. Based on these findings, we present a new, integrative model linking impairments in SOD to reduced neural and behavioral synchrony in BPD. The implications of these findings for future research and clinical interventions are outlined.


Author(s):  
Giovanni Stanghellini ◽  
Milena Mancini

Persons with borderline personality disorder are often described as affected by extreme emotional fluctuations. This article analyses their fundamental emotions: dysphoria and anger, despair, boredom, shame, and guilt. Our focus will be mainly on the two distinct life-world configurations that originate from dysphoria and anger: the dysphoric life-world and the life-world of anger. The first is characterized by a quasi-ineffable constellation of feelings in which Self and Others are irritatingly indefinite. In the second, the vague sense of Self and Others disappear: the Self is the victim, the Other the Offender. This emotional intensity does not allow borderline persons to distance themselves from what they feel here-and-now, thus feelings and values overlap. We call this “frustrated normativity.” Borderline persons are guided by the value of authenticity thus entering into collision with the social norms/conventions which they consider inauthentic and therefore an unwarranted challenge to their truly natural being: spontaneity.


Author(s):  
Andrew Chanen

Although borderline personality disorder (BPD) usually has its onset in young people, its diagnosis is often delayed, and specific treatment is usually only offered late in the course of the disorder. Over the past two decades, the explosion of knowledge about personality disorder has shown that BPD is neither a variant of normal adolescent development, nor a ‘passing phase’ of little consequence. In fact, BPD is associated with harmful personal, social, and economic consequences. This has provided solid ground for early diagnosis and treatment of both subthreshold borderline personality pathology (‘indicated prevention’) and full-syndrome disorder (‘early intervention’). Over the past two decades, the Helping Young People Early (HYPE) programme has been developed and researched in Melbourne, Australia. HYPE is a comprehensive and integrated indicated prevention and early intervention programme for youth (15–25 years of age). HYPE is comprised of a service model and an individual therapy, and incorporates the principles of cognitive analytic therapy. HYPE primarily aims to alter the life-course trajectory of young people with borderline personality pathology by improving functional outcomes, interpersonal relationships, and self-management, developing support networks independent of mental health services, promoting adaptive help-seeking, and avoiding or reducing iatrogenic harms.


Sign in / Sign up

Export Citation Format

Share Document