Tag Archives: Borderline Personality Disorder

‘Splitting’ – What BPD Sufferers And 18 – 36 Month Old Infants Have In Common

splitting andBPD

Infants and toddlers (aged from approximately eighteen months to thirty-six months old) find it extremely hard to tolerate ambiguity and ambivalence. For this reason, their perception of features of the external world become polarized, or, as it is often, informally and metaphorically put, ‘black and white’.

For the infant / toddler (18 – 36 months, approx.) then, what we might call ‘grey areas’ are effectively eliminated as everything including, most significantly, the infant’s / toddler’s mother (or primary carer) is CATEGORIZED AS EITHER ‘GOOD’ OR ‘BAD’, depending upon how she is behaving in relation to him/her at any given point in time.

When the mother fails to satisfy adequately the infant’s needs, s/he perceives her as ‘all bad’. And, in stark contrast, when the mother DOES satisfy the infant’s needs (e.g. with a satisfying feed or by providing appropriate physical comfort) s/he perceives her as ‘all good’.It is only as the child gets older and develops and his/her understanding of the world and of those who inhabit it becomes increasingly sophisticated that s/he is able to integrate such contrasting perceptions and come to realize that both good and bad elements can exist in the same person simultaneously.

 

However, the adult sufferer of borderline personality disorder (BPD) becomes stuck in this toddler-like state of seeing others as either all good or all bad and, as a result, forms extremely unstable relationships with others, particularly significant others, perpetually vacillating and between idealizing them and demonising them ; this phenomenon is known as SPLITTING and, in essence, is a defense mechanism serving to protect  the individual with BPD from  feelings of potentially overwhelming anxiety.

 

splitting

The concept of ‘SPLITTING’ was initially developed by Ronald Fairbairn and was a component of his psychoanalytic theory known as‘object relations theory’.

 

Finally, it is worth pointing out that it is not just people with BPD who employ the defense mechanism of ‘splitting’ ; for example, adolescents tend to do so quite a lot. Adults who do have have BPD and who are not mentally ill use it too. However, in the case of those suffering from BPD, the defense mechanism of ‘splitting’ is used abnormally frequently in comparison to the average individual and the extremes in which they perceive others vacillate more dramatically. (NB Although I employ the term ‘used’, defense mechanisms are UNCONSCIOUS processes i.e. the BPD sufferer does not deliberately choose to exercise the psychological response of ‘splitting’).

 

A leading treatment for BPD is, currently, dialectical behavior therapy which you can learn more about by clicking here.

 

eBook :
bpd_ebook

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

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

When Is BPD Diagnosed? The Continuum Of Personality Problems.

personality

The Nine Personality Problems Associated With Borderline Personality Disorder (BPD) :

There is no clear demarcation between those who have borderline personality disorder (BPD) and those who do not ; this is because the personality problems that contribute to a BPD diagnosis lie on a continuum. I have described the symptoms of BPD in numerous other articles that I have previously published on this site, but, for the sake of convenience, will list them again :

Three Criteria That Contribute To A Diagnosis Of BPD :

According to DSM V (The Diagnostic And Statistical Manual Of Mental Disorders, Fifth Edition) an individual must display at least five of these symptoms to be diagnosed as suffering from BPD.

However, as implied above, an individual does not either have these personality problems or doesn’t have them – things are not that clear cut or black and white. So how is it decided whether or not each symptom is serious enough to count towards a diagnosis of BPD?

Essentially, it is a question of three considerations. For each of the above nine key symptoms, it is necessary to ask :

  1. Is the symptom chronic?
  2. Does the symptom cause the sufferer, or other people, significant problems?
  3. Does the symptom adversely affect multiple areas of the sufferer’s life?

peronality continuum

Let’s briefly look at each of these in turn :

Conclusion :

Essentially, the more of the above nine symptoms an individual has (as stated above, it is necessary to have a minimum of five to be diagnosed with BPD), and the more chronic, the more problematic and the more pervasive these symptoms are are, the more likely the individual is to be diagnosed with BPD.

However, diagnosis is not an exact science so there is always the possibility of unreliable diagnoses ; for example, person A may be diagnosed as having BPD by Dr X whereas person B may NOT be diagnosed as having BPD by the same doctor.

