Category Archives: Bpd

Childhood trauma and BPD.

Why BPD Sufferers Often See Others As Malevolent

This article is based upon ‘Object Relations Theory’ which places crucial importance upon interpersonal relationships, most of all interfamilial relationships, especially between the mother and the child. The theory, in particular, concerns itself with how we develop. in our early lives, inner, mental images of ourselves and others and how these images affect our interpersonal relationships throughout later life. The theory also incorporates the idea that humans are primarily motivated by a powerful desire to form positive relationships with others (breaking away from Freud’s belief that humans are primarily motivated by the instinctual drives of sex and aggression).

Research suggests (e..g. Malevolent object representations in borderline personality disorder and major depression. Nigg et al., 1992) that those suffering from BPD are prone to develop ‘malevolent representations’ of others. This article summarizes why this might be in terms of psychoanalytic theory.

First, it is necessary to introduce two terms: ‘Object Cathexis’ and ‘Object Hunger.’

According to the APA Dictionary of Psychology, ‘object cathexis’ is a classical psychoanalytic term that refers to the process of the investment of libido or psychic energy in objects outside the self, such as a person, goal, idea, or activity.’

Object hunger, on the other hand, refers to an intense need of, and dependency upon, others (e.g. family, friends, intimate partners) or, especially in the case of BPD sufferers who experience profound feelings of emptiness, substitutes such as narcotics, tobacco, alcohol, promiscuous sex, overeating, overspending on material goods etc.

In simple terms, if we were brought up in early life by primary cares who made us feel safe and secure we are likely to have developed healthy object cathexis and a general trust in the world and others. However, if our primary carers failed to make us feel sufficiently safe and secure, we are much more likely to have developed a diametrically opposed general view (i.e. that the world and others are unsafe, threatening and not to be trusted). This, in turn, creates in us ‘object hunger.’

Introjection is a psychoanalytic term that means:

the unconscious incorporation of attitudes or ideas pf others into one’s personality’. [particularly in relation to the child and his/her parents/primary carers].

Loving and nurturing parents lead us to introject their positive attitudes about others, ourselves and the world in general whereas parents who are abusive or neglectful lead us to introject their negative attitudes about others, ourselves and the world in general which, in turn, creates a proneness in us to see ourselves as unlovable, the world as unsafe and threatening and others as essentially malevolent.

Furthermore, if we are unable to introject positive attitudes from our parents due to their abuse and/or neglect we will be unable to construct a positive, internal, mental representation of them to comfort us in times of stress when they are not physically present. And, because of this, we are likely to have an impaired ability to calm ourselves down and self-soothe when emotionally upset.

Our inability to effectively self-soothe, due to our failure (because of our parents’/primary carers’ abuse and/or neglect) to create for ourselves in early life a ‘soothing introject’ can mean that when feeling fearful and under threat we create instead in our minds a ‘malevolent other’ in order to help us to make sense of the situation and to rationalize it. For example, if a friend unconsciously triggers in us the feelings of rejection we felt in childhood we may demonize and devalue them because we are unable to draw on the emotional resources a ‘soothing introject’ would otherwise have provided. In this sense, the mental creation of the ‘malevolent other’ operates as a defence mechanism based upon the process of transference (‘transference refers to an individual’s displacement or projection of feelings originally directed at parents/primary carers in the individual’s childhood onto others.

Of course, if, due to our childhoods, we have developed this in-built tendency to view others as malevolent, we are likely to encounter serious problems in relation to our interpersonal relationships. To learn more about how these problems may arise, you may wish to take a look at my previously published article about how our adult relationships can be ruined by our childhood experiences.

BEAT FEAR AND ANXIETY SELF-HYPNOSIS PACK

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

 

Three Important Theories On Why Some Develop BPD And Others Do Not.

Although most people who are diagnosed with borderline personality disorder (BPD) report having experienced childhood trauma, this is not invariably the case (although, of course, just because a person does not report having suffered childhood trauma does not mean s/he didn’t experience it. For example, s/he could be in denial, may have suppressed or repressed memory of the trauma or may have been too young to have stored the trauma in conscious memory).

