In this cognitive-behavioral, skills training approach, BPD is characterized as a disorder of emotion and behavior regulation. The goal is to provide the individuals with BPD, other professionals treating them, and closely allied friends and family members with a common language to communicate clearly about the disorder and the skills used to manage it. Clients learn specific emotion and behavior management skills. Splitting, like other behaviors common in BPD, is viewed not as an intentional act of aggression but as an automatic response to the emotional intensity and dysregulation which the client can learn to anticipate and replace with more effective behavior. As a result, the BPDI is periodically overwhelmed by abnormally intense emotional upheavals that drive him or her to seek relief.
Family studies suggest an underlying biologic vulnerability.
The childhood history of the BPDI often includes inconsistent emotional support or even abuse by important caregivers. In most cases there is a complex interplay between underlying vulnerability and the social environment. We believe that individuals with BPD do not consciously choose to have this disorder and, with rare exceptions, parents and other important caregivers do not consciously choose to create an inconsistent and unsupportive childhood environment. For these reasons, clients often resist the label of BPD, even though they may readily acknowledge the behaviors. Bartels and Crotty have suggested the name Emotional Intensity Disorder as a more accurate description that clients find easier to understand and accept.