Borderline Personality Disorder: The patient psychologists fear most?

Published: July 30, 2014 / 20 Comments



Borderline personality disorder (BPD) is a psychological issue that is diagnosed in about 2% of the population – that is more than bipolar and schizophrenia combined. BPD also happens to be a very serious illness: research shows that 10% of ‘borderline’ adults succumb to suicide, a higher rate than any other mental illness, and a third of the young people who commit suicide have features of BPD.

Yet, despite the fact that it is one of the most common personality disorders, the vast majority of sufferers, their families and friends, and many mental health professionals don’t know where to turn for information or help.

Because BPD has a huge number of symptoms (experts claim that there are some 256 different ways the disorder can present itself!), diagnosis is often difficult. Add to this, too, the fact that treatment can be further complicated by the disease’s misleading label – rather than referring to a problem with a patient’s personality, the name traditionally refers to the mix of symptoms located on the border between psychosis and neurosis. What’s more, because patients tend to subject not only their loved ones but also their therapists to a roller-coaster of emotions, BPD sufferers are often regrettably labelled the patients psychologists fear most.

‘People with borderline personality disorder have a distorted image of themselves and often feel worthless and fundamentally flawed,’ says Janine Taylor, a counselling psychologist who lectures the Abnormal Psychology module, part of both the Bachelor of Psychology and the Bachelor of Applied Social Science degrees at SACAP.

Taylor explains that BPD sufferers are thought to have longer, deeper and more extreme emotional reactions to situations and are often unable to comfort themselves or see past a time of extreme emotion: ‘As a result, in an attempt to relieve themselves of the unbearable emotional pain they experience, borderlines are susceptible to impulsive behaviour.’

Taylor is quick to add, however, that at the root of all that emotion is a very real fear of abandonment. ‘A person with borderline personality disorder will spend the majority of their time worrying about being abandoned by those they most love, and acting on that feeling in a negative way,’ she says.

‘Sufferers of BPD often experienced neglect, abuse or unstable attachments as children,’ Taylor continues, explaining that, frequently, borderline sufferers would not have had their emotions regularly validated as children. ‘When children have to cope with dysfunctional parents – a demanding mother, say, and a father who is absent physically or emotionally – they learn to suppress their own needs and capitulate to the needs of their parents. Essentially, the child learns that hiding his true thoughts and feelings is the surest way to survive.’

Taylor describes how this ‘emotional camouflaging’ is then carried into adulthood, where it causes untold frustration in interpersonal relationships: ‘Always holding back their true thoughts and feelings, borderlines feel constantly misunderstood, yet are blind to their own role in the communication difficulties. Instead, they blame others for everything.’

This dynamic explains why BPD clients are so dreaded by many psychotherapists. ‘Because healthcare workers often do not understand that a difficulty to trust is innate to the pathology, they take their patients’ actions personally,’ explains Taylor. ‘It’s said that it takes just one borderline patient to make a therapist feel like a failure.’

Despite the seriousness of the disorder (or maybe because of it), borderline personality disorder remains greatly misunderstood. ‘In my opinion, therapists are too quick to attach the BDP label,’ says Taylor, adding that it has even been claimed that virtually every major mental illness can be represented within a BPD diagnosis.

It is for this reason that screening for BPD must be done thoroughly, preferably by a professional trained in the field, she emphasises, but adds that it is also time to reject the notion that people with personality disorders are beyond help: ‘While borderline personality disorder causes difficulties with social interactions that can be debilitating for those with the disorder as well as their loved ones, BPD is not untreatable and specialised psychotherapy can significantly improve the lives of individuals with this debilitating disorder.’

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Your Comments on “Borderline Personality Disorder: The patient psychologists fear most?”

  1. Debbie

    I have been diagnosed with BPD 7 years ago. I am now 29. I am in desperate need of help as my psychiatrist has retired, and my meds dont work. I am not so much suicidal as I am homicidle. I am going to snap and hurt someone. Any references in cape town that can deal with the type of issues I have? I suffer from audio hallucinations daily and I feel like my mind and body is being shared by a very very sick man. He is starting to take away more of me and making me more if him. Any help will be appreciated.

  2. Yolanda

    My daughter has BPD symptoms. She was in hospital in March for trying to harm herself. I am struggling to cope with her and the outbursts. Is there any support groups for parents in durban.

    Thank you


  3. karen

    My son 30 years has destroyed his life after his wife left him. He has been a troubled child his whole life. Went the drug route as a teen ager, cleaned up, studied theology and worked for a church for 10 years, then his marriage broke and now he lives a life of solitude, cant work, depressed, no value for life. Blames everyone including himself. He is intellegent reacts well from time to time, then gets upset and goes and liveS on streets commintting pety crimes to live and trying to get himself killed. There is so much to say but he desperately needs help before he ends up dead or in jail. He is willing to see someone, but cant afford private prices. I have read up about BPD OR PTS and feel this is closest to his needs. Please help with someone that does not charge extranomical costs so that I can get him HELP!!!

  4. Jean

    Are there any support groups for parents who have children who suffer from BPD? How does one find a professional trained in this field?

