(Over 2% of the population have some degree of (BPD). Of this population 8 to 10% commit suicide – this rate is more than 50 times the rate of suicide in the general population and ten times the rate of suicides due to depression alone. This blog is an attempt to understand the nature of at-risk behavior, one of the sub traits of disinhibition, so that we can survive and even thrive with BPD.)

 Pathological Personality Traits in Disinhibition – Risk taking: Engagement in dangerous, risky, and potentially self-damaging activities, unnecessarily and without regard to consequences (DSM5).

One of the traits of borderline personality disorder is risk-taking without regard to consequences. This trait shows up in several areas including drug abuse and at risk sexual behavior. First of all let’s look at substance abuse.  Using a longitudinal study involving 1280 female adolescent twins from age 14 to 18, Bornovalovato and others[1] examined the developmental, genetic, and environmental factors underlying the co-occurrence of BPD traits and substance use.  Shared environmental factors accounted for the association between BPD traits and substance use at age 14, but genetic factors accounted for the association at age 18.

Looking at at-risk sexual behavior, Northey and others[2] asked 955 college students to fill out a questionnaire involving four BPD symptoms: affective instability, identity disturbance, negative relationships, and their relationship to self-harm. They then looked at the correlation of these four sub traits with sexual sensation seeking, sexual compulsivity, and sexual risk-taking. Sexual compulsivity was positively predicted by all four BPD symptoms. Sexual sensation seeking was positively predicted by negative relationships and self-harm. Sexual risk taking was not significantly predicted by any BPD symptoms.

So in plain English, what do these two studies tell us about risk taking for those of us with BPD. First of all we see that BPD seems to evolve during adolescence. Childhood is essentially a latent peaceful period with few outside traits or symptoms. However in adolescence we do not seem to have the eternal resources needed to withstand peer pressure, in this case as it refers to drug use. In other words we use drugs because our friend use drugs. However by our late teen years when our friends are moving on, we seem to be stuck in drug use and drug abuse patterns because of our genetic predisposition. We use drugs perhaps because drugs fulfill an internal need for pleasure soothing and anxiety relief.

When we look at sexual behavior, a similar patterns seems to exist. Because of our lack of self-esteem, we are vulnerable to the desire for the anxiety soothing and release provided by sexual pleasure and orgasm. This creates a situation where if it feels good we compulsively let ourselves become engaged without any concerns for the consequences often leading to risky casual unsafe sex. This seems to be related to negative relationships often formed by emotional neglect and emotional abuse by parents and then reinforced with subsequent unsuccessful relationships. This also seems to be related to seeking the pleasure sensations as a kind of distraction from our inner turmoil rather than just for the excitement of risk-taking itself. Once engaged, it appears that we may neglect the consequences simply because we feel we deserve to be treated badly and we may engage as a means to punish ourselves.

These two studies indicate that some of our difficulties dealing with drug use and at-risk sexual behavior are related to genetic predisposition and our response to internal signals rather than external ones. Both drugs and sex appear to be possible outlet for dealing with low self-esteem and the anxieties related to childhood issues. These behaviors appear to be impulsive because we either cannot or do not want to deal with the consequences because the pleasure involved is considered essential to our emotional survival.

My five suggestions for borderliners:

  1. We have to learn to deal with our compulsive behavior patterns by building in a reality check. I came across an experiment done a few years ago (sorry can’t find the reference) where overweight people tended to eat more shelled peanuts than non-overweight while waiting for an appointment, but the difference disappeared when the peanuts were still unshelled. This shows that compulsive behavior may be compulsive simply because it’s compulsive. For example I like to snack at night so I made a pact with myself to brush my teeth immediately after dinner and then remind myself that I should not snack because I would have to brush my teeth again. Sounds simple but it works. If we can build in a safety valve to give us time to think it through, and then make a conscious decision, then it is no longer compulsive.
  2. We have to learn to love ourselves including our beautiful brain. Drugs, even Maryjane, are mind-altering drugs. That means they alter the functioning of the brain by artificially changing the neurotransmitters and the neural circuits to the pleasure centers. If we love ourselves we will not do anything to harm our beautiful mind that is so well designed to find real ways to enjoy real pleasure.
  3. Casual sex may provide a need for emotional and physical release and we can certainly make a case for allowing ourselves a little pleasure. However, this kind of behavior is usually based on not caring for ourselves and believing that no one truly could love us. This is not true. We can search for good sexual partners, either through partnership or on-going relationship, where we respect our sexual partner and we know they respect us. Again this is a conscious decision which frees us from compulsive behavior.
  4. Our sense of self-worth has to come from within. We can develop this like any other belief. We work at it. We make deals with ourselves. We recognize our achievements and our talents and gifts. We tell ourselves we love ourselves over and over again until we actually believe it.
  5. We learn to love life, to get pleasure and satisfaction from the beauty of the world around us instead of drugs, and from wholesome sex with people who treat us with respect rather than casual encounters.

Please Note: If you are serious about developing the skills needed to life a life free of anxieties that leads to at risk behavior, try my program – The Grounding Virtue – a Path to Self-Actualization.

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[1] Bornovalova, M. A., Hicks, B. M., Iacono, W. G., & McGue, M. (2013). Longitudinal twin study of borderline personality disorder traits and substance use in adolescence: Developmental change, reciprocal effects, and genetic and environmental influences. Personality Disorders: Theory, Research, and Treatment, 4(1), 23–32. https://doi.org/10.1037/a0027178

[2] Northey, Lynnaea; Dunkley, Cara R.; Klonsky, David e.; and Gorzalka, Boris b.. Borderline personality disorder traits and sexuality: Bridging a gap in the literature. August 2016.