borderline-personality-disorder.com
In the past, researchers concluded that more women suffered from borderline personality disorder (BPD) than men, but more current peer-reviewed research reveals that there are no gender differences in terms of prevalence; both men and women present with BPD in roughly equal numbers. There are, however, differences in the way men and women present with BPD, and therefore differences in the ways their family members and loved ones perceive them. A man with BPD is more likely than a woman to be assumed to have antisocial personality or a drug/drinking problem, for example, and because of this, his diagnosis may be missed.
When Carter sat in the cushioned chair in his therapist’s cozy office, he felt safe. He felt finally that he could trust someone. She’d been guiding him through an examination of his story for a long time now, and despite his repeated attempts to push her buttons or to push her away, she’d continued to be there—to invite him to keep coming back. She was the only person in his life who’d ever told him she believed he could become better; that she knew he already was. It was in that therapist’s chair that Carter took the first honest look back at his life, and what he saw there began to make sense in an odd and unsettling way—he had a pattern.
He tended to leap right into relationships with women. To seduce them through the use of his charm and wit, to get them into bed right away. The sex was always intense, and it unfailingly led Carter to believe he was connected, in love. He was head-over-heels every time, and always a little too soon. He believed a woman was perfect in the beginning, and then, when he got to know her better, her warts started to show. He took these failures personally; he felt deceived. Disgusted. Soon enough, he’d put up a veritable Berlin Wall between himself and his lover, and would already be off looking for someone new. He never came clean to a girlfriend; he just cheated recklessly, waiting to get caught. And when he did, he’d have hell to pay, but that hell was something Carter seemed to long for, something he almost needed.
More than one woman had called the police on Carter for domestic violence. He’d shoved a girlfriend so hard once that she’d broken the glass coffee table as she fell and had been badly cut. Another, he’d repeatedly hit and choked. He’d been so remorseful after the fact that he’d melted into inconsolable tears. If she didn’t come back to him, he swore, he couldn’t go on living. He would have no choice but to commit suicide. That wasn’t the only time Carter had made such a threat.
It was his therapist that helped Carter to make the connection to his childhood, a time he never liked to think about. He hadn’t known his father; the man had left when Carter was 2, and his mother had been emotionally ambivalent about Carter. When she drank, which was frequently, she alternated between adoring and affectionate, and violent and enraged. He never knew what to expect. Carter longed for his mother’s love, as any child would, and had even idolized her into his 20s (his mother had been a beautiful and well-known actress), but consistent love would never come. She had committed suicide when Carter was 30; she’d left no note. Carter was terribly afraid of being abandoned again, a feature distinctive to BPD, and made every effort to ensure he would not be, though this had not left him feeling any less alone, any less afraid. He needed to get his life together; he needed to heal.
Among the traits listed for BPD is a tendency toward self-harm, such as cutting, burning or head banging (as into a wall in order to cause damage). According to new research, there may also be a link between violence toward others and BPD, which is seen more often with men who have the diagnosis than with women. This may be, as the study suggests, due to the high rate of comorbidity BPD sufferers experience. In other words, people with BPD stand a strong likelihood of suffering another mental illness alongside BPD. According to the NIMH funded National Comorbidity Survey, about 85 percent of BPD sufferers also experience another mental illness, such as depression, anxiety disorders or bipolar disorder—or for men, a substance use disorder or antisocial personality disorder, which has a violent behavior component.
For a long time, BPD was considered a tragic diagnosis, one with the very worst of symptoms and virtually no hope of recovery. But with advancements in therapeutic practices and greater understanding of the disorder as a whole, BPD is now commonly referred to as “the good prognosis diagnosis”; sufferers stand a very good chance of recovery if they commit to wellness. The pain and difficulty that BPD presents are often—though not always—rooted in early stories of abandonment or trauma of some kind. A willingness to examine the past without a sense of victimhood, but with the stance of a survivor, is key.
Even men who have struggled with risk-taking, impulse control and violent outbursts find they can become calmer, more self-aware individuals. They learn that as adults, others do not have the power to truly abandon them; they are their own home in the world. BPD is, on the whole, an illness marked by troubled relationships and therefore one that impacts the lives of many more people than just the sufferer. But by undertaking a commitment to recovery, patterns can be changed and wellness can be realized.