However, if both seek a second opinion from Dr Y, the diagnoses may be reversed (i.e person A is diagnosed as NOT having BPD whilst person B is diagnosed as having BPD. Of course, in the case of individuals suffering from particularly extreme (even within the context of the disorder) symptoms, diagnoses are likely to be more consistent and reliable.

eBook :

BPD ebook

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

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

BPD Sufferers Need To Be ‘Held’ According To Theory

holding

Buie And Adler :

Buie and Adler propose that the pathology displayed by sufferers of borderline personality disorder (BPD) such as instability, uncontrolled rage and anger, can be attributed, primarily, to early dysfunction in the relationship between the individual as a young child and his/her mother.

More specifically, Buie and Adler hypothesize that, as a young child, the BPD sufferer was insufficiently ‘held’ by the mother, particularly during the rapproachment phase of interactions.

What Is Meant, In Psychotherapy, By ‘Holding’?

In psychotherapeutic terms, the word ‘holding’ does not necessarily entail literal, physical holding (although, ideally, of course, a mother would physically hold her young child when s/he was distressed and in need of comfort), but can also involve its emotional equivalent (verbally comforting and soothing the child, for example).

However, because of the mother’s failure to sufficiently ‘hold’ (physically, emotionally or both) the BPD sufferer when s/he was a young child in distress, s/he never had the opportunity to internalize adequate maternal ‘holding’ behavior so that now, as an adult, s/he lacks the ability to self-soothe in response to the further distress that s/he will inevitably experience as an adult.

self-soothe

Profound Feelings Of Aloneness :

Buie and Adler further propose that the BPD sufferer’s inability to ‘self-sooth’ at times of high stress leads to a pervasive and profound sense of aloneness ; indeed, Buie and Adler consider this deep sense of loneliness to be a core feature of the BPD sufferer’s psychological experience and describe it in the following manner :

‘an experience of isolation and emptiness occasionally turning into panic and desperation.’

Projection :

Also, according to Buie and Adler, BPD sufferers use the psychological defense mechanism of projection in relation to their profound feelings of inner isolation which means, in short, that they project these feelings onto the external environment, and, as a result of this, perceive the outside world, and life in general, to be empty, meaningless and devoid of purpose.

Longing To Be Held By Idealized Others :

Furthermore, Buie and Adler propose that this inability to self-soothe and self-nurture (due to the original failure to internalize maternal holding behavior, itself a result of the mother’s dysfunctional interaction with the BPD sufferer when s/he was a young child) leads to intense, desperate longing and desire to be ‘held’ by idealized others.

Separation Anxiety :

Additionally, according to Buie and Adler, such longings perpetually leave the BPD sufferer vulnerable to feelings of extreme separation anxiety.

Rage :

Because of the BPD sufferer’s proneness to idealize others (see above), Buie and Adler point out that this can lead to him/her (i.e. the BPD sufferer) to develop extremely exacting expectations of such idealized others that it is not possible for them (i.e. the idealized others) to live up to.

This inevitable failure of the idealized others to live up to the BPD sufferer’s stratospheric expectations can then induce feelings of extreme rage and anger in him/her (i.e. the BPD sufferer) directed at the ‘failed’, idealized other.

Implications For Therapy :

In line with their theory, Buie and Adler put forward the view that it is the role of the therapist to provide the holding and soothing functions that the BPD sufferer is not capable of providing for him/herself. The ultimate goal of this is that the BPD sufferer is eventually able to internalize these functions (holding and self-soothing) so that s/he learns to provide them for him/herself in a way that s/he was unable to as a child due to the defective nature of the mothering s/he received.

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

 

BPD Sufferers May Avoid ‘Mentalising’ Due To Parental Rejection

BPD Sufferers May Avoid 'Mentalising' Due To Rejecting Parents

Peter Fonagy, an internationally renowned clinical psychologist, psychoanalyst and expert in borderline psychopathology and early attachment relationships, and who has produced some of the most influential work relating to this field, has stressed the importance of MENTALISING (or, more precisely, the avoidance of it) in relation to borderline personality disorder (BPD).

What Is Meant By The Term ‘Mentalising’?

The term ‘mentalising’ refers to a person’s ability to perceive, understand and make use of other’s emotional states (and their own).

Why Might Those Suffering From BPD Avoid ‘Mentalising’?

