Tag Archives: Bpd

Often Craving High-Intensity / Highly Arousing Activities?

Those of us who suffered significant childhood trauma may, as adults, find it very hard to calm ourselves when experiencing stress and anxiety. This is sometimes referred to by psychologists as an inability to self-sooth or to regulate our emotions. The result can be that we find ourselves in chronic states of deep distress and intolerable emotional pain.

Such is the intensity of this pain that we might frequently find ourselves absolutely desperate to numb it. However, we may find, too, that the ‘ordinary’ ways mentally healthy individuals may use to calm themselves, such as talking to a friend, taking a relaxing bath, going for a walk or taking some other form of exercise are simply of very little, or no help. These activities can be categorized as low-arousal activities.

Instead, to reduce our mental anguish, we may be driven to seek out and undertake high-arousal activities, sometimes referred to as sensation seeking or thrill seeking.

Whilst such high-arousal activities may provide short-term relief, they tend, also, to cause us harm over the long-term and to be high-risk.

I provide examples of such high-arousal activities below :

Examples Of High-Arousal Activities :

  • getting very drunk
  • self-harming (eg cutting) . Whilst this causes physical pain it can simultaneously reduce psychological pain due to the biochemical effect it has on the brain. Also, physical pain can actually provide a welcome distraction from comparatively far more distressing mental pain.
  • abusing drugs
  • high-stakes gambling (read about my experience of this here).
  • excessive, promiscuous sex (possibly leading to feelings of self-disgust)
  • anti-social behaviours such as stealing cars, joy-riding, shop-lifting
  • planning suicide (not only can this produce a high level of mental arousal but can also provide one with a sense of control. Indeed, at one period in my life, which I have written about elsewhere, I contemplated suicide virtually all day and every day for a period of several months; the only way I could fall asleep at night, in fact, was by repeatedly reminding myself that it was within my power to end my suffering. Paradoxically, it was this thought that kept me alive, however odd that might sound.

The high arousal activities that I have listed above are sometimes referred to as ‘acting-out’ behaviours which you can read more about by clicking here.

NB Seeking out high risk, intensely arousing activities can be a major component of borderline personality disorder (BPD). At present, one of the most effective available treatments for this condition is dialectical behaviour therapy (DBT).

 

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OTHER RESOURCES :

Traumatic childhoodIMPROVE IMPULSE CONTROL.

 

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

 

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Copyright 2016 Child Abuse, Trauma and Recovery

Early Trauma’s Effect On Development Of Id And Ego

According to psychodynamic theory, originally associated with Sigmund Freud (but modernized by various psychologists since), the most crucial part of our psychological development takes place in the earliest years of our lives, between birth and about five years old.

A central concept of psychodynamic theory is that our minds comprise three parts, namely the id, the ego and the superego, which I briefly describe below:

THE ID : According to Freud, the id can be viewed as the primitive part of the mind, driven by biological needs (such as for food and sex), which demand instant gratification ; it is completely unsocialized and its operations are unconscious. It is also described as acting according to the ‘pleasure principle‘ which means it is constantly and potently urging us to gain pleasure, irrespective of consequences (including harmful effects on others and harmful effects on ourselves).

THE SUPEREGO : Basically, the superego represents our conscience which we form by internalizing a sense of ‘right’ and ‘wrong’ (or morality) derived from the influence of our parents, education, social environment and culture. Freud stated that whilst some of the operation of the superego is conscious, much of it also occurs on an unconscious level. Our ‘punishment’ for transgressing the superego’s exacting moral standards is guilt.

THE EGO : Freud said that whilst the id operates according to the ‘pleasure principle’, the ego operates according to the ‘reality principle’. Essentially, its task is to mediate between the deeply conflicting demands of the id, the superego and the outside world (and it is this constant need to mediate and reach an unending series of compromises that contributes much to the inner turmoil, tension and anxiety being human must necessarily entail, Freud helpfully informs us). It acts according to reason and will try to inhibit impulses that, if acted upon, would lead to harm; in other words, it takes into account the possible consequences of our actions.

