|
Types
of BPD
High
Functioning, Low Functioning
People
with BPD vary a great deal in their functionality: that is, in
their ability to live a normal lifestyle, work inside or outside
the home, cope with everyday problems, interact with others, and
so on.
Some people with BPD are so incapacitated by their illness that
they are unable to work. They may spend a great deal of time in
the hospital because of self-mutilation, severe eating disorders,
substance abuse, or suicide attempts. BPD makes it very hard for
them to form relationships, so they may have a weak support system.
They may be so incapable of dealing with money that they have
no cash for food or a place to live.
People who are close to low-functioning borderlines often find
themselves living from crisis to crisis. They often feel manipulated
by self-mutilation and suicide attempts. However, because the
borderline is obviously ill, non-BPs usually receive understanding
and support from family and friends.
High-functioning borderlines act perfectly normal most of the
time. Successful, outgoing, and well-liked, they may show
their other side only to people they know very well. Although
these borderlines may feel the same way inside as their less-functional
counterparts, they have covered it up very well-so well, in fact,
that they may be strangers unto themselves.
Non-borderlines involved with this type of BP need to have their
perceptions and feelings confirmed. Friends and family members
who don't know the borderline as well may not believe stories
of rage and verbal abuse. Many non-BPs told us that even their
therapists refused to believe them when they described the BP's
out-of-control behavior.
Of course, there's a lot of room in between high-functioning (sometimes
referred to as the "borderline" borderline) and low- functioning
BPs. Stressful life events are most likely to trigger dysfunctional
coping mechanisms.
Acting
In, Acting Out
Most
borderline behavior is about one thing: trying to cope with internal
anguish. However, people with BPD may do this in different ways.
In our experience, the behavior of people with BPD tends to fall
into two general categories: "acting out" and "acting in." These
are not official, empirically researched categories. Rather, they
are a convenient, real-world way of looking at differences.
Acting-out behaviors are attempts to alleviate pain by dumping
it onto someone else-for example, by raging, blaming, criticizing,
making accusations, becoming physically violent, and engaging
in verbal abuse. Acting-out behaviors cause direct anguish for
friends, family members, and partners. For example, one borderline
woman, Kiesha, became very angry when she felt that her husband
was ignoring her at an office Christmas party. So she went up
to him, threw her drink in his face, and stalked out.
Acting-in behaviors mostly hurt the person with BPD, although
non-BPs are also affected. Someone with BPD who mostly acts in
may feel extremely guilty over imagined transgressions. They may
mutilate themselves, try to hold in their anger, and blame themselves
for problems that are not their fault. Suicide is also a
possibility.
Some BPs seem to mainly act in. Some mainly act out. And some
both act in and act out. Take Kiesha, for example; after she embarrassed
her husband at the Christmas party, she felt very guilty. She
walked home from the party, a distance of several miles. When
she arrived home, she grabbed several ornaments from the tree
and crushed them with her hands, causing a great deal of
bleeding.
|
