Borderline personality disorder (BPD) is a serious form of mental illness characterized by a pattern of mood swings, impulsive actions and problems with relationships. People with BPD have trouble regulating their emotions effectively. They may experience splitting, which is a term that refers to seeing things as all good or all bad.
Splitting means having difficulty holding opposing thoughts. A person who experiences splitting is unable to weigh positive and negative attributes of a person or event or recognize that good and bad attributes can be true at the same time.
Seeing Things in Black and White Terms
A person with BPD frequently sees things in black and white terms, which means things and people are seen as either all good or all bad. They may even perceive themselves in these rigid, all or nothing terms. They don’t believe good people can be bad sometimes or can make mistakes, which can lead to becoming consumed with anger toward people who fall short of idealistic thinking.
Splitting is considered a coping mechanism that helps a person with BPD avoid getting hurt. It allows them to discard things and people they have decided are all bad. In spite of the fact that it is meant to be a coping mechanism, splitting can cause a person with BPD to experience intense episodes of rage or depression that may last for days.
Troubled Relationships and Stigma
Mental illness in general is frequently stigmatized, and the root of stigma is misunderstanding. When a person sees things in a much different way than most people, it can be difficult for others to understand or tolerate this way of thinking. Those who are stigmatized are left not only dealing with the challenge of living with their symptoms, but also dealing with the judgmental attitudes and closedmindedness of others. This can make it very difficult for a person with BPD to ask for help or to get treatment.
Relationships can be very challenging for a person with BPD, and splitting has a lot to do with it. People are either idealized or devalued, with no middle ground. The source of the stigma is that people who do not have BPD don’t understand why people with BPD can’t simply choose to stop seeing things in black and white terms.
Other factors that can damage relationships for a person with BPD include:
- Intense fear of abandonment and frantic efforts to avoid it
- Uncontrollable anger, possibly followed by shame or guilt
- Reactivity, irritability and anxiety
- Impulsive behaviors such as reckless driving or spending
- Unstable self-image or sense of self, including seeing oneself as bad or as if not existing at all
- Difficulty trusting
Splitting is a coping strategy to help a person with BPD make more sense of the world around them. They have such an intense fear of abandonment that by using splitting, they are able to tell themselves the other person is bad rather than that they have been rejected or abandoned. Chronic emptiness and fear of abandonment can also cause idealization of another person, which means believing the other person is all good or perfect.
Treatment for BPD
The symptoms of BPD, including splitting, are mainly treated with psychotherapy. Medication may be part of a treatment plan, particularly if there are co-occurring disorders such as anxiety disorders. Group, peer and family support may also be part of a treatment plan.
Psychotherapy is one of the most important aspects of treating BPD, because it aims to help a person to cope with the intense emotions that are a big part of BPD. With therapy, a person can learn coping skills while growing in insight and acceptance. Forms of therapy include:
- Dialectical behavioral therapy (DBT) – teaches coping skills to regulate emotions along with mindfulness and techniques needed to reduce suicidal urges
- Mentalization-based therapy (MBT) – helps people explore emotions and work on difficult interactions with others
- Cognitive behavioral therapy (CBT) – helps a person recognize negative thoughts and learn new coping strategies
Residential treatment for BPD can be helpful for someone who is struggling with self-harming behaviors, suicidal thoughts and impulse control. Obtaining treatment on an inpatient basis provides a safe space where a person can learn new skills for regulating emotions without the distractions of day-to-day life.
With evidence-based treatment, those with BPD can experience fewer symptoms and more stability. Episodes of splitting and other signs of emotional dysregulation can be reduced, leading to an improved quality of life.