Here is an article on CNN that caught my eye. I found it funny because, over a year ago, a friend of mine and I discussed this very topic and he urged me to write a book about it. I started, but ended up with WHINE, because I felt more comfortable talking about BPD.

Beware catching this from your spouse

• Story Highlights
• Studies: Emotional contagion in marriage can harm spouse with bad moods
• Wives more likely to get hardening of arteries from hostile fights with husband
• If your husband is in nasty mood, go for a walk and recognize it’s his mood
• In happy marriage, one spouse’s optimism can rub off on partner

By Kathyrn Matthews

(OPRAH.com) — For better or for worse, when you get married, you sign on for a life of sharing –bedsheets, bathroom space, cold germs. Moods, too, as it turns out. And it’s becoming increasingly clear that “emotional contagion,” the unconscious tendency to mimic the emotions of others, affects spousal health.

Heart bypass patients with neurotic and anxious spouses, for instance, were much more likely to be depressed 18 months after surgery — independent of their own personality — according to one study led by John M. Ruiz, Ph.D., assistant professor of clinical psychology at Washington State University.

The findings are troubling because depression is known to put recovering cardiac patients at higher risk of further heart attacks and death.

Another study showed that hardening of the coronary arteries was more likely in wives when they — or their husbands — expressed hostility during fights.

As for how one catches a partner’s foul humor, the brain’s aptly named “mirror neurons” are to blame, says John T. Cacioppo, Ph.D., director of the Center for Cognitive and Social Neuroscience at the University of Chicago and co-author of “Emotional Contagion.”

These neurons fire in response to other people’s actions and intentions, especially when you care about the individual. So if you see that your husband is anxious or depressed, you literally feel his pain. There are, however, a few ways to prevent spousal mood infection. Oprah.com: What’s really going on in his head!

Disengage

When he makes a nasty remark and you give it right back, you’re off to the races. You can avoid getting stuck in this loop by planning how you will respond to his negativity. One option is to walk away: Take a stroll around the block, go for a bike ride. Once you’re on your own, you can see how much your partner’s mood is really affecting you. If it’s substantial, you might schedule more alone time in your relationship.

Or ask him to exercise with you or visit a therapist (see “Play as a Team”) to try to improve his mood. If you’re the problem, leaving the premises when you feel a funk coming on is also a good way to keep him — and the marriage — healthy.

Let him see the light

His doldrums could be a symptom of seasonal affective disorder — yours too. If either of you is worse in the winter, cheerier when it’s sunny, try installing bright full-spectrum lighting.

Play as a Team

Demanding that he go to a shrink is often not an effective way to motivate him to get help, Cacioppo says. Suggesting that you see a couples therapist together may prove more successful.

Keep your spirits up

People who are content in their relationships are much less vulnerable to a spouse’s neuroticism, according to Ruiz’s research. On the flip side, in a happy marriage, one partner’s optimism may rub off on the other — an actual health benefit. Did someone say optimism? The good news is, you can catch that too.

By Kathyrn Matthews from “O, The Oprah Magazine” © 2008

Bon Dobbs :: Nov.04.2008 :: Odds and Ends, Other Disorders, Emotions :: No Comments »

It was extremely sad to see that David Foster Wallace killed himself last month. He was a talented writer and an excellent observer of the human condition. Apparently, he suffered from major depression and had ceased his medications. Really sad. I was reading an article about him in the current issue of Rolling Stone and found a quote that summarizes my attitudes toward people with BPD’s view of themselves. I’m not saying Wallace had BPD – I really don’t know enough about him to say – but this view of oneself encapsulates the deep feeling of shame that accompanies BPD:

There’s good self-consciousness, and then there’s toxic, paralyzing,
raped-by-Bedouins self-consciousness. I think being shy basically means
being self-absorbed to the point that it makes it difficult to be around
other people. For instance, if I’m hanging out with you, I can’t even
tell whether I like you or not because I’m too worried about whether or
not you like me. (David Foster Wallace)

You see, I often hear Non-BPs (the loved ones and family members of people with BPD) tell me that they feel that their loved one with BPD is extremely “selfish” or very “Narcissistic.” I always try to caution them on this statement because, when someone is in pain, yes, they will tend to look inward, but it’s not selfishness or Narcissism, in my opinion. It’s the ravages of deep shame and shyness that cause people with BPD to take such a view of the world. A person with BPD will dread the judgment, punishment and/or disapproval of other people. That is the kind of self-consciousness that is present in BPD.

