Ending relationships – Is it BPD?

I hate you - don't leave me.  Image by Kaoxita - Deviant Art.com  (http://www.deviantart.com/art/I-hate-you-don-t-leave-me-102465289)

I hate you – don’t leave me.
Image by Kaoxita – Deviant Art.com

A diagnosis of BPD is not something to be taken lightly, it is life altering, in many ways.

Increasingly I am finding that people are contacting me through my blog regarding their relationship difficulties. Mainly the end of a relationship that has been quite turbulent or toxic, most often the person breaking off the relationship in these scenarios is a woman, and nearly every message includes reference to a concern that the ‘ex’ in question had/has BPD. I apologise if you have recently written to me about something like this, you may not like what you are about to read, but it’s nothing personal about anyone who has contacted me, just a general observation and attempt to clarify things a little…

I recognise that writing this post is likely to bring a few attacks and trolls around, but I need to share it anyway, I’m ready for the hate mail!

I think it is time to address a few key points about BPD and relationships…

I am concerned at the frequency of the BPD label being bandied about and attached to people just because they break off a relationship. Sure there may have been much on-again, off-again, going on in the situations I am reading about. The bluntness, coldness and confusing behaviour of going from one minute proclaiming to be the ‘love of your life’ wanting ‘to get married’ and intense relationships, to suddenly saying ‘never contact me again’ ‘forget me, move on’ ‘I don’t love you’ is harsh but is it really BPD?

Just how much attention has been paid to what has been read about BPD for people to jump to this conclusion?

Yes, unstable relationships, push-pull behaviour and fear of abandonment that leads to someone with BPD pushing people away before they can leave them because they are so scared that being left is inevitable are traits of BPD. This behaviour in someone with BPD comes as an overlap under the first two criteria for a BPD diagnosis – 1. Frantic efforts to avoid real or imagined abandonment and 2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

HOWEVER – there are 7 other criteria that need to be considered for a diagnosis of BPD and so very many of the messages  I receive do not make reference to any, or even a few of these – suggesting that BPD is highly UNLIKELY to be the cause of the relationship difficulties…

Let’s just review those other 7 criteria and then I will explain a bit more about my thinking…

  1. Identity disturbance: markedly and persistently unstable self-image or sense of self. (having an unstable sense of identity, such as thinking differently about yourself depending on who you are with)
  2. Impulsivity in at least two areas that are potentially self-damaging (e.g., promiscuous sexeating disordersbinge eatingsubstance abusereckless driving). Note: Do not include suicidal or self-injuring behavior covered in Criterion 5 (taking risks or doing things without thinking about the consequences)
  3. Recurrent suicidal behavior, gestures, threats or self-injuring behavior such as cutting, interfering with the healing of scars (excoriation) or picking at oneself. (suicide attempts, self-harm)
  4. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability or anxiety usually lasting a few hours and only rarely more than a few days). (having emotions that are up and down for example, feeling confident one day and feeling despair another)
  5. Chronic feelings of emptiness
  6. Inappropriate anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
  7. Transient, stress related paranoid ideation, delusions or severe dissociative symptoms (sometimes believing in things that are not real or true (called delusions) or seeing or hearing things that are not really there (called hallucinations).)

Okay, so looking at those does it make it any clearer how much more there is to BPD than JUST not being able to hold down a relationship?

Take this into consideration for a start – a diagnosis of BPD is almost NEVER made unless this criteria is included as one of the dominant pervasive characteristics demonstrated by the individual being considered for diagnosis – Recurrent suicidal behaviour, gestures, threats or self-injuring behaviour such as cutting, interfering with the healing of scars (excoriation) or picking at oneself. (suicide attempts, self-harm).

It is very rare that the messages I receive make reference to the person having this problem!

So, if it’s not BPD what could it be that is causing this person to break off relationships? Well the list of possibilities is almost endless really, so please don’t take this is a gospel, or a prescription, the list here is just a few suggestions that come to mind…

  • They are just commitment phobic – plain and simple, commitment scares them so they panic and pull back.
  • They are confused – they do not know how they really feel about you, it’s not always as easy and cut and dry as being in love or not being in love, some people struggle to be certain of their feelings.
  • They meet someone else who they are more attracted to – not nice, but it happens.
  • You are too pushy, clingy, possessive – sorry but it could be true – you may be putting too much pressure on them!
  • They do have a mental health problem – but it may not be BPD, it could be any number of other problems!
  • YOU have a mental health problem – again, sorry but it does take two to make a bad relationship, before you apportion blame take the time to consider your own behaviour!
  • You have issues – maybe not a mental health problem, but just your own issues that are causing the problem…
  • BOTH of you have issues – more likely than anything is that both of you are coming into this with your own baggage from previous relationships and if you (both) cannot let go of the past you are doomed to make the same mistakes…

Now, I’m sorry if this post seems to some as though I am being harsh.

