Self-Validation: What Do You Do?
By KARYN HALL, PHD

Validation is like relationship glue. Validating someone brings you closer. Validating yourself is like glue for fragmented parts of your identity. Validating yourself will help you accept and better understand yourself, which leads to a stronger identity and better skills at managing intense emotions.

Being out of control of your emotions is a painful experience and damaging to relationships. Knowing how to self-validate is important to learning to manage your emotions effectively. Self-validation means you can accept your internal experience as understandable and acceptable. But learning to self-validate is not so easy. How do you apply the six levels of validation to self-validation? Notice that mindfulness and self-validation go hand in hand.

READ THE ARTICLE

More about validation at ATSTP

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Talking about mental health destigmatises it

Clare Allan
Tuesday 4 June 2013

In my experience, speaking out helps people with mental health problems to reveal themselves as individuals rather than categories

It’s often said that one of the best ways to tackle prejudice against those with mental health problems is for people to speak openly about their mental health. I think this is true and it works because while prejudice sees people as types, or even not quite as people, when an individual talks about their own experience, you can hardly fail to recognise a fellow human being.

But there are very good reasons for people choosing not to speak out. And chief among these is the discrimination they know they will encounter when they do so. It’s a catch-22.

For me the process of coming out has been to some extent an inevitable consequence of what I do for a living. It would have been odd not to have written a novel set in the mental health system, as that’s where I’d been for 10 years when I wrote it, and for much of that time the parameters of my world had extended very little beyond the psychiatric.

It’s not a question of autobiography, but more that the themes I wanted to explore – What constitutes normality? How does language cope with extremes of experience? – were ones for which this context offered a fertile environment.

Read the article

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Mental Illness May Be Detected in Online Gaming Partner

By Traci Pedersen Associate News Editor

Behaviors associated with mental illness can be picked up on by a healthy person playing an online strategy game with someone they’ve never met.

A team of researchers at the Virginia Tech Carilion Research Institute found that healthy people and those with borderline personality disorder displayed different patterns of behavior while playing the game. In fact, when healthy players played people with borderline personality disorder, they simply gave up trying to predict their partner’s next move.

For the study, scientists used a multiround social interaction game — the investor-trustee game — to study the level of strategic thinking in 195 pairs of subjects.

In each pair, one player played the investor and the other the trustee. The investor decided how much money to give the trustee, and the trustee then decided how much to return to the investor. Profit required the cooperation of both players.

“This classic tit-for-tat game allows us to probe people’s responses to the social gestures of others,” said Read Montague, Ph.D., director of the Human Neuroimaging Laboratory at the Virginia Tech Carilion Research Institute.

“It further allows us to see how people form models of one another. These insights are important for understanding a range of mental illnesses, as the ability to infer other people’s intentions is an essential component of healthy cognition.”

 Read the entire article

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Bon  (me) is funding the creation of an online learning course for people to learn Emotional Agility. What I have learned over the past 8 years of this blog and last 7 years of operating the ATSTP online support list is that these skills, enumerated in When Hope is Not Enough and my other publications, are teachable. The skills can be transmitted to other non-BPD people, as well as parents, partners, children and friends of BPD and Emotionally Sensitive People (ESPs) supporters.

Why are you asking for money? 

I am asking for money via Fund Anything because I need to hire a consultant to develop the technology to deliver the online course. The online course will consist of three things:

1. The online course that will instruct people on how to use the tools in their lives.
2. A workbook that will guide people through the online course.
3. A self-help book that will reinforce the skills learned from the online course.

I don’t like to be a “beggar” for money. Yet, I need the funds to hire a consultant to develop the software to deliver the training content in the most effective way. I’ve looked around the Internet to find this software and it doesn’t really exist in the form I’d like to be most effective in transmitting the skills.

If you can give $5 or $10 or more, I’d really appreciate it. If you give at a certain level, you can have the materials and access to the online course for free.

Thanks so much for your help!

Bon

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1. Why did I bother to write a book?
2. Ask Bon: How do I get my borderline loved one in therapy? What’s the best kind of therapy? How long will it take to cure them?
3. Ask Bon: How do I balance validating somebody’s feelings with protecting myself or my children from emotional abuse?

Thinking About Thinking May Help At-Risk Children
Mentalization lets kids consider situations from many points of view
Published on May 18, 2013 by Kristi Pikiewicz, PhD in Meaningful You

Imagine that you have arrived at a museum to view an Ancient Grecian statue. Your experience, including your thoughts, emotions, and physiological reactions, would be dictated by two factors: the nature and quality of the artwork itself, and the space within which it is presented. The statue may be beautiful or frightening, sturdy or fragile, well-preserved or in a state of disrepair. These are immutable properties that cannot be easily changed, but your reaction to the piece will also be informed by how it is presented. The size and layout of the gallery determines whether or not you may move around the statue to see it from all angles, appraise it from afar or up close, or even gain enough distance to see multiple statues at once and compare them.

This metaphor may tell us something important about the social and emotional development of children. Each child carries models of relationships unconsciously — templates about how people will treat and react to him or her — borne out of early experiences with caregivers in infancy. These models are like the statue: old and difficult to change. The gallery represents the internal space in which those models exist: that is, the child’s ability to think about and reflect on the mental states of the self and others. Attachment theorists such as Mary Main and Peter Fonagy have long proposed that the development of such a reflective capacity, also known as mentalization, ought to be protective for children whose early models are problematic. (Children may develop troublesome models for a variety of reasons, stemming from parental, environmental, and genetic sources.) A child with high mentalization would have the space to consider his models from all sides, compare and contrast them, and choose how near or far to “stand” from them. On the other hand, without the ability to mentalize a child may feel trapped with distorted or fractured models, repeatedly entering into new relationships with expectations of painfulness and chaos.

There is now some concrete evidence that mentalization is indeed uniquely helpful for children from adverse backgrounds. In my work with early adolescents, mentalization is assessed through an open-ended interview called The Friends and Family Interview (a.k.a. the FFI). In order to assess children’s ability to mentalize, we ask them questions like, “What do you think your mother thinks about you?” and, “What are your favorite and least favorite parts of your relationship with your father?” We have found that in a broad sense, mentalization breaks down into two important factors: 1) empathy, or thinking about how other people feel and why they behave the way they do; and 2) introspection, or considering one’s own diverse feelings about important others, like parents, friends, and siblings.

In a recent study, we administered the FFI to two groups of children, all around age 11. One group consisted of middle-class, White children from intact homes in London, England. The other group consisted of minority children of lower socioeconomic status from New York City, nearly half of whom lived in single-parent households. All of the New York children were members of an afterschool program that aims to keep at-risk children from dropping out of school.

Our question was whether the children’s mentalization impacted their attachment security, an important component of social-emotional development. We found that for both groups, higher empathy significantly predicted secure (versus insecure) attachment. For the London group, introspection did not make any real difference in their attachment security, suggesting that they did not “need” this aspect of mentalization to develop healthily. On the other hand, New York City children with high introspection were over 15 times more likely to be securely attached than those with low introspection. In other words, for these more at-risk children, the ability to reflect on their own mixed feelings directly related to their presentation as balanced and emotionally stable.

Mentalization-based psychotherapy is an increasingly popular option for treating adults with a wide range of psychological issues, but it is far less commonly used with adolescents and children. Though the above research is preliminary, increasing mentalization may ultimately prove to be an important means of helping at-risk children follow new pathways toward social and emotional health.

Read the Original Article

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Here is the link to and text of the obit for Eric:

Obituary: Trying to save a life, Eric Dietz lost his own
Article by: MARY LYNN SMITH , Star Tribune Updated: January 24, 2013 – 11:04 PM

Eric Dietz didn’t let anything stop him.

“He was very adventurous,” said his mother, Lisa Dietz of Golden Valley.

On Jan. 6, a day when the surf was extraordinarily rough along Kehena Beach in Lower Puna on Hawaii’s Big Island, Dietz, who grew up in the Twin Cities, is presumed to have drowned while trying to help another swimmer get to shore, his mother said. He was 29.

Hawaiian officials said a search for Dietz’s body was suspended after three days. Currents in that area are extremely strong, said police Capt. Mitch Kanehailua. The beach, which is off the beaten path, is popular with nearby residents who generally know that the area has dangerous currents with a surf that is rough most of the year, he said.

On the day Dietz was reported missing, a surf advisory had been posted, Kanehailua said. Amid a pounding surf, a body boarder got to Dietz, but it appeared that he had already died, Kanehailua said. And then a wave separated the two, he said.

Dietz’s mother said she last talked to her son two days before he died. “He was the happiest I’ve ever known him to be,” she said. “I think Hawaii gave him life. It gave him the freedom to be himself.”

Dietz had been in Hawaii, where his father lives, since March, was living in a commune with other artists, his mother said. “He was an incredible musician,” she said.

Growing up in St. Paul and Minneapolis, Dietz graduated from Southwest High School in 2001 and attended Augsburg College and then the University of Minnesota, where he studied mathematics, music and computers, said his sister, Amelia Cohoes of Minneapolis. “He was an involved, loving man,” she said.

No related posts.

