The Hardest Symptom of Borderline Personality Disorder for Me to Explain
To some degree, all borderline personality disorder (BPD) symptoms are challenging to explain or understand. On one hand, BPD has been described as the mental illness with “surplus stigma,” on the other hand, it is a complex disorder with a combination of painful symptoms that seem impossible to put into words.
However, the identity-based symptoms, or as the criteria puts it, “Identity disturbance: markedly and persistently unstable self-image or sense of self” has always been a tricky symptom for me to explain. Vague statements such as “lack of self-esteem” or “uncertainty with goals and values” do not seem to capture the reality of this symptom.
In fact, this difficulty is something all people face daily. It is ingrained in our culture. “What do you want to be when you grow up?” “Where do you plan to go for college?” “What are your plans after high school?”
People worry about their career, college major, appearance, social interactions and job performance, on top of insecurity through life transitions, peer pressure and maintaining and forming relationships with others. These questions and thoughts challenge stability and self-perception, and they hit especially during transitions after high school, college and breakups. The real or perceived presence, actions and thoughts of other people constantly influence thoughts of ourselves, actions and emotions.
It is not to say these transitions and difficulties are easy; nonetheless, these life occurrences are not automatically the same as having BPD. As a result of this misunderstanding, I find this symptom most commonly met with a skeptical look or a remark such as, “That is everyone, though…” or “What kid knows what they want anyway?” or “It’s not that hard!”
It doesn’t help that watered down, vague, minimized or stigmatized versions of illnesses are everywhere. Social media and articles seldom elucidate accurate representations of mental illness, especially BPD and psychotic disorders.
I have repeatedly attempted to explain this BPD symptom to no avail. It is so strenuous for me to explain that I usually find it distressing to try and think about. It is deep. It is complex. It is ingrained in my self-perception and very existence.
I still have not figured out how to explain this symptom, but I did finally stumble upon three clever quotes that successfully capture the complexity and variation of it.
Dr. Richard Moskovits explains this symptom this way:
To have little sense of who you are or what turns you on. At its extreme, it may mean having to turn to others for cues in order to know when to eat or drink, work or rest, or even laugh or cry. It may mean intensely embracing a person, idea, or thing one day, and having no use at all for it the next. This lack of a constant picture of one’s self, one’s values or one’s passions is at the heart of the borderline personality. Imagine floating randomly through space without any sense of up or down and without a map to show you either your origin or destination. To be borderline means to lack grounding emotionally and to exist from moment to moment without any sense of continuity, predictability or meaning. Life is experienced in fragments, more like a series of snapshots than a moving picture. It is a series of discreet points of experience that fail to flow together smoothly or to create an integrated whole.
Additionally, he explains, “You may experience your life as fragile and flickering, lacking in substance and permanence. You may, at times, burn brightly and intensely with emotion and, at other times, feel empty and bored. You may dart wildly about, following your impulses in a frantic effort to soothe the pain inside and create a shred of identity.”
Finally, Dr. Jerold Kriesman and Hal Straus state,
Identity is graded on a curve. Who they are (and what they do) today determines their worth, with little regard to what has come before. They allow themselves no laurels on which to rest. Like Sisyphus, they are doomed to roll the boulder repeatedly up the hill, needing to prove themselves over and over again.
These quotes demonstrate how this symptom can be understood through the combination of symptoms, their interaction and what is going on in the environment, which make it BPD. The triggers can be minor compared to what may typically sway others.
It seems a slight change in the environment can shake and shape my core being. One minute, I will beam with euphoria, and the next, I will cry and become overwhelmed by stimuli. With these constant shifts, it is rather cumbersome to maintain a stable sense of identity and sense of control. The BPD emptiness, splitting, emotional shifts and changes in structure all shift the sense of self along with it.
I changed my name over five times. I have a scar on my ankle and foot that says “fail” because at one point, I thought a “failure” was my identity. I remember being fueled by self-hatred and uncertainty from as young as 4 years old. I first engaged in self-harm at 10 years old.
I feel like I live in an everlasting “fall.” I reach to grasp a rope or leverage for comfort and stability, but nothing is there. I grab the air and just keep falling. I search and reach for something that doesn’t exist.