Some may even think I am trying to deflect attention/blame away from those with BPD.

You could not be further from the truth – all I am trying to do is create a little perspective, and remind people NOT to jump to conclusions!

DO NOT DIAGNOSE someone with BPD just because you have a had a difficult relationship with that person! BPD is not the only answer – how would you like it if they jumped to the same conclusion about you?! You are not a professional mental health expert, nor am I – we cannot diagnose other people with a mental health condition based on a limited set of information. It takes a long, comprehensive assessment by a PROFESSIONAL to make such a diagnosis, examining the history of the patient in detail looking at many years of their life and experiences – and even then sometimes even the professionals get it wrong.

All I am asking is that you stop, think and examine the evidence not label people – it’s not fair, it’s not right and could be very damaging for them and you to make such assumptions.

Relationships go wrong, relationships end – stop trying to find reasons. And yes it may be hard, and you feel you world has been ripped from under you and your heart has been trampled on, but we’ve all been there and if we haven’t at some point we will – the only way to get over it, survive and move on is to do just that – move on.

I’m not saying I don’t have any sympathy for you, I do and I can empathise completely with how difficult it is to pick yourself up after losing someone – it’s a grieving process and I have been through it myself, but I can assure you it will and does get better with time.

Just stop calling it BPD – because chances are it isn’t!


25 comments on “Ending relationships – Is it BPD?

  1. It is true that when researchers do studies, they want someone who self-harms and is suicidal. But it is not true that this must be present in order to diagnose BPD: in people in treatment it is pervasive–that’s usually what brings them to treatment–but people who have or more traits but NOT those two are extremely common in my BPD world of the last 18 years. For one thing, 25% of people with BPD with me. Where are they? Where are the 30% with comorbid NPD (there is some over lap with men of course). Are all the people with 5 traits who blame others. Just because the clinical world doesn’t see them it doesn’t mean they’re not there.

  2. Sorry, I meant to say that 25% of people with BPD are MEN. Also meant to point out that because studies require suicidality and self-harm to be present before a person qualifies for the study, these two traits are overrepresented, giving the impression that it has to be present.

  3. Great post. I agree 100%. Before contacting you on your blog I did my own research on BPD . Out of the 9 criteria , my ex has 8. Ive experienced all 8 many times, im not aware of her cutting herself. Being a non , the acts of what we would call strange behaviour do tend to stick in our minds. Well… for me atleast. The breaking up every week, I had to constantly reassure her that she was pretty. She always felt “empty” inside , which I couldnt understand or relate to. Low self esteem., sudden bouts of rage , Splitting me black, mood swings and shed fall apart when she was stressed.

    I can see why you have written this. So.e people could jump to conclusions vert quickly without really taking time out to think about it.

    I guess what actually made it worse for me is that my ex wasnt an animal, she didnt act absurdly. She was quiet and pretty introvert but unfortunately for me, I personally think that makes it more brutal and heartbreaking cause she tugged even harder on my heart strings and I was unaware of what was really going on. Being the “rescuer” that I am (was) it made to so much harder.

    I definitely do see your point and I feel people she do some solid research as ive done before self diagnosing some one. Btw, this is not hate mail at all lol.

    • Added to the list is also an abusive childhood which plays a huge part. Abusive or neglective parenting of which my ex had too. Its just so sad to know that not all bpd are as aware as you. Imagine how much hurt and heartache would be irradicated.

      • Yes, very true we do learn from experience and if that experience is bad our learning is not what it should be! I have worked hard to gain my awareness because I thought it was important to do so, I guess not everyone thinks that way…

    • Thanks Ty, yeah I’m hoping that people may think twice before self-diagnosing after reading this because it really doesn’t help anyone, only professionals should diagnose, sure we’re all welcome to our opinions/beliefs and if it helps us deal with things sticking a label on it then fair enough but they should remember that a self-diagnosed label is not necessarily accurate or fair and maybe they should keep it to themselves…

  4. Great article , I am glad you clarified being in a bpd relationship or being in a difficult relationship. Unfortunately my ex meets all the requirements of having bpd. Now that we have begun speaking again I need to try to get her into treatment.
    Thanks again and looking forward to your next post.

  5. True true true.

    Pshhhh… Even ‘normal people’ have difficulties with relationships and they have no mental health problems. I can’t say that percentage-wise, there is that big of a difference whether you have BPD or not.

    Great post.

