Beyond the Myth of Manipulation in Borderline Personality Disorder
“We become whole not by choosing one side of ourselves, but by learning to embrace them all.”
— Joseph Mounts
In earlier editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), individuals diagnosed with Borderline Personality Disorder (BPD) were often described using moralistic or pejorative terms—language that implied these patients intentionally sought to manipulate others. One example characterized the borderline patient as shifting “from being a needy supplicant for help to being a righteous and vengeful victim.” Such language reflected a clinical bias that interpreted behavior through a moral lens rather than a developmental or behavioral one.
The word pejorative refers to language that conveys disapproval or contempt. In mental-health discourse, terms such as manipulative, attention-seeking, or vindictive are pejorative because they ascribe intent or moral failure where dysregulation and distress may actually be the cause.
Fortunately, the DSM-5 (2013) eliminated much of this stigmatizing language. It defines BPD as “a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity,” beginning by early adulthood and present across contexts (American Psychiatric Association [APA], 2013). The tone is now descriptive and functional rather than judgmental. This shift reflects the growing influence of Marsha Linehan’s work on emotion dysregulation and invalidating environments, which helped reframe borderline behavior as an issue of skills deficit and learned coping, not moral failing (Linehan, 1993/2006).
Why “Manipulation” Is a Problematic Label
The term manipulate is generally defined as “to influence or manage shrewdly, deviously, or unfairly,” implying a deliberate and deceptive intent. When applied to individuals with BPD, it suggests that their behaviors are calculated or malicious. However, Linehan (1993/2006) challenges this assumption, writing that in her clinical experience, “when borderline individuals try to influence someone, they are typically direct, forceful, and if anything, unartful” (p. 16).
In other words, what often appears manipulative is better understood as a frantic, overt attempt to relieve overwhelming emotional pain. Labeling these reactions as “manipulation” invalidates the person’s lived experience and reinforces stigma. As Linehan and later scholars note, invalidation is central to the suffering of many individuals with BPD—it mirrors the very environments that helped produce the dysregulation in the first place (Carpenter & Trull, 2013; Cheek, 2018).
Function Does Not Equal Intention
It is understandable that family members, clinicians, or partners may feel manipulated when a person with BPD reacts to distress in ways that appear extreme or disproportionate. Yet inferring intent from impact is an error in logic. A behavior can function to relieve distress or gain attention without that outcome being consciously intended (Linehan, 1993/2006).
Consider a few common examples:
A client might storm out of a session, send a flood of emotional texts, or threaten to quit therapy after feeling misunderstood or criticized. These behaviors may serve to protect against rejection or shame, not to control the therapist.
Another may cut off a friend or partner completely after a perceived slight, then later attempt intense reconnection. What looks like emotional manipulation is actually panic in the face of abandonment.
Some might engage in reckless behaviors—spending sprees, substance use, risky sex, or self-sabotage at work—not to punish others, but to numb emotional pain or escape unbearable internal tension.
Others may fabricate crises or exaggerate symptoms when they fear being ignored, not because they wish to deceive, but because they have learned that only heightened displays of distress elicit care or safety.
In each of these examples, the function of the behavior (reducing pain, re-establishing connection, or defending against rejection) is often unconscious. The intent is not to deceive or harm, but to regulate emotions using the only strategies available at that moment.
For instance, if a person lashes out angrily after feeling dismissed, and that anger temporarily restores their sense of control or gains them attention, the behavior may be reinforced. Yet this does not mean they plotted to “manipulate” others—it simply reflects how emotion-driven behavior can become conditioned over time. Confusing reinforcement with intent obscures the real issue: a skills deficit in emotional regulation and distress tolerance, not the presence of deceit or malice.
Dysregulation as the Core Issue
Modern research conceptualizes BPD as a disorder of dysregulation rather than manipulation. Dysregulation typically occurs across four domains:
Emotional – intense, rapidly shifting moods that take longer to return to baseline.
Interpersonal – unstable relationships, fear of abandonment, difficulty trusting stability.
Behavioral – impulsive acts such as self-harm, reckless behavior, or angry outbursts.
Cognitive – transient dissociation, paranoia, and black-and-white thinking (Carpenter & Trull, 2013; NCBI Bookshelf, 2024).
These behaviors arise from vulnerability + invalidation—a dynamic Linehan called the biosocial model. A child who experiences intense emotion in an environment that minimizes or punishes it learns to express distress in extreme ways to be noticed or soothed (Linehan, 1993/2006). Thus, BPD behaviors are best viewed as learned survival strategies rather than deliberate manipulation.
However, these same survival strategies often create a profound inner conflict. The person is torn between opposing needs: to seek closeness and to protect themselves from the pain that closeness can bring. Over time, these contradictions become embedded not just in relationships, but in the individual’s very sense of self. This internal push and pull gives rise to what psychoanalytic theory calls splitting—a defense mechanism that tries to manage emotional extremes by dividing the world into absolutes of good and bad, safe and dangerous, love and hate.
