Tag Archives: Childhood Trauma Resources

A Closer Look at the Link Between Childhood Experiences and BPD.

childhood trauma and bpd

BPD And Childhood Trauma

One of the things that frequently marks the childhood of individuals who later develop BPD is LOSS, especially when the loss has occurred as a result of death, divorce or serious illness (necessitating long periods in hospital). In one particular research study looking at this, it was found that three-quarters of those suffering from BPD had experienced such losses in childhood.

Abuse also plays a large part in the development of BPD. One study found that 75% of those suffering from BPD had experienced sexual abuse during their childhood compared to 33% of those who suffered from other psychiatric conditions.

However, it is not just obvious trauma in childhood that is linked to the later development of BPD. More subtle forms of problematic parenting also put the child at risk. Examples of this include:

– the parent/s emotionally withdrawing from the child
– inconsistent parenting (eg praise and punishment being distributed in an UNPREDICTABLE manner)
– parent/s discounting, belittling or ignoring the child’s feelings

Another form of problematic parenting which has been linked to the child later developing BPD include:

– the parent behaving too much like a friend rather than a responsible, caring figure
– turning the child into a CONFIDANT
– role reversal : treating the child like a parent

OBJECT RELATIONS THEORY:

Parenting problems are so closely tied to putting the child at risk of later developing BPD because as illustrated, for example, by object relations theory, the way a parent brings up a child has a critical influence on the way the child develops, especially in relation to the following:

– how the child goes on to see him/herself (self-identity, self-concept)
– how the child goes on to view others
– how the child goes on to deal with relationships (functioning in this area often becomes deeply impaired).

The theory suggests, then, that problematic parenting can lead to the child developing identity problems later on together with problems of self-image (affected children will often later develop a view of themselves as ‘bad’, or, even, ‘evil’) with concordant effects upon behavior. Often, also, a feeling of profound HELPLESSNESS will develop.

In relation to how the affected child sees others, certain patterns have been found to emerge. For example, the child may develop into an adult who deeply mistrusts those in authority, viewing them as overwhelmingly vindictive, malicious and punitive. Interestingly, also, however, there can develop a tendency to IDEALIZE people of importance to him/her in the initial stages of knowing them; because, however, this is likely to lead to UNREALISTIC EXPECTATIONS of the one who has been idealized (especially in relation to them – the idealized one, that is – being able to protect and nurture them) when these high expectations are not lived up to the failure gives rise to feelings of having been BETRAYED in the one who had those expectations.

In conclusion, it should be pointed out that a very difficult childhood does not guarantee the later development of BPD, but risk is elevated if the individual also has a genetic disposition to developing emotional problems.

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

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Dialectical Behavior Therapy for Borderline Personality Disorder (BPD).

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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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Childhood Trauma : Treatment by Hypnosis Combined with Other Therapies.

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Although hypnosis has been used for a very long time to treat the effects of trauma (for example, it was used effectively to treat soldiers who were traumatized by their experiences in both World War One and World War Two), in the 1990s its use became controversial and misunderstood. This was due to the fact that there had been some cases in which hypnosis was used to try to recover painful memories which traumatized indivduals were thought to have buried in their unconscious.

However, it was later found out that these ‘recovered memories’ were false. Despite this setback and because far more care is now taken in considerations of whether hypnosis should be used in an attempt to recover memories, hypnosis is enjoying something of a renaissance. It is increasingly being argued that hypnotherapy can be very effective in the treatment of trauma, especially in relation to facilitating the individual’s processing of (genuine) traumatic memories. Many believe that it is necessary for traumatized individuals to process their traumatic memories properly in order to gain relief from the anxiety they cause. Indeed, hypnotherapy is being increasingly used by adult survivors of childhood trauma.

One particular benefit of the use of hypnosis in the treatment of trauma is that it can give rise to feelings of DISSOCIATION which can help an individual protect him/herself from the full impact of the shock which would otherwise have been caused by the particular traumatic event which has occurred. It is a flexible therapy and is being used in innovative ways.

