Anything to Stop the Pain - BPD and Non-BPDs» Anything to Stop the Pain – For Non-Borderlines and Loved Ones of People with BPD

BPD, Self-Regulation and Others

Bon Dobbs — Tue, 08 Jun 2010 16:28:28 +0000

Ok, after posting about book sales recently and stuff like that, now it’s time for a much more substantive post about BPD. Today, I plan to talk about self-regulation and a new study that points out an intriguing aspect of BPD. There has been much talk in the BPD research and clinical community about the “core” of BPD. Once it was thought to be a personality disorder or even an extreme form of PTSD. Dr. Marsha Linehan (the inventor of DBT) talks about dysregulation in a number of systems, the most important of which (in my interpretation) is the emotional regulation system. People with BPD are extremely emotionally sensitive and subject to emotional “cues” or triggers. They seem to have a less tolerant (in the “controls” sense of the word, meaning more highly sensitive) emotional system. They are triggered more easily and the reactions seem to be more intense and longer-lasting. In “When Hope is Not Enough” I compare this feature to a heat-sensing device and say:

The core problem with BPD is poor emotional regulation. That particular problem can cause other symptoms to arise as the person with BPD becomes emotionally dysregulated. This term emotionally dysregulated (or just dysregulated) is used to denote the state in which a person with BPD is overcome with powerful and, at many times, misaligned emotional reactions. Remember that emotions don’t arise on their own; they are based on cues or triggers from the environment and compared by our “emotional immune system” to the meaning of the cue. For a person with BPD, the meaning can be misjudged or, as is more often the case, the sensitivity to emotional cues is greatly heightened.

An example is a heat-sensing system that helps to detect and suppress fires. Sometimes companies will install heat-sensing equipment in addition to smoke detectors so that they can protect assets that need a certain temperature to operate (e.g. computer equipment which might cease working at a high temperature). The setting at which an alarm goes off might be 80 degrees Fahrenheit. In the case of someone with BPD, the setting (or “tolerance” as it is called in the control community) is naturally set much lower, at say, 50 degrees Fahrenheit. That means that the alarm will be raised much more often and lead to a reaction to the alarm. In other words, people with BPD will experience many, many (what you would consider) false alarms. However, these false alarms seem completely real to them, because their tolerance for emotional triggers is set very low. They are constantly running a fire drill. Unfortunately for you, the BP may drag you along unwillingly and unwittingly for the drill. (Pages 32-33 of WHINE)

As you can see, the position I take in WHINE is that emotional regulation is the “core issue” of BPD. This position is in line with the DBT way of thinking, which is why one of the “modules” of DBT is emotional regulation skills.

The question is today: is emotional regulation at the “core” of BPD? Or does it go deeper than that? Is there a “cause” for emotional regulation? What are the triggers and how does a person with BPD’s internal feelings affect this “systems dysregulation”?

In the American Journal of Psychiatry, Drs. Stanley and Siever recently (January 2010) publish an article entitled “The Interpersonal Dimension of Borderline Personality Disorder: Toward a Neuropeptide Model “ in which they seem to posit (in my interpretation again, since I am a lay person and not a doctor) that this systems dysregulation actually has another cause instead of being a “core cause’ of the disorder. They begin the article like this:

Borderline personality disorder is a complex disorder associated with substantial morbidity, mortality, and public health costs. Prominent symptoms include suicidal behavior, nonsuicidal self-injury, aggressive outbursts, and emotional reactivity, all of which typically manifest in an interpersonal context. For several years, there has been an ongoing discussion about whether impulsive aggression or affective dysregulation is at the core of the disorder. While these factors are important in borderline personality disorder, it is the exquisite interpersonal sensitivity that frequently triggers both dysregulated affect and impulsive behaviors, which suggests that this sensitivity perhaps rests at the core of the disorder and may in turn drive impulsivity and dysregulated affect.

They go on to say this:

It is noteworthy that many symptoms in the interpersonal domain of borderline personality disorder are actually manifestations of intrapersonal difficulties (e.g., difficulty being alone and misperception of the intentions of others as malevolent), and this dimension could perhaps be reconceptualized as “intrapersonal dysfunction.” We suggest that an internal feeling of well-being, stability, and self-regulation in borderline personality disorder is tenuous and may rely heavily on a sense of interpersonal contact and connectedness.

So, what’s afoot here? What are they saying and what does it mean to the nons of the world?

