Borderline Personality Disorder is Real .

The term Borderline, like the disorder it describes, is subject to constant lively discussion in the mental health community. The noted BPD researcher

Those with BPD live very difficult lives and although there is hope in many ways for treatment that can lead to a more satisfying life , it is a long and hard road with many ups and downs and constant treatment is a very important factor in determining whether the Borderline will or will not recover.

Although different for every single person in how they experience the symptoms of BPD the list below is very common that the Borderline will experience these criteria of the disorder.

1. Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in (5).
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. This is called "splitting."
3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in (5).
5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
6. 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).
7. Chronic feelings of emptiness.
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

What is BPD?
Treatment Options
Treatment Modalities

It is vitally important that the patient get a good psychiatric evaluation by a board-certified psychiatrist who specializes in personality disorders before treatment begins. It is worthwhile to do this because the course of the patient's entire treatment may be determined by an initial evaluation. Local chapters of mental health organizations (i.e. the American Psychiatric Association) can help patients and families find such a practitioner in the patient's general geographic area.

By the time a family member has been diagnosed as suffering from a borderline personality disorder, so much stress has been generated in the family that everyone is affected. For this reason, it is advisable for the entire family to seek support services.

If outpatient therapy reaches a stalemate or is interrupted by repetitive suicide attempts, or if the patient cannot stay consistently with a therapy and continues to disrupt his or her own life and that of others, the family and patient may want to seek consultation in a center specializing in the treatment of borderline personality disorder. A thorough assessment may lead to the recommendation of a more specific individual therapy, adjunctive group or family therapy, referral to substance abuse treatment, or more intensive treatment in the form of hospitalization or a day hospital program.

Day hospital treatment, where the patient is committed to attending daily therapy sessions and workshops but resides at home, is helpful both in enabling patients to understand their problems and how these affect others, and also in bringing patients into close daily contact with others who are working on those problems. Borderline patients tend to support each other-sometimes in a negative way, to be sure, but more often in a very positive way. Articulate, candid and forthright, they are often extremely effective in cutting through the denials and excuses and the blaming of others that so hamper a person's ability to see his or her own problems. The recognition of the illness and the determination to overcome it have everything to do with successful treatment.

Without adequate treatment, the illness is lifelong, and all too often ends in suicide. With good treatment, the outlook is very favorable indeed in many cases. Among the 500 borderline patients studied by Dr. Michael Stone at the Columbia Psychiatric Institute over more than 20 years, 4 out of 10 are clinically recovered 10-20 years after their point of entry into the study during hospitalization. Seventy-five percent are self-supporting and doing reasonably well. The suicide rate was 7% as of 16 years post-admission. The patients who recovered tended to be those who persisted in psychotherapy over many years.

Psychotherapy Approaches

Treatments for BPD have improved in recent years. Group and individual psychotherapy are at least partially effective for many patients. The individual outpatient psychotherapy for the borderline patient usually consists of 2-3 therapy sessions a week over a period of years. The therapist works with the patient to understand the meanings and motives of his or her behavior, and to strengthen his or her capacity to endure frustration, anger and loneliness without acting impulsively upon those feelings.

One form of therapy that is psychodynamic in nature, is known professionally as transference-focused psychotherapy (TFP). This therapy is geared primarily at understanding the underlying causes of the patient's borderline condition and working to build newer, healthier ways of thinking and behaving for the patient.

STEPPS:

STEPPS is an acronym for Systems Training for Emotional Predictability and Problem Solving. The approach of this treatment is cognitive-behavioral and based around skills training. BPD is regarded as a emotional and behavioral regulation disorder, and therefore learning emotion and behavior regulation skills is the primary goal of treatment. In addition, professionals treating the BPD patient, as well as the patient's family members and close friends are taught methods of reinforcing and supporting the new emotional and behavioral regulation skills, reducing the likelihood that the patient will practice "splitting" with those in their social support system.

Supportive Psychotherapy:
Medication Support
DBT Therapy
Art and Crafts Therapy
Family and Friend support
Hospitalization
Group Therapy

There is hope for the borderline to recover and get better, keep in mind that BPD has no cure but we do get better with these support and treatments to guide us through.