There is some debate about whether hypnosis should be seen as a treatment in its own right, or whether it should more accurately be seen as a procedure which, used in combination with other therapies, can augment the postive effects of those therapies.

The debate has not been fully resolved, but hypnosis is increasingly being used as an ADJUNCT to other therapies, enhancing their effectiveness. For example, hypnotherapy is now used effectively in combination with cognitive behavioral therapy (CBT) to give a therapy called cognitive hypnotherapy. It has also been used in combination with psychodynamic therapy (known as psychodynamic hypnotherapy). Initial results are encouraging and research is ongoing.

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Childhood Trauma : Defense Mechanisms Resulting from Stress.

In response to stress resulting from our childhood trauma and other factors we often develop psychological DEFENSE MECHANISMS in an attempt to protect ourselves (though, very often, we are not consciously aware that many behaviours/defense mechanisms we have developed have developed in order to try to reduce the adverse effects of stress (though not all, eg CONVERSION – see below).

Often, however, the behaviours we develop which serve as these defense mechanisms to protect ourselves against stress are, at best, unhelpful, and, at worst, extremely damaging. I list and give a brief description of the main defence mechanisms that may develop below:

1) COMPENSATION: this behaviour occurs to offset a weakness or failing in ourselves eg someone who has very low self-esteem becoming a workaholic in an attempt to gain social status.

2) CONVERSION : anxieties can be CONVERTED into physical symptoms eg racing heart, sweating, high blood pressure, psychosomatic illnesses.

3) DENIAL : this defense mechanism is well known and the term has entered into the realms of popular vocabulary. It refers to a situation in which someone will not acknowledge something is wrong (eg after being told by a doctor one has only 3 months to live).

4) DISPLACEMENT : this is when we transfer the emotions we feel caused by one person onto somebody else who has nothing to do with how we’re feeling eg a man badly treated by his boss at work coming home and taking his anger and frustration out on his children.

5) DISSOCIATION : this is when we avoid examining how our behaviours relate to our beliefs by avoiding looking, too closely, at this relationship eg seeing ourselves as caring and compassionate but doing little or nothing to help others

6) FIXATION : this is when we have behaviours which stay fixed at an earlier stage of development and are therefore not appropriate to the life stage the individual is at eg a middle-aged remaining highly emotionally dependent upon his parents

7) IDENTIFICATION : this is when we behave, dress etc in a way which duplicates the way the person we are modelling ourselves on would behave and dress etc (this can occur on both conscious and unconscious levels and is not considered abnormal in young people).

8) INTROJECTION : this is when we turn our feelings towards others onto ourselves. Freud, for example, believed someone who is clinically depressed has, unconsciously, turned his/her anger with another/others onto himself and is, therefore, in effect, punishing him/herself with his/her depressive feelings in a way he/she unconsciously wishes to inflict upon others.

9) INVERSION : this is where we REPRESS a desire which we are uncomfortable having and act in a way which expresses the opposite eg a repressed homosexual who acts in an obsessively homophobic manner. This often occurs on an unconscious level.

10) PROJECTION : this is really the opposite of introjection (see above). It is where we constantly see faults in others which we, ourselves, are ashamed of and feel guilty about having eg constantly pointing out selfishness in others when we ourselves are ashamed of our own selfishness. Again, this can occur on an unconscious level.

11) RATIONALIZATION : this is when we, in effect, deceive ourselves and tell ourselves that something we have, in fact, done due to bad motives we have really done for socially acceptable reasons eg a man who divorces his wife and leaves his young family may tell himself it’s in the best interests of everyone, when, really, deep down, he is doing it purely in his own interest

12) REGRESSION : this is when we go back to behaving in a way that is no longer appropriate and would usually only occur at a much younger age eg a middle-aged man having a child-like tantrum.

