Hello! Welcome back to another episode of diagnosing a killer.
This is Dr
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Oh, yeah, the 15th?
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This is actually a request by the lovely ladies that host the podcast, Lady You're
Scaring Us.
Oh, hey, ladies.
Hey, ladies.
And we did take your request.
So today, we are going to deep dive into Borderline Personality Disorder.
Oh, my gosh.
So we've talked about different personality disorders on the mental breakdown.
We've talked about them on cases.
We've definitely talked about BPD before, but in passing, we haven't really done a
deep, deep dive of it.
Yeah.
So I decided to bring that today.
I'm excited.
So, this is a content warning.
This episode contains depictions of self-harm, self-sabotage, extreme reactions to particular
scenarios, talk of suicide, and mention of murder of children.
If this episode is not for you, we encourage you to find another one of our episodes.
Remember your mental health is super important to us, and we love you.
We love you.
Love you.
Bye.
So yeah, content warning is a little bit of a doozy, but it's just because specific
cases get brought up that people had BPD, and we talk about just a little bit of that.
Okay.
So, here's what your dudes, borderline personality disorder, or BPD, is a mental illness that
severely impacts a person's ability to manage their emotions.
This loss of emotional control could increase impulsivity, affect how a person feels about
themselves, and negatively impact their relationships with others.
The DSM-5 defines BPD as a pervasive pattern of instability of interpersonal relationships,
self-image and affects, and marked impulsivity, beginning by early adulthood and present in
a variety of contexts, as indicated by five or more of the following.
Number one is frantic effort to avoid real or imagined abandonment.
Number two, a pattern of unstable and intense interpersonal relationships characterized by
altering between extremes of idealization and devaluation.
These words are very big.
I was going to say, good job.
Thank you.
Number three, identity disturbance, markedly and persistently unsable self-image or a sense
of self.
Number four, impulsivity in at least two areas that are potentially self-damaging, such as
spending, sex, substance abuse, reckless driving, or binge eating.
Oh, wow.
Number five, recurrent suicidal behavior, gestures or threats, or self-mutilating behavior.
Number six, effective instability due to a marked reactivity of mood, such as intense
episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely
more than a few days.
Number seven, chronic feelings of emptiness.
Number eight, inappropriate intense anger or difficulty controlling anger, such as frequent
displays of temper, constant anger, and recurrent physical fights.
And number nine, transient stress-related paranoid ideation or severe dissociative symptoms.
It sounds like Chris and Gilbert.
Oh yeah.
I mean, just to a T, for sure.
And we've done a lot of cases, like I said, that this has gotten brought up because there
is a lot of cases where people do become serial killers and they have, or just killers in
general, and they're diagnosed.
That impulsion one is pretty interesting because it's a wide range of other types of, I guess,
like comorbidities, do you know?
Yeah, definitely.
People with BPD may experience intense mood swings and feel uncertainty about how they
see themselves.
Their feelings for others can change quickly and swing from extreme closeness to extreme
dislike.
These changing feelings can lead to unstable relationships and emotional pain.
People with BPD can also tend to view things at extremes, like all good or all bad, and
their interests and values can change quickly, causing them to act impulsively or recklessly
at times.
People with BPD tend to be extremely sensitive, with small things affecting them largely,
and having a difficult time calming themselves down after getting upset.
That's really interesting.
I feel like I've absolutely met at least one or two people that I feel have that kind
of, I don't want to call it like a pendulum swing, but an adverse reaction, something
that does not equate to the actual issue.
I've seen it a lot too, and I will say that it's definitely a symptom of drinking, because
I've seen it a lot at the bar per se or perhaps.
People can flip on the switch of a flip or whatever, or flip of a switch.
I think that the alcohol obviously increases the chances of that happening.
And the impulsivity, like you said.
And the impulsivity, for sure.
This is also not to be confused with someone that's having a panic attack.
Someone that has a panic attack has a hard time calming themselves down.
Obviously, you're going to have a hard time getting out of that.
Someone that is maybe not explosively angry, but stays angry for a long time, even if it's
not really intense anger.
It's beyond a reasonable measure.
Exactly.
Yeah, exactly.
Other signs and symptoms of VPD include getting panicky or angry when a friend is a few minutes
late or cancels plans, causing the person to feel abandoned.
Having a quick temper and lashing out verbally at friends, parents, or family, especially
when they think someone is not meeting their high demands for support, is also a symptom.
Don't you think that ironic, though, that this behavior is probably turning a lot of
people off to wanting to be around you?
Not that it's something that you're doing.
This is a disorder.
For sure.
