Borderline Personality Disorder: The Doll People

Have you ever encountered someone who seems to fit in with a group perfectly? As you get to know them better, do you find that they seem to mesh well with another, very different group? Does the person seem to abandon projects and relationships after a while? Do they pick up the relationships sometimes as if nothing really happened in between? Do they seem to expect you to be there for them any time they call? These are some of the trademark characteristics of Borderline Personality Disorder.

Borderline Personality Disorder: a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity. (DSM-IV) This is part of the Cluster B grouping of personality disorders, which appear as dramatic, emotional, and/or erratic behavior. Included in this group are also Antisocial, Histrionic, and Narcissistic Personality Disorders.

Many individuals with Borderline Personality Disorder appear to be fully-functioning, especially in social settings. This is mostly due to their need for social interaction and approval and a deep fear of abandonment. They may begin a relationship (friendship or romance) intensely and seem to invest a lot of time and effort into it. However, after a while, they may abandon the relationship in pursuit of a new one. Once the new relationship wanes for them, they may either seek another relationship or attempt to rekindle a recent one. However, Borderline individuals are not very good at maintaining long-term relationships. They expect others to do all the work without realizing that this is their expectation.

Most fully-functioning individuals understand that maintaining a relationship requires both parties to keep the lines of communication open, both parties to make an effort to keep in touch. A Borderline individual usually makes no effort to contact "old" relationships unless they are desperate for some kind of contact from anyone because their current relationships are not meeting their needs. This is why I refer to them as the "doll people". They seem to "put you on a shelf" when they don't need you and expect you to stay in place just in case they need you again. Fully-functioning individuals understand that others do have lives outside of their relationships. Fully-functioning individuals understand that if another person is not instantly available it is not necessarily a personal affront but simply the other person being busy. A Borderline individual does not seem to be able to grasp this concept and they may become very upset if you are not readily available when they want to interact with you.

Another characteristic of Borderline Personality disorder is the intensity with which they begin a project or hobby. They may seem to be consumed by the project, and any social interaction surrounding the new activity such as online forums or local interest clubs. However, their intense interest will quickly fall to the wayside, not necessarily because something else comes along but because they are not capable of maintaining the intensity of interest for extended periods of time. This sprinting of interest also extends to potentially harmful behaviors like over-spending, sexual promiscuity, substance abuse, alcohol consumption, overeating, gambling, or reckless driving. The plus side is that their extreme interests in these detrimental behaviors will be short-lived. The down side is that some damage may already be experienced before the disinterest occurs.

Borderline individuals may experience moments of intense dissatisfaction and disinterest with life, irritability, or anxiety about abandonment. These moments do not generally last longer than a couple of days, however. The individual may also experience chronic feelings of emptiness between these episodes. Occasionally, they may have problems controlling their anger, frequently displaying intense temper tantrums or even violent fits of rage at inappropriate times. They may not always have a full grasp of the actual source of their anger, either.

They may engage in frantic or desperate behaviors to avoid real or imagined abandonment, sometimes to the extreme of "dumping" a person before they are dumped themselves. They may also engage in suicidal behavior--threats, gestures, self-mutilation--that are not necessarily related to depression or suicidal desires. Rather, these behaviors may be an attempt to pull a person into a care-giving position for the Borderline individual. The suicidal behaviors may (or may not) also be related to the Borderline individual's identity disturbance--unstable self-image or sense of self--which is where the label derives its meaning. They are "borderline" because their personality is not stabilized. It is dependent upon their relationships with others, even though they are not capable of maintaining those relationships themselves. A Borderline individual may also experience paranoia regarding another person's abandonment of them.

What makes Borderline Personality Disorder a dangerous situation is the volatility of the behavior of the individual. The unpredictability and their constant shifting of interest from intense to complete disinterest makes them mostly unpredictable. You don't always know when they may explode or abandon you because they don't know. You may feel like they are the perfect lover, husband, wife, mother, father, or friend one moment, and the next moment they drop you like a hot potato to pursue another relationship. If things don't go smoothly in that new relationship, they may call you up as if nothing really happened between you. They require a stabilizing force in their lives in order to solidify their personality, but the very nature of their personality disorder prevents them from maintaining the stable relationships.

Unless you have saint-like patience and devotion, beware the doll-people.

Histrionic Personality Disorder

Remember when your parents would tell you that some kid was acting up just because they wanted attention? Well, it is possible that they could have been right. There is a relatively rare personality disorder in which the primary motivation for all behaviors, positive and negative, is to gain the attention of others.

Personality disorder: disorder in which a person adopts a persistent, rigid, and maladaptive pattern of behavior that interferes with normal social interactions. There are 10 listed personality disorders in the DSM-IV-TR, 7 of which made the list in the DSM-V. In the DSM-IV-TR, the personality disorders are broken down into three basic categories, or clusters. Cluster A is the odd or eccentric types, usually seen as "weird" by others. This includes the paranoid, schizoid, and schizotypal personality disorders. Cluster B includes the dramatic or erratic types, typically individuals who tend to over (or under) react to things. Within this category are the antisocial, borderline, histrionic, and narcissistic personality disorders. Cluster C is known as the anxious or fearful category. Individuals fall into this grouping when their main emotional response seems to be an over abundance of caution, fear, and/or anxiety. Found in this group are the avoidant, dependent, and obsessive-compulsive (not to be confused with obsessive-compulsive disorder, an anxiety disorder) personality disorders.

Histrionic Personality Disorder: characterized by a tendency to overreact and use excessive emotions to draw attention from and manipulate others. This individual thoroughly enjoys being the center of attention. However, unlike the narcissistic personality disorder, histrionic individuals do not care if the attention is positive or negative, so long as they are in the midst of it. Individuals with this type of personality disorder have a tendency to "make a mountain out of a mole-hill" and are sometimes referred to by others as "drama queens/kings." Attitudes may change rapidly, along with moods, and great pleasure is derived from shocking others with their behaviors, appearances, and/or opinions. It is not uncommon for someone with a histrionic personality disorder to dress completely inappropriately for the social situation (e.g. a young woman wearing a low-cut, provocative dress that shows off as much as legally possible to a funeral) or to attempt to pick a fight (verbal or physical) with someone if they are not already the center of attention. When one situation is "milked" for all it can be--friends get tired of praising them for their promotion or congratulating them on their new boyfriend/girlfriend--these individuals may manufacture another situation in order to regain the center of attention. They might quit their job, complain about some real or imagined hardship, use another person's dilemma to their own advantage (e.g. "feel sorry for me because my cousin's dog was run over"), force a break-up with their significant other in order to generate sympathy, get a piercing or tattoo in order to elicit comments from others, or make shocking statements to see how others respond. Fishing for compliments is also a common behavior for these individuals.

The root cause of histrionic personality disorder is not fully understood. Some theorists suggest that a mismatch between the child's character and the parenting style with which they were raised could be the culprit. Some suggest that there is a genetic link, as this type of maladaptive behavior sometimes runs in families. Others theorize that the children picked up the behaviors from their parents or others who may have had the same disorder. Still others suggest that the children did not receive the right amount of attention that they needed, and thus lash out for any kind they can get as adults.

As with other personality disorders, it is not always easy to identify behaviors as disordered, unless you have more exposure to the individual and detect significant patterns. It is also highly unlikely that the individual will see anything wrong or maladaptive with their behavior, assuming the rest of the world needs to change, not themselves. This is what makes treating personality disorders so difficult. A key component to the success of all psychotherapy is the desire on the part of the client/patient to want to change.