Borderline Personality Disorder: 101

People (usually women) with this disorder present with highly unstable moods. They often feel as though they lacked a certain level of nurturing while growing up and, as a result, incessantly seek a higher level of caretaking from others as adults. This may be achieved through manipulation of others, leaving them often feeling empty, angry, and abandoned, which may lead to desperate and impulsive behavior including self harming and in extreme cases suicide attempts.

Sorry for the psych babble, but I have been working with a lot of women with Borderline Personality Disorder lately, and they can be extremely challenging! (I guess I need to vent!)

This week I worked with a sweet lady that seemed happy and was socializing well with the group for the first few hours. However, I noticed her mood change when we went down to dinner, and she refused to get a tray. We had a little chat about proper nutrition to no avail -- until we returned to the unit and I finally talked her into eating an orange. I watched her peel it, and then another patient drew my attention away. A few minutes later I noticed her slip into the bathroom -- when she came out I asked her if she ate the orange. "Half of it" she said shyly.

"What happened to the other half?" I probed.

"Well, . . . I flushed it down the toilet." She admitted (What!? ) Then, she went into her room and closed her door.

I followed her: "Do you want to talk about anything?. . . (Silence) . . .Are you okay?"

"Yeah, I am just really tired, I think." She said sluggishly.

I reminded her that she needed to keep her door open, and she agreed.

I was hyperaware of her bizarre mood change, so I went to check on her again all of 5 minutes later and I found her self harming! I guess she had pulled the wire out of a spiral notebook earlier in the day and hidden it. She was using it's sharp edge now to superficially cut herself a ton of times from her wrist to her elbow!

Luckily, she eagerly agreed to hand over the contraband, and I helped her clean and bandage the ugly wounds. She apologized profusely the whole time!! She said that she was just feeling really sad and lonely because only one person had come to visit her in the week she been admitted. (Although it's hard to understand, they use the physical pain from self harming to distract them from the emotional pain that is far more overwhelming to them.)