It seems to me that they are saying two very important things about BPD that has previously been “unnoticed” as DBT has reigned the clinical community. These are:

“…it is the exquisite interpersonal sensitivity that frequently triggers both dysregulated affect and impulsive behaviors, which suggests that this sensitivity perhaps rests at the core of the disorder and may in turn drive impulsivity and dysregulated affect.” Basically, that the interpersonal sensitivity is the “control” of is sensitive to the (emotional) heat.
“We suggest that an internal feeling of well-being, stability, and self-regulation in borderline personality disorder is tenuous and may rely heavily on a sense of interpersonal contact and connectedness.” That means that the lack of internal well-being makes the person with BPD sensitive to interpersonal cues.

What do those two important factors mean to you – the loved one or family member? In my mind they mean that a person with BPD uses people in close personal relationships to self-regulate. In other words, being unable to self-regulate internally, they look to external people to regulate their emotions, reactions, sense of well-being and behavior. They believe at some level that you, the loved one, is an extension of their mind, emotions and feelings and assume to you “should know what to do” when they are feeling dysregulated.

What SHOULD you do when this situation occurs? What should you do when they are triggered? What should you avoid?

I believe that the most effective answer is to help them learn to self-regulate and self-validate. This “lack of well-being” is an unpleasant feeling (I would imagine) and probably feels like a HUGE lack of control. I mean, if a person has to rely on other (unpredictable) people to self-regulate, how must that feel? Having compassion for that feeling is definitely a goal. However, before that comes (and it can be cultivated BTW), one can listen, ask, redirect the choice, validate, normalize and cheer lead when appropriate. Don’t defend or minimize. Living a life in which you’re always waiting for the other shoe to drop has got to be unpleasant.

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Shame and BPD

Bon Dobbs — Tue, 09 Mar 2010 16:08:52 +0000

In researching the implications of shame in BPD, I found this research study:

Shame and Implicit Self-Concept in Women With Borderline Personality Disorder

* Nicolas Rüsch, M.D., Klaus Lieb, M.D., Ines Göttler, M.D.,
Christiane Hermann, Ph.D., Elisabeth Schramm, Ph.D., Harald Richter, Ph.D.,
Gitta A. Jacob, Ph.D., Patrick W. Corrigan, Psy.D., and Martin Bohus, M.D. *

*OBJECTIVE: *Shame is considered to be a central emotion in borderline personality disorder and to be related to self-injurious behavior, chronic suicidality, and anger-hostility. However, its level and impact on people with borderline personality disorder are largely unknown. The authors examined levels of self-reported shame, guilt, anxiety, and implicit shame-related self-concept in women with borderline personality disorder and assessed the association of shame with self-esteem, quality of life, and anger-hostility.

*METHOD: *Sixty women with borderline personality disorder completed self-report measures of
shame- and guilt-proneness, state shame, anxiety, depression, self-esteem, quality of life, and clinical symptoms. Comparison groups consisted of 30 women with social phobia and 60 healthy women. Implicit shame-related self-concept (relative to anxiety) was assessed by the Implicit Association Test.

*RESULTS: *Women with borderline personality disorder reported higher levels of shame- and guilt-proneness, state shame, and anxiety than women with social phobia and healthy comparison subjects. The implicit self-concept in women with borderline personality disorder was more shame-prone (relative to anxiety-prone) than in women in the comparison groups. After depression was controlled for, shame-proneness was negatively correlated with self-esteem and quality of life and positively correlated with anger-hostility.

*CONCLUSIONS: *Shame, an emotion that is prominent in women with borderline personality disorder, is associated with the implicit self-concept as well as with poorer quality of life and self-esteem and greater anger-hostility. Psychotherapeutic approaches to borderline personality disorder need to address explicit and implicit aspects of shame.

http://ajp.psychiatryonline.org/cgi/content/abstract/164/3/500

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On My Side

Bon Dobbs — Mon, 31 Aug 2009 17:18:24 +0000

Are you and your BP on the same team?

I often hear people with BPD/ERD say that they feel that their loved ones are “not on my side” or that the loved ones are “supposed to be on my side.” This phrase stuck out at me when I read the story about the suicide of Megan Meier (the “MySpace suicide” case), because, although I have no insight into Megan’s mental health, clearly when she was insulted and rejected on MySpace, and she was emotionally dysregulated. She came to her mother, and after her mother admonished her for the use of foul language on MySpace, Megan cried and said, “You’re my mom. You’re supposed to be on my side!” (This according to her mother’s reports).

