Borderline Personality Disorder: A Differential Essay

This essay discusses the aetiology and pathophysiology of Borderline Personality Disorder, its impact on individuals, families, and society, and the treatments available. The movie Girl Interrupted provides a practical approach towards the disease and a peek into the life of a person who suffers from such an ailment.

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Running Head: Borderline personality disorder: A detailed study.
Title: Borderline Personality Disorder: A Differential Essay
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Borderline personality disorder: A Differential Essay
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Contents
Introduction................................................................................................................................3
Borderline Personality Disorder: A Detailed Study...................................................................3
Conclusion................................................................................................................................12
References................................................................................................................................13

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Introduction
Every human being, when he or she is born enjoys a state of physical and mental health.
The physical and mental health of the child grows with the passage of time (Enos, 2017). But
there are also cases where either the physical or the mental development of any child is not in
accordance with the age of the child. It is easy to analyze whether the child is growing
physically as it is visible to the naked eyes. The problem comes in case of mental health
which is not visible to the naked eyes. Another problem related to the mental health
development is that at times there are cases where the problem does not come to surface till
the adolescence or the late teenage. One such mental disorder is the Borderline Personality
Disorder (Bech, Elklit and Simonsen, 2015). This disorder has always been the topic of
debate amongst the mental health professionals. It is the borderline between the psychosis
and neurosis. In this essay, we will discuss the aetiology and pathophysiology of this mental
illness as with respect to the character Susana in the movie Girl Interrupted. We all also
assess the treatment or the mental health assessments as shown in the movie regarding the
borderline personality disorder ("Borderline personality disorder: management", 2014). The
essay will also try to assess the impact of the disorder on the lives of the individual, family
and the community as a whole along with the stigma and discrimination attached to it by the
people and society. The movie Girl Interrupted will try to provide us with a practical
approach towards the disease and a peek into the life of a person who suffers from such an
ailment, her sufferings and the trauma she has gone through during her stay in the mental
health facility.

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Borderline Personality Disorder: A Detailed Study
The Borderline personality disorder affects close to 7% of Americans in their lifetime. It
affects approximately 50% more patients as compared to Alzheimer’s and more than 2.25%
schizophrenia and bipolar diseases together. The current scenario regarding the circumstance
focuses on the in-progress patterns of intricacies involved in self-control i.e. ability to pacify
oneself in times of pressure and trouble with behavioural relationships emotions, thoughts,
and self-image (Crowell, 2016). If we try to analyze the causes of borderline personality
disorder it can be said that the research is in its early stages. Mainly there are two major
causes of borderline personality disorder i.e. genetic causes and environmental causes.
Scientists agree that the above mentioned two factors are majorly responsible for this mental
disorder. In the movie also when Susana’s parents come to Claymore facility, and they are
having a discussion about when they can take her home Susana asks the doctor if it is genetic.
Then the doctor says that there are 5% more common among those with the borderline parent.
Whereas some personality traits are symptomatic of borderline personalities akin to the
recklessness and hostility can be inherited or genetic but the brain expansion and growth are
not entirely genetic (Stroud & Parsons, 2012). They get affected by the environment also. In
addition to this, it has been found in the current as well as the available research that it is
more likely to be found in the females as compared to the males. The environmental factors
can be like events during the childhood like emotional abuse, social-cultural surroundings,
post-traumatic stress disorder, intense and chronic stress, loss of a family member, neglected
child, bullying, sexual abuse, physical abuse, mental agony, unstable relationships and
disturbed family life, etc which too play a task in the growth of the disorder at the later stage
of life ("Borderline features are associated with inaccurate trait self-estimations", 2014). All
such risk factors increase the chances of the brain abnormalities. In the movie also it is also
shown that during the party, how Bonnie’s mom Bobby Gilchrist flaunts in front of Susana