According to the National Education Alliance for Borderline Personality Disorder, borderline personality disorder (BPD) is a serious mental illness that centers on the inability to manage emotions effectively. The disorder occurs in the context of relationships: sometimes all relationships are affected, sometimes only one or several.

The symptoms include: fear of abandonment, impulsivity, anger, bodily self-harm, suicide, feelings of emptiness and chaotic relationships. While some persons with BPD are high functioning in certain settings, their private lives may be in turmoil. Others are unable to work and require financial support.

Officially recognized in 1980 by the psychiatric community, BPD is more than two decades behind in research, treatment options and family psycho-education compared to other major psychiatric disorders. BPD has historically met with widespread misunderstanding and blatant stigma. However, evidenced-based treatments have emerged over the past two decades bringing hope to those diagnosed with the disorder and their loved ones.

Following are some of the facts:

– BPD afflicts up to 5.9 percent of adults (approximately 14 million Americans).

– BPD is more common than schizophrenia and bipolar disorder.

– 20 percent of inpatients admitted to psychiatric hospitals and 10 percent of outpatients have BPD.

– 10 percent of adults with BPD commit suicide.

– 55-85 percent of adults with BPD self-injure their bodies.

– 33 percent of youth who commit suicide have features of BPD.

– Heritability of this illness is estimated to be up to 68 percent.

Following are some of the aspects of treatment:

– Evidence-based therapies for BPD exist but need wider dissemination.

– About 85 percent of people with BPD also meet the diagnostic criteria of another mental disorder.

– A 30-year-old woman with BPD typically has the medical profile of a woman in her 60s.

– 38 percent of adults with BPD are prescribed three or more medications.

Economic Impacts

– Up to 40 percent of high users of mental health services have BPD.

– Over 50 percent of people with BPD are severely impaired in employability.

– BPD is implicated in 17 percent of the prison population.

– 38 percent of those with BPD have substance abuse/dependence disorders.

If you know a loved one who appears to exhibit any of these symptoms, talk with the person about meeting with a mental health professional. Left untreated, BPD can be tragic. Treated, a person may lead a more healthy, normal life.

The Original Article

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Tips For Teaching Teens Compassion, Empathy (link)

Dr. Fran Walfish Answers Your Questions

Q: Dear Dr. Fran, my wife and I are worried about our 16-year-old daughter. At times she can be cold, callous, and mean to us. Compassion does not seem to be part of her personality. Can this be taught? Please help us! -Jason E.

A: Dear Jason: empathy and compassion are learned best by experience. If the child is treated with warmth, empathy, and compassion, she has a high likelihood of becoming an empathic adolescent and adult.

Of course, this empathic relating must begin at birth when the new mom responds to each of her infant’s cries/needs. This warm maternal response should carry through into the early and middle childhood years.

You may ask: “What if this warm responsiveness did not occur in the child’s early life?” Can it be taught to a teen? The answer and final outcome depends on a number of complicated things.

• Number one, and most importantly, the teen must personally want to become a compassionate, empathic person. Without that desire, the change will not happen. To change requires a tremendous amount of motivation and hard work.

• If, indeed, the teen is motivated to change, he or she usually does best if they have a mentor. The mentor can be a parent, teacher, relative, minister, counselor, or therapist. It must be someone the teen looks up to, admires/respects, and can trust.

This opens the pathway for communication. You can tell the teen to treat the other person the way they want to be treated. But, without the idealized respect and trust it will fall on deaf ears.

• Independence is earned by demonstration of responsible behavior. In other words, if your teen is responsible by consistent demonstration of getting his homework finished on time, coming home before curfew, going to sleep and rising on time—then he should be rewarded with increments of extra freedom and independence.

These added freedoms need to be comfortable with both parents. Maybe, you let him stay out one hour later with his friends on Saturday night. Or, perhaps you allow him to go to a rock concert with his buddies.

• Parents can help their teens by building in the expectation of reasonable failure. In other words, to be successful one must first experience rejection, failure, and disappointment. Learning to deal with inevitable letdowns only makes success, when achieved, that much sweeter.

Personality development begins much younger in the toddler and early childhood years. By adolescence, personality is virtually set and gelled.

• A key way parents affect teenage personality development is how they relate to their kids.

If a parent is harshly critical the teen will likely emerge with a harsh Superego. That’s a fancy psychological way of saying the teen is strongly self-critical. After years of being the target or object of the parent’s criticisms, the teen takes in (Introjects) the parent’s harsh critic and becomes a self-critic.

If during the infancy, toddler and early-childhood years, the parent does not consistently warmly read the child’s cues and needs accurately or the parent inconsistently responds to the baby, then the child grows up to be uncertain of where she stands in the mind of the mother (significant other). The child emerges with fear of abandonment and a black -and-white style of relating. She either loves or hates you. There is no gray in between. The personality is called Borderline Personality Disorder. There are many, many ways in which parents affect the type of personality organization their teen will develop.

• Role models are crucial in a teen’s life. A highly-regarded, trusted, confidante (grandmother, aunt, teacher, priest, therapist) can save a teen from walking down the wrong path in life. A loving uncle can take his nephew under his wing and rescue a teen from family dynamics and the temptation of evil (drugs, truancy, and delinquency).

• Parents can serve as role models, as well. That’s why it’s so important for parents to be accountable for their errors. Own up to your mistakes. Teach your children to strive to be “good enough.” Help them see that perfection does not exist. When they err teach them to forgive themselves gently to remain motivated to keep trying.

• Teens are well defended. They have developed and practiced skilled ways of locking parents out of information.

Ask your teen a question and you are likely to hear words like, “Fine,” “Okay,” “Nothing’s up.”

This frustrates parents greatly. Bottom line, open honest communication begins early on. It is nurtured and nourished all through the lifespan. Teens generally hate to be told what to do.

• Make your suggestions by wondering out loud. For instance, say things like: “I wonder what you think about trying it like this sometimes,”or “Have you ever thought about what might happen if you did it this way?” Try to present your ideas by giving your teen an out if she doesn’t want to listen. You always get another chance later to run your idea by her again.

Dr. Fran Walfish–Beverly Hills psychotherapist and author of The Self-Aware Parent at www.DrFranWalfish.com. Send questions to franwalfish-@gmail.com.

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3. Teaching Mindfulness to Children

Removing stigma of ‘mental illness’
By Kevin Doerzman, kevin.doerzman@iowastatedaily.com | Posted: Thursday, April 18, 2013
12:00 am

When you hear the word “psychiatric hospital,”what do you think of? Do you think of a place for
insane people who pose a danger to themselves and everyone around them? I’ve been to one, and it’s
anything but that. It’s a place to get the necessary help in time of crisis. When I share that with people
I’ve become comfortable with, they get the same solemn expression on they face and the same hollow
tone in their voice. It’s come to my attention in psychology classes that often a stigma is attached to
those who have been diagnosed and treated for mental illnesses — for example, mood disorders such
as major depressive disorder and bipolar disorder, borderline personality disorder, schizophrenia and
a whole slue of other mental illnesses.

The term “mental illness”has negative connotation in itself. It almost sounds like someone doesn’t
have the mental capacity or intelligence to be able to function properly in a social world. When the
American Psychiatric Association first published the Diagnostic and Statistical Manual of Mental
Disorders, many of the terms used in the book were negative or derogatory. For example,
contemporary versions of the manual have IQ scales that determine mental retardation. Before the
second edition, more pejorative terms such as “morons,” “imbeciles,” and “idiots” were used to
identify mental retardation. Yet most diagnosed with a type of mental retardation are capable of taking
care of themselves and being economically independent.

Mental illnesses can also cause issues in the workplace. According to the Organization for Economic
Co-operation and Development, those diagnosed with a mental illness are two to three times more
likely to be unemployed. In popular belief, depression, anxiety, obsessive compulsive disorder and
others are thought to be more dangerous than they really are. With proper behavioral therapy and
medication, those diagnosed with mood disorders can function to the same level as those not
diagnosed. The dangers of mental illness are sometimes blown far out of proportion. Someone can be
tacked with a mood disorder or some other mental illness only because they show minor symptoms.
It’s normal for everyone to be sad, nervous, or angry every once in awhile. It doesn’t necessarily mean
they’re suicidal or psychotic.

Read the rest of the article

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2. Research effort reveals differences in brain activity for bipolar and borderline
3. Active Minds hosts Pershall to combat mental illness stigmas

Dear Cary,

I’ve been reading your column for years and it’s helped me a lot. Thank you for that.

A recent suggestion that a daughter-in-law who throws outrageous tantrums at the end of visits might have a borderline personality disorder really struck a chord with me. The videos you linked to were so similar to my mother. For example, at least twice a year she’ll unleash a barrage of furious and hostile emails and phone calls to me and accuse me of gloating while she cries, being abusive, lambasting her and making her as miserable as I possibly can, never saying anything supportive, being secretive and a user (because I didn’t tell her that my husband and I had separated until we knew for sure we were headed for divorce) … I could go on and on. None of it matches my view of myself at all, though I do tend to close myself off and not react when she screams at me. I used to get really wrapped up in the hurtful things she says, but I’m used to it enough that it mostly gives me a week or two of feeling depressed and like I’m a horrible person, and then I just shrug and carry on.