To further follow up on this idea, here is a quote from me to a member of the ATSTP list from about two years ago. I was responding to the “lack of empathy” that his significant other (SO) was showing toward him:

It is frustrating and part of it seems very selfish on their part. My
wife actually showed sympathy for me this morning - I had a bit of an
upset stomach, so she said “I hope you feel better” a couple of times.
Of course, initially she thought I was mad at her or something (there
was still a lingering feeling that it was about her).

I also think there’s a step beyond empathy, and that’s compassion. I
think if you look at the spectrum of understanding for other people
you have something like self-centeredness (but not necessarily
positive) - pity - sympathy - empathy - compassion. (and there’s
probably a bunch of feelings in-between. The spectrum seems to run
from extreme self-interest to selflessness, of course, I could be
wrong on all of that - just an idea. It is easy to have compassion and
unconditional love for your kids, but for your SO it can be more
difficult because there are expectations on each side of the equation.
When your SO doesn’t live up to those expectations, even if they are
simple consideration, it is disappointing. I know it is difficult with
my wife as well - some of the time. Even my kids are wary of my wife’s
behavior at times.

I wonder if our SO’s don’t have much understanding of other people’s
pain because of the judgment factor. Perhaps they believe that
with “understanding” comes a level of judgment at least for
themselves. Or it could be that they believe no one actually
understands them, so the process of understanding others is pointless.

Bon Dobbs :: Oct.30.2008 :: Celebrities, Suicide, Other Disorders, Shame, Borderline Personality Disorder :: No Comments »

NY Times article mentioning BPD. I’d love to comment, but will have to do so later….

October 21, 2008

Mind

When All Else Fails, Blaming the Patient Often Comes Next

By RICHARD A. FRIEDMAN, M.D

Doctors and psychotherapists generally don’t like it when their patients don’t get better. But the fact is that lots of patients elude our clinical skill and therapeutic cleverness. That’s often when the trouble starts.

I met one such patient not long ago, a man in his early 30s, who had suffered from depression since his teenage years. In six years of psychotherapy, he had been given nearly every antidepressant under the sun, but his mood hadn’t budged.

Weeping in my office one day, he explained that he was depressed because he was a failure and a whiner. “Even my therapist agreed with me,” he said. “She said that maybe I don’t want to get better.”

I could well imagine his therapist’s frustration. She had been working with him for nearly three years without significant progress, and she was now doing what many clinicians do when the chips are down: blame the patient for failing to improve.

“I think he has an unconscious desire to remain sick,” she told me.

About a month later, I saw this patient respond remarkably well to a novel treatment. Free of depression at last, he was joyful and relieved — an odd reaction, you must admit, from someone who secretly wished to be ill.

Not just that, but he no longer felt like a failure and was much more upbeat about his future prospects.

I decided to challenge him. “How come you’re feeling so much better despite the fact that nothing in your life has really changed in the past few weeks?”

“Well, I guess I just think like that when I’m down.”

Exactly. His sense of worthlessness was a result of his depression, not a cause of it. It’s easy to understand why the patient couldn’t see this: depression itself distorts thinking and lowers self-esteem. But why did his therapist collude with the patient’s depressive symptoms and tell him, in effect, that he didn’t want to get better?

For an all too human reason, I think. Chronically ill, treatment-resistant patients can challenge the confidence of therapists themselves, who may be reluctant to question their treatment; it’s easier — and less painful — to view the patient as intentionally or unconsciously resistant.

