Category Archives: Bookjuly2016

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).

 

 

 

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Copyright 2016 Child Abuse, Trauma and Recovery

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).

 

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Copyright 2016 Child Abuse, Trauma and Recovery

BPD – A Masked Illness : And Why It’s Hard To Identify

Bpd_and_childhood_trauma

We have seen from other posts how childhood trauma, especially multiple and cumulative trauma, is strongly associated with the development of borderline personality disorder (BPD) in adult life.

However, many BPD sufferers are at risk of going undiagnosed or misdiagnosed.

The reason for this is that BPD can generate a number of symptoms associated with other conditions that mask the underlying illness (BPD).

Sadly, because of this, BPD can go undiagnosed for years, decades or a whole lifetime. This means many go without the proper treatment they require.

When one considers that approximately ten per cent of those diagnosed with BPD end their lives by suicide, the full, tragic implications of this failure of accurate diagnosis can be appreciated.

What Symptoms Of BPD Can Mask It, Thus Making It Less Likely To Be Accurately Diagnosed?

They include :

– excessive use of alcohol, leading to a diagnosis of alcoholism

self-harm / suicidal thoughts, leading to a diagnosis of depression

instability of mood, leading to diagnosis of cyclothymic or bipolar disorder

aggression/violence, leading to diagnosis of sociopathy (sometimes still referred to as psychopathy)

eating problems, leading to diagnosis of anorexia nervosa or bulimia

Whilst this list is not exhaustive, it represents some of the ways in which BPD can seemingly, upon preliminary invetigations, present itself as other psychological conditions, leading to misdiagnosis or incomplete/partial diagnosis.

bpd

Because, too, many with BPD are able to work successfully, and/or socially integrate successfully, much of the time without displaying blatant signs of psychological pathology, identifying BPD in individuals becomes trickier still.

However, such individuals are still likely to display tell-tale signs of the disorder due to sudden, dramatic and unpredictable shifts in mood (such as explosions of rage) which may, by the layman (or even the professional) be put down to ‘a difficult temperament’.

In order to correctly diagnose BPD it is necessary to look at the whole tapestry of the interplay of the individual’s behaviours and emotions in the context of their lives as a whole, with a particular focus on their relationship history (tends to be tumultuous), mood stability/instability, drug/alcohol use, sexual history (tends to be promiscuous and high risk), internal/mental life (often marked by feelings of chronic emptiness and lack of identity), emotional reactiveness/lability, and, vitally, of course, experience of childhood trauma.

In short, accurate diagnosis calls for a holistic approach; only then will all BPD sufferers get the treatment they both desperately need and deserve.

Resources:

 

BPD

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

 

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

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Copyright 2016 Child Abuse, Trauma and Recovery

BPD : How It Affects Men And Women Differently

Bpd_and_childhood_trauma

We have seen that those who have experienced significant childhood trauma are more likely than the average person to develop borderline personality disorder (BPD) in their adult lives.

It is now known that borderline personality disorder (BPD) affects men and women in equal numbers. However, the way this serious condition (one out of ten BPD sufferers, tragically, end their lives by suicide) affects individuals’ emotions and behaviour tends to differ depending upon whether the sufferer is male or female.

I outline these differences below:

1) Men are less likely than women to seek psychotherapy for their condition, often because they see seeking help as a sign of weakness and, therefore, a source of shame

2) However, if men do seek treatment, because BPD is stereotypically associated with females and therapists may be poorly trained in recognizing BPD in men, they are frequently misdiagnosed. Such misdiagnoses include :

– addiction to alcohol or drugs (when, in fact, this should not be the primary diagnosis as it is a symptom of the underlying BPD)

– bipolar disorder

– antisocial personality disorder

– narcissistic personality disorder

3) Men do not obtain medication for the treatment of their condition as much as women do (due to receiving a wrongful diagnosis or because they do their best to conceal their illness from the medical profession and from society in general).

4) Men who have BPD are more likely to:

– act impulsively

– thrill/sensation-seek

– take high risks

– seek out novel and exciting experiences

Bpd_in_males

5) Men are more likely, also, to suffer from intermittent explosive disorder (I.E.D) running alongside BPD than are their female counterparts

6) Men are five times more likely than women to take their own lives.

However, it is also true that women are more likely to attempt suicide than men are – it’s just that a much higher proportion of their suicide attempts do not ‘succeed’ (this is, in part, due to the fact men tend to use more lethal methods to try to kill themselves than women).

It may also be that women’s suicide attempts may, sometimes, be more half-hearted, or more of  ‘a cry for help’, although this, of course, is by absolutely no means always the case.

7) Women are more likely than men to also suffer from eating disorders, mood disorders and anxiety disorders if they have a primary diagnosis of BPD

 

NB :  Anyone who thinks they may have BPD should consult an appropriately qualified and experienced professional for advice. Therapies can include, CBT,  DBT  and/or medication.

Resources/Links:

Famous People With BPDclick here.

 

More information :

To find out more about BPD, its effects and available treatments, click here.

ebook:

BPD

Above eBook available for immediate download from Amazon. Click here for more details.