Splitting, Polarity, and the Path to Integration
A hallmark of BPD is splitting, the inability to integrate opposing emotional truths. A person might idealize someone one day (“You’re the only one who understands me”) and devalue them the next (“You’re just like everyone else who’s hurt me”). From a psychoanalytic perspective, splitting represents an attempt to resolve unbearable inner conflict: love versus hate, dependence versus autonomy, life versus death (Kernberg, 1984).
Healing requires learning to hold both poles at once. Dialectical Behavior Therapy (DBT) calls this dialectical thinking—the ability to see that two contradictory statements can both be true. For example:
“I love you, and I’m angry at you.”
“I want connection, and I’m afraid of it.”
“I want to live, and I sometimes want to die.”
Developing this both/and mindset reduces emotional swings and stabilizes relationships. Integration of these opposites allows the person to experience nuance, complexity, and ultimately, wholeness (Linehan, 2009).
The Path Toward Balance
At its core, borderline suffering is about imbalance—between emotion and reason, connection and autonomy, self and other. Healing requires cultivating that balance. Individuals with BPD do not need to “stop being manipulative”; they need to learn how to regulate distress, tolerate ambiguity, and connect safely with others.
As clinicians, friends, or family members, our task is to shift from moral judgment to compassionate understanding. When we do, we help remove one of the greatest barriers to recovery: the stigma that tells people with BPD that their pain is a character flaw rather than a call for healing.
Personal Reflection
From the earliest moment I encountered clients with Borderline Personality Disorder, I sensed something deeper than the stereotype of manipulation. They seemed to live under a constant weight of emotional agony that few could see. Research confirms what my intuition already told me: their suffering is distinct, both in depth and in quality.
Carpenter and Trull (2013) describe BPD as involving extreme emotional sensitivity, difficulty regulating negative affect, and reliance on maladaptive coping strategies. Fertuck, Karan, and Stanley (2016) found that while overall levels of “mental pain” were similar to those in depressive disorders, individuals with BPD scored higher on pain tied to rejection, loss of self-worth, and injury to the sense of self and belonging—a kind of deep, self-evaluative wound that strikes at the core of identity. Malejko et al. (2020) showed that these individuals experience alterations in the emotional dimension of pain perception—how pain is felt and interpreted—rather than in the sensory detection of pain itself, suggesting that the suffering of BPD is not merely psychological but embodied. More recently, Bourtzoni and Reed (2024) found that dysregulated pain perception, both physical and emotional, is closely linked to symptom severity, implying that distress regulation and pain processing are deeply intertwined.
In my experience, these findings describe what I witness in the therapy room: the unartful attempts, as Linehan (1993/2006) would say, to manage unbearable feelings, to tolerate distress, and to resolve impossible internal contradictions. Their behaviors often appear impulsive or self-defeating, yet beneath them lies a struggle to regain control over emotions that feel ungovernable. For many, the capacity for volitional autonomy—making choices with awareness and intention—has been eroded by years of trauma, invalidation, and survival-based coping. Without treatment interventions that build regulation skills and self-understanding, behaviors may indeed feel beyond choice. But with time, compassion, and evidence-based care, that autonomy can be rebuilt—and with it, the possibility of peace.
—Joseph Mounts M.Ed, AADC, LPC
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
Bourtzoni, S., & Reed, P. (2024). Pain perception in personality disorders. PLOS ONE, 19(4), e0323004. https://doi.org/10.1371/journal.pone.0323004
Carpenter, R. W., & Trull, T. J. (2013). Components of emotion dysregulation in borderline personality disorder: A review. Current Psychiatry Reports, 15(1), 1–10. https://doi.org/10.1007/s11920-012-0332-4
Cheek, J. (2018, May 9). The myth of the “manipulative personality disorder”: Taking the blame out of the illness. This Changed My Practice. https://thischangedmypractice.com/personality-disorders-taking-the-blame-out-of-the-illness/
Fertuck, E. A., Karan, E., & Stanley, B. (2016). The specificity of mental pain in borderline personality disorder compared to depressive disorders and healthy controls. Borderline Personality Disorder and Emotion Dysregulation, 3, 19. https://doi.org/10.1186/s40479-016-0036-2
Kernberg, O. F. (1984). Severe personality disorders: Psychotherapeutic strategies. Yale University Press.
Linehan, M. M. (1993/2006). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.
Linehan, M. M. (2009). DBT® skills training manual (2nd ed.). Guilford Press.
Malejko, K., Huss, A., Schönfeldt-Lecuona, C., Braun, M., & Graf, H. (2020). Emotional components of pain perception in borderline personality disorder and major depression. Psychiatry Research, 291, 113239. https://doi.org/10.1016/j.psychres.2020.113239
National Center for Biotechnology Information (NCBI) Bookshelf. (2024). Borderline personality disorder. In StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK430883/