I recall an elderly woman who was referred by a colleague for intractable depression, in which I have a special interest. I was eager to help her.several months and many treatments later, I began to get frustrated that she was no better and noticed that my thinking about her shifted. I wondered whether there was something about the sick role that she found rewarding.

After all, she had constant visits from friends and family members, not to mention an army of medical experts who were all trying, in vain, to cure her. If she got better, she might lose all that care and attention.

Then one morning, shortly after starting a new combination of antidepressants, she called. I did not recognize the cheerful voice. “I’m feeling really good,” she told me. “Not depressed at all.”

My delight aside, I felt chagrined that I had begun to write her off as a help-rejecting crank.

Of course, it makes good medical sense for therapists to rethink the diagnosis and treatment of any patient who fails to improve. But this is a double-edged sword.

Another patient, a young woman with unstable moods, was recently hospitalized with a diagnosis of bipolar disorder. When she failed to respond to two mood stabilizers, the staff began to entertain a diagnosis of borderline personality disorder, which involves emotionally chaotic relationships and impaired ability to function in the world.

“She’s pretty aggressive and demeaning, and we think she has some serious character pathology,” one of the residents told me.

But partly treated bipolar disorder can mimic borderline personality disorder, and after she received a third mood stabilizer, her “personality disorder” melted away, along with her provocative behavior.

This patient had frustrated her clinicians with her lack of response to treatment. In turn, her doctors reacted by changing her diagnosis to a personality disorder. The change in thinking shifted the blame from the clinicians to the patient herself, who was now viewed more as bad than sick.

To be sure, some patients really do want to be sick. People with Munchausen syndrome, for example, deliberately produce physical or psychological symptoms for the express purpose of assuming the sick role. And they will go to extraordinary means to defeat doctors who try to “treat” them.

But a vast majority of patients want to feel better, and for them the burden of illness is painful enough. Let’s keep the blame on the disease, not the patient.

Richard A. Friedman is a professor of psychiatry at Weill Cornell Medical College.

Bon Dobbs :: Oct.21.2008 :: Other Disorders, Blame, Treatment, Borderline Personality Disorder :: 1 Comment »

I don’t like to quote Sam Vaknin much… for various reasons, but I stumbled on this quote from him about NPD vs. BPD. The reason this came up to begin with is that I was discussing whether certain people in on-line support groups might be dealing with something other than BPD.

There are certain support groups in which women make up a large proportion of the group. This confused me a bit, because BPD is much more likely to be diagnosed in women, rather than men. Removing the homosexual female component, there are still more women complaining about their abusive “BPD” men (most often BPxh - which means “Borderline Ex Husband” for all the uninitiated). When I read their accounts, it appears to me that their “BP men” are (mainly, but not exclusively) either suffering from NPD or suffering from the disorder of being an ass.

We talked about this on my board ATSTP some time ago. I also discussed it with an another knowledageble person about BPD. She disagreed with my assessment that BPD and NPD are (usually) mutally exclusive and my idea that perhaps these self-diagnosed “BPs” are really suffering from something else. (again all of this, as always, is my NON-MEDICAL opinion… and this quote below is from Sam Vaknin’s non-medical opinion - he’s a doctor, but not a medical doctor… and I’m not going into the rabbit hole of his degrees). Anyway, here’s the quote and my take on it (again emphasis mine):

http://samvak.tripod.com/faq82.html

NPD and BPD - Suicide and Psychosis

A sense of entitlement is common to all Cluster B disorders.

Narcissists almost never act on their suicidal ideation – Borderlines do so incessantly (by cutting, self injury, or mutilation). But both tend to become suicidal under severe and prolonged stress.

NPDs can suffer from brief reactive psychoses in the same way that Borderlines suffer from psychotic microepisodes.