But I don't think that people that have VPD can even recognize that that's what they're
doing is a problem.
Yeah.
Not a problem, but something that's going to turn people off.
Do you think that because of the disorder, the behavior itself is probably very confusing
for someone that doesn't understand the disorder.
Yeah.
So that's the pattern of abandonment that they're experiencing?
Maybe.
These symptoms of VPD, they lash out at people and then in turn they get abandoned, but they
don't recognize that it was their actions that caused that.
Yeah.
Which is really hard because, again, you said it's a disorder.
People are not doing this just to be difficult or to lose friendships or relationships, but
it's almost like they can't control that because it's an impulsive thing.
They can't control the explosive anger and the lashing out verbally and stuff, especially
when someone lets them down, quote unquote.
Right.
And again, like you said, one of the criteria is the fear of abandonment or any cost try
to avoid that feeling.
Yes.
So it's just kind of ironic that that's built in with the criteria of the disorder.
For sure.
Now, moving forward with these are signs and symptoms of VPD, so shifting their views rapidly,
like I stated in the criterion, such as going from praising someone to being overly critical
of that person.
So praising someone at first and then maybe something happens that's really minuscule
and then now you have a lot of things to say negatively about that person.
You're a liar.
You're whatever.
You're a thief.
Yeah.
Stabotaging themselves when they're about to reach a particular goal, like dropping
out of college shortly before graduation.
That's an extreme skill.
Harming themselves on purpose, such as cutting or burning themselves and creating crises,
such as an attempted suicide or threatening suicide to keep people from abandoning them.
Oh, wow.
I know.
That's really extreme.
Although most people that have VPD will not harm themselves to the point of fatality,
almost one in 10 individuals with VPD will ultimately die from suicide.
The average population prevalence of VPD is 1.6%, but experts estimate that it could
be much higher, as high as 5.9%.
Out of the population that is diagnosed, about 75% are women.
Eileen Warnos and Kristin Gilbert are examples of people women diagnosed with VPD, but Jeffrey
Dahmer was also reportedly diagnosed with VPD as well.
Oh.
And it's funny that you did all three of those people.
I did.
I have a type.
Yeah.
VPD can be caused by a couple of different reasons, but the two most likely are genetic
and stress that occurred during childhood.
According to the DSM-5, quote, bear with me, because this is a lot of big words, quote,
there is considerable variability in the course of VPD.
The most common pattern is one of chronic instability in early adulthood, which episodes
of serious affecting and impulsive discontrol and high levels of use of health and mental
health resources.
The impairment from the disorder and the risk of suicide are greatest in the young adult
years and gradually wane with advancing age.
Although the tendency towards intense emotions, impulsivity, and intensity in relationships
is often lifelong, individuals who engage in the therapeutic intervention often show improvement
beginning sometime during the first year.
During their 30s and 40s, the majority of individuals with this disorder attain greater
ability in the relationships of vocational functioning.
Some studies of individuals identified throughout patient mental health clinics indicate that
after about 10 years, as many as half of the individuals no longer have a pattern of behavior
that meets full criterion for VPD.
End quote.
So that is interesting.
So do you think that in their earlier years, certain behaviors are accepted because you're
a young adult and nobody's choosing to correct the behavior because they just think that,
well, maybe it's hormones, maybe it's the frontal lobe, maybe it's these things.
Yeah, exactly.
I think we agree.
But then the older they get, the more they begin to understand what this is like unacceptable
behavior to anybody.
Like you should have grown out of that by now, essentially.
Yeah.
VPD is usually diagnosed in late adolescence or early adulthood, but occasionally people
younger than 18 can be diagnosed.
This is only possible if their symptoms are recurrent and last for over a year, which
is kind of like sucks because like you have to be dealing with this for like over a year
and all the time to be diagnosed before 18.
Which, you know, I think quite a few of those personality disorders are probably like that
as well.
Oh, for sure.
Right?
Yeah, definitely.
VPD commonly occurs comorbidly with other mental disorders such as PTSD.
Unfortunately, this can make it difficult to diagnose because their symptoms can be linked
to other disorders.
Bipolar disorder, anxiety disorders, substance use disorder, and eating disorders are also
common comorbidities.
So I'd like to talk about some famous people who have been diagnosed with or suspected
of having VPD.
Okay.
The first is Philip K. Dick.
He is a science fiction writer whose themes revolve around a shifting sense of consciousness.
Philip married five separate times with most of his relationships ending tumultuously.
He had actually had one of his wives admitted to a psychiatric facility and he actually
drove his car off the road with another girlfriend of his in the passenger seat.
