Why are Borderlines so Sexual?

The Why’s of Sex, Promiscuity, and Borderline Personality Disorder

Why are you so sexual my dear Borderline? That’s a good question isn’t it? One that does not come with a quick answer. This is a first. I’ve found almost no information on why sex seems to be such a prominent feature of Borderline Personality Disorder. What I have found has been only a paragraph or a sentence here or there. So let’s look at what I’ve found, what I feel, and what some of my own theories are.

One of the more obvious theories as to why people with BPD have such reckless sex lives is the fact that they constantly feel emotional emptiness. “Even when they find a stable emotional relationship their fear of abandonment causes them to become paranoid about the stability of their relationship and the validity of the love coming from their partner. A possibility for the reasoning behind sex and borderline personality disorder is that the sufferer of BPD actually tries to self-sabotage their relationship in order to end the relationship before they are actually abandoned by their partner. Another theory as to reckless sex and borderline personality disorder is that the BPD sufferer actually gets an emotional high from bonding with the sexual partner even if only for a short time. They are literally trying to fill in emptiness inside themselves and they try and try to fill that void with sex. After having a sexual affair the person with borderline personality disorder may not have the same amount of guilt as someone with non-BPD. The reason is projection; oftentimes people with borderline personality disorder project their negative behaviors onto others including their partners. This means that someone with borderline personality disorder who is having a reckless sexual affair may have a tendency to build a fake affair that their spouse or loved one is having in their head. They literally make themselves believe that their partner is also cheating and that they are therefore justified in having their reckless sexual affair.”

A previous article I mentioned notes that there may be a number of reasons for the more negative attitudes about sex. “First, many women with BPD are survivors of child abuse, which may contribute to overall negative reactions to adult sexual experiences. Also, women with BPD are more likely to experience a great deal of conflict in their relationships, so they may feel less positive about sex because relationships in general feel less fulfilling.”

Having these negative attitudes doesn’t however, justify why we may still have an attitude directed towards reckless sex. I would take this from a different angle and say that perhaps due to previous abuse there is a subconscious need for approval where it was not given, withheld, or used against us. Overt sexual behavior may be a way of taking back control, exerting control in the present where control was once absent.

Also, knowing that we have the ability to interest and consume someone with our sexuality or ability to seduce them is a form of validation of our own self-worth.

Those are my thoughts currently. I’m sure I’d have more but I’m utterly brain fried from today and yesterday at work. I’ll be sure to post more on this if the thoughts should arise.

So there’s that. To fill an emotional emptiness with a physical, well ::grins:: I don’t have an argument for this. I also believe that when it comes to sex, people with BPD are more likely to be sexually open and adventurous. We can be virtually uninhibited. Or exactly the opposite. I’ve noticed a trend towards the extremes. Either we’re all or nothing. So you may have borderlines like myself that are ALL for sex or those that have severe issues from resultant traumatic experiences and avoid it whenever possible.  

Another theory comes from Thomas R. Lynch, a psychologist at Duke University. He and his colleagues found a clue in the reading of facial expressions. “The researchers asked 20 adults with BPD and 20 mentally healthy people to watch a computer-generated face change from neutral to emotional. They told subjects to stop the changing image the moment they had identified the emotion. On average, the people with BPD correctly recognized both the unpleasant expressions and the happy faces at a much earlier stage than the other participants did. The results suggest that BPD patients are hyperaware of even subtly emotive faces—problematic in people who are intensely reactive to other people’s moods. So, for example, a hint of boredom or annoyance on a person’s face that most people would not notice might produce anger or fears of abandonment in a person with BPD. Conversely, someone with BPD might see a happy expression as a sign of love and react with inappropriate passion, leading to the whirlwind, stormy romances that rock the lives of people with BPD.”

I’ve talked about hypersensitivity before. It’s very easy to read too much into what we see in someone else and I do think this theory has some validity, but I don’t think it’s substantial all on its own. This may be a contributing factor but not the main reason.

I’ve said before that I use sex as a means to be close, but not too close. It’s comforting. It allows that very real, very human connection that makes me feel less hollow and alone, while maintaining my safeguards.  I’ve been so hurt and traumatized due to past abuse and experiences that while some part of me does need this closeness, at the same time I do not trust it. There’s something more personal about letting someone into my mind, than into my body. If I can distract them with my body, they’ll have proven themselves not trustworthy enough to get into my mind, but at the same time, I have someone near. I’ll have validated my own paranoia and satisfied my need to not be alone. How’s that for messed up. When I’m alone I feel empty. Sex is one of those ultimate expressions of being not alone. Having your life literally interwined in the arms and legs of another, it’s an encompassing experience, without being completely consumed. There’s the ability to maintain a distance while holding someone close. Or maybe there’s some overdeveloped primitive instinct that if we find a partner, let them into our lives in such a way, we will develop a bond. And from there maybe a lasting one. The more partners, the greater the likelihood of this happening.

