Category Archives: Bpd Articles

Linehan’s Biological Vulnerability Model Of BPD

BPD and biological vulnerability

 

 

 

Linehan (1993) proposes that various biological aberrations contribute to borderline personality disorder (BPD) which causes sufferers great difficulty controlling (regulating) their emotions. Linehan described this impaired ability to regulate emotions as consisting of three key factors :

Three Key Factors Contributing To Impaired Self-Regulation Of Emotions :

1) Heightened emotional sensitivity (particularly in relation to experiences that give rise to negative emotions, according to research by Jacob et al., 2008)

2) Inability to regulate intense emotional responses (again, particularly in relation to negative emotions)

3) Slow return to emotional baseline (ie. once emotionally upset, the BPD sufferer finds it very hard to calm down again)

Is Being Highly Sensitive A Bad Thing?

Linehan points out that, in fact, being highly sensitive, per se, should be seen as neither a good thing nor a bad thing, but, rather, it should be viewed in neutral terms ; whilst those with BPD frequently find their high level of sensitivity causes them immense mental turmoil and suffering, such individuals can learn to make their sensitivity work for them rather than against them with help from a skilled and experienced therapist.

biological vulnerability

Biology Of Borderline Personality Disorder (BPD) – The Limbic System:

As stated above, Linehan proposed that individuals who develop BPD may have a biological predisposition to do so (such as abnormalities in the brain’s limbic system) and, whether these individuals develop BPD or not, will depend upon the environment in which they grow up. Childhood environments that are especially likely to lead to the development of BPD, according to Linehan, are those which are INVALIDATING (invalidating environments are ones in which the parents significantly inhibit the child’s healthy expression of emotions).

Other Biological Factors Thought To Be Associated With BPD :

Since Linehan first proposed her theory of how biological vulnerability and BPD may be interlinked, far more research has been conducted on the topic. From this research, it has been found that sufferers of BPD tend to have :

amydalae (see notes below) that are of smaller than average volume

hippocampi (see notes below) that are of smaller than average volume

– underactive prefrontal cortices (see notes below)

– lower than average levels of serotonin (see notes below)

It has also been hypothesized that the activity of the neurotransmitter, dopamine (see notes below), and the hormone, vasopressin (see notes below) , may be disrupted in individuals suffering from borderline personality disorder (BPD).

NOTES :

Amygdala – a region of the brain involved in various emotional processes

Hippocampus – a region of the brain involved in the consolidation of new memories

Prefrontal Cortex – functions of this brain region include discerning right from wrong, repressing unacceptable social behaviour, planning and other complex processes. It is also crucially involved with the development of the personality.

 – Serotonin – is a neurotransmitter that has been described as ‘a natural mood stabilizer’ and is involved in sleep and the regulation of anxiety (amongst other processes). Many experts subscribe to the theory that low levels of serotonin in the blood (and it is supposed, therefore, but not proven, in the brain) are associated with depression.

Dopamine – this neurotransmitter is involved in motivation, reinforcement of behaviour through reward, arousal, sexual gratification, control of the body and executive function (including problem solving, planning, reasoning and inhibitory control).

 – Vasopressin – this is a hormone that can be released directly into the brain and there exists a growing body of research that suggests it may be involved in sexual motivation, pair bonding and social behaviour.

 

eBook :

BPD childhood

Above eBook now available from Amazon for instant download. Click here for further details.

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

 

 

Click here for reuse options!
Copyright 2017 Child Abuse, Trauma and Recovery

Emotional Intensity Disorder

emotional intensity disorder

Many who have been diagnosed with borderline personality disorder (a condition strongly associated with a history of significant and long-lasting childhood trauma) resent the label, preferring instead to consider themselves as having complex post traumatic stress disorder (although this diagnosis has still to be formally acknowledged and is not yet included in the DSMDiagnostic And Statistical Manual Of Mental Illness) or, more recently, emotional intensity disorder.

