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Paranoia, Delusions and Dissociation in Borderline Personality Disorder


Paranoia, delusions and dissociation are the subject of the ninth diagnostic criteria for BPD.

The DSM IV-TR states:

9. transient, stress-related paranoid ideation or severe dissociative symptoms

Borderline Personality Today explain this as:

During periods of extreme stress, transient paranoid ideation or dissociative symptoms (e.g., depersonalization) may occur (Criterion 9), but these are generally of insufficient severity or duration to warrant an additional diagnosis. These episodes occur most frequently in response to a real or imagined abandonment. Symptoms tend to be transient, lasting minutes or hours. The real or perceived return of the caregiver’s nurturance may result in a remission of symptoms.

As with most of the criteria for diagnosis you can see again here the overlap between symptoms, in how abandonment issues (criteria 1) are closely linked to criteria 9, often causing the expression of these symptoms.

Personally I would say that on the point of these symptoms being transient that I feel the paranoid delusional elements are more transient than the dissociative symptoms. A paranoid delusion is:

Paranoid Delusions are beliefs of a suspicious nature, where the person believes something is not right with them, another person(s), or the world in general, which poses serious problems for them.

source: SimplePsych

For me these kinds of thing will occur infrequently at times when I am very stressed out by a situation or person. I will feel like they or everyone is out to get me and become very distressed (sometimes to the point of triggering self-harm episodes). This will often be linked to being let down or hurt by someone I thought I could trust or rely on in some way. I will then feel like I can trust no-one, a ‘me against the world’ syndrome developing temporarily. During these episodes of paranoia and delusion I worry about what people think of me and feel there is something fundamentally wrong with me that causes people to hate me and treat me badly, I feel I don’t deserve to be happy or loved and that everyone would be better off without me, which can then lead to suicidal ideation’s. I get suspicious of everything and everyone, imaging a multitude of motivations for their action or inaction, with beliefs that they want to hurt me and are being nasty or taking advantage of me.

Paranoid delusions can then lead on to dissociation, dissociation can happen independently but is more likely to be triggered by paranoid thoughts. For me dissociation can be far more long lasting than the short periods of paranoia and delusions. While the paranoia and delusions can be very harmful to me in the short term (due to the risks of self-harm and suicide attempts as a result) the pervasive persistence of dissociation is possibly more damaging overall.

Dissociation is a form of detachment, most often it occurs of it’s own accord, leaving you feeling numb, strange, unreal and apart from everything. All people can experience mild versions of this, like those times when you just feel like you have been on automatic pilot whilst doing something. With BPD and other dissociative disorders, this feeling can be much more all encompassing and normal life can feel like you are a robot just going through the motions of ‘doing’ without feeling or connecting on any level – this is how I feel much of the time. A its most extreme dissociation will lead to a complete block of memories of an event, such as those people who cannot recall situations in which they were severely abused, because they had cut-off completely, blocked all memory of the event as a survival method.

I have currently been experiencing a phase of severe dissociation, bought on by a stressful event in which I was hurt and let down by people I thought were friends. Initially it led to paranoid delusions, but then those delusional thoughts led to a complete social shut-down. I switched off, locked out and cut off from life outside. Leaving the house for anything other than ‘must-do’ activities such as food shopping and appointments became not only something I couldn’t do, but didn’t want to. I didn’t want to see or be near people at all. Fear of feeling any more hurt – a conscious dissociation was coupled with the natural development of subconscious dissociation. basically it is all about escaping from painful, stressful feelings and situations. Some people will do or say things they cannot remember when they experience severe dissociation, or the distorted connection with reality will mean that you experience a situation very differently to others who may share the situation/event.

For me dissociation is more closely associated with my low phases, depression, difficulties eating and sleeping will accompany these phases. At the moment I have been deliberately trying to fight against the conscious elements of my dissociation once I realised I was cutting myself off from the outside world I have been forcing myself to do things that get me out of the house and mixing with people, however this is only serving to reinforce the paranoid thoughts and pushing the subconscious dissociation forward. The last time I entered a phase like this I spent all my time sat at home studying and barely spoke to anyone for 3-4 years, when I finally broke out of the cycle I went into a manic phase and was behaving impulsively and recklessly. As I don’t want to become a social leper, hermit, recluse for the next few years I am trying, and trying to maintain links with the outside world and get out, but it is hard to keep this up as I really just want to hide away and vanish – this is the conscious level of dissociating. On the subconscious level even when I am going out mixing with people I don’t feel I am really ‘there’ it’s like I’m watching myself through a mirror this person being happy, smiling, having fun isn’t really me, it’s a mask, an act, the real me is locked behind the glass. None of it feels real, and anything that does feel real hurts – sparking a vicious cycle of triggering more paranoia, self-harm and so on. I am not sure when I will come back from this place, or even if I will, and sometimes I’m not even sure I want to as reality just feels like something I am too scared to face at the moment…