When someone is highly emotional, they need to know that they have an advocate and that someone is on “their side.” I often ask my consulting clients (especially partners of people with emotional regulation issues) if they feel that their partner and they are “on the same team.” Many times the answer is no. Why does someone have a desire to have someone on their side, even when the “sides” are not desired, intended or even clearly delineated? The answer in my mind comes down to shame and rejection sensitivity.

If a person has shame (or even low self-worth, which is similar), then the person is likely to have a high level of rejection sensitivity. Being rejected by others is painful, especially for emotional people. Having an advocate of their “side” of the issue, which is essentially answering, “I am on your side no matter what the situation,” is tantamount in these highly emotional, social interactions that involve rejection. One can be “on their side” emotionally without condoning whatever behavior that one doesn’t agree with.

There are teaching moments and there are times that one doesn’t teach. If you try and teach, punish or impart values during a period of emotional dysregulation, the relationship will be damaged and nothing effective will be accomplished. Instead, emotional validation and support can be used to cool the bonfire. Once it is cool, then a teaching moment can present itself.

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Fear and Shame

Bon Dobbs — Mon, 06 Jul 2009 18:41:44 +0000

Fear and Shame

Today, I figured I would discuss fear and shame. Not many people realize the impact that these two emotions have on people’s behavior. I believe that most of the “controlling” behavior in relationships is based on these two emotions. My daughter is angry at her boyfriend for being controlling. He monitors her and gets upset when she does something that is not what he expects. I believe that his behavior has to do with his fear of losing her to someone else and his shame that he feels deep down that he is not really good enough for her. Shame is particularly corrosive, and it is, of course, a big problem in BPD. Fear has to do with the unexpected and thinking about the future with trepidation. Expecting the worst or, better, fearing the worse, is how many people operate – especially if they are wracked with shame.

The core idea here however, is that these two emotions, which motivate controlling behavior, are not about the person who is being “controlled.” No, these emotions are about the controller. I often say in my group (and in my book) that poor behavior in someone with BPD (or anyone in fact) is “not about you” (the recipient of the behavior) or, after rephrasing it: “it’s all about his/her feelings” One of the misunderstandings of that attitude in some of my readers is that some people read that and think “When is it about MY feelings?” That was never the intention of this approach. In fact, the idea was intended to be a way of elucidating the motivation of the behaviors to which Non-BPs object. You see, in my experience, the behaviors of a person with BPD (or anyone emotional) can be explained as being motivated by poorly regulated emotions. The behaviors serve a function which is to halt the negative and overpowering emotional states. Fear and shame are very painful emotions and any person will do anything to halt them (anything to stop the pain). So, while the behaviors seem to be directed at you (like my daughter’s boyfriends controlling behavior seems to be directed at her), in reality the function of the behaviors is to halt the pain. If the fear and shame were not present, the behaviors would cease to exist. That is why I encourage people to act on the emotions directly, rather than on the behaviors directly. This is possible through the application of emotional skills both within one’s own mind and within the context of the relationship.

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Marriage Problems and Authentic Self

Bon Dobbs — Fri, 08 May 2009 22:41:22 +0000

Today I was reading the Psychology Today blog of Dr. Steven Stosny, called the “Anger in the Age of Entitlement” blog. Here is a nice article that married people (BP, Non-BP and others) should read:

Marriage Problems: How Can I be Me When You’re being You?
By Steven Stosny on August 18, 2008 – 3:09pm in Anger in the Age of Entitlement

Most people get married because they like the way they are with their partners – loving, compassionate, engaging, supportive, sexy, and flexible. They get divorced because they don’t like the way they are with their partners – resentful, turned off, frustrated, rigid, or bored, all of which they blame on their relationship.

In the course of this death march, many go into marriage therapy to find better ways to manipulate their partners into, at best, doing what they want or, at worst, becoming who they want. The self-defeating flaw in this strategy, apart from the fact that it hardly ever works, is cognitive dissonance — the discomfort generated by holding contradictory cognitions.

In marriage, cognitive dissonance is the difference between how you would like to be and how you are. For instance, “I am loving, compassionate, supportive, sexy, etc., yet I am not these things with you.”

This aspect of cognitive dissonance isn’t bad; it can act as a motivation to be true to your deepest values, by making you behave in more loving and compassionate ways. Unfortunately, most people who divorce or go to marriage therapy choose to resolve their cognitive dissonance with something like this:

“Since I am unable to be my loving and compassionate self with you, you must be too selfish, insensitive, withholding, demanding, emotional, rigid, sick, or defective in some way.”

