The Association Between Child Abuse, Trauma and Borderline Personality Disorder (BPD).

brain damage caused by childhood trauma.  BPD

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childhood_trauma_and_early_signs_of_psychosis

‘Character depends essentially on whether a person is given love, protection, tenderness and understanding during the formative years or is exposed to rejection, coldness, indifference and cruelty.’

Alice Miller.


THE ASSOCIATION BETWEEN CHILDHOOD ABUSE, TRAUMA AND BORDERLINE PERSONALITY DISORDER.

Many research studies have shown that individuals who have suffered childhood abuse, trauma and/or neglect are very considerably more likely to develop borderline personality disorder (BPD) as adults than those who were fortunate enough to have experienced a relatively stable childhood.

it is thought marilyn munroe suffered from BPD

It is thought Marilyn Monroe suffered from BPD

 

WHAT IS BORDERLINE PERSONALITY DISORDER (BPD)?

 

BPD sufferers experience a range of symptoms which are split into 9 categories. These are:

1) Extreme swings in emotions
2) Explosive anger
3) Intense fear of rejection/abandonment sometimes leading to frantic efforts to maintain a relationship
4) Impulsiveness
5) Self-harm
6) Unstable self-concept (not really knowing ‘who one is’)
7) Chronic feelings of ’emptiness’ (often leading to excessive drinking/eating etc ‘to fill the vacuum’)
8) Dissociation ( a feeling of being ‘disconnected from reality’)
9) Intense and highly volatile relationships

For a diagnosis of BPD to be given, the individual needs to suffer from at least 5 of the above.

frequently rejected in childhood, BPD sufferers live in terror of abandoment

frequently rejected in childhood, BPD sufferers live in terror of abandonment

A person’s childhood experiences has an enormous effect on his/her mental health in adult life. How parents treat their children is, therefore, of paramount importance.

BPD is an even more likely outcome, if, as well as suffering trauma through invidious parenting, the individual also has a BIOLOGICAL VULNERABILITY.

In relation to an individual’s childhood, research suggests that the 3 major risk factors are:

– trauma/abuse
– damaging parenting styles
– early separation or loss (eg due to parental divorce or the death of the parent/s)

Of course, more than one of these can befall the child. Indeed, in my own case, I was unlucky enough to be affected by all three. And, given my mother was highly unstable, it is very likely I also inherited a biological/genetic vulnerability.

 

EXAMPLES OF DAMAGING PARENTING STYLES:

 

1) Dysfunctional and disorganized – this can occur when there is a high level of marital discord or conflict. It is important, here, to point out that even if parents attempt to hide their disharmony, children are still likely to be adversely affected as they tend to pick up on subtle signs of tension.

Chaotic environments can also impact very badly on children. Examples are:

– constant house moves
– parental alcoholism/illicit drug use
– parental mental illness and instability/verbal aggression

 

2) Emotional invalidation. Examples include:

– a parent telling their child they wish he/she could be more like his/her brother/sister/cousin etc.
– a parent telling the child he is ‘just like his father’ (meant disparagingly). This invalidates the child’s unique identity.
– telling a child s/he shouldn’t be upset/crying over something, therefore invalidating the child’s reaction and implying the child’s having such feelings is inappropriate.
– telling the child he/she is exaggerating about how bad something is. Again, this invalidates the child’s perception of how something is adversely affecting him/her.
– a parent telling a child to stop feeling sorry for him/herself and think about good things instead. Again, this invalidates the child’s sadness and encourages him/her to suppress emotions.

Invalidation of a child’s emotions, and undermining the authenticity of their feelings, can lead the child to start demonstrating his/her emotions in a very extreme way in order to gain the recognition he/she previously failed to elicit.

 

3) Child trauma and child abuse – people with BPD have very frequently been abused. However, not all children who are abused develop BPD due to having a biological/genetic RESILIENCE and/or having good emotional support and validation in other areas of their lives (eg at school or through a counselor).

Trauma inflicted by a family member has been shown by research to have a greater adverse impact on the child than abuse by a stranger. Also, as would be expected, the longer the traumatic situation lasts, the more likely it is that the child will develop BPD in adult life.

