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Amy Winehouse, addiction and BPD from the NY Times

Before her death, I’d written about Amy Winehouse and my analysis of why she was very high on the BPD-o-meter. Here is an article from the NY Times about addiction that mentions both Amy Winehouse and Borderline Personality Disorder (but not as her having it). Here are some interesting quotes:

Clinicians have long been aware that patients with certain types of psychiatric illnesses — including mood, anxiety and personality disorders — are more likely to become addicts. According to the National Institute of Mental Health’s Epidemiologic Catchment Area Study, patients with mental health problems are nearly three times as likely to have an addictive disorder as those without.

Conversely, 60 percent of people with a substance abuse disorder also suffer from another form of mental illness. Still, it’s unclear whether addiction predisposes someone to mental illness, or vice versa.

Scientists do know that having a mental illness doesn’t just increase the chance of intermittent drug abuse; it also significantly raises the risk of outright dependence and addiction. The conventional wisdom is the link represents a form of “self-medication” — that is, people are using drugs long-term to medicate their own misery.

And of course, I can’t overlook this one:

Certain personality disorders also raise the odds of drug abuse and alcohol abuse. Narcissistic patients, who constantly battle feelings of inadequacy, are frequently drawn to stimulants, like cocaine, that provide a fleeting sense of power and self-confidence. People with borderline personality disorder, who struggle to control their impulses and anger, often resort to drugs and alcohol to soften their intolerable moods.

Maybe that is an interesting factor for understanding the difference between NPD and BPD. In my experience, those with BPD are usually drawn to benzos, alcohol, and opiates. In my poll about substance abuse over 75% of respondents said they have had problems with substance abuse. Because of the u-opioid study by Stanley and Siever (and others), it seem natural for borderlines to seek pain-squelching medications, illicit or not.

Amy Winehouse found dead at 27

It appears that Amy Winehouse has joined the “dead at 27″ music crowd (Kurt Cobain, Jimi Hendrix, Janis Joplin, Jim Morrison, others). It’s sad and unfortunate. She was #1 on my BPD-o-meter because of her erratic behavior.

Singer Amy Winehouse Found Dead

London (CNN) — Singer Amy Winehouse was found dead at her apartment in London Saturday, the UK Press Association reported. She was 27.

London police said they were called to a home, which matches Winehouse’s address, Saturday afternoon in response to “a woman found deceased.”

“On arrival officers found the body of a 27-year-old female who was pronounced dead at the scene,” a police statement said.

“At this early stage it is being treated as unexplained,” police said.

The “Rehab” singer had a history of battling drugs and alcohol and recently left a British rehabilitation program that a representative said was intended to prepare her for scheduled European concerts.

But she cut short the European concert tour in Belgrade, Serbia, last month after she staggered around the stage and stumbled through several songs.

Audience members booed Winehouse off the stage that night just a few songs into the first concert of the tour.

Winehouse rep Tracey Miller told CNN at the time that the singer “agreed with management that she cannot perform to the best of her ability and will return home.”

“Everyone involved wishes to do everything they can to help her return to her best and she will be given as long as it takes for this to happen,” representative Chris Goodman said in a statement in May.

Winehouse’s throaty vocals brought the British musician stardom in 2007, but her off-stage life gained her notoriety. The lyrics of her songs, especially the hit “Rehab,” chronicled her troubled life.

The song, in which she sang “They tried to make me go to rehab, I said no, no, no,” helped form the public’s view of Winehouse.

“I don’t care enough about what people think of me to conform to anything,” she said in a CNN interview.

Winehouse, born in London in 1983, became a picture of a tattooed teenage rebel after she was expelled from a prestigious performing arts school.

Her first album, “Frank,” debuted in 2003, when the singer-songwriter was 19.

International success came with her 2007 album “Back To Black,” which in included the single “Rehab.”

 

Understanding Emotional Agony Through David Foster Wallace’s Eyes

Here is a quote from Infinite Jest about “depression” or the “Great White Shark of Pain”. I think it helps illustrate the difference between the chronically depressed and those in emotional agony. I see that people with borderline personality disorder are more likely to be in the second category. I have bolded some key points here. The “suicide contract” is exactly the same as a “behavior contract”. With a person in this much pain, it ain’t gonna work.