This ill-fated resolution of cognitive dissonance only makes you both feel like victims and sends you searching online or in self-help aisles for a checklist that validates your suffering and a diagnosis that nails your partner.

Cognitive dissonance can undermine marriage (and marriage therapy) in sneaky ways, even when you are successful at getting what you want, namely, change in the other person. If you do get what you want by changing your partner, your self-concept is reduced to:

“I am loving, compassionate, supportive, etc., as long as you do what I want.”

Do you really want this on your tombstone:

“As long as I got what I wanted, I was great to the people I love,” ?????

The irony is that the last thing you need is an externally regulated self concept, i.e., one determined not by your own behavior but by what your partner does for you. Externally regulated, your sense of self becomes totally dependent on your partner, not just for consistently doing what you want but for doing it with love and joy in his/her heart, since resentful submission is far from satisfying. Externally regulated, self-concept needs more and more validation, if not submission, from the partner to stay afloat. This sends satisfaction on a downward spiral as it necessarily destabilizes both the sense of self and the relationship.

Successful marriage is not about getting your partner to do what you want; it’s about being who you are, i.e., behaving according to your deepest values. For most people, this means being loving and compassionate to the people they love.

Happily, you have the best chance of getting your partner to do what you want by being who you are.

Consider the effects of positive reciprocity and negative reactivity. Which of the following is more likely to inspire cooperation?

1. Approaching your spouse as your authentic, loving and compassionate self
2. Approaching your spouse with entitlement and demands (even if couched in the rehearsed language of “behavior requests”)?

Marriage (and marriage therapy) run into a brick wall of cognitive dissonance when they focus on “getting your needs met,” or “getting the love you want.” They are more likely to have lasting success with focus on each of you being the partner you most want to be.

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Are personality disorders enough to nullify a marriage?

Lindsay Lohan and BPD (maybe but not for sure)

Bon Dobbs — Sun, 12 Apr 2009 15:20:31 +0000

OK readers, now is the time to revisit Lindsay (I think I was spelling her first name wrong for a while there) Lohan and possible BPD. She has all of the classic signs of the disorder. I was struck by this quote:

“Sam and Lindsay are speaking,” the source tells PEOPLE. “But Sam has begged Lindsay to get help.”

“Lindsay, despite appearances, is insecure and has relied on Samantha and their relationship to build her up,” explains the pal. “Lindsay barely sleeps, which explains a lot of her behavior. She’s exhausted. She can’t even sit down for a minute without pacing around the room. It’s really sad.”

Sam is begging Lindsay to get help? For what? Well, perhaps we know. Looking at Lindsay’s case, I can’t help but see Borderline Personality Disorder (BPD). She is erractic, emotional and sexually confused. She has all the classic signs of an untreated person with BPD. I hope she gets help – and I hope that, if she is diagnosed with BPD, she would come out publically and say so – to reduce the stigma of the disorder.

Lindsay Lohan and BPD?

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Why Shame is Corrosive in a BP/Non-BP relationship

Bon Dobbs — Sun, 29 Mar 2009 16:12:14 +0000

This is my response to someone who asked why shame is corrosive in a BP/Non-BP relationship…

Shame is corrosive to a relationship because it keeps the BP or NP in “pretend mode” where they are behaving “as if” they are engaged in the relationship, but in reality their only real goal is to protect themselves from discovery. The closer you get to it, the more panicked they become. Often the shame is never revealed to others and covered up with bullshit (in the art term, not the common term). If a person is bullshitting their way through something (and sometimes they bullshit themselves too) then they are not genuinely engaged in the relationship. THAT is corrosive, especially when it is discovered and you think “was this EVER real?” That’s what leads people to think BPs can’t really love. But the bullshit is a defense mechanism to protect against mind numbing shame. In fact it could be argued that all defenses are at some level bullshit (or pretending things are ok). Still, we need them on some level to protect us from the brutal truth at times. Acceptance is not bullshit, it is taking things how they really are. If a BP can’t accept themselves as they are (and want to change) then you’re in for a steaming pile of bullshit in the form of protecting their shame – and that is no way to have a genuine relationship. Still, if they had no defenses against experiencing shame, they would all commit suicide.

