Borderline Personality Disorder – BPD

• Borderline Personality Disorder (BPD) Although the impulsivity and rages expected to accompany this disorder are far from the behavior of most sensitive persons, even this diagnosis can be misapplied because of the intense emotions of the highly sensitive. After all, one criterion for the disorder is “affective instability due to a marked reactivity of mood” (APA, 1994, p. 654). Here is another case where a nonsensitive therapist especially might see something wrong in what is normal for a sensitive person.
  
  
•  Sensitive patients can have what could be better seen as extreme attachment insecurity and meet very well some but not at all of the DSM criteria for BPD. For example, they may seem to make “frantic efforts to avoid real or imagined abandonment”
  
  
•  While a sensitive patient, like those with BPD, might defensively idealize or devalue others, they would rarely do both to the same person at different times. The self-esteem of sensitive persons does fluctuate more than others according to events, but they do not usually show a “markedly and persistently unstable self image”
  
  
•  There is a strong relationship between BPD symptoms and sensitivity, no doubt in interaction with a damaged early development or abuse.
   
  
• A substantial 74% of the BPD subjects were rated as both gifted and psychologically abused, compared with only 13% of the controls, suggesting that some of the symptoms represent exceptionally high perceptual skills—perhaps due to high sensitivity—recruited into defense mechanisms due to trauma.
   
  
• Sensitive patients with BPD assiduously avoid behaving in a way that would disturb others, even if they inadvertently do so. When they realize it, they usually become depressed immediately afterward, concerned about the harm they may be doing to a relationship that they understand they need.