  

Sexual Deviation: A Diagnostic Criteria in BPD

I’ve been reading again. This time I found two articles discussing sexual behavior in those with a Borderline Personality.

I couldn’t find good picture today

The first was Sexual Behavior in Borderline Personality: A Review by Randy A. Sansone, MD. And Lori A. Sansone, MD. According to the DSV-IV, various forms of impulsivity are associated with borderline personality disorder, including sexual impulsivity. The existing empirical literature indicates that patients with borderline personality disorder appear to differ from patients without this personality disorder in a number of relevant ways. Specifically, those with borderline personality disorder are more likely to exhibit greater sexual preoccupation, have earlier sexual exposure, engage in casual sexual relationships, report a greater number of different sexual partners as well as promiscuity, and engage in homosexual experiences. In addition, patients with borderline personality disorder appear to be characterized by a greater number of high-risk sexual behaviors; a higher likelihood of having been coerced to have sex, experiencing date rape, or being raped by a stranger. Overall, the psychological themes relating to sexual behavior in borderline personality disorder appear to be characterized by impulsivity and victimization.

Impulsivity is represented by: greater sexual preoccupation, earlier sexual exposure, more casual sexual relationships, a greater number of different sexual partners, promiscuity, and homosexual experiences.

Victimization is represented by: a greater number of high-risk sexual behaviors; a greater likelihood of being coerced to have sex, date rape, and/or rape by a stranger.

The authors created a compilation of 12 databases from both psychiatric and non-psychiatric sources and found that those with BPD reported approximately twice the number of different sexual partners. One clinician noted that more than 25% of his outpatients with BPD exhibited promiscuity which was decidedly uncommon from his non-BPD patients. In another empirical study it was shown that women with BPD showed evidence of greater sexual assertiveness, erotophilic attitudes, sexual esteem, sexual preoccupation, and sexual dissatisfaction. The article goes on to say that individuals with BPD reported earlier sexual experiences as well as a greater likelihood of date rape.  It also showed those with BPD as being significantly more likely to report having been raped by a stranger and having been coerced into having sex.

In reading this article I was amused that they described patients as “suffering” from promiscuity. Really? Because getting laid a lot really sucks. I was also fairly angry that it stated “patients with BPD exhibit heightened sexual impulsivity as well as a vulnerability to homosexual experiences”. Vulnerability to homosexual experience? As if it’s a bad thing? This article was written by a close minded bigot as far as I’m concerned. Clearly I’m not heterosexual. Frankly, I’m more vulnerable in heterosexual relationships than I am in homosexual ones. This makes me really furious that there would be such anti-homosexual sentiment in a recent medical publication. It’s 2011 for fraks sake! I think what they meant was ‘being more open to homosexual experiences’.

According to this article there are only 2 studies that seem to counter these trends. The only real conclusions that this article seems to draw are that people with BPD may have a higher risk for sexually transmitted disease. Well, sure, that follows, but it doesn’t get into any psychological reasoning for WHY this behavior seems so common.

In fact I think the last two sentences are the most relevant, “ In summary, the psychodynamic theme of impulsivity, as described in the DSM IV, appears to be a legitimate sub-criterion in many patients with BPD. What seems to be missing in the current descriptors is the undertones of victimization that also characterizes the sexual behavior of these patients.”

Basically it says that the criteria of impulsivity is a good indicator for BPD, especially in terms of sexual impulsivity, except it should also note that there is an increased risk of victimization and/or feelings of victimization. This at least I find useful.

I’m not going to lie. I think about sex a lot. And I do mean, A LOT. My sex drive is uncommonly high from my observations amongst my own friends and I often fantasize about seducing those around me. Not for any real attraction to them, often just out of curiosity to see if I could, though in my defense I very rarely act on this.

In another article by Sansone and Wiederman they assessed two types of sexual impulsivity 1) having sex with individuals whom respondents hardly knew (casual sexual relationships) and 2) promiscuity. Again, the goal seems to have been to determine if there was genuine empirical support for sexual impulsivity to be a diagnostic criterion. While many of the findings from the previous article supported this, findings from Dr. Zanarini found that 41% of  his BPD patients avoided sexual relationships entirely. So who do you believe? Well, that’s the point of this article.