 

4) Separation and loss – here, the trauma is caused, in large part, due to the child’s bonding process development being disrupted. Children who suffer this are much more likely to become anxious and develop ATTACHMENT DISORDERS as adults which can disrupt adult relationships and cause the sufferer to have an intense fear of abandoment in adult life. They may, too, become very ‘clingy’, fearful of relationships, or a distressing mixture of the two.

This site examines possible therapeutic interventions for BPD and ways the BPD sufferer can help himself or herself to reduce BPD symptoms.

 

David Hosier BSc Hons; MSc; PGDE(FAHE).

Abandonment Issues

childhood_trauma

If we were rejected as a child by parents/primary caregivers we are at high risk of growing up into adults with serious abandonment issues. This means we will be hypersensitive to rejection by others, deeply afraid of such rejection and profoundly hurt and distressed when we experience it.

Because we may be preoccupied with, or even obsessed by, the fear of rejection and abandonment we are likely to be constantly on ‘red alert’, looking for the smallest signs that someone may reject us.

Frequently, too, because of our constant anticipation that we are going to be rejected, we may believe we perceive signs of rejection where, in reality, they do not exist.

Rejection by others is so painful to us as it reminds us (consciously or unconsciously) of the intensely traumatic abandonment we experienced in childhood; therefore, when we are subsequently rejected in adulthood, we are, in effect, retraumatized.

Being intensely fearful of rejection can have numerous adverse effects on us. For example:

– we may become extremely ‘clingy’

– we may need constant reassurance from others that they are not going to leave us

– we may socially withdraw so that we don’t get close to others in order to avoid the risk of rejection

– we may be unconsciously motivated to reject others before they get the opportunity to reject us

Fear of abandonment

– we may feel constantly insecure

– in extreme cases we may threaten/attempt suicide in response to signs of rejection from others

Internalization:

Due to rejection in childhood, many with abandonment issues have inferred from this (erroneously) that they must be ‘bad’ people and have then gone on to deeply internalize this mistaken view of themselves. This means such individuals tend to have both extremely low self-esteem and confidence.

Also, wrongly believing themselves to be ‘bad’, they may feel constantly guilty, expect others to somehow ‘sense’ their ‘badness’ and, therefore, perpetually feel their ‘badness’ will be exposed and that they will, as a result, become social pariahs

Some may become excessively reliant on drink and/or drugs in an attempt to alleviate the emotional pain they feel.

Emotional Abandonment:

Finally, it should be noted that being abandoned as a child need not involve actual physical abandonment; it can, instead, involve emotional/psychological abandonment – this may come about by growing up with a parent who is cold and distant or who ignores his/her child.

Therapies:

Two therapies which may help with abandonment issues are dialectical behavior therapy and EMDR (Eye Movement Desensitization And Reprocessing).

Resource:

Ten Steps To Overcome Insecurity In Relationships. Click Image Below:

Causes of insecuriy

 

David Hosier BSc Hons; MSc; PGDE(FAHE).

 

Mental Illness, Nature And Nurture.

childhood_trauma_mental_illness

We have seen that those of us who suffered significant childhood trauma are more likely than those who were fortunate enough to experience a relatively stable upbringing to develop mental health problems in later life (all else being equal).

However, when in comes to treating mental disorders, there exist two distinct approaches; we can call these the nature approach and the nurture approach; I explain how these two approaches differ from one another below.

1) The Nature Approach:

Mental health professionals who use the nature approach assume the mental disorder is caused by physical factors such as:

– genes

– neurological biochemistry

hormone dysregulation

Therefore, the treatments such mental health professionals use seek to correct the assumed physical problem; these include:

– drugs that alter the brain’s biochemistry such anti-depressants that change levels of serotonin in the brain and anti-psychotics that alter levels of dopamine in the brain

– transcranial magnetic stimulation

electroconvulsive therapy

implants of electrical devices

vagus nerve stimulation

2) The Nurture Approach :

Those who take this approach regard one’s environment as being the cause of one’s mental illness. Such environmental factors include, for example :

– society

– culture

– family

– war

– parental neglect/abandonment/rejection/abuse

– poverty

– social ostracization

Treatments based upon the nurture approach include :

– attempts to improve the individual’s environment

– psychoanalysis

– counselling

 

INTERACTION OF PHYSIOLOGICAL AND ENVIRONMENTAL FACTORS :

The truth is, however, that mental illness is caused by the ways in which physiological and environmental factors interact with one another.

