What is the Relationship between Borderline Personality Disorder and Shame/Guilt?

This video answers the question: What is the relationship between borderline personality disorder and shame and guilt. Borderline personality disorder is a Cluster B personality disorder in the Diagnostic and Statistical Manual (DSM). That is the dramatic, emotional, and erratic cluster. There are nine symptom criteria for borderline personality disorder: 1) frantic efforts to avoid abandonment, 2) an unstable, intense relationship pattern - sometimes we think of this as an idealization devaluation cycle, 3) identity disturbance, 4) impulsivity in at least two areas that would be self-damaging, 5) recurrent suicidal behavior, like gestures, attempts, and threats, 6) affective instability, 7) chronic feelings of emptiness, 8) intense and appropriate anger (this one's particularly important when we talk about shame and guilt) and, 9) paranoid ideation and dissociation. Five symptom criteria are required for a diagnosis, which can only be made by a licensed and qualified clinician. Shame and guilt are not specifically mentioned anywhere in the symptom criteria, but we know they are features associated with borderline personality disorder. This idea of being more likely to experience shame is referred to as shame proneness and there's a lot of research that shows that borderline personality disorder has this component. For example, we see with borderline personality disorder an increased level of shame when compared to other disorders that have an affective instability component. We also see that the effect of shame lasts longer in borderline personality disorder than we see with other negative effects. This shame component is really considered a cornerstone borderline personality disorder. We also know that guilt has a relationship with borderline personality disorder. We usually think of this relationship as being less guilt, so we see more shame but less guilt.
There is a difference between shame and guilt. Both shame and guilt are self-directed negative emotions. With shame, there's this belief that individual has that they are bad, are not good enough, or have a defect or a deficit. Guilt is when someone believes their behaviors are bad. Guilt is more logical than shame, and it's actually more useful than shame in a lot of ways. We generally view shame as destructive. Shame has been associated with increased feelings of anger, increased aggression, and an increased probability of externalizing blame. All three of those characteristics have an association with borderline personality disorder. We also see with increased levels of shame an increased probability of ruminating about experiences that led to the anger in the first place, whether those experiences would have normally resulted in anger or not. Guilt is associated with less anger and less aggression. This really gives us the idea that in general, shame is bad and unhelpful and guilt is good and helpful. Of course, that's not always true. We see with other mental disorders, like major depressive disorder for example, where there's oftentimes inappropriate and unhelpful levels of guilt. It is a generalization to say that shame is unhelpful and guilt is helpful, it's not necessarily appropriate or accurate for every situation.

Peters, J. R., & Geiger, P. J. (2016). Borderline personality disorder and self-conscious affect: Too much shame but not enough guilt? Personality Disorders: Theory, Research, and Treatment, 7(3), 303–308

Видео What is the Relationship between Borderline Personality Disorder and Shame/Guilt? канала Dr. Todd Grande