Thank you for reading!  If you have enjoyed reading this post please share it with others who may be interested and I always enjoy receiving feedback and comments :)



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64 comments on “Paranoia, Delusions and Dissociation in Borderline Personality Disorder

  1. thanks for visiting my blog and posting here, and thanks for writing. in the midst of so many theories of treatment, the most profound healing for me has taken place by hearing myself in the experiences of others, and having others hear themselves in my experiences. Thanks for being so articulate — the paradox of brilliance and isolation.

    • Dearest heartjunky:
      Your blog helps so much. My husband was married to a woman who suffers from Borderline Personality disorder. Only recently was this “diagnosed”. I was so angry at this woman and how abusive she treated a man that I love and who worked so hard to save his marriage and her. My understanding and research has totally defused my anger at her mistreatment, abuse and verbal/physical attacks on him because for the first time I understand the prison she lives in. Thank you so much for being so open and letting me see the person behind the diagnosis. It helps!! May the knowledge that you are helping others help you too.
      Leslie

    • wow thank you so much for posting this. As I was reading i could relate to every word..it was like me typing, except I never knew how to put it in words because i was confused by it so much I couldnt put it into words. Thank-you..i’m glad there is someone I can relate to.

    • I don’t know how old this post is or if it will reach you, but I would be curious to know if you share in a related experience as me. I’ve become aware of a deft capacity to consciously shut down my memory after what I deem to be shameful behavior on my part – for example, I was caught by my dr when abusing prescription meds. My immediate response was internal shame and fear. But within an hour I knew I was pushing the event outside my spectrum of awareness, in part to nullify the emotional agony, but also because this event was heaped upon so many other triggering stresses, it was as though I was psychologically buckling under the pressure and my mind has become quite skilled at selective amnesia. Some of my behaviors which I find excruciatingly painful CAN be recalled if I press myself. It’s not really forgotten. However I’m fascinated at how I can shut down embarrassing or painful memories and carry on as though they did not happen.

      • Hi, Thanks for the comment. I haven’t experienced that to the same degree that you have, but there have been things more from childhood, that happened that I have blocked out. More I find that there is a tendency to dissociate from events, they are no longer real to me and as such the emotional connection to them is removed, if you get what I mean? Not sure if that helps at all?

  2. Great post! I have felt shut down from people for a while now. It also started after a traumatic event with loved ones. I was also feeling unreal, both among people and alone, for a long time. I force myself to be around people too, and lately it has started to feel a little more natural at times. I think maybe dissociation takes a while to wear off, even when exposed to healthy situations with others? Yesterday I went to visit a friend who lives in another city, I hadn’t seen her for a while and during the last year I was almost always dissociated when we met, but yesterday it was a lot better, I was much more confident and relaxed. A conciouss relationship with the God of my choice has helped with this too, I guess. It works for feeling your primary caregiver is always with you and won’t abandon you, I guess ;)
    I really like your blog. And I’m sure you’ll get over it. Probably it will just take some more time, or you need to figure out something more, who knows. But you are strong and determined, I trust you’ll get well.
    See you around! :)

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  15. Hello, first of all I think you are very brave to be so open and honest about this condition. I wanted to ask something because I am very much in the dark myself about this condition.

    How do you go about helping someone who could be suffering from this disorder that doesn’t know they have it? Someone you live with.

    So much of what you have written rings true to me when I think of my partner. The delusions and paranoia that everyone is out to get him, he can turn into someone so negative and hard mouthed. It is so harmful to the relationship that it scares me, and in time could completely destroy it.