Notwithstanding the above, it is also the case that the development of some mental illness are contributed to more by the genes we have inherited than by the environment within which we have existed and visa versa.

For example, the development of schizophrenia, the latest research suggests, appears to have a genetic contribution of about 80℅ (although it follows from this, of course, that environment still plays a significant role).

By over-focusing on the physical underpinnings of mental illness clinicians may neglect to properly examine vital environmental/psychological contributing factors, and visa versa.

Above eBook now available on Amazon for immediate download. Click here.

David Hosier BSc Hons; MSc; PGDE(FAHE).

What Is ‘Trauma Informed’ Therapy?

childhood_trauma

Many individuals who seek treatment and therapy for problems such as alcoholism, drug addiction, clinical depression, severe anxiety, anger management issues and eating disorders (or a combination of such problems) often have an underlying problem: they have experienced severe and protracted childhood trauma.

In other words, it is their experience of trauma that has significantly contributed to the existence of such problem as those mentioned above.

Such people are increasingly being said by psychiatric professionals to be suffering from complex posttraumatic stress disorder (CPTSD). However, this diagnosis has yet to be included in the DSM (Diagnostic And Statistical Manual Of Mental Disorders).

In CPTSD sufferers, the problems that go with it such as those listed above (alcoholism, drug addiction etc) are often referred to secondary problems/conditions/diagnoses whilst the the core CPTSD is referred to as the primary problem/condition/diagnosis).

Sadly, all too frequently, the diagnosis of CPTSD is missed due to practitioners focusing exclusively on the secondary problems without taking the time to discover the underlying and primary problem, namely the effects of childhood trauma manifesting as CPTSD.

Unfortunately, it is much harder to treat the secondary problems if their link to the primary problem (the experience of childhood trauma / CPTSD) is not identified. Indeed, in my own case, for years my secondary symptoms were treated without success due in large part due to the fact none of my doctors or psychiatrists I saw (and, believe me, these were numerous) thought to ask me about my childhood.

TRAUMA INFORMED THERAPY:

Trauma informed therapy is treatment which identifies the link between the primary problem (the effects if childhood trauma) and the secondary problems (alcoholism, drug addiction etc…).

Indeed, according to the principles of trauma informed therapy, if the psychiatric professional fails to make this connection and tailor the treatment accordingly, it is much less likely the patient will be able to permanently conquer his/her secondary problems, let alone the primary problem (as it remains unidentified as a causal factor and as a major problem in its own right).

Resource:


 

David Hosier BSc Hons; MSc; PGDE(FAHE).

 

Hallmarks Of High And Low Functioning BPD Sufferers.

childhood_trauma

Those who have developed borderline personality disorder (BPD) as a consequence of their traumatic childhood experiences are, of course, individuals and act and behave in their own unique ways.

However, those who are involved in the research of BPD have made various attempts to group those suffering from this very serious disorder into various sub-categories.

In this article I will look at a sub-categorization method which places BPD sufferers into three groups/categories; these are as follows:

1) High Functioning

2) Low Functioning

3) A mixture of the above two categories

 

What Are The Hallmarks Of Individual BPD Sufferers In Each Of These Three Sub-categories?

These are as follows:

1) The hallmarks of low functioning BPD sufferers:

Low functioning BPD sufferers may frequently self-harm, often contemplate suicide and, sometimes, attempt suicide.

They are also likely, sometimes, to be hospitalized in a psychiatric ward, either voluntarily or under Section, as an inpatient, or, on other occasions, they may make use of the hospital’s services as an outpatient.

Often, too, low functioning BPD sufferers will have co-morbid conditions such as anorexia, bulimia and bipolar disorder (which used to be referred to as manic depression).

Also, their day-to-day functioning is likely to be significantly impaired. For example, they may find it very hard to hold down a job or even to work at all.

Low functioning BPD sufferers also tend to be highly dependent on family members for help and support to the extent that they (the BPD sufferer’s family) may experience ‘compassion fatigue’ and feel overwhelmed, unable to cope, inadequate and impotent.