13) REPRESSION : this is when we, unconsciously, bury feelings and attitudes which are unacceptable to us, and contrary to our moral beliefs, deep in the mind away from conscious access eg an illicit sexual attraction. When we consciously bury feelings that we are not comfortable with (often referred to in popular language as ‘putting something to the back of our mind’) it is called SUPPRESSION.

14) RESISTANCE : this is where there is a barrier between what we have repressed/banished into the unconscious mind. In other words, what we have repressed is not allowed conscious access. Freud believed this process meant the psychological tension produced by keeping the feeling, memory etc repressed can’t be resolved and so perpetuates the emotional pain that the individual is feeling.

15) SUBLIMATION : this is where the energy associated with feelings that are unacceptable to us (usually sexual, according to Freud) and buried in the unconscious mind is channeled into something else that is socially acceptable. Unlike many of the other defence mechanisms that I have described, this can be very positive, and, even, Freud thought, produce great art.

16) TRANSFERENCE : this is where feelings and emotions we have about a particular individual are transferred onto somebody else who was not the original cause of them. For example, an individual in therapy who transfers the feelings of hatred he feels towards his mother onto the therapist.

17) WITHDRAWAL : this is when we just cut off from a stressful situation, give up, lose interest and become apathetic eg a man who stops trying to make conversation with his wife or take any interest in her after the relationship has been very difficult for a long period of time and he can no longer cope with it

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

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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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Childhood Trauma Leading to Excessive Need for Approval.

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If we did not receive approval from those close to us in childhood we may grow up to have an excessive need for it from others later in life as a kind of compensation and in order to raise our shattered self-esteem. This can make us vulnerable and excessively anxious to make everybody like us and admire us. Of course, this is impossible to achieve.

It is just not possible to interact fully in society without sometimes experiencing disapproval and rejection. Very often, such rejection and disapproval does not mean that there is anything particularly wrong with us.

Indeed, it could be much more to do with failings in the other person, obvious examples are prejudice, discrimination, biased and irrational thinking or misdirection of emotions which were not originally generated by us (eg ‘displacenment’ – the psychological term for when somebody takes something out on us which was not our fault; or ‘projection’ -the psychological term for constantly ‘seeing’ in other people the things we don’t like about ourselves and may have repressed).

Frequently, too, a person’s behaviour towards us might be due to distorted beliefs stemming from psychological wounds that have been inflicted upon them in the past (eg a woman who distrusts men because her husband used to beat her).

When we are (inevitably) sometimes rejected, a useful exercise is to calmly think about why we have been responded to in a negative manner and analyze if it really was something to do with us or to do with something else not really connected to us.

For example, perhaps the person who behaved in a negative way towards us was over-tired or under a great amount of stress. In such a case, the disapproval is likely to be ephemeral, in any event, and something we do not need to dwell upon or take personally.

Obviously, when someone rejects us it does not mean that we are of no value. Even if we have done something wrong, one action or set of actions does not define us as a person (either in the present or in the future). To become defined in such a way would be absurdly limiting and simplistic. Human beings are, after all, complex creatures (hence expressions like : ‘he’s the sum of his contradictions’).

Individuals who have an excessive need for approval often feel that it is imperative that EVERYBODY approves of them. I repeat, this is impossible, and, in my view, undesirable (often, history has shown us, the most enlightened and edifying views can meet with vicious opposition). We do not need the approval of everyone we meet in order to live a happy and meaningful life. Also, other people’s views of us should not be given equal weight (eg most of us would value the view someone we respected had of us more than the view a stranger had).

It is also important to point out that we can sometimes feel hurt and upset if someone criticizes us in a mannner which we do not feel is warranted – to avoid falling into such a trap we need to remind ourselves that we need not let our mood be affected adversely by something negative someone says about us if we know it not to be true.

