Category Archives: Bpd Articles

Dialectical Behavior Therapy for Borderline Personality Disorder (BPD).

childhood-trauma-fact-sheet

DIALECTICAL BEHAVIOR THERAPY (DBT) is an exciting new treatment option for those suffering with BPD. It is a therapy which has elements in common with cognitive behavioral therapy (CBT).

It is an evidence-based treatment (ie it is backed by scientific research).

In the past, BPD was considered to be extremely difficult to treat, but, with the development of therapies such as CBT and DBT, the prognosis is now far more optimistic.

DBT was originally created by the psychologist Marsha Lineham; at first, it was developed with the treatment of females who self-harmed and were suicidal in mind. However, since then, its possible applications have become much broader; it is now used to treat both males and females suffering from a large array of different psychological conditions.

As already stated, DBT has many elements in common with CBT; in addition to this, it also borrows from ZEN and a therapy, which is becoming increasingly popular, called MINDFULNESS.

DBT has been particularly successful in the treatment of BPD (for information about BPD see Category 3 of the main menu : BORDERLINE PERSONALITY DISORDER AND ITS RELATIONSHIP TO CHILDHOOD TRAUMA). It is thought that one of the main CONTRIBUTING FACTORS of BPD is a traumatic childhood in which the child grows up in an INVALIDATING ENVIRONMENT (eg made to feel unloved and worthless). Such a childhood environment is especially likely to result in the child developing BPD in later life if he/she also has a BIOLOGICAL VULNERABILITY (carries certain genes making him/her particularly vulnerable to stress).

When a person is suffering from BPD the condition causes him/her to REACT WITH ABNORMAL INTENSITY TO EMOTIONAL STIMULATION; the individual’s level of emotional arousal goes up extremely fast, peaks at an abnormally high level, and, takes much longer than normal to return to its baseline level.

This condition leads to the affected individual – a victim of his/her uncontrollable, intense emotional reactions – prone to stagger in life from one crisis to the next and to be perceived by others as emotionally unstable. It is thought that, due to the invalidating environment which the sufferer experienced in childhood, the normal ability to develop the coping strategies needed to regulate emotions is blocked, leaving the person defenceless against painful emotional feelings and leading to maladaptive (unhelpful) behaviors.

It is this problem which DBT was is now used to address. The therapy teaches individuals how to cope with, and regulate, their emotions so that they are no longer dominated and controlled by them. This is vital as the inability to control feelings will often wreck crucial areas of life, including friendships, relationships and careers. It is because of these possible effects that DBT also helps individuals develop SOCIAL SKILLS to help reduce the likelihood of them occurring.

DBT has been found to be effective in helping people suffering from a large range of psychiatric conditions; these include;

– self-harming
– depression
– suicidal ideation
– bipolar
– anxiety
– ptsd
– eating disorders
– substance abuse
– low self-esteem
– problems managing anger
– problems managing relationships/friendship

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

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Copyright 2013 Child Abuse, Trauma and Recovery

Latest Research Leads to New List Of Main Borderline Personality Disorder (BPD) Symptoms: The List

childhood-trauma-fact-sheet

Recent research has led to an expansion of the description of the main symptoms of BPD. Following the development of the Sheldern Western Assessment Procedure 200 (an assessment tool which includes 200 questions that aid in the diagnosis of BPD) experts, based on up-to-date research, have now developed a much more detailed and comprehensive list of symptoms of BPD than used to be the case. The list is published in a book by Patrick Kelly and Francis Mondimore -called Borderline Personality Disorder – New Reasons For Hope – who are experts in the field of BPD. I reproduce the list of symptoms in full below:

SYMPTOMS OF BPD SUFFERERS:

– FULL OF PAINFUL AND UNCOMFORTABLE EMOTIONS : unhappiness, depression, despondency, anxiety, anger, hostility.