However, it is also the case that not all of those who suffer childhood trauma go on to develop BPD. This means that there must exist individual differences which make some vulnerable to developing BPD whilst making others resilient.

In order to help cast light upon this, various diathesis-stress models have been proposed and below I summarize three of the most important ones. But, first, let’s define what is meant by a diathesis-stress model:

According to the APA Dictionary Of Psychology, a diathesis-stress model is: ‘a theory that mental and physical disorders develop from a genetic or biological predisposition for that illness (diathesis) combined with stressful conditions that play a precipitating or facilitating role. Also called a diathesis-stress hypothesis, or paradigm or theory’.

 

THREE IMPORTANT THEORIES ABOUT WHY CERTAIN INDIVIDUALS DEVELOP BPD (ALL BASED UPON THE DIATHESIS STRESS MODEL):

  1. The Schema-Focused Therapy Model (Young et al., 2003):

According to this theory, dysfunctional family characteristics such as rejection and deprivation prevent the child from having his/her core emotional needs met which, in turn, leads to frustration.

These frustrations then lead to the child developing ‘maladaptive schema.’ Young defined ‘maladaptive schema’ as:

‘a broad pervasive theme or pattern regarding oneself and one’s relationship with others, developed during childhood and elaborated throughout one’s lifetime, and dysfunctional to a significant degree.’

Information is then processed via the lens of these dysfunctional schemas and it is this distorted informational processing which lies at the heart the BPD sufferer’s maladaptive cognitions, behaviours and emotional reactions, according to Young’s theory.

Core emotional needs include :

An example of a dysfunctional schema that might result from childhood trauma (e.g. rejection and betrayal) is: ‘nobody can ever be trusted.’

Children who are most at risk of being significantly psychologically damaged by the behaviours of the dysfunctional family are those children who are emotionally temperamental due to pre-existing biological/genetic influences, according to this theory.

2. Dialectical Behavior Therapy Model (Linehan, 1993a):

According to Linehan’s theory, children are at risk of going on to develop BPD if they are temperamental, highly sensitive, emotionally vulnerable and predisposed to emotional dysregulation (diathesis) AND ALSO grow up in an environment which is invalidating and dismissive/undermining of the child’s personal experience (stress).

3. Transference Focused Therapy Model (Kernberg, 1984):

According to Kernberg, children who are highly prone to negative emotions, especially aggression (diathesis) and experience certain environmental factors such as emotional frustration (stress) may, as a consequence, develop the dysfunctional defence mechanism known as ‘splitting’ (click here to read my article on ‘splitting’) and it is this that underlies the development of BPD. According to the APA Dictionary Of Psychology, ‘splitting’ is defined as:

‘…a primitive defence mechanism used to protect oneself from conflict, in which objects [i.e. person’s] provoking anxiety and ambivalence are dichotomized into extreme representations (part-objects) with either positive or negative qualities, resulting in polarized viewpoints that fluctuate in extremes of seeing the self or others as either all good or all bad.’

THERAPIES RELATED TO THE ABOVE MODELS:

You may wish to read my previously published articles about the therapies relating to each of the above models which I list below:

 

 

 

 

 

 

 

 

 

 

 

Above eBook now available for immediate download on Amazon. Click here for further information.

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

 

 

 

 

 

Reducing Risk Of Intergenerational Transmission Of BPD

A study conducted by Stepp et al. (2012) adds further evidence in support of the theory that children of mothers with borderline personality disorder (BPD) are at increased risk of developing their own psychosocial problems (i.e. impaired mental health and difficulties relating to social interaction).

The authors of the study acknowledge that, to some extent, genetics may play a part in this. Although there is not a gene for BPD, children of BPD mothers may be at increased risk of inheriting problematic characteristics such as d difficult temperament, a predisposition towards behaving impulsively and emotional dysregulation((the experiencing of intense emotions which the individual finds extremely difficult to keep under control), Such inherited characteristics may make the child at higher than average risk of developing BPD.