The latest episode was provoked because I couldn’t give her a ride to a doctor’s appointment with only two days notice due to work commitments. She had said that if I couldn’t, it was no big deal. But I’ve learned that these kinds of events are precarious, and I steeled myself for the inevitable.

Read the rest

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With BPD, the messages that are sent are sometimes not in tune with the actual environment – there may indeed be no basis in reality for her reactions. An ancient Hindu text characterizes this “misperception” of reality in the following manner: “A rope may be momentarily perceived as a snake before ignorance is lifted.”11 The importance of this “ignorance” is that during the time the rope is perceived as a snake, your emotions react almost automatically. (I say “almost” because if you have been taught to love snakes and not to fear them, you will not have a fear reaction even if you misperceive the rope as a snake). You feel fear, it is real, and you jump away. Your body reacts as well. When I say “feel fear,” I really mean it. Your heart rate increases, the capillaries in your extremities contract to save blood for vital organs, adrenaline is released to your blood stream. Your fear is real and felt directly. However, it is based on a misperception of reality. When you see that it is actually a rope, you might feel foolish or you might, if you had BPD, still try to convince everyone else that it is really a snake even though others can see it is a rope. The reason for this behavior is that the feelings are so immediate and seem so “true” that you have to make “reality” match your feelings, rather than the other way around. When an emotional reaction conflicts with the state of the environment for whatever reason, it is said to be a “misaligned” emotional reaction.

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

When Hope is Not Enough ebook (Kindle Locations 366-373).

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Games and BPD

The researchers discovered that healthy people and those with borderline personality disorder displayed different patterns of behavior while playing an online strategy game, so much so that when healthy players played people with borderline personality disorder, they gave up on trying to predict what their partners would do next.

Hallmarks of psychiatric illness can reveal themselves remotely (link)
April 9th, 2013

Researchers discovered that healthy people and those with borderline personality disorder displayed different patterns of behavior while playing an online strategy game, so much so that when healthy players played people with borderline personality disorder, they gave up on trying to predict what their partners would do next.

Most people are so attuned to the nuances of social interaction that they can detect clues to mental illness while playing a strategy game with someone they have never met.

That was the finding of a team of scientists led by Read Montague, director of the Human Neuroimaging Laboratory at the Virginia Tech Carilion Research Institute. The researchers discovered that healthy people and those with borderline personality disorder displayed different patterns of behavior while playing an online strategy game, so much so that when healthy players played people with borderline personality disorder, they gave up on trying to predict what their partners would do next.

For their large neuroimaging study, the scientists used a multiround social interaction game, the investor-trustee game, to study the level of strategic thinking in 195 pairs of subjects. In each pair, one player played the investor and the other the trustee. The investor chose how much money to send the trustee, and the trustee in turn decided how much to return to the investor. Profit required the cooperation of both players.
“This classic tit-for-tat game allows us to probe people’s responses to the social gestures of others,” said Montague, who also directs the Computational Psychiatry Unit, an academic center that uses computational models to understand mental disease. “It further allows us to see how people form models of one another. These insights are important for understanding a range of mental illnesses, as the ability to infer other people’s intentions is an essential component of healthy cognition.”

The scientists classified the investors according to varying levels of strategic depth of thought. The healthy subjects fell into three categories: about half simply responded to the amount the other player sent; about one-quarter built a model of their partner’s behavior; and the remaining quarter considered not just their model of their partner, but also their partner’s models of them.

Not surprisingly, the depth-of-thought style of play correlated with success, with the players who looked deeper into interactions making considerably more money than those who played at a shallow level.

When healthy subjects played people with borderline personality disorder, though, they were far less likely to exhibit depth of thought.
“People with borderline personality disorder are characterized by their unstable relationships, and when they play this game, they tend to break cooperation,” said Montague. “The healthy subjects picked up on the erratic behavior, likely without even realizing it, and far fewer played strategically.”

Notably, the functional magnetic resonance imaging of the subjects’ brains revealed that each category of player showed distinct neural correlates of learning signals associated with differing depths of thought. The scientists used hyperscanning, a technique Montague invented that enables subjects in different brain scanners to interact in real time, regardless of geography. Hyperscanning allows scientists to eavesdrop on brain activity during social exchanges in scanners, whether across the hallway or across the world.

“We’re always modeling other people, and our brains have a substantial amount of neural tissue devoted to pondering our interactions with other people,” Montague said. “This study is a start to turning neural signals into numbers – not just theory-of-mind arguments, but actual numbers. And when we can do that across thousands of people, we should start to gain insights into psychopathologies – what circuits are involved, what brain regions are engaged, and how injuries, congenital disorders, and genetic defects might play into psychiatric illness.”

Montague believes the study represents a significant contribution to the field of computational psychiatry, which seeks to bring computational clout to efforts to understand mental dysfunction. “Traditional psychiatric categories are useful yet incomplete,” said Montague, who delivered a TEDGlobal talk on the growing field of computational psychiatry last year. “Computational psychiatry enables us to redefine with a new lexicon – a mathematical one – the standard ways we think about mental illness.”

Computationally based insights may one day help psychiatry achieve better precision in diagnosis and treatment, Montague said. But until scientists have the right instruments, they cannot even begin to make those connections.

“The exquisite sensitivity that most people have to social gestures gives us a valuable opening,” Montague said. “We’re hoping to invent a tool – almost a human inkblot test – for identifying and characterizing mental disorders in which social interactions go awry.”
The study appeared in PLoS Computational Biology in the article “Computational Phenotyping of Two-Person Interactions Reveals Differential Neural Response to Depth-of-Thought.”

More information: Xiang T, Ray D, Lohrenz T, Dayan P, Montague PR (2012) Computational Phenotyping of Two-Person Interactions Reveals Differential Neural Response to Depth-of-Thought. PLoS Comput Biol 8(12): e1002841. doi:10.1371/journal.pcbi.1002841
Provided by Virginia Tech

“Hallmarks of psychiatric illness can reveal themselves remotely.” April 9th, 2013. http://medicalxpress.com/news/2013-04-hallmarks-psychiatric-illness-reveal-remotely.html

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Research effort reveals differences in brain activity for two types of mental illness

April 4, 2013 by Bob Yirka

(Medical Xpress)—Researchers in Australia have uncovered what they describe as differences in brain behavior for people diagnosed with either bipolar disorder (BP) or borderline personality disorder (BPD). As they describe in their paper published in the journal Molecular Psychiatry, brain scans of people diagnosed with one or the other of the disorders show differences in the ways emotions are processed, leading perhaps to a true biological marker for the two ailments.

BP is generally characterized by wild mood swings. Those with BPD also exhibit mood swings but also are generally described as being impulsive, likely suicidal and have problems with interpersonal relationships. Traditionally, people are diagnosed with one or the other by professionals trained to spot the signs and to distinguish between the two. Because of this, most experts in the field believe many patients are misdiagnosed, which is a serious problem because BP is most often treated with drugs, while BPD is treated with various forms of therapy. Scientists have been searching for a biological marker for both disorders as well as for a host of other mental diseases for several years all to no avail. In this new research, it appears the team from Australia has made a breakthrough.

To nudge the brains of BP and BPD patients into revealing their differences, the researchers enlisted volunteers with one or the other disorder as well as some people who do not suffer from any mental ailment. All were asked to engage in a task known as an emotional Stroop—it’s where people are asked to engage in a task that taxes the emotional parts of the brain. In this case, they were asked to do so while having their brain scanned.

The scans revealed that those with BP were able to function quite normally under normal conditions, but when taxed, their brains were found to have to work harder than normal to keep up. Those with BPD on the other hand, showed heightened activity in the amygdala, a part of the brain normally associated with fear response.

The results are preliminary, of course, and will have to be duplicated by others, but at this point, it looks like this new research could mark a turning point in mental illness diagnosis. Being able to prove a person has either disorder or even something else could have a profound impact on the science of mental illness, doctors and of course patients and how they are treated by both physicians and insurance company’s who often refuse to pay for treatment for diseases that can’t be proved to exist.

Read More

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2. New insights into the borderline personality brain
3. Borderline personality disorder: The “perfect storm” of emotion dysregulation

Bullying and borderline personality disorder: a missing link

04 April 2013

Children abused by adults are known to be at increased risk of developing the serious and persistent mental illness known as borderline personality-disorder (BPD). New research suggests that bullying and victimization by other children during the elementary school years should be acknowledged as another important risk factor.

Psychologists in Britain, Germany and the United States base their conclusions on an analysis of data from the Avon Longitudinal Study of Parents and Children (ALSPAC) which has followed the development of more than 6,000 mothers and children in south west England since pregnancy in the early 1990s.

After comparing the results of diagnostic interviews with the children when aged 11 with reports of bullying gathered when they were aged 8 and 10, they conclude that intentional harm inflicted by peers is a significant precursor of BPD symptoms – although it could be a “marker” for the increased level of risk, rather than a direct cause.