– INABILITY TO REGULATE EMOTIONS : emotions change rapidly and unpredictably; emotions tend to spiral out of control leading to extremes in feelings of anxiety, sadness, rage, excitement; inability to self-soothe when distressed so requires involvement of others ; tends to catastrophize and see problems as unsolvable disasters ; tends to become irrational when emotions stirred up which can lead to a drop in the normal level of functioning ; tends to act impulsively without regard for the consequences

– BECOMES EMOTIONALLY ATTACHED TO OTHERS QUICKLY AND INTENSELY : develops feelings and expectations of others not warranted by history or context of the relationship ; expects to be abandoned by those s/he is emotionally close to ; feels misunderstood, mistreated and victimized ; simultaneously needy and rejecting of others (craves intimacy and caring but tends to reject it when it is offered) ; interpersonal relationships unstable, chaotic and rapidly changing.

– DAMAGED SENSE OF SELF : lacks stable self-image ; attitudes, values, goals and feelings about self may be unstable and changing ; feels inadequate, inferior and like a failure ; feels empty ; feels helpless, powerless and at mercy of outside forces ; feels like an outsider who does not belong ; overly needy and dependent ; needs excessive reassurance and approval.

Quite a list! These symptoms, in my case, ring all too familiar sounding bells ; so much so, in fact, that a set of ear-plugs would not go amiss. Actually, I feel exhausted just by having typed the list out! I think I’ll go and have a lie down.

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

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Copyright 2013 Child Abuse, Trauma and Recovery

Borderline Personality Disorder (BPD) : Further Treatment Options.

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Individuals suffering from psychiatric conditions such as borderline personality disorder (BPD) find there are a vast array of therapies on offer purporting to be able to effectively treat them. The choice can seem overwhelming and confusing.

In the case of BPD, however, although many different therapists may claim that the particular therapy that they offer is beneficial, research shows that there are only a few which result in significant improvement.

Cognitive Behavioural Therapy (CBT) is one example of an effective treatment, but, as I have dealt with that in several of my other posts (just enter ‘CBT’ into this site’s search facility if you are interested in reading any of them) so will not discuss it further here. Instead, in this post I will look at the following 4 evidence-based therapies for individuals suffering from the condition of BPD. These are:

1) DIALECTICAL BEHAVIOUR THERAPY (DBT)

2) MENTALIZATION BASED THERAPY (MBT)

3) TRANSFERENCE-FOCUSED PSYCHOTHERAPY (TFP)

4) SCHEMA THERAPY

Let’s look at each of these in turn:

DIALECTICAL BEHAVIOUR THERAPY –

this was the first therapy specifically designed to treat BPD. Research into its effectiveness have yielded encouraging result : it reduces the risk of the individual who undergoes it from attempting or commiting suicide, and, further, after a year of being treated with DBT many show a significant improvement in their condition (although, despite this improvement, they may still feel substantial emotional distress; due to this fact, it is clear treatment programs lasting significantly longer than a year need to be implemented and assessed).

What does DBT involve? The therapy uses a combination of psychotherapy and group therapy. The group therapy helps the individual recognise that his/her intense emotions often get out of control, in a destructive way, and teaches techniques related to how these emotions may be regulated (controlled) by the individual who suffers them.

DBT is strongly influenced by Buddhist philosophy, and, drawing from it, encourages the individual to accept his/her distress (see my post entitled ‘Why Fighting Anxiety can Make It Worse’ for more on why such an approach is effective); it also encourages the individual being treated to meditate to calm down the inner emotional storms that may often rage within them.

In conclusion, it is worth saying that although much research suggests that DBT is very effective for treating BPD, because it is complex, and uses techniques from several other therapies, it is difficult for researchers to know exactly which elements of the therapy are the effective ones. More research is necessary to answer that question.

MENTALIZATION BASED THERAPY –

MBT, like DBT, was designed specifically to treat borderline personality disorder. MBT is largely based upon the idea that the core reason why individuals develop BPD is that they EXPERIENCE PROBLEMS EARLY IN LIFE IN CONNECTION WITH HOW THEY BONDED, AND RELATED TO, THEIR PRIMARY CAREGIVERS, which, in turn, leads to them experiencing further DIFFICULTIES WITH FORMING AND MAINTAINING RELATIONSHIPS IN LATER LIFE. MBT seeks to help the individual suffering from BPD empathize with others, ‘put themselves in their shoes’, and develop awareness and understanding in relation to how their volatile emotional outbursts affect others (people with BPD tend to have an impaired ability to do this if they do not seek out trewatment).

