Borderline Personality

Ryder and Jolie in Girl Interrupted (1999)

Hollywood is rich in mainstream movies with characters with Borderline Personality Disorder (BPD)- Winona Ryder in Girl Interrupted, Penelope Cruz in Vicky Cristina Barcelona, and Uma Thurman in My Super Ex-Girlfriend to name a few.  Even celebrities themselves have been associated with the disorder- Angelina Jolie, Megan Fox, Lyndsey Lohan, Amy Winehouse, and Christina Ricci to name several. I wouldn’t be surprised if the list of celebrity borderlines ran longer than that of their fictional counterparts.

So what is Borderline Personality Disorder?

Borderline originally earned its name in psychiatry from being thought to be on the “border” between psychosis and neurosis. In lay terms- almost but not entirely crazy (now refer to the aforementioned celebs to see if you get an aha reaction). The disorder is characterized by pervasive instability in mood, self-image, behavior, and interpersonal relationships. This typically means people suffering from BPD have chronic feelings of emptiness and low self-esteem, suicidal thoughts and gestures (cutting), anger issues, and even bisexual tendencies. Marsha Linehan, an expert on BPD, describes borderlines as “the psychological equivalent of third-degree-burn patients. They simply have, so to speak, no emotional skin. Even the slightest touch or movement can create immense suffering.”

Relationships tend to be very intense and unstable. I don’t watch much reality TV, but I’d bet network executives cast borderlines primarily to inject drama into their shows to boost ratings. Borderlines are capable of switching from deep affection and adoration to hostile rage and contempt quicker than you can say Britney Spears.  Breakups are especially difficult. Due to fear of abandonment, borderlines may threaten to hurt themselves if their partner wants to move on or date others.

The cause of BPD is unknown, but almost certainly there is a history of childhood trauma. This includes parental abandonment and neglect, poor communication and disruption in the family, and physical and sexual abuse. Clinically, BPD is often misdiagnosed as Bipolar Affective Disorder (BAD) because of the overlap in mood instability symptoms. The main difference is that borderline symptoms are triggered by interpersonal difficulties while bipolar symptoms are autonomous and independent of relationship stressors. Medications are far less effective for treatment of BPD than BAD.

The treatment of choice for BPD is Dialectical Behavioral Therapy (DBT). It’s a form of talk therapy that helps borderlines learn to manage intense emotions to minimize self-destructive, maladaptive behaviors and thus function better in relationships. The goal is to promote acceptance, yet encourage change, which is inherently contradictory and confusing.

For simplicity’s sake, let me use Bruce Banner and his emotional self-destructive alter ego, the Hulk, as a case in point to illustrate the theory behind DBT. In order for Bruce to have a functional relationship with any woman, he cannot transform into the Hulk. But the Hulk is an inseparable part of Bruce, which he can never truly get rid of.  Similarly, borderlines can never get rid of their childhood trauma. DBT will help Bruce learn to accept that he is the Hulk, while concurrently teaching him to harness his emotions so he will not become the Hulk.

BPD can be quite a severe and debilitating disorder. Relationships are particularly intense and unstable. In the entertainment world where steady relationships are already few and far between, an aging celebrity borderline probably stands a better chance of sustaining a career without needing cosmetic touch-up surgery than maintaining a lasting marriage.

Good luck Brangelina.

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17 Comments

Filed under Celebrities, Personality Disorder

17 responses to “Borderline Personality

  1. Matt

    this article was better than your first one. Write more please.

  2. Bibi

    I’m digging the blog, Dr. C. Good choice of Angelina’s photo and I also liked the Hulk analogy. I look forward to more insights.
    Do you think that BPDs generally make good actors because of their fluctuating mood and dramatic presentations? Is this a good career choice for them? In what other career choices might a BPD succeed?

    • Hi Bibi! Glad you dig it. Great questions. I think BPDs also make good actors because the combination of 1)not having a secure sense of self and 2)having experienced a wide range of intense emotions can help them with “becoming” a fictional character. I think BPDs do well in professions where they can express and channel their emotions in a healthy productive manner, which is usually in the arts. Of course, this is not to say they cannot succeed in other professions, but they may have a tougher time “playing politics” in jobs requiring them to work with people while keeping their emotions at bay. For more info, I found this good link http://bpd.about.com/od/livingwithbpd/f/JobsFAQ.htm

  3. Dan

    “The treatment of choice for BPD is Dialectical Behavioral Therapy (DBT).”

    Unless you happen to be a certain psychiatrist at Stanford, in which case you can diagnose them with bipolar II and use ECT 😉

    • Leja

      Interesting… I was recently diagnosed with Borderline Personality Disorder after a botched suicide attempt (I swallowed one entire bottle of my old Xanax prescription and chased it with half a bottle of Klonopins; only reason I am here right now is because my mom heard me with a bottle and knew something was wrong, so she barged in on me in the bathroom trying to down the last few K’s and rushed me to the hospital – for which I am SO glad now that I’ve received help) but I always thought I was Bipolar, because I tend to experience up’s that mimic “manic” episodes experienced by Bipolar folks.

      Is there a likelihood I could have BOTH?

  4. chester w

    I think its great that you use celebrities that we can relate to and get an understanding of the cause and their characteristics showing the symptoms. Its very apparent and helpful in distinguishing people with BPD..

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  6. I’ve thought a lot (probably too much) about how Katy Perry’s song Hot N Cold is about someone with borderline personality.

    Check it out: http://psychiatryfun.blogspot.com/2010/03/katy-perry-slays-me.html

  7. Nathaniel

    How funny, I was just in the book store today and passed by a big book titled ” Borderline Personality Disorder.” My immediate thought was, “who comes up with these names of disorders?” Anyways, good to know what it is now….

  8. tracy

    Just call me “Hulk”. If you think it’s fun writing about it, try living with it…
    The article was quite interesting, Dr. C, however, you will never know what it’s like to be the most hated diagnosis in the Psychiatric world…plus, being bunched all together…we’re not all screaming bitches whose goal it is to destroy families and relationships. i am getting help from a very patient, (yep, i know, he would HAVE to be) Psychiatrist and trying to deal with this most difficult of diseases life has handed out to me. i did not choose this disease nor the sterotypes that go with it.

    • Leja

      I have read elsewhere about the discrimination that BPD’s supposedly face. I was recently diagnosed… what have been your experiences? And why are we “the most hated”? I find it hard to believe we are more hated than Bipolars!

  9. Dr. Quack

    What about Glenn Close in Fatal Attraction?

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  12. It is really a great and helpful piece of information.
    I’m happy that you simply shared this helpful info with us. Please stay us informed like this. Thanks for sharing.

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