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

 

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Copyright 2016 Child Abuse, Trauma and Recovery

BPD And The Triune (3 Part) Brain

reptilian_brain

Our brains can be divided into three parts, as follows:

1) Reptilian Brain (also called the brain stem):

This part of our brain is the oldest in evolutionary terms, and, therefore, the most primitive. It reacts to events instinctively without conscious deliberation ; in particular, it gives rise to :

– our fight / flight / freeze / fawn responses

– our immediate biological sexual responses

Essentially, then, this part of our brain is responsible for our survival. If we feel seriously threatened, it over-rides the two other parts of our brain (see below).

Also, if we drink too much, the influence of the reptilian brain becomes more dominant, as alcohol can significantly reduce the activity of the two (mammalian and neomamallian) higher parts of the brain; when drunk, therefore, we are more likely to get into fights or indulge in promiscuous and/or unsafe sex.

2) The Mammalian Brain (also called the limbic system or midbrain)

This was the second part of our brain to evolve. It is involved in :

– the generation and experience of our emotions

– memory and other aspects of learning

3) The Neomammaliam Brain (also called the neocortex) :

This is the most recently evolved part of our brain and is involved with :

– decision making

– conscious control of social behaviour

– speech / writing

– logic

– purposeful (as opposed to instinctual) behaviour

– planning for the future

– expression of the personality

triune_brain

Which Animals Do We Share These Three Parts Of Our Brain With?

1) Reptilian Brain :

reptilian_brain

We have this part of our brain in common with crocodiles and snakes

2) Mammalian Brain :

mammalian_brain

We have this part of our brain in common with cats and dogs

3) Neomammalian Brain :

neomammalian_brain

We have this part of our brain in common with chimpanzees and gorrilas.

What Has All This Got To Do With Borderline Personality Disorder (BPD)?

If we have suffered significant childhood trauma, it is possible that the physical / biological development of our brains has been adversely affected. And, if we are unlucky, and, especially, if we have a genetic susceptibility, we may, as a result, go on to develop borderline personality disorder (BPD) as adults.

Indeed, a leading theory relating to BPD, is that the brain has developed in an atypical and detrimental manner in connection with our ability to regulate our emotions and control our behaviour.

As such, the neomammalian part of the brain (responsible for conscious control of behaviour, decision -making, planning and logic) may be underactive.

AND :

The more primitive parts of the brain (the reptilian brain and the mammalian brain) may be overactive and too easily to being triggered (e.g. even a very small threat may trigger great activity in the reptilian part of the brain which is responsible for the fight or flight response.

This combination of faulty brain areas can mean that individuals with BPD experience emotions, such as anger and fear, far more frequently, and far more intensely, than the average person; and, also, have a significantly impaired ability to exercise control of their behaviour, make sensible decisions, plan for the future and think rationally.

How Can BPD Sufferers Gain More Control Over Their Feelings And Behaviour?

In order to gain greater control of their lives, it follows from the above theory that it is necessary for BPD sufferers to make the neomammalian part of the brain more dominant and to quieten the more primitive brain areas.

Research shows that an effective way to do this is to practice mindfulness meditation – if possible, on a daily basis.

Resources:

brain damage caused by childhood trauma.

Above ebook now available for instant download on Amazon. Click here for further details.

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

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Copyright 2016 Child Abuse, Trauma and Recovery

Arrested Development : Are Adult BPD Sufferers Eternal 13-Year-Olds?

arrested development

Many people, such as, most famously, the now deceased Michael Jackson during his adulthood, want to be forever young. But be careful what you wish for : new research suggests that those suffering from borderline personality disorder (BPD) may have ceased to develop emotionally at around the age of thirteen years due to the occurrence of severe trauma around this critical period in their psychological development.

In other words, they become emotionally developmentally arrested : puer aeternus (eternal children). Far from being a desirable state, it can make their adult lives all but impossible (click here to read my article about BPD to learn about its main symptoms).

And their consequent behaviour during adulthood, as a result of having BPD, is not like that of a well-balanced and well-adjusted thirteen- year-old, but that of a challenging and difficult one.

arrested development

So, according to this new research, those suffering from BPD can be regarded as being ‘stuck’ in the early adolescent phase of personality and emotional development. Because of this, their emotions remain labile, unstable and turbulent.

In particular, due to this arrested development of the personality, research suggests such individuals will :

– be hypersensitive to rejection

– have poor self-control (eg impulsivity/recklessness/diminished concern for the negative consequences of behaviour)

– have an excessive need for instant gratification

Therapies which may help individuals experiencing the kinds of psychological symptoms that I have referred to above may benefit, in particular, from two specific types of psychotherapy – these are cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT).

 

You can read my article about how cognitive behaviour therapy may be helpful, please click here.

Or, to read my article on dialectical behavioral therapy, please click here.

You may also be interested in reading my post on the so-called Peter Pan Syndrome by clicking here.

For more general information about CBT, click here

For more general information about DBT, click here

 

Resources:

 

Hypnosis control emotionsCONTROL YOUR EMOTIONS : Advanced Self Hypnosis Audio MP3

 

eBook:

BPD, arrested developmet

Above eBook now available for instant download from Amazon. For more detail, click here.

