Since last January, a new care unit specially dedicated to people suffering from borderline personality disorder has opened at the Toulouse University Hospital. The Borderlink team offers group psychotherapy to help these patients manage their hyperemotivity.
Doctor Anjali Mathur, psychiatrist at Toulouse University Hospital, is responsible for the Borderlink care unit. She explains the nature of this mental disorder and what this new unit offers.
How to define borderline personality disorder?
The word borderline means “on the edge” because this mental disorder was originally considered “on the edge” between neurosis and psychosis. Today, it is a clearly defined disease which generally manifests itself at the end of adolescence and has a strong impact on the daily and relational life of patients. It is characterized by hyperemotivity and hypersensitivity. It is the most common personality disorder. It affects between 1 and 3% of the population, mostly women, and represents 10% of patients treated in psychiatry and at least 20% of hospitalizations. It can be accompanied by associated diseases, depressive episodes, anxiety or addictions
What are the symptoms associated with this disease?
Borderline disorder results in marked impulsivity, great instability in emotions, in relationships with others and in self-image, a feeling of emptiness and boredom that is very difficult to bear and a fear of abandonment. . This fear of abandonment is the heart of the disease. It creates significant suffering with often thoughts, suicidal behavior and self-injurious gestures, but you should know that borderline personality disorder (TPB) has a good prognosis, especially if it is treated quickly and specifically. The most important symptoms, self-harm and impulsivity, are the ones that disappear the fastest.
Is it in early childhood that we must look for the causes?
This disorder is the result of a combination of factors. There is a genetic part, of around 50%, but the genes are expressed because the family environment does not provide an appropriate response to the needs of a child who is born with this emotionality. The parents are unable to respond to them due to lack of availability, because of a psychic disorder or because their mode of expression imposes a control of emotions. A child who is told, “We’re not crying about that, we’re not sad about that,” can neither recognize his emotions, nor accept them, nor learn to manage them.
Marked impulsiveness, emotionality, it can speak to many people who are not necessarily borderline…
Borderline personalities have a bit of the life we all have, but much stronger. With them, the emotions, the sadness, are very intense and last longer. One can be emotional but without having the degree of suffering of these patients nor the desire to hurt oneself to manage one’s emotions nor recurrent suicidal thoughts. BPD is also often confused with bipolar disorder due to mood swings. In the borderline patient, they can take place several times a day and are linked to micro-events or interactions with others. Furthermore, there is no drug treatment for borderline personality disorder.
What is the support offered by the Borderlink unit?
This unit offers an adapted form of one of five specific psychotherapies that have been shown to be effective for BPD. Our team includes two nurses, a psychologist and two psychiatrists. About 40 patients are currently being cared for and have integrated skills training groups which take place once a week for three or six months. They learn to get out of judgment of themselves and others, to put their emotions into words and not to act on them immediately or to end harmful relationships. We encourage patients to create a social life, to have a job and to study, as this provides them with a structuring framework and a goal. Our plan is also to offer, as of this fall, groups intended for those around patients to help them better manage relations with borderline personalities.