This is largely due to the fact that many patients and clinicians consider the label borderline personality disorder to be stigmatizing, demeaning and even insulting as it seems to imply the person’s whole personality (and, perhaps, by extension, character), is fundamentally flawed, giving him/her the status of social outcast and pariah – this, of course, can only exacerbate their isolation, and illness, further. NOT HELPFUL! (Especially as it is the experience of profound rejection, often by parents and other family members, which has contributed to the illness in the first place.

emotional intensity disorder

Other terms have also been considered to replace the borderline personality disorder label; I list these below :

– emotionally unstable personality disorder (not much of an improvement, it has to be said!)

– emotional regulation disorder

– emotional dysregulation disorder

– impulsive personality disorder

– impulsive emotional dysregulation disorder

Emotional Problems Of Those With BPD :

So, what emotional problems do people with BPD suffer? Below, I attempt to summarize them:

– rapid and dramatic mood swings

explosive rage and anger, even in response to (objectively speaking) minor provocations

– emotions so intense the individual experiencing them feels ‘out of control’

– incongruous emotional displays (such as crying at times that the majority of people would find ‘inappropriate’).

– experiencing of strong emotions which seem to ‘come out of nowhere.’

– suicidal impulses

depression

– feelings of ’emptiness’

intense psychological pain (often this leads to ‘self-medicating’ behaviour (i.e. excessive use of drugs and/or alcohol)

– extreme fear of abandonment

paranoia

– impulsivity

(The above list is not exhaustive; to read my article on borderline personality disorder, click here).

 

What Causes These Emotional Problems?

– imbalances in the brain of certain chemicals ; in particular, dopamine and serotonin

– childhood trauma (such as neglect, abuse, rejection, loss, grief and abandonment)

– further research needs to be conducted on the contribution of genes

How Common Are These Problems?

About one in every fifty people suffer from these severe emotional problems I refer to above. Also, women are about three times more likely to suffer from them than men. For most sufferers, the condition improves once the individual approaches middle-age.

Currently, one of the most effective treatments for borderline personality disorder is dialectical behaviour therapy (DBT). Many sufferers also find mindfulness training and cognitive behavioural therapy (CBT) helpful.

Resource (click on image below for details):

borderline personality disorder

 

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

 

Click here for reuse options!
Copyright 2017 Child Abuse, Trauma and Recovery

BPD, Algopsychalia And Examples Of Specific, Amplified Emotions

algopsychalia

In my last article I wrote about how borderline personality disorder (BPD) sufferers are especially likely to suffer from intense, tormenting, psychological pain, a condition known as algopsychalia. Why is this?

What Are The Possible Causes Of This Pain?

The causes of this pain are highly complex; however, one interesting theory put forward by Schneidman is that algopsychalia comes about as a result of unfulfilled and frustrated psychological needs.

 

What Are These Unfulfilled And Frustrated Psychological Needs?

According to Schneidman, these include :

– affiliation / meaningful connection with others

– love

– personal autonomy / a sense of control over one’s own life

– achievement

– the need to avoid shame

Also, associated with such unfulfilled and frustrated needs, sufferers of BPD experience particularly intense, negative emotions. Indeed, all negative emotions felt by BPD sufferers are, in general, more amplified, and, therefore, generate more psychological pain, than is the case for the ‘average’ person.

Examples Of Amplified Negative Emotions In BPD Sufferers Contributing To Psychological And Emotional Pain :

amplified emotions

  • instead of becoming annoyed or irritated the BPD sufferer may well, instead, fly into an uncontrollable rage and fury from which s/he is not easily able to calm down.
  • instead of mild or moderate embarrassment, the BPD sufferer may experience on overwhelming and profound sense of shame
  • instead of feeling mildly apprehension, the BPD sufferer may experience a severe, full-blown panic attack, complete with hyperventilation and fear of imminent and impending death
  • instead of feeling sadness, the BPD sufferer may suffer a sense of deep and intense grief.

