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…
- 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)
- Impulsivity in at least two areas that are potentially self-damaging (e.g., promiscuous sex, eating disorders, binge eating, substance abuse, reckless driving). Note: Do not include suicidal or self-injuring behavior covered in Criterion 5 (taking risks or doing things without thinking about the consequences)
- 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)
- 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)
- Chronic feelings of emptiness
- Inappropriate anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
- 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!