Phenomenology of Identity Disturbance and Affective Instability in Borderline Personality Disorder
Abstract
IntroductionBorderline personality disorder (BPD) is a psychiatric disorder, characterized by intense emotional fluctuations, uncontrollable emotional reactions and anger, chronic suicidality, and feelings of emptiness, stemming from an intense fear of abandonment, leading to unstable sense of self and interpersonal relationships. The disorder most often develops as a defence mechanism from childhood trauma or neglect. BPD is one of the most common personality disorders with one of the highest suicide rates, often misdiagnosed, primarily diagnosed in women, and stigmatised by professionals and the public [1, 2].
BPD is one of the few personality disorders that studies show to have a high success rate in treatment. However, due to diagnostic complications, patients commonly have difficulties accessing treatment. To improve the treatment options for BPD, one must first understand it; the best way to do that is to realise ‘what it is like’ for the borderline person, what they value and how they make sense of the world [1]. Several studies have been conducted on BPD, but concrete real-life experiences remain underexplored, and identity disturbance has received little empirical attention.
Method & ImplicationsThe study intends to investigate the phenomenological aspects of disturbed identity in BPD: how patients experience it, how it evolves through time and how it affects their life. As identity disturbance is connected to unstable affect and relationships, the study will explore how these symptoms interact and reinforce one another. The participants will provide experiential data through experience sampling, which include items about affectivity, identity and the social dimension. After a day of sampling, the participants will be interviewed following the micro-phenomenological method. After the data acquisition, personalised network models will be constructed for each patient, outlining the relationships between different domains of functioning [3]. As the framework for psychiatric diagnoses is shifting from categorical distinction of disorders towards a dimensional perspective – focusing on the underlying mechanisms, the personalised network model approach could aid in an integrated understanding of mental disorders and provide new insights into their management and treatment.
References[1] M. Mancini and G. Stanghellini, “Values in persons with borderline personality disorder: their relevance for the therapeutic interview,” Research in Psychotherapy: Psychopathology, Process and Outcome, vol. 23, pp. 48-55, 2020.
[2] J. J. Kreisman and H. Straus, Sometimes I act crazy: Living with borderline personality disorder. Hoboken, NJ: John Wiley & Sons, 2006.
[3] S. de Haan, Enactive psychiatry. Cambridge: Cambridge University Press, 2020.