So far research into the effectiveness of MBT has been encouraging. It has been found to:

– reduce hospitalizations

– reduce suicidal behaviours

– improve day-to-day functioning

TRANSFERENCE-FOCUSED PSYCHOTHERAPY (TFP) –

this type of therapy is based upon the theory that individuals who suffer from BPD often have severe difficulties with their perception of interactions with others. Following on from this observation, the theory also assumes that the BPD sufferer will tend, too, to misinterpret his/her relationship with the therapist. In order to try to correct these chronic misperceptions and misinterpretations relating to the individual’s personal interactions, the therapist helps the individual gain awareness of what is going wrong with his/her interpersonal interactions and teach him/her strategies and techniques which help to correct the problem. Research into the effectiveness of TFP continues.

SCHEMA THERAPY –

SCHEMAS are deeply embedded CORE BELIEFS ABOUT ONESELF, OTHERS and THE WORLD IN GENERAL; these deeply held beliefs are LAID DOWN IN CHILDHOOD. The therapy aims to change the BPD sufferer’s NEGATIVE, MALADAPTIVE and UNHELPFUL SCHEMAS into more POSITIVE, ADAPTIVE and HELPFUL ONES.

Early research into the effectiveness of this type of therapy suggests that it can significantly improve quality of life and reduce BPD symptoms. Whilst these findings are encouraging, it is necessary to carry out further research into the therapy’s effectiveness.

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

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Copyright 2013 Child Abuse, Trauma and Recovery

Childhood Trauma, Borderline Personality Disorder (BPD) and Dissociation.

childhood trauma

I have already written posts explaining the connection between childhood trauma and BPD. An important symptom of BPD is DISSOCIATION, which this post will examine in greater detail.

Dissociation is generally considered to be a COPING MECHANISM in response to severe trauma or stress. The phenomenon of dissociation can involve feeling disconnected from one’s emotions, one’s memories, one’s thoughts or even from reality itself. It is common in those suffering from BPD; BPD frequently occurs in individuals who have experienced childhood trauma.

Dissociation is, essentially, a way of ‘escaping’ from the stressful situation, or memory of the stressful situation, by changing one’s state of consciousness (this often occurs automatically and without intention); sometimes people report feeling ‘numb’. In situations of terror, one may dissociate, and, paradoxically, feel a detached state of calm. It may feel, too, that the traumatic event is not happening to oneself, but that one is ‘observing the traumatic event from outside of the body’, leading to passivity and emotional detachment.

Dissociative feelings of ‘being outside of oneself’ are described as DEPERSONALIZATION and dissociative feelings of being disconnected from reality are described as DEREALIZATION.

Some experts have described dissociation as working a bit like morphine – dampening down emotional and physical pain. However, it is yet to be properly explained what the exact biological mechanisms are that underpin the dissociative experience.

images

The four main types of dissociation are:

1) DISSOCIATIVE AMNESIA
2) DISSOCIATIVE IDENTITY DISORDER
3) DISSOCIATIVE FUGUE
4) DEPERSONALIZATION DISORDER

Let’s look at each of these in a little more detail:

1) Dissociative Amnesia: here, large parts of, or all, the traumatic event/s cannot be remembered.

2) Dissociative Identity Disorder: this is also known as MULTIPLE PERSONALITY DISORDER. Here, the person adopts two or more distinct, utterly different personas. The different personas talk in different voices, use different vocabularies etc (they can also actually differ in handedness). The different personas do not have access to ‘each others” memories, studies have shown, so they have distinct ‘personal histories’. It is likely that each persona represents a different strategy for coping with stress.

