Tag Archives: Bpd

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. )

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

 

 

 

 

 

Explaining BPD In Terms Of The Diathesis-Stress Model

BPD, diathesis stress model

What Does ‘Diathesis’ Mean?

The medical definition of ‘diathesis’ is ‘a heriditary or constitutional predisposition to a disease or other disorder.‘ (The word ‘diathesis’ itself derives from the Greek word for ‘disposition).

What Is The Diathesis-Stress Model?

The diathesis-stress model is a psychological theory that proposes that a psychiatric disorder is caused not by heriditary factors (i.e. predispositional vulnerability) alone, NOR by psychologically stressful experiences alone, but by the way in which the two factors interact with one another.

Explaining Borderline Personality Disorder (BPD) In Terms Of The Diathesis-Stress Model :

The diathesis-stress model is an appropriate model with which to explain how borderline personality disorder (BPD) develops in the individual. It is appropriate because research suggests that BPD does not occur in a person solely because of his/her traumatic and stressful childhood experiences nor solely because of an unfortunate genetic inheritance. What is vital in determining whether or not a person ‘succumbs’ to BPD is  how their genes and childhood experiences combine and interact.

In other words, a person who is genetically vulnerable to developing BPD and experiences severe, protracted trauma during childhood may well go on to suffer from BPD in adulthood (see equation 1, below)

However, another individual who has low genetic vulnerability to the disorder and suffers a similarly traumatic childhood (although, of course, the ‘amount’ of trauma a person experiences is impossible to quantify – each case is utterly unique) may well avoid developing it (see equation 2, below)

So, we could represent the above with the following equations :

1)   HIGH LEVEL OF CHILDHOOD TRAUMA + HIGH GENETIC VULNERABILITY = HIGH CHANCE OF DEVELOPING BPD.

2)   HIGH LEVEL OF CHILDHOOD TRAUMA +LOW GENETIC VULNERABILITY = LOWER CHANCE OF DEVELOPING BPD (compared to 1, above).

And, of course, it naturally follows that :

3)   LOW LEVEL OF CHILDHOOD TRAUMA + LOW GENETIC VULNERABILITY = LOW CHANCE OF DEVELOPING BPD

4)   LOW LEVEL OF CHILDHOOD TRAUMA + HIGH GENETIC VULNERABILITY= HIGHER CHANCE OF DEVELOPING BPD (compared to 3, above)

More About Genetic Vulnerabilty To BPD :

In terms of genetic inheritance, what will make a person more susceptible to developing BPD?

The main consideration here is the person’s innate temperament. In particular, those who have naturally impulsive and emotionally labile personalities will, in general, be more predisposed to developing BPD if they also experience protracted and significant trauma during their childhoods compared to those more naturally inclined towards stoicism and timidity.

A Third Factor : Culture / Society :

However, the stress-diathesis model is not the whole story when we are considering the multiple, inter-relating causes that can lead to someone developing BPD. There is also the question of the culture / society in which the individual exists.

To learn more about this, you may wish to read my article entitled : Childhood Trauma, BPD, Genes And Culture.

 

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

Do BPD Sufferers Have A ‘Split Personality’?

do people with BPD have a split personality?

In terms of symptoms, there exists a clear overlap between the psychiatric conditions of borderline personality disorder (BPD) and Dissociative Identity Disorder (DID). DID used to be referred to multiple-personality disorder.

Borderline Personality Disorder, Dissociative Identity Disorder And ‘Splitting’

‘Splitting’ is a psychological defense mechanism in which one ‘part’ of the personality becomes separated / un-integrated with / isolated from another ‘part’ of the personality. In the case of individuals suffering from BPD, these two parts can, in simple terms, be described as PART ONE and PART TWO, where :

PART ONE represents the part of the person’s personality which is relatively accepting of him/herself and others

whereas :

PART TWO represents the part of the person’s personality which is full of self-hatred, as well as anger and hostility (and, underlying the latter two emotions, fear of being psychologically harmed) in relation to others.

When PART ONE is ‘operational’, it tends to enter a state of denial about the existence of PART TWO.