That dead-eyed anhedonia is but a remora on the ventral flank of the true predator, the Great White Shark of pain. Authorities term this depression clinical depression or involuntary depression or unipolar dysphoria. Instead of just an incapacity for feeling, a deadening of soul, the predator-grade depression Kate Gompert always feels as she Withdraws from secret marijuana is itself a feeling. It goes by many names — anguish, despair, torment, or q.v. Burton’s melancholia or Yevtuschenko’s more authoritative psychotic depression — but Kate Gompert, down in the trenches with the thing itself, knows it simply as It.

It is a level of psychic pain wholly incompatible with human life as we know it. It is a sense of radical and thoroughgoing evil not just as a feature but as the essence of conscious existence. It is a sense of poisoning that pervades the self at the self’s most elementary levels. It is a nausea of the cells and soul. It is an unnumb intuition in which the world is fully rich and animate and un-map-like and also thoroughly painful and malignant and antagonistic to the self, which depressed self It billows on and coagulates around and wraps in Its black folds and absorbs into Itself, so that an almost mystical unity is achieved with a world every constituent of which means painful harm to the self. Its emotional character, the feeling Gompert describes It as, is probably mostly indescribable except as a sort of double bind in which any/all of the alternatives we associate with human agency — sitting or standing, doing or resting, speaking or keeping silent, living or dying — are not just unpleasant but literally horrible.

It is also lonely on a level that cannot be conveyed. There is no way Kate Gompert could ever even begin to make someone else understand what clinical depression feels like, not even another person who is herself clinically depressed, because a person in such a state is incapable of empathy with any other living thing. This anhedonic Inability To Identify is also an integral part of It. If a person in physical pain has a hard time attending to anything except that pain [(the big reason why people in pain are so self-absorbed and unpleasant to be around)], a clinically depressed person cannot even perceive any other person or thing as independent of the universal pain that is digesting her cell by cell. Everything is part of the problem, and there is no solution. It is a hell for one.

The authoritative term psychotic depression makes Kate Gompert feel especially lonely. Specifically the psychotic part. Think of it this way. Two people are screaming in pain. One of them is being tortured with electric current. The other is not. The screamer who’s being tortured with electric current is not psychotic: her screams are circumstantially appropriate. The screaming person who’s not being tortured, however, is psychotic, since the outside parties making the diagnosis can see no electrodes or measurable amperage. One of the least pleasant things about being psychotically depressed on a ward full of psychotically depressed patients is coming to see that none of them is really psychotic, that their screams are entirely appropriate to certain circumstances part of whose special charm is that they are undetectable by any outside party. Thus the loneliness: it’s a closed circuit: the current is both applied and received from within.

The so-called ‘psychotically depressed’ person who tries to kill herself doesn’t do so out of quote ‘hopelessness’ or any abstract conviction that life’s assets and debits do not square. And surely not because death suddenly seems more appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who jump from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire’s flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It’s not desiring the fall; it’s terror of the flames. And yet nobody down on the sidewalk, looking up and yelling ‘Don’t!’ and ‘Hang on!’, can understand the jump. Not really. You’d have to have personally been trapped and felt flames to really understand a terror way beyond falling.

But and so the idea of a person in the grip of It being bound by a ‘Suicide Contract’ some well-meaning Substance-abuse halfway house makes her sign is simply absurd. Because such a contract will constrain such a person only until the exact psychic circumstances that made the contract necessary in the first place assert themselves, invisibly and indescribably. That the well-meaning halfway house Staff does not understand Its overriding terror will only make the depressed resident feel more alone.



Infinite Jest (Paperback)

By (author) David Foster Wallace

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What Diane Schuler’s story can tell us about emotional honesty and acceptance

You may or may not remember this story from 2009. Diane Schuler, a mother and aunt with her children and her sister’s children in a min-van, goes the wrong way on the Taconic Parkway in Westchester county and plows into an SUV head-on killing three in the SUV and 4 children and herself in the mini-van. Toxicology reports showed she had a blood alcohol level of .19 over twice the legal limit of .08. She also reportedly smoked marijuana and had several ounces of undigested alcohol in her stomach. Here’s an article that analyses the NY Magazine article about her husband Daniel Schuler. This analysis from Jezebel.com, points out the problems, isolation, secrets and tragedy that can exist when a spouse is unable to communicate his/her emotional pains.