To make the adverse effects of these terribly painful emotions worse still, those suffering from BPD find it very difficult indeed to self-comfort or self-sooth when experiencing such feelings due to early life disruption to the development of certain critical brain regions. (To read my article entitled : ‘Three Critical Brain Regions Harmed By Childhood Trauma’, click here).

RESOURCES :
1) Article about DISTRESS INTOLERANCE – click here

2) Article about DIALECTICAL BEHAVIOUR THERAPY (a therapy specifically developed to help those suffering from BPD and difficulty controlling their emotions) – click here

3) HYPNOSIS DOWNLOADABLE MP3/CD – CONTROL YOUR EMOTIONS -click here.

 

David Hosier BSc Hons; MSc; PGDE(FAHE)

Click here for reuse options!
Copyright 2017 Child Abuse, Trauma and Recovery

BPD Sufferers Up To Ten Times More Likely To Be Homosexual

 BPD and homosexuality

A study conducted by Reich and Zanarini (2008) involving the interviewing of 362 psychiatric inpatients (290 of whom were suffering from borderline personality disorder ; the remaining 72 were included in the study for comparison purposes and had personality disorders other than BPD).

THE INTERVIEWS :

All of the 362 participants in the study were given interviews in which they were asked about their sexual orientation and the gender of their intimate partners.

RESULTS OF THE INTERVIEWS :

1) Those individuals suffering from BPD were significantly more likely than individuals from the comparison group to identify as having a homosexual or bisexual sexual orientation.

2) Those individuals suffering from BPD were significantly more likely than individuals from the comparison group to report having same-sex relationships.

(The above results were not significantly different in relation to whether the interviewee was male or female).

BPD and homosexuality

In another study, published in the American Journal of Psychiatry, it was found that, from a sample of 80 individuals (nineteen of whom were male and sixty-one female) who had been diagnosed with BPD :

  • 21 % were homosexual (this percentage breaks down to 53℅ of the men with BPD and 11% of the women with BPD – quite a gender difference!)
  • 5 ℅ were bisexual
  • 11℅ were diagnosed as having a paraphilia

How Do The Above Figures Compare To The General Population?

According to this study :

Men diagnosed with BPD are TEN TIMES more likely to be homosexual than are men randomly selected from the general population.

Women diagnosed with BPD are SIX TIMES more likely to be homosexual than are women randomly selected from the general population.

The Velvet Rage :

In his book, The Velvet Rage, Alan Downs, PhD, examines the reasons that might explain why gay men are far more prone than straight men to suffering from mental health conditions, including depression, sex addiction, alcohol and drug dependence, as well as being at elevated risk of committing suicide.

In doing so, he suggests that the emotional pain of growing up gay in a predominantly heterosexual world, especially if it encompasses feelings of shame and invalidation, significantly contribute to the development of mental health problems. His book is available from Amazon :

Resource :

Let go of shame

 Let Go Of Shame – Downloadable MP3 / CD – click here.

 

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

Click here for reuse options!
Copyright 2017 Child Abuse, Trauma and Recovery

BPD And Algopsychalia

algopsychalia

For several years, unremittingly, I was in a constant state of intense psychological torment. I realize this sounds melodramatic or exaggerated. It isn’t. In fact, no words can fully convey the intensity of the mental anguish from which I suffered.

I would complain to others I had a ‘terrible pain in my head’, neither physical nor solely mental, but some appalling, inarticulable, combination both. I constantly meditated on suicide as an escape : thinking about it, talking about it to anyone who would listen (other psychiatric inpatients when I was in hospital, cab drivers, even, once, when I was in a desperate state, sobbing, to complete strangers in a coffee bar – much to their alarm), planning it, researching how to do it online, buying various items to make it practicable (including, once, a rope with which to hang myself – a surprisingly complex purchase involving considerations of thickness, strength and length) and, more than once, attempting it. Indeed, the knowledge I could escape my pain by suicide was, ironically, the only reason I was able to endure it.

algopsychalia

I told various psychiatrists about this, but, having experienced some psychiatrists to whom it was difficult to warm, I frequently felt paranoid in their presence and believed if I used terms like ‘psychological torment’ and ‘mental torture’ to describe my emotional state they’d regard me as an hysteric prone to exaggeration.