  6. Agree – BPD is a catch all and such a confusing condition/diagnosis that many mental health professionals (or at least quite a few I’ve met) simply refuse to use it anymore. They know the stigma, they know the (extra) self-hatred and feeling of weakness that can come with feeling like a diseased/disordered victim, so to them, it’s easier to simply address the core issues and never use the BPD label. On the one hand, I agree with them: people and their problems are totally unique and it’s probably more helpful to prioritize that approach over a catch-all, widely misunderstood diagnosis. On the other hand, getting the diagnosis – whether or not my current therapist thinks it was helpful – WAS helpful for me. The main way it helped me was in not feeling so alone: after all, it led me to blogs like this and such a wonderful online community! 🙂 I think there are simply many types of pain and ways that people cover that pain that, strictly speaking, do not involve chronic conditions/disorders/diseases. That doesn’t make them any less sad or serious, or any less deserving of mental healthcare. But to muddy the waters with false labels is not a good thing. Thanks for the post! xx

    • Thank You. I agree, BPD is a label we don’t want but at the same time getting it is a relief because at least we know what is wrong, I don’t think I would be where I am now without having had the label, because trying to fix something when you don’t know what is wrong is near impossible! Everyone has their own baggage and issues no matter how mentally healthy they seemingly are and relationships are never going to be completely smooth running, that’s life! 😉 xx

  7. Or perhaps we should consider whether BPD is in fact a valid diagnosis?
    Much evidence actually suggests that BPD is not valid or reliable as a diagnosis period. If that is the case, it would throw a wrench in any effort to say that someone is or is not borderline based on their observed behavior in relationships.
    I touch on this issue in my blog post here, which is more about the degree to which BPD may be genetic, but also touches on BPD’s overall validity as a diagnostic entity, something of which I am highly doubtful – http://bpdtransformation.wordpress.com/2013/12/09/is-borderline-personality-disorder-caused-by-faulty-genes/

    • Thanks for sharing your link, I guess everyone is always just seeking a ‘why’ for things that seem to need an explanation… even when there may not be a reason, some things/behaviours just ‘are’ no more no less…

  8. Thanks for another great post. Do people realize you’re not a doctor? That they are probably not doctors either and have no business diagnosing someone else? It’s just bizarre to me that people are writing you looking for you to diagnose their boyfriends or girlfriends.

    • Thanks Ana, I’m pretty sure some people must assume I am a doctor given what I write and how I convey it! lol But yes I do fully agree it is bizarre that people are asking me to diagnose others based purely on their perception of that person, even a doctor would need to see and speak to the individual in question over a lengthy assessment (not just a one hour session) to diagnose BPD!

    • I re-read this and I have another thought. One thing I always point out to people is not only the nine criteria (which I think is your main point) but that in order for ANY PD to be diagnosed it must be persistent across many situations, longstanding (many years) and intense (e.g. VERY black and VERY white). If someone asks me if so and so has BPD, I never answer yes or no for many reasons (one of them, I hate to say, is that I don’t want to bother to read their very long email) but instead ask, “What exactly, is your concern?” If a person is not going to get treatment (99% of the cases in the people who come to me) you’ll never know for sure, and it doesn’t matter in that the tools used by family members (at least the ones I talk about) work in ANY relationship. It is always good to validate and be validated. It is always good for people to set consequences that enable them to remain in relationships. It’s good to take care of yourself as well as your partner. My five cents.

      • Thanks Randi, yes indeed the persistence of the symptoms is key to diagnosis. I fully agree about it being pointless if they aren’t seeking help/treatment too, and that using good communication and validation skills and tools can help any relationship regardless of a diagnosis or not 🙂

      • I believe it is true what you are saying. The symptom could be vague at time and need to be recognized, with good help and support. I always thought for such a long time something was not okay with my bf. He never agreed to go on treatment, everything was remained as a concern. I saw it taken the worst of him. As selfish as it might have seen, I had to walk out. I did not know whether I made a mistake or he did? Always feel bad thinking of the past.

  9. Reblogged this on Art Therapy and Related Topics and commented:
    It’s still May: Borderline Personality Disorder Awareness Month: This is a really great blog and in particular, this blog post describes BPD in terms of how many people are confused about it and label it on people without understanding the full extent of what it is about and really understanding the diagnosis. When a relationship ends, or gets “crazy”, it seems that many people think their partner has BPD based on a few, granted, extreme types of behaviors, but in fact these are very common behaviors in humans when ending or acting out in very intimate romantic/sexual relationships. Even if one of the people is going hot and cold from one day to the next and pushing and pulling away, starting arguments to get closer, threatening crazy things, having a lot of angry outbursts, doing scary things like punching walls or getting very drunk or disappearing and reappearing, none of that stuff guarantees the person has BPD. Indeed, if you want to get inside someone who really suffers from BPD, think of your worst, most scary bad or painful relationship in which some of the above behaviors occurred, and imagine that happening not just daily but feeling that unsure about yourself and others moment to moment and also having the other criteria that this blogger explains in more detail; if you imagine this or have felt this way, you might be able to begin to understand the pain and suffering involved in having this disorder:

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