Philip would state about his mentality, quote,
I experience an invasion of my mind by a transcendently rational mind as if I had been
insane all my life and suddenly I had become sane, end quote.
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He gaslight himself.
He did gaslight himself.
That's absolutely incredible.
I did not know that he drove a car off with a wife inside.
Off the road with a girlfriend.
Pay attention.
No, she can't.
He drove his wife off a cliff.
His girlfriend off the road.
So number two, like I said earlier, is Jeffrey Dahmer.
If you have not listened to the episode of JD, please go listen.
It's a really in-depth episode.
It's a Patreon only, so you'll have to join tier two or three to listen to it, but Koala
did a great job.
Thanks.
Jeffrey had a terribly unconventional childhood with his parents leaving him to care for himself
at a young age, leaving him with an intense fear of abandonment.
This along with many other things he experienced and engaged in paved the way for Jeffrey Dahmer
to be diagnosed with BPD.
That's all I have to say about that.
Well, yeah, I mean he started, you know, he would keep his victims in his apartment.
He would keep body parts in his apartment.
Remember the shower thing I told you?
That's awful.
That episode was gross.
Yes.
Or that tidbit in that episode rather.
Yeah, and then eventually he would eat people.
Well, don't give everything away if you want to listen to the episode.
That's true, but it all came from that sense of abandonment.
That way this person would never leave.
He would never leave.
He does have a digestive system work, that's fine.
He's also an alcoholic, so he pooped a lot.
Sorry.
Don't give it all away.
Right.
Moving on.
Please.
Number three is HP Lovecraft, he was a science horror writer.
He suffered a number of deaths in the family at a young age, with his father dying when
he was little and his grandmother dying a few years later, sending him spiraling into
a deep depression.
His grandfather would also die suddenly following a business failure, and he would state that
his life changed almost instantly of warmth and death to a poverty and loneliness.
Oh, fuck.
HP would begin writing but was unable to take criticism to the point of sometimes not publishing
his works at all.
His aunt would describe his mental state around this time as, quote, so hideous that he hid
from everyone and did not like to walk upon the streets where people could gaze on him.
End quote.
That is so fucking sad.
I know, it's very, very sad.
Number four is Jodi Arias, who all did an awesome episode on this case as well.
I told you I have a type.
Yes, and a lot of the cases that you've done, yeah, just pop up in this episode.
Jodi murdered her ex-boyfriend by the name of Travis Alexander, and she fit the bill
pretty well for BPD.
Jodi had a strange obsession with Travis and was not fully realistic about the status of
their relationship.
For more info on this, listen to the case, of course.
I don't know if she was ever diagnosed.
I think it was just suspected.
I feel like afterwards, yeah, she did, I think.
Number five, it is thought that Princess Diana could have met the criterion for BPD.
She was just 19 years old when she met Prince Charles, and although their relationship seemed
pretty perfect on the outside, it seems as though there was intense emotions coming from
Diana.
Even though there was never an official diagnosis that we know about, plenty of books about
the princess suggest that she could have been suffering from BPD.
That's interesting to me.
I don't know if that explains the affair, or if that does explain the affair.
You know what I mean?
Maybe she was, because I was just thinking like a bannermint, you know, I don't know
if it's necessarily having to do with one subject or multiple subjects, but you know,
if there's that want of needing to be loved and admired by others, then that might explain
the affair.
Yeah, definitely.
And it's so long ago, honestly, and it's hard to tell, because back then it was like,
what is, even BPD?
You know what, it probably wasn't.
Really a thing.
Number six, number seven, hey!
Edgar Allen Poe.
I love Poe.
This one might not be as closely accurate to the symptoms of BPD, but it has been suspected
that Edgar suffered from the disorder.
When he engaged in risky behaviors after experiencing bad relationship with his foster father, he
has also been thought to have recurring depression and even signs of potential bipolar disorder.
But again, never diagnosed.
Also Edgar Allen Poe.
He just has everything.
Depressy messy is like his thing.
Yeah, for sure.
Number seven, Ernest Hemingway.
Lots of writers.
Yes, similarly to Edgar Allen Poe, Ernest Hemingway has been suspected of meeting the
criterion for BPD, but also had many signs of severe depression, anxiety, and alcohol
abuse.
Lots of writers, lots of killers.
Yeah, for sure.
Well, they put it into their writing.
Yeah, right?
While he had these symptoms, it is thought that he might have had BPD due to the fact
that he engaged in often risky behavior.
Although this was never diagnosed, it's not simple to rule out, especially considering
the way mental health care was looked at back then.
And Hemingway would also commit suicide in 1961.