Instead, I used terms like ‘severe mental pain’ or ‘intense mental pain.’ Now, you’d think (would you not?) that that was putting it strongly enough to galvanize them into immediate and fervent therapeutic action. Stunningly, however, the usual response was a blank stare, a barely perceptible nod and a quick Biro jotting in their notebook (although I would not be surprised, in some cases, if they carried out this latter action because they were working on their shopping list at the time).

Another name for the mental anguish I describe is ALGOPSYCHALIA. This condition is particularly prevalent amongst people who suffer from borderline personality disorder (BPD).

Indeed, research shows that those with BPD are worse affected by algopsychalia than are people with any other personality disorder and/or mood disorder (including bipolar and unipolar depression).

This is, perhaps, why approximately 10% of those suffering from BPD end their lives by suicide and why many, many more BPD suffers unsuccessfully attempt suicide.

It also helps to explain why so many BPD sufferers seek to escape their pain through any means possible, such as overeating, chain-smoking, taking illegal drugs, gambling, compulsive sex and physical self-harm (to detract attention from mental pain and to release endorphins into the brain) amongst other forms of dissociation.

TREATMENT :

There is some research to suggest that several weeks of treatment with paracetomal my help alleviate certain aspects of this mental suffering (this is theorized to be the case because aspects of both physical and mental pain are processed by the same brain regions). Always consult a doctor when considering taking medications to treat BPD and other serious conditions.

Learning, and then regularly practicing, mindfulness has also been shown to be of therapeutic value.

Hypnosis can be utilized to alter the meaning we attribute to pain and, by doing so, alter our perception of it.

 

RESOURCES :

Pain relief Hypnosis for pain relief : click here.

 

 

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

Click here for reuse options!
Copyright 2017 Child Abuse, Trauma and Recovery

Symptoms Of Dissociation : Mild And Severe

symptoms of dissociation

If we have suffered significant childhood trauma, we may, as adults, frequently find ourselves in various states of dissociation, ranging from mild to severe. Indeed, dissociation is a key feature of complex posttraumatic stress disorder (Cptsd).

What Is Meant By The Term ‘Dissociation’?

Dissociation is a symptom of the effects of childhood trauma which we developed as a defense mechanism in order to better equip us to cope with the emotionally painful and destructive environment in which we grew up. It is a way of mentally escaping and psychologically cutting off from reality; it is sometimes colloquially referred to as ‘zoning out’ or ‘tuning out’.

Dissociation And Flooding :

We are particularly likely to dissociate when we feel overwhelmed, or ‘flooded’, by stress and psychological threat. Symptoms of dissociation can range from mild to severe. I outline examples of such symptoms below:

symptoms of dissociation

Mild symptoms include:

– feeling in a daze (sometimes referred to as ‘mind fog’),

– feeling utterly exhausted, numb and soporific for no obvious reason,

– finding oneself tongue-tied when trying to talk about difficult experiences (as if experiencing a kind of mental block).

 

More severe symptoms include:

– amnesia for certain events, or large periods of time, in one’s life (for example, I have no memory whatsoever of large chunks of my childhood) – such ‘dissociative amnesia’ far exceeds normal forgetfulness.

time loss : an individual may suddenly find him/herself in a particular place, with no memory of how s/he got there, unable to remember anything that has occurred in the recent past (eg the last few hours or days)

feeling very out of control (eg uncontrollably angry)

– periods of apparent deafness (at my first school, when things were at their worst at home between my parents, at times I did not respond to my name being called out in class – the school thought I was suffering from deafness; in fact, though, the cause was deep psychological trauma. This is certain as it became apparent this ‘deafness’ only occurred when the class was discussing parents/family matters or associated topics).

symptoms of association

 

Dissociation And Switching:

Some people dissociate when under extreme stress (ie when ‘flooded’, see above) in a way that almost resembles ‘changing personality’; this is referred to as ‘switching’.

