Impairment 9 – Significant impairments in interpersonal functioning – Intimacy: intense, unstable, and conflicted close relationships.


What We Know

In a review of thirteen empirical studies, Agrawal et al (2009) found that every study concluded that there is a strong association between BPD and insecure, unresolved, preoccupied, and fearful attachments. These studies indicate that there is a longing for intimacy that is troubled by concerns about dependency and rejection. Barone (2010) using the Adult Attachment Interview with forty BPD patients and forty controls, discovered that the two strongest types of attachment problems were entangled/preoccupied (20%) and traumatic experiences (50%).

Let’s take a closer look at these attachment disorders starting with the one that showed up in both studies. Ambivalent/preoccupied attachment disorder is formed during childhood when the mother is unpredictable in her interactions with the infant. The child ends up feeling helpless and fearing abandonment. This may result in a child being anxious about their mother’s whereabouts, thereby hampering their ability to explore and develop autonomy. As they progress through childhood, these children tend to be clingy, immature, and hard to soothe, a pattern that can continue into their adult lives.

This may result in one two types of adult behavior patterns. They may be angry or passive. The angry child (and later the adult) while seeking connection, tends to feel rejection when ignored or misunderstood and reacts with anger and hostility. The passive child (and later the adult) again seeks connection but reacts to being ignored or misunderstood with a feeling of helplessness. In both cases, children approach intimate relationships cautiously and appear to be preoccupied with their own state of mind.  They seem to have no idea of what to do with intimate relationships and quickly feel helpless and overwhelmed. They may feel more comfortable avoiding relationships because of their difficulties in interacting with one another. When in a relationship, they may react to disagreements with anger or withdrawal. They will flee from these relationships thus rejecting before being rejected, or act in such a way as to drive the person away, thus reinforcing their feelings of rejection and abandonment.

When we look at traumatic experience attachment disorder, the information becomes cloudy. Cases of violence in childhood appear to be related more to Post Traumatic Stress Disorder than BPD, presenting a different kind of behavior pattern, one that can be processed and dealt with more successfully through therapy. On the other hand, when trauma is interpreted as neglect or disruptions due to separation or illness with the parents during childhood, this tends to lead back to ambivalent/preoccupation attachment disorders. In these cases the infant feels early connection with the parent and then rejection as the parent is no longer able to meet their emotional needs.

Rather than take things apart and try to find specifics within the whole as must be done for research purposes, we need to look at intense and unstable close relationships as a whole. Then we can see that this impairment may be due to several causes but they all result in one outcome. Those causes include unresolved childhood conflicts with the parent, preoccupation involving process of self-blame, shame and anger, and reluctance in forming close relationships because of fear of rejection and abandonment.

If these feelings are due to trauma, we deal with the trauma and then move on. Time really does heal. If these feelings are due to early emotional childhood experiences, they are much more difficult to deal with and the problems, instead of getting better, actually worsen with time leading to suicidal behavior. The solution is an intense therapy involving constructive psychology which in my case involved a process of recognizing and celebrating my talents and gifts rather than focusing on my faults. Once I felt worth in my own eyes when I gazed into the mirror, I was able to accept that I was indeed precious and lovable. I was then able to enter into another relationship with confidence and without the fear of rejection. If this person could not recognize my beauty then it would be perfectly okay to live my own life or find someone who could appreciate me just the way I am.

(Please Note: I have put my own constructive process that I developed during my own self-healing into a workbook that will soon be available for sale on my website and is now available on Amazon. It is called: The Grounding Virtues – A Path to Self-Actualization. It includes five virtues with five activities for each virtue. If followed strictly, it becomes a one month intense self-therapy program that worked for me and may work for you.)


Agrawal, Hans R.; Gunderson, John; Holmes, Bjame M.; Lyons-Ruth, Karlen. Attachment Studies with Borderline Patients: A Review. Published online. July, 2009.

Barone, Lavinia. Developmental protective and risk factors in borderline personality disorder: A study using the Adult Attachment Interview. Published online. Oct., 2010.