There are some differences between NPD and BPD, though:

1. The narcissist is way less impulsive;
2. The narcissist is less self-destructive, rarely self-mutilates, and practically never attempts suicide;
3. The narcissist is more stable (displays reduced emotional lability, maintains stability in interpersonal relationships and so on).

Ok, well, given that quote the separation regarding acting on suicidal  ideation makes sense to me. However, that being said, his comment about “borderlines do so incessantly (by cutting, self injury, or mutilation)” is basically inaccurate - self-injury is not about suicide, it’s about pain management (and in some ways even suicide attempts, purposeful or accidental, are about pain management)… but I digress…

I was looking over Dr. Heller’s site some more today and found that HIS “other common disorders associated with BPD,” don’t include NPD, but he’s a medical doctor and doesn’t seem to think any disorder should be called a “personality disorder.”

Although I don’t know much about NPD, I think  that a borderline is likely to hate herself … a narcisstist love himself. It’s simple (of course again it’s IMO), but seems right to me. I just wonder if people with BPD have been given even more of a bad rap by being confused with those with NPD (or a similiar disorder like APD). Emotional tools will not work (in my experience and in the experience of members of my list with NPD husbands) for someone with NPD.

Bon Dobbs :: Jul.22.2008 :: Other Disorders, Borderline Personality Disorder :: 4 Comments »

There has been numerous articles and discussion in the therapeutic community about renaming BPD. Here is the text of an interview with Dr. Leland Heller about a new name and about his feelings about the current Borderline Personality Disorder Name (the emphasis in this article is mine):

A POSSIBLE NEW NAME FOR BORDERLINE PERSONALITY DISORDER

Many people would like to change the terminology of the “borderline personality disorder” to a new term that more accurately describes the illness. The term “BPD” in and of itself is as if the whole person (and the personality) is flawed, rather than looking at the BPD as a medical problem it actually is.

The term “borderline personality disorder” implies that there is no hope for treatment as many mental health professionals unfortunately still believe. There is thought that this illness borders on schizophrenia, thus the term “borderline.”

What then is borderline personality disorder? These questions have been posed to Dr. Leland Heller, expert in treating borderline personality disorder.

Q. What do you think about the term “borderline personality disorder”?

A. “I think it’s a horrible, insulting label for a real medical illness. The name alone reduces serious research, stigmatizes victims, and implies the person is crazy. It denies the medical nature of the process, and implies simply a personality problem.”

Q. Do you think “borderline personality disorder” is an accurate description?

A. “No I don’t. It implies a character problem. While I’ve encountered many people with a bad character who had the BPD, most borderlines I’ve treated (over 2100) do not have character problems. “Borderline” means patients live “at the border” between psychosis and reality. When borderlines are well treated medically, psychotic experiences are few and far between - and can be treated well. Borderlines don’t live at that border, they simply go into psychosis too easily under stress.”

Q. What is the BPD?

A. “The BPD is a medical problem, likely a form of epilepsy (brain cells firing inappropriately and out of control). The characteristic symptoms include inappropriate moodiness, chronic anger, emptiness, boredom, dysphoria (anxiety, rage, depression and despair) and psychosis. The other criteria are symptoms related to these medical problems.

ALL neurological disorders can have an effect on the personality, such as Parkinson’s disease which isn’t called the ‘shaking personality disorder.’ ”

Q. What does this term “Dyslimbia” mean?

“ ‘Dys’ means malfunction, and limbia meaning from the limbic system.

‘Dyslimbia’ is malfunction of the limbic system. While other neuropsychiatric disorders involve malfunction of the limbic system, the limbic system dysfunction is profound in the BPD. I chose Dyslimbia for my patients to take the stigma away. The BPD needs a new name, one that emphasizes healing not labeling.

I don’t care if it’s renamed ‘Dyslimbia’ or not, but a more honest, humane, and hopeful name needs to be made for this illness. Patients deserve to get medical attention for ‘Dyslimbia’ (or an equivalent name), rather than have doctors and therapists shun them because they are ‘borderlines.’”

