How BPD is related to problems with identity
According to the DSM people with BPD suffer from "chronic feelings of emptiness."
But what does this actually mean?
It all sounds a bit metaphysical and for those who don't spend a lot of time reading theories or the latest research (hands up everyone!) it can be a bit confusing.
For clinicians it can also be hard to translate this idea into a client's presentation.
It must be even harder for carers and families to recognise it and for people with BPD more challenging still to see how it might manifest in themselves.
It's hard to imagine a parent saying "well, I can see you are having problems with your inner emptiness today - so I'll just leave you be" - or a young person with BPD saying "I'm feeling close to my internal void today - leave me alone - or help me" (or both !)
The idea of identity and problems with identity can help us understand the overall picture of BPD and what people are going through.
“Emptiness” tells me a lot about people's trauma and how BPD and other personality disorders develop - and manifest.
For a person with BPD, emptiness can often feel like a terrible underlying pressure or tension and a fundamental fear of being alone that sits with them throughout everyday life.
To be alone means being close to feelings that are frightening and that might be explained as something akin to losing themselves or falling apart. It's hard for language to encompass or describe these traumatic feelings - perhaps its more a job for poets. In these circumstances, without the input of another person, it can sometimes feel like we will cease to exist. "Latching" onto someone who could have the answer can seem like the only way out.
But what if that person can't or won't support us?
We might have expectations that are unreasonable even though we don't mean to be demanding. Sometimes we just can't help it.
It can be a very precarious existence. Depending on others to maintain our sense of self is tremendously taxing and dangerous. Although everyone needs others to help them, providing feedback and reflecting back our ideas and feelings, for people with BPD, the need for support and congruence will be far more compelling and intense - at times it can feel like our lives depend on it.
This inner emptiness needs to be filled with response and support from the outside world. When we don't get what we want or need from others we often feel deflated and empty, or filled with rage. That is why people with BPD can seem moody, unpredictable and volatile. From the outside it looks like frustrating and distressing changeability.
But on the inside it feels like terror, fear - and emptiness.
To make inroads into this, to restructure and provide access to the authentic self, is a long journey.
In treating BPD, psychotherapy can help people discover, value and strengthen that internal world - to fill the emptiness with true substance.
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