The items for the current study relating to sexual impulsivity were as follows: 1) the Personality Disorder Questionnaires** item referring to casual sexual relationships: “I have done things on impulse that can get me into trouble…[such as] having sex [acts of a sexual nature] with people I hardly know”) and (2) Self Harm Inventory item 11: “Have you ever intentionally, or on purpose,…been promiscuous [i.e., had many sexual partners]?”.

Yes, and yes. Surprise. Now does having done these things mean you are one step closer to having a Borderline Personality Disorder? Not even close. Don’t forget you still need at least a couple more impulsive traits and 4 other DSM-IV diagnostic criteria. You may just enjoy sex.  Congrats. More power to you.

Promiscuous: I certainly am. I don’t seem to manage casual sexual relationships though. I’ve had many that I intended to be as such, but they always seem to progress and evolve into something long term so they’ve never ended up being truly casual. Even my promiscuity involves being in relationships of a significant duration. Sooo, what? I’m not as slutty as the stigma would have you believe.

Anyways, through all the technical jargon and statistics in these articles the general conclusion was this: The prevalence of these behaviors was approximately doubled among those with Borderline symptomology.  The data supports the concept that a substantial minority of patients with borderline personality disorder evidence casual sexual behavior as well as promiscuity and thereby supports the inclusion of this criterion in the assessment of Borderline Personality Disorder. 

These studies only compared those with Borderline impulsivity to those without a borderline diagnosis. I’d be curious to see how this compared to other personality disorders or personality types that were marked by impulsive behavior.

When I found these articles I was expecting something more along the lines of explaining and understanding why this phenomena is greater in those with BPD. Instead they were more a clinical study to justify the diagnostic criterion. So next I think I want to: Look at the study that provides counter evidence. Understand the ‘why’ behind this kind of behavior.

Going from my own personal experience I’m not going to argue their findings. I can’t. I have no reason to. The whole point of this blog is to be honest about my journey through this disorder after all and frankly, I’m not really ashamed of anything I’ve done in this arena. Have I had a lot of partners? Compared to some, sure. Am I impulsive and promiscuous? Well, yes. Am I preoccupied by thoughts of sex?  Definitely. Does that mean everyone with a Borderline Personality Disorder is? Not at all. However, now that we’ve determined that this is a valid diagnostic criteria, let’s look at why we crave this kind of attention. I know I have theories already.

My final question: How can two articles about BPD and sex be so bloody freaking boring. Yeesh.

** PDQ-R32 or PDQ- 48

Threat of Intimacy

Acting on Impulse. Reckless Sex. Being Promiscuous.

It’s all the same right? Not quite.

Impulsive behavior, or acting without thinking about the consequences of a behavior, is one of the symptoms of BPD listed in the DSM-IV. Impulsive behavior can include many different types of acts (Spending Sprees, Shoplifting, Drinking&Drugging, Dangerous Situations, Stripping, and  yes, Sex), but reckless sexual behavior seems to be a more common one among people with BPD (and Histrionic PD).

“People with BPD are most at risk of engaging in impulsive acts when they are experiencing intense emotional responses, or when they are disinhibited by alcohol or substances. Intense sadness, fear, jealousy, or positive emotions may lead to impulsive sexuality.

Why might people with BPD be more promiscuous? One possibility is that people with BPD use sex to combat feelings of emptiness that are associated with the disorder. When feeling empty, numb, lonely, or bored, sex may generate positive emotional responses.”

I’d like some intense emotional response on top of my intense emotional response please. With a cherry on top. What? No cherry? Yeah, that’s gone. It’s almost like a drug. When you’re already so emotionally driven, adding a situation that is even more intense can push me into an almost emotional high. If it’s someone I have a strong attachment to, the world slips away in a rush of touch, sweat and sensation. As someone that longs to escape the mundane and boredom that often suffuses my life and drives me to depression, sex, is the ultimate escapism.

“These patients struggle with feelings of depression, loneliness and isolation; they’re caught in a spiral of self-destructive behavior that eventually sabotages their lives. Lacking a stable sense of self, they attempt to compensate by seeking satisfaction in material possessions, superficial friendships and impersonal sexual encounters. They substitute empty lifestyles for real lives and shy away from channeling their energies into personal growth and fulfillment.”

