Are borderlines perfectionists? (9 symptoms of BPD)

In this article, we will answer the following question: Are borderlines perfectionists? We will talk about the symptoms of BPD and treatment options. 

Are borderlines perfectionists?

Borderline people are often perfectionists. Specialists describe perfectionism as a combination of two factors: extremely high personal standards and the evaluation of oneself in a very critical way. Borderline patients have a persistently unstable self-image or self-awareness, which can be made worse by perfectionism.

Against the background of anxiety and depression caused by perfectionism, physical health problems, such as gastrointestinal disorders, can also occur. Inflammatory bowel disease could be associated with perfectionism and mental disorders, although studies are still being done on the subject, with researchers looking for evidence to confirm this link.

Insomnia often occurs against the background of perfectionism and obesity, which we know has some risks and can have many complications. What is even more harmful is the fact that society promotes this perfectionism as an asset. Perfectionism can cause several health problems, both physical and mental.

Other associated conditions with Borderline disorder that can be accentuated by perfectionism are: 

  • major depressive disorder
  • anxiety disorder
  • bipolar spectrum disorder
  • post-traumatic stress disorder
  • ADHD (Attention Deficit Hyperactivity Disorder)
  • alcohol-induced mental disorders
  • drug-induced mental disorder
  • impulse control disorder
  • eating disorders (bulimia, compulsive eating).

To better understand the connection between Borderline Disorder (BPD) and perfectionism, let’s explore BPD symptoms. 

Symptoms of borderline disorder

To be able to make the diagnosis, according to the current criteria, the person must present 5 of the following 9 symptoms:

(1) Desperate efforts to avoid real or imaginary abandonment.

For example, the person tolerates separations extremely difficult, tends to call/look for his partner very often, endures with anger and pain delays, delays, refusals, and often has jealousy attacks, with multiple accusations for the smallest real or imaginary violation of expectations. 

The person will find it very difficult to accept the end of a relationship, sometimes insisting months/years with phones and messages. It can also be difficult to bear the therapist’s vacation/absences/mistakes, with many angry moments related to “how little he/she matters” to the therapist.

(2) A pattern of intense and unstable interpersonal relationships, characterized by alternation between the extremes of idealization and devaluation.

The person frequently alternates in relationships of friendship, love, therapy, between moments of maximum emotional outpouring, in which the other is “wonderful/perfect / best”, and then, if he feels/implies a rejection/violation of expectations, to think and to react angrily, arguing that the other is “the worst / devil/bastard/”. He may impulsively decide to “break” the relationship, so a little later, to reconsider the decision, arguing the opposite.

In general, life and people are seen in “black and white”.

This pattern of relationships led to writing a famous book about BPD: “I Hate You, Don’t Leave Me”, 1991, by Jerold J., M.D. Creation, Hal Strauss.

(3) Identity disorder: marked and persistently unstable self-image or self-awareness.

The person may have frequent moments when the opinion about himself is extremely negative, sometimes going to self-hatred and feelings of complete worthlessness, the uselessness of his own existence, alternating with moments of pride, strong conviction of the justice of his own opinions. / opinions, possibly with the devaluation/irony of others.

The opinions about what matters/want to achieve in life are changing, but the person is always convinced of the current decision’s permanence.

(4) Impulsivity in at least two potentially harmful areas (eg, spending, sex, substance abuse, reckless driving, compulsive eating)

Alcohol and drug use can be a very common problem and aggravate the course of the disorder. Unprotected, impulsive, and sometimes compulsive sex also occurs in both sexes and can lead to serious diseases (HIV, hepatitis).

The person uses such behaviors as a mechanism to calm extremely intense and painful emotions, to alleviate the pain felt related to abandonment, against boredom and inner emptiness, as an expression of hatred towards oneself / others or, on the contrary, as an expression of strength. 

(5) Recurrent behavior, gestures, or threats of suicide or self-harming behavior.