Finally, it is worth saying how it might be helpful to react when someone disapproves of us when we HAVE done something we regret. A constructive response might be as follows:

a) we can learn from the criticism

b) just because we know we have done something wrong, it is illogical to overgeneralize from this and view ourselves as a wholly bad person

c) accept that we feel temporarily uncomfortable but to keep in mind, too, that this feeling will pass and that we are not necessarily being totally written off as a person by the individual we have upset, let alone by everybody else for evermore!

RESOURCES :

OVERCOME THE NEED FOR APPROVAL MP3 – CLICK HERE

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

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Childhood Trauma: Food and Nutrition which may Help with Resultant Depression.

Due to the side-effects associated with anti-depressants, together with the controversy which surrounds their effectivenes, some individuals prefer to try to treat their depression in more natural ways; in relation to this, many people adjust their intake of nutrients in ways which research suggests may lift their mood. I examine the foods and nutients which may help this goal to be achieved below:

FOODS AND NUTRIENTS WHICH MAY HELP TO LIFT MOOD

Not only does some research suggest that the foods and nutrients listed below may help lift mood when depressed, it suggests they may also make depression less likely to recur once feeling better:

1) SELENIUM : this can be found in oysters, mushrooms and Brazil nuts

2) CHROMIUM : this can be found in turkey and green vegetables

3) ZINC : this can be found in shellfish, seafood and eggs

All of the above nutients can also be bought in supplement form from chemists and health food shops. However, they should not be taken in large doses so be sure to read the relevant labels to obtain the recommended amounts to take.

4) VITAMIN B12 : this vitamin, which can also be bought as a supplement from health shops and chemists, is thought to help maintain general mental alertness and, also, help keep feelings of depression at bay. It can be found in salmon, meat, cod, milk, cheese, eggs and yeast extract.

FISH

Some scientists recommend eating fish as a way of reducing depressive symptoms. The reason for this is that some research studies have provided evidence that FISH OILS have both an ANTI-DEPRESSANT and MOOD-STABILIZING effect. However, because of the amount of fish oil which needs to be ingested, one would have to consume a vast quantity of fish. In order to rectify this problem, many companies now produce FISH OIL CAPSULES (eg OMEGA – 3) as dietry SUPPLEMENTS. These contain very concentrated fish oil. However, more research needs to be conducted in order to come to a definitive verdict on their effectiveness. One benefit of them, however, is that they have no side-effects, apart from, rarely, a mildly upset stomach.

5-HTP

Otherwise known as HYDROXTRYPTOPHAN. The body manufactures this from tryptophan (an AMINO ACID) in the diet (sources include turkey and bananas) and it is linked to the production of SEROTONIN (a neurotransmitter which I discuss in other posts – please enter ‘SEROTONIN’ into this site’s search facility if you wish to access those posts) in the brain. Depleted serotonin levels in the brain are thought to be connected with depression and insomnia. Indeed, taking supplements of 5-HTP has been linked to not only helping to treat depression and insomnia, but, also, obesity.

The Cochrane Review (2001) found two studies suggesting that 5-HTP was more effective at treating depression than placebos, but, also, concluded that more research needed to be conducted in order to reach a proper conclusion in relation to how beneficial it is.

CONCLUSION:

A lot more research needs to be conducted in order to come to any definitive solutions about just how helpful diet, nutrients and supplements are at treating mental health conditions. However, there is a vast number of people who take them and are convinced of their effectiveness.

Finally, I wish to stress that it is extremely important to speak to a doctor if you are considering coming off any prescribed medication.

Click here for a hypnotherapy download to treat depression.

I hope you have found this post of interest.

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

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Copyright 2013 Child Abuse, Trauma and Recovery

A Closer Examination of The Effects of Childhood Trauma. Part 2

In Part One I looked at how childhood trauma can adversely affect an individual’s ability to control his/her emotions and his/her ability to maintain relationships and interact socially.

In this post, Part 2, I wish to look at how 3 other areas of the individual’s functioning may be adversely affected by the experience of childhood trauma. These are:

– Behaviour
– Physical Health
– Cognitive Functioning (thinking skills).