    He comes out with things days later that he has twisted up so badly I have no idea what he is talking about and refuses to accept there is no truth in it. He accuses me of being disrespectful and ganging up on him with my son. In the mean time I am the one that is made to feel disassociated and left on the sidelines not knowing what is wrong until I can eek out the root of it. This hurts and then he accuses me of sulking – it is not a sulk, I am simply hurt by his behaviour. I am beginning to think he does not trust me and there are no grounds for this at all. I love him dearly but of late it is causing resentment in my son, (he is not his son, but my first partners) because of the anti-social way my partner talks to me sometimes. I could not ask for a more wonderful and kind son, he is 17 and a rock for me. I am wondering if maybe my partner is jealous of him, maybe he wants me all to himself, I don’t know. One day we are his rock and the next it feels like there is no trust.

    We have been together for 3 years and talking of marriage. I have alarm bells going off and I really want this to work – I know this is my problem but if anyone has any ideas on what I can do to help him, I would love to know, thanks Fi.

    • Hi Fi,

      Thank you. Trying to help someone who is not aware of having BPD can be very difficult, as he may not accept that he has a problem and may think you are the one with a problem instead, especially if he is very paranoid like you say. It may also be that any number of other mental health conditions or even drugs (cannabis smoking produces high levels of paranoia) could be the cause of his issues. Without a medical diagnosis it can not be certain that BPD is the issue, and again trying to get a diagnosis, especially if the person does not think/believe there is anything wrong with them can be tough. As you can understand you cannot make someone get help if they don’t want to and even if you manage to talk to him about your concerns he may not respond well.

      Have you read any of my other posts about BPD? as there is so much more to it than just the paranoia, delusions & dissociation described in this post.

      You say you love him and want your relationship to work but at the same time alarm bells are going off and you are scared of the harm he is doing to your relationship. To be honest this doesn’t sound like it is good for you, sometimes love just isn’t enough :( If he cannot, will not or does not want to get help or try to change his behaviour there is little you can do to help him, you need to find out if he can/will do anything to change. If he wants to then you can help and support him but if not you are probably better off walking away before it destroy’s you. I’m sorry if this is not what you wanted to hear, as giving up on someone you love is very difficult but at the end of the day improvements have to start with him, you can’t do it for him. So, basically all you can do at this stage is try to find out what he is willing to do in order to try (e.g get a diagnosis and help) and save his relationship with you, once you know that you can determine your next steps.

      Sharon

  16. I had to google BPD delusions and I’m glad your blog came up! I’m very much experiencing this or I think I am. Someone is lying too me (either myself or my partner or I guess no one) and I really don’t know what to do. I find this embarrassing to I don’t even want to talk about it.

  17. Hi!
    First of all, thank you for sharing what you feel and how difficult it gets to cope with BP. It has really helped me understand what my (recent) ex must go through.
    Around two months back, my (then) boyfriend and I were having major issues in our relationship. I am a highly temperamental person myself, and when he started telling me about his insecurities of feeling inferior (even to me) and hence not liking people, it used to really get to me and we would always end up in a fight. At that time, none of us knew what he was suffering from although we knew both of us were in need of counselling for depression and suicidal tendencies. He started going to the shrink and then the counsellor to get help but they both suggested immediate admission at the hospital. He has a job that isn’t even a year old and can’t take a long break from it and hence, he didn’t get admitted although he did go for a few more sessions.
    When I couldn’t take the fights and the spats anymore, I broke up with him. I thought maybe I didn’t know how to deal with relationships or people and it must be for our good that we learnt to handle our own shit before helping the other. Unfortunately, the break up was a bad trigger and he started getting more violent and started harming himself more than ever. For the last one month, the poor guy has been going bonkers trying to figure out why he’d been having black and white phases and why he thought the way he did- at one moment loving me to death and at the other, hating me to be able to kill. I too, couldn’t understand why he would react so extremely to me and why he couldn’t make up his mind.
    About a week back, he was browsing online and came across BPD and realized it looked more familiar than anything else. Although he hasn’t gone to the counsellor in the last month, we are pretty sure he obviously has BPD. This is where your blog figures. He read your blog and identified with it and referred it to me to tell me how it feels. I read your blog and cried. I realized it must be so difficult. If only I had known and read more about BPD earlier, things wouldn’t have turned so bad. Hopefully, now I can do my little to understand him better. Thank you over and over again for this blog and for your help.

