BPD, Dissociation and Understanding What Is Happening: Moving from Shame to Choice.

Have you ever found yourself thinking:

“Why did I react like that?”, “Why do my feelings change so quickly?”, “Why do I suddenly feel completely different about someone?”, “Why can't I just control myself?”

If you have been diagnosed with or are exploring the possibility of Borderline Personality Disorder (BPD), you may already be familiar with these questions.

You may experience emotions that become extremely intense, rapid changes in how you feel about yourself or other people, a powerful fear of rejection or abandonment, impulsive actions, anger, emptiness, or periods where you feel disconnected from yourself or from what is happening around you. Sometimes these experiences can also involve dissociation.

Understanding the difference between the experiences associated with BPD and those seen in dissociative disorders can be helpful—not because one diagnosis is more or less “real” than another, but because understanding what is happening can help you develop more choice in how you respond.

BPD and dissociation can overlap

One of the confusing things about BPD is that dissociation can be part of the picture.

During periods of intense emotional distress, someone with BPD may experience:

• feeling unreal or detached from themselves

• feeling as though they are watching themselves from the outside

• feeling that the world around them is unreal or distant

• becoming emotionally numb

• losing their sense of connection to what they were feeling moments before

• experiencing gaps in their awareness or memory

• feeling as though a very different version of themselves has suddenly taken over.

These experiences can be frightening.

They can also lead someone to wonder whether they have a dissociative disorder such as Dissociative Identity Disorder (DID).

The answer isn't always straightforward, because there is overlap.

Dissociation exists on a spectrum, and someone can experience significant dissociative symptoms without meeting the criteria for a dissociative disorder.

The important distinction is therefore not simply:

“Do I dissociate or not?”

but rather:

“What happens to my sense of self, memory, emotion and behaviour when I become overwhelmed?”

What can be characteristic of BPD?

BPD is particularly associated with difficulties involving emotion regulation, staying within strong sense of self, and relational aspects..

For example, a person's perception of another person may change dramatically depending on their emotional state.

Someone may feel:

“You're the only person who understands me.”

And after feeling rejected or hurt:

“You don't care about me at all. I can't trust you.”

These shifts can feel completely genuine in the moment.

Similarly, someone may move rapidly between wanting intense closeness and desperately wanting to withdraw. The emotional experience can be powerful and immediate.

There may also be a strong sense of “I don't know who I am”, with identity, values, goals and self-image changing depending on the situation or relationship.

These experiences can sometimes be understood through what is happening between the self and other people, particularly when attachment, rejection, abandonment or perceived criticism becomes activated.

What can dissociation look like?

Dissociation can involve something somewhat different: a disruption in the normal integration of consciousness, memory, identity, emotion, perception and bodily experience.

Rather than experiencing an intense emotion, a person may feel disconnected from the emotion, their body, their surroundings, or aspects of their own identity.

For some people, there can be significant discontinuities in memory or a sense that experiences belong to different parts of themselves.

The structural dissociation model offers a way of understanding this in terms of different parts of personality becoming organised around different functions.

One part may be focused on ordinary everyday life—working, caring for others, managing responsibilities and getting through the day.

Another may become activated around fear, threat, traumatic memories, bodily sensations or intense emotional experiences.

In more complex forms of structural dissociation, there may be a greater differentiation between these parts, including more pronounced changes in identity, memory and experience.

So how are BPD and dissociative disorders different?

There isn't one symptom that provides a simple dividing line and the symptoms can overlap under significant distress, and careful assessment is important.

Very broadly, however, BPD includes symptoms of affect dysregulation, negative self-concept and interpersonal difficulties (along with dissociative symptoms under distress). While someone with dissociate disorder would have similar symptoms but additionally have re-experiencing of traumatic memory, patterns of avoidance, altered sense of thereat, depersonalisation and derealisation, dissociative amnesia, and disruption to identity.

This is why trying to decide “Which one am I?” from a list of symptoms can sometimes create more confusion.

A better question is

“What is happening to me in these moments?”

Moving from “Why am I like this?” to “What is happening?”

This is an important shift in therapy.

People living with BPD are often given messages—sometimes explicitly and sometimes implicitly—that they are too emotional, too difficult, manipulative, attention-seeking or somehow responsible for the intensity of their reactions.

Over time, these messages can become internalised.

The person starts asking:

“Why am I like this?”

And underneath that question can be another:

“What's wrong with me?”

Traumatic and invalidating relationships can leave us carrying enormous amounts of shame.

But asking "why" in this way can sometimes keep us trapped in self-criticism.

A different approach is to slow down and become curious about what is happening.

