Identity disturbance is used to describe an inconsistent or incoherent sense of self. It is associated with borderline personality disorder, as identity disturbance is one of the criteria for the condition.
Identity disturbance often shows up as consistent and remarkable changes in a person’s beliefs, values, and behaviors that significantly impact their life, such as difficulty in maintaining jobs or relationships.
Research on identity disturbance is ongoing. More research is needed to help untangle the complexity of how identity disturbance is interpreted and connected to personality disorders.
Identity disturbance is defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5) as “markedly and persistently unstable self-image or sense of self.” This might show up as dramatic, noticeable changes in self-image, conveyed by changing goals, values, and aspirations.
Identity disturbance is one of nine criteria for diagnosing borderline personality disorder. However, there are still some gaps in how identity disturbance is defined and how it varies in people.
Identity disturbance is difficult to define because a sense of self and identity are complex in and of themselves. In other words, what it means to have an “unstable self-image” can be open to several interpretations. However, some signs may point toward identity disturbance, such as:
- Contradictory beliefs, thoughts, and behaviors
- Changes in values
- Lack of commitment (e.g., to jobs or values)
- Feelings of emptiness
- Feeling a painful lack of consistency in self
- Role absorption (i.e., defining oneself in terms of a single role and having the feeling of always playing a role)
Of course, it’s natural to have changing beliefs, behaviors, and commitments throughout life. What sets identity disturbance apart is that it shows up as a very noticeable and consistent pattern of instability in one’s sense of self, and it significantly affects someone’s life, including their direction in life or lack thereof.
For example, in a case study of someone with identity disturbance, researchers noted that their identity problems affected their interpersonal relationships and educational career.
Research on how identity disturbance comes to be is ongoing. There is no known cause of identity disturbance itself. However, identity disturbance is one of the criteria for diagnosing borderline personality disorder, and none of the other personality disorders shares this same criterion.
This suggests that identity disturbance is a key symptom of borderline personality disorder, though it is unclear whether identity disturbance can exist on its own. Thus, it is difficult to parse out what exactly causes identity disturbance.
It may be that the key components of borderline personality disorder, such as emotional instability, which, in itself can lead to unstable moods, behaviors, and relationships, causes someone to struggle with identity.
For example, if someone experiences unstable behaviors and emotions, maintaining relationships and a daily routine (a job, for example) is difficult. This can lead to a sense of unstable self-image, as interpersonal relationships and commitments impact how we see ourselves.
Some causes of borderline personality disorder might also be shared in identity disturbance since the two are intertwined. Causes of borderline personality disorder include:
- Family history
- Brain factors (i.e., changes in parts of the brain that control impulses and emotional regulation)
- Environmental, cultural, and social factors (e.g., traumatic life events; unstable, invalidating relationships; hostile conflicts)
Overall, an exact cause of identity disturbance is not well understood, but the fact that it is a key component of borderline personality disorder gives some idea on how it comes to be. More research on identity disturbance will help untangle the complexity of the concept.
Since identity disturbance is a key component of borderline personality disorder, some borderline personality disorder treatments may also work for identity disturbance, including:
- Dialectical behavioral therapy
- Cognitive behavioral therapy (CBT)
The goal of dialectical behavioral therapy is to decrease emotional instability by using the concept of mindfulness. Working on emotional regulation may help someone with identity disturbance since emotional instability may make it harder to maintain a stable sense of self.
Cognitive behavioral therapy may be helpful to treat identity disturbance because it focuses on changing patterns of unhelpful thoughts and behaviors.
Since identity disturbance involves markedly conflicting thoughts and behaviors, CBT may help a person identify and change the thoughts or behaviors that cause inaccurate perceptions of themself and others. This can make it easier to maintain a more stable self-image and, as a result, relate better to others.
Medication is not usually used to treat borderline personality disorder because the benefits are unclear. Thus, medication may not be an appropriate treatment for identity disturbance either.
Someone with personality disturbance can feel a constantly changing sense of self on the inside. Others may see the person struggling to maintain relationships, jobs, or consistent behaviors because of their difficulty in maintaining identity.
Personality disorders are highly stigmatized, and identity disturbance is no exception. Though it is not known what exactly causes identity disturbance, social causes, such as abandonment and invalidating relationships, may be at play.
Therefore, as with many mental health disorders, it is critical to consider the external factors that may be causing someone’s difficulty with maintaining a sense of self rather than assuming it’s something inherently wrong with the person. As much as identity is personal, it is also social.
Identity disturbance is a persistent and noticeably unstable sense of self. It is a diagnostic criteria for borderline personality disorder. It can result in challenges in maintaining relationships, jobs, and a social life. It may be treated with psychotherapy.
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Having an identity disturbance can be unsettling. It may make going through everyday life more difficult as you struggle with holding onto a sense of self. In addition to an internal struggle of conflicting values and behaviors, relationships with others can be hard to maintain as your relationship with yourself is always changing.
It’s important to keep in mind that an identity disturbance does not define a person. It can be a result of external factors and factors outside of your control. Thus, although it can feel like a personal issue, it cannot be blamed on the affected person.
If you or someone you know has identity disturbance, reach out to a doctor or mental health specialist. Psychotherapy can be an effective tool in helping change unhelpful patterns of thoughts and behaviors. That could, in turn, help stabilize a sense of self.
Frequently Asked Questions
What is an identity disturbance?
An identity disturbance is a noticeable and persistently unstable self-image or sense of self.
What is identity disturbance a symptom of?
Identity disturbance may be a symptom of borderline personality disorder, as it is one of the criteria for diagnosing the condition. As of now, it is not a criterion for any other personality disorder, but diagnostic criteria for mental health conditions do change.
What does identity disturbance feel like?
Someone with identity disturbance may feel like they do not have a sense of “I/me/myself” and may have feelings of emptiness or a lack of core existence.
One critical aspect of identity disturbance is having consistent and obvious changes in values, beliefs, and aspirations that severely affect everyday life, such as difficulty maintaining relationships or commitments and not having a sense of direction in life.
Do identity disturbances happen with borderline personality disorder?
Yes. Identity disturbance is one of the nine criteria for diagnosing borderline personality disorder. However, it is not clear that identity disturbance is only associated with borderline personality disorder; more research is needed.