However, the researchers also stress the importance of environmental factors on the child’s psychosocial development, particularly parenting skills or lack thereof. They point to other research showing that BPD mothers are prone to oscillating between the extreme idealization of others and intense devaluation of them (which, as I have said in other posts on this site, is an accurate description of how my mother interacted with me, culminating in her finally throwing me out of the house when I was thirteen years old, then, not being one who could ever be accused of doing things by halves, telling anyone who would listen that I’d ‘chosen’ to go and live with my father as I was a snob and he lived in a bigger house than she did). The authors go on to say that if mothers behave in this way towards their children (i.e. fluctuating between the extreme idealization of them and the intense devaluation of them) this is likely to have a significantly injurious effect upon their (i.e. the children’s) psychosocial development.

Furthermore, it is pointed out by those who ran the study that previous research has also shown that those suffering from BPD often swing between behaving in a very hostile and controlling way towards others and behaving with passivity/coldness towards them.  Again, it is observed that, if mothers behave with similar inconsistency towards their children, this too is likely to grossly impair their psychosocial development.

BPD mother’s, too, may be prone to behaviours that frighten the child.

Such mothers may also have a marked tendency to invalidate the  child’s emotions (for example, in my own case, when I was very young my mother would behave in a verbally sadistic way towards me, then mock me if I became visibly upset as if I was ‘over-reacting’ or being ‘too sensitive.’

Sadly, the above list examples of dysfunctional behaviour exhibited towards children by PDD mothers is far from exhaustive.

Effects On Child :

Evidence exists to suggest that children of BPD mothers are at increased risk of anxiety, depression, interpersonal difficulties, problems with authority. problems relating to identity, and various other psychological difficulties. (For more on this, see my previously published articles: ‘The Effects Of BPD Mothers On Their Children’ and Four Types Of Borderline Mother: Witch, Hermit, Waif And Queen.)

Possible Interventions Which May Help To Reduce The Likelihood Of Intergenerational Transmission Of BPD And BPD-Type Symptoms:

 

  • Attachment-based interventions
  • Psychoeducational interventions
  • Skills to promote consistency in scheduling and monitoring
  • Skills to promote consistency in warmth and nurturing
  • Mindfulness-based parenting skills to facilitate behavioural and emotional consistency

For much more on this, see the original study by clicking here.

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

 

 

 

 

How Childhood Trauma Can Alter Brain’s Reward Circuits

There is increasing evidence to suggest that chronic, severe stress during childhood can lead to changes in the brain’s reward circuitry that leads individuals to prefer short term gains and immediate gratification over postponed, long-term gains and pleasures.

So, for example, rather than save up money to start a business or for an exotic holiday or undertake a diet and fitness regime to improve one’s health and fitness, an individual who has undergone chronic, early-life stress may prefer the kind of instant highs obtainable from alcohol, smoking, junk food, gambling, casual sexual encounters and narcotics.

It is hypothesized that this dysregulation of the appetites may be linked to damage (caused by chronic childhood stress) to the prefrontal cortex which, in turn, reduces its ability effectively to send signals/chemical messages that would otherwise be able to inhibit the nucleus accumbens.

The nucleus accumbens is a region of the brain that drives our sense of desire, or, to put it more simply, makes us want what we want. And, if the prefrontal cortex is unable to keep it under control due to the factors explained above, it can run amok and, potentially, turn us into chain-smoking, alcoholic, drug-addicted, morbidly obese, gamblers and sex-addicts. Clearly, quite apart from other relevant considerations, this would not be good for our physical health (indeed, statistics show that, all else being equal, those who have suffered severe and protracted childhood trauma, on average, die significantly earlier than those who have had more fortunate early life experiences).