Dieter Wolke of Warwick University and his colleagues note that BPD is a chronic psychiatric condition estimated to affect between 0.7 per cent and 5.9 per cent of the adult population. Its characteristics include poor mood and impulse control, unstable and intense personal relationships, and severe difficulty trusting the actions or motives of others.

Threats, rumors and lies

Existing studies have linked BPD to childhood experiences of physical and sexual abuse, neglect and exposure to domestic violence. In addition, bullying or “peer victimization” in childhood has been associated with the emergence of psychotic symptoms and suicidal thoughts as well as adverse neurobiological changes in the brain.

Read the rest of the article

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Two traveling monks reached a town where there was a young woman waiting to step out of her sedan chair. The rains had made deep puddles and she couldn’t step across without spoiling her silken robes. She stood there, looking very cross and impatient. She was scolding her attendants. They had nowhere to place the packages they held for her, so they couldn’t help her across the puddle.

The younger monk noticed the woman, said nothing, and walked by. The older monk quickly picked her up and put her on his back, transported her across the water, and put her down on the other side. She didn’t thank the older monk, she just shoved him out of the way and departed.

As they continued on their way, the young monk was brooding and preoccupied. After several hours, unable to hold his silence, he spoke out. “That woman back there was very selfish and rude, but you picked her up on your back and carried her! Then she didn’t even thank you!”

“I set the woman down hours ago,” the older monk replied. “Why are you still carrying her?”

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Attachment-Related Mentalization Moderates the Relationship Between Psychopathic Traits and Proactive Aggression in Adolescence.

Taubner S, White LO, Zimmermann J, Fonagy P, Nolte T.

Source
Department of Psychology, University of Kassel, Kassel, Germany, Svenja.taubner@uni-kassel.de.

Abstract

The lack of affective responsiveness to others’ mental states – one of the hallmarks of psychopathy – is thought to give rise to increased interpersonal aggression. Recent models of psychopathy highlight deficits in attachment security that may, in turn, impede the development of relating to others in terms of mental states (mentalization). Here, we aimed to assess whether mentalization linked to attachment relationships may serve as a moderator for the relationship between interpersonal aggression and psychopathic traits in an adolescent community sample. Data from 104 males and females with a mean age of 16.4 years were collected on mentalization capacities using the Reflective Functioning Scale on the Adult Attachment Interview (AAI). Psychopathic traits and aggressive behavior were measured via self-report. Deficits in mentalization were significantly associated with both psychopathic traits and proactive aggression. As predicted, mentalization played a moderating role, such that individuals with increased psychopathic tendencies did not display increased proactive aggression when they had higher mentalizing capacities. Effects of mentalization on reactive aggression were fully accounted for by its shared variance with proactive aggression. Psychopathic traits alone only partially explain aggression in adolescence. Mentalization may serve as a protective factor to prevent the emergence of proactive aggression in spite of psychopathic traits and may provide a crucial target for intervention.

Link

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• Describing things as good or bad, valuable or worthless, smart or stupid, terrible or wonderful, beautiful or ugly, etc.
• Describing how things “should” or “shouldn’t” be
• Describing by comparing or contrasting

Usefulness of judgments?

• They allow for quick descriptions by creating simple categories
• They are fast, short hand for describing preferences and consequences

Problems with judgments?

• They often distract from reality (judgments may replace facts; when we judge we often stop observing)
• They tend to feed negative emotions (anger, guilt, shame)
• Positive judgments are fragile: anything judged “good” can also be judged “bad”

Steps for letting go of judgments

• Practice noticing judgments. Keep a count of judgments.
• Ask yourself, “Do I want to be judging?” “Is the judging helping or hurting me?”
• Replace judgments with:

1. Statements of preference: “I like…” “I prefer…” or “I wish…”
2. Statements of consequences: “This is helpful/harmful for…”, “This is effective/ineffective for…”
3. Statements of fact: “This thing happened in this way, at this time…”

• Practice accepting what is (facts, preferences, consequences) and letting go of the judgments. Let the judgments drift away.
• Remember not to judge your judging!

Related posts:

1. Cognitive Distortions
2. DBT Skill of the day: Radical Acceptance
3. DBT Skill of the Day: One Mindfully from Mindfulness Module

Self-Soothe. Get yourself some hot cocoa, coffee, soda,  juice or water. Drink your beverage slowly focusing on the  sensations of taste, smell and temperature.  Intense Sensations. Go to the kitchen and take a piece of  ice, and some napkins. Hold the ice in your hand, and use the napkins to absorb the melting water. Focus on the intense cold sensation of ice in your hand.

Distract yourself. Pick up a magazine and focus your attention on the pictures or an interesting article. Bring your mind to whatever you are reading or looking at, redirecting it from upsetting thoughts and feelings.

Practice deep breathing. Place one hand on your belly, inhale slowly counting to 5, feeling your belly expand. Pause. Exhale slowly, counting to 5, feeling your belly deflate. Practice this deep breathing 10 times.

Use Relaxation. Give yourself a little neck and shoulder massage- you can rapidly tap your fingers on your neck and shoulders or rub your neck and shoulders. Focus on
different muscles in your body from your head to your feet telling yourself to let go of tightness and tension.

Watch skills video. Ask a staff member to set up the TV with a distress tolerance video. Focus on the skills presented in the video and choose one to practice right now.

Pray. Pray either to a higher power, your own wise mind, or just open yourself up to peace and serenity. Open your hands, uncross your arms and legs, slow your breathing and focus on acceptance. Ask for strength to bear the pain in this moment. Breath in and out while telling yourself something like “I breathe in peace and breathe out
distress” or “acceptance will help ease my suffering.”

Self-encouragement. Think of what you might say to someone in a similar situation as you. Give yourself the same encouragement and support. Tell yourself things like “I can get through this” or “This won’t last forever.”

Use imagery. Imagine a wall between yourself and the situation. Or imagine a peaceful, happy, secure place. It can be someplace you have been or someplace that you create in your mind. Imagine in detail what your place looks like, any soothing smells, if there are any comforting people or animals with you, what it feels like where you are sitting or laying, what sounds you can hear…

Make comparisons. Distract yourself by thinking about problems that you don’t have or that you no longer have. Focus on something that someone else is struggling with, or find a magazine article about a problem that doesn’t apply to you. Consider ways that you are better off now than you were at other points in your life.

Focus on thoughts. Count backwards from 100. If you lose track, start over again. Make a shopping list. Describe the furniture in the room or other objects in front of you.

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2. DBT Skill of the Day: Wise Mind from the Mindfulness Module
3. DBT Skill of the Day: IMPROVE the moment from the Distress Tolerance Module

Embed Youtube by Dennis

Part 2 of Marsha Linehan discussing DBT.

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When painful events happen in your life and you cannot change them, solve them, or make them go away.

Reality Acceptance Skills Set

1. Radical Acceptance
2. Turning the Mind
3. Willingness

Radical Acceptance

Radical Acceptance is accepting that…

1. Reality is what it is
2. Everything has a cause
3. Life can be worth living even when there is pain

Remember …

• Pain + Non-Acceptance = Suffering
• It is easy to accept things you like
• It is hard to accept things you hate, disapprove of , or that cause you a lot of pain.
• The higher the pain, the harder the acceptance
• If you want things to change, accept them first, then change them
• Reality is always changing and if you want to influence how it changes, you must first
• accept it.

Turning the Mind

What is Turning the Mind?

It is like walking down a road and coming to a fork where one road is accepting and one
road is rejecting and choosing to turn toward the accepting road over and over again.

Steps to Turning the Mind

Notice …

• anger, bitterness, annoyance, falling into the sea of “Why me?”
• when you are trying to…
•  escape reality
•  block things out
•  hide how you feel

Make an inner commitment to turn your mind toward acceptance
Practice turning your mind toward acceptance over and over again.

Willingness

Willingness is …

• Allowing the world to be as it is
• Agreeing to participate in the world as it is
• Actively participating in reality
• What you need to overcome a threat

Willfulness is …

• Saying NO, NO, NO
• Denying
• Pushing Away
• Avoiding

Steps to Turning Willfulness to Willingness

Ask yourself,

• “What is the threat?”
• “What is the catastrophe?”

Notice and observe willfulness
Radically accept the willfulness
Turn your mind towards willingness, acceptance, and participating in reality just as it is.
When it becomes difficult to Turn The Mind, adopt a willing posture (open arms & palms,
half smile)

Getting started with Reality Acceptance Skills

• Find small things to Practice Accepting first
• Write yourself a note that says Turn the Mind, hang it somewhere, & practice every time
• you look at it
• Notice and observe Willfulness
• Practice Willingness by participating in reality
• Adopt a Willing Posture (open hands, arms, half-smile)
• Remember Acceptance is Difficult and requires much time & practice to be effective.

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Embed Youtube by Dennis

New series of Marsha Linehan discussing DBT on you tube. I will be posting a series of these talks.