Anger is often one of the most obvious traits of borderline personality disorder (BPD), as so often the anger seems explode without warning and can be extremely intense.

The anger of the BP is hard to miss, as it is often an attack, meant to hurt back, and meant to defend. It seems to come from nowhere, a suddenly explosive rage. The BP may not even understand why she feels so angry, just that she feels this way.
Anger In Place Of Other Feelings

For those with BPD, anger often develops from other unexpressed and uncomfortable feelings, such as frustration, sadness, disappointment, and anxiety that the BP is unable to experience or express. The life of the BP, like anyone, is full of frustrations, disappointments, and stresses, but the BP can be unable to process them effectively, inadvertently storing them.

Anger can derived from these pent-up feelings.

Anger tends to be an emotion that can be easier to recognize and express. The BP may be able to respond, or react, to the anger, but not other emotions.
What Triggers the Anger Outburst?

Anger can be an omnipresent feeling for those with borderline personality disorder. It may be that it is always there, sleeping and not noticed, but easily awakened. Once awakened, the anger makes its presence known, loudly and ferociously, almost like a hibernating bear.

The angry outburst is experienced by the BP as a reasonable reaction to threat, attack, or hurt by the target of the rage. The target, or recipient, of the anger attack may be completely caught off-guard, unaware of what they did to trigger this reaction. The BP's anger can have a hair trigger; little is required to set it off.

Often the BP feels raw, hyperaware of every potential negative be it a slight, danger, or disappointment. Everything feels much stronger: a slight from a coworker can feel like a stabbing pain, overwhelming in its intensity, blocking out all other thoughts. Anger then seems a natural reaction, something to be expected, perhaps even something understandable.
What the Anger Is

It is important to remember that anger, even the explosive anger often so evident in borderline personality disorder, is nothing more than an expression of feelings. Although the anger can seem out of synch to an observer, for the BP the anger is an honest reaction to hurts and fears. It is real.

For the BP, feelings of anger are very strong and often have a lot of old "baggage" behind them. It is not always clear to the BP, or those witnessing the anger, how the "baggage" is tied to the current target or event that triggered to interaction. However, for the BP, the old feelings, or baggage, were triggered and the current reaction is an honest display of her feelings. A display meant to protect, or defend, and to communicate.

* Anger As a Protection and Defense Against Hurt
* Communicating Through Anger

Rage is a very challenging and difficult aspect of Borderline Personality
Disorder, (BPD) for both the person with BPD and those who know someone with
BPD. The degree to which rage effects those with Borderline Personality Disorder
(BPD), like the degree which rage manifests itself, can be a very individual
experience. Rage is encompassed within the Borderline trait:

intense anger or difficulty controlling anger; frequent displays of temper"
(listed in the DSM-IV)
Some people with BPD will manifest this rage inwardly through self-harm,
suicide attempts and others will manifest it outwardly by either showing "fits
of rage, temper, anger" (yelling - push/pull behaviour -- the "I hate you don't
leave me" kind of thing) or through emotional abuse and physical abuse of those
closest to them and or toward therapists. And some borderlines will express this
rage both inwardly and outwardly. In my Expierience I feel Rage all of the Sudden and It usually is brought on by someone not giving me my nway, or challenging Me in one way or another. Foe Example, Today The Landlord of my Aprtment would not fix the Lock on the door, he said it was our responsibility, I felt wronged in this situation but he would not Listen to me ( could be that he did not understand English) So I started cursing and Yelling and feeling this intense Anger inside, sense of Rejection and Hurt, I was At the boiling Point and had to walk away, I imagine that in this instance and others that I feel Wronged , I rage because I feel that I am not in Control and I think that by Bringing it to the next level and combatting with Anger I can get my way and be right. I am not sure of all the Reasons That I get Angry and have this Inappropriate reaction to Authority and others that have Control over me or Stir up this Rage in Me But I know that It may have to do with always feeling like the Victim and that as a child My family never told me "NO" or at least not for very Long. I know that my Anger is also a feeling of coping with the Inner turmoil inside of me, The Guilt over Relapsing, The shame and fear that consumes me and my Helplessness to make positive changes, a way of making others see things my way, a cry for help.. it is very Common that Alcoholics and Addicts as well as those with Severe Mental and Emotional Instability have a strong Inability to Control their Anger or any Emotions at all. It is also common that the Borderline Lashes out at others in order to take some of the Blame off themselves for their shortcomings in Life and To escape the Constant feeling of Being Emotionally Trapped. When I feel angry I feel out of control, Like this adrenaline stirs in me and I react suddenly in these intense and outragous ways , Often resulting in Harm to others but mostly to myself as I then Burn the  Bridge and often more than One. My anger is caused by Pain, Fear, and overall Feeling of Helplessness to solve the problem with a Pòsitive result in my favor. Like I said, I do not know why Myself or others have such Rage But Know that it is not the Correct response, But only one I know, either I lash out against others or Myself. I feel the need to escape what I am feeling at that the person I am angry with wants me to fail, be misrable, and Not be Happy.. This is the best way I can explain it right now but I know it is something that needs strong examination as It is one of the most destructive behaviors I face Another Brief Piece I found on the Subject that May shed some Light )

