Causes

There is still a great deal of debate concerning the causes of Borderline Personality Disorder. It is perhaps more meaningful to talk of the factors that shape Borderline Personality, about which there is increasing agreement and research. Broadly speaking there are two schools of thought on the processes that lead to the development of BPD.

These models of the development of BPD emphasis the psychobiological and neurophysiological processes that influence personality. During the first five years of life, and in particular during the first two, a child's brain is still growing and developing at a substantial rate. All the experiences that child has are directly influencing how various parts of the brain develop. Of prime importance in this process is the child's interaction with its mother or primary care giver. Separation from the mother, or poor or negative nurturing (eg abuse, violence), can have a dramatic effect on the development on areas of the brain, especially those which handle emotions and social functioning.

"traumatic experiences, especially if severe, sustained and repetitive, lead to cell damage and premature death in key centers [of the brain] and wiring patterns that evoke unmodulated and maladaptive responses to the ordinary events of life."
Kernberg et al, "Borderline Patients: Extending the Limits of Treatability"

It is perhaps this 'hard-wiring' that makes BPD and other PDs resistant to treatment. Whilst the brain is in a state of constant flux throughout adult life, it is harder to change the wiring pattern in later life. However, it is possible to learn to manage the behavioural difficulties that a differently wired brain may produce.

Whilst more is becoming known about what processes influence the development of BPD, far less is known about why certain individuals seem more prone to develop BPD (and other psychiatric problems) than others. It increasingly appears that there may be a genetic predisposition, given an adverse environment, for certain individuals to develop BPD.

Poor nurturing and an adverse environment is not guaranteed to result in a child experiencing psychiatric problems in later life; equally, good nurturing in a positive environment is no guarantee that a child will be free from psychiatric difficulties as an adult. However, a genetic predisposition towards psychiatric problems coupled with poor nurturing is far more likely to result in problems later in life.

As research expands, more and more theories regarding the cause of BPD are being developed. Some of these theories suggest that BPD is a “neurological” illness – having little or nothing to do with environmental factors. Other recent research has suggested an interaction between a person’s early environment and their neurological development which may precipitate the onset of BPD. Of course, there are also those people who refute any neurological involvement at all.