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

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Copyright 2016 Child Abuse, Trauma and Recovery

Those In Grip Of BPD Do NOT Deserve Blame For Their Actions

 

We have seen in many other articles that I have posted on this site that there is a strong association between the experience of childhood trauma and the development of BPD (borderline personality disorder) in later life (to read one of these articles, click here).

Sadly, compounding their problem, those suffering from BPD can be stigmatised by their friends, associates, work colleagues, and even by their own parents and siblings. As well as, of course, by society in general.

One reason for this is that when someone with BPD upsets others s/he may be accused as having behaved badly deliberately, intentionally, wilfully and premeditatively. This state of affairs is, of course, inevitably going to exacerbate yet further the BPD sufferer’s already intense feelings of rejection, isolation, alienation and disenfranchisement.

However, research clearly shows that a mistake is being made in assuming that those in the grip of this serious illness have any real control over their less than helpful behaviours. Indeed, neurological studies have now revealed DIFFERENCES IN THE BRAIN of BPD sufferers compared to non-BPD sufferers that affect, in particular, three dimensions of their behaviour.

These three behavioural dimensions are as follows :

1) Emotional control

2) Impulsivity

3) Cognitive abilities (specifically, learning, memory and reasoning)

NB. BPD sufferers are not an homogenous group and individual BPD sufferers will vary in relation to the extent to which the three behavioural dimensions are adversely affected.

download

What has gone wrong in the brain to cause these 3 behavioural dimensions to be adversely affected?

1) Problems with emotional control (sometimes referred to as EMOTIONAL DYSREGULATION) appears to be connected to disruption of the part of the brain called the AMYGDALA.

2) Problems controlling impulses appear to be connected to disruption of the parts of the brain called the ORBITOMEDIAL and ANTERIOR CINGULATE SYSTEM.

3) Problems relating to learning, memory and reasoning appear to be connected to disruption of the part of the brain DORSOLATERAL PREFRONTAL SYSTEM.

All of the above neural systems can be damaged during their development by the experience of significant childhood trauma. To read my article on this, click here.

download

People who suffer from BPD are also far more susceptible to the negative effects of stress than the average person (which is also due to neurological dysfunction). This is particularly unfortunate as, when a BPD sufferer is under stress, the behavioural dimensions described above are liable to be especially badly affected. It is imperative, therefore, that BPD sufferers who wish to maximise their chances of recovery live in as near to a stress-free environment as is feasible. Indeed, in a supportive, positive, substantially stress – free environment the brain can gradually begin to recover and repair itself. This is due to a quality in the brain known by psychologists as neuroplasticity.

From the above, we may infer the following conclusion:

– dysfunctional behaviours of BPD sufferers are not intentional or deliberate. They are also not premeditated, overturning the cynical theory that BPD sufferers are ‘manipulative’. Essentially, BPD sufferers do not have the social skills, cold, calculating control capabilities (quite the opposite, in fact) and rational planning abilities to be manipulative. They act, impulsively, according to their feelings and cannot help these extremely powerful and overwhelming emotions or their impulsivity to show them. From this perspective, they act authentically.

Neither is their behaviour self-indulgent, as it is not under their control. Indeed, their behaviour tends to ultimately hurt themselves more than anyone else, filling them with shame and self-hatred. People do not willingly choose to be so utterly self-destructive and anyone who thinks they do is a fool.

Above ebook now available for instant download from Amazon. Click here.

(Other titles available).

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

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Copyright 2015 Child Abuse, Trauma and Recovery

The Injustice Of Prejudice Against BPD Sufferers.

It is indeed a tragedy and injustice that many people who suffer from Borderline Personality Disorder (BPD), a condition which can inflict excruciating mental pain on the suffer (10℅ eventually kill themselves), are not only not helped by others, but blamed for the symptoms they display as a result of their illness.

This can result in complete rejection from family and friends, and I state this with the benefit (if that’s the word we’re looking for) of my own bitter experience. Their lack of knowledge, understanding and imagination can lead them (family and friends) to view the BPD sufferer as having a flawed character rather than accept s/he is genuinely, and seriously, ill.

Of course, if one’s family has contributed to one’s illness (there is a strong association between childhood trauma and the later development of BPD) it can very much suit them to blame the sufferer rather than to face up to their own culpability for reasons that are far too obvious to require elucidation from me.

To use an analogy, it’s rather like one’s family beating one to a pulp and then blaming one for bleeding over them and spoiling their clothes, is it not?

The author of Borderline Personality Disorder Demystified, Robert O. Friedel, MD, Distinguished Clinical Professor at Virginia Commonwealth University, states:

Many people believe that the symptoms and behaviours of people with Borderline Personality Disorder should be entirely under their control. This is not the case. To a significant degree, Borderline Personality Disorder is the result of disturbances in brain pathways that regulate emotion and impulse control. In other words, this is a true medical disorder, and, basically, no more under one’s control than diabetes or hypertension.’

I rest my case.

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

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Copyright 2015 Child Abuse, Trauma and Recovery