Let’s look at how each of these 3 areas of functioning may be negatively affected now:

BEHAVIOUR – Because the effects of childhood trauma are so complex, it is not possible to fully articulate them; a demonstration of their effects, then, may frequently be ‘acted out’ through DISTURBED BEHAVIOUR. Some individuals may become withdrawn and emotionally ‘flat’, others may become disruptive, aggressive, hostile and attention seeking.

PHYSICAL HEALTH – Sometimes, a secondary effect of emotional distress may express itself physically – in other words, the individual may develop psychosomatic symptoms (the term ‘psychosomatic’ refers to the mind’s effects upon the body – chronic and severe stress, in other words, can create physical symptoms; it is important to point out here that, just because a physical symptom is psychosomatic, it does not make that symptom any less real or harmful than physical symptoms caused by non-psychological factors).

What sort of physical symptoms can occur as a result of protracted and intense stress? Examples can include changes in appetite, insomnia, headaches and stomach aches, although this list is not an exhaustive one.

COGNITIVE (THINKING) SKILLS – Severe and chronic stress can impair an individual’s ability to think clearly, concentrate and learn; these impairments mean that the individual will be unable to live up to his/her potential. This can result in difficulties maintaining employment; if this happens, self-esteem and self-confidence are often adversely affected.

CONCLUSION – It is important to point out that just because an individual does display symptoms like those described above, it does not mean for certain that the affected individual has suffered extreme childhood trauma. However, because the symptoms signal great distress, it is likely that if childhood trauma is not responsible, other serious stressors are at play.

I hope you have found this post of interest. Please leave a comment if you would like to.

New posts are added to this blog at least twice a week.

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

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Copyright 2013 Child Abuse, Trauma and Recovery

Simple Questions We can Ask Ourselves to Reduce Anxiety

Below I have listed a set of questions we can ask ourselves when we are worried and anxious. The questions are intended to help us CHALLENGE OUR NEGATIVE THOUGHTS; this technique derives from Cognitive Behavioural Therapy (CBT):QUESTIONS WE CAN ASK OURSELVES WHICH HELP US TO CHALLENGE OUR NEGATIVE THOUGHTS:

1) What evidence is there that the negative thought I am having is true?
What evidence is there that the negative thought I am having is not true?

2) Is the negative thought a fact based on rational and logical thinking?
Or is it influenced (distorted) by the way I am feeling (ie based upon EMOTIONAL REASONING rather than on rational thinking)?

3) Is constantly focusing on this negative thought helping me to move forward in my life? Or is focusing on the negative thought causing me unnecessary distress, hindering me and holding me back, preventing me from making a valuable contribution in life?

4) Is there a more positive way I can interpret events? Is there another perspective I can take/ Can I apply ‘out of the box’ thinking?

5) If a close friend was in the same situation, what advice and help would I give him/her? Can I apply the same sensitivity, compassion and understanding I’d show to a friend to myself? If not, why not? Am I treating myself unfairly?

6) What is the worst outcome of the situation in which I find myself? Am I over-estimating the probability of the worst happening? If the worst does happen, am I underestimating my ability to cope with such an outcome?

7) Can I change my mind-set from viewing this situation as a problem, to viewing it as a challenge? Which of these two approaches is likely to be of most benefit to me?

It is possible, of course, for us to write these questions down and remind ourselves of them when we feel particularly anxious; we can even carry them around with us if we feel so inclined! Sometimes, a simple shift of perspective can have a very liberating effect.

A technique which can be highly effective at helping us to overcome our anxiety is hypnotherapy :

TO FIND OUT MORE ABOUT HYPNOSIS, HERE IS A LINK TO A RECOMMENDED HYPNOTHERAPY BLOG TO WHICH THIS SITE IS AFFILIATED : http://www.hypnosisdownloads.com/blog/feed/?a=5719!blog

 

Best wishes, David Hosier BScHons; 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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