    Much love,
    K
    (Sorry if this was unnecessarily long! :( )

    • Hi K :)

      First of all don’t worry about long posts, that’s fine here! lol ;) and thank you, I’m glad my posts have been helpful :)

      It can take a long time to discover you have BPD and many professionals hesitate to diagnose it because of the implications such a label carries (as you have probably read in some of my posts!) but the knowledge can be a relief as I think your (ex) boyfriend has found even without full diagnosis because at least it means you have explanations for things you never understood about your own behaviour and finding ways to get better and overcome them :) I hope that he can now work on defeating the aspects that cause him the most difficulties as I have and am doing, it’s a long hard journey to recovery but the first step is knowing what you are working with!

      Best wishes Sharon x

  18. Thank you for shedding some light on a frustrating behavior I’ve had to deal with from my undiagnosed textbook-case BPD mother. She would consistently re-invent and revise past conversations, especially on the topic of “what day/time will you come visit?” She NEVER heard or remembered what my brother or I actually answered, preferring instead to accuse us of not showing up on time (we’d SAY 6pm but she’d swear we said 4). I finally realized, after talking to a therapist, that she’d get so stressed and paranoid at the idea that we secretly didn’t WANT to see her at all, that any conversation about our next get-together would be stressful enough to trigger her dissociation, and she subsequently got the times wrong. Unfortunately, her constant accusations and rages became a self-fulfilling prophecy, and she’s pushed everyone away.

    • Sorry to hear your mom is suffering so much and as a result you are too, I hope you all manage to get the help you need to be happy, BPD is so hard to live with :(

  19. Thanks so much for sharing. For the last 18 months I have been a hermit, never leaving my house unless I have to. This also coincided with a diagnosis of Lupus, which in itself can cause mental instability, therefore has exacerbated my BPD symptoms. I have two children and that makes this “hiding” from the world much harder, which in turn causes me to turn even more inward. This is a vicious cycle and its comforting to know I am not alone in this. I have sought out support where I live but unfortunately there are no support groups that are free of charge in order for me to seek this solace.

    • How awful that you are unable to access support, this is not uncommon I have to pay for my therapy as there was no free support available for me either (I can’t really afford it, but needs must!) I hope you manage to find something to help you!

  20. Thank you for sharing your story. My 12 year old marriage to my BPD husband has been a living hell. Although he’s been clinically diagnosed twice by separate psychiatrists, he refuses to believe there is anything different about him. Maybe, in reading your blogs, he can see that he’s not alone in his diagnosis. I think it’s too late to help the marriage, but it might make him a bit more settled on his own.

    • Sorry to hear about your husband, it is a shame BPD has destroyed your marriage but I can understand how you could need to be free of this. Best wishes to you both for a better future!

  21. Hello,
    I did not yet got diagnosed for Bornerline but I came to the diagnosis by my self. i can find everything you said happening to me. I also lost my bf coz of it..he do not know about my borderline but this is what he siad today:we ended also coz of drama and lack of trust and crazy thoughts in your head that i can’t change.
    I had this abusive father and mother lefted me and didnt speak to me for 8 years.
    In every relationship I looked for this idealised love and when i did not got it I start to hate this person and start act abusive and terible. I allways make this scenarious in my head if my partner do something, like ..ahaa…I know why you said this and do that..it is coz of that and that…I ALLWAYS know what he is upt to..Like I allways want to predict his actions and I allways can know what he will do…just coz he dont really love me but just saying so….I am a mess…I am now in surch for good therapist to start work on this. I so hope it will help me. I so want to change. i dont want to live a life this way. I want to trust people and let them love me and love them back. I would so apretiate if I could talk about it with someone. and in a way I am releived that I know there is a help out there and this can be treated.

    • Thanks for sharing, I hope you do manage to find a good therapist and get some help, it is out there although it can be hard to find depending on where you live but when you find it it will make a huge difference and because you want to change and get better with time and support you will be able to. Best wishes for your journey :)

  22. Wow reading this felt as if my thoughts were being written down. I get better at times but it doesn’t stay that way. I wish I could wake up one day and have no negative thoughts about myself and the few close to me.

  23. Its the first time I enter to this blog, I was looking for information because we have a daughter recently diagnosed with BPD, she is only 15, we want the best for her, want to help her, and at this moment is something very difficult,she is receiving medical treatment, but how work with an adolescent with this is very hard,do you have information of any group for parents in Puerto Rico?I will really appreciate your help. We need strategies, the last thing that she present about the BPD was the dissociation around one week ago, this help to understand a little, thanks

    • Thanks for visiting, I am afraid I don’t know of any support specifically in Puerto Rico but maybe someone else reading this might? You may find the forums on http://www.bpdworld.org/ helpful as there may be someone there who knows of something local to you as it is a worldwide forum? :) Hope you manage to find some support. Sharon x

  24. Thanks for sharing this post to us! It is very helpful to us since we have a friend who is experiencing paranoid personality disorder symptoms and it really helps a lot here in your site. Thanks and keep posting.

