Anxiety sensitivity and borderline personality disorder

Anxiety sensitivity, or the fear of becoming anxious, has been indicated as a factor in the occurrence of panic attacks for a long time. It is believed that many panic attacks are caused or intensified by the fear of anxiety, a self-perpetuating cycle that can eventually leave the sufferer house-bound in an effort to control their environment. New research indicates that anxiety sensitivity may also be indicated as a factor in the development of borderline personality disorder, or BPD. If this is the case, there may be new hope for treating this severe and destructive personality disorder.

Anxiety sensitivity and borderline personality disorder: a newfound sympathy? (link)

Anxiety sensitivity, or the fear of becoming anxious, has been indicated as a factor in the occurrence of panic attacks for a long time. It is believed that many panic attacks are caused or intensified by the fear of anxiety, a self-perpetuating cycle that can eventually leave the sufferer house-bound in an effort to control their environment. New research indicates that anxiety sensitivity may also be indicated as a factor in the development of borderline personality disorder, or BPD. If this is the case, there may be new hope for treating this severe and destructive personality disorder.

Borderline personality disorder is mostly misunderstood by the general public. It can be hard to have sympathy for those who suffer with this disorder, which causes impulsive, aggressive, or needy behavior, often vacillating between rage and helplessness. Two of the main markers of BPD are splitting and a tenuous self-image. Splitting is seeing people as either all good or all bad. There can be no in-between. If someone does what the BPD person likes, they are idealized; if they make a mistake, they must be completely evil. Those with borderline personality disorder also suffer from an unstable self-image and lack a steady sense of who they are.

A recent study showed that anxiety sensitivity might have something to do with the unstable behavior of someone with BPD. While their behavior may appear destructive to outside observers, splitting and a tenuous sense of self along with all the byproduct behaviors produced by these two markers may simply be the way that someone with borderline personality disorder keeps anxiety at bay.

Outpatients who suffered with borderline personality disorder were compared with those who did not suffer from any personality disorder. They were measured for anxiety sensitivity as well as experiential avoidance, or attempts to avoid unwanted internal experiences such as anxiety. What they found was that there was a noticeably higher incidence of anxiety sensitivity and experiential avoidance in patients suffering with borderline personality disorder.

What does this mean? It could mean that borderline personality disorder is developed partially in response to anxiety sensitivity. Because the borderline fears certain situations and outcomes, they avoid anxiety-provoking possibilities through splitting and lack of a concrete self-image. How would this work?

Splitting allows the borderline to avoid facing the unpredictable nature of other people. Facing the fact that no one is all good or all bad brings up fears that the borderline will not be able to protect him or herself from other people, so blanket generalizations make it much easier for them to know how to handle interpersonal relationships. Someone does something “wrong?” Simply cut them off. The person with borderline personality disorder wreaks havoc in their relationships because of splitting, but they fear life without it.

A tenuous self-image allows the borderline to become a chameleon, behaving however they believe they have to in order to earn the love of others and keep an overwhelming fear of abandonment away. Again, they have anxiety sensitivity about the negative feelings abandonment or rejection would bring up, so they use a lack of stable self-image to lessen feelings of anxiety sensitivity.

While the behavior of a person with BPD is ultimately more harmful than helpful, they begin using these behaviors and beliefs as self-protection. In recent years, dialectical behavioral therapy, or DBT, has shown great promise for treating this disorder—once thought untreatable. Still, further research into the link between anxiety sensitivity and BPD may uncover even more treatment options and offer hope to a group of people who’ve struggled for so long with misunderstanding and pain.

© Copyright 2007 Insight Journal Online Magazine.