Mentalization, Attribution, and Meaning in Borderline Personality Disorder
Most people probably believe that their mental picture of life, people, and experiences represents an accurate representation of reality. The mental assumption is that thoughts or attribution made about observations are relatively fixed and stable that accurately describe reality. However, consider the possibility that perception about others, objects, experiences, or life situations might be interpreted or distorted because of the way the brain functions, interprets, and assigns meaning to things and people. Intentional stance, or how human beings recognize attribute meaning of others can be distorted by a deficit capacity to “understand each other in terms of mental states—thoughts and feelings, beliefs and desires—in order to make sense of, and even more importantly, to anticipate, each others’ actions” (Fonagy, 2000, p. 1130).
Intentional stance is a technical label that psychologists use to describe the theoretical application of cognitive processes within “mentalization or reflective function, which denote the understanding of one’s own as well as others’ behavior in mental state terms” (p. 1130). For instance, in the developmental phase of early childhood, mentalization may assign false beliefs about self, others, or behaviors from “inappropriately equating mental state with reality” (p. 1130). The problem clearly identified is a faulty assignment of meaning to an experience, which embeds a belief creating a skewed perception of reality. One important matter concerning the origin of faulty assignment and mentalization distortion stems from skewed thinking processes often associated with the symptomatic patterns of Borderline Personality Disorder. One direction of research focuses attention upon causes of the disorder and reports that, “Evidence on the aetiology of BPD is conflicting. Some research supports a biological basis for the disorder. First, there are indications that erratic mood swings, social cognitive difficulties, and maladaptive behaviours may be caused by prefrontal and temporolimbic dysfunction, as cited in (Swift, 2009, p. 23). For many practitioners, the importance of research focuses questions upon the ways that Borderline Personality Disorder links to mentalization deficiencies and the ways maladaptive behavior correlates with the inherited biological basis for personality disorders.
As well as, framing an understanding the biological aetiology of (BPD), an effort to further explain how meaning allocates thinking absolutes in (BPD) perception the answering research questions. In the work of Robert J. Gregory (2007), he explains the process of attribution by stating that, “Attributions help … to understand ourselves, our experiences in the world, and others’ intentions” (Borderline Attributions, p. 133). Indeed, it is possible that perception of experiences, self-understanding, and others intentions may have to do with the way thoughts work to organize a belief into an absolute held to be true about reality. Therefore, attribution is a reliable measure to form a stable perception of reality, but when there is an “identity disturbance or pathology of the self-structure” (Borderline Attributions, p. 131), can reality constructed by a mental state accompanied by a Axis 1 mental health condition consistent with Borderline Personality Disorder.be an accurate reflection of reality?
The challenge of understanding the mental processing hierarchy of the presentation of a person with definable conditions associated with BPD presents great difficulty in maintaining an effective way of managing stable thinking states. To illustrate the level of challenge that practitioners encounter treating (BPD); Ann R. Bland, Carol A. Williams, Kathleen, Scharer, and Shari Manning (2004) point out that, “Mental health providers describe individuals diagnosed with BPD as among the most challenging and difficult patients they encounter (APA,2002; Sable, 1997)” as cited in (p. 656). Consequently, a challenge for therapists presents through the fundamental difficulty associated with mentalization accompanied with emotional processing, which affects attribution of meaning. Consequently, faulty assignment of meaning into irrational beliefs about people, events, and life situations impedes progress for clinicians in the way that the interpretation of perception, emotion, and logical information is interpreted. On one level, the information from research indicates that the level of difficulty faced by psychology practitioners is challenging in a clinical setting. Therefore, it is reasonable to assume that difficulty is equally magnified within a social system of family members, spouses, and friends who may be trying to rationalize living in conjunction with an untreated person with (BPD), while having a limited grasp of mental attribution processes.
The Impact of BPD on the Family System
The aggregate problem magnified in a BPD personal a relationship is that “Borderline personality disorder (BPD) can be thought of as a disorder, which affects not only the person with the disorder, but also those around them systemically. People with BPD have ongoing emotional pain that is often most intensely felt in their relationships with others” (Giffin, 2008). Indeed, the ongoing pain of a person with a borderline personality is not a solitary event that only affects the person with the disorder; it has an impact upon everyone in the social system of relationships. When it is someone that you love and have lived with, it is very hard to come to terms with the unusual behaviors because the behavior coupled with a skewed sense of reality may mean that something is happening you may not fully comprehend. Unfortunately, the depths of events are very difficult to understand without realizing the nature of a personality disorder coupled with a mental illness. Indeed, behaviors seen and heard in the experience of life confuses the meaning of events about the disorder. The confusion results largely from a lack of awareness about ambiguous and confusing actions witnessed.
While many people have an understanding that something seems off, the conditioning that naturally occurs in a relationship system coupled with unusual behaviors are difficult to identify because of the strong emotional connection to persons involved, along with a lack of objectivity about occurrences in emotional charged familial relationship. Consequently, one of issues often neglected is the systemic effect deeply felt because of the intense emotional pain felt in relationships with others. Obviously, one issue of concern with is the personality disorder and the effect upon the person with the disorder. However, equally important is how the personality disorder effects family systems, i.e., those most directly affected by behaviors, feelings, and experiences not easily deciphered in a way that makes emotional sense.
