In detail

The Borderline Personality Disorder

The Borderline Personality Disorder

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Video about the TLP

Before we can talk specifically about the TLPIt is important to understand what personality is and when you can talk about disorder.

The personality It is the set of traits that best describe the way of being, of being and of behaving habitually of an individual. And thanks to this, it is possible to predict quite accurately its operation in other contexts, activities or vital situations. Personality traits only constitute personality disorders when they are inflexible and maladaptive and when they cause significant functional impairment or subjective discomfort.

Once we know this you can talk about the Borderline Personality Disorder. At a general level it could be defined as a general pattern of instability in interpersonal relationships, self-image and affectivity, and a remarkable impulsivity that begins at the beginning of adulthood and occurs in various contexts. Of the personality disorders is the most prevalent, about 2% of the population suffers.

The DSM-V (manual of diagnosis of mental disorders) talks about the following criteria to be able to diagnose this disorder (they must manifest at least 5):

  1. Desperate efforts to avoid homelessness Real or imagined.
  2. Pattern unstable and intense interpersonal relationships characterized by an alternation between the extremes of idealization and devaluation.
  3. Identity alteration: intense and persistent instability of self-image and sense of self.
  4. Impulsiveness in two or more areas that are potentially self-injurious (eg, expenses, sex, drugs, reckless driving, binge eating).
  5. Recurring behavior, attitude or threats of suicide, or behavior of self-mutilation
  6. Affective instability due to a remarkable reactivity of the mood (eg, intense episodes of dysphoria, irritability or anxiety that generally last a few hours and, rarely, more than a few days).
  7. Chronic feeling of emptiness.
  8. Anger inappropriate and intense, or difficulty controlling anger (e.g., frequent display of genius, constant anger, recurring physical fights).
  9. Paranoid ideas transient related to stress or severe dissociative symptoms.

It is important to comment that although these are the diagnostic criteria, it is often difficult to find people who manifest the symptoms of the borderline disorder in a similar way. Therefore, it is important to focus on each case, and perform a good evaluation and diagnosis at a descriptive and functional level.

In relation to treatment, for this type of cases the ideal is a combined treatment, that is, psychotherapy together with pharmacological treatment (SSRIs and atypical antipsychotics are usually used).

In the psychological treatment, we must bear in mind that one of the great challenges in this type of case is to create a good therapeutic alliance, the emotional instability experienced by BPD and relational difficulties also lead to many controversies in the therapeutic process, so it is important from the outset to explain the framing and limits of therapy.

In relation to intervention objectives, authors such as Millón, Linehan and Young suggest that the treatment should focus on establishing a clear sense of identity, improving the ability to control emotions and changing beliefs and misfits assumptions. Therefore the cognitive behavioral treatment It is usually one of the approaches of choice, since it is necessary to work both behaviorally, emotionally and cognitively.

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Gunderson, J. (2002). Borderline Personality Disorder: Clinical Guide. Barcelona: Ars Médica.