I’d like to write more about the struggle for a new name… but one of the things to note is that most researchers in this area have recommended dropping the word “personality” from the name and reclassifying it Axis I. The most common and likely new name is “Emotional Regulation Disorder (ERD).”

More on this later.

Bon Dobbs :: Jul.22.2008 :: Resources, Other Disorders, Borderline Personality Disorder :: No Comments »

Today’s subject is the Myth of the High-Functioning Borderline. I have been scouring the research on BPD to find out if anyone in the research or therapeutic community uses this term or concept high-functioning versus low-functioning Borderline. I have yet to find any author in either the research community or therapeutic community reference this concept. It crops up in the support community (in “Stop Walking on Eggshells” and on both bpd411.org and bpdcentral.com). It also crops up in the “cross-over” community (see more later) but only in a sarcastic way. The idea of high vs. low-functioning BPD doesn’t seem to hold much weight in any other community than the support community.

What do I mean by referencing these “communities”? I think that there are basically three BPD/Non-BP “communities” out there: the research community, the support community and the therapeutic community.

The research community is comprised those scientists doing medical research (and psychological research) on BPD. They publish scholarly articles and research in medical and psychological journals. Some “supposed” psychological researchers publish in the less-well-known and scientifically suspect journals (see my article about “Demonic Possession and BPD” for an example of this type of researcher). For the most part, these researchers don’t try and “cure” BPD, they merely provide data to other professionals about the configuration of BPD, the biology of BPD and the “common” features of BPD. This group of people does not differentiate between high-functioning and low-functioning BPs. In fact I have found no reference to high- or low-functioning BPD at all in any of these research papers or reports.

The therapeutic community is those practitioners (mainly psychologists, psychiatrists, social workers, other “therapists” and consultants) that try and “cure” or remediate BPD in patients. Some (very few) also serve the families, friends, spouses, children, etc. (the Non-BPs). Their purpose in life is to help the BP overcome or to effectively manage their disorder. In this group of people, I have found no mention of high- or low-functioning BPs. The only “partial” mention is that of Dr. Paul Mason, who co-wrote “Stop Walking on Eggshells” with Randy Kreger. Several of these people within the therapeutic community have written popular books about BPD, including “Sometimes I Act Crazy,” “Lost in the Mirror,” “The Angry Heart,” and “I Hate You, Don’t Leave Me.” None of these books, as far as I can tell, refer to the idea of high-functioning vs. low-functioning BPD. Of course, Dr. Marsha Linehan and Dr. John Gunderson are prominent individuals within the therapeutic community. Their theories about BPD have a distinct influence on how therapy is conducted with people with BPD.

The final community is the support community. This community is comprised of ex-BPs, Non-BPs and others who provide advice about how to “deal with” BPD or with someone with BPD. This community includes myself, the authors of “Stop Walking on Eggshells,” the author of “Tears and Healing,” A. J. Mahari, the proprietors of bpd411.org and others. Only in this community have I seen any mention of high- vs. low-functioning BPD.

Some individual and organizations actually straddle the support/therapeutic (or even the research/therapeutic) community split. These include: myself (at least I hope so), TARA, A. J. Mahari and others. Some of these are more therapeutic (or at least psycho-educational) like TARA. I try and be both psycho-educational and to offer support resources to Non-BPs; yet, in doing so, also try and dispel the many, many myths about BPD (where possible).

The problem with assigning either high-functioning or low-functioning to a person with BPD is that the very nature of the disorder debunks these categories. BPD is chiefly an emotional disorder (with impulse control issues). Emotions are ever-changing, like waves that carry the mind along for the ride. Whether someone is high-functioning or low-functioning at any given time will be subject to their current emotional state. If a BP is emotionally dysregulated they will adapt to that (usually) painful state in whatever way that they have learned will assuage the pain. Some people with BPD will cut themselves, take drugs, avoid situations or behave in other ways that might be considered harmful to themselves or those around them. If a BP is not dysregulated, he/she has no need to behave in these ways. The core point is that BPD is about emotional instability and no person with BPD will be always high- or low-functioning. A person with BPD will swing – sometimes wildly – between several polar ways of feeling and behaving.

