A Qualitative Examination of Borderline Personality Disordered (BPD) Patients: Interpersonal Dynamics and Underlying Paradoxes

Abstract

Theoretical conceptualizations of symptomatology in patients with borderline personality disorder (BPD) have noted an inability to integrate contradictory perceptions (splitting, or dichotomous thinking) as a hallmark of the disorder. This study investigated contradictions manifest in the thinking and behavior of BPD patients, using the concept of paradox. A paradox occurs when an apparent contradiction contains an underlying logic which makes the contradiction comprehensible. Using qualitative methods of analysis, this study explored paradoxes evident in 10 BPD patient narratives about relationship events. Specific paradoxes relating to interpersonal conflicts and self-destructiveness are presented, along with the underlying logic of each paradox as described by patients. Implications for treatment are discussed.

The experience of loneliness among people with a “personality disorder” diagnosis or traits: a qualitative meta-synthesis

“…This theme reflected a paradoxical combination of a yearning for closeness and connection, conflicting with a strong fear of intimacy [ 36 , 63 , 73 , 74 , 76 , 78 , 86 , 87 ]. This simultaneous conflicting pull for closeness and distance was very challenging for participants to resolve.…”

Evaluations of emotional noninterpersonal situations by patients with borderline personality disorder

“…Most studies on evaluations by patients with BPD (Arntz & Veen, 2001;De Bonis, De Boeck, Lida-Pulik, Hourtane´, & Fe´line, 1998;Leichsenring, Roth, & Meyer, 1992;Sheffield et al, 1999;Veen & Arntz, 2000) support the hypothesis that DT is prominent in BPD. Overall, it was found that borderline patients evaluated others more extremely than clinical and nonclinical controls.…”

“…It is assumed that split evaluations (1) are unidimensional or univalent, i.e., all good or all bad, and (2) can be extremely positive (idealization) as well as extremely negative (devaluation). Studies focusing on interpersonal evaluations found evidence for both unidimensional DT (Arntz & Veen, 2001), as well as multidimensional or multivalent (for example, very good and very bad) DT (De Bonis et al, 1998;Sheffield et al, 1999;Veen & Arntz, 2000). According to Arntz and Veen (2001), response format might explain these ambiguous findings.…”

A Research on the Characteristics in the Initial Sandtray and the Pathological Model and Inner World Model of Patients with Borderline Personality Disorder

“…ity Disorders)中文版本 [11] [13] 和 Linehan [14] 的观点， 即边缘型人格障碍的决定性特征是分裂(splitting)的 防御机制的使用。但不同的是，分裂的防御机制是指 把世界看成或者全好或者全坏，而在沙盘中，分裂更 多地表现为不相干的、矛盾的、对立的东西同时出现， 并且没有得到很好的整合，没有协调统一起来，仅仅 是"在一起" 。Sheffield 等 [15] 提出了"悖论"(paradox)…”