In other words, if we have suffered significant early life stress we are at increased risk of impulsivity and of seeking and obtaining immediate rewards whilst ignoring the harm and potential losses such behaviour may cause us in the long term

EXPLAINING THE PRIORITIZING OF IMMEDIATE REWARDS OVER GREATER, LONG TERM REWARDS IN EVOLUTIONARY TERMS:

Such impulsive behaviour and prioritizing of short term gains due to the effects of excessive stress and of living in the constant anticipation of danger can be explained in evolutionary terms: If our ancestors were chronically stressed and perpetually feeling under threat because their survival was in danger due to scarce resources and/or because they could at any time be attacked and killed by a predator, it would have been evolutionarily adaptive to consume as many calories as possible when the opportunity presented itself (as there was no way of knowing how long it would be until the next meal became available) and to mate as early and frequently as possible (to maximize the chances of their genes being passed on), as well as to exploit opportunities to achieve other short term ‘wins.’

Indeed, in support of this idea, there exists research (Sweiitzer et al., 2008; Gianaros et al., 2011) to suggest that those from the lowest socioeconomic echelons of society have a greater propensity than those from wealthier backgrounds to opt for immediate rewards and instant gratification at the expense of forfeiting larger, future rewards.

RELATED POSTS:

Can’t Control Impulses? Impulse Control Activities For Adults.

    Impulse Control: Study Showing Its Vital Importance.

 

RESOURCE:

 

CONTROL IMPULSIVE BEHAVIOUR: SELF HYPNOSIS DOWNLOADS

 

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

Odd, Quasi-Psychotic And True Psychotic Thinking In BPD Sufferers

A study conducted by Zachirini et al. (2013) investigated the prevalence of disturbed thought in 290 in-patients who had been diagnosed with BPD (borderline personality disorder). The quality of disordered thinking measured in these 290 BPD in-patients was compared to the quality of disordered thinking measured in 72 non-BPD in-  patients who had another (i.e. different) Axis II disorder (BPD is an Axis ii disorder, but the category includes several other personality disorders including paranoid, schizoid, schizotypal, antisocial, histrionic or narcissistic personality disorder).

The types of disordered thought of interest to the researchers in this total of 362 in-patients were divided into three main categories which were as follows :

1) NON-PSYCHOTIC THOUGHT:

This category was broken down into:

  • odd thinking
  • atypical perceptual experiences
  • paranoid thoughts (of a type that fell below the threshold to be considered delusional)

2) QUASI-PSYCHOTIC THOUGHT: delusions and hallucinations that related only to limited aspects of perception/thought, were ephemeral (i.e. of short duration limited to hours or days) and ‘non-bizarre’ (i.e. involving situations which could theoretically and conceivably happen in real life such as fear of others conspiring  and plotting against one, fear that somebody is attempting to poison one or fear one is being covertly followed); such ‘non-bizarre’ delusions most frequently occur due to the BPD sufferer’s misinterpretation of their experiences/perceptions

3) TRUE PSYCHOTIC THOUGHT.

 

RESULTS OF THE STUDY:

It was found that the BPD in-patients had significantly more disordered thought in relation to all three of the above categories, i.e. (1) non-psychotic but odd, atypical and non-delusional paranoid thinking; (2) quasi-psychotic thinking and (3) true psychotic thinking than those non-BPD in-patients who had been diagnosed with other Axis II disorders (see above).

OTHER TYPES OF DISORDERED THINKING FOUND TO EXIST IN THE BPD IN-PATIENTS STUDIED:

The participants in the study were followed up over a sixteen-year period by the researchers and during this time 17 more specific types of thinking/perception problems were examined and it was found that the BPD sufferers, when compared to the individuals who had been diagnosed with other Axis II disorders, also had a significantly increased likelihood (over this sixteen-year period) of suffering from the following eleven of these 17 types of disordered thinking; I list these below:

  • overvalued ideas
  • recurrent illusions
  • undue suspiciousness (e.g. ‘everybody despises me’; ‘everybody wants to destroy me.’).
  • quasi-psychotic hallucinations
  • true-psychotic hallucinations
  • quasi-psychotic delusions
  • derealization
  • depersonalization
  • ideas of reference (e.g. ‘I’m a terrible person’; ‘I’m irreparably damaged, and my condition will never improve, no matter what.’)
  • paranoid ideation
  • magical thinking (the belief that one’s own desires, thoughts and wishes can directly influence the real world e.g. ‘putting a curse’ on somebody or putting pins into a voodoo doll).