In fact, it is NOT a literal switch of personality, but a switch of ego states/states of consciousness sometimes referred to by psychologists as ‘parts’ or ‘alters.’

Studies suggest that nearly all people who suffer such switching have experienced severe early life trauma. It is NOT a genetic disorder.

When a person switches due to stress, they switch from the ego state/state of consciousness/part/alter that s/he relies on for his/her day-to-day functioning to the ego state/state of consciousness/part/alter that is normally dissociated/’kept in a separate compartment’ in mind (it is this separation that allows the individual to function daily, by preventing the feelings in the dissociated part from interfering in it).

This dissociated part contains profoundly painful trauma related feelings such as fear, shame and anger.

 

Can dissociation be treated?

The short answer is, YES.

Individuals can be helped by becoming aware of the link between their childhood trauma and the dissociated part of their mind that they switch to when under severe stress.

As well as this, individuals suffering from dissociation can be enormously helped by learning the skills of mindfulness. Mindfulness, essentially, helps a person to live in the present/the ‘here and now’, rather than staying trapped in the past.

RESOURCES :

Excellent site about MINDFULNESS – mindfulness.org

eBook :

childhood trauma and homosexuality

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

 

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

Click here for reuse options!
Copyright 2017 Child Abuse, Trauma and Recovery

Questioning The Borderline Personality Disorder (BPD) Diagnosis

We have seen that if a person has suffered significant and protracted childhood trauma, s/he is at greatly increased risk of being diagnosed, as an adult, with borderline personality disorder (BPD). According to the Diagnostic and Statistical Manual of Mental Disorders (usually abbreviated to DSM), a person diagnosed with BPD must meet at least FIVE of the following nine criteria:

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

NB These symptoms must have been stable characteristics present for at least six months

questioning BPD diagnosis

However, some theorists and researchers have pointed out certain problems with defining BPD in this manner and question the validity of the diagnosis; I outline the most serious of these problems below :

1) In order to be diagnosed with BPD, a person need display just five of the above nine symptoms. It logically follows from this that two people could each be diagnosed with five of the above symptoms, yet have only one of those five symptoms in common with one another. In other words, two people could each be manifesting very different symptoms, yet receive identical diagnoses.

2) Stipulating that an individual must have five or more of the above symptoms is essentially arbitrary (why not four or six?). Also, linked to this criticism, there seems to be a third problem with the diagnosis :

3) The third problem is this : a person with four of the above symptoms, even if they were very severe, would have to be (according to the diagnostic criteria) diagnosed as NOT having BPD whereas a person who just manages to be judged to be displaying five symptoms (even if none are as severe as the first person’s four symptoms) WOULD be diagnosed as having BPD. This brings us onto the fourth problem with the diagnosis :

4) In accordance with the diagnostic criteria, an individual is either deemed to HAVE BPD or NOT HAVE BPD. In other words, it is an ‘all or nothing’ diagnosis which doesn’t allow for grey areas. This is ironic as one of the symptoms BPD sufferers are said to show is ‘black and white’ or ‘all or nothing thinking’ (such as seeing others as ‘all good’ or ‘all bad’ but never as anything inbetween).

Because of this problem, some critics have suggested that it would be better to view BPD as a ‘spectrum’ disorder, with each individual occupying a specific place on this spectrum (in the way that autism is treated as a spectrum disorder).

