About Borderline Personality Disorder

  Ms. Li suddenly picked up a utility knife and cut her wrist while she was at work last month. The team leader took her to the hospital urgently for treatment, and the wound was deep. The factory was worried about her safety and asked a psychiatrist for urgent psychological intervention.  Ms. Li since May last year, always can not control their emotions, feel very depressed, can not find a way to vent, so will not be able to control the knife to cut their wrists. The first cut is a little painful and a little scared, but after that several times it does not feel, and also feel comfortable, temporarily forget about the pain. Sometimes also take sleeping pills, because after taking the daze, will not remember the painful experience. But doing these acts is not for suicide, only to make themselves less painful.  Once when she was a child, Ms. Lee felt so much pain that she confided in a good sister and asked her to keep it a secret, but the story leaked out to her, and Ms. Lee has not trusted anyone since. When she was in pain, she would drink alcohol or take sleeping pills, but later she felt that these could not relieve her pain, so she felt that the only way to help herself temporarily was to cut herself.  Ms. Li’s problem belongs to borderline personality disorder, borderline personality disorder is a psychiatric disorder characterized by the instability of interpersonal relationships, emotions, self-image, and impulsivity, the core of this disease is the inability to regulate emotions, using self-injury methods to relieve pain, regulate emotions or achieve other purposes.  Patients with borderline personality disorder generally give a headache and cannot cooperate well, although if they are properly recognized, they can uncover a lot of trauma and the behaviors they commit, although bad, are soothing to them.  Further understanding revealed that Ms. Li was adopted, abandoned by her biological parents as a child, and later abandoned by her boyfriend in her first love. Ms. Li felt that when cutting herself she could temporarily forget the pain, felt that she could find a sense of existence, and felt that although it would be painful, but comfortable. In fact, it is also an escape, used to escape from previous traumas.  The most effective treatment for borderline personality disorder is dialectical behavioral therapy. Ms. Li needs to vent, to feel pleasure, to control, to feel alive, so we have to teach her how to get these things, but these feelings are not obtained by cutting herself, they are obtained by other ways. These other ways include relaxation techniques, delay techniques, distraction, somatic focus and other techniques such as counting, 5-5-5 breathing, 5-minute walks, basketball, listening to music, taking a bath, holding ice cubes in your hands, playdough, clenching your hands, etc. Self-injury is replaced by these other means.  When treating the patient, the most important thing is to tell her beforehand so that she does not have too high expectations, cutting herself is very quickly can get the function of the behavior, go for a walk, listen to music these are not possible to give her the same feeling as cutting herself, but why try, because we teach her methods that will not hurt, hands will not have scars, let her weigh herself, after cutting herself will relieve the pain, but venting After, may feel very frustrated, very low self-esteem, very angry. If you go for a walk, listen to music, etc., it’s not strong enough, but because there will be no harm, no low self-esteem, no more frustration, and it’s up to her to comprehend and be willing to try. Sometimes patients are impatient, they are afraid of the pain now, they want to take the pain away quickly, the patient’s pain has to go from 100 to 0, after cutting themselves to 0 , but the pain is unbearable at 70, 80, so we have to teach them that expectations should be reasonable, not to take 100 to 0’s, but to take the pain from 100 to 90, from 90 to 80, from 80 to 70, step by step Take your time, as if you are adjusting the temperature with an air conditioner, slowly adjusting it down instead of changing it immediately.  Teach patients not to be afraid of their emotions, many patients with borderline personality disorder are afraid of their emotions, they are too strong and too scary, teach them that your emotions are yours, you can control them, you can strengthen them you can lower them. Slowly adapt to the emotions and try to see with those behaviors instead of self-injury. Our goal today is not to put your your emotions back to zero, but to slowly come to terms with them. By doing so, we can help people with borderline personality disorder to ease their pain and regulate their emotions by using alternative self-injury.