However, there is better news: as time went on over the sixteen-year period of study, it was found that symptoms of the above types of disordered thought in BPD sufferers diminished (with the exception of true-psychotic hallucinations).

CONCLUSION:

The researchers concluded that the type and intensity of thought disorder in BPD sufferers could help to distinguish those suffering from the disorder from those suffering from other Axis ll personality disorders such as those mentioned above. It was also pointed out by the authors of the study that, whilst thought/perception disorder tends to diminish over time in those suffering from BPD, such thought disturbance (particularly in relation to non-psychotic thought disorder) can remain a residual problem.

THE VITAL IMPORTANCE OF REDUCING STRESS:

As alluded to above, full-blown psychotic thinking, if it does occur in BPD sufferers, tends to be ephemeral and transient, lasting no more than hours or days. Other research, as one would expect, suggests that if such disordered thinking does occur, in BPD patients, it is usually brought on by stress which provides yet another reason why it is imperative for those recovering from BPD (many do recover or go into remission with therapeutic help such as undergoing dialectical behaviour therapy) keep toxic stress levels down to an absolute minimum.

eBook:

 

 

 

 

 

 

 

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

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

Research Into Children Of Mothers Suffering From Borderline Personalty Disorder.

 

 

 

Reviewing previous studies involving children between the ages of 4 years and 18 years, Macfie states that such children of BPD mothers are at increased risk of :

  • experiencing changes in household composition (e.g. due to divorce/BPD parent co-habiting with varying new partners/acquisition of step-parents/acquisition of step-siblings etc.).
  • experiencing excessive changes in school (e.g. due to constant relocations).
  • being removed from the home(e.g. due to being taken into care/being palmed off to relatives/being thrown out of home etc).
  • being exposed to living with a mother who is an alcoholic.
  • being exposed to living with a mother who is a drug addict.
  • being exposed to living with a mother who threatens/attempts/completes suicide.
  • suffering from problems relating to poor powers of concentration/attention, delinquency, inability to control anger/proneness to aggressive outbursts,  anxietydepressionlow self-esteem.

And, reviewing previous studies involving infants, Macfie states that such offspring of BPD mothers are at increased risk of :

  • having mothers who are intrusive and insensitive in their behaviour towards the infant.
  • reduced responsiveness towards the mother, including dazed looks and looking away from the mother.

And, perhaps most worryingly of all, Macfie cites research conducted by Hobson et al., 2005, suggesting that, at the age of 13 months, a staggering 80% of infants of borderline mothers have a disorganized attachment style in relation to their interactions with their mothers.

ROLE REVERSAL:

Macfie suggests that mothers suffering from BPD may use the child to satisfy their own needs (e.g. the need to feel loved) and discourage the infant’s instinct to develop autonomy. This, Macfie suggests, can eventually lead to a kind of role reversal (e.g. parentification /adultification) which, in turn, increases the child’s risk of developing difficulties controlling his/her emotions and behaviours.

REPRESENTATIONS OF SELF AND OTHERS :

Macfie also states that if the child has developed a disorganized attachment style due to frequently being frightened by the BPD mother and/or due to frequently witnessing the mother in a fearful and anxious state, s/he is likely to develop a negative representation of others which may include a marked tendency to view people in general as dangerous, threatening and incompetent, Such a child’s self-representation is also likely to be negative, including seeing himself/herself as unworthy of love and care ; such a negative self-view can then become self-perpetuating.