This may be because when PART ONE is ‘in charge’, the individual develops a state of mind similar to amnesia regarding  the existence PART TWO ; alternatively, the denial may be underpinned by feelings of profound shame. However, more research needs to be conducted in relation to these possibilities.

‘Splitting’ and amnesia (when one part of the personality is unaware of how another part of the personality has manifested itself) are also symptoms of dissociative identity disorder.

do BPD sufferers have a split personality?

Borderline Personality Disorder And ‘Switching’ Between ‘Part One’ And ‘Part Two’

As stated above, ‘PART ONE’ and ‘PART TWO’ have become un-intergrated in the personality of individuals suffering from BPD (the BPD sufferers personality, in this respect, may be described as having ‘disintegrated’). A more formal way to put this would be to describe the BPD sufferer as having an un-integrated ego-state (in contrast to the relatively integrated ego-state that psychologically ‘healthy’ individuals enjoy).

Those with BPD ‘switch’ between ‘PART ONE’ and ‘PART TWO’ and this can occur quite suddenly (but is not usually dramatically instantaneous).

Furthermore, these unintegrated ego-states interfere with each other (because they are not completely separate from one another) and this may cause symptoms such as the following :

  • unstable mood / affect / emotions (sometimes referred to as emotional lability)
  • unstable sense of identity (some sufferers describe this with phrases such as : ‘I have no idea who I am…’).

How ‘Splitting’ Affects The BPD Sufferer’s Relationships With Others :

When ‘PART ONE’ is ‘in charge’, the BPD sufferer desires emotional attachments with others. However, when ‘PART TWO’ is dominant, s/he becomes hostile towards others and withdraws from them – this leads to the classic ‘love-hate’ scenario.

Why Does This Unintegrated Ego-State Arise In Those Suffering From BPD?

The two separate parts can develop in a person who has suffered severe and prolonged abuse as a child.

When the abused child becomes an adult, PART TWO (hostility etc) can be kept in abeyance for much of the time to allow daily social functioning. However, PART ONE makes itself apparent when the BPD sufferer is reminded of the abuse s/he suffered as a child (such a reminder is called a ‘trigger’).

This reminder/trigger may be detected by the BPD sufferer consciously or unconsciously and occurs as a defense mechanism against real or perceived psychological threat (especially the treat of betrayal, rejection or abandonment as occurred in the individual’s childhood).

If the individual had not developed this defense mechanism as a child, s/he faced what may reasonably be termed as ‘psychological destruction.’ In other words, the development of the ‘splitting’ defense mechanism makes complete evolutionary sense as it allowed the individual to survive childhood – it is a normal, predictable, adaptive response to childhood loss, fear, distress and betrayal.

Conclusion ;

There is an overlap between symptoms of borderline personality disorder and dissociative identity disorder in as far as they both involve ‘splitting’ and ‘dissociating’. However, in the case of DID, the separation between the different PARTS of personality are MORE DISTINCT AND CLEAR CUT THAN THEY ARE IN THE CASE BPD. Those suffering from DID may have more than two un-integrated / separate PARTS of their personality / ego-state ; however, arguably, this can also be the case in those suffering from BPD (although this is beyond the scope of this article).

In conclusion, though, we can say, with some confidence, that BPD sufferers do have a ‘split personality’, but the division between these two parts is more nebulous than in the case of DID sufferers.

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

Are Those With Borderline Personality Disorder (BPD) Manipulative?

are those with BPD manipulative?

Sadly, many individuals suffering from borderline personality disorder (BPD) are stigmatized by others and, amongst other perjorative terms, are frequently described as ‘manipulative’.

However, in recent years, it has been increasingly recognized that intentionally manipulative behavior is, in fact, NOT a defining characteristic of BPD sufferers after all ; this shift in attitude is best exemplified by the fact that the Diagnostic And Statistical Manual Of Mental Illness, Fifth Edition, or DSM-V (sometimes informally referred to as the ‘psychiatrists’ bible’), has ceased to list ‘manipulative’ as one of the personality traits associated with borderline personality disorder.

However, this begs the question : ‘Why has it been so common for those suffering from BPD to be scornfully dismissed as manipulative in the past?

