Borderline Personality Disorder (or BPD) became a common appellation among the university educated, often as a term of abuse, in the Eighties. Such casual misuse ignores the misery of the sufferer - I doubt the same name-callers would attack someone for being depressed.
Originally devised as a diagnosis by psychoanalysts (followers of the Freudian Tradition), it was colonised by psychiatrists (medical doctors), especially American ones. The 'borderline' in psychoanalytic diagnosis is that between madness (psychotic loss of identity, delusions) and neurosis (obsessions, hysteria). BPDs have a pervasive instability and ambivalence in their lives (see pp194-208 of my book They F*** You Up). Erratic, impulsive and often explosive, they make for awkward, manipulative companions, perhaps explaining why BPD is a term of abuse. Other people are put on edge by their sullen displays and hurt looks or by their obstinate nastiness, eliciting rejection.
BPDs shift between extended periods of dejection and apathy, and frantic spells of anger, anxiety or excitement. Angered by the failure of others to be nurturant, they use moods and threats to 'get back' and 'teach a lesson'. By exaggerating their plight and by moping about, they avoid responsibilities. Silences are punitive blackmail, a menace of trouble. Offended by trifles, they're readily provoked to contrariness.
Unsurprisingly, sustaining a stable personal relationship is tricky. A study comparing BPD women seen in a marriage-guidance clinic with non-BPDs found the BPDs to be filled with self-deceit. They had greater sexual dissatisfaction yet thought of themselves as highly desirable. They reported more problems in their relationships, greater sexual boredom, difficulties in achieving orgasm and proneness to affairs, yet they invariably identified their partner as the one with the sexual problem.
BPDs (and the Personality Disordered in general) are more likely to have a ludic love style, in which love is seen as a game, something done to rather than with another person. They believe that what their lover does not know about cannot hurt them. When deceiving partners, they gain more pleasure from the playing of roles than from intimacy or sex.
Intimate contact leaves BPDs feeling battered because their omnipotent and narcissistic fantasies are constantly banging against the ceiling of reality. It also leaves them feeling drained, increasing their loneliness and dependence on others and need for company, yet seeking it out only sets off the same vicious cycle. They are at risk of filling the emptiness with manic addiction to sex, drugs, alcohol, gambling or work.
Several studies suggest that the 'lie on the couch and tell me all about it' psychoanalytic monty is the best treatment for BPD. It's expensive and hard to obtain, but if you've got BPD, well worth the effort. Since childhood maltreatment is the main cause, methods which ignore this are less likely to succeed.
