Rejection and Rage with Borderline Personality Disorder

This video answers the question: What is the relationship between rejection sensitivity, rage and borderline personality disorder. Borderline personality disorder is a Cluster B personality disorder and the Diagnostic and Statistical Manual (DSM), which is the emotional, erratic, and dramatic cluster. It's the same cluster as antisocial, narcissistic, and histrionic personality disorders. The symptom criteria include: frantic efforts to avoid abandonment, an unstable relationship pattern (sometimes this is called the love-hate cycle), identity disturbance, impulsivity in at least two areas that could be self-damaging, suicidal behaviors, affective instability, a chronic feeling of emptiness, inappropriate, intense anger, and paranoid ideation or dissociation. It's important to note here of course that only five of these symptoms need to be present for a diagnosis of borderline personality disorder. Only a licensed and qualified clinician can make a diagnosis. There are presentations of borderline personality order that don't involve inappropriate, intense anger. In my experience these are not as common as presentations that do involve anger, but it is still important to recognize that we see with borderline personality disorder, not all presentations are similar. When the symptom criterion of anger is met in borderline personality disorder, we see this anger has a certain characteristic to it a lot of times. This particular type of anger is sometimes referred to as borderline rage. This is because it's not only intense and inappropriate, but there's an uncontrolled feeling to this particular type of anger, and it causes a lot of problems for individuals of borderline personality disorder. We see evidence of this in the research. This anger or rage can disrupt relationships including romantic relationships, friendships, relationships at work, and even the therapeutic relationship. We also see that this anger or rage is associated with violence and it predicts early termination of treatment on the part of the individual with borderline personality disorder. Individuals who have this rage are more likely to drop out of therapy. We also see an increased risk for self-harm and suicidal behavior associated with borderline rage. Research shows a strong association between rejection sensitivity and rage. It's important when looking at the results to here that we keep in mind that rejection sensitivity isn't the only thing that explains rage in borderline personality disorder, but it does appear to be a significant factor.

Berenson, K. R., Downey, G., Rafaeli, E., Coifman, K. G., & Paquin, N. L. (2011). The rejection–rage contingency in borderline personality disorder. Journal of Abnormal Psychology, 120(3), 681–690.