2) The hallmarks of high functioning BPD sufferers:

High functioning BPD sufferers often excessively blame others for their difficulties (which is not the same as saying they are always wrong to do so) and may, too, have great difficulty suppressing intense feelings of anger (for example, they may frequently fly into fits of rage, even over things that others may regard as relatively trivial).

Often, too, they resist advice to seek psychiatric help, regarding such advice as a slur on their character and claiming that there is absolutely nothing psychologically wrong with them (often because they lack insight into their condition). As a consequence of this, they may remain unknown to psychiatric services for their entire lifetimes).

Also, they may (co-morbidly) suffer from narcissistic personality disorder and regard seeking professional help from psychiatric services ‘beneath their dignity.’

Because of their relatively high level of functioning, they may be able to hold down a job and even excel at it.

Their family members often become highly frustrated and despairing that their relative with BPD fails to acknowledge that they clearly have a psychological problem requiring professional intervention.

3) BPD Sufferers Who Suffer A Mixture Of The Above Two Sets Of Symptoms:

This is self-explanatory.

Resources:

BPD

 

 

David Hosier BSc Hons; MSc; PGDE(FAHE).

 

 

 

Are ‘People Pleasers’ Created By Their Childhoods?

childhood_trauma

Guilt, as we know, is a mentally uncomfortable or painful feeling that arises when we do something that conflicts with our internal code of morality; obviously, its intensity can vary from mild to excruciating depending on what we’ve done and how sensitive our conscience is (the only people who may be exempt from such feelings are those suffering from anti-social personality disorder – also referred to as sociopathy or psychopathy- who are said to have no conscience ,or, at best, a severely blunted one).

Others, however, have very strong consciences and a very strict internal moral code. Such people have a particular propensity to feel guilty. How does this happen?

Many factors play a role, such as religion or the prevailing moral views of the particular society one is a part of at a particular place and time (obviously, prevailing moral views of any given society alter across space and time).

Also, of course, what we learn as children from how our parents treat us is of vital importance and it is this crucial influence that I am going to focus on here.

As children, we are dependent on our parents (or primary care-giver/s) and are thus instinctively driven to seek and maintain their approval. However, when we (inevitably, of course) do things that displease them and that they regard as ‘wrong’ or ‘bad’ they may withdraw approval from us or actively disapprove of us, possibly punishing us.

Because we are dependent on their approval, we are also, naturally, motivated to AVOID their disapproval.

Therefore, we have evolved (through means of natural selection) to feel bad when they disapprove of us as this will encourage us to avoid doing things which displease them.

In this way, as we grow up, we become CONDITIONED to please our parents (as we are rewarded with approval) and, also, to avoid upsetting them (as this results in punishment/loss of approval).

In evolutionary terms, quite simply, staying in our parents’ ‘good books’ has SURVIVAL VALUE.

It can be understood, then, why children are especially prone to feelings of guilt and strongly desire love, approval and acceptance from their parents/primary caregiver.

For the same reasons, we later become conditioned to seek the approval of society in general; humans are social animals, and, throughout our evolutionary history, being accepted by our immediate social group has been vital to the survival of our species.

POSSIBLE EFFECTS OF CONSTANTLY DISAPPROVING PARENTS:

If, when we were growing up, our parents constantly criticized us and perpetually disapproved of us, we may have come to internalize their negative view of us and to have grown up feeling the constant anxiety that we are ‘bad’. This, of course, results in low self-esteem – a painful emotion.

In order to try to escape such painful feelings, we may become desperate to avoid yet further disapproval from society (which would remind us of our childhood pain) and, as a consequence, feel constantly psychologically compelled to avoid such disapproval.

This can lead us to become what is known in everyday parlance as a ‘people-pleaser’, finding it hard to say ‘no’ and, very often, neglecting our own needs.

In essence, we may become desperate to receive the validation that we did not receive from our parents.

This can result in our self-worth becoming utterly dependent upon what others think of us; however, condemning ourselves to remain on the treadmill of constantly seeking the approval of others ( in order to keep our fragile sense of self-esteem ‘topped up’) tends to be futile as a genuine and sustainable sense of self worth needs to come from a sense of inner, personal conviction, irrespective of the perception of others.

Furthermore, dependency upon the approval of others can lead to us becoming vulnerable to exploitation and manipulation by others.

