People with borderline personality disorder (BPD) engage in frantic efforts to avoid being abandoned, have an unstable sense of identity, feel chronically empty, have difficulty controlling their anger, and may engage in self-harm. If you know someone with BPD, you undoubtedly have experienced the rage that can occur when this person feels neglected, vehemently blaming you for not being caring or supportive enough.
Prominent psychological theories of BPD vary in the explanations they provide for its development, including genetic determinants, early childhood experiences, difficulties in understanding how others feel, and a hypersensitivity and hyperreactivity to cues from other people.
In summarizing these perspectives on BPD’s origins, Marco Cavicchioli and Cesare Maffei (2019), of the Vita-Salute San Raffaele University and San Raffaele-Turro Hospital (Milan, Italy), believe that there is a more concise and theoretically viable way to explain BPD and, by extension, its diagnostic features. Their analysis begins with the criticism that the BPD theories are based on the idea that the disorder is somehow an entity distinct from normal personality. As they note, “all these theories are not based on a theory of normal personality, such as trait-based or sociocognitive approaches, which are necessary to explain the continuum existing between adaptive and maladaptive personality” (p. 1).
Despite the fact that the DSM-5 retained the previous categorical system that groups people into distinct diagnoses, personality disorder researchers maintain that a dimensional approach provides a more realistic understanding, allowing as well for a more useful diagnostic framework. A personality “disorder,” according to those who argue for this dimensional approach, should be viewed as an extreme on a continuum ranging from adaptive to maladaptive. Everyone has a personality, in other words, but for some people, that personality creates serious and chronic difficulties living in the world.
Cavicchioli and Maffei propose that, instead of relying on genetic explanations or problems in reading and then reacting to the emotions of others, a better framework is provided by the “cognitive-affective personality system” (CAPS; Mischel & Shoda, 1995). CAPS is based on the view of personality as consisting of ways of reacting to situations. Personality is not a set of consistent traits, either inherited or developed early in life, but is based on an interaction between the person and the situation. You don’t have the trait of extraversion, CAPS would argue. You’ll act in an extraverted way if the situation draws this out within you, such as being at a social gathering with people you know. If you’re in a different situation, such as when you’re placed in a room with complete strangers, you won’t act in this extraverted way.
CAPS proposes that these interactions involve the way people encode a situation, their expectancies and beliefs, their feelings, their goals and values, and their plans for self-regulation or self-monitoring. You don’t want to stick out like a sore thumb in a situation where no extraversion is called for, to return to the previous example. People with a personality disorder would be unable to distinguish situations in which certain behaviors and feelings are called for and those in which it is not appropriate. For example, narcissistic individuals would believe that it is always appropriate to dominate in a social situation, even if they would be better served by taking a back seat to the action.