Social Cognition in Borderline Personality Disorder
Borderline personality disorder (BPD) is one of the most serious clinical entities in existence. In fact, under the umbrella of the label ‘serious syndromes’, there are only two more disorders: bipolarity and psychosis.
Sufferers of BPD experience extraordinary difficulties when it comes to interpersonal relationships. Indeed, they often feel abandoned by those around them. Consequently, a lack of interpersonal stability is the norm rather than the exception. They tend to oscillate between two extremes, either praising or denigrating the people around them.
In this article, we’re going to include quotes from a particular poet who suffered from this disease: Alejandra Pizarnik. In her writings, she reflected in a suffocatingly beautiful way what it was like to feel this way. We hope they can help shed more light on this complex clinical entity.
“Don’t abandon me even if I have abandoned myself.”
An approach to borderline personality disorder (BPD)
This clinical entity is characterized by a typical way of behaving. It begins in adolescence and continues throughout adulthood.
Sufferers of BPD have difficulty managing the way they relate to others, as well as the way they perceive themselves. In addition, their behaviors are often driven by impulsiveness and they experience great difficulties regulating their emotions (APA, 2015).
According to the American Psychiatric Association, for a diagnosis of BPD to be made, in addition to the above characteristics, sufferers must also exhibit five or more of the following symptoms:
- They intensely avoid feeling alone or abandoned.
- They relate in an unstable way to others.
- Their identities are poorly constructed. This is characterized by a lack of stability in their own image and in the Self.
- They’re extremely impulsive.
- They threaten to harm themselves and inflict self-harm.
- They’re emotionally unstable.
- They feel permanently ’empty’.
- They tend to lack control over their anger. Moreover, they find it difficult to exercise their will over their emotions.
- They may present paranoid ideas and dissociative symptoms.
The origin of BPD is currently unknown. However, it’s believed that childhood trauma could play a relevant role. In fact, for authors like Stern, this disorder lies somewhere between neurosis and psychosis.
If the sufferer was faced with a context in which their thoughts and feelings were given little credibility and validation when they were young, this becomes a risk factor for the development of BPD (Belloch, 2022). ).
“I am a wish suspended in the void.”
Social cognition is the way we think of others. It alludes to how we process the information that comes from our social universe. Thus, cognition can be understood from the perspective of a set of abilities (Coma, 2021). These involve the ability to assign mental states both to others and to ourselves, in relation to thoughts, feelings, and intentions in the form of actions.
Social cognition relates to the way in which people operate with information gathered from their interpersonal relationships. It alludes to how they perceive and interpret it and how they react. For example, “What did you mean when you said that I’m a disaster? If I’m a disaster, you’re going to abandon me aren’t you?”
Alterations of social cognition in borderline personality disorder
People with this disorder are extraordinarily sensitive to messages from others. They experience serious difficulties in decoding them. In fact, they usually interpret them wrongly. For this reason, they’re really receptive to the possibility of being rejected. This is related to social cognition in two ways (Belloch, 2022):
- In cognitive terms, they present alterations in their ability to mentalize. This capability consists of the ability to reflect on what others may be thinking and what their intentions are.
- They experience affective difficulties with their empathic capacity. That’s to say, they find it difficult to understand what another individual is thinking. Moreover, it’s difficult for them to experience the emotion that another person is feeling.
“I don’t know how to speak like everyone else, my words sound strange and come from afar, from where they are not, from encounters with no one.”
Therefore, it’s extremely difficult for sufferers of BPD both to express themselves and to understand the amalgam of emotions that characterizes the human being. Consequently, interpersonal relationships usually bring them a great deal of discomfort. This could be explained by a deficit in their ability to communicate with others.
This deficit could have its origins in childhood. It’s during this period of life that children begin to learn to relate to themselves and others, known as attachment. In the case of this disorder, it’s likely that the sufferer’s primary caregivers were negligent in providing social situations in which they learned to relate to others. Consequently, it hindered their development of social cognition.
“Language is a challenge for me, a wall, something that expels me, that leaves me out.”
For Belloch (2022), one of the consequences of this lack of social interaction in childhood is the development of what he calls epistemic mistrust. This term refers to the fact that these people learn to adapt to family environments characterized by abuse and hostility.
Thus, when they’re adults, they intensively and extraordinarily track and monitor their social environment. They look for hidden intentions whose purpose is to harm them. However, these intentions are often non-existent. Needless to say, this causes them immense discomfort.
As we mentioned earlier, sufferers of this disorder experience serious difficulties in social cognition, especially when it comes to relating to others. This is because it’s difficult for them to figure out their intentions. Thus, they tend not to regulate their own behavior, which leads to instability.
Fortunately, there are successful therapies for these patients. For example, dialectical behavior therapy (DBT) or mentalization-based therapy (MBT).
“Mentalization has to develop through a process of childhood experiences in which one sees oneself in the mind of another during an attachment relationship.”