I wouldn’t say I channel my energy away from personal growth and fulfillment. I wouldn’t say it, but that doesn’t mean it isn’t strictly true; at least in areas concerning healthy relationships. I have a lot of incredibly fulfilling hobbies and pursuits so I know this isn’t pervasive in my life but I can see the patterns of it in some aspects of me. The relationship aspects of me. Cognitively I know when I have a good thing going for me. Hell, cognitively I know when I have a bad thing going for me. But I get so swept up in not wanting to be alone, being bored, needing to fill the time, the space, the emptiness that I act without regard for the consequences that will inevitably follow. It’s not that my life is empty, it just feels so hollow some days and I’ll do anything to fill the void. Heh. I just don’t know what I want. Don’t know how to internalize what I should want. It’s easier to figure out what other people want.

I wonder if there’s an aspect of:  if I can give someone what they want, maybe I’ll have that feeling of satisfaction as well. I’ll understand what it means to have something I want, vicariously. I’m good at knowing what other people want. It’s very natural for me to quickly deduce what will make someone happy, make their life easier, turn them off or turn them on. It’s almost a game figuring out how to give that to them. It’s fun for me, for a while. Except it’s not really for me. I do things for other people, elsewhere, lock myself into some convoluted commitment and suddenly I’m trapped inside my own skin, clawing to get out of the situation I set myself up to fall from.  It’s like wearing a mask made from someone else’s desires. I forget what my own face looks like underneath.

A lot of people have occasional doubts about their identity and self-worth. There are times I’m not sure I even know what these things even are. Some days I am absolutely confident in my sense of worth. I do know I have value. Unfortunately it’s often after receiving validation from someone that I’ve done something for. Sex is the ultimate validation of desire isn’t it? It’s a very visceral display of approval for the things I can do. I wonder if I don’t seek this kind of attention to validate my own sense of worth. If I can get someone to want me enough to be with me, than I must be doing something worthy of their appreciation. Something, alright. In this manner it skews my tenuous sense of identity. I am who I am, and that’s whoever I need me to be. Or whomever I perceive that you want me to be. Ok, not to such an extreme. I’m not quite that kind of chameleon, but I can be. I just don’t want to be.

One psychologist postulates that adopting this sort of false Self is a way to cope.

“People dominated by false Self adopt an illusion of coping, which substitutes for genuine self-assertion. They depend on others to constantly provide them with a sense of internal security, a way of relieving feelings of worthlessness. The borderline personality is constantly on the defensive, guarding against intimacy out of a twin fear of being engulfed and abandoned. While it’s natural to feel anxious about a new relationship, most of us realize that we need love in our lives. The borderline, however, is incapable of handling closeness and substitutes inappropriate relationships with unavailable partners.

The threat of intimacy may lead a borderline patient to become promiscuous. Since her fears make her unable to make a lasting commitment to one person, she goes from one lover to another, acting out the fantasy of somebody taking care of her. Sex tends to be mechanical, in order to avoid the powerful drive to emotional intimacy that accompanies sex. What she seeks is not orgasm but being held, as if to compensate for her not having been held as a child.”

The threat of intimacy. This rings so true to me I can’t emphasize this point enough. I just like the phrase: the threat of intimacy.

“In addition to engaging in reckless or impulsive sex, there is evidence that people with BPD are more prone to being sexually promiscuous. This differs from impulsive sex in that promiscuity is the act of intentionally having multiple sexual partners (rather than having casual sex on a whim).”

So there’s the difference between just being sexually impulsive and being sexually promiscuous.

For example, as soon as Boring-Ex and I broke up, I was able to begin involvement with a girl I’d liked for years… and her girlfriend… and the misguided drama polygon with Friend… and my best female friend at the time. For the record, let me state that I operate in a group of people that view polyamory as almost the norm and no we’re not mormon. It’s not unusual for my friends to have open marriages and multiple partners so I don’t actually view this as being very deviant. My Therapist would disagree.  

I don’t mind being the secondary relationship of a poly couple. At least in the past I haven’t. It allows me to maintain my illusion of intimacy while not having the focus primarily upon me. When you’re involved in a polyamorous relationship and you’re not the primary significant other, there’s a safety from that threat of intimacy that arises. I was close, but not living with her. When I needed space it was fine because odds are her other girlfriend needed attention… and on it went. This works great, until it doesn’t, and I want more than I’m able to have. The question though: Do I want more because I really want more, or because I know I can’t have it? Hm.