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Ian Curtis and BPD (or another disorder)

Bon Dobbs — Sun, 08 Feb 2009 18:25:12 +0000

Rarely do you find an individual artist who expresses his/her emotions and pain as clearly as did Ian Curits. He was the lead singer and song writer for the band Joy Division. In May of 1980, two days before their first U.S. tour, Curtis hung himself in his kitchen. Joy Division reformed as New Order and had a major impact on dance/rock music. But Joy Division was an amazing band. Curtis’ lyrics read like a suicide note. He had epilepsy and the medication he was taking for it supposedly depressed him. The lyrics on their two albums (Unknown Pleasures and Closer) are fought with pain, shame and depression. Two years ago there was a bio-pic about Curits (“Control”) and a documentary about Joy Division. Again, rarely do you find someone who expresses his pain in such clear terms. Here is a sampling of Curtis’ lyrics:

Isolation

Mother I tried please belief me
I’m doing the best that I can
I’m ashamed of the things I’ve been put through
I’m ashamed of the person I am
Isolation, isolation, isolation

New Dawn Fades

Different colours, different shades
Over each mistakes were made
I took the blame
Directionless so plain to see
A loaded gun won’t set you free
So you say

Passover

Forgive and forget’s what they teach
Or pass through the desserts and wastelands once more
And watch as they drop by the beach
This is the crisis I knew had to come
Destroying the balance I’d kept
Turning around to the next set of lives
Wondering what will come next.

Atmosphere

Your confusion
My illusion
Worn like a mask of self-hate
Confronts and then dies
Don’t walk away

Some Joy Division Stuff:

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More on Hoovering

Bon Dobbs — Thu, 13 Nov 2008 18:46:13 +0000

Yesterday, I received a long and thoughtful comment about my post The Myth Of Hoovering. I wanted to respond to it, because I believe that the commenter actually misunderstood my point about hoovering and why I called it a “myth.” Certainly, I was well-aware that the post (along with The Myth of the High-Functioning Borderline) would be controversial in the non/BPD-support community. The commenter said the following about my post:

“Regarding the misinformation you mention, you’ve discounted the existence of the “hoovering” phenomenon on the basis that it’s not a conscious behaviour. In the link you provided, and in mentions of this concept I’ve seen elsewhere, I didn’t note any stipulation that the key ingredient of hoovering is premeditation. It’s merely an esoteric term to describe the behaviour that follows after the person with BPD has done something to scare off / push away their partner, and it is very compelling and sometimes very dangerous for the Non. It also mirrors the cycle of violence in cases of domestic abuse and you are dismissing the realities of countless victims who are so frequently told they should “just leave”. THIS is a shining example of ignorance. Whatever household appliance you name it after, the behaviour pattern in question most certainly does exist, in studies, interviews, textbooks, and therapy sessions, regardless of whether the person enacting it is conscious of its effects.”

The link I provided was to the definition of “hoovering” at BDP411.org. My argument against hoovering was to point out that hoovering is not a pre-meditated form of manipulation, but in reality, I should have made a more salient point about hoovering and the existence (or lack there of) of the phenomenon. The link on BPD411.org says this:

“The intent of the hoover is to get the Non back into the relationship.”

In my experience with BPs, this statement is not the case. The intent of hoovering or any behavior that a person with BPD does (when untreated and emotionally dysregulated) has nothing to do with the non. The intent to two-fold IMO: 1) to as immediately as possible feel better emotionally and 2) to confirm that the BP is not a “bad person” and deserving of love, no matter what poor behavior was previously exhibited to argue otherwise.

When Hope is Not Enough
Get the Non-BPD book
that has helped hundreds!
If you have the disorder, give it to you loved ones! It will help.

You see, hoovering is routed in shame (shame of the BP, not the non). The person with BPD will want to confirm to themself that the non (who supposedly loves them – of course this goes both ways) does not discover that deep inside they are a shameful and unworthy person. I mentioned the “toxic self-consciousness” mind-set when I was talking about David Foster Wallace and his suicide. Toxic self-consciousness is there so that someone can be vigilant about protecting others from discovering their shame and thus, leaving them because they are “bad” and unworthy of love. The shame element is what feeds the fear of abandonment, not the other way around. Often, nons (and professionals) talk about the fear of abandonment as the “core” of BPD, but I believe that BPD actually has 3 core features that lead to the others (including fear of abandonment, rejection sensitivity, fault-finding behavior and others). Those core features are emotional dysregulation, shame and impulsiveness. So, in the event of a hoover, the BP is fearful that you (as a non) will discover their shame and this leads to emotional dysregulation (basically, panic) which can lead to impulsive behavior (including hoovering).