I suspect many “high-functioning” BPs do not have BPD at all. I have read many, many posts on Internet boards in which the “BP” in question clearly does not have the disorder. Many times, if you read carefully, you will find that these “high-functioning” BPs are diagnosed by their (usually) ex-wives, just because the “xBPh” (ex-husband with BPD) raged or was selfish during their relationship. BPD is more than raging – and as a Non just because you’re “walking on eggshells,” it doesn’t mean that your “BP” has the disorder at all. In fact, recently the list owner of WTO (the Welcome to Oz Internet list) asked the women Nons on the list if there husbands (or, more appropriately, ex-husbands) exhibited the symptoms of Narcissistic Personality Disorder (NPD). Every “Non-BP” that responded to that request confirmed that their “BP” met the criteria for NPD.

NPD (which IMO is more likely a disorder that appears to be “high-functioning ‘BPD’”) and BPD are distinctly different disorders. There may be a slight bit of overlap – deep, deep down within the psyche of the individual (and that is shame, most likely), but the basic configuration of the disorders are quite different. People with BPD do not like themselves, for whatever reason. People with NPD adore themselves, for whatever reason. That alone separates the two disorders. While people with BPD may exhibit “deserving” behavior (that they deserve love, riches or whatever), people with NPD believe that being “special” is their birthright and want to be surrounded by important or exclusive groups of people. The thing to note with BPD is that the “deserving” behavior is counter-balanced with “undeserving” behavior – polar opposite feelings and behavior that is the hallmark of BPD. So, it seems unlikely to me that “high-functioning” (or low-functioning) BPs can actually exist.

Let’s briefly look at the DSM-IV diagnostic criteria for BPD and NPD , and we can illustrate the differences. First, BPD:

1. Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in (5).
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. This is called “splitting.”
3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in (5).
5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
7. Chronic feelings of emptiness.
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

And now NPD:

1. has a grandiose sense of self-importance
2. is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
3. believes that he or she is “special” and unique
4. requires excessive admiration
5. has a sense of entitlement
6. is interpersonally exploitative
7. lacks empathy
8. is often envious of others or believes others are envious of him or her
9. shows arrogant, haughty behaviors or attitudes

Clearly, these two conditions are different. Some interpersonal aspects may seem similar (#8 in BPD and #6 and #7 in NPD); however, the emotional aspect of BPD (#6) is not present in NPD. There seems to me to be a split between self-hatred and the instability of self (in BPD), and self-importance and self-love (in NPD). I’m not sure this a gulf that can be bridged sensibly between the two disorders.

Why does it matter? Well, IMO it matters a lot, because the “prescription” that is effective for BPD is not the same prescription that works with NPD (or other variants on the Narcissistic spectrum). NPD is not a chiefly an emotional disorder, and emotional tools that are so effective with BPD will not be effective with someone with NPD. Now, you might say, “My ‘BP’ is diagnosed and he/she is always thinking about his/herself.” That may be true, yet, IMO, this type of “thinking” about oneself is really experiencing overwhelming negative emotions. It is difficult for anyone to think about anyone else when they are in deep emotional pain. As I have said in the past, I have coined (with the help of others) the term IAAHF (it’s all about his/her feelings) to help represent this state to Non-BPs.

