The most intricately complex part of the human body is the brain. It is capable of sending, receiving, processing and responding to massive amounts of information in the blink of an eye. For every process, there are infinitely smaller processes that play a part. All of these processes either affect or are affected by every single thing you do.
To understand more about borderline personality disorder and treatment, it will help to learn about the brain.
The Three Floors of Personality Development
A licensed psychologist and board-certified mental health nurse practitioner explains these functions in a more comprehensible way in “Your Brain And You.” You can think of the brain as a three-story house with each floor doing different things that ultimately result in your personality.
• Top floor: This part of the brain is what controls our reality or rather our perception of it. It forms this reality based on the information it receives via sensory input: information from the eyes, skin, mouth, nose and other parts responsible for physical sensations. It also takes input from our emotional center and memory. Therefore, our perception of reality is significantly influenced by what we’ve experienced in the past, and this allows us each to experience our own versions of reality all the time.
• Middle floor: The job of the middle floor is to interpret what the projector tells us. This is where we choose how we respond to the perception of our reality put out by the top floor. This is where memories are formed and then recalled, a process that elicits an emotion that drives the response.
• Bottom floor: The area of focus here is the sense of physical well-being and balance we feel as opposed to the mental and emotional well-being affected by the top two floors. It is responsible for physical functions like breathing, sleeping, eating and maintaining a heartbeat. This area is also regarded as the “front door” to the outside world; all the sensory input for the top floor comes in this way carried by neurotransmitters called neurons), and our responses go out the same.
It’s important to know that, within each of these three areas, there are many more processes going on. This can be broken down substantially further, referencing many more brain parts, but this three-floor model is a helpful visualization and should provide a good understanding of the framework of how personalities are formed.
How a Communication Breakdown Affects Brain Function
Just as it does in our physical reality and our daily face-to-face interpersonal activities, a communication breakdown within any part of the brain can be hugely problematic. All must be functioning perfectly: the neurons traveling into the part of the brain that processes them, the neurons that come back out that dictate our response, and the neurotransmitters carrying them in and out.
Any disturbance at all that disrupts how these parts communicate with each other can lead to problems with how the brain processes information and may result in abnormal mood, thinking, perception or behavior.
This communication breakdown and the subsequent problems that follow can be caused by a few different factors. Environment and social circumstances, early life experiences such as early childhood trauma and genetics are all possible factors. Research supports environment and early childhood trauma as causes due to the changes in the brain that occur as a result. Genetics as a factor is a bit more controversial and continues to be researched.
The changes in the brain caused by these factors, which result in this communication breakdown, are manifested by more rigid thinking and reacting behaviors that make it hard for people to adapt to a situation. These behaviors often disrupt their personal, professional and social lives.
Diagnosing Borderline Personality Disorder
There are 10 different recognized personality disorders, and they are further broken down into three sub-categories or clusters:
• Cluster A: resulting in behaviors that are odd or eccentric
• Cluster B: resulting in behaviors that are dramatic, emotional or erratic
• Cluster C: resulting in behaviors that indicate fear and anxiety
Along with three others, borderline personality disorder is categorized as a cluster B disorder. Medical authority Johns Hopkins defines manifestations of it as follows:
“People with this disorder are not stable in their perceptions of themselves. They have trouble keeping stable relationships. Moods may also be inconsistent but never neutral. Their sense of reality is always seen in black and white. People with borderline personality disorder often feel as though they lacked a certain level of nurturing while growing up. As a result, they constantly seek a higher level of care-taking from others as adults. This may be achieved through manipulation of others, leaving them often feeling empty, angry and abandoned. This may lead to desperate and impulsive behavior.”
A diagnosis of borderline personality disorder, or BPD, is contingent upon the following taking place:
• Detailed interview or discussion with your doctor or another mental health professional
• Completion of a thorough psychological evaluation, which will likely include completion of at least one questionnaire
• Obtaining your full medical history and conducting a new medical exam
• Additional discussion about your specific symptoms and signs
BPD is typically not diagnosed until one reaches adulthood. It is possible that traits that could be considered indicative of BPD in a child or teenager will wane or disappear entirely as the minor grows up and matures emotionally and mentally. It is because of this possibility that mental health professionals wait to diagnose BPD until adulthood.
