27). Though the individual suffering from BPD can be very sensitive to others, they lack the ability to be empathetic. .
The second criterion involves impulsiveness. The individual's mood swings can change suddenly and be contradictory as a result of his/her strong feelings, which are the result of perceptions that represent isolated and unconnected experiences from the past. Consequently, patterns of consistency and predictability are not available to the individual; consequently, the same behavior patterns are repeated. The borderline's lack of patience and need for immediate gratification connects to other behaviors that are defined in the DSM-IV criteria. .
The third criterion discusses the radical mood shifts known as "affective instability". Moods can suddenly change from a relatively normal mood to depression, irritability, or anxiety and last for a few hours. The normal mood of the borderline individual can be hyperactive or pessimistic (Kreisman and Straus p. 57).
The fourth criterion gets into inappropriate and intense anger, or the lack of anger control. The outbursts of rage are unpredictable and can be frightening. The outrage can be triggered by a seemingly insignificant incident. The borderline's anger can be a cry for help, a test of devotion, or a fear of intimacy (Keisman and Straus). In any case, the outbursts tend to push away the person they need most. .
The fifth criterion represents a plea for help. There are frequent threats or attempts at suicide. Often the treats are made in an attempt to communicate pain and a cry for help. However, the repeated threats often lead to people turning away. Self-mutilation is a strong characteristic of the borderline. In the beginning the mutilations are impulsive and self-punishing; however, over time the behavior becomes more ritualistic and severe. Borderlines may scar their bodies in areas that can be covered by clothing, again demonstrating their ambivalent feelings.