According to Peter Fonagy’s theory, children of cold and rejecting parents avoid mentalising because thinking about their parents’ lack of emotional warmth, rejection, absence of love and, perhaps, even, hatred would be too psychologically distressing and painful.

Prevention Of Recovery :

However, Fonagy also theorizes that this evasion (both conscious and unconscious) of the truth about how one’s parents treated one and felt about one prevents the individual from resolving the trauma and recovering from the emotional mistreatment. He proposes that it is necessary for those suffering from borderline personality disorder (BPD) to confront, and consciously process, the traumatic elements of their childhoods, and, in particular, their difficult, perhaps tortured, childhood relationships with their parents.

The Need For Understanding And Verbal Expression :

Only by understanding what happened to one in childhood, and by learning to express, verbally, this understanding, Fonagy proposes, is recovery possible.

Conclusion :

Whilst Fonagy’s theory has been influential, some researchers have criticized it for not placing enough emphasis upon the fundamental problem sufferers of borderline personality disorder (BPD) frequently experience – namely their inability to control intense emotional reactions (often referred to as ’emotional dysregulation’ ; to read my previously published article relating to this, entitled ‘Three Types Of Emotional Control Difficulties Resulting From Childhood Trauma’, CLICK HERE. )

Resources :

 

eBook :

 BPD ebook

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

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

 

 

 

 

 

What Are The Differences Between BPD And Complex PTSD? : A Study

difference between complex ptsd and bpd

bpd-versus-complex-ptsd

Because there is a considerable overlap in symptoms between those suffering from borderline personality disorder (BPD) and those suffering from complex posttraumatic disorder (complex PTSD) , those with the latter condition can be misdiagnosed as suffering from the former condition (you can read my article about this by clicking here).

In order to help clarify the differences between the two conditions and help show how they are distinct from one another, this article is about a research study which sought to delineate these two very serious psychiatric conditions.

What Are The Differences In Symptoms Between Those Suffering From Borderline Personality Disorder (BPD) And Those Suffering From Complex Posttraumatic Stress Disorder (Complex PTSD)?

A study into the different symptoms displayed by sufferers of borderline personality disorder (BPD) and complex posttraumatic stress disorder (complex PTSD) involving the study of two hundred at eighty adult women who had experienced abuse during their childhoods and published in the European Journal of Psychotraumatology in 2014 compared the symptoms of those suffering from BPD with those suffering from complex PTSD.

bpd-versus-complex-ptsd

 

The following results from the study were obtained :

SYMPTOMS SHARED APPROXIMATELY EQUALLY BETWEEN THOSE SUFFERING FROM BPD AND THOSE SUFFERING FROM COMPLEX PTSD :

Some symptoms were found to be shared approximately equally between those suffering from  borderline personality disorder (BPD) and those suffering from complex posttraumatic stress disorder (complex PTSD). The symptoms that fell into this category were as follows :

  • AFFECTIVE DYSREGULATION (ANGER) i.e. frequent feelings of intense rage that the individual cannot control (regulate)
  • VERY LOW FEELINGS OF SELF-WORTH
  • AFFECTIVE DYSREGULATION (SENSITIVE) i.e. feelings of hypersensitivity that cannot be controlled (regulated)
  • INTENSE FEELINGS OF GUILT
  • INTERPERSONAL DETACHMENT / ALONENESS i.e. feeling cut-off and alienated from others, isolated and apart
  • FEELINGS OF EMPTINESS

However, some symptoms were found to be significantly more prevalent amongst those suffering from borderline personality disorder (BPD) than amongst those suffering from complex posttraumatic stress disorder (complex PTSD) as shown below :

SYMPTOMS THAT WERE FOUND TO BE SIGNIFICANTLY MORE PREVALENT AMONGST THOSE SUFFERING FROM BORDERLINE PERSONALITY DISORDER (BPD) THAN AMONGST THOSE SUFFERING FROM COMPLEX POSTTRAUMATIC STRESS DISORDER (COMPLEX PTSD) :

 

eBooks :

    

 

Above eBooks now available from Amazon for instant download. For further details, click here.

 

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

 

 

 

 

‘Amygdala Hijack’ And BPD

amygdala hijack

One of the main, and most problematic, symptoms that those with borderline personality disorder (BPD) suffer from is the experiencing of disproportionately intense emotional responses when under stress and an inability to control them or efficiently recover and calm down once such tempestuous emotions have been aroused. This very serious symptom of BPD is also often referred to as emotional dysregulation.