I remember, as a first year psychology undergraduate, our lecturer telling us that the ego’s job could, perhaps not wholly inaccurately, be compared to that of a referee who finds himself constantly obliged to oversee a fight between a ‘crazed chimpanzee’ and ‘a puritanical, pious and forbidding grandmother.’

 

Above : The perpetual battle between the id and superego, with the ego always having to act mediator.

It is theorized that if the infant is traumatized in early life, through lack of adequate care, s/he will fail to learn to control his/her basic drives and impulses and the development of his/her ego will be impaired. This can lead to various problems including :

  • poor ability to tolerate frustration
  • poor ability to inhibit impulses that may lead to harm (too likely to act in accordance with the dictates of the id due to deficits in ego development)
  • lack of consideration concerning the possible effects of one’s actions upon others / not taking into account the needs of others (including, as an infant, impaired ability to pick up on verbal and visual cues of the mother / primary care-giver)
  • impaired judgment
  • impaired ability to think logically and with clarity

It is thought that these problems occur as inadequate care that traumatizes the infant can damage the actual physical development of certain vital brain regions.

The infant who experiences satisfactory care, attention and nurturing, on the other hand, will learn to better control his drives and impulses, having learned from the mother to keep him/herself relatively calm and not exhibit unwarranted distress if his/her biological needs happen to not be instantaneously met (this ability is known as the competence to ‘self-regulate’).

Many of the symptoms of borderline personality disorder (BPD), which is linked to childhood trauma, reflect some the symptoms listed above.

 

eBooks:

          

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OTHER RESOURCES :

Traumatic childhoodIMPROVE IMPULSE CONTROL

 

Traumatic childhoodCONTROL YOUR EMOTIONS

 

 

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

 

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Symptoms Of BPD Require Early Intervention

It is problematic trying to diagnose borderline personality disorder (BPD) in children as their personalities are still developing. However, some children exhibit symptoms which seem to mimic the symptoms of BPD.

Ideally, BPD would be prevented before it fully develops so identifying symptoms which suggest BPD may develop later on in an individual’s life as early as possible is clearly desirable in order to start appropriate therapy before the problem becomes out of hand.

Early treatment is particularly valuable as the young child’s brain is at its most ‘plastic’ which means, by using the appropriate therapies, its physical development can be much more easily beneficially altered than would be the case in adulthood.

Also, the earlier therapy is given, the less time undesirable symptoms have to ‘take root’ and become ingrained into the young person’s behavioural patterns.

One therapy that may be used for therapeutic purposes in connection with the above is known as floor time therapy‘ (also referred to as the Developmental – Individual difference – Realtionship-based Model or DIRand was originally developed by Greenspan (1989).

Although the therapy was originally developed in order to treat children with autism, it can be used to treat a variety of childhood psychological conditions, including the treatment childhood symptoms similar to those of BPD such as dramatic shifts in mood and difficulty controlling impulses. (However, further research is needed to establish, more accurately, this therapy’s effectiveness).

It is called floor time therapy for the very simple reason that it involves the parent getting on the floor with the child and playing (in a specialized way taught by the therapist) with him/her.

Therapists trained in this type of therapy include some specialized psychologists and occupational therapists.

Finally, it should be noted that many children who might benefit from such therapies miss out as they are regarded as ‘difficult’, ‘troublesome’, ‘over-sensitive’ etc when, in fact, there may be a strong biological component underlying their behaviour over which the child has no control ; blaming such a child then severely compounds the problem.

RESOURCES :

You can visit Dr Greenspan’s site about this therapy by clicking here.

 

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

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Copyright 2016 Child Abuse, Trauma and Recovery

‘Distress Intolerance’ : Do Your Feelings Sometimes Feel Unbearable?

distress intolerance

The term DISTRESS INTOLERANCE refers to a frame of mind in which we consider the mental pain, anguish or discomfort we are experiencing to be UTTERLY INTOLERABLE AND UNBEARABLE so that we become frantic and desperate to avoid it/escape it.

