A common symptom of Borderline Personality Disorder (BPD) is frequent “inappropriate, intense anger,” also known as rage.
This rage seems, based on clinical observation — and, probably, the observations of those on the receiving end of the rage — to be closely linked with another BPD symptom: fear of abandonment.
The fear of being abandoned, or rejected, often leads to rage. This link has become known as the “rejection-rage contingency.”
Research on Rejection, Rage
A study conducted by Professor Geraldine Downey, Ph.D., of Columbia University and published in the Journal of Abnormal Psychology took a closer look at the connection between the BPD symptoms of fear of abandonment and rage.
She worked from prior Borderline Personality Disorder research that found that rejection normatively elicits rage, but with significant individual differences.
Downey studied the connection first in a laboratory experiment, then through a 21-day experience sampling study. Downey compared non-BPD controls with rejection and rage in men and women diagnosed with Borderline Personality Disorder.
Through her research, Downey found a specific, automatic cognitive link between rejection and rage in those with Borderline Personality Disorder relative to the control group.
Rejection Sensitivity Model
In a recent call-in presentation through the National Education Alliance for Borderline Personality Disorder (NEA.BPD), Downey discussed the vicious circle of the Rejection Sensitivity Model.
In the Rejection Sensitivity Model, the relationship partner with Borderline Personality Disorder anxiously expects rejection, a common symptom of BPD. If a trigger is present, the interpersonal behavior response is to rage at their partner. This leads to relationship problems, which cycles back to the anxious expectation of rejection.
In Downey’s study, both in the experience sampling portion and in the laboratory experiment, the rejection-rage reaction was highly elevated in those diagnosed with Borderline Personality Disorder. This corroborates the evidence that reaction to rejection plays a strong part in the rages seen in those with symptoms of BPD.
You can listen to Downey’s explanation of the rejection-rage contingency in Borderline Personality Disorder and the Rejection Sensitivity Model here.
Regarding parents with BPD, fear of rejection would not be a key factor in the parent-child relationship (children are abjectly dependent on their parent for love, attention and approval), yet a parent with BPD can be triggered into inappropriate, extreme anger by their own child/children and can engage in rage behaviors toward their child.
Being subjected to BPD rage can traumatize a child, particularly if the child is in the sole care of their BPD parent and the rage behaviors happen frequently and/or intensely.
Any studies on this would be appreciated, and any information regarding how the non-BPD spouse or other family members can handle this issue in the home and in the context of therapy would be invaluable. Is it standard practice to include family therapy when a patient with BPD is also a parent?
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