Pathological personality traits in negative affectivity – d. Depressivity: Feelings of inferior self-worth (DSM5)

Perhaps the most defining trait associated with BPD is a feeling of inferior self-worth. To get a better understanding of self-worth for us with BPD perhaps we should look at two studies that show how our inferior feelings differ from others.

Lynum and others (1) compared self-esteem in patients with avoidant personality disorder (APD) and borderline personality disorder (BPD) using the Index of Self Esteem. Subjects from both disorders had self-esteem levels associated with clinical problems. Patients with higher levels of depression reported lower levels of self-esteem in both groups. Hedrick and Berlin (2) looked at the difference in feelings of self-worth with 18 subjects with borderline personality disorder (BPD) and 18 subjects with depersonalization disorder (DPD) using the Implicit Association Test. They discovered that BPD participants had significantly lower self-esteem and less self-directedness and cooperativeness. They also had higher harm probabilities and impulsivity.

The first study states the obvious; we share feelings of inferior worth with other personality disorder groups; however our low self-esteem is clinical in nature and often associated with depression. This feeling has its roots in low self-esteem that seems to be part of our sometimes warped and twisted self-concept that has the potential to lead to dysfunctional thought and behavior patterns. The study by Hedrick and Berlin is particularly interesting as it sheds more light on the nature of this pathological trait. It would appear that those of us with BPD have a deeper sense of unworthiness leading to difficulty making good life decisions. This lack of self-worth appears to make us more defensive often leading to conflicts with others. We tend to say to hell with caution and just barrel ahead often leading to dangerous and self-defeating behaviors. If it goes unchecked it may eventually lead to high risk and self-harm behaviors.
So what can we take from these studies? First and foremost, it places feelings of unworthiness and the core of our self-defeating behaviors at a clinical level. The flip side, again, is that at this point it is just a trait and traits can be changed by changing our thought patterns before they become behavior patterns. Secondly, it narrows our focus. Instead of looking at all the dysfunctional behaviors, we can focus on one issue – improving our self-concept.

I suggest the following:
1. Instead of focusing on feelings of inferior self-worth, focus on your gifts and talents. Make a list of ten things you like about yourself and post it on the fridge your office space, some place where you will see it several times a day. Each time you get a feeling of being unworthy, read your list over and over again until you feel the power of your talents and gifts.
2. Each day add something new and celebrate that talent or quality during that day.
3. Meditate for at least fifteen minutes each day. During mediation focus your attention on some part of your body or your life and become mindful of how amazing this gift is. Do not rationalize it. Just develop a feeling of profound gratitude and appreciation and let that positive vibration occupy your whole mind and body.
4. Begin to see yourself as special. When you look in the mirror look yourself in the eye and keep looking until you feel appreciation for the person you are.
5. Begin to structure your life to reflect this new self-concept. Set a new goal each week that reflects that you are worthy of good things happening in your life. Each day do something to grow and expand that concept. Watch your positive feelings begin to bring good things into your life.

 

 
(1) Lynum, L; Wilberg, Theresa; and Karternd, Sigmund. Self-esteem in patients with borderline and avoidant personality disorders. Scandinavian Journal of Psychology. 2008.

(2) Hedrick, Alexis N.; and Berlin, Heather A.. Implicit Self-Esteem in Borderline Personality and Depersonalization Disorder. Frontier Psychology. 2012