3) Dissociative Fugue: in this state, individuals can disconnect from their previous personalities, and, then, often, travel far from home to take on, and live under, a completely new persona. They may appear normal to others who have never met them before, even though they are living under a completely new identity, having left a whole life and set of memories behind.

4) Depersonalization Disorder: in this state, individuals can feel detached from their bodies or experiences. A phrase I read in a novel recently may aptly illustrate the sensation: ‘it’s like living in a dream underwater.’

A large number of people who have suffered extreme childhood trauma report experiencing such automatic dissociative states. Furthermore, they may often seek to induce dissociative states, deliberately and artificially, as a way of escaping the constant psychological pain resulting from the initial trauma by, for example, USING ALCOHOL TO EXCESS, USING NARCOTICS, SELF-HARMING or GAMBLING. The kinds of psychological state from which the individual is seeking to escape through dissociation include INSOMNIA, NIGHTMARES, FEELINGS OF RAGE and INTENSE ANXIETY.

LONG-TERM PROBLEMS OF DISSOCIATION:

Dissociation may be helpful (adaptive) in the short-term but problems develop when the state persists long after it has served any beneficial purpose. The psychologist ,Lifton, described prolonged states of ‘psychic numbing’ and ‘mental paralysis’ often resulting from a dissociative response to severe trauma. This can make even basic day-to-day functioning extremely problematic and requires professional intervention.

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

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How Adult Children Can Manage Their Relationship With Parents Who Have Borderline Personality Disorder (BPD). Part 2.

 

bpd mother

For Part 1, click here.

IMPROVE RELATIONSHIP WITH MOTHER HYPNOSIS MP3 - CLICK HERE

IMPROVE RELATIONSHIP WITH MOTHER HYPNOSIS MP3 – CLICK HERE

If we have been brought up as children with a parent who has BPD, it is often necessary to seek therapy to help resolve the trauma that we have suffered and to help us come to terms with our loss – in effect, our ‘stolen childhood’.

the unpredictable mood swings of the BPD sufferer

Above : the unpredictable mood swings of the BPD sufferer

In therapy, it may often be necessary to work through the resentment we might well feel (particularly as this feeling of resentment can be deeply painful for us to carry around) and consider how our lives have been adversely affected.

Also, we may want to work with our therapist to consider what positive or useful things we may have learned from our difficult childhood, perhaps through strategies we adopted to deal with this problematic period of our lives, or from other, more positive, role models (eg teachers, friends, counselors etc).

Reviewing things in such a way can bring to the surface very painful feelings, and, if we do not have a therapist to speak to, talking things over with a sensitive and compassionate friend can be valuable.

Releasing emotions connected with our past through ‘talking them out’ can help us to move forward in our lives. Until we do this, our emotional development can remain arrested (‘stuck’), as I am quite convinced happened in my own case for more years than I care to recollect.

One way in which we can express our, perhaps, long pent-up feelings towards the parent with BPD is to write them a letter describing how their behaviour made our lives so stressful and painful. (It is usually better not to actually send the letter as this runs the risk of making matters worse still; however, some therapists may have different views.)

HOW, AS AN ADULT CHILD, WE CAN NOW PROTECT OURSELVES FROM OUR PARENT WITH BPD?

Individuals with BPD find it very hard to understand that others have personal boundaries, thus it is necessary to put more effort into establishing such boundaries with a parent with BPD than might otherwise be the case.

In some cases, it may be necessary to cut off completely from the parent with BPD, as the relationship is mutually destructive and it appears that this is beyond remedy. That, very sadly, was the decision I had to take with my own mother.

However, such drastic action may not be required; it might, instead, be necessary to make it clear we are unable to cope with constantly supporting the parent with BPD with their endless emotional problems as we have our own to deal with; that we need time alone/personal space/privacy; or that we are not prepared to discuss certain topics which always give rise to unpleasantness, hurt and pain.

These are just examples; there may be several other areas in which we need to make clear our boundaries. A parent with BPD will often put their own emotional needs ahead of ours; we need to be clear in our own minds that we have a right to have our own needs respected.