Which brings me to my final point: self-diagnosis. It is dangerous to diagnose your loved one with BPD (or any other mental disorder). Only a trained and knowledgeable (and yes, I know, there are too few of these) professional can diagnose a person with any disorder. Assuming on your own that your loved one has BPD can be troubling for the relationship (at best) and damaging to their (and your) mental health (at worst). After reading a self-help book, such as “Stopping Walking on Eggshells” (SWOE), one has to be careful to diagnose someone else with the disorder. Even my book, “When Hope is Not Enough” (WHINE), can be used to “diagnose” your loved one with BPD, but I’d like to dissuade you from doing so. Instead, I would suggest you use the tools in my book (or, for that matter, SWOE) and see if they work. If my tools do not work, I suspect either you haven’t practiced enough (it takes time, believe me, it took me 2 years) or your loved one does not have an emotional disorder. I personally tried what I learned in SWOE for months before I realized that those “tools” were not effective in my life – which is why I bothered to write a book in the first place.

If you are tempted to introduce yourself to a support group with the statement, “I am married to a high-functioning BP…,” I’d suggest you take a step back and see if your loved one has the other signs of an emotional disorder (which BPD is and NPD is not).

Bon Dobbs :: Jun.10.2008 :: Resources, Other Disorders, Emotions, Borderline Personality Disorder :: 21 Comments »

I posted the link to Herschel Walker and DID for a reason. I recently came across Dr. Leland Heller’s comment on his Biological Unhappiness site. Here is an excerpt:

 While DID (f.k.a.. “multiple personality disorder”) is not uncommon, I have seen a few. They all also have the BPD. I view the DID as what happens when even psychosis no longer protects against crushing pain.

I find this quite interesting. He seems to be saying that when certain behaviors, including psychotic behavior and BPD-like disassociative  behaviors, are no longer effective to reduce crushing pain, DID can develop to protect the person from the pain. In other words, I read this as a “pain-control” spectrum issue with DID on the far end of the spectrum. I wouldn’t say that BPD is on the other end, because I think it’s probably closer to the DID end than substance abuse (in absence of BPD)  to manage pain.

Certain people have, for whatever reason, an inhibited ability to manage their pain and (I think it’s clear) more (emotional) pain than the “average” person. This pain IMO is a combination of a biological propensity to dysregulated emotions and an invalidating environment. I don’t think most Non-BPs intend to be invalidating, but I think most people are invalidating when faced with dysregulated emotional states. They (including parents, friends and partners) just have no idea what to do. The typical reaction is to tell the other person that they are “too emotional” or it’s “not that big a deal” or they should just “get over it.” All of these responses are invalidating to the emotional reaction of the other person. They don’t help a person learn to self-soothe and, ultimately, that is one of the goals of recovering from BPD.

Bon Dobbs :: Apr.24.2008 :: Other Disorders, Borderline Personality Disorder :: No Comments »

Heisman Trophy winner and former NFL running back Herschel Walker reveals details of his dissociative identity disorder, formerly known as multiple personality disorder. For years, he tried to manage over ten different personalities, and it eventually brought him to the brink of suicide. His new memoir is Breaking Free.

Listen to the WNYC show or watch the video.

Bon Dobbs :: Apr.23.2008 :: Other Disorders :: 1 Comment »

Here’s an article about ODD and Conduct Disorder (CD) in children and the correlation to adulthood personality disorders:

Borderline Personality Disorder is called this because patients have many traits from different psychiatric disorders. They have very unstable moods, like bipolar disorder. They often have strange experiences, like people with schizophrenia. Their relationships with others are usually quite unstable. They often don’t have much of a sense of who they really are or where they are going. They often cut themselves. Most of the people with this problem are female. If you have ODD/CD and are female, you have approximately a 15% chance of getting this.

There is also info about Antisocial Personality Disorders. My question is: are these really separate disorders or does emotional dysregulation play a part in all of them? If someone is emotionally volatile it seems to me that they will act out in different ways depending on the emotion they feel most often - anger, sadness or guilt/shame. So, all these different “”disorders”" - ODD, CD, ADD, BPD, APD and others - are they really the same disorder (emotional dysregulation) exhibiting itself in different forms?http://www.klis.com/chandler/pamphlet/oddcd/oddcdpamphlet.htm

bon :: Mar.21.2006 :: Other Disorders, Anger :: No Comments »