Treatment Options for Borderline Personality Disorder
After you have obtained this diagnosis from your doctor, you are faced with many options as far as implementing a treatment approach that works for you. Often, you may not know what works or does not work, and a trial-and-error process is required to find the right path. It is crucial at this point to continue to focus on treatment and not give up in frustration. Many patients in treatment will try several different approaches before settling on the one that is most beneficial for them. You should also know that treatment rarely consists of only one thing. More often than not, a combination of treatments that you do concurrently is far more conducive to symptom management than utilizing only one.
For example, psychotherapy is a highly recommended method of treatment for BPD, and there are different types of psychotherapy available. Medications may also be helpful with amelioration of symptoms, freeing your mind to an extent to focus on treatment.
In particularly serious cases, a stay at a mental health facility or hospital may be needed or even required. In the event that suicidal thoughts are occurring or a suicide attempt has taken place, a hospital stay will be required for medical clearance, after which time you could be released to a mental health facility for recovery.
Residential Treatment: The Best Resource Available
While there is still an unfortunate stigma that can be associated with a stay in a mental health facility, it is an amazing resource and one of the best options available. The level of personalized care that is received and the protected, recovery-based environment make for an easier transition into this new lifestyle. The more intimate the setting, the better.
NFA Behavioral Health is a residential treatment center that offers one of the most intimate settings and is set up to address the various manifestations of BPD. The facility is located in the countryside of Canterbury, New Hampshire; it’s quiet, peaceful and restorative. The staff provides an outside environment that works in tandem with a safe and secure environment on the inside, ideally relieving any anxiety you may be experiencing.
At NFA Behavioral Health, you will have access to the different types of psychotherapy most successful in treating BPD, one of which is dialectical behavior therapy, or DBT. DBT is widely used and has been successful in treating many clients. This skill-building psychotherapy focuses on the development of mindfulness and the regulation of stress response as it impacts behavior.
As research shows that BPD is likely caused by early childhood trauma, NFA Behavioral Health offers both PTSD treatment and trauma treatment programs.
NFA Behavioral Health and Alternative Therapies for Borderline Personality Disorder
While the symptoms of BPD and the outward manifestations of it may be largely the same between those who have it, responses to different types of therapy oftentimes are not. With this in mind, NFA Behavioral Health offers experiential therapy, which can be used on its own or in tandem with other methodologies. Experiential therapy takes a step away from the psychological principles that a methodology like DBT is rooted in; it has the patient focus on their feelings toward and responses to the outside world in more tangible, concrete ways. For example, it can include animal therapy, such as working with horses. It also uses music and art as integral parts of the therapy process.
BPD increases the likelihood of substance use disorder. It’s possible that a drug or alcohol abuse problem or even addiction could be present. Knowing this, NFA Behavioral Health is equipped and prepared to help those with dual diagnoses, which means treatment for co-occurring disorders is needed. This includes alcoholism and drug addiction.
While the methodologies mentioned here focus on BPD specifically, it is important to note that NFA Behavioral Health offers many other types of treatment to ensure that every possible option is available and pursued on your road to healing. These options range from therapies based on clinical psychology to recreation and holistic therapies such as yoga, meditation, drama and dance. All of this and more is provided so that every part of the human psyche is addressed and healed during this important journey.
A More Rewarding Life Awaits
What you are doing is very brave. Many people find it difficult to accept help, let alone actively seek treatment for the presence of a mental health condition. They are able to come up with reasons that keep them out of treatment and in so doing suffer in silence, all the while continuing to sustain more psychological damage. Being willing to accept the presence of BPD in your life and having the desire to address it takes courage. It is the first and biggest step of this process in moving away from an existence that has been tortuous, exhausting and depleting.
You are here to break free of the patterns and beliefs that have controlled your life.
NFA Behavioral Health is here to provide you with the tools you need to move forward. It is our privilege to be a part of your support network.