Indeed, we have a duty to ourselves to meet our own needs, especially as so much emotional damage was done to us as children. We need to ASSERTIVELY make this clear.

Of course, our parent with BPD is very likely to respond by trying to make us feel guilty and bad about ourselves for expressing our own needs, so we need to be prepared in advance for this reaction and not to give in to emotional blackmail. We need to maintain our strength and confidence – a good view to take is that we have a duty to protect the hurt child who still resides within us.

As I have said, it is extremely advisable to have support when thinking about making such changes as I have written about, ideally professional. If, however, this is not possible, there are many support groups for people affected by BPD, both online and offline.

RESOURCES :

MP3s:

DEALING WITH DIFFICULT PEOPLE MP3 – CLICK HERE

 

EBOOKS :

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

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Borderline Personality Disorder and Reasons for Low Self-Esteem.

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We come to form our beliefs, including those about ourselves, through our life experiences. Of course, the beliefs we hold because of what has happened to us in life can be very inaccurate.

Experiences that we have early in life have a particularly strong impact on how we feel about ourselves, and, below, I list some that are likely to lead us to develop a feeling of low self-esteem, leading us to dislike ourselves, overly criticize ourselves, lack confidence, feel unlovable and believe we’re not interesting or important:

– our parents treating us as a constant disappointment in childhood
– being bullied/ left out/ maliciously teased when we were at school
-feeling, or being treated, like we don’t fit in at home – ‘black sheep syndrome’
– suffering prejudice and discrimination when we were children
– experiencing systematic and cruel punishment as children
– being neglected when we were children (eg deprived of love, security, interest, praise etc)
– having constantly to cope with a parent’s distress/emotional needs when we were children, at a cost to ourselves.

I elaborate on each of these below:

OUR PARENTS TREATING US AS A CONSTANT DISAPPOINTMENT IN CHILDHOOD:

This can include parents always putting our mistakes and weaknesses in the spotlight whilst simultaneously ignoring our strengths and the positive aspects of ourselves. It can also involve being constantly ridiculed and teased in a hurtful way ( my own mother referred to me as ‘scabby’, because, as a child, I had the nervous habit of picking at scabs on my arms and legs; and also ‘poof’, because I was highly sensitive ). Over time, it is all too easy to become conditioned into believing that there is something FUNDAMENTALLY wrong with us and that we are of no value.

BEING BULLIED/LEFT OUT/MALICIOUSLY TEASED AT SCHOOL:

We all want to be accepted by our peer group when we are young and developing our fragile and vulnerable self-concept. It is a human instinct, particularly pronounced during adolesence, to want to be accepted by the group. We evolved, as a species, after all, as social animals because acceptance by the group added to our chances of survival. It is, therefore, a fundamental psychological drive, created by millions of years of evolution, difficult (putting it mildly), therefore, to overcome.

Indeed, it is so powerful that it can lead to problems such as feeling a need to conform to group expectations even if it makes us uncomfortable (eg feeling a pressure to be confident and jovial when we actually feel depressed and anxious).

If we don’t conform to the expectations of the group (unless one is an exceptionally strong personality, which normally does not materialize until later in life) we may be rejected, bullied and cruelly teased and this can have a very damaging and lasting effect on our self-esteem.

FEELING, OR BEING TREATED, LIKE WE DON’T FIT IN AT HOME:

This is sometimes referred to as ‘being the black sheep of the family’. Perhaps there is something about us that does not fit in. An example might be the central character of the film, ‘BILLY ELLIOT’, who, at a very young age, decides he wants to be a ballet dancer much to the violent chagrin of his tough, alpha-male, former miner father (who would much rather see him incurring possible brain damage in the boxing ring). Or simply being the quiet one, or the introverted one. Obviously, there is absolutely nothing wrong with being any of these things, but, if it makes us stand out in the family, we might be treated as odd, a misfit, strange, ‘not quite one of us’ and in some way deficient and of less value. Again, over time, this can significantly wear down our self-esteem and can lead to growing up feeling rather like a pariah.