Same year that Princess Diana was born.
Oh yeah.
Number eight, Van Gogh.
Another artist.
Yes, like the people previously talked about on this list, Van Gogh engaged in very risky
behavior.
This is an understatement, as we know that he cut off his own ear after a supposed argument.
Sorry, that's not funny.
That's not funny.
Goh experienced bouts of depression, mood swings, and extreme impulsive acts.
He would ultimately experience psychotic thoughts and behaviors that led him to staying
in an asylum for a number of months.
Van Gogh would fall into a deep depression that led him to shooting himself.
Unfortunately, he would not die instantaneously and would live for a few days following this
incident.
He was noted as stating about this, quote, I shot myself.
I only hope I haven't botched it, end quote.
You like shot himself in the abdomen or something, right?
Yeah, I think his chest area.
That's like, you know.
It's also kind of a conspiracy theory.
People don't think that he committed suicide.
Oh really?
Yeah, almost like a curcumin kind of situation.
Oh, like somebody did it to him?
I don't know the conspiracy.
I just know that people don't believe it.
Just like Courtney Love then too.
Yeah, a lot of people don't know that.
She's an ancient.
Number nine is Susan Smith.
Coelle did a great episode on this case as well.
Oh my gosh, it's like everyone.
I know.
Susan had two suicide attempts that we know about and was desperate to find a wealthy man
whom she could be in a relationship with.
Unfortunately, when she found a man whom she liked, it became clear to Susan that he did
not like children.
This is what investigators believe led her to murdering her two sons.
Susan was diagnosed with BPD.
Number 10.
This is actually the last one on this list.
Eileen Ornos, like I said earlier, and again, Coelle did an episode on this case.
I just have all of them.
Thanks for promoting me so much.
Like many others on this list, Eileen engaged in extremely risky behavior as she was a sex
worker and she used her work to lure men to where she wanted to in order to murder them.
Eileen had a horrible childhood, leading her to go down the path that she did, but she
absolutely fits the bill for BPD as well.
For sure.
A lot of abandonment at an early age for her too.
Definitely.
So there are a number of ways to treat BPD and the different types of treatment depend
on how severe a person's symptoms are.
Psychotherapy, or better known as talk therapy, is the most common form of treatment for BPD
and there are many different types of psychotherapy that can be beneficial.
The goals of psychotherapy are to focus on one's current ability to function, learn to
manage emotions that are uncomfortable, reduce one's impulsiveness by helping them observe
feelings rather than acting on them, work on improving relationships, and learn about
BPD in general.
So I'm going to go through the different types of BPD psychotherapy and treatment options.
So the first one is called mentalization-based therapy, or MBT.
This is a type of talk therapy that helps someone identify their own thoughts and feelings
at any given moment.
This also helps create an alternative perspective on the situation at hand.
This type of therapy essentially emphasizes thinking before reacting.
The second one is called schema-focused therapy.
This can be done individually or in a group setting, and its goal is to help someone identify
unmet needs that led them to negative life patterns.
That's interesting, I like that.
Yeah, these patterns were perhaps beneficial to someone in the past, but now that they
have gotten through that hard time, it is no longer necessary, and I know that we've
talked about that before.
And in fact, now that they've gotten through that, it can be harmful to them.
This type of therapy focuses on helping someone get their needs met in order to promote positive
life patterns.
Number 3!
It is called dialectical behavior therapy, or DBT.
This type of therapy can also be done in an individual or group setting, and this is
a therapy specifically designed to treat BPD.
DBT uses a skills-based approach to teach someone how to manage their emotions, tolerate
distress, and improve their relationships.
Number 4 is called transference-focused psychotherapy, or TFF.
T-P-F- Excuse me, TFP.
Jesus.
I was like, I just said it.
This is also referred to as a psychodynamic psychotherapy.
TFP's goal is to help one understand their emotions and interpersonal difficulties through
the developing relationships between the client and the therapist.
The insights learned in this type of therapy are then encouraged to be utilized in outside
settings.
Number 5 is good psychiatric management.
This type of treatment, not psychotherapy, but it's just a treatment, relies on case
management and anchors treatment and an expectation of work or participation from the client.
It also focuses on emotionally difficult moments by considering the interpersonal context for
feelings.
This type of treatment may also integrate medications, groups, family, education, and
individual therapy as well.
So you can do these both at the same time.
And the last one is called systems training for emotional predictability and problem-solving,
or steps with two P's.
This is a 20-week treatment that involves working in groups that incorporate a client's
family members, caregivers, friends, or significant others into the treatment.