  5. mark silbert

    My wife of 8 years ( she is now 50) is a classic case of BPD -she ticks every box there is for this.
    While i was away for 6 days – she packed up our entire home , put everything into storage and dissappeared, to try to “sort herself out” it took me 4 days to discover she had left Cape Town and gone to her daughter in Durban.
    She has categorically stated that she loves me but cannot go on hurting me with her actions and repeated separations and therefore has now left.
    I dont seem to be able to get through to her that I love her and will help her in any possible way, paying for a psychologist or whatever else is needed. She has up to this point refused to seek out help and she is of the opinion that she can “sort herself out” by herself.
    We have had almost no contact now for 7 weeks and Im dying inside. i have told her repeatedly over many years she cannot do this by herself but she is adamant she can – or is this just a way of avoiding the real issues and seeking professional help ??

    how can I get through to her that she does need to seek help and she does have the option of getting better ??

    Im would also be very interested to start a support group for BPD sufferes and their partners – how would i go about this in cape town

    • Adele Bezuidenhout

      Hi Mark,

      We’re sorry to hear about your current experience with your wife. It would be best to talk to SADAG as they have support groups for people in your situation. We wish you all the best.

  6. Nadeemah

    I suspect my husband is emotionally unstable , I have recently asked him for a divorce because he has withdrawn himself emotionally from myself and our children he does so using his online gaming , which in the past two years have become like his safe haven , he has become so detached that he blatantly ignores our kids, refused to go out doesn’t want to socialize with the rest of his family, he chooses not to share important financial issue with me , only to find out recently by his work colleagues and family that he talks negatively about me and degrading me to others and when I approach him with my feelings about spending time with us , his family, I get blamed,
    After I asked him for a divorce be freaked out throwing everything back in my face telling me its my fault that the marriage hasn’t worked and im the one that’s not present and I don’t pay him attention and Im the one that doesn’t want to talk , he called me broken and damaged , and said I don’t know how to love, then turns around and tells me he loves me and even though im breaking his heart he is willing to give me a chance , the has threaten to kill himself, has said a bus should just run him over or he should catch pneumonia and die, he said he wont let me go because our vows said “till death do us part”…it has become even more difficult in recent weeks because his father passed away , he used my comfort and support and latched onto that to make our marriage work saying his fathers last wish was for use to make things right , in this time he has completely detached himself from the kids saying he cant look at them knowing they came from the woman he loves and they remind him of his dead father
    he is continuously trying to make sexual advances and guilt trips me when I reject him , he tried to force himself on me the day of his fathers funeral , then brushed it off as him needing comfort , he then blamed me fr not being there for him , says he feels worthless , and unattractive because I don’t want to have sex with him , he has hacked my phone , is tracking my every move but denies it saying he trusts me and wants to make things better
    im sorry I know this is a lot and only half of what has been happening but I fear for myself for my kids and for him , he lashes out acts irrationally, I want to leave him but have nowhere to go and he refuses to leave, what do I do

    • Adele Bezuidenhout

      Hi Nadeemah,

      It would be best to urgently contact the SADAG Mental Health Line on 011 234 4837. We wish you all the best in this trying time.

  7. Gaill Fraser

    Hi..could you possibly refer me to a specialist in this field in the Western Cape….as close to Somerset West as possible? Thank you

    • SACAP


      Contact your local nurse or doctor and request them to refer you to a specialist near you.

    • Natasha

      Hi Gail, did you find someone in somerset west? Natasha

  8. wendy schoeman

    Good day – I visited your site on the internet and would like to know whether you can offer any insight into how to accommodate (as in house) our schizoaffective Borderline Personality Disorder family member.

    This person is impossible to live with and her anxiety levels leave a trail of chaos behind her.

    She has time and time again been rejected by various psychiatric residencies mainly due to her bad behavior. She is 47Yrs old Single White woman.

    Any comments would be welcome. She has since been rejected by yet another care facility who cite the following reasons:

    “ We do not accept:
    • `Borderline Personality Disorder `
    • `Personality Traits`
    • `Major Depressive Episodes` or status on anti-depressants and anti-anxiolytics.

    She also has the following areas of concern:
    • `Doesn`t take or disobeys the Rules`
    • `Aggressive behaviour`

    Hopefully the family will manage to find a most suitable place for her.”

  9. Heidi Bresler

    Hi – i’m desperately requiring help/guidance, please! Trying to save my relationship…is there a specialist in the field in CT that i can make an app with to discuss the right and wrong way of going about things with my partner, who ticks all the boxes for BPD. I recall there was a psychiatrist (from Kenilworth i think..) who spoke on Cape Talk a few weeks back on Bipolar…and i phoned in to discuss with him the differences in the two…and he too clarified many things for me ito my partners behaviour…but i don’t know how to handle this?!
    Kind regards
    082 856 3520

    • Cheryl

      Hello Heidi

      I have only recently been correctly diagnosed as having BPD. Prior to that I was treated for depression, then bipolar. Depression is still such a stigmatised disorder, can you imagine how hard it is to even admit to your loved ones that you have BPD? You’re doing the right thong, trying to get support for you and your partner-you’re in it together. Please let me know what you have found re a support group in Cape Town. I would like to join one.

  10. Antoinette James

    Looking for a therapist specialising in BPD in the Cape Town area, specifically southern suburbs.

    • SACAP


      Please contact your doctor or local clinic so that they refer you to a suitable therapist.

  11. Claudia Spann

    Good Afternoon.
    I was wondering if you perhaps knew of any Psychotherapists specialising in BDP within the Cape Town, Somerset West or stellenbosch area?

    Thanking you in Advance.


    • Margo

      Hi Claudia
      Did you ever manage to find anyone in the Somerset West, Stellenbosch or Cape Town area that specialises in BPD? Am very desperately trying to find someone now.

      Would love to hear from you soonest.