What is Raging?

Rage is a shame based expression
of anger. Rage is by definition abuse. Ragers react to strong emotions with
rage. (i.e. feelings of  fear, sadness, shame, inadequacy, guilt or loss convert
to rage.) Ragers were typically shamed or punished by
their caretakers for expressing emotion when they were young; i.e.: "Be a man
and don't cry", "Nice girls don't get angry";"I'll give you something to cry
about".Raging gives the rager a feeling of
power offsetting their shame and feelings of inadequacy .Rage sets
up a neurochemical reaction in the brain that can be addictive, producing what
is known as rageaholism or ragaholics,Screaming, physical expressions of anger, violence or threats of violence,
sulking, manipulation, emotional blackmail, silent smoldering, and anger used to
Healthy expression of anger involves confrontation of what makes you angry
and an effort to set  boundaries. (What you will do in response to what makes
you angry.)
When you (a behavior), I feel (a feeling) , and to protect myself I will
Healthy anger is not used to punish, is not violent, and isn't used to
intimidate, control or manipulate. It is expressed, discussed, and moved
through. Healthy anger is not stuffed down and ignored. (Stuffed anger
created resentment and a wealth of physical / mental and emotional problems.)
Healthy anger is not expressed in passive aggressive and manipulative ways.
Anger and Addictions">Unhealthy
Anger is component of Alcoholism, Addictions and Abusive Relationships. Anger management is critical to recovery from addictions and
trauma, childhood sexual mental or physical abuse, and relationship recovery. 
Addictions are in part a coping mechanism to deal with feelings by masking them.
Alcoholics and Addicts often "use at" the source of their
anger. (i.e.: I'm angry at ______ so I'll have a drink, take a drug, or act out
sexually.  Obviously this is a highly self destructive response to
anger.

Borderline Personality Disorder results from stunted emotional maturation at any early stage of development. This results in the person diagnosed with BPD being stuck in a child-like place from the past that then becomes an inappropriate place to be emotionally in adulthood. This results in so much of the maladaptive behavior generated by those who are borderline. This personality disorder can be recovered from. Change is necessary. Change in the way one thinks, feels, and acts. Learning to re-parent oneself so that one can grow past the point where emotional maturation was interfered with usually by abuse, sexual abuse and/or an invalidating environment. Change is a part of life. Radically accepting that change is necessary part of life can mean the difference between what you can learn to make manageable difficult moments, hours, days, or truly a lifetime of what feels like endless suffering. For the Borderline, however, change has likely always felt very threatening. This, in my past and present experience, went back to the fact that it was what I experienced change as - namely abuse and all the very painful things I had to endure - that left me unconsciously for years trying to avoid change.I still continue to avoid change and most times do not know how but even with all my unresolved issues I know that If I do not change then my life will not get better..I can blame my disorder all I want but I still have some say in my choices. Avoiding change or refusing to change is really a choice to stay stuck. Yes, a choice. I know it doesn't feel like a choice but those with BPD make so many choices often at subconscious levels to protect themselves. What doesn't seem to be realized, often, is that it is this very aversion to change that keeps borderline stuck making the same choices over and over no matter how much evidence that those choices don't work is available in the way things aren't working in life. When you have been hurt and have learned fear you learn to protect yourself at all costs. The very protection that you think you will keep you safe and the very maladaptive defense mechanisms employed in the war against maturation amount to the "borderline behavior" that keeps you from getting healthier. If you can step back and realize that what you are doing today, in the here and now, as someone with BPD, isn't working in your life, isn't making you or those around you happy, then you will be able to realize on some level that change is necessary. Change can be threatening. It can feel very scary. Even though what you know in your life, if you have BPD, is that most of your attempts to relate to others and to feel good about yourself have left you hurting like hell and not much works out, especially relationally, still the thought of trying new ways of thinking, feeling, and behaving just mirrors your worst fears based upon the unresolved losses from your childhood.

