Borderline Personality Disorder (BPD) is a complex mental health condition marked by pervasive instability in mood, behavior, and interpersonal relationships. This instability results in significant distress and difficulty in maintaining a consistent sense of self. BPD is not a singular experience but manifests in various ways among those who meet the diagnostic criteria. This article focuses on a specific, less visible manifestation known as the discouraged subtype.
Defining the Discouraged Subtype
The discouraged subtype of BPD, often referred to as “quiet BPD,” is characterized by an internalization of emotional turmoil rather than the outward, explosive behaviors traditionally associated with the disorder. While core features of BPD, such as emotion dysregulation and an intense fear of abandonment, remain present, the behavioral expression is fundamentally different. Instead of acting out, individuals with this presentation tend to act in, directing their distress toward themselves. This pattern involves suppressing intense emotions, leading to withdrawal and self-blame.
The primary difference lies in the expression of anger, which is internalized as self-loathing and chronic feelings of inadequacy, rather than externalized as angry outbursts or volatile behavior. This internalizing tendency can make the individual appear outwardly composed, even “high-functioning,” while they are experiencing severe internal suffering. This presentation is sometimes linked to a proposed four-part classification of BPD, where the discouraged subtype is distinct from the impulsive, petulant, and self-destructive types.
Key Characteristics and Internal Experience
The internal experience of the discouraged subtype is dominated by chronic shame and guilt. These individuals often scrutinize their own actions and words, attributing fault and responsibility to themselves, even for conflicts that are not their doing. This extreme self-criticism is rooted in low self-esteem and a belief that they are inherently flawed or a burden to others. They may over-apologize and exhibit excessive humility, driven by a need to avoid criticism and secure acceptance.
A defining feature is how the intense fear of abandonment is managed. Rather than clingy or demanding behavior, the discouraged individual tends to withdraw or isolate themselves to preemptively avoid perceived rejection. When upset by a loved one, they may retreat emotionally or physically, sometimes employing the silent treatment as a defense mechanism. Their identity is frequently tied to their relationships, and the prospect of a relationship ending can cause profound destabilization and feelings of helplessness. This withdrawal often accompanies extreme mood swings that are kept hidden, causing intense emotional pain while maintaining a calm exterior.
Why Diagnosis is Difficult
The internalizing nature of the discouraged subtype complicates the diagnostic process, leading to frequent misidentification or missed diagnoses. Clinicians are often trained to recognize the more overt manifestations of BPD, such as explosive anger, dramatic mood swings, and impulsivity, which are not prominent in this presentation. Because the emotional turmoil is directed inward, the patient’s presentation may more closely resemble other conditions, particularly Major Depressive Disorder or various anxiety disorders. The presence of co-occurring conditions like depression can further overshadow the underlying BPD symptoms.
A person with the discouraged subtype may appear outwardly high-functioning, especially in professional or superficial social settings, which can mask the severity of their internal distress. They are also less likely to present to a clinician in a state of crisis or with the dramatic, attention-seeking behaviors associated with other BPD presentations, further obscuring the diagnosis. Furthermore, the tendency to be people-pleasing and avoid conflict can lead them to minimize their symptoms or present themselves as more stable to the clinician, inadvertently contributing to a misdiagnosis. This difficulty in clinical recognition can delay access to appropriate, specialized treatment.
Therapeutic Approaches
The primary treatment for BPD, including the discouraged subtype, involves specialized psychotherapy, with Dialectical Behavior Therapy (DBT) being an effective method. DBT is useful for this group as it teaches skills in emotion regulation, distress tolerance, and mindfulness, helping manage intense internal emotional states. The skills training component addresses the maladaptive coping mechanisms of withdrawal and self-blame by providing healthier strategies for handling emotional discomfort.
Schema Therapy (ST) is also beneficial, as it directly targets the deep-rooted patterns of thinking, or “schemas,” that involve intense self-hatred and fear of abandonment common in the discouraged subtype. ST works to reshape these negative core beliefs, allowing the individual to develop a healthier sense of self. For the discouraged subtype specifically, therapy must prioritize building trust and validation to counter the chronic self-invalidation before effectively introducing skills acquisition. Mentalization-Based Therapy (MBT) is another effective option, focusing on helping the individual understand their own mental states and those of others, which is crucial for managing the intense fear and withdrawal in relationships.