SUFFERING PREJUDICE AND DISCRIMINATION WHEN WE WERE CHILDREN:

There are many ways in which this can occur – I remember, when I was at school, a boy in my class who came from a very poor and not especially caring family; he was not properly cared for by his parents and used to turn up to school in very tatty and dirty clothes everyday. Cruelly, he was nicknamed ‘Tramp’ by the other boys. Another boy, perhaps slightly effeminate, was always being called ‘Poof’. A third came from the travelling community and was called ‘Dirty Gypo’ and more or less completely ostracized. Children, then, through no fault of their own whatsoever, can become the focus of hostility and contempt. They also, of course, tend to be the most vulnerable, already struggling with self-image.

Such treatment, particularly if the child has a lack of solid emotional support at home, can have long-lasting effects on self-esteem.

EXPERIENCING SYSTEMATIC AND CRUEL PUNISHMENT:

If we are often severely and unfairly punished as children, we may come to equate the fact with meaning we must be a bad person, that we have somehow brought it upon ourselves, and that we deserve it. This, especially, becomes true if the punishment is inconsistent and unpredictable (eg more to do with the parent’s mood and lack of self-control than what the child has actually done), extreme and the child does not understand what he/she is supposed to have done wrong.

Also, more ‘subtle’ punishments, such as being ‘given the silent treatment’ ( my mother had this down to a fine art) can be equally damaging.

Such treatment is another very high risk factor in relation to causing long-term and severe problems with the development of self-esteem.

BEING NEGLECTED WHEN WE WERE CHILDREN (eg being deprived of love, security, interest, praise etc):

It is not just the presence of bad things in our childhoods which can affect self-esteem adversely, but, also, THE ABSENCE OF GOOD THINGS. These include praise, interest, affection, reassurance of being loved, reassurance of being wanted and reassurance of being valued. In other words, then, it is not just blatantly bad treatment which impacts adversely upon the child’s self-esteem, but, also, the missing fundamental good things.

HAVING CONSTANTLY TO COPE WITH A PARENT’S DISTRESS/EMOTIONAL NEEDS WHEN WE WERE CHILDREN:

Some parents are emotionally immature and, in a kind of role reversal, actually turn to their children for emotional support, as happened in my own case following my parents’divorce when I was eight. Indeed, by the time I was eleven, my mother sometimes referred to me as her ‘Little Psychiatrist’ (encouraging me to continue in my rather bizarre role). This wa,s obviously, a great psychological burden and caused me great worry and concern.

Also, if there is friction in the parents’ marriage, or other pressures, parents can transfer their own distress onto their children and are more likely to become volatile, lose control, become prone to anger or withdrawal due to their own problems. Such deficient parenting, too, can affect the child’s self-esteem.

I hope this post has been of interest to you. My next post, to be published very soon, will look at how, if we have had some of these experiences, we can repair our damaged self-esteem.

Remember, if we have low self-esteem ,we will imagine there are things wrong with us that are not, in reality, the case, however powerful the illusion is that they are.

childhood trauma borderline personality disorderchildhood traumachildhood trauma therapies and treatments

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

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How Adult Children can Manage Their Relationship with Parents who have Borderline Personality Disorder (BPD). Part 1.

childhood trauma and borderline personality disorder

Some of us experienced childhood trauma due to a parent being unstable. As has been described in previous posts, BPD causes great instability in individuals, which can have a very serious impact on that individual’s child/ren, so some of us who experienced childhood trauma may have grown up with a parent with BPD. This could have contributed to ourselves developing similar problems, or, even, to us developing BPD ourselves. However, whatever the state of our mental health, as adults now ourselves, we need to know the best way to manage our relationship with BPD parent/s in the present, and, also, understand what effect our parent/s condition may have had on our own lives. This is of particular interest to me as I was brought up by a highly volatile and extremely unstable mother.

POSSIBLE EFFECTS ON THE CHILD OF A PARENT WITH BPD:

Parents with BPD can lack the necessary resources to bring their children up – in the worst case scenario, this may lead to neglect and/or abuse.

