People with borderline personality disorder (BPD) often have trouble dealing with emotions. The way people with BPD deal with unpleasant emotions may affect their recovery.
A recent study looked at how people with BPD defended against unwanted feelings. Then, they compared BPD patients to people with other personality disorders. People with BPD more often used less helpful defenses. These defenses were linked to longer time to recovery.
People with BPD who used humor had shorter recovery times. The authors suggested that therapy can focus on teaching more effective defense strategies.
Defense mechanisms are ways that people deal with unpleasant thoughts or situations. They come in many forms. Most are helpful in the short term, but some can cause problems over time. Most people use many different types of defense mechanisms depending on the situation.
Researchers, led by Mary C. Zanarini, EdD, of McLean Hospital in Massachusetts, wanted to know what types of defense mechanisms people with BPD used most often. They also wanted to know how this related to their recovery and function.
They enrolled 290 people with BPD and 72 people with other personality disorders who were in the hospital for treatment.
At the start of the study, they interviewed participants about their symptoms and about their defense mechanisms and defense styles. The researchers conducted a similar interview every two years for 16 years.
All the people in the study reported less use of isolation as a defense mechanism over time. Isolation is a form of avoiding people or situations that are unpleasant.
BPD patients used more defense mechanisms that are considered less effective than people with other personality disorders: emotional hypochondriasis, acting out and projection.
Emotional hypochondriasis is a defense style in which people say that no one understands their pain. Acting out is when a person uses actions to express emotions, like throwing things or hitting things. Projection is a way of putting your thoughts and feelings onto others as a way of avoiding them.
All three of these defense mechanisms can be helpful for a person in the moment. But over time, they can cause problems in relationships. In fact, the people in the study who used these mechanisms were more likely to take longer to recover.
The researchers also found that people with BPD who used humor as a defense mechanism were more likely to recover more quickly. Humor is considered to be a more productive defense style.
The study authors concluded that BPD patients were more likely to use less effective defense styles, and this could be an important aspect of recovery and treatment.
They went on to say that BPD patients should discuss defense styles with their therapist. Strategies to improve defenses can be included in treatment, which may lead to better recovery.
The study included patients who were in the hospital for treatment, so they were a group of people with fairly severe symptoms and limited function. These results may not apply to people who are healthier.
The study was published January 1 in the American Journal of Psychiatry. The study was funded by grants from the National Institute of Mental Health. The authors reported no financial conflicts of interest.