I don’t necessarily want to have multiple partners. What I want is to be close, but not too close. I can’t figure out how to do this without pushing away and pulling closer. Allowing someone in, and then forcing them back out. I don’t set out to be promiscuous, I’m honestly not even sure it’s my fault. Or how it happens. I hermit away and I don’t have to worry about any of it. I’m secluded so I have no people to bother me. Really it’s as soon as I start putting myself out there that people begin to take an elevated interest in me. When I’m actively seeing someone though, it’s like a red cape is waved in front of the eyes of the bystanders that shouts at my potential unavailability and they begin to charge. My problem is, when faced with a fight or flight response, I tend to fight. I don’t run, I don’t stop, I don’t say no. I engage. With only vague thoughts that I could end up emotionally maimed, the act is practically impulsive. I don’t think about other people when they’re not in my immediate vicinity (people I’m not very attached to), because it’s like they’re no longer a part of my life. For as much as I hate to be alone, and want to have someone near, I do not attach easily. This is my problem with having a lack of object constancy. But when they are around…  Once I do finally attach my thoughts border on obsessive and I can’t extricate my mind. Once that happens there’s almost no thought or desire to allow anyone else near me and the problem of promiscuity disappears as quickly as it, came::grin:: What I’m getting at is, I don’t set out to be promiscuous, it just sort of falls in my lap. Or I fall into its lap. I don’t know. I blame the booze.

What I really want is to be close, and able to embrace that closeness without the terror of impending abandonment gripping my heart. That’s all I really want. My problem is I have no idea how to go about getting it. I’m trying. I’m actively focusing on things that are considered healthy in this new relationship with my Lady Friend. It’s so incredibly frustrating to know that what I’m doing, I have to do, because I’m simply incapable of being normal naturally. It shouldn’t be so hard to seek happiness. I know I really shouldn’t be seeking happiness in someone else. Everyone wants to be loved. It’s not really a matter of finding someone else to make me happy though, so much as finding someone that I can be happy with myself, with. If that makes any sense.

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Let’s talk about Sex

Disclaimer: I’m going to be talking about sex. If you have delicate sensibilities; I will offend them. You’ve been warned.

Let’s talk about sex. **Cue that awful song**

Now that I’ve gotten that stuck in your head. Moving on.

Because it’s been on my mind a lot lately: Sex. Borderline Personality Disorder has something of a reputation. Part of the stigma surpassed only by Histrionic PD.  Sexual Impulsivity and Promiscuity. 

I don’t do things by halves. I either have no partner, or I seem to open myself up to the world of them. I am either completely abstinent or completely promiscuous. I enjoy sex. It’s fun, it’s hot… it’s pretty much impossible to do alone. Which makes it comforting. Until the thoughts of my partners motives begin to intrude into the warm cloud of lazy euphoria that flows through my body after a wild romp.

My feelings are mixed. I love it, and I hate it. I am constantly at odds with myself over what I want. Sex, is not intimacy. Intimacy is frightening. Sex, on the other hand, is a comforting diversion. A substitute of sorts. The appearance of closeness, the act of closeness, with the ability to distract from actual emotional closeness.

Borderline Personality Disorder is a disorder of emotional dysregulation that affects relationships and the ability to control your behavior. It’s not surprising that this would also have a major impact on our sex lives. How it affects our sex lives can vary though.

“Research has demonstrated that women with BPD tend to have more negative attitudes about sex than women in the general population. For example, women with BPD report more mixed feelings about sexual relations, and are also more likely to feel pressured to have sex by their sexual partners. In addition, women with BPD report more general sexual dissatisfaction. Much less is known about how BPD affects men’s attitudes about sex.

There may be a number of reasons for these more negative attitudes about sex. First, many women with BPD are survivors of child abuse, which may contribute to overall negative reactions to adult sexual experiences. Also, women with BPD are more likely to experience a great deal of conflict in their relationships, so they may feel less positive about sex because relationships in general feel less fulfilling.”

My attitudes about sex are far from negative. I love sex. My attitudes about my partners and how I relate to them afterwards, well, those might shift. Talk about a discrepant mentality. I distrust peoples motives when they try to get close to me. Especially with men (sorry, guys) I’m fairly certain that I’m only wanted to be used. I don’t actually want to believe this though, but in order to figure that out sometimes I test the waters to test my theory, only to be disappointed when the men I know are not chivalrous and chaste. What do I really expect? Someone that just wants to be friends with me for my mind? I’ve proven my own theory true so often, but would it have been proven if I hadn’t have pushed? It’s never a plan though, it’s almost always in the heat of a moment. One that I wish I had thrown a bucket of water on in the end.

So it seems to me that there is healthy sex, impulsive sex, promiscuous sex, and avoidance of sex. Healthy and avoidance I’m not as familiar with so we’ll save those for their own post. Over the next couple days I want to explore this issue further.