Diane Schuler’s Story Is One Of Isolation, Denial, And Rage
Anna North

One of the saddest news stories of the summer just got sadder — the husband of Diane Schuler, whose wrong-way drunk-driving crash killed her and seven others, tells New York Magazine he still believes his wife was essentially perfect.

New York’s Steve Fishman tells a depressing tale of denial and rage. On one side is the bereaved Schuler, struggling to go on after the death of his wife and daughter, and on the other is the Bastardi family, two of whose members were killed when Diane Schuler’s Winstar struck their TrailBlazer. Mike Bastardi lost his father, Michael Sr., and his brother Guy, and is angry at the whole Schuler family for what he sees as their role in the accident. He says, “They make like it was not even their fault. I think they knew she was drunk and stoned.” Bastardi’s wife Jeanne is even harsher. She says, “Not even a second have I felt sorry for Danny. This becomes a man you can’t hate enough.”

Part of the reason the Bastardis are so angry with Schuler is that he won’t own up to his wife’s guilt. After the crash, he said at a press conference, “She did not drink. She is not an alcoholic. My heart is rested every night. Something medically had to have happened.” He’s stuck to this story ever since, hiring a private investigator and a lawyer who speculated that a small stroke or abscess might have caused her to suddenly lose judgment and down ten shots of vodka before getting behind the wheel. Not only was his wife not an addict, he says, she was nearly flawless. Though he spoke to the investigator about “ups and downs” in his marriage,” he told Fishman, “There were never any downs. Up for twelve years.” He says they were “perfect” for each other, she was an “outstanding” mom, and, tellingly, “She never complained. I do; she doesn’t.”

Diane Schuler’s friends also portray her as keeping her feelings — especially negative ones — to herself. One says, “I’ve never seen her mad or angry,” another, “she infrequently talked about personal feelings.” She never talked about her parents’ divorce, and refused to speak to her mother — some friends even thought her mother was dead. When Fishman asked Danny “how well he really knew” his wife, Danny answered, “She’d talk to me if things came up.” His examples: “The house needs painting, the gutters need to be cleaned.”

To hear Fishman tell it, the Schulers’ story seemed like a long, drawn-out, and bloody example of the consequences of secrets in a marriage. Did Diane Schuler feel pressured to be the perfect mom — Danny mentions her expertise with birthday cards and holiday decorations — and thus keep her substance problems to herself? Did she feel she couldn’t confide in her husband because their work schedules meant they were rarely home at the same time? Did her parents’ divorce make her feel she couldn’t rock the boat in her own marriage? Why didn’t her friends know more about her troubles? Probably these questions will never be answered, but if there’s a tragic flaw in the whole Schuler saga, it’s isolation.

Despite her supposedly close-knit family, Diane Schuler apparently kept herself hidden from everyone. This led not only to her death and the deaths of seven others — it also plunged her husband into denial and the surviving Bastardi’s into fruitless anger. They won’t be satisfied until he admits guilt; he won’t be satisfied until he proves his wife was blameless. It’s hard to know how much of this cycle of despair was caused by Diane Schuler’s own particular pathology, and how much by an American idea of marriage that often positions the spouse as sole confidant even when, as was the case with the Schulers, that spouse may be physically unavailable. Only one thing is clear: if Schuler had felt able to open up about her own life, she might have avoided destroying countless others.

 

Polls and Ineffective Borderline Behavior

I’ve had conversations with several BPD “experts” about borderline behavior. There seems to be an assumption that many people with BPD are “silent” or “high-functioning” and do not engage in dangerous and/or ineffective behavior often attributed to the “typical” borderline.

In my group recently, a non-BPD was questioning his own “sanity” (I put it in quotes because I don’t believe that people with BPD are insane) and speculating that he was the one with BPD. One of our longer-time posters replied:

If you’re not throwing full-blown temper tantrums, freaking out because EVERYONE is out to get you, threatening to hurt or kill yourself, running away from those who love you because you’re afraid they’re going to leave you first, complaining that NOBODY loves or respects you AND popping pills and guzzling alcohol all at the same time… then, I think, you can go ahead and disqualify yourself.

