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Section 1
Anger Myths and Borderline Personality Disorder

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As you know, Borderline Personality Disorder, or BPD, is characterized by the client’s inability to resist impulses. These impulses can manifest themselves in promiscuity, over-spending, or rage. In this course, we will discuss the connection between BPD and rage. I have found that many BPD clients are reluctant to admit that their anger is unnatural or more severe than others’. 

In such cases, I believe that the root causes of this reluctance include three anger myths that clients hold. 

In this section, we will examine these three anger myths. The three myths are  anger is biochemical; anger is an instinct; and ventilation is healthy.  I will also provide information that I have found helpful in dispelling these myths.

Three Myths of Anger

♦ Myth #1 - Anger is Biochemical
The first myth is that anger is biochemical. Many clients will link such hormones as testosterone and adrenaline to their anger. I have found that this is a great scapegoat for males who wish to blame their anger on something other than emotional intake. Andrew, a 22 year old BPD client, stated, "Guys are just more aggressive than girls because we have more testosterone. We get that rush and we can’t control it." 

However, what many clients do not understand, is that there are two parts to an aggressive or angry reaction. These two parts are  the physiological aspects and the emotional interpretation.  Although there may be adrenaline or testosterone present in the blood during an angry reaction, this does not necessitate that the hormones were primarily responsible for the client’s actions. 

I shared with Andrew a study done by Doctors Schachter and Singer.  In these experiments, subjects were given what they thought were vitamins, but were in fact, adrenaline capsules. Half of the group was told to expect side effects such as heart palpitations or tremors, which are side effects of adrenaline. The other half was not told to expect any side effects. The subjects were then told they would be taking an eye exam. 

While sitting in the waiting room, each subject came into contact with a person who had been hired by the experimenters. The "stooge" as they called him, would act out two very different emotional displays. In one case, he would act euphoric and silly, throwing paper airplanes and laughing out loud. In the other cases, he would act angry, eventually tearing up the questionnaire the subjects were asked to fill out.  Those subjects who were not told about the side effects reflected the same emotions displayed by the stooge. 

However, those subjects who were told about the side effects did not display the emotions they saw in the stooge, despite the fact that they had been given the same amount of adrenaline as the other subjects. As you can see, the amount of hormone in the blood was not the deciding factor on emotional outbursts, but rather the ability to expect and control the impulses. After I shared this experiment, Andrew became more hesitant in blaming his anger on biochemical reactions.

♦ Myth #2 - Anger is an Instinct
The second myth BPD clients hold is the belief that anger is an instinct. This myth holds that anger and aggression date back to the stone age, when man used violence as a weapon to survive and was in fact a violent character. The basis of this belief is held in the idea that prehistoric man was extremely territorial and used aggression to maintain his territory. However, there is significant evidence against this theory.

Carrie, a 21 year old BPD client, once stated, "Why should I be blamed for what my ancestors did to me? They did what they could to survive, and if that meant knocking off the other guy, well then so be it. It’s still a dog-eat-dog world out there, and if you can’t bite back, you might as well put your tail between your legs and roll over, that’s what my aunt used to say." I stated, "But Carrie, if everyone was as aggressive as you say, and violence was a way of life, how did the species survive?" 

I then asked her, "Think about other animals, like lions or gorillas for instance. Do you really ever see them fight or are their aggressions more display than anything else?" Carrie answered, "Well, you’re right, I haven’t ever seen an animal kill another one in the wild." I then stated, "Wouldn’t it be counterproductive if the entire species went around ‘knocking off’ the other guy?  Wouldn’t that put him in danger?" 

Carrie stated, "I guess. It would be kind of dumb to stick your neck out so far that it gets cut off." I then shared with Carrie conclusions come to by a conference of twenty distinguished behavioral scientists. Their Conclusions about Rage and Violence included the following points:

  1. It is scientifically incorrect to say that we have inherited a tendency to make war from our animal ancestors.  Warfare is a particularly human phenomenon and does not occur in other animals.  War is biologically possible, but it is not inevitable.
  2. It is scientifically incorrect to say that war or any other violent behavior is genetically programmed into our human nature.  Except for rare pathologies, the genes do not produce individuals necessarily disposed to violence.
  3. It is scientifically incorrect to say that in the course of human evolution there has been a selection for aggressive behavior.  In all well-studied species, status within the group is achieved by the ability to cooperate.
  4. It is scientifically incorrect to say that humans have a "violent brain".  While we do have the neural apparatus to act violently, there is nothing in our neurophysiology that compels us to do so.