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I wanted to post a couple of observations about the new edition as well as some of the experiences that I and others have had with the book. My basic feeling about the book is that it is NOT a book to be used for staying with someone with BPD. SWOE is a book about YOU and YOUR feelings. It is a book that placates the Non-BPD person. That is fine, since that is the audience of the authors (which is probably why it has sold so many copies that and because it has a great title), yet people must realize that SWOE can’t be used to engender a trusting, loving relationship with someone with BPD. The evidence of this is in the subtitle: Taking back your life when someone you care about has borderline personality disorder. This is what I have observed from users of SWOE and the methods contained therein:  sure, you take your life back, but the relationship with the person you care about with BPD is wrecked.

Why?

Because SWOE is all about you. It is understandable that the authors created a book like this. I mean, how many of us Nons have asked “what about me?” Probably all of us. That’s a very natural question.

Yet, if the relationship is going to work properly, one of the first things that one must accept is that the behavior of the person with BPD is not about you.

What New Harbinger did with this new version of SWOE is that they highlighted the “angry non” aspect of the book. How? Look at the following images from the new version of SWOE:

As you can see, New Harbinger highlights the aspects of:

• manipulation
• irrational rages
• that YOU are not crazy
• chaos
• standing up for yourself
• protecting yourself

…which again is all very well and good if your goal in the relationship is to punish the other person and to make them behave. What really happens though is that the relationship will come to a screeching halt (or just get worse and worse) if you take this approach.

I know this because I tried it, as did several other husbands of wives with BPD and found (almost universally) that things get better for a while. SWOE CAN modify the BP’s behavior, but only through threats and punishment (which SWOE calls “boundaries”). Threats and punishment WORK, but only for a short period of time. When I applied the things in SWOE to my relationship, things got better for about a month or so. Then things got decidedly worse. The reason is that my wife was responding initially to the threat of punishment. However, those threats did not change her feelings or thoughts in any way. Only through positive reinforcement did she start to behave better. SWOE doesn’t teach positive reinforcement. And even positive reinforcement doesn’t change the way someone with BPD feels. That is done through a change in thinking patterns. You can take step one toward building a trusting, loving relationship with my book When Hope is Not Enough. Although the SWOE crowd don’t place much stock in it, it really works toward building a better relationship.

When Hope is Not Enough
Get the Non-BPD book that is designed for
staying and working on the relationship

Additionally, if one wants to really change the relationship and build it into a more trusting, loving one, what ultimately has to change is the way one thinks (both the person with BPD and the Non-BPD). Approaching the relationship with a “I’m not crazy, you’re the one that’s crazy” attitude, which IMO SWOE advocates, will never improve the interpersonal relationship. If you want to know how to take step two and change the thinking, try my eBook Beyond Boundaries:

New! An eBook that can help you in your relationship with someone with Borderline Personality Disorder. Beyond Boundaries is the next step in the evolution of the Non-BPD/BPD relationship.

I think one has to ask oneself – what is the goal of what I am doing? If the goal is to make yourself feel better and more in control, regardless of what the other person feels, SWOE is a good candidate for you. If you want to build a relationship built on mutual understanding and trust, you will have to look elsewhere.

If you still want to give the new version of SWOE a whirl, have at it…

Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder

No related posts.

DBT: Not Just for Borderline Personality Disorder
By KAT DAWKINS

You may think Dialectical Behavioral Therapy is only for those that live with borderline personality disorder. However, I am an example of a person with bipolar disorder that has benefited from this approach.

What is Dialectical Behavioral Therapy?

Dialectical Behavioral Therapy (DBT) is an approach that combines cognitive and behavioral therapies together. It also incorporates other methodologies including Eastern mindfulness techniques.

DBT allows the learner to build skills in areas like mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.

Read the rest of the article at psychcentral

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Methods: Participants were 78 consecutive female patients who were referred for evaluation of an eating disorder.

All participants completed the mood and eating disorder sections of the SCID-I/P and the borderline personality disorder section of the SCID-II, in addition to the MDQ and BSDS. Predictive validity of the MDQ and BSDS was evaluated by Receiver Operating Characteristic analysis of the Area Under the Curve (AUC).

Results: Fifteen (19%) and twelve (15%) patients fulfilled criteria for bipolar II disorder and borderline personality disorder, respectively.

The AUCs for bipolar II disorder were 0.78 (MDQ) and 0.78 (BDSD), and the AUCs for borderline personality disorder were 0.75 (MDQ) and 0.79 (BSDS).

Conclusions: Among patients being evaluated for eating disorders, the MDQ and BSDS show promise as screening questionnaires for both bipolar disorder and borderline personality disorder.

Author: Toshihiko NagataHisashi YamadaAlan R TeoChiho YoshimuraYuya KodamaIrene van Vliet
Credits/Source: BMC Psychiatry 2013, 13:69

READ

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Active Minds hosts Pershall to combat mental illness stigmas

By Daniel Mcinerney

Courtesy of www.activeminds.org

For three days, Stacy Pershall suffered from violent seizures that left her body bruised and her tongue so badly bitten and swollen that she was unable to talk. The seizures were the result of a near-fatal drug overdose from an attempted suicide.

On Thursday night, Active Minds, a national student organization dedicated to removing the stigmas associated with mental illnesses, invited Pershall to tell her story during National Eating Disorder Week. Speaking to a full theater in Trabant University Center, Pershall recounted the events that led up to her hospitalization as attendees sat in silence.

Senior psychology majors Lauren Tedeschi and Hillary Porter, the presidents of the university’s Active Minds chapter, spread awareness about mental illnesses throughout campus by hosting speakers and distributing information on campus.

“We try to have these big events to get the student body out there and listening to these personal experiences because that’s what changes people’s minds,” Tedeschi said.

In 2001, after breaking up with her boyfriend, Pershall said she decided to “end it all.” At the time Pershall was a “cam-girl,”—a woman regularly featured on a webcam—broadcasting her entire life on the Internet, including her darkest moment. With a cabinet full of medication to treat her misdiagnosed bipolar disorder, she grabbed her camera and filmed herself as she hit rock bottom.

Pershall said she was determined to kill herself that day.

“I couldn’t take it anymore,” she said. “I couldn’t take this life that I lived from the time I was a child that I felt was nothing but invalidation and rejection.”

Viewers watched as Pershall swallowed over 100 pills and then collapsed. The camera continued to run as the paramedics broke open her front door to reach Pershall lying on her bathroom floor, nearly dead.

Read the Entire Article

See larger image Loud in the House of Myself: Memoir of a Strange Girl (Paperback) By (author): Stacy Pershall “An utterly unique journey down some of the mind’s more mysterious byways . . . ranges from the shocking to the simply lovely.”—Marya Hornbacher Stacy Pershall grew up as an overly intelligent, depressed, deeply strange girl in Prairie Grove, Arkansas, population 1,000. From her days as a thirteen-year-old Jesus freak through her eventual diagnosis of bipolar disorder and borderline personality disorder, this spirited memoir chronicles Pershall’s journey through hell and her struggle with the mental health care system. List Price: $14.95 USD New From: $8.68 USD In Stock Used from: $6.02 USD In Stock

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I get so emotional, baby … and I think of food

By Jeff Schnaufer CTW Features

You’ve had a bad day at work. Or maybe someone cut you off in traffic. Or perhaps you found a handful of bills in the mailbox.Whatever the case, you walk through the front door and head straight for the freezer and devour a carton of frozen goodies to relieve that emotional angst gnawing at you.

Sound familiar?

No matter age, weight or gender, emotional overeating is an equal opportunity offender affecting millions of us. But is it an eating disorder? “Emotional eating is not in itself a specific eating disorder, though emotional eating occurs in eating disorders,” says Dr. Jennifer Taitz, co-author of “End Emotional Eating: Using Dialectical Behavior Therapy Skills to Cope with Difficult Emotions and Develop a Healthy Relationship to Food” (New Harbinger Publications, 2012).

Taitz, who is a clinical psychologist and director of the dialectical behavior therapy program at the American Institute for Cognitive Therapy in New York, says emotional eating is associated with binge eating, obesity and bulimia. In the United States, nearly 10 million females and 1 million males are fighting a life and death battle with an eating disorder such as anorexia or bulimia, according to the National Eating Disorders Association (NEDA). Millions more are struggling with binge eating disorder.

So why do we emotionally overeat? Health, psychological and nutrition experts give a variety of reasons.

“Eating may serve as a temporary distraction, facilitating moving away from boredom, sadness, anxiety or other distressing feelings,”Taitz says.“In addition to helping you briefly escape an uncomfortable emotion, eating may also add a positive emotion. So it’s doubly rewarding — takes away a negative and adds a positive.”

Read the entire article

See larger image End Emotional Eating: Using Dialectical Behavior Therapy Skills to Cope with Difficult Emotions and Develop a Healthy Relationship to Food (Paperback) By (author): Jennifer Taitz PsyD If you eat to help manage your emotions, you may have discovered that it doesn’t work. Once you’re done eating, you might even feel worse. Eating can all too easily become a strategy for coping with depression, anxiety, boredom, stress, and anger, and a reliable reward when it’s time to celebrate. If you are ready to experience emotions without consuming them or being consumed by them, the mindfulness, acceptance, and dialectical behavior therapy (DBT) skills in End Emotional Eating can help. This book does not focus on what or how to eat—rather, these scientifically supported skills will teach you how to manage emotions and urges gracefully, live in the present moment, learn from your feelings, and cope with distress skillfully. List Price: $17.95 USD New From: $10.47 USD In Stock Used from: $10.01 USD In Stock

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The former country star apparently took her own life on Sunday at her home in Heber Springs, Ark. Authorities say McCready died of a suspected self-inflicted gunshot to the head and an autopsy is planned. She was 37, and left behind two young sons.