The emotions we feel unable to tolerate usually belong to three main categories; these are:

  1. Emotions connected to sadness (such as depression, shame and guilt)
  2. Emotions connected to fear (such as dread, anxiety and terror)
  3. Emotions connected to anger (such as hatred, rage and frustration)

Those who have suffered severe childhood trauma, especially if, as a result, they have gone on to develop Borderline Personality Disorder (BPD), tend to feel emotions particularly intensely, tend to have impaired ability to control their emotions, and tend not to be adept at self-soothing/ self-comforting/ self-compassion and are therefore much more likely to suffer from DISTRESS INTOLERANCE than the average person.

Unsurprisingly,the more we tell ourselves our feelings are unbearable and intolerable, the more difficult they become to manage. In effect, we start to feel bad about the fact that we feel bad. This phenomenon is sometimes referred to as meta-worry (worrying about the fact that we worry) and adds a superfluous layer of suffering to our already less than optimal mood state.

A simple example of such meta-worrying would be:

‘My constant worrying is ruining my life.’  (but doing nothing to address one’s worrying)

 

THE PARADOX OF TRYING TO ESCAPE AND ‘RUN AWAY’ FROM OUR MENTAL DISTRESS

Counter-intuitively, research suggests that when we mentally struggle hard to stop feeling our emotional distress, frequently the effect is actually to intensify it (rather like thrashing about in quick sand – we just sink deeper in).

HOW OUR BELIEF SYSTEM IS LINKED TO OUR STRESS INTOLERANCE :

Individuals who find distress very difficult to tolerate tend to have a set of beliefs that contribute to this intolerance; such beliefs may include :

  • it is essential I rid myself of these feelings immediately
  • these feelings are going to send me permanently insane
  • these feelings mean I’m a weak and pathetic person
  • these feelings are completely unacceptable

Such beliefs are sometimes referred to as catastrophizing beliefs and worsen our psychological state; cognitive therapy can help us to reduce catastrophizing thoughts.

 

HOW WE TRY TO ESCAPE OUR MENTAL DISTRESS

Three ways in which we try to escape our mental distress are as follows:

  • avoidance
  • dissociation (self-numbing)
  • self-harm

Lets look at each of these in turn:

1) AVOIDANCE :

For example, avoiding social situations due to social anxiety or avoiding going outside due to agoraphobia.

2) DISSOCIATING /SELF- NUMBING :

People may try to achieve this by using alcohol, drugs or overeating

3) SELF-HARM :

For example, some people cut themselves in an attempt to release emotional distress; this may be because the physical pain detracts from the psychological pain and/or because physical self-harm releases endorphins (the body’s natural pain-killers) into the brain.

 

WHY THESE METHODS DON’T WORK :

There are obvious problems with these methods which I list below :

  • whilst they may afford some short-term relief their long-term effects are damaging
  • relying in negative coping methods such as those detailed above erodes self-esteem and increases feelings of depression
  • continually ‘running away from’ and desperately trying to avoid difficulties means one never provides oneself with the opportunity to learn how to deal with them effectively or how to cope with distress using healthier methods
  • by constantly avoiding distressing emotions (e.g. by using drugs and alcohol) one deprives oneself of the opportunity to put one’s catastrophic beliefs (see above) to the test (e,g. the catastrophic belief that one’s feelings of distress are intolerable) and, hopefully, prove them to be inaccurate.

 

 

LEARNING DISTRESS TOLERANCE :

By learning to interpret distress differently (e.g. by changing our catastrophizing belief system in relation to distressing feelings) and how to develop healthier ways of coping with uncomfortable/difficult emotions we can start to put together a set of skills which will help us to cultivate distress tolerance (SEE RESOURCE BELOW).