Borderline personality disorder: A Differential Essay
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and her mother about her daughter being accepted into Redcliff College. Apart from the
research, the existing theories are more expected to build up borderline personality disorder
owing to harmful childhood experiences biology, genetics (Amad, 2014). When examinations
are done during the research on the borderline personality disorder patients it has been found
that the prefrontal cortex in the patients which helps in regulating self-control, behavior and
emotions may be comparatively minor as compared to normal or not as grown as it may be
required to fully function. Contrarily the amygdala is on the other hand so much proactive
which in turn leads to more intense emotional reactions and heightened emotions as in case of
Susana when she behaves angrily when she is in session with Dr. Mrs. Potts.
Neurotransmitters inside the human brain whose responsibility is to regulate learning, mood
and sleep are also at lesser levels as required in case of borderline personality disorder cases
("Characterizing adult attention-deficit/hyperactivity disorder and comorbid borderline
personality disorder: ADHD symptoms, psychopathology, cognitive functioning and
psychosocial factors", 2016). If we see the pathophysiology or the symptoms of the disorder
we can list them down as under. The first symptom is the intense fear of rejection and
abandonment which has been shown in the movie when Susana visits a doctor who is a friend
of Susana’s father who has left counseling but gives her time due to his friendship. At the end
of the session, Susana’s mother leaves her baggage at the door with the doctor and doesn’t
come out of the car when she goes. Another symptom is unstable moods and intense
emotions. Susana shows intense emotions in the argument with the Lisa and she yells at her
saying that you are dead already and her heart is cold. The patients with borderline
personality also depict the chronic feeling of emptiness and extreme sadness (Brickman,
Ammerman, Look, Berman & McCloskey, 2014). At various accounts, the protagonist
Susana shows sadness like when her friend commits suicide and a feeling of emptiness
surrounds her when she leaves her boyfriend. Such patients are also sensitive to criticism.

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They get easily frustrated with themselves and the surroundings. When the people they care
the most disappoint them they get annoyed at them or when the things don’t go as they have
planned it in their minds. Susana gets frustrated or annoyed when she watches a fellow
inmate getting out of the facility whom she thinks is not eligible to get out. They also get
angry and show aggression. They also indulge in self-harming behavior at times which may
also include the attempt of suicides like Susana gulped a bottle of aspirins with a bottle of
vodka. They also have unstable and changing relationships like Susana first have relation
with Jared and then suddenly leave him because she has established a bond with the
institution (Lewis, Caputi & Grenyer, 2012).
It is also possible for the mental health professionals to make mental assessments of the
borderline personality disorder patients after having a few sessions with them . Dr. Melvin
Potts in her mental health assessment if Susana writes that she suffers from psychoneurotic
depression reaction, although she is judged to be highly intelligent but she has been found in
denial of her existing mental condition resistance and also her there is a personality pattern
disturbance which is resistant and mixed type r/o undifferentiated schizophrenia. There are
many treatments which have been researched and developed over the period of time (Biskin
& Paris, 2012). Some of the prominent ones are like talk therapy, dialectical behaviour
therapy, metallization based therapy, transference-focused therapy, good psychiatric
management, cognitive behavioural therapy, medication and self care activities. The first and
major treatment is the talk therapy which is the foremost choice of the professionals as
compared to the medicines in other ailments or diseases. In the movie also Susana’s father
sends her to his friend who is a mental health professional. Generally, there are one or two
sessions a week depending on the response of the patient to the treatment. This treatment to
be successful the patient must feel relaxing and a relation of fidelity must be established. This
treatment reduces anger and self-harm and overall improves the social and mental functioning

Borderline personality disorder: A Differential Essay
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of the patient. Another therapy practiced by the professionals is dialectical behavioral therapy
(Abdelhamid Gado, 2016). It lays emphasis on the notion of mindfulness or paying
consideration to the current sentiment. It teaches methods to be in charge of strong emotions
minimize self-destructive behavior and handle anguish and get better at relations like Susana
at the end of the movie make amends with Lisa and how she let go the emotions attached
with the cat by handing her over to the inmate. This proactive problem-solving technique was
specially designed for borderline personality disorder and includes therapy sessions and
group tasks. Another therapy is a metallization based treatment which is also a talk based
therapy which assists people identify and comprehend what other people are possible
understanding and feeling about them (Bohus, Schmahl & Oldham, 2014). Next is the
transference-based therapy which assists the patients to comprehend their interpersonal and
emotional problems by the means of association between the patient and professional
therapist. The insights the patients learn in the sessions are applied by them in different
scenarios. Good psychiatric management provides the mental health professionals a particular
set of the toolbox which they can use with patients with severe disorders. Then comes the
cognitive behavioral therapy which studies the relationship between the thoughts and beliefs
vis-a-vis feelings and behavior. It basically combines cognitive therapy and behavioral
therapy. Medication is also a treatment for the borderline personality disorders but
professionals are of the opinion that it cannot be cured with medication but it helps in treating
other conditions that worsen the situation for this disorder like anxiety, depression, etc
("Psychotherapy for Borderline Personality Disorder Reduces the Need for Prescription
Medication", 2015). Patients with this disorder are always encouraged to talk with their
doctors about the effects of medicines and side effects. The most effective remedy is the self-
care techniques like scheduled exercise, good quality sleep habits, nourishing diets, eating
medicines as approved and health stress administration all this can assist in reducing routine