And this would also be combined with a type of psychotherapy that would also benefit the
client.
Yeah, it sounds like a little bit of rehab, but like Alanon too, with the family friends
coming in.
And it kind of sounds like a restart.
Yeah, a reboot.
Definitely.
Steps.
Although there are no medications that are approved by the FDA to treat BPD, someone
can be prescribed medications that can help improve the symptoms that are usually comorbid
with BPD, such as anxiety, depression, impulsiveness, or aggression and irritability.
So how do you know if you're experiencing symptoms of BPD or just a number of other things
that can mimic the disorder?
I love this.
You can ask yourself the following questions to determine your potential for this disorder.
Of course, you should always see a doctor for any medical information.
Do you want to answer?
Yeah.
Okay.
Although we're not licensed to diagnose.
Of course not.
But I don't think you want to identify with this disorder.
Oh, okay.
Did you find this in Cosmo?
I'm kidding.
No.
Okay.
Do you identify with the following statements?
Number one, I often feel empty.
No.
Number two, my emotions shift very quickly and I often experience extreme sadness, anger,
and anxiety.
No.
Number three, I'm constantly afraid that the people I care about will abandon me or
leave me.
Oh, gosh, that's too real.
Can I a little bit of yes and a little bit of no?
Yeah, for sure.
Yeah.
Number four, I would describe most of my romantic relationships as intense but unstable.
No.
Number five, the way I feel about the people in my life can dramatically change from one
moment to the next and I don't always understand why.
No.
Number six, I often do things I know are dangerous or unhealthy such as driving recklessly, having
unsafe sex, binge drinking, or going on spending sprees.
I mean, I smoke and I drink but that's it.
Yeah, but not bingeing.
Yeah.
I have once or twice recklessly driven.
Really?
Yeah.
Same.
I don't know how that was that funny.
It was just your face, you're like the same.
I just didn't ever but also I did.
I just drive fast.
I really don't drive recklessly.
I just drive fast.
I guess fast is reckless.
And then one more, when I'm feeling insecure in a relationship, I tend to lash out or make
impulsive gestures to keep the other person close.
Probably not an attempt to...
No.
Yeah.
Okay.
Well, there's many more than just that.
Those are just a couple of examples I wanted to bring in.
I feel like I guess there's a little bit of everything.
A little bit of truth.
Yeah, for sure.
But again, we talk about the fact that everybody has a brain, everybody's capable of these
emotions and feelings, right?
Who wants to...
I mean, some people want to be alone, you know, and that's fine.
There's nothing wrong with that.
But me personally, do I want to be alone?
No, I enjoy being in a relationship.
But am I going to do everything in my power to keep that relationship?
No.
No, exactly.
If you do identify with several of the previous statements, you may meet criteria to be diagnosed
with BPD.
Again, always seek a professional opinion if needed because we are not licensed professionals.
If someone you know is showing signs or symptoms of BPD, it may be difficult to start a conversation
about it.
However, that conversation is extremely important.
There are some suggested ways to talk to someone with BPD or suspected BPD.
Take the time to learn about the illness to understand what your friend or relative is
experiencing.
Offer emotional support, understanding, patience, and encouragement.
Change can be difficult and scary to people with BPD, but things can improve over time.
Encourage your loved one to seek help and seek counseling for yourself if necessary.
If you or someone you know is experiencing a crisis, you can call 988-247 to speak with
someone.
And of course, if it's an emergency, always dial 911.
But that's my mental breakdown.
That's a great topic.
Thank you, lady, for suggesting that.
Yeah, absolutely.
Like you said, we had mentioned many times this disorder, but we never really did a full
on deep dive.
Yeah.
So, yeah.
Well, I think it was good going to the New Year with a suggested case because I think
that, I mean, at least I'm sure you are as well and you have them on your list, but
I'm definitely going to start tackling more requested cases because I know that our listeners
are the reason why we're here.
And so I definitely want to be honoring the requested cases that they're doing, even if
it's a mental breakdown or a regular case.
So yeah, that's all I got today.
Thanks for being on the topic.
Yeah, you guys continue to reach out to us and let us know what you want us to break
down next.
There's only so many diagnoses that we can cover, honestly, unless we do all the obscure
ones for the TSM that are real, not a lot of information on them, but anything, experiment,
event, something that you just think is cool.
Psychological synominal.
Yeah, anything.
Seriously, let us know.
This is our loophole to talk about other things than just your crime where the killer
is, you know who the killer is and you know who did it.
So thank you guys for joining us and we will see you on Thursday.
Yeah, see you on Thursday.
Love you.
Bye.
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