 

RESOURCE :

TO DOWNLOAD DISTRESS TOLERANCE HANDOUTS FREE, CLICK THIS LINK OR CLICK ON IMAGE BELOW:

 

BOOK :

 

FREE APP, CLICK LINK BELOW:

DBT911

 

 

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

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BPD And Objects Relations Theory

 childhood_trauma-bpd
What Is Meant By Objects Relations Theory?
In broad terms, it is the theory of how people interact and relate to others, especially within the family and, more especially still, how the child and mother relate to one another. 
The theory stresses how dysfunctional relationships, especially in early life, can lead to the development of psychological disorders in later life.
Kohout’s Theory:
Kohout (1971), theorised that Borderline Personality Disorder (BPD) had its primary origin in the way the mother related to, and interacted with, her baby/toddler between the ages of approximately 18 months and 3 years of age.
In particular, Kohout proposed, the baby/toddler is put at high risk of developing BPD in later life if s/he is brought up by a mother who does not allow him/her to psychologically separate from her, thus depriving him/her of the opportunity to develop and assert his own unique individuality.
For example, a child brought up by a mother with BPD may develop a high risk of developing the same psychiatric condition himself in later life. This is because such mothers tend to view their child as an extension of themselves, whose purpose is to fulfil her emotional needs, rather than allowing the child to psychologically differentiate him/herself from her, develop his/her own individuality and unique identity, and to learn to tend effectively to his/her own emotional needs. It is as if the mother sucks the life out of her child for her own emotional nourishment.
BPD,_objects_relations_theory
Such mothers, Kohout suggests, can interact adequately with their baby/toddler when s/he (the baby/toddler) is in a state of neediness, but will become cold and rejecting when the child attempts to psychologically separate from her to try to develop independence and a proper, clearly defined, sense of self.
Kohout goes on to describe his theory that such a dysfunctional early upbringing leads to the child, in later life, developing a psychological defense mechanism known as ‘splitting’. I will describe what is meant by psychologists when they use the term ‘splitting’ in my next post.

David Hosier BSc Hons; MSc; PGDE(FAHE).
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Brain Areas That May Be Adversely Affected By Childhood Trauma

BPD_and_brain_areas

We have already seen in other posts that I have published on this site that, if we have been unfortunate enough to have been subjected to severe and chronic childhood trauma, it is possible that this adversely affected how our brain physically developed during our early life.

And, if we have been particularly unlucky, this disrupted brain development could have made us highly susceptible to developing borderline personality disorder (BPD) in our adult lives.

 

Indeed, research involving brain scans suggest that sufferers of BPD can have abnormalities in the following brain areas :

– prefrontal cortex

– anterior cingulate

– medial frontal cortex

– subgenual cingulate

– ventral striatum

– ventromedial prefrontal cortex

– amygdala

 

Below : Brain Areas Which May Have Had Their Physical Development Adversely Affected By Our Traumatic Childhood Experiences, Particularly If We Have Developed Borderline Personality Disorder ( BPD) :

BPD brain

 

What Are These Brain Areas Associated With?

The function of these brain areas are described below:

PREFRONTAL CORTEX:

– decision making

– conscious control of social behaviour

– speech / writing

– logic

– purposeful (as opposed to instinctual) behaviour

– planning for the future

– expression of the personality

ANTERIOR CINGULATE :

– decision making

– heart rate

– blood pressure

– impulse control

– emotions

MEDIAL PREFRONTAL CORTEX:

– decision making

– memory

SUBGENUAL CINGULATE :

– sleep

– appetite

– anxiety

– mood

– memory

– self esteem

– transporting serotonin

– our experience of depression

VENTRAL STRIATUM :

– decision making

– emotional regulation (the control of emotios)

– the extinction of conditioned responses

AMYGDALA :

– appetite

– emotion

– emotional content of memories

– fear

The Effects Of Disruption Of The Above Brain Areas :

Poor decision making ; poor control of social behaviour ; impaired ability to think rationally ; poor planning for the future ; dysfunctional personality ; increased physiological response to stress ; poor impulse control ; poor emotional control ; insomnia ; changes in appetite ; severe anxiety ; mood instability ; low self-esteem ; impairment of the brain’s ablity to make effective use of serotonin leading to clinical depression ; changes in appetite ; emotionally charged memories leading to flashbacks, nightmares, intrusive thoughts, panic attacks ; feelings of being under constant threat, fear, terror and extreme vulnerability.