The constant part of living with BPD and this symptom for me is that nothing is good enough. I enrolled in 13 classes at once and graduated high school when I was 16 with a 3.9 GPA, which was not good enough. To put it briefly, ultimately, my perfectionisms and inability to console myself at the slightest perceived failure largely contributed to my first, and hopefully only, psychiatric hospitalization in 2017. As one BPD Mighty contributor brilliantly explains it, my identity based symptoms have manifested itself through an extreme need to achieve.
On the plus side, passion, ambition, determination, hard work and conscientiousness are no strangers to me. I would describe myself as confident, eager and motivated. I yearn for a bold and consistent sense of self. I yearn to make a difference and advocate. I care deeply for people. I work with a burning passion, my whole heart and sense of urgency. I know what I want, and I go for it. This is what makes me happy and light up inside. I love spending my time constructively, hard work, and I love being around people. I am Kellyann, the psychology and disability studies college student, martial artist, pizza and panda lover, and soon-to-be doctor. I have a passion for what I do, define it as who I am, and it is no secret.
On the negative side — I get distressed and obsess. I alternate between over-involvement and withdrawing. I think and act in extremes. I neglect myself or my needs. I, as cheesy as it sounds, often “put all my eggs into one basket.” But, it is a basket with holes that empties as soon as it is filled. I am never satisfied nor proud. I grieve with the slightest change in structure and transition. I feel a heaviness inside my chest. I would describe my constant, baseline state as “empty and heavy.”
I feel like the White Rabbit from Alice in Wonderland. I am time-obsessed, which largely contributed to when I enrolled in and finished 13 classes at once in high school. I, “allow myself no laurels on which to rest.”
I live in a constant state of being overly-aware and obsessed with time in various ways. Whereas my emotional reactions constantly shift, the preoccupation, emptiness and identity symptom has been a constant state for as long as I can remember. Yet, my perception of time is distorted — I struggle with remembering a chronological sequence of events and my subjective passing of time races. My emotional reactions are time-dependent on whatever stressor, stimulus or state are coming my way — they tick, tick and tick. Once the alarm sets, I cannot shut it off on my own. My emotions are out of whack and dysregulated, so I self-harm or self-destruct or smash the darn clock.
This identity and perception symptom of BPD makes sense considering the emotional intensity, hypersensitivity and the interpersonal symptoms, such as the extreme reactions to and preoccupations with being abandoned, slighted, forgotten and replaced. Emotional/object permanence, the understanding and feeling that objects continue to exist independently even when they cannot be observed through the senses, extends to the lack of permanence and consistency with the sense of self, too. Sound familiar? “Who they are (and what they do) today determines their worth, with little regard to what has come before…” Likewise, unless the emotion is being presently experienced, those of us with BPD may feel disconnected and cut off from it. It is like it never happened.
With brief separations, we may begin to doubt the person still exists and cares. With minor slights, we may shift straight to suicidal ideation or tears. We may not be able to recall the “happy times.” Life is experienced in extremes and like a tunnel vision. The passage of time, separation, and pain seems to speed up and last eternity. There is a lack of constant picture of others, as well as of ourselves and experiences.
Likewise, splitting in BPD, an extreme thought pattern symptom in which positive and negative perceptions of the self and others are not integrated, leads to a maladaptive pattern of thinking in extremes. It often interferes with perceptions, social functioning and emotionality. Splitting in BPD is usually sudden, intense and longer lasting or quickly changeable. Someone with BPD may, for instance, alternate between over-involvement and withdrawing. Positively, we may idealize others and have a strong sense of right and wrong.
Again, this demonstrates how this identity symptom can be understood through the combination of all parts of being, where symptoms rise and fall and interact with each other.
The low-stress threshold of BPD may lead to even further cognitive/perceptual symptoms connected to identity. This includes transient hallucinations, body distortions or dissociation, where we feel as if our body parts and identity are detached from the self and immediate surroundings.
The complex interaction and variation of this identity-based symptom is what makes it so difficult to explain. Maybe, for once, I have finally captured it. We may have a passionate and intense need to achieve, with feelings of worthlessness, unstable esteem, intense relationships, fear of loss and abandonment, leading to impulsiveness and self-harm. We may passionately grasp someone or something, intensely fearing abandonment or failure and desperately seeking a self. We may view ourselves as an image of evil and failure itself and swarm with self-hatred. We may constantly switch ideals, aspirations, appearance, decisions and jobs. We may struggle to conjure up an image in our mind of not only other people, but of ourselves and experiences.
Unsplash photo via Brooke Cagle