Borderline Personality Disorder and How It Relates to Addiction

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This guest blog post is written by Matt Aaron. Matt is the outreach coordinator at The Clearing, SPC where he helps spread the word about healing underlying core issues in dual diagnosis addiction treatment. He is an avid reader whose favorite author is John Fante. Fluent in 3 languages, Matt loves to travel.

Did you know that there is a significant connection between addiction and mental health disorders? It’s true. In fact, there’s a technical term for the combination of a substance abuse issue and a mental health issue: dual diagnosis.

In times past, the prevailing belief was that addictions and mental health issues rarely overlapped. But nowadays, we understand that the majority of people who are dealing with an addiction are also dealing with a mental health concern.

According to the National Alliance on Mental Illness (NAMI) website’s Mental Health By The Numbers page, “Among the 20.2 million adults in the U.S. who experienced a substance use disorder, 50.5% – 10.2 million adults – had a co-occurring mental illness.”

Mental health conditions are the norm among those with addiction. In this post, we’ll look specifically at Borderline Personality Disorder (BPD) and how it relates to addiction.

A Brief Overview of BPD

Let’s clarify what BPD means, because it’s a term that many people use indiscriminately. To start, people with BPD have a high level of emotional instability. They have trouble regulating their emotional states, moods and behaviors. They display extreme mood swings, engage in impulsive and dangerous behaviors and have an intense fear of abandonment.

In BPD, people see life in a very black and white fashion; it’s either very right or it’s very wrong. There’s no gray area in the middle. Unfortunately, the world is full of gray! As such, people with BPD have a difficult time navigating relationships. They find themselves dealing in extremes in their thinking and their feelings.

BPD is a mood disorder, which means that it’s in the same general category as Depression, Anxiety and Bipolar Disorder. There is no one single cause for mood disorders. Some cases are caused by an imbalance in brain chemistry, while others are caused by substance abuse, alcohol abuse or other medical conditions.

How Does BPD Relate to Addiction?

Substance addiction represents an attempt to cope with some form of mental and emotional pain. When people feel intense inner turmoil for a prolonged period of time, they often turn to drugs and alcohol to feel better…or just feel nothing at all. This is the self-medication aspect of addiction.

Since individuals with BPD have a hard time with emotional regulation, they may turn to mood-altering drugs for respite. For example, when their fear of abandonment comes to the surface, they may push it down with drinking or drugging. Addictive substances do provide momentary relief, though they exacerbate the issue over the long term.

Addiction and the Inner Balancing Act

It’s also helpful to think of addiction as an attempt to bring the psyche into balance. It represents an effort to equalize all levels of self.

Spiritual Psychology tells us that humans operate on four levels: the physical (what we do), the mental (what we think and believe), the emotional (what we feel) and the spiritual (who we really are). As humans, we’re constantly seeking to balance out these four levels within ourselves.

Say you feel terrible about yourself on both a mental and an emotional level. Perhaps you believe that you’re worthless or broken, and you carry around a lot of sadness and anger. You experience a great deal of negativity on both the mental and emotional levels of your life.

What do you think happens on the physical level? That’s right: drinking, drugging, and other addictive behaviors such as workaholism come into play. The mental and emotional upset is reflected in your physical actions.

Now imagine that you’ve managed to stop using substances for a time. You have stayed sober through willpower and other physical-level coping strategies. Yet you haven’t addressed the underlying mental and emotional issues, so what happens the next time a major stressor hits? You start using again. Put another way, your physical reality snaps back to match your negative mental and emotional reality.

Often, addiction treatment approaches focus on physical-level coping strategies and tools to prevent using. These are important, but they’re not the whole picture. In addition to physical approaches, you need powerful work on the mental, emotional and spiritual levels of self.

Mental Health Treatment for BPD and Addiction

Most people with BPD can benefit immensely from therapy, because mood disorders are manifestations of underlying mental and emotional issues. When people with mood disorders work with their underlying issues, their symptoms lessen.

For example, one evidence-based way to work with BPD at the mental level is by using Rational Emotive Therapy (RET). RET involves working with limiting beliefs, which are the rules that we create about life. Through RET, we can become conscious of our black-and-white thinking. Once we’re conscious of it, we can work to relax those self-limiting rules and begin to accept some gray areas. We’re empowered to see that people are not “all right” or “all wrong”.

After that, we can begin working on the emotional level using Gestalt, Developmental Psychology and Neuro Linguistic Programming (NLP) to work with those emotional aspects. We can give those buried feelings a voice, track them back to where they came from, and heal them. With emotional therapeutic modalities, we work with those younger parts that created very black-and-white thinking as a self-protective measure.

The rigid thinking that characterizes BPD comes from a place of pain. Unconsciously, we’re saying, “When the world matches this belief system that I have built for myself, then I feel safe. When the world doesn’t match this belief system that I’ve built for myself, then I feel very unsafe.” As such, we need to broaden those rules so that we feel safer in this world.

Trauma and BPD

Traumatic events can lead to rigid thinking. That said, a “traumatic event” in psychology is simply something that was shocking to me personally. I don’t have to justify it to another person. The same event may very well not have been traumatic to my brothers or sisters or even to my twin. But it was shocking to me, so I created a rule around that experience.

For example, say I grew up in a volatile family situation. Maybe Mom and Dad fought a lot and I felt very unsafe. So I created some extreme rules in my mind about how Mom and Dad should be, and the way life needs to be so that I can be safe. We create rules so we are not shocked in the same painful way the next time. It’s all about self-preservation. But when we create those extreme rules over and over, we also create that rigid, black-and-white thinking that is a hallmark of BPD.

Fortunately, we don’t need to stay stuck. If we’re willing, we can work with our underlying core issues and find healing on the deepest levels. And when we address our mental and emotional health concerns, we find that our substance addictions naturally fade away. After all, there’s no need to escape and numb out when we feel safe, held, and loved within ourselves.

 

 

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