Borderline personality disorder: A Differential Essay
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symptoms of borderline personality disorder like mood swings, impulsive behavior. Finding a
mental health professional is equally important as it is to get the treatment. He must have
certain qualities or traits before anyone is selected. He/she must be an experienced consultant
with which the patient feels comfortable and it is easy to trust him/her. He must use a blend
of various techniques for the patient so as to avoid monotony. He/she must have a valid
license for practice and cares and understands about the patient. He should accept the patient
without any judgment. As it is all a talking therapy he should be a good listener. Similarly, a
faculty also must have a license to operate and must have specially trained professionals and
must be in existence for a minimum number of years ("Consistency and coherence in
treatment outcome measures for borderline personality disorder", 2015). Patient staff ratio is
also an important criterion. Facilities provided are also an important number of times therapy
is offered in a week, kind of staff trained or untrained, aftercare options, rules handbook etc.
Every ailment or mental disorder affects the life of the individual, family and the society in a
way or other. The borderline personality disorder also affects the individual in an adverse
manner. The major effects are discussed as under. The first effect is that the person suffering
from borderline personality disorder has to go through the emotional irregularity. Researchers
suggest that the brain areas responsible for emotional response become overactive and less
active are the areas controlling emotions and aggressive impulses. It becomes confusing to
live with when you are not sure whom to trust and not. Every emotion is exaggerated and
over-amplified. Difficulty in controlling anger and getting bored easily creates a feeling
emptiness and restlessness. Another impact on the individual is the unstable relationships,
being sensitive to what we call as rejection. They start hating the persons on the basis of fear
that they are going to leave them at the end. They start manipulating people without being
aware of the fact they are doing so. They become possessive, suspicious and paranoid
regarding their relationships. They are not able to judge anyone like Susana left Jared when

Borderline personality disorder: A Differential Essay
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he asks her to go with him. Another impact on the patients is that they become impulsive in
behavior ("The impact of posttraumatic stress disorder on the symptomatology of borderline
personality disorder", 2016). They start keeping to themselves in case of certain events like
Susana keeps lying on her bed after the death of the inmate. The doctor and has carry her to
put her in a bathtub to break the continuity. Another example of the impulsive nature is when
Susana runs away with Lisa from Claymore, establishes a relationship and comes back.
Borderline personality disorder patients also suffer from identity disturbances. They always
have a conflict going on with themselves. They have a fluctuating self-esteem. Along with
the individual suffering, the family of the patient also suffers (Flynn et al., 2017). Their pains
and sufferings are also heightened. The first impact on the family is the social stress and
taboos fixed, as depicted in the movie, Susana’s parents are worried that when will she be
back as there is Christmas and what are they supposed to tell the family members and
relatives coming to their place. They always feel a sense of guilt around them as if they have
committed some crime in the society if their children have a mental disorder. The immediate
and the extended family also suffer in their respective workplaces, colleges, schools as they
are also taunted regarding their relationship with the person. At times there is also a risk of
the family members getting into depression because of the personal sufferings and the
individual sufferings. Another impact is that they are not trained to handle the mental
disorder people even though they are their relations. There is always a chaotic environment at
the home. People go to their workplaces with problems in their minds which have an adverse
impact on their professional lives. Such people also face lack of social support which can be a
great morale booster of received. As the treatments are expensive also they come under the
financial stress also after a period of time. Individual and the families when combined
together give us society or community in which we live in. The mental disorders whether
borderline personality disorder or any other do have an impact on the society. Although it is