Resource :

Hypnotherapy MP3 – ‘Stop Seeking The Approval Of Others.’ Click here.

David Hosier BSc Hons; MSc; PGDE(FAHE).

 

 

PTSD Sufferers More Likely To Be Obese.

childhood_trauma

Currently, in the UK, about 65% of men and 58% of women are clinically classified as being either overweight or obese. In the USA, the figures are similar : approximately 58% of women are clinically defined as overweight or obese, whilst the corresponding statistic for male Americans is 70%.

A study conducted by Bartoli et al. found that those suffering from post-traumatic stress disorder (PTSD) were about one and a half times more likely to suffer from obesity than were the controls (participants who did not have PTSD) who took part in the research.

So, if, as adults, we suffer from PTSD as a result of our highly disturbed childhoods we are at increased risk of also becoming obese compared with the average individual (all else being equal).

Why should this be the case? Well, one explanation is that the depressive symptoms that accompany PTSD can lead to the so-called ‘comfort eating’ phenomenon as well as much decreased levels of physical activity due to lack of motivation (in my own case, I was frequently utterly incapable of getting out of bed); therefore, we are likely to consume more calories each day than we burn up.

Above : The Cookie Monster : Me love cookie…

Also, the severe anxiety that accompanies PTSD can lead to various different compulsions, one of which being compulsive eating.

Furthermore, many PTSD sufferers experience severe insomnia and intense, terrifying nightmares (as I know from my own bitter experiences). This can lead (as it did in my own case) to getting out of bed frequently in the night for the purpose of consuming self-medicating (i.e. mentally soothing), nocturnal feasts (especially carbohydrates, which help many to feel slightly calmer, temporarily).

A Psychodynamic Theory Of Why Some Individuals May Become Obese:

Psychodynamic theory suggests that if we suffered severe childhood trauma and frequently felt threatened, intimidated and fearful due to the treatment we received by those who were supposed to be caring for us and protecting us then we might be unconsciously driven to become very large (i.e. obese) as it gives us the feeling that we are less vulnerable and more able to defend ourselves. This theory is, however, difficult to prove (although it does not logically follow, of course, that it is necessarily incorrect; indeed, it seems to make intuitive sense).

David Hosier BSc Hons; MSc; PGDE(FAHE).

Childhood Trauma And The Development Of Impulse-Control Disorders.

childhood_trauma

If, as adults, we find we have poor impulse control, this may be, in large part, due to the legacy of a disturbed and traumatic childhood. For example, those who have suffered severe and chronic childhood trauma are more likey to suffer from conditions such as borderline personality disorder (BPD) and anti-social personality disorder (APD) than the average person and both these conditions include impulsiveness  as one of the symptoms.

If a person is impulsive it means s/he often acts prematurely with insufficient planning and lack of thoughtful deliberation; importantly, too, impulsiveness (when it is pathological) involves repeated efforts to make short-term gains but at the expense of long-term gains.

Tell-tale signs that a person may be impulsive:

– frequently making inappropriate comments (speaking without forethought)

– constantly interrupting others during conversations

– often displaying impatience (e.g when having to wait in queues)

Impulsiveness disorders may involve:

– ‘binge’ shopping for unnecessary items (although many ‘binge’ shoppers indulge in the activity in an attempt to escape from negative emotions such as depression)

– excessive use of alcohol/narcotics (which may themselves increase impulsiveness, thus creating a vicious cycle)

– binge eating (again, though, many indulge in binge eating to  overcome – temporarily, of course – negative emotions)

– dangerous risk taking (such as dangerous overtaking of other vehicles when driving)

– promiscuous, unsafe sex

– kleptomania

– arson

intermittent explosive disorder (I.E.D)

pathological gambling

impulse-control-disorder

The Five Main Stages Involved In Impulse-Control Disorders:

Research has identified five main stages a person who has pathological problems controlling his/her impulses goes through; these are:

STAGE 1: The experience of a powerful urge

STAGE 2: A failure to resist/inhibit this urge

STAGE 3: A state of high excitement/arousal (with physical and psychological manifestations)

STAGE 4: Giving in to the urge (this usually results in a sense of deep relief from tension)

STAGE 5: Feelings of guilt for having carried out the impulsive act (this feeling of guilt may be very intense and involve profound feelings of self-disgust, self-loathing and self-hatred).