In short, the child of the BPD mother is in danger of developing a cognitive-negative-triad involving a negative view of the self and others, a negative view of the future and a negative view of the world in general (see SHATTERED ASSUMPTIONS THEORY) together with a set of most unhelpfully distorted core beliefs.

Out of these negative representations of self and others, Macfie reminds us that the individual who holds them may develop various severe problems which include:

INTERVENTIONS:

The author of the study suggests that for ‘at risk’ children (i.e. those who are emotionally vulnerable – due, for example, to temperament, emotional reactivity and impulsivity – and grow up in a stressful environment due to various factors including those referred to above) the following interventions may mitigate the danger of developing full-blown BPD:

 

 

Above eBook now available from Amazon for immediate download. CLICK HERE FOR MORE DETAILS.

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

 

 

 

 

Why Trauma Survivors May Find It Hard To Learn From Past Behaviour.

Many of us who have experienced severe and protracted childhood trauma, particularly if we have gone on to be diagnosed with conditions such as complex PTSD or BPD as a result, are frequently liable to ‘act out‘  unbearable inner pain (being unable to express it in healthy ways or even to understand its origin) in ways we later regret and feel ashamed of; indeed, such feelings of shame can be intense and devastating. [Related to this concept is the theory that anger, a frequent component of ‘acting out’, may sometimes operate to soothe emotional pain.]

However, despite such regret and shame, many, too, find themselves trapped in a perpetual cycle of repeating such self-defeating, ‘acting out’ behaviours, often at a very high cost to themselves and those who trigger their trauma-related feelings (e.g. feelings of rejection). In this way, the traumatized individual seems powerless to learn from experience and past mistakes, as if driven by unconscious psychological forces beyond their control (which, without effective therapy, may indeed be the case).

THE ROLE OF FAULTY MEMORY PROCESSING :

Such apparent helplessness to learn from experience is, however, much easier to understand when we consider how the severely traumatized individual’s memory processing abilities may have been negatively affected by his/her traumatic past.

To be more specific, trauma can impair brain and memory function in a variety of different ways, including adversely affecting the functionality of a part of the brain known as the hippocampus (indeed, research has shown that those who experience severe, long-lasting trauma in childhood can develop SHRUNKEN HIPPOCAMPI due to the chronic over-stimulation of the body’s stress hormones which have, in excess concentrations, a toxic effect upon the brain and other bodily organs)

Such impairment of brain and memory function, in turn, leads to DIFFICULTIES IN TRANSFERRING MEMORIES FROM SHORT-TERM STORAGE TO LONG-TERM STORAGE and, furthermore, interferes with the brain’s ability to process and make rational sense of information. Episodic memories (memories of past personal experiences that occurred at a particular time and place) may not be properly processed which prevents a corresponding semantic memory (a form of long-term memory essential for the use and understanding of concepts and language) from being formed, making it hard for the individual to use knowledge (which, in normal circumstances, would have been gleaned from the episodic memory and have made it available to be subjected to rational analysis)) to inform and beneficially adjust future behaviour.

DISSOCIATION:

Studies also show that memory function is impaired due to the tendency of traumatized individuals, especially those suffering from complex PTSD and BDP, to dissociate when ‘acting out’ as a result of a trauma-related feeling triggered.

Both of the above (i.e.impaired memory processing ability due to organic damage and dissociation) impact on learning ability which, in turn, then, help to explain why traumatized individuals find it hard to learn from experience, particularly in the context of interpersonal conflict that mirrors early-life traumatic experiences and results in dissociated, ‘acting-out’ type behaviour). Furthermore, such individuals may also suffer from depression which is itself known to impair learning, memory and cognitive processing abilities.

Impaired memory, learning and cognitive processing ability, of course, can also interfere with other crucial areas of life, such as academic and occupational performance.

THERAPY:

Therapies that reduce stress and increase emotional resilience can help people who have been affected in this way and there exists some evidence that antidepressants can increase hippocampal volume (N.B. Always consult an appropriately qualified expert before deciding whether or not to take antidepressants).

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