Borderline personality disorder: A Differential Essay
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not in control not to have such diseases or problems and they cannot be avoided but till the
time they exist or occur they will continue to have financial impact on the society, the funds
which are used for providing facilities can be used for some more constructive purposes. As
we have studied already that the behaviour can get impulsive or aggressive, the patients have
to be kept under observation and control so that it may not happen that they harm anyone
close to them ("The Effectiveness of Dialectical Behavior Therapy on Reducing Symptoms
of Borderline Personality Disorder: Case Study", 2016).
Also, there is a discrimination and stigma attached to the personalities and people attached to
such kind of disorders (Myers, 2017). It is necessary to fight stigma so that the patients can
be cured and joined with the mainstream people. But the irony of the fate is that the people
who are expected to cure them, bring them to the mainstream ate the ones who are pulling
their legs. They are ones majorly responsible for bringing them down. The mental health
professionals have more stigma and discriminating attitude toward the patients then their
families or the society as a whole has. The professionals are the persons who misunderstand
the patients; they misdiagnose the patients as compared to any other illness. It has been even
found that the mental health professionals go to the extent of denying the patients their right
to treatment on the grounds that they do not have any problem. In some cases i.e. where the
professional take the cases they do not perform the case studies professionally. They do it just
for the sake of doing it. They do not have any professionalism in their approach or any
feeling of attachment towards the patient. Those who do it, they do it without proper training
which is comparatively more harmful than beneficial thus making the therapy sessions more
frustrating, mentally painful and physically uncomfortable. A little knowledge of anything is
a dangerous proposition which these professionals always apply. The frustrated patients are
misjudged and denied treatments by the professionals who act as an act of hopelessness
(Ramleth, Groholt, Diep, Walby & Mehlum, 2017). The abandonment by the professionals of

Borderline personality disorder: A Differential Essay
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the patients closes all the doors for them and makes the situation for them, even more, worse
as it was in the beginning. Then they are condemned for their destructive actions, their
families distance themselves, but in the end, all they need is a help. The therapists push the
limits during the sessions between the client and professionals. People having borderline
personality disorder require a very special type of treatment. The stigmatization of the
patients within the mental health profession as well as in the society at large needs to be
discontinued (Kling, 2014). The same stigma then moves on to the society thus expanding
like a tumor in the minds of the society. The discrimination is often linked to the prejudicial
attitudes which develop amongst the society due to various reasons like upbringing of the
family, peer and society’s company, etc. The stigma being faced by the people is nerve
wrecking be it from the friends as shown in the movie when all the inmates go out to the ice-
cream parlor how Susana tries to avoid her family friend Bonnie and her mother. The stigma
can be ended by creating awareness and correcting the common misconceptions. The people
who are subject to the stigma and discrimination at the hands of the professionals providing
services or the society in which they live in and are an integral part of the same, they have
rights as granted to them by their countries. Many countries provide fundamental rights like
right to equality and right to life which when violated the person can move to the courts.
They have the right to be treated with dignity and the respect they deserve like fellow human
beings ("The impact of childhood temperament on the development of borderline personality
disorder symptoms over the course of adolescence", 2014). They have the right to privacy
like all others and it cannot be made public at any cost whatsoever. It may lead to social
isolation, poor housing, and mental health problems. It also affects the process of getting
treatment. It is also because of such treatment by the mental health professionals, the society
that the patients with borderline personality disorder or any other disorder do not recover
completely. The situation gets worsened by the exaggerated media reports which highlight

Borderline personality disorder: A Differential Essay
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the matter so much that it becomes a taboo of the society. The best way to challenge these
stigmas of the society is through the first-hand meetings and contact of the people with the
patients. The society should feel itself that they are a part of their society and as much as part
of the society as they are. There is a need for deeper understanding by the family especially
mothers social interactions and professionals (Ball Cooper, Venta & Sharp, 2018). We need
to develop new skills that promote positive nature and amicable atmosphere for all. We must
not forget that the patients are human beings too; all that is required is attention and care.
Once all the required efforts are put it is bound to be a success and they will also be the part
of the mainstream.
Conclusion
Movies are considered as the mirror of the society they reflect what happens in the society if
Susana can be cured and go home, so could all others who suffer from such mental health
disorders. We must remember that all those patients who are suffering from such diseases did
not choose themselves to be the patients. It was their bad luck that they got chosen by their
destiny. They do not come from someplace else. They are the part of the same society of
which we are. Being the part of the same society they and us, it becomes our moral and
societal duty to comfort them, provide the treatment and professional help they require. All
they need is love, care, and support of their families and a little bit of medical attention from
the doctors (Madan & Fowler, 2015). When the stigma is removed and no discrimination is
made on the basis of their illness and they are given their due place in the society they will be
able to cope up faster than expected and will be the part of the mainstream society. All the
mental health disorders are curable with proper counseling and medication as all other
ailments are.

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