664 Personality Disorders
efforts to avoid abandonment may include impulsive actions such as self-mutilating or sui-
cidal behaviors, which are described separately in Criterion 5.
Individuals with borderline personality disord er have a pattern of unstable and intense
relationships (Criterion 2). They may idealize potential caregivers or lovers at the first or
second meeting, demand to spend a lot of time  together, and share the most intimate details
early in a relationship. Howeve r, they may switch quickly from idealizing other people to
devaluing them, feeling that the other person does not care enough, does not give enough,
or is not “there” enough. These individuals can empathize with and nurture other people,
but only with the expectation th at the other person will “be ther e” in return to meet their
own needs on demand. These indi viduals are prone to sudden and dramatic shifts in their
view of others, who may alternatively be seen as beneficent supports or as cruelly punitive.
Such shifts often reflect disillusionment with a caregiver whose nurturing qualities had
been idealized or whose rejectio n or abandonment is expected.
There may be an identity disturbance charac terized by markedly and persistently un-
stable self-image or sense of self (Criterion 3). There are sudden and dramatic shifts in self-
image, characterized by shifting goals, values, and vocational aspirations. There may be
sudden changes in opinions and plans about ca reer, sexual identity, values, and types of
friends. These individuals may suddenly chan ge from the role of a needy supplicant for
help to that of a righteous av enger of past mistreat ment. Although they usually have a self-
image that is based on being bad or evil, individuals with this disorder may at times have