Borderline Personality Disorder and the Attachment Theory
Frances, a woman in her 20s, had been admitted into the hospital several times, many followed
by suicidal threats and overdoses.
She was also a chronic self-cutter, a severe alcoholic, and exhibited
She had violent bouts of rage, in which often escalated into physical attacks
toward hospital staff.
She only had a ninth-grade education and never had a steady job. Twenty-seven
years later, when Frances was 49, many of the symptoms noticeable in her 20s still persisted. She also
complained of chronic depression, panic attacks, and suicidal thoughts (Paris, 2003).
This woman was diagnosed with borderline personality disorder (BPD), which is “a pervasive
pattern of instability of interpersonal relationships, self-image and affects and marked impulsivity
(DSM-IV-TR, 2000; 710).”
BPD is one of several different types of personality disorders. Personality
disorders are an “enduring pattern of inner experience and behavior that deviates markedly from the
expectations of the individual's culture (DSM-IV-TR, 2000; 689).”
Personality disorders affect four primary areas: cognition, or “ways of perceiving and
interpreting the self, other people and events;” affectivity, or “the range, intensity, lability and
appropriateness of emotional response;” interpersonal functioning; and impulse control (DSM-IV-TR,
They are further subsumed into three “clusters:” Cluster A, which odd or eccentric
behaviors are exhibited; Cluster B, in which noted behaviors are dramatic, emotional or erratic; and
Cluster C, in which behaviors are anxious or fearful.
Paranoid, schizoid, and schizotypal personality
disorders are contained in cluster A, while cluster B includes antisocial, borderline, histrionic, and
narcissistic personality disorders.
Grouped in cluster C are avoidant, dependent, and obsessive-
compulsive disorders (DSM-IV-TR, 2000).
BPD is one of the most common (of all personality disorders, it ranges from 30-60% in the
clinician population) and severe of the personality disorders (Sperry, 2003; DSM-IV-TR, 2000). IT is