Mindy McCready dies in apparent suicide (LINK)

HEBER SPRINGS, Ark. (AP) — Perhaps there was one heartbreak too many for Mindy McCready.

The former country star apparently took her own life on Sunday at her home in Heber Springs, Ark. Authorities say McCready died of a suspected self-inflicted gunshot to the head and an autopsy is planned. She was 37, and left behind two young sons.

McCready had attempted Suicide at least three times since 2005, as she struggled to cope amid a series of tumultuous public events that marked much of her adult life.

“It is a giant whirlwind of chaos all the time,” she said of her life. “I call my life a beautiful mess and organized chaos. It’s just always been like that. My entire life things have been attracted to me and vice versa that turn into chaotic nightmares or I create the chaos myself. I think that’s really the life of a celebrity, of a big, huge, giant personality.”

Read the Rest of the Article at Daily Caller

My Take…

It’s sad, no doubt. I had “featured” Mindy McCeady as possibly having BPD in two posts on this website (Mindy McCready and BPD and Mindy McCready and the BPD-o-Meter) during the last few years. I take no joy in seeing someone kill themselves, either by suicide or by substance abuse. I mentioned Mindy McCready in my extensive post, Celebrities with Borderline Personality Disorder (possibly, not for sure). What’s sad about that particular post is that, although it’s been updated a few times, I wrote it in January of 2008, more than five years ago. In the intervening years, at least two of the names on that post, McCready (although not in the “top five”) and Amy Winehouse, are now dead. Others, like Lindsay Lohan and Courtney Love, have had numerous drug and legal problems. While none of these individuals have come out publicly as suffering from borderline personality disorder, the list alone is a sad testament to emotional pain and struggle. Just being a celebrity doesn’t seem to make one immune from the deep pain involved in BPD or other mental issues/substance issues. We have all seen people in the public eye struggle with substances, yet I feel that there is something deeper and more primal at work, deep emotional agony. That agony is a hallmark of BPD.

I think it’s time for my readers to understand that this kind of pain, the pain associated with BPD, is lethal. It’s a life and death issue. The suicide rate for people with borderline personality disorder is 400 times the U.S. national average. Over 75% of people with BPD (based on a poll from this website) have attempted suicide at least once in their lives. This disorder is progressive, powerful and fatal. Who is to say the number of people whose death certificate doesn’t read “suicide” that are victims of this deep emotional pain and seek to squelch it through the use of chemicals or impulsive/risky behavior?

I’ve read a number of articles about Mindy McCready in the last few days. I was not a fan of hers. I did have a deep sympathy for her pain though. In the article referenced above, she says: “I call my life a beautiful mess and organized chaos. It’s just always been like that. My entire life things have been attracted to me and vice versa that turn into chaotic nightmares or I create the chaos myself. I think that’s really the life of a celebrity, of a big, huge, giant personality.” Perhaps it was not so much the “life of a celebrity” as the life of someone doing anything to stop the pain.

In an interview with her ex-boyfriend, Billy McKnight, he states: “Perhaps staying in there and grieving around people that could help her over the death of her fiancé could’ve calmed her down, but the demons that she hasn’t beaten were there, and until she was going to face them, something was going to happen and everyone who knows her personally knew that. She would’ve had to probably stay in somewhere quite a long time until she really healed and started looking into herself for getting better.” Clearly, he believed she had struggle with “demons” for some time.

She says in another interview: “It was hurting so bad and then they just did what they could to make it hurt even more. My life hasn’t really ever made sense to me because I do know what kind of person I am, and I do know that I try to be as good a person as I can possibly be every day.”

I would like for the people who read this, who are friends and loved ones of people with BPD or people with BPD themselves, to get help, to show compassion, to understand this life completely, before the disorder and the pain gets the best of the person who “[tries] to be as good a person as [they] can possibly be”. The pain can seem insurmountable. It is important for loved ones to understand that this disorder can be fatal.

To Read the Interview with Billy McKnight

To Read a History of Mindy McCready’s Struggles (and what lead me to include her in this site)

Related posts:

1. Amy Winehouse Threatens Suicide
2. Jessica Cahill, who attempted suicide a month ago, describes her anguish
3. I’m going to jump – Suicide Prevention and influencing factors

Rejection and Pain

People with borderline personality disorder (BPD) often have trouble dealing with emotions. 

Defending Against Unpleasant Feelings

Borderline personality disorder patients may use less effective defense
mechanisms

(dailyRx News) People with borderline personality disorder (BPD) often have trouble dealing with emotions. The way people with BPD deal with unpleasant emotions may affect their recovery.

A recent study looked at how people with BPD defended against unwanted feelings. Then, they compared BPD patients to people with other personality disorders. People with BPD more often used less helpful defenses. These defenses were linked to longer time to recovery.

People with BPD who used humor had shorter recovery times. The authors suggested that therapy can focus on teachingmore effective defense strategies.

“Talk to your therapist about coping skills.”

Defense mechanisms are ways that people deal with unpleasant thoughts or situations. They come in many forms. Most are helpful in the short term, but some can cause problems over time. Most people use many different types of defense mechanisms depending on the situation.

Read the entire article at dailyRX

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New insights into the ‘borderline personality’ brain (link)

New work by University of Toronto Scarborough researchers gives the best description yet of the neural circuits that underlie a severe mental illness called Borderline Personality Disorder (BPD), and could lead to better treatments and diagnosis.

The work shows that brain regions that process negative emotions (for example, anger and sadness) are overactive in people with BPD, while brain regions that would normally help damp down negative emotions are underactive.

People with BPD tend to have unstable and turbulent emotions which can lead to chaotic relationships with others, and which put them at higher risk than average for suicide. A number of brain imaging studies have found differences in the function of brains of people with BPD, but some of the studies have been contradictory.

A team led by Anthony C. Ruocco, assistant professor in the Department of Psychology and program in neuroscience, analyzed data from 11 previously published studies and confirmed a number of important differences between people with BPD and those without.

On the one hand, a brain area called the insula – which helps determine how intensely we experience negative emotions – is hyperactive in people with BPD. On the other hand, regions in the frontal part of the brain – which are thought to help us control our emotional reactions – are underactive.

“It’s not just that they have too much drive from their emotions,” Ruocco says. “They seem to have less of the ‘brakes’ to try to curb those emotions and to help regulate their intensity.”

The findings fit well with symptoms seen in people with BPD, Ruocco says. “The hallmark symptom that people describe is emotion dysregulation — you’re happy one moment, and the next moment you’re feeling angry or sad or depressed. People with BPD can cycle through emotions, usually negative ones, quite rapidly.”

More important is how the findings might be useful in diagnosis and treatment. One challenge is that BPD often occurs with other disorders, such as major depression, which can make it harder to identify and treat.

The new results raise the possibility that brain imaging could be used to make a more definitive diagnosis of BPD. In the future it might also help determine what treatments are most likely to be effective for an individual patient, based on what the imaging studies show about their brain function before they even begin treatment, Ruocco says.

Related posts:

1. BPD: Emotional Dysregulation and MRI/fMRI
2. Specific Brain Region Tied to Empathy
3. One Way to Identify Borderline Personality Disorder Is by Testing “Mentalization” Skills

Borderline personality disorder: The “perfect storm” of emotion dysregulation

Philadelphia, PA, January 15, 2013 – Originally, the label “borderline personality disorder” was applied to patients who were thought to represent a middle ground between patients with neurotic and psychotic disorders. Increasingly, though, this area of research has focused on the heightened emotional reactivity observed in patients carrying this diagnosis, as well as the high rates with which they also meet diagnostic criteria for posttraumatic stress disorder and mood disorders.

New research now published in Biological Psychiatry from Dr. Anthony Ruocco at the University of Toronto and his colleagues paints perhaps the sharpest picture we have so far of the patterns of brain activity which may underlie the intense and unstable emotional experiences associated with this diagnosis.

In their report, the investigators describe two critical brain underpinnings of emotion dysregulation in borderline personality disorder: heightened activity in brain circuits involved in the experience of negative emotions and reduced activation of brain circuits that normally suppress negative emotion once it is generated.

To accomplish this, they undertook a meta-analysis of previously published neuroimaging studies to examine dysfunctions underlying negative emotion processing in borderline personality disorder. A thorough literature search identified 11 relevant studies from which they pooled the results to further analyze, providing data on 154 patients with borderline personality disorder and 150 healthy control subjects.

Ruocco commented, “We found compelling evidence pointing to two interconnected neural systems which may subserve symptoms of emotion dysregulation in this disorder: the first, centered on specific limbic structures, which may reflect a heightened subjective perception of the intensity of negative emotions, and the second, comprised primarily of frontal brain regions, which may be inadequately recruited to appropriately regulate emotions.”