The main theory as to why such problems managing emotions occur is that damage has been done to the development of the brain region known as the amygdala in early life due to chronic trauma and, consequently, this area of the brain having been overloaded and overwhelmed by emotions such as fear and anxiety during early development causing a longterm malfunction which can extend well into adulthood or even endure for the BPD sufferer’s entire lifespan (in the absence of effective therapy).

The damage done to the development of the amygdala means that, as adults, when under stress, BPD sufferers are frequently likely to experience what is sometimes referred to as an emotional highjack or, as in the title of this article, an amygdala hijack.

What Is ‘Amygdala Hijack’ And How Does It Prevent Emotional Calm?

When external stimuli are sufficiently stressful, the amygdala ‘shuts down’ the prefrontal cortex (the prefrontal cortex is responsible planning, decision making and intellectual abilities).

In this way, when a certain threshold of stress is passed (and this threshold in far lower in BPD sufferers than the average person’s) the amygdala (responsible for generating emotions, particularly negative emotions such as anxiety, fear and aggression) essentially ‘takes over’ and ‘overrides’ the prefrontal cortex.

amygdala hijack

Above : under sufficient stress the prefrontal cortex (the seat of rational thought) is shut down, leaving the amygdala (the seat of intense, negative emotions like anxiety, fear and aggression) to ‘run riot.’

As such, the prefrontal cortex ‘goes offline’ leaving the BPD sufferer flooded with negative emotional responses and unable to reason, by logic or rational thought processes, his/her way out of them.

When the amygdala is ‘highjacked’ in this way, there are three main signs. These are :

1) An intense emotional reaction to the event (or external stimuli)

2) The onset of this intense emotional reaction is sudden

3) It is not until the BPD sufferer has calmed down and the prefrontal cortex comes ‘back online’  (which takes far longer for him/her than it would for the average person) that s/he realizes his/her response (whilst under ‘amygdala highjacking’) was inappropriate, often giving rise to feelings of embarrassment, humiliation, guilt, remorse and regret.

Resources:

Click here for further information.

 

eBook :

childhood trauma ebook

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

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

 

 

 

 

BPD Sufferers May Have Subtle Learning Difficulties

Borderline Personality Disorder (BPD) And Learning Difficulties :

Research suggests that individuals who suffer from borderline personality disorder (BPD) may have mild to moderate dysfunctions in certain areas of cognitive processing, in particular in the area of learning and memory that involves the processing of complex information.

However, such problems tend to be subtle and are therefore difficult for doctors, psychiatrists, psychologists and other clinicians to detect.

Notwithstanding this difficulty of detection, brain abnormalities have shown up in EEGs of borderline personality disorder (BPD) sufferers that are consistent with the learning/memory problem hypothesis.

In particular, the difficulties in cognitive processing appear to be associated with both visual and verbal memory (including, it is currently thought, both the encoding and retrieval of information) in which complex information is involved.

Borderline Personality Disorder (BPD) Sufferers Frequently Seem Incapable Of Learning From Experience – Is This Why?

These findings have given rise to the hypothesis that these subtle problems relating to learning and memory may help to explain why those suffering from borderline personality disorder (BPD) so frequently seem to make the same mistakes over and over again, seemingly incapable of learning from their social and interpersonal experiences.

Why May These Subtle Memory And Learning Problems Exist In Borderline Personality Disorder (BPD) Sufferers?

Many people who suffer from borderline personality disorder (BPD) experience periods of dissociation ( you can read about my article on dissociation by clicking here), particularly when under severe stress, and this state is clearly likely to seriously impair their memory functioning and, it follows, their ability to learn.

Also, the majority of individuals who go on to develop borderline personality disorder (BPD) as adults have suffered significant childhood trauma due to abusive parenting and it is known that this can lead to damage being done to the vulnerable, highly plastic, developing physical brain (to read my article about how childhood trauma can damage the developing brain on an organic level click here).

Further, severe clinical depression frequently co-morbidly exists alongside borderline personality disorder (BPD) which itself can impair both memory and learning.

Finally, it should be noted that research into this area is still at an early stage so more research needs to be conducted in order to confirm or shred further light upon the above theories.

eBook:

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

 

Related Resource :

  Improve learning and memory with hypnosis MP3 audio. Click here.

 

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

 

Top