Instead of:

“Why did I do that?”

we might ask:

“What happened just before I felt this?”

Instead of:

“Why am I so needy?”

we might ask:

“What did I perceive was happening between us?”

Instead of:

“Why did I suddenly hate them?”

we might explore:

“What changed in my experience of this person?”

And instead of:

“Why can't I control my emotions?”

we might ask:

“What emotion has appeared, what triggered it, and what am I experiencing in my body and thoughts right now?”

This is not about finding excuses for behaviour. It is about creating enough space to understand it. And understanding creates the possibility of choice.

How MBT-informed therapy can help

Mentalization-Based Therapy (MBT) offers a particularly useful way of approaching these experiences.

Mentalizing means trying to understand our own and other people's behaviour in terms of underlying mental states—our thoughts, feelings, intentions, wishes, fears and perceptions.

When we become highly emotionally activated, our ability to mentalize can temporarily become much more limited. We can become absolutely certain about what someone else is thinking. Such as - “They don't care about me.” “They're going to leave.” “They deliberately did that.”

At that point, trying to analyse everything immediately can sometimes make things worse.

Therapy can instead provide a place to slow down.

• What happened?

• What did you notice?

• What were you feeling?

• What did you imagine the other person was thinking?

• What happened in your body?

• What changed?

• What might have been happening for the other person?

• What else could be possible?

This process creates a small but important space between experience and action, and allows the pre-frontal cortex to engage. executive functioning and rational thinking can switch off at times of distress. Asking "why" reinforces the helplessness and panic. Refocusing onto the step by step what experience allows for the front brain to slowly come back online.

Trauma-informed therapy adds another layer

A trauma-informed approach recognises that some of our most intense reactions may make sense in the context of experiences where we had to protect ourselves, adapt or survive.

A reaction that feels disproportionate in the present may have roots in earlier experiences of threat, rejection, instability, neglect, abuse or relational trauma.

But we don't necessarily need to start by asking:

“Why did this happen to me?”

Sometimes it is more helpful to begin with:

“What is happening in me right now?”

We can become curious about the part of you that is frightened, the part that becomes angry, the part that wants to run away, the part that desperately wants reassurance, the part that becomes numb, the part that tells you that you are not good enough. Rather than judging these experiences, we can begin to understand their function. We simultaneously appropriate the different emotional experience and beliefs to where they belong rather than having our emotional intensities bubble under the surface in wait of latching onto present triggers and exploding.

From blame to compassion

If you have spent years blaming yourself for your reactions, this can be a profound change.

Instead of:

“Why am I doing this to myself?”

we can ask:

“What am I experiencing right now?”

Instead of:

“Why am I so difficult?”

we can ask:

“What is happening between me and this person?”

Instead of:

“Why can't I just be normal?”

we can ask:

“What has become activated, and what do I need in this moment?”

And instead of treating one part of yourself as the enemy, we can become curious about what that part may be trying to communicate or protect. This does not mean that every behaviour is healthy or that we cannot be accountable for our actions. Quite the opposite.

Greater understanding can make greater responsibility possible. When we can recognise what is happening before we act, we have more opportunity to pause, reflect and choose.

The goal isn't to get rid of your emotions

Therapy isn't about becoming someone who never gets angry, frightened, overwhelmed or attached. It isn't about eliminating the parts of yourself that feel difficult. It is about developing a more integrated relationship with your own experiences.

Over time, you may become better able to notice:

“I'm becoming overwhelmed.”

“I'm interpreting this as rejection.”

“A familiar fear has been activated.”

“I'm beginning to disconnect.”

“I'm certain about what they are thinking, but I don't actually know.”

That moment of noticing can be incredibly important. Because between what happens and what we do next, there can be a space. And within that space, there can be choice.

You don't have to work this out alone

If you have BPD and have sometimes wondered whether your experiences are “normal for BPD,” whether you are dissociating, or whether something else is happening, you don't need to diagnose yourself. Therapy can provide a space to slow things down and explore your experiences without judgement.

An MBT-informed, trauma-informed approach can help you become curious about what happens in your mind, body and relationships when you become overwhelmed.

Rather than focusing on the “Why”, together we can explore the "What"

You are not your diagnosis.

You are not your reactions.

And you are not the shame that may have accumulated around them.

Your responses have a history. They may have developed for understandable reasons. And with a safe, compassionate therapeutic relationship, it is possible to become more curious about them, understand them more clearly and develop greater freedom in how you respond. The aim isn't simply to understand why you are the way you are. It is to understand what is happening—so that, little by little, you can have more choice in what happens next.