5) A diagnosis of BPD does not seem to describe a unique, separate, distinct disorder clearly delineated from other personality disorders ; indeed, many who have been diagnosed with BPD are found to suffer from comorbid conditions such as antisocial personality disorder and narcissistic disorder

In conclusion it should be mentioned that many critics of the BPD diagnosis feel many individuals have been wrongly diagnosed with it (and unnecessarily stigmatized) and should be diagnosed with complex post traumatic stress disorder instead.

In relation to the above, you may wish to read these other posts:

Other Resources :

eBooks :

digital_book_thumbnail-1

 

Above eBooks now available from Amazon for instant download. Click here for further information.

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

Click here for reuse options!
Copyright 2016 Child Abuse, Trauma and Recovery

Can Children Be Diagnosed With Borderline Personality Disorder (BPD)?

Borderline personality disorder (BPD) is usually diagnosed in adulthood or late adolescence. But can children suffer from this serious psychiatric condition?

Unfortunately, there exists a paucity of academic research published on this particular topic, but some research and evidence relating to the question does exist, some of which I look at here.

Anecdotal Evidence Reported By Parents Of Adult Children With A BPD Diagnosis :

Whilst anecdotal evidence is not scientific, many scientific theories, hypotheses and research projects are preceded by, and have their foundations in, anecdotal evidence, so it shouldn’t automatically be contemptuously dismissed. So what is the anecdotal evidence that has been collected from parents?

Many parents with (now grown-up) children who have been diagnosed with borderline personality disorder (the adult children, not the parents) have reported that signs of BPD in their offspring started to show in early childhood and included the following :

  • particular proneness to worry
  • particular proneness to bouts of sadness
  • a greater than normal need for attention
  • hypersensitivity, especially in relation to criticism
  • proneness to becoming very easily frustrated
  • a susceptibility to developing physical symptoms in response to stress (called psychosomatic illness) such as headaches and stomach upsets
  • proneness to irritability, anger, rage and temper tantrums
  • easily upset

However, it is important to point out that not all parents of adult children diagnosed with BPD reported that these offspring had such childhood symptoms.

Image result for bpd

Studies Related To The Question Of Whether Children Can Be Diagnosed With Borderline Personality Disorder (BPD).

In 1983, Cohen et al (Yale University) devised a set of diagnostic criteria for children suffering from what they called borderline syndrome; however, after further research they renamed the condition multiple complex developmental disorder (MCDD). This disorder incorporates three main categories of symptoms which are as follows :

  • poorly controlled (regulated) emotions
  • impaired perception and thinking
  • markedly disturbed relationships

NB The above symptom categories also occur in borderline personality disorder and complex post-traumatic stress disorder. (It should be noted, too, that MCDD has not been included in either DSM IV or ISD-10).


MCDD is also associated with anxiety conditions, psychotic thought processes and disruptive behaviour (de Bruin et al, 2007)

Physiological Basis :

Cohen also pointed out that many of these children were found to have physiological brain disturbances and believed that there was a biological basis to MCDD. This adds further to the obvious argument that children affected in such a way are in crucial need of understanding, treatment and therapy – not judgment.

Vital Importance Of Early Detection And Treatment:

Whilst it may well be stigmatizing to be ‘labelled’ with borderline personality disorder (or similar condition), early detection of the disorder, or of symptoms displayed in those at risk of developing such conditions, is vital so that effective therapy may be started. The earlier detection and effective, sensitive, expert treatment begin, the better are likely to be the results of treatment (indeed, if left untreated, such conditions are likely to become more severe, entrenched and complex).

 

Finally, it must once again be reiterated that environmental factors / childhood trauma / childhood abuse are strongly linked to the development of BPD and similar conditions. In other words, a child with a genetic/biological predisposition that puts him/her at risk of developing BPD, or similar condition, may not do so if s/he grows up in a secure, loving stable family, whereas a child similarly genetically/biologically predisposed is at far greater risk of doing so.

 

   

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

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

Click here for reuse options!
Copyright 2016 Child Abuse, Trauma and Recovery