Borderline personality disorder is the most common personality disorder. It occurs in about 2% of the population. Symptoms usually flare up when a psychological stressor occurs, such as the threat of a break-up. When the stress subsides, the symptoms usually subside as well. People with borderline personality disorder may even experience brief periods in which they separate from reality. This disorder often overlaps with dysthymia (milder, longer lasting form of depression) and psychotic disorders. Nearly 90% of those with borderline personality disorder are also diagnosed with another personality disorder or major mental illness. The major characteristics of borderline personality disorder are: Unstable personal relationships People with borderline personality disorder fear abandonment and make desperate attempts to maintain relationships. However, their perception of relationships is so unstable that a friend can become an enemy over an ordinary disagreement. Unstable self-image This disorder is characterized by marked uncertainty in major life issues, such as life goals, sexual orientation, values, career choices, or types of friends. Unstable emotions Their emotional state can fluctuate dramatically from euphoria to intense anxiety to rage in a matter of hours or days. Typically, these emotional fluctuations are reactions to social interactions. Little control over impulses Reckless impulsivity may cause people with this disorder to act in self-destructive ways such as driving dangerously or bingeing on food, alcohol, or sex.

People with BPD require great care and understanding and the best way to do that is to adopt the S.E.T. set of principles. It is a way to help and support the person with Borderline without enabling them or further supporting their behaviors . The S is for Support , be there for them and tell them you love and care and just be a rock for them in their time of need. The E is for empathy , try to get on their level and show them your understand, identify with what they are going through; this will help them feel less chaotic . The T is for Truth ; be honest with them, try to tell them exactly what you feel and tell them what is really happening; try to get past the distorted thinking so common with BPD. This model has worked for many in dealing with the Borderline and can make life easier for the person dealing with The BPD and for the Borderline themself.

In my experience, the most profound area of life that is affected by BPD is that of relationships. In my experience, this was the case right from my relationship to and with myself and continued on to anyone that got close to me. I am usually my craziest in relationships; I figure I can only vent to those that love me and that they will not leave me for such behaviors but for myself and any Borderline, this behavior is not acceptable and not healthy either; we act out because we do not know what to do with these feelings and it is not our intention to hurt anyone by our rants and raves but at the same time we need to try and be responsible for our actions and others can help us do this by treating us with care and understanding and seeing that these outbursts are BPD and not the individual person; fight the disease and love the person.

Constantly I hear people blaming Borderlines for their actions but it is not our ( their ) fault that they act the way they do. Would you blame someone who had Cancer or Aids for their disease ? No, this is no different, although the Borderline should learn to be responsible for their lives and actions they have to work on that and cannot just change the way they feel and ignore the symptoms. People also say that we as Borderlines use our illness as an excuse for things, this angers me greatly as they do not know how difficult it is to live with this disorder and how it impacts every aspect of their ( our ) lives, This is another thing that must change, people need to stop blaming the Borderline person for their illness and start trying to understand and help them.

May is Borderline awareness month and congress has said this as well; hoping to dmystify this horrible and complex illness. It has been recognized by Congress and there is the hope that more and more people will stop ignoring those who suffer from BPD and start realizing and accepting that it does indeed exist and do something to help those afflicted by it. Show your support , care , and understanding about the Borderline in your life.