Brain Regions Thought To Be Involved In Impulse-Control Disorders:

Although further research is required in order to determine with greater accuracy how certain brain regions are involved in impulse-control disorders, it is currently hypothesized that damage to both the amygdala and orbitofrontal cortex may be relevant (it is also believed that these parts of the brain may be damaged by the experience of significant childhood trauma). Furthermore, it is theorized that the brain’s exexcutive function may also impaired.

Neurochemical Involvement:

Theories also exist that suggest people who suffer from impulse-control disorders are likely to have lower than normal levels of the neurotransmitters dopamine and serotonin in their brains.

The Possible Role Of Genes:

It is also thought that the dopamine receptor and serotonin receptor genes may be involved in impulse-control disorders which would, of course, follow from the above.

POSSIBLE TREATMENTS:

Cognitive Behavioural Therapy (CBT) currently seems to be the most favoured non-pharmacological method employed to address the disorder although it may also be treated with SSRI (selective serotonin re-uptake inhibitors) anti-depressants (which should only be taken on the advice of an appropriately qualified professional).

RESOURCE:

Reduce Impulsivity Hypnotherapy MP3/CD (MP3 instantly downloadable). Click here.

eBook:

Above eBook available from Amazon (instantly downloadable). Click here.

David Hosier BSc Hons; MSC; PGDE(FAHE).

Does BPD Run In Families?

childhood_trauma

 

The short answer is yes.

If a first degree relative (such as our mother or father) has BPD (Borderline Personality Disorder), our chances of developing the disorder are about 1,000% greater than the average person’s (i.e. ten times greater).

Does This Mean The Disorder Is Genetic?

This fact in itself does not prove a genetic component to the disorder. For example, if our mother has BPD and we develop it ourselves during our adult life, it may be because having a mother with BPD has led us to have a very unstable childhood and it is this unstable childhood that has led us to develop BPD, not the genes we have inherited from our mother.

HOWEVER:

Although more research needs to be conducted in this area, currently researchers believe that our genes may play approximately a 50% role in the causation of BPD (this comes from studies comparing the incidence of BPD amongst identical twins with the incidence of BPD amongst non-identical twins; such ‘twin studies’ are intended to tease out environmental factors from genetic factors).

How Might Genes Increase A Person’s Risk Of Developing BPD?

Essentially, it is thought that the inheritance of certain genes have an adverse effect on the chemistry, structure and function of the brain and it is these adverse effects which heighten a person’s risk of developing BPD.

Let’s briefly look at each of these adverse effects in turn:

Adverse Effects On Brain Chemistry:

A current leading theory is that the way in which the brain uses the neurotransmitter serotonin is disrupted which may make a person more aggressive, more impulsive and more emotionally labile (i.e. much less able than the average person to control his/her emotional responses – this is also sometimes referred to as emotional dysregulation; in colloquial language, some, through lack of understanding of this very serious condition, may refer to such people as drama queens).

Adverse Effects On Brain Function:

A part of the brain called the executive system (which controls rational decision-making) is also thought to be disrupted in people with BPD.

Adverse Effects On Brain Structure:

Those with BPD are also thought, according to current research, to have damage to the area of the brain known as the amygdala (the amygdala is involved in emotional regulation) leading the individual to being highly prone to extremely intense emotional reactions, even over things that others may consider trivial or of no importance – essentially, their internal ’emotional reaction dial’ is set far too high.

To exacerbate the problem of dramatically high emotional reactivity yet further, the part of the brain that inhibits and controls emotional reactions (the frontal cortex) is also thought to be malfunctioning in BPD sufferers.

Conclusion:

Because BPD is believed to be intimately associated with organic brain dysfunctions, this may explain why BPD sufferers often do not seem able to learn from experience.

However, it should be stressed again that research into this area is in an early stage and it is still not clear if the brain abnormalities described above are the result of BPD or the cause of it.

Notwithstanding the above, a large number of BPD sufferers DO recover. Currently, one of the most effective treatments is Dialectical Behavioral Therapy (DBT).

Recommended Book:

 

David Hosier BSc Hons; MSc; PGDE(FAHE).