Values in persons with borderline personality disorder: their relevance for the therapeutic interview

Abstract

This is an explorative study on values of 25 patients affected by borderline personality disorder interviewed in a clinical setting (phenomenological-dynamic psychotherapy) and re-classified following Consensual Qualitative Research. We identified three main categories of values: recognition (the importance for attention, acknowledgment, commendation and acceptance by the other), authenticity (the importance of absolute emotional fusion with the other), and immediacy (the importance of instantaneous, hic et nunc satisfaction of one’s needs/desires). Each of these values expresses a kind of ‘logic’, namely the logic of intimacy (the other’s closeness as indispensable for defining oneself and establish/reinforce one’s selfhood and identity), spontaneity (over-reliance on feelings unrestricted by social norms undermining their intensity), and instantaneity (glorification of ‘now-moments’/execration of procrastination draining the vitality of feelings). The borderline person lives an emotional normativity constituted by the intensity of feelings under the spell of a frustrated normativity since they enter into a collision with the hypocrisy of common-sense ethical norms and social rules and conventions, as well as by potential conflicts with the feelings of the other. Acknowledging the values affirmed by borderline persons may help to better understand their condition - that is, to grasp ‘what it is like’ and make sense of the phenomena that affect them – and particularly to find a logic in their otherwise irrational and incomprehensible self-defeating behavior.

Meaning-Making Activity in the Emotional Experience of Borderline Personalities

“…The symptoms mentioned above are, in fact, a logical consequence of the affective disturbance in the resonance that should keep BPD/EUPDs connected to their intersubjective and interaffective community. In accordance with Mancini and Stanghellini [11], I think that the emotional cascade of problems such as alexithymia, hypersensitivity, and the empathy paradox 9 affecting BPD/EUPDs' life can find logical explanations if we access their interaffective lifeworld.…”

“…The most logical behavior that follows from this implied obligation is self-exclusion. This means that instead of trying to fit in, the subject prefers quitting the relationship before being formally excluded from it; in this way, the stress and anxiety accompanying the impending sense of exclusion is won by the relief gained in knowing that the anticipated emotional pain generated by the actual exclusion will be avoided 11 . It happens often that when the individual feels that it is about to be excluded from its intimate or social circle, the first reaction is not rage but self-exclusion and the creation of an alternate paler reality where to live [29].…”

“…Phenomenological literature on the problem [8][9][10] agrees to interpret any symptom associated with this disorder as a way to understand their lifeworld [11]. I believe that these symptoms could be investigated as a consequence of the disruption of the interaffective lifeworld.…”

The Axiological Structure in Psychosis

“…These idiosyncratic values should not be easily confused with abnormal beliefs. Instead, they must be recognized as the world of the person in order to be modulated or adjusted in therapy [16]. This adjustment process would help the patient to untangle themselves from this egoic existential position.…”

“…Even initial phases, more focused on evaluation and establishing connection, are potentially valuable and enlightening moments. They can be used as opportunities to search for meaning and recognition -key moments for understanding and clarifying the value structure -from which a great deal a person's experience and actions originate [16].…”