Based on the polls that I have conducted over the past few months, I believe that she is right on the money. Here are the poll results from the last few polls about borderline behavior:

Borderline Behavior Poll Results

As you can see by these polls results, more than 73% responded that their borderlines (or themselves if they have the disorder) indicated that they have engaged in self-injury, suicide attempts and/or substance abuse. While these polls are certainly not scientific and it’s pretty much impossible for me to understand the profile of a person that responded, they results are, for me, striking. If 7 out of 10 (or more) individuals engage in these “low functioning” or ineffective borderline behaviors at some point in their lives, what should that tell us?

I believe that it tells us that the “typical” profile of someone with BPD is the “low functioning” or “classic” borderline. While I am sure there are others out there that operate in pretend mode (and pretend everything is ok while they “white-knuckle” their way through life), the vast majority of people with BPD seem to be caught in a spiral of ineffective and often dangerous behavior. They seem to me to be sending the message that they are in a great deal of emotional pain and are suffering greatly – that they will do anything to stop the pain that they feel. It also indicates to me that it is vital for parents of child with borderline-like traits and feelings do their best to get the child into appropriate treatment before their teenage years.

Interesting Statement from Judge in Lindsay Lohan Case

Lindsay Lohan’s judge makes a statement about Lilo:

Sautner disagreed with the recommendation Wednesday, saying she didn’t think Lohan had a substance abuse problem.

“She has other problems, which she self-medicates,” the judge said.

I wonder what those “other problems” are? Perhaps you can check here for more information on the behavior of Lindsay Lohan.

Here’s the full text of the article:

Lindsay Lohan says she’s glad theft case resolved

LOS ANGELES – A lawyer entered a no contest plea Wednesday for Lindsay Lohan in the theft of a necklace, setting the stage for a summer of confinement, counseling and community service.

Defense attorney Shawn Holley made the plea for the actress, who did not appear in court in the misdemeanor case involving a $2,500 necklace taken from an upscale shop in the Venice area of Los Angeles.

Lohan, 24, did not acknowledge guilt through the plea, but the court will log the case as a conviction.

She said later in the day in a written statement that she was glad to put the case behind her and has already started her 300 hours of community service at a shelter for women.

“I hope to be able to fulfill my obligation without any press attention,” Lohan said. “I think the media spotlight should be on issues such as homelessness and domestic violence instead of on me.”

Lohan did not have to attend the hearing because she was facing a misdemeanor charge.

Superior Court Judge Stephanie Sautner ordered Lohan to serve a 120-day jail sentence and remain on probation in a 2007 drunken driving case while she completes a total of 480 hours of community service and undergoes psychological counseling.

Along with the women’s shelter, she will do 120 hours of community service at the coroner’s office, with the remainder to be decided.

The judge ordered the additional counseling after reviewing a probation report that showed Lohan tested positive for alcohol in February, a little more than a month after she was released from rehab.

The report also said authorities found evidence the actress had been drinking in December while receiving treatment at the Betty Ford Center.

Lohan had been sent to Betty Ford for three months of treatment last year after failing a drug screen. The report indicated she had tested positive for cocaine and amphetamines during the court-mandated drug test in September. Continue reading Interesting Statement from Judge in Lindsay Lohan Case

Charlie Sheen and Borderline Personality Disorder

Does Charlie Sheen have BPD?

Alright, I have to admit it, I’m fascinated – as I’m sure many of you are - watching Charlie Sheen and his “meltdown”. I’m fascinated, yet sickened because he seems to be having a mental health crisis right before our collective eyes. The question is: what are the mental health issues? Since I am not a doctor, nor have I ever met Charlie Sheen, I’m not qualified to diagnose him with anything. I have meet a lot of people with Borderline Personality Disorder (BPD) and their families and friends. I have watched first-hand what BPD can do to a person and a family.