It is the most easily recognizable feature of the disorder and the one that, through the difficulties it raises, has led to the shaping of the opinion of specialists that borderline disorder “is impossible to treat”.

The trait occurs in the most severe forms of BPD.

The person often uses threats and suicide attempts, as a solution to psychological problems, psychological pain felt negative self-image. Often, the person may have major depressive episodes. Suicide attempts are serious and complete suicide is possible.

Interpersonal relationships can be severely affected by these permanent dangers and vital emergencies, being difficult for the life partner, parents, therapists to continue relationships in such a dynamic.

Self-mutilation is extremely varied. From cuts to hands and feet, burns with cigarettes, sources of chemical burns, swallowing of sharp objects, and self-administered blows with palms and fists. Many self-mutilation are dangerous to health (infections), others leave unsightly scars.

Self-mutilation can be impulsive, done “on the nerves”, to calm a psychological pain, to “wake up” a reaction when the psychological vacuum is too terrifying, as a method of self-control in the face of psychological and relational instability.

(6) Affective instability due to a marked reactivity of the disposition.

For example, intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).

The reactivity of the mood is one of the most painful aspects of BPD, because even the emotional reactions to ordinary stimuli are extremely intense, “hot”, the intensity of the emotion reaching very quickly the “temperature” maximum. Their duration varies greatly from hours and days to weeks, and can sometimes warrant an additional diagnosis of major depression or anxiety disorder. The association with bipolar disorder or cyclothymia is common.

(7) The chronic feeling of emptiness.

People with BPD often describe this feeling of “inner emptiness” or “emptiness” as a complete lack of internal emotions, sometimes so strange and unbearable that they may resort to self-harm as a way of feeling something. Sometimes they describe the condition as a feeling of deep boredom or a lack of meaning in life, coming from a position of life such as “I’m not OK, others are not OK, life has no meaning.

(8) Intense anger, inadequacy or difficulty controlling anger

For example, frequent expressions of anger, permanent anger, repeated beatings.

Frequently, abandonment, rejection, or disappointment of expectations cause extremely intense states of anger, for which justifications appear in the waves until the anger reaches maximum intensity. 

Sometimes it leads to verbal or physical aggression, broken objects, other destructive acts did impulsively, but it can also be expressed through self-aggression: either self-harm or involvement in acts that are aggressive towards oneself (alcohol, drugs, dangerous sexual acts, compulsively eaten).

(9) Paranoid ideation or severe, transient dissociative symptoms related to stress.

As a justification for the anger or devaluations of others, transient moments of paranoid ideation, sometimes of psychotic intensity, may appear, which resolve quickly. Sometimes dissociative phenomena appear, with sensations of derealization or dissociation: “it was as if I was no longer me, the world was turbulent, I felt as if I were being followed from the outside,” etc.).

Can Borderline Disorder be treated?

The treatment is almost exclusively psychotherapeutic, the drug treatment is intended for comorbidities.

Psychotherapy is generally a long-term therapy of 5-7 years. Psychotherapy is marked by numerous interruptions and changes by psychotherapists. Therefore, before deciding to stop the treatment or change the therapist, an analysis of the therapeutic relationship is necessary.

There are therapies specially designed for BPD, the effectiveness of which is supported by long-term studies:

Dialectical Behavioral Psychotherapy (DBT).

Developed by Marsha Linehan in the late 1970s, DBT became the gold standard for the treatment of the borderline disorder, being recommended by all international guidelines and the World Health Organization.

It has proven effective in reducing suicidal behaviors, self-harm, days of psychiatric hospitalization, and depression. It reduced treatment discontinuations, reduced substance use symptoms, impulsivity, and anger, and increased quality of life and overall functioning.

DBT consists of:

  •  individual therapy
  •  psychoeducation group
  •  interview group for psychotherapists

Psychoeducation groups are group therapies designed to develop behavioral skills.

The group takes place as a class in which the group leader teaches the skills and assigns the homework to the clients so that they can practice them in their daily life.