According to the psychologist, Marsha Lineham (well known for having developed Dialectical Behavior Therapy (DBT) for the treatment of BPD), this mis-labelling of BPD sufferers as manipulative has been based on a MISINTERPRETATION of certain types of their behavior.

Lineham puts forward the view that, often, some of the behaviors of BPD patients are wrongly perceived as being  manipulative whereas, in fact, they are desperate manifestations of intense psychological and emotional pain.

Indeed, borderline personality disorder (BPD) is generally accepted as being the most excruciatingly, psychologically and emotionally, painful of all mental health conditions ; as I have stated elsewhere on this site, approximately one in ten of those suffering from BPD end their lives by suicide. (To read my article, Living With Mental Agony, click here, or to read my article, Anger May Operate To Soothe Emotional Pain, click here.)

Sometimes, an example some people may give of so-called ‘manipulative’ behavior from BPD sufferers is the threat of suicide. For example, someone with BPD may take an overdose of tablets but then phone a friend or family member to say what they have done. Lineham points out, however, that this is unlikely to be a coldly calculated ploy but, rather, a desperate and confused expression of inner mental turmoil (the intensity of which the individual may not have the words to convey) and ambivalence – ambivalence in the sense that a part of the BPD sufferer may genuinely want to die whilst another (say, instinctual) part may be driven to survive.

Indeed, the fact that, as stated above, one in ten BPD sufferers eventually die by suicide suggests that any threat to do so should be treated extremely seriously.

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

Four Types Of ‘Dysregulation’ Displayed By BPD Sufferers

types of dysregulation

BPD And Dysregulation :

We have already seen from many other articles that I have published on this site that those who have suffered severe and protracted childhood trauma are at greatly increased risk of going on to develop borderline personality disorder (BPD) than those who were fortunate enough to have experienced a relatively stable upbringing.

One of the main symptoms of this very serious and life-threatening condition (about ninety per cent of sufferers attempt suicide and about ten per cent die by suicide) is termed ‘DYSREGULATION.’

What Is Meant By The Term ‘Dysregulation?’

When the term DYSREGULATION is used in the psychological literature it most commonly refers to the great difficulty the BPD sufferer has controlling behavior and emotional states. However, more specifically, the dysregulation that those with BPD experience can be sub-divided into four particular types; these are :

1) EMOTIONAL DYSREGULATION

2) BEHAVIORAL DYSREGULATION

3) COGNITIVE DYSREGULATION

4) SELF DYSREGULATION

Below, I briefly define each of these four types of dysregulation :

  • Emotional Dysregulation :

This type of dysregulation refers to extreme sensitivity and difficulty controlling intense emotions. Individuals suffering from this type of dissociation not only feel emotions far more deeply than the average person, but also take longer to return to their ‘baseline’ / ‘normal’ mood.

For example, a person with BPD who is emotionally dysregulated may be easily moved to intense expressions of anger and then take far longer to calm down again compared to the average person. Others may disparagingly (due to their lack of knowledge and understanding of this life-threatening – see above – and acutely, indeed uniquely, mentally painful condition) describe such an individual as extremely ‘thin’skinned’, as ‘having a chip on his/her shoulder’, ‘a drama queen’ or as or as someone who is prone to extreme ‘over-reactions.’

A leading theory as to why individuals with BPD are emotionally dysregulated is that the development of their AMYGDALA (a brain region intimately involved with how we express emotions and how we react to stress) has been damaged as a result of severe childhood trauma.

emotional dysregulation

  • BEHAVIORAL DYSREGULATION :

This type of dysregulation refers to the severe problems those with BPD can have controlling their behavior ; such individuals may be highly impulsive and liable to indulge in high-risk behaviors that are self-destructive. Such behaviors may include :

    • excessive drinking
    • excessive drug taking
    • gambling
    • compulsive self-harm
    • risky sex
    • drink-driving / dangerous driving
    • excessive / compulsive spending leading to debt problems

 

  • COGNITIVE DYSREGULATION :

This type of dysregulation refers to disorganized thinking which may manifest itself as paranoid-type thinking and/or as states of DISSOCIATION.