Importantly, reduced activity in a frontal area of the brain, called the subgenual anterior cingulate, may be unique to borderline personality disorder and could serve to differentiate it from other related conditions, such as recurrent major depression.

“This new report adds to the impression that people with borderline personality disorder are ‘set-up’ by their brains to have stormy emotional lives, although not necessarily unhappy or unproductive lives,” commented Dr. John Krystal, Editor of Biological Psychiatry.

“Given that many of the most effective psychotherapies for borderline personality disorder work to improve emotion regulation skills, these findings could suggest that dysfunctions in critical frontal ‘control’ centers might be normalized after successful treatment,” concluded Ruocco.

read the article

Related posts:

1. BPD: Emotional Dysregulation and MRI/fMRI
2. Sounds like Childhood Borderline: new diagnostic category called disruptive mood dysregulation disorder, or DMDD
3. Emotions and Borderline Personality Disorder

Expressing negative emotions could extend lifespan

German researchers just published a study that shows statistically that people who constrain themselves and don’t express anger live on average 2 years shorter than individuals who do.

Researchers Marcus Mund and Kristin Mitte at the University of Jena in Germany analyzed data from more than 6,000 patients to find that exhibiting self-restraint and holding back negative emotions could have serious repercussions for a person’s physical and mental well-being – those who internalized their anxiety suffered from an elevated pulse.

Raised pulse can result in high blood pressure and increase a person’s risk of developing a wide range of conditions from heart disease to cancer, kidney damage and more, according to researchers.

The German study, published in the journal Health Psychologies, reveals that a group of so-called “repressors”, who are characterized by defensive behavior and their propensity to conceal fear, are particularly at risk.

“They avoid risks and always seek a high level of control over themselves and their surroundings,” explained researcher Mund. “For instance, when exposed to a stressful task they exhibit a higher heart rate and pulse ratio than non-repressors and show other objective signs of stress and anxiety.”

But on a positive side, the researchers found that “repressors” also have faster rates of recovering from a range of conditions because they are more disciplined and more motivated to adapt their lifestyles.

“Because of their need for control, repressors are very disciplined and more motivated to adapt their lifestyles,” Mund explained.

 Read more at Science World Report

Related posts:

1. Values vs. Emotions
2. Specific Brain Region Tied to Empathy
3. High personality disorder comorbidity rates identified in anxiety

Dialectics requires a balance of viewpoints

The concept of dialectics comes from philosophy in which two opposing points (the thesis and the antithesis) are brought together in a new understanding of the concept at hand, through a synthesis of these opposing view points. DBT seeks to moderate the black-and-white thinking that people with BPD and all of us sometimes get into. Here are some hints about thinking dialectically:

1. Shift from either-or to both-and thinking. Avoid the polarized words like always, never, every time and you made me. Be descriptive of the situation without judging the situation as good or bad. Example: “My father always treats me unfairly” becomes “Sometimes my father treats me unfairly and at other times he treats me fairly.”
2. Look at all sides of a situation and use varying points of view. Find the meaning in each side and understand the reason another person my have a different view of the situation. Try to see the situation through other people’s eyes. (Keep on your TOES – through other’s eyes).
3. No one has absolute truth when it comes to interpersonal situations. All truth is colored by a person’s beliefs and feelings. Be open to alternative explanations.
4. Use “I feel…” statements, instead of “you are…” or “that’s the way it is…” statements. Rather than “you are always so mean to me” say “I feel you are being mean to me right now. That makes me feel angry.” A statement of feelings is most often true, whether or not the situation is being looked at dialectically.
5. Accept that different viewpoints may be valid, even if you do not agree with them.
6. Do not assume that you know what other people are thinking. Check your assumptions by asking. Ask, don’t tell.
7. Do not expect others to know what you’re thinking or feeling.

Dialectical thinking requires a balance of viewpoints and a synthesis of feelings and opinions. It requires that you open your mind to other ways of thinking.

Related posts:

1. DBT and Acceptance
2. Ask Bon: Why can’t this person listen to reason (or see the truth)?
3. Understanding Borderline Personality Disorder from WHYY

Psychiatry is failing those with personality disorders
05 December 2012

IF DOCTORS sent patients with angina home with nothing but a prescription for a painkiller to control chest pain, they would be sued for malpractice. Sadly, that is a fitting analogy for what happens all too often to people with personality disorders.

These conditions can wreck lives. Take borderline personality disorder, the most visible of the 10 such disorders currently recognised by the American Psychiatric Association (APA). Emotional instability can wreak havoc on the relationships of people with this condition.

All too often, there is no help at hand. The system for classifying these conditions in the APA’s Diagnostic and Statistical Manual of Mental Disordersis so confusing that many patients receive multiple diagnoses, while others receive none at all. Doctors may recognise and treat secondary symptoms such as anxiety or depression, but antidepressants don’t address the root of the problem. These patients need psychotherapy to help them interact with others.

This is why the APA’s failure to agree a new system of diagnosing personality disorders for the next edition of its handbook, DSM-5, is tragic (see “Personality disorder revamp ends in ‘horrible waste’“). It means that many patients will continue to be treated inadequately. What is now urgently needed is renewed determination to produce a workable diagnostic system, recognising that problems with personality operate on a scale of severity and abandoning the current constellation of disorders, which creates pigeonholes into which many patients don’t fit.

So it is critical that the APA makes good on its promise to make DSM-5 a “living document” that is updated between major rewrites. Personality disorders must be a priority for DSM-5.1.

The other hope is a system being developed for the next revision of the World Health Organization’s International Classification of Diseases, due out in 2015. It seems a step in the right direction, focusing on rating people’s difficulties in interacting with others on a four-point scale.

It will take time to convince doctors and patients that any alternative system is useful. But the only other option is to stick with the status quo – and that is not really an option at all.

Read the Article  at newscientist

Related posts:

1. DSM-V Changes to Personality Disorders
2. DSM-V: Personality disorder revamp ends in ‘horrible waste’
3. NY Times: Thinking Clearly About Personality Disorders

Unemployment rates high in BPD and Bipolar

Unemployment poses a significant burden on the public no matter what the cause. But for those who have been diagnosed with a psychiatric illness, chronic unemployment is often coupled with significant health care costs. A Rhode Island Hospital study compared unemployment rates among those with various psychiatric disorders, and found that borderline personality disorder is associated with as much unemployment as bipolar disorder.

Researcher Mark Zimmerman, M.D., the director of outpatient psychiatry at Rhode Island Hospital, and his colleagues studied unemployment and disability rates in patients with bipolar disorder and depression with borderline personality disorder to determine the level of disability associated with each illness. The study is published in the December issue of the journal Bipolar Disorders.

Zimmerman found that depressed patients with borderline personality disorder were significantly more likely to have been persistently unemployed, as compared to patients with depression who do not have borderline personality disorder. When looking at patients with bipolar disorder, no distinct differences were found between those who have a co-morbid diagnosis of borderline personality disorder and those who do not.

“Bipolar disorder incurs a very high cost on patients, the mental health care system and society as compared to many other mental illnesses, and it is ranked as one of the leading causes of disability in the world,” Zimmerman said. “Bipolar disorder often leads to profound disruptions at work and social functioning, and also carries with it an increased risk of suicide.”

Previous studies in the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, led by Zimmerman, found that more than 80 percent of patients with bipolar disorder reported missing some time from work due to psychiatric reasons in the previous five years, and more than one third missed up to two years or more from work.

This study found that 29.6 percent of patients reported not missing any time from work in the past five years due to psychiatric illness, and 28 percent reported missing anywhere from a few days up to one month from work. Persistent unemployment, defined as missing up to two years or more from work, was present in 13.4 percent of patients, and 4.2 percent were chronically unemployed throughout the five-year period.

Read the rest of the article at medicalxpress

Related posts:

1. Four reasons bipolar disorder is accepted and borderline personality disorder is not
2. High personality disorder comorbidity rates identified in anxiety
3. The Economics of Providing Psychotherapy

God, give me grace to accept with serenity
the things that cannot be changed,
Courage to change the things
which should be changed,
and the Wisdom to distinguish
the one from the other.

Living one day at a time,
Enjoying one moment at a time,
Accepting hardship as a pathway to peace,
Taking, as Jesus did,This sinful world as it is,
Not as I would have it,
Trusting that You will make all things right,
If I surrender to Your will,
So that I may be reasonably happy in this life,
And supremely happy with You forever in the next.

Amen.

The second, less-known part really points to mindfulness for me. You can’t deal with all the future moments or change the past moments. You can only deal with a single moment at one time. And, hopefully, it will be one of enjoyment.

Related posts:

1. Teaching Mindfulness to Children
2. DBT Skill of the Day: One Mindfully from Mindfulness Module

Wise Mind is the balance of Reasonable and Emotional Minds

Wise mind is a balance between Reasonable (or Rational) mind and Emotional Mind. Like many skills in DBT, it’s a synthesis of the two opposing mental forces (that’s what dialectics is all about). Marsha Linehan, the inventor of DBT, states: “”Wise mind is that part of each person that can know and experience truth. It is where the person knows something to be true or valid. It is almost always quiet, It has a certain peace. It is where the person knows something in a centered way.”

