For the Defense - Volume 1, Issue 3 - 2016 - 11

When evaluating a client for a possible psychiatric disorder, mental health professionals are likely to consult the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is the authoritative treatise for the diagnosis and classification of psychiatric disorders within the mental health field. 5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. 6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). 7. Chronic feelings of emptiness. 8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights). 9. Transient, stress-related paranoid ideation or severe dissociative symptoms. The Connection Between BPD and Homicide With the above characteristic features of BPD as a base, we can begin an exploration of the connection between BPD and the emotions that are engendered during a violent act. In general, a strong connection between BPD and violence is well documented in the literature.5 An examination of the diagnostic criteria of BPD, alone, reveals that an individual with BPD would likely experience unstable and intense interpersonal relationships, inappropriate and intense anger and stress-related paranoid ideation.6 In addition, such an individual would also be likely to have severe deficits in their ability to process and regulate their emotions.7 The combination of hostility and an inability to regulate emotions could certainly set the stage for an impulsive, if not, deadly violent act. Historically, the idea that an individual could act out violently, even to the point of taking the life of another, without apparent provocation has always fascinated society. Researchers have long sought an understanding of this phenomenon. One of the first was Frederick Wertham. In 1937, he applied his concept of a "catathymic crisis"8 in an effort to explain an individual's murderous actions.9 Jealousy, fear, hate, anger/rage, rejection, depression/hopelessness and embarrassment are among the generally recognized emotions that motivate an assault or even a homicidal act.10 The extent to which BPD may serve to predispose an individual to a violent act is underscored by the work of Marsha Linehan.11 Linehan's research draws attention to the extent to which individuals with BPD experience severe dysregulation in multiple areas of their daily lives including their emotions, interpersonal relationships, behavior, cognition and the sense of self.12 These findings suggest that the symptomatology of BPD would enhance the likelihood of someone with this diagnosis to act out violently. As noted above, individuals with BPD are hypersensitive to rejection, can experience trust issues and have an intense fear of abandonment.13 Researchers have found that the cognitive and emotional dysfunction prevalent in BPD predisposes individuals to a delusional thought process which may serve to initiate an emotional crisis as the result of a perceived rejection, a threat to the ego, and/or a psychological insult.14 Since individuals with BPD have difficulty regulating their emotions, they will frantically attempt to relieve the psychic tension through such defense mechanisms as projection15 and splitting.16 17 Thus by projecting blame for the perceived insult and/or hurt onto the victim, the BPD individual attempts to return to his/her pre-crisis status.18 At this point, internal psychic/emotional tension builds causing the defendant to become even Vol. 1, Issue 3 | For The Defense 11

Table of Contents for the Digital Edition of For the Defense - Volume 1, Issue 3 - 2016