Yet, I’m not at all convinced that Charlie Sheen has BPD. Some online analyses have pointed to BPD for Charlie, but thus far his behavior doesn’t seem to support that. Sure, he’s impulsive and seemingly either manic or hypo-manic. Hypo-mania can certainly be a feature of BPD. In my experience, this hypo-mania usually comes along with drug abuse (active) when the person with BPD takes medications or drugs that interferes with their impulse control. They think of something and do it without thinking about the consequences. Certainly, Charlie Sheen’s doing that right now. Except with BPD, the “mania” (or hypo-mania) typically only lasts a few hours or (at most) a couple of days. Charlie Sheen seems to be in an extended manic episode and it is not drug-fueled (if we are to believe his drug tests). This type of mania is more common in Biploar Disorder (either bipolar I or II).

He also seems to have lost touch with reality at some level. This disassociating can also be a feature of BPD, as well as other disorders. See his “Charlie’s Korner” episode 4 for that seeming losing touch with reality.

One thing I did notice about Charlie Sheen and his current rantings is that he seems fixated on judgment of him from others. This feature is one that is very common with BPD, although it’s probably common with other disorders as well. He seems to have set up an “us (or me, the warlock) versus them (the trolls)” mentality which is also very common (black and white thinking) in BPD. Yet, the shame and self-image issues seem to not be there (at least as far as we can see at this point).

Anyway, I guess the jury’s still out on Charlie Sheen. I hope that he will goes to get a professional mental health evaluation and take care of whatever mental or behavioral problems he’s experiencing.

Article about teen eating disorders and suicidal thoughts

Article showing that teens with eating disorders have more suicidal thoughts:

Teens with eating disorders more likely to harbor thoughts of suicide, study finds

By Amina Khan, Los Angeles Times

7:21 AM PST, March 8, 2011

Teens suffering from anorexia, bulimia and other eating disorders are more likely to suffer from suicidal thoughts, anxiety disorders and substance abuse — but how much they suffer may depend on the type of eating disorder they have.

That’s according to an analysis published online Monday in the Archives of General Psychiatry that, with 10,123 adolescents surveyed, is the largest and most comprehensive study of eating disorders in teens in the United States.

About 0.3% of the teens surveyed reported suffering from anorexia nervosa, and 0.9% from bulimia nervosa. A full 1.6% suffered from binge-eating disorder. Ethnic minorities were more likely to report binge-eating disorder, and white teens tended more toward anorexia.

Those who had one of these three eating disorders often suffered from other issues as well. For example, those who were anorexic were 1.6 times more likely to have problems with alcohol – but bulimics were 3.1 times as likely, the study found.

As for phobias, people with anorexia were 1.8 times more likely to suffer from a social phobia. Those with bulimia were at 3.9 times the risk, but even that jump was dwarfed by those with binge-eating issues, who were 5.9 times as likely to suffer a social phobia.

Sound scary? It could be worse than we think: The researchers write in the paper that some of these numbers may actually be “a lower bound of the true prevalence of eating disorders.”

Follow me on Twitter @LAT_aminakhan.

Copyright © 2011, Los Angeles Times

Fox News Mental Health Guy Gets It Wrong on Lindsay Lohan

Lindsay Lohan and BPD?

