Why Borderline Personality Disorder Is Considered The Most “Difficult” To Treat

Borderline personality disorder (BPD) is defined by the National Institute of Health (NIH) as a serious mental disorder marked by a pattern of ongoing instability in moods, behavior, self-image, and functioning. Due to this, unstable relationships and impulsive behavior often occur. A person with BPD may experience stress-related paranoid thoughts, dissociative symptoms, inappropriate and intense anger issues, chronic feelings of emptiness, and more. The National Alliance on Mental Illness (NAMI) estimates that 1.6% of the U.S. population has BPD, but it may be as high as 5.9%. Nearly 75% of the people diagnosed with BPD are women, but men have been misdiagnosed in the past.

According to Dr. Thomas Lynch, assistant professor of psychology at Duke University and the Duke University Medical Center, individuals with BPD “exhibit chronic, pervasive problems getting along with people in all kinds of different contexts…and this includes therapists.” The American Psychological Association (APA) noted that while individuals with BDP may be quick to open to a therapist, they may be even quicker to shut down. APA also claimed that while people with BPD often seek out treatment, many tend to leave therapy. It is suggested that individuals with BPD may be triggered easily in therapy, which can be difficult for them to regulate those emotions and work with their therapist.

A call to action is provided to therapists, because understanding the client’s reality and their emotions may help to work with them in a more collaborative way. Dr. Lynch further describes this by stating, “They never gain a sense that their needs, wants and desires are reasonable.” David M. Allen, author of the book, How Dysfunctional Families Spur Mental Disorders: A Balanced Approach to Resolve Problems and Reconcile Relationships, told Psychology Today in 2015 that people with BPD often have families that counteract the work done by a therapist. He noted that while not true for all, many families often only elicit love and concern by misery, sickness, and debilitation. Family chaos for individuals with BPD include them being blamed for problems and treated as the “black sheep” of the family.



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