Returning to the idea of looking past the “dysfunctional” and “disorder” aspects of mental health conditions, like we did in Why Dyslexia Is A Cognitive Strength, Not A Disorder? In this great podcast episode I want to look at the evidence and arguments for borderline personality disorder in fact not being a mental disorder but instead being an adaption that has helped humanity to survive. If you’re interested in personality psychology and clinical psychology then this is a brilliant podcast episode for you!
Today’s episode has been sponsored by Personality Psychology and Individual Differences. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it.
How Has Borderline Personality Disorder Traditionally Been Seen?
Whenever Borderline Personality Disorder is spoken about it is often seen as a brain dysfunction with Borderline Personality Disorder being described as a disorder related to interpersonal relationships. Due to people with Borderline Personality Disorder traits often have chaotic as well as unstable relationships, causing the sufferer to rapidly switch from valuing a person to devaluing them completely without much notice, if any.
In addition, Borderline Personality Disorder is associated with the sufferer being hypersensitive to rejection, having difficulty in controlling their emotions and they’re mistrustful of others. As well as Borderline Personality Disorder tends to have a positive outcome in the end because the symptoms of the condition tend to gradual decrease around a person’s mid-life and there are plenty of psychological treatments designed to help people with Borderline Personality Disorder.
However, the reason why I’m writing this introductory section is because mainstream research into the condition often sees the condition as something that is caused by a brain dysfunction, with one leading theory proposing that Borderline Personality Disorder is caused by a frontal lobe deficit, this impacts a person’s impulse control.
Nonetheless, there is a new argument forming in the literature of Borderline Personality Disorder because there is increasing evidence and argument that the condition is not caused by a dysfunction but instead caused by an adaption that has helped the person to survive.
So what is this new argument and most importantly what does it mean for Borderline Personality Disorder?
Why Is Borderline Personality Disorder Seen As An Adaption?
The main supporter and author working on the argument for Borderline Personality Disorder as an adaption comes from Martin Brune who is a professor of psychiatry at Ruhr University Bochum and a psychiatrist at LWL University Hospital. The professor has previously written a lot on evolutionary psychiatry, and this is a field that proposes we need to think about mental health and mental health conditions in terms of the big evolution picture as conditions and adaptions that have allowed our species to survive. Therefore, where other professionals see mental health conditions as a pathology, they see the conditions as adaptions.
Personally, I do want to jump in here quickly and mention something. I do want to flat out point out that yes it is very modern and helpful to move away from the “every single mental condition is a problem” mindset that is flawed and we’ve covered the damage this mindset does on the podcast before. However, not every single behaviour is down to evolutionary, but it is an interesting subfield of behaviour but it isn’t necessarily correct. Because like everything in psychology and human behaviour everything is caused by a range of factors, and not all that factors include evolution.
Additionally, Brune (2016) based the idea of Borderline Personality Disorder being an adaptation on the original work of John Bowlby and his work about the early in life child development of an “internal working model” of the world. And in short, this is a mental picture that tells them what the world is like and how to survive as well as thrive in the world.
Therefore, to some children, they see the world as an essentially friendly place with plenty of resources for them to enjoy. They also see the world as a place where interpersonal relationships are durable and great, as well as the child can expect their emotional and material needs to be met long into the future. And Bowlby believed children with stable attachments are more likely to develop this sort of internal working model.
On the other hand, to some children the world is a hostile and extremely unpredictable place with their attachments being fragile and fleeting by their very nature, and there is absolutely no guarantee of resources for them. These resources include emotional support and material resources. Resulting in Bowlby to believe that these children don’t tend to have stable early attachments and at the extreme end of the spectrum, these children can and do experience neglect, abuse and a range of other traumas. These children are most likely to develop this sort of internal working model.