I read an article today about Lindsay Lohan from Fox News’ Dr. Keith Albow entitled “What Lindsay Lohan’s Parents Stole From Her”. While I can certainly understand Dr. Albow’s point at some level (although mostly I believe it was to attract readers to Fox with a catchy title about Lindsay Lohan’s situation), I have a problem with Dr. Albow’s analysis of Ms. Lohan’s parents. My problem has several facets to it, so you’ll have to bear with me as I go through them. The first part of my problem has to do with the “blaming the parents” aspect of mental health care and the attitude of mental health care professionals. When you take a child with possible BPD or with behavioral issues like Ms. Lohan has reportedly experienced (those include possible theft, substance abuse, sexual orientation confusion, impulsive actions, self-injury, depression, anxiety and the like), the first thing that is assumed about you is that the child has experienced trauma, neglect or abuse by the parents (that is, YOU). Oftentimes this is NOT the case. I have two daughters (fraternal twins) and one of them has emotional regulation issues, the other does not. The environment in which they were raised was essential the same. The thing is, the children are not the same. I know of another individual who has two daughters, two years apart in age, one of which is a drug addict who never attended college and the other has a ph. d. They were also seemingly raised in the same environment. Granted, neither my children nor the daughters of my friend are child stars as Ms. Lohan was. Yet, my problem #1 is blaming the parents. It doesn’t do anything to help Ms. Lohan. In DBT there’s a couple of rules that you learn at the beginning. One of these “rules” (or guidelines) goes something like this: Even though I didn’t cause some of my problems, I still have to be responsible for solving those problems. In other words, even if you lay the cause and responsibly solely at the feet of Ms. Lohan’s parents and what they “stole” from her, it doesn’t function to make Ms. Lohan behave more effectively or feel any better. Instead, now that she is an adult, she will be required to take responsibility for her behavior and learn the skills necessary to function in a more effective manner, regardless of who caused her problems. I want you all to understand though, if she DOES indeed have a mental illness, these problems might be more difficult for her to overcome. That is because IMO (and in the recent opinions of many scientists) there is a biological component to most mental illnesses (including BPD) and, whereas many people with BPD also have comorbid PTSD from trauma and/or abuse/neglect, many do not. I believe that in order to have BPD the biological component must be present. Dr. Marsha Linehan’s bio-social model seems to reflect this. In other words, in the case of my twins and my friend’s daughters, what is different about each of them is their biological system, not the environment. The kids are different biologically. In the case of Ms. Lohan, perhaps she also has a biological feature that would increase the likelihood of impulsive behavior (among other features).

Now this brings me to point #2 which has to do with boundaries and the fuzzy understanding of what boundaries are. Dr. Albow says:

If she’s guilty, she did it for the same reason she illegally used drugs and drove under the influence and—maybe—assaulted an employee at The Betty Ford Center: She had so much stolen from her as a young person, had her boundaries violated so feloniously, that she considers the boundaries of others irrelevant.

Ahh, boundaries! Anytime I mention BPD to anyone who is not steeped in the world of BPD/non-BPD, including and especially therapists, one of the first things out of their mouths is boundaries (after trauma/abuse). This doctor doesn’t understand boundaries and the way that they function. A person like Lindsay Lohan doesn’t have a boundary problem, she has an emotional problem. You could rewrite the first sentence like this:

If she’s guilty, she did it for the same reason she illegally used drugs and drove under the influence and—maybe—assaulted an employee at The Betty Ford Center: she is in a great deal of emotional pain, has issues regulating her emotions, is impulsive and will behave in an “anything to stop the pain” manner. She acts on her emotions and action impulses before she thinks of the consequences.

Her problem is dysphoria and a poor sense of well-being, which in turn leads to impulsive behavior like shoplifting a necklace when you could just afford to buy one.

I don’t want to go into a long discussion of boundaries here. I‘ve talk about boundaries so many times, it gets old. If you understand my view of boundaries and rules and consequences and intent and the differentiation between these important behavioral and mental concepts, you’ll immediately see why I object to the “boundary violation” explanation of  Ms. Lohan’s make-up and behavior. No, the problem with Lindsay Lohan is (IMO) dysphoria, poor impulse control, emotional dysregulation and a large amount of emotional pain. That is why she does the drugs, steals things (allegedly), engages in risky behavior, cuts herself, etc. It’s not because she “considers the boundaries of others irrelevant”. That statement just shows me that you, doctor, don’t understand boundaries, despite your status as a mental health professional and a Fox News guy. In fact, it has NOTHING to do with the other’s boundaries or feelings at all. It’s all about her feelings.

My last problem with the article has to do with this statement:

Assault and theft. Lindsay Lohan, I would venture, knows all about those things, very deep inside. And not just because of what she did. No, no. Don’t believe that for a moment. Mostly, this is a story about what was done to her.

No, it’s not a story about what was done to her. I’m sorry, but the problem for Ms. Lohan is two-fold. Firstly, if she does indeed have mental health issues, emotional issues, substance abuse issues, and behavioral issues, it is her responsibility as an adult to address those effectively. The question is not “what was done to her by whom?” – it’s “what does she do about it now?” She’s no longer a child. She must address her behavioral issues with the help of a mental health, substance abuse and/or behavioral health specialist. If she continues to play out the approach that Dr. Albow espouses here – the “I had a f*cked up childhood” approach, she’s going to continue to behave ineffectively. What she’s doing is anything to stop the pain, yet, ironically, it is causing MORE pain for her because she’s behaving in an ineffective manner.

