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Does Jodi Arias Have Borderline Personality Disorder?

Armchair shrinks & observers are diagnosing Jodi Arias with BPD. Are they right?

As the shocking details of the Jodi Arias trial continue to cascade into our living room, everyone from armchair shrinks to casual observers has a theory on the mental state of the killer.

She has been “diagnosed” as: narcissistic, a pathological liar, bipolar and a sociopath (which I discuss in a recent blog). But, the most popular lay diagnosis recently is borderline personality disorder (BPD).

Arias is not the only high profile individual with the BPD label. There's also Casey Anthony, Sandy Hook school shooter Adam Lanza, Colorado shooter James Holmes and Robert Kennedy Jr.s’ wife, Mary. It’s almost to the point where BPD is the default explanation for anyone with inexplicable behavior.

The term borderline evolved into the mental health lexicon back in 1938 when Adolf Sterm described patients who seemed to suffer from a mild type of schizophrenia. He described the patients as being on the borderline between neurosis and psychosis. It wasn’t until 1980 that BPD appeared in the DSM as a personality disorder.

It was thought to overlap with schizophrenia and non-schizophrenic psychoses, and was used to label overlapping symptoms that failed to fit neatly into any one diagnostic category. Which explains a lot about where we are today.

Though BPD is a legitimate disorder and listed in the DSM-IV TR, it still remains quite controversial. The problem is that many of these behaviors can be applied to other axis one diagnoses like mood disorders , PTSD, and the anxiety spectrum. The new DSM-5 will be tackling the controversies regarding BPD, but that discussion is for another day.

 

According to DSM IV, five or more of the following symptoms must be present to diagnose Borderline Personality Disorder. Let's look at the list and see how Jodi Arias scores based on what we see/read/hear in the media. (Full disclaimer, this is speculation only; I have not evaluated Jodi Arias).

1) Frantic efforts to avoid real or imagined abandonment: Travis Alexander was trying to break up with Arias. When he began distancing himself, her behavior turned. She threatened suicide, showed up uninvited to his house, broke into online accounts and slashed his tires. She had a fear of being abandoned, and she wasn't going to let him leave her without a fight.

Arias was also extremely jealous, following Alexander on a date which did not include her. She also cornered Clancy Talbot, a female friend of his in the women's bathroom during a conference.

Arias taped many sexual conversations and it is speculated these recordings were frantic attempts to hold onto Alexander in case he tried to leave her. 

No doubt she meets this criteria, at least with respect to Travis.

2) A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation: Arias had several failed relationships and spread negative stories about why they didn’t work. But there was no evidence she idealized prior relationships and who among of us has not said a few negative things about an ex?

Arias spoke very highly of Alexander, up until his death, and clearly idealized him. She was also very possessive. Now that he's dead she claims he was a sexual deviant and pedophile.

Though Arias would meet this symptom with respect to Alexander, there is no pattern of behavior otherwise.

3) Identity disturbance: markedly and persistently unstable self-image or sense of self. Jodi did whatever Alexander wanted -- or suggested it herself -- as long as it kept him interested in her. It was all about him, and keeping him engaged.

Identity disturbance and unstable self-image does not fit here. She became whatever Alexander wanted, but she was well aware of what she was doing. She was into it and she liked it and it was a conscious decision with a purpose.

4) Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating) We have become all too aware of the intense sexual practices that occurred between Alexander and Arias. Let's not forget after the murder, she impulsively threw Alexander's camera with damning photos in the washing machine, rather than packing it up with the rest of the evidence.

Arias would call Alexander from work, only to drop whatever she was doing to go after him if he didn't answer her calls. She kicked the family dog. She kicked her mother. In fits of anger she slashed his tires, twice. The same can be said for breaking into his email and sending a threatening email to a potential rival. She sent insulting texts to women from Alexander's phone while he was in the shower. In the interrogation room, she kicked chairs, sang, admonished herself for not applying makeup and stood on her head.

Arias, by all accounts, was very impulsive.

5) Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. Jodi claims she was planning on killing herself. While in custody, she made a few little nicks, claiming she was trying to slit her wrists, but it hurt too much. She wrote in her journal "I just wish I could die." But there's no record of a real suicide attempt, nor is there any record of self-mutilation.

6) Affective instability due to a market reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). Arias' mood could change quickly, but she had good reason -- Alexander trying to terminate the relationship.

Arias' moods may have switched at the drop of a hat, but there were reasons. BPD mood swings go from high to low, irritable and hopeless to hypomanic and euphoria. This is often irrespective of circumstances, rather it’s an affective instability.

Arias' moods were directly related to the situation with Alexander. As long as things were going well so was she, but when he tried to break it off, she would crash. It appears this was repeated many times.

7) Chronic feelings of emptiness. According to those who know Jody, she was very assertive and quite sure of herself. There is no apparent history of feelings of emptiness. But, we could speculate that she felt she was nothing without Travis, which is why she could not let him go. Again this is specific to her relationship with Alexander, not Jodi’s personality. 

8) Inappropriate, intense anger or difficulty controlling anger (e.g., frequently displays of temper, constant anger, recurrent physical fights). Arias would fly into fits of rage, but only when the relationship was threatened. These rages were aimed at Alexander and potential female rivals.

Before Travis, we simply do not have a record of intense anger. It was written in her diary that she kicked her mother once in a fit of rage. But no reoccurring pattern is seen.

9) Transient, stress-related paranoid ideation or severe dissociative symptoms. Arias claims Alexander was abusive, but this sounds like a way of justifying her actions. Paranoia is an excessive or irrational suspicion of others. She did not think Alexander was out to get her; rather she was afraid he was going to leave her. Arias was not paranoid. The threat of losing the relationship was real, not imagined.

So, according to the DSM IV criteria, Jodi Arias would come close to the borderline personality criterion IF we only consider her relationship with Alexander. But BPD is by definition a personality disorder. It generally starts in the teens and is seen over time with many people, in many situations and circumstances.

That is just not the case here and this points out the dangers of an armchair psychiatrist trying to slap a label on someone they have never met. It’s easy to read the DSM and assign symptoms to an individual, but there is so much more that goes into a true diagnosis.

As this trial of twisted sex, lies and dirty little secrets continues, the danger remains that commentators, newscasters, attorneys and couch potatoes will continue to label and diagnose Jodi Arias. The more the speculation the higher the ratings and the more engaged the viewer.

Borderline Personality Disorder sounds really cool and cutting edge. It makes it seem like you are in the know when you throw it around when discussing behavior and it sure beats not having an answer. But this particular psychiatric diagnosis is extremely challenging, even for experts in a controlled clinical setting. And it has nothing to do with Jodi Arias’s actions or behavior.

For more on Jodi Arias’s mental state click here.

Dale Archer, M.D., is a clinical psychiatrist and author of The New York Times bestseller, Better Than Normal: How What Makes You Different Can Make You Exceptional.

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