Two types of therapy that may be useful are cognitive behavioural therapy (CBT) and dialectical behavioural therapy (DBT).

Resources :

General Information :

NHS information about borderline personality disorder (BPD). Click here.

EBook :

brain damage caused by childhood trauma

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

Self-help :

For immediate help with many of above problems click here.

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

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Copyright 2016 Child Abuse, Trauma and Recovery

BPD And The Triune (3 Part) Brain

reptilian_brain

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

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

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

– our fight / flight / freeze / fawn responses

– our immediate biological sexual responses

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

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

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

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

– the generation and experience of our emotions

– memory and other aspects of learning

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

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

– decision making

– conscious control of social behaviour

– speech / writing

– logic

– purposeful (as opposed to instinctual) behaviour

– planning for the future

– expression of the personality

triune_brain

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

1) Reptilian Brain :

reptilian_brain

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

2) Mammalian Brain :

mammalian_brain

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

3) Neomammalian Brain :

neomammalian_brain

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

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

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

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

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

AND :

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

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

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

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

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

Resources:

brain damage caused by childhood trauma.

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

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

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Copyright 2016 Child Abuse, Trauma and Recovery

Five Types Of Dysregulation Linked To Childhood Trauma.

 

I have written extensively on this site about the link between the experience of significant childhood trauma and the possible later development of borderline personality disorder (BPD).

One of the leading experts on borderline personality disorder is Martha Linehan (who developed the treatment for BPD known as dialectical behavioral therapy, or DBT) and, according to her widely accepted theory, those who have developed BPD as a result of their adverse childhood experiences are often affected by all, or combinations of some, of the following types of DYSREGULATION:

(If we are dysregulated in relation to a quality, it means, in this context, that we have difficulty controlling and managing whatever the specific quality may be.)

download

Above: DBT has been shown to be an effective therapy for helping people who suffer from BPD and problems connected to various types of dysregulation (see five types below).

The Five Types Of Dysregulation We May Experience If We Have Developed BPD As A Result Of Our Childhood Trauma :

1) Emotional dysregulation:

We may have very volatile emotions that are so powerful we can feel controlled and overtaken by them. We may experience particularly intense and fluctuating emotions in response to our relationships with others, particularly our closest relationships.

Also, we may have difficulty identifying what exactly we are feeling (ie. find it hard to name some emotions we experience) and have problems expressing and experiencing some emotions.

2) Interpersonal dysregulation:

This means we might experience significant difficulties both forming and maintaining relationships with others. We may, too, constantly fear rejection and abandonment, leading to us becoming ‘needy’ and ‘clingy’ which, most sadly, can often cause the very rejection we are trying so ardently to prevent.

We may, too, find our feelings for others often vascillate dramatically from idealisation one minute, to demonization the next, possibly apropos (objectively speaking) very little.

3) Cognitive dysregulation:

This type of dysregulation may lead us to experience dissociation, depersonalisation and paranoia.

 4) Behavioural dysregulation:

Our behaviour may become extremely self – destructive : we may self-harm, attempt suicide, have promiscuous and unsafe sex, take unnecessary risks (such as reckless driving), become addicted to drugs and/or alcohol in a desperate attempt to numb and temporarily escape from overwhelming mental anguish, or develop eating disorders.

5) Self – dysregulation:

We may feel confused as to who we are and have a very poor sense of identity. We may feel different aspects of our personality are not well integrated so we can find ourselves acting in rather one-dimensional ways.

Our self-image can be unstable as can our values. We may be confused as to who we really are and what are beliefs and principals are ( indeed, these may frequently alter).

This can leave us feeling lonely and empty.

To read my article on the therapy devised by Marsha Linehan called dialectical behavioural therapy, click here.

 

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

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

 

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Copyright 2015 Child Abuse, Trauma and Recovery