BPD sufferers are also prone to ‘black and white’ / ‘all or nothing’ type thinking, indecision, self-doubt, distrust of others and intense self-hatred.

 

  • SELF DYSREGULATION :

This type of dysregulation refers to the weak sense of their own identity many BPD sufferers feel ( a typical BPD sufferer might express this by saying something along the lines of ‘I’ve no idea who I am‘), feelings of emptiness, and the difficulty many BPD sufferers experienced expressing their likes, dislikes, needs and feelings,

Dysregulation And Stress :

Individuals with BPD are far less able to cope with stress than the average person and dysregulation (relating to all four of the above categories) is especially likely to occur when such individuals are experiencing stress ; indeed, the greater the stress the individual is experiencing, the more dysregulated he/she is likely to become.

 

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David Hosier BSc Hons; MSc; PGDE(FAHE)

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

difference between complex ptsd and bpd

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.

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) :

 

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

 

 

 

 

BPD And Hallucinations

bpd and hallucinations

What Are Hallucinations?

Hallucinations are PERCEPTIONS that people experience but which are NOT caused by external stimuli/ input. However, to the person experiencing hallucinations, these perceptions feel AS IF THEY ARE REAL and that they are being generated by stimuli/ input outside of themselves (in fact, of course, the perceptions are being INTERNALLY GENERATED by the brain of the person who is experiencing the hallucination).

Different Types Of Hallucination :

There are several different types of hallucination and I summarize these below :

  • VISUAL HALLUCINATIONS – these involve ‘seeing’ something that in reality does not exist or ‘seeing’ something that does exist in a DISTORTED / ALTERED form.
  • AUDITORY HALLUCINATIONS – these, most often, involve ‘hearing’ voices that have no external reality (though other ‘sounds’ may be hallucinated, too).
  • TACTILE HALLUCINATIONS – these occur when an individual feels as if s/he is being touched when, in fact, s/he isn’t (for example, feeling the sensation of insects crawling over one’s skin).
  • GUSTATORY HALLUCINATIONS – these occur when a person perceives a ‘taste’ in his/her mouth in the absence of any external to the person causing the taste.
  • OLFACTORY HALLUCINATION – this type of hallucination is sometimes also referred to as phantosmia and involves perceiving a smell which isn’t actually present.

bpd and hallucinations

BPD And Hallucinations :

Mild hallucinations are actually not uncommon even amongst people with no mental illness (e.g. believing one has heard the doorbell ring when it hasn’t).

At the other end of the scale, however, are fully-blown hallucinations that involve the person who is experiencing them being psychotically detached from reality; for example, someone experiencing a psychotic episode might hear, very clearly and distinctly, voices that s/he fully believes are coming from an external source (such as ‘the devil’ or a dead relative). A person suffering from such hallucinations cannot in any way be convinced that the ‘voices’ are being generated within his/her own head/brain.

It is uncommon for people suffering from borderline personality disorder (BPD) to suffer from the most serious types of hallucinations (as described above); however, under acute stress (and those with BPD are, of course, far more likely to experience acute stress than the average person), the BPD sufferer may experience hallucinations that fall somewhere between the mild and severe types.

For example, if s/he (the BPD sufferer) was constantly belittled and humiliated by a parent when growing up, s/he may, when experiencing severe stress, ‘hear’ the ‘parent in their head’ saying such things as ‘you’re useless’ or ‘you’re worthless.’

However, unlike the person suffering unambiguously from psychosis, when this occurs s/he is not completely detached from reality but is aware the ‘voices’ are being generated within his/her own mind and are imaginary as opposed to real.

Severe hallucinations may be indicative of schizophrenia but can also have other causes which include : delirium tremens (linked to alcohol abuse), narcotics (e.g. LSD) and sensory deprivation.

 

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.

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

 

 

 

 

Early Trauma’s Effect On Development Of Id And Ego

 

early trauma id 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 (this is why very early trauma is especially damaging). 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.’

early trauma id ego superego

 

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.

 

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Traumatic childhoodIMPROVE IMPULSE CONTROL

 

Traumatic childhoodCONTROL YOUR EMOTIONS

 

 

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