Keywords
Borderline Personality Disorder
Psychosomatic Symptoms
How to Cite
Abstract
Emotionally unstable personality disorder (F60.3), also known as borderline personality disorder, is a personality disorder characterized by emotional instability, impulsivity, and difficulties in interpersonal relationships. In clinical practice, this disorder is often not detected at an early stage because initial complaints tend to present as physical or psychosomatic symptoms. This study aimed to describe the psychological dynamics of a client with emotionally unstable personality disorder in terms of developmental history, psychosocial factors, and their association with psychosomatic complaints. A qualitative approach with a clinical case study design was employed. Data were collected through in-depth interviews. Descriptive analysis was conducted to obtain a comprehensive understanding of the client’s psychological dynamics. The assessment results indicated a history of non-validating parenting, negative emotional experiences since childhood, and persistent difficulties in emotion regulation. These conditions contributed to mood instability, anxiety, fear of abandonment, and chronic physical complaints without clear medical explanations. Psychotherapy and psychiatric treatment facilitated improvements in self-awareness, emotion regulation abilities, and adaptive functioning in daily life, although several psychosocial challenges remained. Emotionally unstable personality disorder is a complex condition influenced by the interaction of early developmental experiences, family relational patterns, and adult life stressors. This case study underscores the importance of comprehensive psychological assessment in patients presenting with psychosomatic complaints and highlights the need for long-term, integrated interventions to improve clients’ quality of life.
References
Adams-Clark, A. A., Lee, A. H., Everett, Y., Zarosinski, A., Martin, C. G., & Zalewski, M. (2022). Direct and indirect associations among mothers’ invalidating childhood environment, emotion regulation difficulties, and parental apology. Borderline Personality Disorder and Emotion Dysregulation, 9(1), 21. https://doi.org/10.1186/s40479-022-00191-z
Ballespí, S., Vives, J., Alonso, N., Sharp, C., Ramírez, M. S., Fonagy, P., & Barrantes-Vidal, N. (2019a). To know or not to know? Mentalization as protection from somatic complaints. PLoS ONE, 14(5). https://doi.org/10.1371/journal.pone.0215308
Ballespí, S., Vives, J., Alonso, N., Sharp, C., Ramírez, M. S., Fonagy, P., & Barrantes-Vidal, N. (2019b). To know or not to know? Mentalization as protection from somatic complaints. PLOS ONE, 14(5), e0215308. https://doi.org/10.1371/journal.pone.0215308
Bohus, M., Stoffers-Winterling, J., Sharp, C., Krause-Utz, A., Schmahl, C., & Lieb, K. (2021). Borderline personality disorder. The Lancet, 398(10310), 1528–1540. https://doi.org/10.1016/S0140-6736(21)00476-1
Braun, V., & Clarke, V. (2021). One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qualitative Research in Psychology, 18(3), 328–352. https://doi.org/10.1080/14780887.2020.1769238
Leichsenring, F., Fonagy, P., Heim, N., Kernberg, O. F., Leweke, F., Luyten, P., Salzer, S., Spitzer, C., & Steinert, C. (2024). Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies. World Psychiatry, 23(1), 4–25. https://doi.org/10.1002/wps.21156
Lieb, K., Zanarini, M. C., Schmahl, C., Linehan, M. M., & Bohus, M. (2004). Borderline personality disorder. The Lancet, 364(9432), 453–461. https://doi.org/10.1016/S0140-6736(04)16770-6
Moehler, E., Brunner, R., & Sharp, C. (2022). Editorial: Emotional Dysregulation in Children and Adolescents. Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.883753
Naeem, M., Ozuem, W., Howell, K., & Ranfagni, S. (2023). A step-by-step Process of Thematic Analysis to Develop a Conceptual Model in Qualitative Research. International Journal of Qualitative Methods, 22(1), 1–18. https://doi.org/10.1177/16094069231205789
Sharp, C., & Wall, K. (2018). Personality pathology grows up: adolescence as a sensitive period. Current Opinion in Psychology, 21, 111–116. https://doi.org/10.1016/j.copsyc.2017.11.010
Storebø, O. J., Stoffers-Winterling, J. M., Völlm, B. A., Kongerslev, M. T., Mattivi, J. T., Jørgensen, M. S., Faltinsen, E., Todorovac, A., Sales, C. P., Callesen, H. E., Lieb, K., & Simonsen, E. (2020). Psychological therapies for people with borderline personality disorder. Cochrane Database of Systematic Reviews, 2020(11). https://doi.org/10.1002/14651858.CD012955.pub2
Thadani, B., Pérez-García, A. M., & Bermúdez, J. (2022). Functional Impairment in Borderline Personality Disorder: The Mediating Role of Perceived Social Support. Frontiers in Psychology, 13. https://doi.org/10.3389/fpsyg.2022.883833
Willig, C. (2021). Introducing Qualitative Research in Psychology (4th ed.). Open University Press.
World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines (Vol. 1). World Health Organization. https://www.who.int/publications/i/item/9241544228
Xu, W., & Zammit, K. (2020). Applying Thematic Analysis to Education: A Hybrid Approach to Interpreting Data in Practitioner Research. International Journal of Qualitative Methods, 19(2), 1–9. Sagepub.
Zanarini, M. C., Frankenburg, F. R., Reich, D. B., & Fitzmaurice, G. (2010). The 10‐year course of psychosocial functioning among patients with borderline personality disorder and axis II comparison subjects. Acta Psychiatrica Scandinavica, 122(2), 103–109. https://doi.org/10.1111/j.1600-0447.2010.01543.x