Category Archives: Bpd Articles

Borderline Personality Disorder Is Not A Choice

borderline personality disorder

Nobody chooses to suffer from borderline personality disorder ; this is obvious.

Borderline personality disorder (BPD) is probably the most tormenting and agonizing psychiatric condition known to man. One in ten sufferers end up killing themselves after years, or even decades, of appalling mental suffering. Due to the disturbed behavior that accompanies BPD,  sufferers may become social pariahs and/or be rejected by their families – in the latter case, often by the very family member/s who have played a major role in causing the disorder ; I have said elsewhere that this is rather like somebody cutting off all your limbs and then blaming you for bleeding for over them. Or injecting you with a cancer causing agent and then blaming you for wasting away and dying.

One of the great torments of BPD sufferers is a belief that they are bad and that their behavior is due to some fundamental character flaw rather than due to a desperately serious psychiatric condition. It is this false belief (frequently caused by internalizing parental negative views of them whilst growing up) that contributes to many of the suicides and, as such, is a belief which is in urgent need of correcting.

On what grounds do I make this assertion? I summarize them below :

  • DAMAGE DONE TO THE PHYSICAL DEVELOPMENT OF THE BRAIN:

The physical development of the following three brain regions is affected by our upbringing in early life and this physical development may be adversely affected if that upbringing is significantly dysfunctional.

  • AMYGDALA
  • HIPPOCAMPUS
  • ORBITOFRONTAK CORTEX

borderline personality disorder

Let’s look at each in turn:

AMYGDALA : This part of the brain controls emotions and, especially, negative emotions like fear, anxiety and aggression. It follows that because the amygdala has developed abnormally in BPD sufferers, they will be prone to experiencing abnormal levels of fear, anxiety and aggression.

HIPPOCAMPUS : This part of the brain plays a significant role in our ability to exert self-control. Again, it follows that because the hippocampus has developed abnormally in BPD sufferers, they will have difficulties with self-control, leading to impulsive and self-destructive behaviors.

ORBITOFRONTAL CORTEX : This part of the brain is involved with planning and decision making. Yet again, it follows that because the orbitofrontal cortex has developed abnormally in BPD sufferers, they will have problems planning ahead (including poor ability to consider future implications of behaviors or to act in a premeditated or carefully deliberated manner) and be prone to irrational and illogical decision-making.

Furthermore, these three brain areas play a very significant role in mood regulation / our ability to control how we feel. As these three areas have developed abnormally in BPD sufferers, this helps to explain why their moods can fluctuate so dramatically, in turn leading to extensive problems both forming and maintaining healthy relationships with others.

Now, consider this : If a person was hit on the head with a hammer, causing brain damage which, in turn, affected how s/he felt and behaved, should s/he (the person hit) be blamed for this change in behavior? No, of course not. So, why should a different view be taken in the case of BPD sufferers? Indeed, to take a different view would seem suspiciously like discrimination against mental illness and a failure of imagination in regard to how devastating the infliction of emotional suffering can be.

Types Of Dysfunctional Upbringing That May Damage These Brain Regions :

These include :

  • suffering abuse from parent/primary carer
  • being neglected by parent/primary carer
  • being brought up by a parent with a significant mental health problem
  • being brought up by a parent/primary carer who is an alcoholic
  • being brought up by a parent/primary carer who is a drug addict

What About The Role Of Genes?

There is NOT a gene for BPD.

However, some may be born with a greater vulnerability to being adversely affected by stressful environments due to high levels of sensitivity.

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

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BPD Sufferers Over-React To Facial Expressions

over reaction to facial expressions
A study conducted by Donegan et al, 2003, found that sufferers of borderline personality disorder (BPD) were prone to interpreting neutral facial expressions as threatening facial expressions.

The study involved 30 participants split into two groups as follows :

Group 1 : This group consisted of 15 individuals who had been diagnosed with borderline personality disorder (BPD).

Group 2 : This was the control group, consisting of 15 individuals who did not have borderline personality disorder (BPD).

 

How Was The Study Conducted?

All 30 participants in the study were shown pictures of people with four types of facial expressions, these expressions were as follows :

  • neutral
  • happy
  • sad
  • fearful

Sometimes, too, the participants had to focus on single fixation point (rather than a picture of a face).