♦ Myth #3 - Ventilation is Healthy
In addition to anger is biochemical and instinctual, the third and most common myth is that ventilation is healthy. In other words, BPD clients are under the belief that by expressing their anger in an aggressive manner will act as a catharsis and their angry feelings will dissipate. Luke, a 25 year old client, once told me, "I don’t feel better until I’ve shouted my lungs out. One time, my friend was really late and this guy is always late, you know.  So there I was steaming, and when he got there I just let loose. After I got done, I felt so much better." 

I asked him how his anger affected his friendship and Luke stated, "Oh, we don’t talk to each other anymore. The guy was a douche bag, he couldn’t be anywhere on time." I stated, "So, releasing your angry feelings didn’t help you to feel any better towards your friend?" Luke stated "Well… no." Interestingly, this is a common occurrence. As you have observed, even when the anger has been expressed, the client still feels angry towards the other person. 

According to Dr. Jack Hokanson, males generally only achieve catharsis when directing anger towards peers. Even after the altercation, the expressor still feels a resentment towards the instigator. When expressing aggression towards an authority figure, however, stress is actually increased. Females, on the other hand, only feel catharsis after a friendly confrontation. Any kind of aggressive confrontation led to the same amount of stress as males who were confronting authority figures.   

Hokanson theorized that catharsis was actually a learned experience rather than innate.  In a series of experiments on both women and men, Hokanson was able to reverse the source of catharsis.  Each subject was given a sequence of electric shocks and they were given a choice to respond aggressively or friendly. While the males were rewarded for reacting friendly, the women were rewarded for reacting aggressively, which was counter to their nature. Eventually, each subject received catharsis through their new, learned reaction. 

I asked Luke if he still thought it was cathartic for him to release all his anger at once. He stated, "No.  I lost a friend and I really didn’t feel as good as I thought I did. Maybe at that moment, I felt good, but later, I felt just as miserable as I had been before." As you can see, Luke’s previous belief that ventilation is healthy had been dispelled.

In this section, we discussed three anger myths among BPD clients. These three myths are anger is biochemical; anger is an instinct; and ventilation is healthy.  I also provided information that I have found helpful in dispelling these myths.

In the next section, we will examine three sources of anger in BPD clients. These three sources are  learned responses in the amygdala; stress; and trigger thoughts.

The Rejection-Rage Contingency in Borderline Personality Disorder

- Berenson, K. R., Downey, G., Rafaeli, E., Coifman, K., and Leventhal, N. (2011). The Rejection-Rage Cotingency in Borderline Personality Disorder. J Abnorm Psychol., 120(3). p. 681-690. doi:10.1037/a0023335.
Reviewed 2023

Peer-Reviewed Journal Article References:
Baer, R. A., & Sauer, S. E. (2011). Relationships between depressive rumination, anger rumination, and borderline personality features. Personality Disorders: Theory, Research, and Treatment, 2(2), 142–150. 

Distel, M. A., Roeling, M. P., Tielbeek, J. J., van Toor, D., Derom, C. A., Trull, T. J., & Boomsma, D. I. (2012). The covariation of trait anger and borderline personality: A bivariate twin-siblings study. Journal of Abnormal Psychology, 121(2), 458–466. 

Peters, J. R., Geiger, P. J., Smart, L. M., & Baer, R. A. (2014). Shame and borderline personality features: The potential mediating role of anger and anger rumination. Personality Disorders: Theory, Research, and Treatment, 5(1), 1–9.

Southward, M. W., & Cheavens, J. S. (2020). Quality or quantity? A multistudy analysis of emotion regulation skills deficits associated with borderline personality disorder. Personality Disorders: Theory, Research, and Treatment, 11(1), 24–35.

Vansteelandt, K., Houben, M., Claes, L., Berens, A., Sleuwaegen, E., & Kuppens, P. (2020). Self-criticism and dependency predict affective variability in borderline personality disorder: An ecological momentary assessment study. Personality Disorders: Theory, Research, and Treatment, 11(4), 270–279.

Vest, N. A., & Tragesser, S. (2020). Coping motives mediate the relationship between borderline personality features and alcohol, cannabis, and prescription opioid use disorder symptomatology in a substance use disorder treatment sample. Personality Disorders: Theory, Research, and Treatment, 11(3), 230–236.

QUESTION 1
What are three anger myths held by BPD clients? To select and enter your answer go to Test.

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