Blinded by Love

Borderline personality disorder (BPD) is marked by instability in many aspects of life, most remarkably in identity, emotions, and relationships. At its core there is a debilitating fear of abandonment which maladaptively evolves into a self fulfilling prophecy. All of this combined produces dysfunctional relationships which are still ultimately guided by an all consuming feeling of love. This is because positive emotions are also exacerbated by the emotional intensity of the disorder which is nonetheless inseparable from the instability which brought it to existence. To have BPD is to so desperately crave affection and security but to simultaneously be unable to detach relationships from the overpowering belief that any intimate contact will inevitably lead to abandonment. Thus, in the search for love those with BPD become blinded by their misconceptions of it, in which the nebulous idea of what it means to be loved is synonymous with pain and mistrust. This produces a cyclical pattern of highs and lows, love and detachment, feelings of emptiness, and externalizing behaviour, which altogether leads to a significant decrease in life expectancy, Temes CM et al. (2019). 

Traumatic childhood experiences are common amongst people with BPD (Lobbestael, Arntz, & Sieswerda, 2005). Early aversive experiences alter many aspects of cognition through the development of schemas based on beliefs that others cannot be trusted, which ultimately guide how later relationships will be perceived. Young, Klosko and Weishaar (2003) proposed that those with BPD have an ‘abandoned child schema’ in which later experiences that resemble childhood neglect reactivate a feeling of helplessness and the belief that they can’t survive on their own, similarly to that of an abandoned child. This regression into a child-like state leads simultaneously to a longing for emotional support and a distrust induced fear of it, resulting in frightened isolation (Kellogg, S. H., & Young, J. E., 2006), where not unlike a toddler it’s difficult to self soothe. Moreover, interpersonal stressors can also result in the activation of the ‘punitive parent mode’, which leads those with BPD believing they are deserving of punishment. This can serve as an explanation for the self-injurious behaviour which is prevalent in 40-90% of people with BPD (American Psychiatric Association, 2004), and is even included as one of the diagnostic criteria.  Lastly, feeling abandoned can also activate the ‘angry child mode’, which is ultimately an expression of self preservation brought on by feelings of mistreatment, that nonetheless has negative implications with regards to relationships. This exemplifies the predicament people with BPD find themselves in; the convergence of all of these maladaptive schemas makes them less likely to receive the social support they need to thrive (Brodsky et al., 2006), and consequently their needs not being met further reinforces the modes that are already in place.

Paranoid ideation – which involves perceiving otherwise normal behaviour as hostile – is present in 86.6% of patients with BPD (Zanarini, M. C., et al., 2013), often as a manifestation of rejection sensitivity, which is a disposition to readily anticipate abandonment. Its cause can often be attributed to early experiences of childhood rejection, most predominantly emotional neglect and conditional love (Foxhall, M., et al., 2019), where love is only expressed under certain circumstances. This rejection sensitivity even affects sensory processing as people with BPD are extremely attuned to others’ facial expressions, and this is particularly intensified for negative expressions as well those that could signify abandonment (Schmahl CG, et al., 2004). It’s therefore only natural that this perceptual enhancement could lead to feelings of severe paranoia due to a higher (and biased) appraisal of others as hostile. This fear of rejection is further magnified by history of past abandonment, which is a common denominator in many cases of those with a BPD diagnosis. Such prolonged experiences of rejection lead to defensiveness. Even subtle cues of rejection – which are more readily perceived by people with BPD – are enough for those with rejection sensitivity to take an offensive stance, characterized by subsequent aggression and/or withdrawal (Schmahl CG, et al, 2004) (as an attempt to react to a threat in a way that minimizes its psychological damage). This is possibly due to the activation of the ‘abandoned child schema’ and ‘angry child mode’. Essentially abandonment will hurt less if you can anticipate it and pre-actively react, but the problem arises when its anticipation can be attributed to paranoia rather than the recognition of a real threat. Consequently, such behaviour – while under the guise of self preservation – more often than not negatively impacts relationships. Thus, a repeating cycle emerges, where the fear induced coping mechanisms elicit real rejection (Downey, et al., 2004), and this further reinforces the pre-existing fear. Therefore, this fear of abandonment paradoxically manifests itself into reality, as the paranoia induced maladaptive behaviour turns it into a self fulfilling prophecy.

One of the primitive defense mechanisms adopted by those with BPD is called splitting, which involves cyclically spiraling through periods of idealization and periods of devaluation of their loved ones. Splitting is commonly overcome in early stages of development, and the failure to learn how to integrate opposing feelings results in the development of dichotomous thinking which has been proposed as the mechanism underlying BPD’s cognitive, affective, and interpersonal difficulties (Napolitano, L.A, et al., 2007). The act of splitting is often a consequence of the activation of negative schemas, such as those of abandonment and rejection (Beck, 1999), and despite it being a defensive process against psychic conflict (Kernberg, 1975), it quickly becomes dysfunctional due to BPD’s biased appraisal of others as dangerous. Ultimately, splitting is an expression of an old survival tactic where to quickly shift from affection-seeking to self-reliance enabled those with BPD to more adequately navigate early aversive environments. Undeniably this can easily become dysfunctional when it’s also adapted in healthy relationships. The need for survival becomes no longer grounded in reality, but rather a trauma induced misinterpretation of loved ones as an active threat. These abrupt shifts of emotions can overpower any sense of self preservation, ironically leading those with BPD to end the very relationship they once feared would end against their will (Clifton, A, et al., 2007). Thus, further establishing the pattern of unstable social connections, only this time in a self imposed manner. Essentially, to be able to anticipate abandonment and quickly detach yourself from the relationship is a form of self preservation, but to perceive any sign of instability – which is an unavoidable element of all relationships – as an active threat will result in unnecessary stress, and potentially interpersonal conflicts. The borderline personality organization theory proposes that splitting is an expression of two opposing forces: the need for emotional support, and an overwhelming fear of it (Otto F., wt al., 2008). Thus, this results in rapid oscillations between emotional patterns of approach and retreat. Cognitive psychologists suggested that these different strategies – and their accompanying polarized emotional state – are a result of dichotomous thinking, and the opposing beliefs that the person with BPD needs the presence of others for survival, and that those people cannot be trusted (Beck, Freeman, & Associates, 1990), similarly to that of the abandoned child schema. Therefore, splitting is a way to deal with real rejection, but it can also be the cause of it, ironically protecting the person with BPD from the pain it brought to existence.

In essence, BPD is a lonely disorder, guided by a desperation for love which, through its maladapted means, paradoxically results in isolation. The irrationality of the disorder turns the fear of abandonment into a self fulfilling prophecy, further contributing to paranoid ideation, reestablishing negative schemas, and preventing development past the primitive splitting. But it’s not all hopeless. This longing for acceptance and security can be fulfilled, that is through adequate treatment, namely Dialectical Behavioural Therapy. The skills taught in therapy eventually enable the preservation of secure relationships, which in turn positively contributes to further recovery (Larivière, N., et al., 2015). With this a new cycle emerges, only this time it’s based on continuous improvement, where love and stability foster each other. The search for security no longer leads to its demise, and to be guided by love doesn’t entail being blinded by it.<<