“Back from the Edge”–video about borderline personality disorder

Here is an excellent and informative video featuring three people who suffered and were successfully treated for their BPD. Marsha Linehan, a psychologist who also had BPD and developed DBT therapy for borderline patients, is also featured, as well as Otto Kernberg, an psychologist who specializes in NPD and BPD.

BPD is best defined as a severe lack of a sense of self which has its roots in abuse and often sexual abuse during childhood and adolescence but it also has a genetic component. Brain scans of people with BPD show their brains are actually wired differently. Self destructive behaviors such as cutting serve to help the sufferer regulate their emotions for the short term. Borderlines find their inability to regulate their emotions so painful and debilitating that many resort to suicide. One shocking statistic is that 8 – 10% of borderlines will ultimately either kill themselves or die of their self destructive behaviors.

Unlike people with NPD, medications that “turn off” the parts of the brain that overreact to emotional stimuli have been successful for treating and controlling BPD symptoms. Also, while people with BPD are more impaired in being able to function than people with NPD, therapy is much more likely to be successful.

9 thoughts on ““Back from the Edge”–video about borderline personality disorder

  1. While I understand this is well-intended, these ideas are still suffering from the medical model viewpoint, IMO. Here are a few examples:

    “Brain scans of people with BPD show that their brains are actually wired differently” – Well, obviously! Emotional distress will always be reflected in brain chemistry. But on a deeper level, this means less than it sounds like. Any person who experiences severe amounts of emotional distress, for whatever reason, will have different brain chemistry compared to most people who have had less stress/trauma/neglect/difficult emotional experience. That is the natural neurobiology of trauma/distress, to my way of thinking. But these type of brain scans do nothing to prove that BPD is real or valid. They don’t prove that the various people scanned have any condition in common, nor do they reveal what causes the variations in brain activity observed. So, when reading I am wondering what the meaning of this statement is?

    “BPD has a genetic component” – This is actually untrue (i.e. it remains a hypothesis, not a proven theory), although I know you didn’t intend it to be misleading. First of all, BPD is not a coherent illness organization, so saying “it” has a genetic component is null and void right off the bat. Secondly, even in studies of supposed borderlines, there is no convincing replicated evidence that genes are causing subjectively reported borderline distress. Researchers say they think there may be a genetic component, but where is the evidence, and why don’t they prove that BPD is valid and reliable via biological markers first, since that would seem to be prerequisite for researching it accurately?

    If you read about genes in depth (e.g. books like The Mirage of a Space Between Nature and Nurture, The Gene Illusion, The Dependent Gene, or various introductions to Epigenetics), it has not been proven convincingly at all that genes cause or significantly contribute to any so-called mental illness. There are multiple levels of problems with this “research”, the surface level being the way the studies are done, which I could write a lot more about, the deeper level being the lack of validity and reliability with the “disorders”.

    Sorry to be harsh, but this tired trotting out of the gene theory upsets me. It’s not helpful in the long run. Believing that one’s problems are innate and lifelong (e.g. genetically based) doesn’t promote a sense of agency and hope in the long run. So, why promote this idea if there’s no good evidence for it?

    “Medications have been effective for treating and controlling borderline symptoms.” – In the short term, this may be correct. In the long term, I don’t know of any evidence that medications are effective. Where did you find evidence?

    This message is probably not going to make you happy, but given their potential importance, I think that assertions like those in the quotations above need to be supported by clear logic and good scientific evidence.

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    • Duly noted, I was basically just parroting what they were saying in the video. It is very medically based, but it was made at a major hospital so that would explain the medical model perspective. I have my doubts that BPD has biological origins anymore than any other PD does. PD’s are not due to biology and that’s why they can’t generally be treated with drugs. You made a good point about the brain chemistry of someone suffering severe trauma being different than someone who didn’t, which is why BPD perhaps should be considered a long-standing form of C-PTSD or at least a PD that arose from it.

      Oh, and I’m not at all unhappy with what you posted. I don’t even disagree with you, I just like to post differing opinions from different disciplines. You have read a lot more about bpd than I have.

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      • Ok, I guess my response was because the way I read it, it sounded as if it were your positions. Then again, I have to admit that I did not watch the video, mainly because I don’t especially like Linehan nor Kernberg and don’t identify with their reductionistic views.

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          • No, my favorite is Jeffrey Seinfeld’s 4-phase theory of the borderline-narcissistic continuum – which includes out of contact, ambivalent symbiosis, therapeutic symbiosis, individuation phases. Its in his book The Bad Object. Also David Celani describes the same 4 phases in his book Treatment of the Borderline Patient. Also Harold Searles invented this model, in his writing about schizophrenic patients who also exhibited these phases in a different way (e.g. his book Collected Papers on Schizophrenia and Related Subjects) . On my site these phases are summarized in Article #10 .

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            • Well, I know less – most importantly less in an experiential, depth way – than many of the experts who’ve worked with seriously disturbed people in long-term therapy. But for a layperson, I’ve read quite a lot, thanks!

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