Children of BPD parents have frequently grown up in a highly unstable emotional atmosphere, have witnessed highly distressing behaviour in their parent/s, and, often, have been on the receiving end of extreme hostility, expressed verbally and/or physically. Further, they may have been exploited by their parent/s burdening them with their own emotional problems. My own mother, for example, used me, essentially, as her own private counsellor from when I was about 10 or 11- years- old, and would, on top of this, very often be terrifyingly verbally aggressive and hostile.

With experiences such as these, as adults, we can feel that our childhoods were stolen from us and we may go on to enter a kind of mourning for the childhood we never had.

Being brought up with a parent with BPD leads to a much higher probability of us developing the following problems:

alcoholism – illicit drug use
– depression
anxiety – suicidal feelings/ suicide attempts/ suicide
– behavioural problems eg impulse control
– personality/emotional disorders

Indeed, this is not altogether surprising when it is reflected upon that, as children, we may have been exposed to many long, painful, distressing years of intense conflict and arguments, threats (eg of violence, or, as in my own case, of abandoment),and unpredictable, unstable and highly volatile emotions.

Whilst we may feel deep resentment for the way in which we were treated, not infrequently necessitating professional support to deal with it, it is necessary, also, to keep in mind that our parent/s with BPD have developed it due to their own personal histories,including psychological, biological and social factors. However, this is cold comfort when we are children struggling to understand ourselves and living in a permanent state of acute distress.

POSSIBLE IMPACT OF A PARENT’S BPD ON THE CHILD:

1) The parent’s impulsivity: this could include alcohol, drugs, gambling etc causing enormous anxiety in the child and possibly in him/her developing similar problems in later life (due to the psychological concept known as ‘modelling’).

2) The parent’s dependency on child: for example, the parent may become emotionally dependent upon the child, using him/her as their personal counsellor, which can lead to the child feeling overwhelmed with concern, responsibility and anxiety, leading later to anger and resentment.

3) The parent’s volatility, instability and unpredictability: this, again, often leads to the child developing extreme anxiety and deep concerns about being abandoned – causing long-term, deeply ingrained insecurity (the parent may threaten to send the child away to live with relatives or to live in the care system).

4) The parent’s threats of suicide: again, this can lead to the child experiencing acute anxiety, possibly leading, later down the line, to the individual developing his/her own self-harming or suicidal behaviour.

5) The parent’s ambiguity towards the child: technically, this is known as ‘SPLITTING’- being consumed with passionate hatred towards the child one day, but then giving him/her extravagant praise the next – these polarized attitudes towards the child vascillating in a deeply confusing fashion. This will often lead the child to have an extremely unstable identity and self-concept – sometimes feeling they are better than others, but, at other times, feeling worthless, inferior and consumed with self-hatred. Thus, the child can grow up not quite ‘knowing who he/she is’.

This is not an exhaustive list, but, as I am trying to keep these posts to a manageable length and avoid swamping the reader with information, the picture the examples give, I think, is sufficient as an introduction.

In PART 2- I will look at suggested ways to manage our problematic relationships with our BPD parents.

If you would like to view an infographic on the relationship between having a mother with BPD and risk of suicidal behavior, please click here.

childhood trauma borderline personality disorderchildhood traumachildhood trauma therapies and treatments

The above eBooks are now available for immediate download on Amazon. $4.99. CLICK HERE.

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

Click here for reuse options!
Copyright 2013 Child Abuse, Trauma and Recovery

Psychotherapeutic Interventions that Research Suggests are Helpful for Individuals Suffering with Borderline Personality Disorder (BPD).

childhood-trauma-fact-sheet

A quick search of the internet reveals a very large range of therapies on offer which purport to treat BPD effectively. Indeed, the sheer range of putative treatments can seem confusing and overwhelming.

It is for this reason that I concentrate on just six treatments which research suggests are the most beneficial.

Let’s look at each of these in turn:

1) MENTALIZATION-BASED THERAPY (MBT).