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  26. I went through a few years of agoraphobia years ago, until I pretty much had a breakdown and finally got on a 6-month waiting list for help from the local Community Mental Health Centre. I was diagnosed with BPD in 2005. I was 35 years old. I could have probably been diagnosed a couple of decades earlier. Everyone in my hometown was bullying me verbally. I am just finding my voice now to do something about my illness. Love your blog!

    • Hi Joyce, thank you for sharing, glad to hear you like my blog and are finding your voice to do something about your own BPD! I wish you all the best, the healing journey is hard. I’m well along the road but the end is still not in sight – some aspects I don’t think will ever leave me… but at least the worst are no under control so that I can live a normal(ish) life :)

  27. I decided to research my feelings and current issues and found this website right off. It feels great to understand what is actually happening and why. I was diagnosed with Borderline about 7 years ago. My world fell apart when I was diagnosed with Borderline because as soon as I researched it I felt deep in my core and knew it was exactly what was wrong with everything. I cried for about 24 hours, and then began trying to do something about it. I’ve been struggling through therapies and remissions ever since.There are definitely very bad days, and I really wish I had more control, which is why I tend to research. Anyway, thanks for writing this blog.

  28. Great article.
    I get very symptomatic under stress. I also dissociate and imagine people don’t like me or think that “I’m too much” or too needy.
    For example, this week I’m in an intense training program so I can change careers. (Im female baby boomer). I’m very passionate about the things I’m interested in and have been raising my hand in participation or to ask a question about the material.
    At one point, due to time constraints, the instructor “seemed” to ignore me in favor of selecting other students. I could feel myself losing awareness and became confused and believed there was something wrong with me. I have been working for over 40 years, have a huge social network, attend 12 step meetings because i have a co-occuring illness: mental health and addiction. I have 12 years clean, in therapy and see a psychiatrist regularly for med checks for complex PTSD as well as BPD traits.
    The really GOOD NEWS is that I no longer am a “prison of my own making” because I’m taking classes in Dialectal behavior therapy (DBT) invented by Marsha Linehan, a psychologist, who also suffers from BPD. These classes have saved my life in so many ways. I also take classes in a program called WRAP (Wellness Recovery Action Plan). I know it sounds like tons of emotional work but I accept and consider the horrendous cards that were dealt to me.
    The training I’m taking is to become a Certified Peer Specialist, which means i will be able to be there for people with the same challenges–and get paid to do it. There’s so much research being done now on the effects of childhood traumas. It accounts for alcohol and drug abuse, homelessness, incarceration, and suicide due to the inability to regulate our emotions. There’s tons of research out there.
    I am so exhausted from living such an unhappy life I’ll do whatever positive help out here that’s available. I’m happy to report that my episode today only lasted less than an hour which gave me the time to find your extremely honest and helpful blog. I now recognize that often times my feelings are distorted, created from a place of very real deep pain which happened when I was helpless. I’m so grateful i no longer am.

    • Thank you Ellie. It’s great to hear how well you are doing. DBT does sound really good, it’s such a shame I have not been able to access it, thankfully I have several books and have worked through some of the skills with my therapist (but a trained DBT therapist would be better still I’m sure!). Good luck with the training, those of us who have ‘survived’ these things can be such an inspiration to others suffering the same and hopefully evidence that it is possible to get better, and knowing that when a person says ‘I understand…’ they actually, genuinely do is so much more comforting than the feeling you get when someone says that and your mind is screaming ‘NO – you really don’t, and stop lying to me!’. Keep up the good work :)

  29. i read this on my phone on a sleepless night, worried about my (social) delusional thinking and whether i will ever be able to get rid of them, and came across this page. thank you so much for writing this. i’ve been recently diagnosed with bpd after over a year of thinking it was just depression and anxiety, and i keep wondering if i am malingering and just acting out, exaggerating, and behaving in certain ways just to make my problems more severe than they really are, and was only diagnosed with bpd because i was “trying” to fit the criteria. but i can relate so so much to your post that it (perhaps briefly) gave me relief that maybe i’m not just exaggerating or lying and truly have bpd.

    thank you!!!

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