Functional Magnetic Resonance Imaging :

Whilst each of the participants was looking at each of the four different facial expressions, or at the single fixation point, they underwent a brain scanning process known as functional magnetic resonance imaging (fMRI).

The purpose of undergoing the fMRI whilst looking at the pictures of facial expressions or at the single fixation point was to measure the level of activation in a region of the brain known as the amygdala. The amygdala, among other functions,  is involved in generating negative emotions.

Over react facial expressions

What Were The Findings Of The Study?

When participants from GROUP 1 were shown pictures of faces displaying emotions (versus the single fixation point), their amygdalae were found to be more highly activated than were the amydalae of those from GROUP 2 whilst undergoing the same activities.

Furthermore, interviews after the participants were shown the pictures revealed that some in GROUP 1 had interpreted the neutral faces as being threatening.

What Can We Infer From This Study?

This study suggests that individuals suffering from borderline personality disorder (BPD) can be prone to interpreting the facial expressions of others more negatively (e.g. as being threatening when this is not objectively the case) than those individuals who are relatively psychologically healthy.

According to this study, this would, at least in part, appear to be due to an abnormal physiological response in the brain, namely over activation of the amygdala in response to the emotional facial expressions of others.

This finding goes towards explaining why those with borderline personality disorder (BPD) tend to have severe problems in connection with their interpersonal relationships and often perceive others as threatening and as wanting to hurt them which, in turn, frequently gives rise to overly defensive behavior.

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David Hosier BSc Hons; MSc; PGDE(FAHE).
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Thin-Skinned? Its Link To BPD.

BPD and being thin skinned

Do people ever accuse you of being thin-skinned?

If we have developed borderline personality disorder (BPD) as a result of our traumatic childhood, then one of the main symptoms we are likely to have developed is difficulties with interpersonal relationships. Most often, too, part of this difficulty resides in the fact that we are likely to be extremely thin-skinned. 

Our being thin-skinned can, most frequently, be explained by our having experienced severe negative attitudes expressed towards us as children (most commonly by a parent or primary carer), rejection, abandonment, emotional abuse or some combination of these.

BPD and being thin-skinned

Thus, in an unconscious, desperate attempt to protect ourselves from further psychological pain, we become hypervigilant in connection with being on the look out for further signs that someone may be a threat to our psychological welfare by emotionally hurting us.

Rather like a dog who has been regularly beaten, we ‘snarl’ at  (or ‘run away’ from) anyone who remotely seems to represent such a threat lest they harm us like we were harmed before.

Do Those With BPD Imagine Others Are Behaving Negatively Towards Them When, In Reality, This Is Not The Case?

Do people with BPD constantly imagine slights against their character when, in reality, such slights have not occurred?  In fact, this doesn’t seem to be the problem (or, if it is a problem, not the main problem). Rather, people with BPD, due to their hypervigilant state when interacting with others, perceive real negative attitudes towards them which others may not be perceptive or sensitive enough to pick up on or let pass over their heads.

The problem from here is often how those with BPD react once they have picked up on such negative attitudes.

How Do Those With BPD Tend To React In Such Situations ?

In such situations, those with BPD tend to feel intensely hurt and misunderstood ; this can then lead to becoming highly emotional or, as a form of self-protection, detached. Unfortunately, neither of these reactions tend to be useful in terms of resolving the situation; indeed, such reactions most often serve only to compound the BPD sufferer’s interpersonal difficulties.

 

Useful Link :

 

 

 

Resources:

 HOW TO STOP BEING DEFENSIVE : click here for further details.
eBook :

 

borderline personality disorder ebook

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David Hosier BSc Hons; MSc; PGDE(FAHE)

 

 

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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.

 

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BPD childhood

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

 

 

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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).

 

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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)

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BPD Sufferers Up To Ten Times More Likely To Be Homosexual

 BPD and homosexuality

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.

Resource :

Let go of shame

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

 

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

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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).

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Copyright 2017 Child Abuse, Trauma and Recovery

Symptoms Of Dissociation : Mild And Severe

 

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

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

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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 :

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

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Copyright 2016 Child Abuse, Trauma and Recovery