My previous post on BPD referred to how people suffering from it have difficulties with how they are attached to (ie how they relate to) PRIMARY CARE GIVERS (eg parents). This can manifest itself in ATTACHMENT DISORDERS (which I also looked at in my last post) making other relationships they develop in adult life very difficult, volatile, complex, painful and distressing.

MBT seeks to help the person understand the roots of these difficulties and how their feelings and behaviours may be impacting on their relationships which in turn makes these relationships problematic.

Research shows that outcomes of MBT treatment have so far been very encouraging.

As well as reducing relationship problems, the therapy has also been found to lessen the likelihood of suicidal ideation ( thoughts and plans about suicide) and hospitalizations. Also, it has been shown to improve day-to-day functioning.

2) SCHEMA THERAPY.

Schemas are deeply entrenched beliefs relating to both oneself and the world in general. In people with BPD, these schema can be extremely negative (inaccurately so) and very unhelpful (or, to use a more technical term, MALADAPTIVE) to the individual who holds them.

Very often, they stem from a negative mindset which developed during the individual’s early life, due to, in no small part, childhood trauma. It is worth repeating that these negative schema can be very deeply ingrained and colour the individual’s entire outlook on life.

Schema therapy seeks to change these maladaptive schema into more adaptive (helpful) ones.

Treatment can be very lengthy, but there is strong evidence that it can significantly reduce symptoms of BPD.

Research into this type of treatment remains ongoing and I will report on any significant developments.

3) TRANSFERENCE-FOCUSED PSYCHOTHERAPY (TFP).

It is certainly worth first defining the psychotherapeutic idea of TRANSFERENCE:

it may be defined as: THE INAPPROPRIATE REPETITION IN THE PRESENT OF A RELATIONSHIP THAT WAS IMPORTANT TO THE PERSON’S CHILDHOOD.

For example, if our parents hurt, exploited or rejected us as children, in adult life we might feel that everyone we get to know will do the same, but without evidence that this will be the case (we are basing our view on a past relationship which is now not relevant).

The treatment aims to help individuals stop viewing present relationships in a rigid way determined by their painful past and show them that they could be misperceiving their present interactions with others ( including the therapist, as often individuals transfer the feelings they had for their parents as children -eg resentment- onto the therapist in the present).
Research, so far, has shown positive results and remains ongoing.

4) COGNITIVE THERAPY.

Cognitive therapy has long been known to be a very effective treatment for conditions such as anxiety and depression, and it is now being increasingly used to treat BPD. Studies of its effectiveness in relation to this have, so far, been encouraging.

One advantage of cognitive therapy is that it often leads to very significant improvements over quite short treatment periods. I myself underwent cognitive therapy and found it very beneficial.

Cognitive therapy focuses on correcting faulty, distorted, negative thinking styles relating to how we view ourselves, the world and the future. I write in more detail about cognitive therapy in the EFFECTS OF CHILDHOOD TRAUMA category of my blog.

5) DIALECTIC BEHAVIOUR THERAPY (DBT).

The studies on this therapy have , so far, given mixed results. It has been shown, though, in several pieces of research, to reduce the likelihood of suicide attempts in the individual undergoing treatment (the risk of suicide in people suffering from BPD without treatment is high).

Also, after a year of treatment, individuals report a more general improvement in their condition, but, unfortunately, often are still left with significant levels of distress. More studies are required, and, indeed, are being conducted to see if longer treatment periods yield better outcomes. I will report on any significant developments in this area.

DBT draws on psychotherapy, group therapy, meditation, elements of Buddhism and cognitive-behaviour therapy. More research needs to be conducted on the therapy to discover which of its varied components are the most effective in treating BPD. Again, I will report on significant developments.

6) MEDICATION.

Whilst there is, at the moment, no obvious, single medication to treat the whole range of BPD symptoms equally effectively, there are, nevertheless, established medications which can help with some of the symptoms the BPD sufferer might experience, such as anxiety and depression. This is, though, of course, the province of GPs and psychiatrists.

childhood trauma borderline personality disordereffects of childhood traumachildhood trauma therapies and treatments

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

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