Sylvia sits with her head in her hands and tears rolling down her cheeks. Here I am again, all alone. Why cant I trust anyone? Why does the world hate me so much? she cries in tearful despair.

Borderline Personality Disorder (BPD): A lifelong pattern of unstable moods, unstable relationships, unpredictable emotions, and impulsive actions.

To live with borderline personalityis to live with special pain and extra challenges, far beyond anything that most people ever experience. When you have BPD, you may feel positive and happy one minute, and have that all change the next. You may feel wonderfully loved by someone one day and hated by that person the next. You might put a friend, relative or spouse on a pedestal, only to have them become your most reviled enemy soon after.

Life feels unpredictable. Its difficult to like yourself, or to have or sustain positive feelings in your life.

Research has shown several major factors to be the causes of BPD, including genetics, unpredictable parenting and abuse.

Childhood Emotional Neglect (CEN): A childhood characterized by the absence of enough emotional attention, emotional validation and emotional responsiveness from ones parents.

Sylvia doesnt know it, but she is living with Borderline Personality Disorder. Another important thing that Sylvia doesnt know: she grew up with an extreme version of Childhood Emotional Neglect (CEN).

Typical (Non-extreme) CEN

CEN children grow up in a household that is essentially blind to emotion. Children whose emotions are not noticed or responded to enough receive the subtle but powerful message that their emotions are invisible and irrelevant. In order to cope in their childhood home, they push their feelings down, so as not to burden themselves or their parents. These children grow into adults who are out of touch with their own feelings. This causes a pattern of adult struggles, including feelings of emptiness, poor self-knowledge, lack of emotional skills, self-directed anger and shame.

The CEN childhears two messages loud and clear:

Your feelings don’t matter.

YOU don’t matter.

Extreme CEN

Those who develop BPD often (not always because genetics are also a factor) were raised with an exaggerated, more punitive version of CEN, and often in an intensely emotional family. The person with BPDs parents not only ignored her feelings, but also actively invalidated them. Sylvias parents actually rejected and punished the normal feelings that she had as a child. Since her feelings are the most deeply personal, biological part of who she is, Sylvia received these messages loud and clear:

Your feelings are bad and unacceptable.

YOU are bad and unacceptable.

The 5 Effects of Extreme CEN

  1. Your learn that your feelings not only dont matter; they are bad
  2. You learn that you not only dont matter; you are bad
  3. You do not learn the emotion skills that other children learn naturally in their childhood home: how to identify, tolerate, manage, express, or use your emotions
  4. You actively reject your emotional self; this leaves you feeling empty, since youve rejected the most deeply personal part of who you are.
  5. Your identity, or your sense of self, becomes fragmented because you have rejected important parts of yourself

So Sylvia learned not only to push her emotions away; she also learned to punish herself for having feelings. She has no choice but to actively reject her true self. She feels uncomfortable in her own skin, and doesnt like herself very much overall. She has not learned how to soothe her own emotional pain. This leaves her far more vulnerable to depression and anxiety.


Only yesterday, Sylvia felt on top of the world. People at work had seemed extra nice to her, which made her feel happy. After work she had run into an old acquaintance shed had a falling-out with years before, and theyd had a nice chat, almost as if nothing had gone wrong between them.

But today, all of that was turned on its head. It was super busy at work, and her co-worker asked her to hurry in a way that Sylvia felt was rude. This left her feeling raw and vulnerable. Then, as she arrived at her car to drive home, she saw that her tire was flat. At that point Sylvia dissolved into tears. Feeling enraged at other people for being mean, the world for delivering her a flat tire, and herself for it all, she left her car as it was, and impulsively took a taxi home which was far outside her budget.

Now, with her head in her hands, Sylvia is overwhelmed with anger and pain.

“Here I am again, all alone. Why cant I trust anyone? Why does the world hate me so much? she cries in tearful despair.

Treatment for Borderline Personality Disorder

Interestingly enough, although CEN is not generally listed as a contributing factor to BPD, the most effective treatment method identified to date by research is one which specifically targets the primary symptoms of CEN. Its Dialectical Behavior Therapy, or DBT.

DBT teaches you a combination of mindfulness, interpersonal skills, distress tolerance, and emotion regulation. It is a very specific, structured method which helps you begin to intervene between your feelings and your actions so that you can become less emotionally impulsive, and learn to regulate your responses and behaviors in relationships and in your internal world.

Studies show that even though BPD is very painful and challenging, it is possible to lessen the symptoms, and to become more emotionally stable and resilient, with dedicated and persistent work and effective help over time.

So there is hope for Sylvia. She can learn that her emotions are not bad. And that in fact they will enrich and guide her, if she learns the skills she missed in childhood. She can learn that she’s not wrong or bad. She can realize that the world does not hate her.

But for Sylvia to decide to take on the work to change her life, she needs to realize a most vital truth that you andI already know:

That she is worth it.

To learn more about Childhood Emotional Neglect, how it happens, how it affects you in adulthood, and how to heal and the book, Running on Empty.