Unfortunately, the daily happenings with borderline personality presenting symptomatic behaviors is confusing to sort out, partly because, “persons with borderline personality disorder attempt to generate meaning, eliminate ambiguity, and maintain idealizations by assigning polarized attributions of value, agency, and motivation to their experience” (Gregory, 2007). The application that Gregory makes points out one of the confusing and maddening behaviors is symptomatic for many borderlines. The behavior confuses many onlookers because onlookers are blindsighted by polarized meaning characteristic of borderline personality thinking patterns. Others may not realize the way (BPD) thought generating meaning, value of internal perception, and efforts made to eliminate ambiguity that is inconsistent with the (BPD’s) perception of life is a natural and unrecognized pattern of behavior.
The challenge for individuals in relationships with borderlines is to understand how the disorder causes behaviors that attempt to put a spin events, people, and reality to match the mentalization and attributes, which have assigned meaning to a perception of reality skewed by idealization. A point that is worthy of noting is the particular way thinking occurs that is unique in borderline presentation. A notable way of thinking that is characteristic of borderline personality is the linear patterns of polarization. One trait is all good or all bad thinking about others and situations polarized by black and white thoughts that discount abstract and ambiguous ideas that are inconsistent with felt perception of people and life events. Gregory (2007) describes the splitting pattern of thinking by stating, “The observation that patients with BPD exhibit opposing, binary attributions has been incorporated into psychiatry’s modern diagnostic classification system, points out this thinking pattern characterized by splitting. Patient perceptions of self and others are noted to be either all good or all bad, i.e. “characterized by alternating extremes of idealization or devaluation” (American Psychiatric Association, 1994, p.654). A challenge in the family and social system where (BPD) exists is to understand the thinking swing that occurs resulting in idealizing or devaluation with no middle ground.
An important area of struggle that families experience in the relationship dynamics stems from inadequate understanding or poor information among most people living in social relationships with a person with (BPD). Therefore, there is a missing link between lived-experience and understanding about how attribution contributes to unique perception. In addition, perceived anomalies about life events related to the way meaning generates beliefs in the mentalization process. Unfortunately, a negative reaction that some people experience is that feeling caught by the emotional double bind within relationship dynamics that puts family in a position of becoming the villain or unwitting participant in the cycle of dysfunction and emotional pain stemming from (BPD) attribution. In fact, realizing that life experience for a borderline personality affects daily living in a very real way every day because of the important role that relationship plays in the way that self-valuation attaches meaning to perception because of (BPD). Consequently, the person without an informed understanding of the impact of the importance of emotional pain felt in relationship and the way information interprets emotional meaning to reduce ambiguity.
Therefore, the subsequent difficulty of managing relationships for family and friends in a healthy functional way challenges life every day. Indeed, the distinct difference contained within thoughts, meaning, and reasons for polarized idealization places persons in the circle of relationships with (BPD) at risk for behavioral and mental health problems. When a borderline personality interprets meaning and attribution in a skewed manner because of the way the disorder affects thinking patterns, the attribution should not be oversimplified and understood as a malicious choice, but rather a personality disorder with very difficult symptomatology. Because (BPD) is characterized by extremes in how behavior impacts management and treatment, “Health professionals often view personality disorders as an issue of self-control and choice rather than an illness (Kendell 2002). However, research shows that people with the disorder are prone to other psychiatric illnesses and or substance misuse. Personality Disorder: No Longer a Diagnosis of Exclusion (NI MHE 2003) was published to facilitate best practice in the treatment and care of people with the condition”, as cited in (Swift, 2009, p. 22) . Therefore, making sense of the application of research data demonstrates the impulsive self-control and polarized thinking patterns resulting from polarization often are coupled with other mental health diagnosis that complicate the personality disorder presentation with psychiatric conditions. Obviously, the level of difficulty experienced in relationships deeply impacts what is perceived about self, others, and situations and magnifies the deep pain felt by the person with (BPD). However, every person with the disorder is in a system of relationships dramatically affected by the way casual, romantic, and familial relationships with the borderline personality take place. Unfortunately, in many cases, the disorder is undiagnosed or under diagnosed and the result demonstrates patterns of impulsive reckless, and sometimes, self-destructive behaviors resulting in broken or damaged relationships, and misunderstanding about the things that are happening. When people do not seek assistance from professionals trained to diagnose and treat personality and mental disorders, the effects can be devastating to a borderline, as well as, the people in a system of relationship who love and care about the things they are experiencing. Indeed many times fractured or destroyed lives of person’s with the disorder, as well as, the extended social system affected by secondary issues not adequately understanding mentalization, resulting from Borderline Personality Disorder.
Mentalization and Attribution in a Social-Relational Context
This particular attribution pattern associated with (BPD) demonstrates a vital connection between thinking, personality, and socialization disruption. For this reason, associating the focal point of mentalization and attribution with symptomatology presenting in the context of interpersonal relationships suggest a rationale for ongoing patterns of instability. In support of a correlation between thinking, meaning, and relationship behaviours (BPD), describes “‘a severe disturbance in the characterological condition and behavioural tendencies of the individual, usually involving several areas of personality, and nearly always associated with considerable personal and social disruption’, according to the ICD-10 Classification of Mental and Behavioural Disorders (World Health Organization 1992)”, as cited in (Swift, p. 22).
In fact, the connection between ongoing difficulties and presentation of beliefs and behaviours delineates severe disturbance, areas of personality, and social disruption as symptomatic patterns observed. Further observation in relation to the effect of (BPD) falls into categories defined as characterological, or (“enduring”) forms of psychopathology, that characterize personality traits present from adolescence, early adulthood, and into adult life. For this reason, the nature of how mentalization and attribution effects relationships has a systemic relationship to lifespan development and social attachment patterns that reinforce a belief construct in the person with the (PD) and confuses those involved in relationship disruption episodes.
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