Che cos’è?
Questo disturbo è caratterizzato da una modalità pervasiva di instabilità delle relazioni interpersonali, dell’ immagine di sé e dell’ umore ed una marcata impulsività. Le relazioni interpersonali tipicamente sono molto intense, poiché caratterizzate da manifestazioni emotive dell’individuo eclatanti, e caotiche a causa delle continue e brusche variazioni dell’individuo nella considerazione dell’altro oscillando tra idealizzazione (es.“lui è l’uomo della mia vita”) e svalutazione (es. “lui è l’uomo peggiore che abbia conosciuto”). Quando questi individui svalutano l’altro e soprattutto in situazioni di stress, possono sviluppare un’ideazione paranoide, ipotizzando intenzioni malevole da parte dell’altro che diventa un nemico da cui difendersi e percependosi come fragili vittime di un mondo minaccioso, oppure andare incontro a crisi dissociative durante le quali perdono temporaneamente le capacità critiche ed il senso di sé.
Così strutturano nel tempo rapporti destinati a fallire o difficili da gestire sul piano emotivo al punto da rendere difficile anche l’uscita dalla relazione. A fronte di abbandoni reali o solo immaginati, il borderline mette in atto sforzi disperati per evitarli, non tollerando di essere lasciato da solo o di non essere al centro delle attenzioni dell’altro.
Anche l’immagine di sé e la percezione di possono essere molto instabili al punto da non possedere un senso di sé chiaro e coerente e da non avere punti fermi stabili come valori, ideali e scelte. Così, l’idea di sé e dell’altro cambia di continuo, prevalentemente in modo sostanziale e contrastante poiché prevale la tendenza a operare valutazioni estreme (idealizzazione versus svalutazione), e tendenzialmente in direzione negativa a causa della severità con cui si trattano. Tutto ciò non fa altro che creare un quadro di fondo di tipo depressivo.
Altro aspetto caratteristico del disturbo è l’instabilità emotiva che si manifesta con intensi e bruschi cambiamenti dell’umore, anche se l’emozione prevalente è la rabbia, e con la compresenza di emozioni contrastanti. Queste variazioni umorali si scatenano soprattutto in risposta ad eventi relazionali spiacevoli (es. litigio con partner), evidenziando così la disposizione di queste persone a reagire in modo rapido, intenso e duraturo agli eventi.
Nel tentativo di gestire e far fronte a queste tempeste emozionali (tipicamente il cronico senso di vuoto e la depressione), le persone con Disturbo Borderline di Personalità tendono ad agire impulsivamente, senza cioè un’adeguata riflessione, adottando comportamenti come shopping eccessivo, sesso promiscuo, abuso di sostanze, guida spericolata e abbuffate. Inoltre, sempre nel tentativo di gestire queste emozioni intense, l’individuo può agire in modo ricorrente comportamenti autolesivi (es. procurarsi dei tagli sul corpo con delle lamette o delle bruciature con dei mozziconi di sigaretta, ingerire dosi eccessive di psicofarmaci), minacciare e/o attuare gesti suicidari.
Quando nasce e chi colpisce?
Il Disturbo Borderline di Personalità esordisce nell’adolescenza, colpisce il 2% della popolazione ed è più frequente nelle donne.
Perché nasce?
Riguardo le cause, diversi studi hanno evidenziato sia il ruolo di fattori genetici, nel predisporre l’individuo a difficoltà di regolazione emotiva, che l’effetto di fattori ambientali come l’esposizione a un ambiente invalidante nel corso dell’infanzia e l’esposizione a eventi traumatici quali abusi sessuali, fisici, carenza o inadeguatezza delle cure, svalutazione dei vissuti psicologici.
Quali conseguenze?
Gli effetti di questo disturbo possono essere particolarmente dirompenti nei diversi ambiti di vita dell’individuo: lavorativo, familiare e relazionale. In particolare sul piano personale, la tendenza a gestire gli intensi stati emotivi attraverso comportamenti impulsivi, pericolosi e autolesivi espone seriamente questi soggetti al pericolo per la stessa vita.
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