Secondly, like everyone in society, Ms. Lohan has to learn that her behavior has consequences, even unintended ones. Sure, she might have a disorder like BPD in which she would find it difficult NOT to behave impulsively and in a pain-killing way, yet when all that is done, she has to face the consequences of her behavior like everyone else. As I have said in the past, just because you didn’t mean to burn down the house while playing with matches, doesn’t mean the house magically comes back from the ashes. No, the house is still in ashes whether your parents abused/neglected you or you were just trying to stop the pain inside your head. Ms. Lohan’s behavior has consequences and sometimes those consequences are going to jail. The judge is not going to accept the argument, “my parents made me do this by taking away my childhood.”

And all of that brings me back to the serenity prayer, which (as I have said in “When Hope is Not Enough”) I always thought was a stupid cliche, yet, Lindsay Lohan is an excellent example of those words at work. (And BTW, I am not a support of A.A., despite my reference to the prayer). Ms. Lohan has no ability to change what her parents did to her. That is something she must accept. Trying to change those things will  cause frustration and, in her case, maybe incarceration. What she CAN change is her future by learning to behave more effectively and manage her emotions more effectively. If she doesn’t do that, she’s going to end up helpless (“my parents made me this way and there’s nothing I can do about it”), in jail or on the wrong side of the grass.

Why would Lindsay Lohan shoplift?

Well, obviously her shoplifting is alleged at this point. There is a TMZ article about things (other than the necklace) that she allegedly took. And another one regarding a fur coat that she wore and about which she had to settle a complaint against her for that. On these pages, I have analyzed the behavior of Lindsay and made the suggestion that she has borderline personality disorder. I am not a doctor, a diagnostic expert or have I ever actually met with Ms. Lohan. I am a person who is familiar with BPD and I have met numerous individuals with BPD and their families. Shoplifting can be a feature of borderline personality disorder. A question answered by Dr. Leland Heller about shoplifting and BPD says this:

Q. Dear Dr. Heller

Do a large percentage of BPD individuals have difficulty with impulsiveness which involves shoplifting? Can you comment on this form of self-injurious behavior.

Also I understand Klonopin is not to be given to individuals who have difficulty with impulsiveness, Please advise on this medication.

Someone in deep legal trouble that has just learned there is a name for the cause of all this pain.

A. Shoplifting has long been known to be one of the self-destructive, impulsive behaviors borderlines do to make dysphoria – anxiety, rage, depression, despair – go away. It’s similar to reckless driving, binge eating, binge shopping, etc. It’s not common, but it does happen.

Xanax – alprazolam – has been shown to worsen behavioral dyscontrol, which means there may be an increased risk of self-destructive behaviors. Klonopin is a very similar medication, and while I haven’t seen studies on it in this regard, it is logical to assume it will make BPD self destructive symptoms worse.

As you can see, Dr. Heller does indicate that shoplifting is an impulsive behavior and can be used to make the dysphoria of BPD go away. In addition, he goes on to indicate that benzos (particularly Xanax) can worsen self-destructive and impulsive behaviors. I have seen that effect with my own eyes. Xanax definitely decreases impulse control and increases behavioral dyscontrol. When mixed with alcohol, the effects can be even more dramatic. So, I thought I’d go out and try to discern if Lindsay Lohan is taking Xanax or other medications that would have these effects. Sure enough, there have been reports that Ms. Lohan is taking Xanax (along with Paxil and Adderall). The combination of poor impulse control (which is a feature of BPD, although it is also a feature of other disorders) and the Xanax could indeed lead to a self-control issue such as shoplifting. Here is a CNN report about Lindsay’s latest legal troubles regarding the alleged shoplifting of a $2,500 necklace. The question that immediately arises (at least for most people) is why? Why would she shoplift when she can afford to buy the product? Again, see above for possible explanation (Xanax + poor impulse control = try to make dysphoria go away). This whole incident reminded me of Winoa Ryder’s shoplifting case. In addition to her shoplifting, she also has apparently been taking Xanax.