The groups meet weekly for about 2.5 hours and it takes 24 weeks to gain full competencies through the curriculum, which is often repeated to create a 1-year program.

DBT includes four sets of behavioral skills:

  1. Mindfulness: the practice of being fully aware and present at this time
  1. Stress tolerance: how to tolerate pain and stress in difficult situations, not change them
  1. Interpersonal effectiveness: how to ask for what you want and say no, while maintaining self-esteem and relationships with others
  1. Adjusting emotions: how to change the emotions you want to change

Schema Therapy

It was developed by Dr. Jeffrey E. Young for use in the treatment of personality disorders and chronic disorders in DSM Axis I, when patients do not respond or relapse after undergoing other therapies (eg, traditional cognitive behavioral therapy). 

Schema Therapy is an integrative psychotherapy, combining the theory and techniques of previously existing therapy, including cognitive-behavioral therapy, psychoanalytic theory of object relations, attachment theory, and Gestalt therapy.

Mentalization-based therapy (MBT)

MBT is a form of psychodynamic psychotherapy, developed and handled by Peter Fonagy and Anthony Bateman. MBT was designed for people with borderline personality disorder (BPD) who suffer from disorganized attachment and because of this, they have failed to develop a mental capacity in the context of a secure attachment relationship. 

Fonagy and Bateman believe that mentalization is the process by which we implicitly and explicitly interpret our actions and those of others as meaningful based on intentional mental states. The goal of treatment is for BPD patients to increase their mental capacity, which should improve emotion regulation and stabilize interpersonal relationships.

Transference focused therapy (TFP)

TFP is a modified, highly structured psychodynamic treatment twice a week based on Otto Kernberg’s borderline personality disorder model.

It sees the individual with borderline personality organization (BPO), as having representations of self and significant, unreconciled, and internalized contradictorily, representations with a great load and emotional significance. Defense against these contradictory internalized object relationships leads to disturbed relationships with others and with oneself.

Distorted perceptions of oneself, others, and associated emotions are at the heart of treatment because they occur in the relationship with the therapist (transfer). The treatment focuses on the integration of these separate parts of the (split) Self and representations about others because of the consistent interpretation of these distorted perceptions is considered the main mechanism of change.

TFP is one of several treatments that may help treat BPD. However, only TFP has been shown to change the way patients think about themselves in relationships.

Final thoughts

Borderline personality disorder is characterized by emotional instability, difficulties in maintaining interpersonal relationships, self-harm, and suicidal behavior.

The name of this personality disorder – borderline was given because the patient is on the border between psychosis and neurosis. Borderline is a serious mental disorder, which manifests itself through emotional instability, distorted self-image, problems in relationships with others, and serious behavioral disorders. In general, the manifestations of this condition cause problems for the patient, both personally and professionally.

Borderline people are often perfectionists. Borderline patients have a persistently unstable self-image or self-awareness, which can be made worse by perfectionism.

If you have any questions or comments on the content, please let us know!

FAQ on Are borderline perfectionists?

Do borderlines have mania?

Yes, borderline patients can experience mania or depression that can last for weeks, sometimes even months. The mania is usually triggered by something. 

Are borderlines aware of their behavior?

Most borderlines are aware of their behavior, but they have no control over it. Borderline personality disorder is characterized by emotional instability, difficulties in maintaining interpersonal relationships, self-harm, and suicidal behavior.

Why do borderlines get so angry?

Borderlines get angry when they are triggered by something, for example, a break-up, loss of a job, a fight with a friend, feeling criticized or rejected by a loved one, etc. 

References

Borderlineintheact.org.au

Sciencedirect.com

Sciencedaily.com

Divya is currently a Clinical Psychology Trainee in a Master of Philosophy program and holds a Master’s in clinical psychology. She has a special interest in Personality studies and disorders, having researched the subject before, and Neuropsychology; with an additional interest being Mood disorders. She likes to write about Psychiatric issues, having worked in multiple specialty setups during her time as a clinical psychology student, and in her free time she likes to cook and read.

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