Another article from BPD411.org – the “rules of engagement” can be found here: Rules of Engagement. This is actually the article of which I was thinking when I posted my previous post on hoovering. Here’s what it says:

Rule #5: If at any time the Non figures out the Rules of Engagement for BPD Land, the BPD’er must change the situation, rewrite history, and thereby purchase the Non a one way ticket back to BPD Land.

Rule #6: If Rule #5 fails, the person with the disorder must use a major hoover, promise anything, mirror the Non exactly, seduce the Non, or engage in multiple acts of what ever worked last time to convince the Non that “this time will be different”.

As you can see rule #6, does imply premeditation, since “Rules of Engagement” imply premeditation. It states that a BP will use a major “hoover” to “convince the Non that ‘this time it will be different’.” What many of these documents and posts (such as the “Ten Demandments”) imply is that the BP is motivated by and reacts to the behavior of the Non. My view on this is that a BP will react and behave completely in response to their own feelings, shame and conditioned behavior. Very little of a BP’s behavior is about the non. In the words of WHINE – IAAHF (“It’s always about his/her feelings). Why does this matter?

It matters because a Nons approach toward a perceived hoover will be different and more effective than in the past. When given the choice between “giving in” or “rejecting” a hoover – each comes with a price. The price of giving in can be your own shame, feeling of stupidity when things don’t change and/or anger at the other person for manipulating you and your feelings. The price of rejecting a hoover is (in my experience) rage, rejection, fault-finding and the “what about you?” argument that many BPs will use to deflect attention from their own shame. However, if you realize that the actual problem is not the hoovering behavior (which DOES exist, I’m not denying that), it is the feelings of panic and shame that motivate the hoovering, the act of hoovering can be faced more effectively. Meaning, if you solve the real problem (which is the emotional dysregulation and feelings of shame in the BP), the hoovering behavior will cease because the motivating factor is NOT “to get the Non back at whatever the costs” – it is to make the BP feel better and worthy of love in themselves.

As an aside, I had an experience with my cat this morning that could be seen as hoovering. This cat is not very loving (except when she wants to be). She was a stray and abused, so she is pretty shy about showing affection. I’ve had her for about 2 years. Anyway, last night she got locked out of the house all night. When I came downstairs at 7 AM this morning, she was sitting in the back window (on the outside) meowing. I opened the door for her and she ran inside and rubbed up against me, followed me around for about 20 minutes and made me pet her by pushing her head against my hand. This was all before she went to the food bowl, which is usually the first thing she does in the morning. Again, this is not an affectionate cat, normally. But she was upset and needed to have affection shown to her. After she calmed down and made sure we still loved her and didn’t abandon her, she went upstairs, climbed in the linen closet and went to sleep. My point is that even a simple animal (although cats are hardly simple animals, they have interesting personalities) undergoes emotional dysregulation and needs assurances and needs to feel better. If the point of hoovering is to feel better and to receive feedback from a loved one that you are worthy of love – what is wrong with that? I believe that in the moment, those feelings are completely genuine (although further emotional dysregulation at a later time might cause opposite behavior) and can be assuaged with emotional tools. In the case of the cat, I just had to pet her and reassure her that all was OK. Of course most cats hate vacuum cleaners, whatever the brand.

BTW, a member of my ATSTP list provided an “inside out” view of both hoovering and of the “Rules of Engagement” in her “Net Debunks” section. It is worth checking out each of these.

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The strange case of Ashley Todd

Bon Dobbs — Mon, 03 Nov 2008 19:23:48 +0000

When I saw the backward-carved “B” in Ashley Todd’s face last week, I couldn’t help but think about Borderline Personality Disorder (BPD). And one Mental Health professional actually came out and said that Ms. Todd did, in fact, exhibit traits of the disorder. Personally, I have to disagree with the experts that have “diagnosed” her with BPD. While self-injury is a hallmark of BPD, the motivation behind self-injury in BPD is usually NOT to get attention. Clearly, Ms. Todd, who was the “victim” of an attack by a black man in Pennsylvania (which later she admitted was a hoax), carved the “B” in her own cheek and she must have known that this action and the made-up story about the attack would garner a lot of attention. Yet, what I have seen in most cases of BPD-related self-injury is that the motivation is typically pain-relief and not attention-getting. The mere act of self-injury is a shameful one, and, in BPD, which already fuels shameful feelings, the self-injurer usually hides the act from others, doing it in private and on places that are not detectable by others. That’s because the self-injury functions to stop private emotional pain. Cutting oneself on the face (especially a letter on the face) would seem to me to indicate a different disorder. While it is possible that Ms. Todd does have BPD, I personally think it is unlikely.

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