As a result, now we know the child development aspect of the adaptation model, we need to connect it to Borderline Personality Disorder. As a result, children who develop the second type of working model could and would behave very differently to the first type of children. Since these children could mistrust others, they could be hypervigilant in protecting themselves from rejection and abandonment, as well as they could have lower expectations about access to future resources. This might cause the child to have more of an “all or nothing” approach to life, which we, as outsiders, might see as them being impulsive or reckless.
In other words, the second type of internal working model might cause them to develop the traits of Borderline Personality Disorder.
Although, it is worth mentioning that Brune himself doesn’t believe that Borderline Personality Disorder in itself is an adaption, he sees it as an extreme and maybe maladaptive version of an adaptation. But it doesn’t matter what we or he see Borderline Personality Disorder traits as an adaptation or not, the most important thing is that his argument forces us to consider the potential value that these traits have, or the value they give a child in their formative years.
Personally, this is what I like about these more modern clinical psychology episodes because they really do help us to question the status quo of mental health, and it helps us to realise that maybe the outlook and the negativity of the past is a horrific thing, that does need to sectioned to the past. So moving forward we can make our thinking more modern and hopeful towards mental health conditions like Borderline Personality Disorder.
The Evidence For This Adaptationist Model
As psychology is a science, we must always focus on the evidence and thankfully there is a good amount of evidence for this adaptationist model.
For example, we know that abuse, neglect and other trauma are all risk factors for Borderline Personality Disorder and up to 80% of people with Borderline Personality Disorder have reported these types of adverse childhood experiences. This supports the adaptationist model because it shows that a high amount of children could have developed the second type of internal working model and Borderline Personality Disorder traits could have helped them to survive in their formative models.
Furthermore, Borderline Personality Disorder affects up to 6% of the general population and the condition does have genetic factors. As well as I have mentioned on previous podcast episodes how evolution tends to wipe out most genetic disorders and flaws so they affect a tiny amount of the population, and a 6% is not a tiny amount. So if Borderline Personality Disorder is so bad for us, then why didn’t natural selection get rid of it from our genetic makeup?
Finally, people with Borderline Personality Disorder have a high level of emotional empathy, meaning they can “read” other people’s emotions very well. Therefore, this could be seen as an adaptation as it allows them to navigate relationships and intimacy better than people who don’t have high levels of emotional empathy.
Clinical Psychology Conclusion
To wrap up today’s podcast episode, if Borderline Personality Disorder is in fact an adaptation and not a disorder, then a lot of the language we currently use for the condition are extremely damaging, misleading and just flat out false. And like most clinical psychologists, I completely agree that this is extremely troubling considering all this negativity surrounding mental health conditions only leads to stigmatising people with these conditions.
And whilst I have mentioned it on other podcast episodes, but there is supporting evidence for this sort of thinking in other mental health conditions. For example, Hans et al. (2022), a preprint, suggests at the very least that depression is a coherent response to the problems in a person’s life rather than a disease in its own right.
Therefore, all of this does beg the very simple question, could the same be true for Borderline Personality Disorder? And if that’s true then how many mental health conditions could this be true for?
Personally, I really hope that it is true for a very wide range of conditions so we can seriously start to move away from the damaging, unhelpful and stigmatising mental illness models from the last century, but without more research we simply cannot know for sure.
The future will definitely be interesting, that’s for sure.
I really hope you enjoyed today’s biological psychology podcast episode.
If you want to learn more, please check out:
Personality Psychology and Individual Differences. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it.
Have a great day.
Clinical Psychology and Personality Psychology References
Brüne, M. 2016. Borderline personality disorder: Why ‘fast and furious’? Evolution, Medicine, and Public Health 1: 52-66.
Del Giudice, M. 2018. Evolutionary Psychopathology: A Unified Approach. Oxford: Oxford University Press.
Schroder, H., Devendorf, A., & Zikmund-Fisher, B. (2022, May 16). Framing depression as a functional signal, not a disease: Rationale and initial evidence. https://doi.org/10.31219/osf.io/2pbzt
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