Codependents also yearn for love and fear abandonment. Codependents already have low self-esteem and poor boundaries, so they placate, accommodate, and apologize when attacked in order to maintain the emotional connection in the relationship. They often become caretakers. They do so sometimes to the point of self-sacrifice or enabling.
In the process, they give over more and more control to the borderline and further seal their low self-esteem and the couple’s codependency. Giving in to their partner and giving them control does not make either of them feel safer, but the opposite.
Borderlines need boundaries. Setting a boundary can sometimes snap them out of their delusional thinking.
Calling their bluff is also helpful. (See also my blog on manipulation.) Both strategies require that codependents build their self-esteem, learn to be assertive, and derive outside emotional support.
The relationship can improve when the partner takes steps to heal their codependency. (See Codependency for Dummies.)
Making the Diagnosis
Like all personality disorders, BPD exists on a continuum, from mild to severe. It affects women more than men and about two percent of the U.S. population.
BPD is usually diagnosed in young adulthood when there has been a pattern of impulsivity and instability in relationships, self-image, and emotions. They may use alcohol, food, or drugs, or other addiction to try to self-medicate their pain, but it only exacerbates it.
To diagnose BPD, at least five of the following symptoms must be enduring and present in a variety of areas:
1. Frantic efforts to avoid real or imagined abandonment.
2. Unstable and intense personal relationships, marked by alternating idealization and devaluation.
3. Persistently unstable sense of self.
4. Risky, potentially self-damaging impulsivity in at least two areas (e.g., substance abuse, reckless behavior, sex, spending)
5. Recurrent self-mutilation or suicidal threats or behavior. (This doesn’t qualify for Nos. 1 or 4.) Around 8 to 10 percent actually commit suicide.
6. Mood swings (e.g. depressed, irritable, or anxious) mood, not lasting more than a few days.
7. Chronic feelings of emptiness.
8. Frequent, intense, inappropriate temper or anger.
9. Transient, stress-related paranoid thoughts or severe dissociative symptoms.
Related: 7 Surprising Positive Aspects Of BPD
Causes and Treatment
The cause of BPD is not clearly known, but often there has been neglect, abandonment, or abuse in childhood and possibly genetic factors.
People who have a first-degree relative with BPD are five times more likely to develop BPD themselves. (For more read here.)
Unlike narcissists who often avoid therapy, borderlines usually welcome it; however, before recent treatment innovations, its effectiveness had been questioned, which led to stigmatization.
Today, BPD is no longer a life sentence. Studies have shown that some people recover on their own, some improve with weekly therapy, and some require hospitalization. Long-term treatment is required for maximum results, with symptom relief increasingly improving.
A 10-year study showed substantial remission after ten years. Use of medication and DBT, CBT, schema therapy, and some other modalities have proven helpful. Most individuals with BPD have another co-occurring diagnosis, such as addiction and/or depression.
Acute symptoms diminish more readily than temperamental ones, such as anger, loneliness, and emptiness, and abandonment/dependency issues. Borderlines need structure and a combination of knowing that they’re cared about plus boundaries that are communicated calmly and firmly.
Learn to be assertive, and set boundaries.
Get How to Speak Your Mind- Become Assertive and Set Limits (and webinar: Be Assertive) For partners, it’s also important to seek therapy in order to raise your self-esteem.
©Darlene Lancer, LMFT 2013
Written by Darlene Lancer Originally appeared in What Is Codependency