There are 3 states of mind when we think about Wise Mind and Mindfulness.  They are described as follows:

Reasonable Mind

When you are in reasonable mind you are devoid of feelings and emotions. You are like a robot or computer, completely logical and reasonable, yet disconnected from the rich emotional experience of the things and people around you.

 Emotional Mind

When you are in emotional mind, you are devoid of reason, living by feelings and emotions. You are spontaneous/impulsive and can be chaotic and unpredictable, completely driven by your current emotion.

 Wise Mind

When you are in Wise Mind, you are calm and serene with a balance of reason and emotion, of reasonable and emotional minds. You can be logical, controlled, sensible, creative, caring and motivated. The Pros of both mind states are available to you. You can maintain both your good judgement and your equanimity. Wise Mind makes for sound decisions, even when faced with difficult situations. In Wise Mind, you can face/do hard things.

Related posts:

1. The First Two Rules of DBT are…
2. DBT Skill of the Day: Opposite Action from the Emotional Regulation Module
3. DBT Skill of the Day: One Mindfully from Mindfulness Module

1. People are doing the best they can. (This includes the person with BPD and their loved ones)
2. People want to improve.
3. People need to do better, try harder and be more effective and more motivated to change.
4. People may not have caused all of their own problems, but they have to solve them anyway.
5. The lives of the suicidal, depressed, anxious and angry people are painful as they currently are being lived.
6. All people must learn new behaviors in different situations in their lives.
7. There is no absolute truth.
8. People cannot fail at DBT.

Related posts:

1. Some Assumptions about BPD
2. The Challenge of Treating Substance Abuse in People with BPD
3. Ask Bon: How do I get my loved one with BPD to go to therapy?

Personality disorder revamp ends in ‘horrible waste’

11:00 03 December 2012 by Peter Aldhous

A planned overhaul of the way in which personality disorders are diagnosed will not now appear in the manual dubbed “the bible of psychiatry”.

The failure to agree a workable system for the next edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, known as DSM-5 is bad news for people with serious personality difficulties, who are frequently misdiagnosed.

“It’s a horrible wasted opportunity,” says Jonathan Shedler of the University of Colorado School of Medicine in Denver, one of the fiercest critics of the rejected new system.

Personality disorders revolve around difficulties in relating to other people, but can manifest in different ways. Experts agree that the system in the current DSM, which dates from 1994, is seriously flawed. It features a bewildering set of symptoms and checklists that attempts to match patients to one of 10 disorders.

Symptoms, not cause

The problem is that patients may end up being diagnosed with several disorders at the same time, while others with seriously disturbed personalities don’t clearly meet any of the diagnoses. Add this confusion to the commonly held but outdated view that personality disorders can’t be treated, and many patients never get the help they need.

Rather than receiving intensive psychotherapy, which can be effective, patients with personality disorders often get treated for the anxiety and depression that can be triggered by their difficulties with social interaction. Others get misdiagnosed as suffering from attention-deficit hyperactivity disorder or even post-traumatic stress disorder.

Read the entire article

Related posts:

1. A New Name for Borderline Personality Disorder (BPD)?
2. Neuropsychiatric Mechanisms of Change in Mentalization Based Treatment of Borderline Personality Disorder (MENTAB)
3. High personality disorder comorbidity rates identified in anxiety

Options to IMPROVE your current situation

Many of us have distress and frustration in our lives. Your car keys are lost. You don’t have enough money to pay the bills. A friend rejects you when you ask to go out on Saturday night. You get a flat tire on the way to a big meeting. Stuff happens in life. Sometimes you can do something about it. Sometimes you can’t.

The IMPROVE DBT skill is for when you have to tolerate the distress or frustration that you’re facing. It’s for those times when you can’t do anything about the crisis at hand or can’t do anything right away to solve the problem. When there is no immediate solution to a problem, you can improve your mental and emotional situation using the IMPROVE skill. Like many skills in DBT IMPROVE is an acronym. It stands for:

• Imagery
• Meaning
• Prayer
• Relaxation
• One thing in the moment
• Vacation
• Encouragement

Imagery: Use you imagination to image a better situation than the one that you’re currently in. Imagine a situation in which everything will turn out OK. Go within yourself and imagine a time in which you were not in crisis or a time in which you used your skills to get through a crisis successfully.

Meaning: Sometimes old crises can provide meaning to new ones. What meaning did you find in getting through other previous trials? If you’re a spiritual or religious person meaning can come through understanding the spiritual meaning or the will of God. You can ask yourself “How can I grow?” or “How can I prove to myself that I can get through hard situations?”

Prayer: Prayer can be talking to God or to the spirit of the universe. It can be opening yourself up to God’s will and accepting the situation as is. It can be asking for guidance from your Higher Power, however you perceive that power.

Relaxation: Do you tighten your muscles in a crisis? Many people do. The physical pain and exhaustion that this causes can worsen a crisis. Relax you muscles. Breathe. My dentist or doctor tells me that it will hurt less if I relax my muscles. Tense your muscles and then release the tension. Breathe in and out slowly and deliberately.

One thing in the moment: If you bring old emotional issues into the situation, you’re likely to make things worse. If you say, “This always happens to me!” or “Why do bad things continually happen to me?” This compounds the issue. Focus on this moment, this issue. Do what you can do to focus on the now and not bring in old problems. If you’re suffering in the moment, adding old suffering just throws fuel on the fire. Stay in the moment.

Vacation: Have you ever said to yourself, “I need a vacation from all of this!” Well, take one, however brief. It doesn’t have to be in Hawaii or in a far-flung place. You can take a brief vacation at home, doing something you enjoy. Don’t take a mind vacation though. Drugs and alcohol, for example, will likely make any problem worse. Sometimes a vacation can be a walk around the block. A vacation can be a brief break from the difficult task at hand, but it shouldn’t be a complete avoidance. It shouldn’t be a permanent vacation.

Encouragement: Encouragement is like self cheerleading. Tell yourself you can do and face hard things. Come up with examples of when you’ve acted effectively in the face of a difficult situation. Validate yourself and your abilities.

Related posts:

1. Dialectical Dilemmas
2. DBT Skill of the Day: One Mindfully from Mindfulness Module
3. DBT Skill of the Day: Teflon Mind from Mindfulness Module

Opposite Action can help turn negative emotions

Opposite Action (or Opposite to Emotion Action) is a skill to help you deal with painful emotional situations, particularly chronic emotional responses such as sadness from depression or rage from criticism. Basically, wheat one does is the opposite of how you feel emotionally. It’s a difficult skill, especially when you are deep inside a painful emotion and you’re going against the natural, reflexive behavior that your action impulses tell you to do.

An example of Opposite Action is when you’re so depressed you don’t want to get out of the bed in the morning. Maybe you feel such pain, sadness and hopelessness that you would just rather hide under the covers and sleep all day. If you use opposite action, you would instead get up, take a shower and engage the day. Do something physical. Take a walk or talk to a friend. Go to the library or to the bookstore.

You might say that this skill is very difficult. You just don’t FEEL like getting out of bed. That’s exactly the point. Acting opposite to how you feel has been shown to change the feelings. The feelings of sadness and pain will gradually subside. It may not happen all at once, but if you continue to do this, an association can be formed in your mind: “When I feel depressed and want to stay in bed all day with the covers over my head, I instead get up, take a shower, get dressed and go for a walk in the woods.” If that walk is conducted mindfully (see One Mindfully), you can even further boost your “emotional immunity” to those feelings of depression and combat the worries that may creep into your mind as you walk through the woods.

Related posts:

1. Emotional Literacy
2. DBT Skill of the Day: Teflon Mind from Mindfulness Module
3. I-AM-MAD Skill makes it to Partners in Wellness Blog

• Let go of distractions and worries in the current moment.
• Focus your attention on the moment.
• Breathe and allow the distracting and worrying thoughts to exit your mind, like water going down a drain.
• Concentrate on the current moment. When you wash the dishes, just wash the dishes. Attend to the sensory feelings – the feel of the warm water on your hands, the sound of the water in the sink.
• Stop intrusive or assumptive thoughts and push them to the back of your mind.
• Listen to the words of the other person, without personalizing or judging.
• Deal with one task at a time. Your attention can be focused on the now. Other thoughts and worries can be set aside until later.

One way to practice One Mindfulness is to observe nature and to use your senses and focus on the sensory input. Listen to the wind in the trees. Watch the river flow by. Focus your attention on your breath. When interacting with another person, listen non-judgmentally to their words and don’t just wait for your turn to speak and express your opinion. Internalize a single moment as fully as possible without allowing distracting thoughts and worries to pollute the current moment. Many people have noisy minds. Quiet your mind and focus your attention on your senses. What am I seeing? What am I hearing?

Related posts:

1. Wise Mind and DBT
2. Getting to know you – the essence of supporting someone with BPD
3. Teaching Mindfulness to Children

Don’t let negative emotional experiences stick to your mind. Especially when things heat up.

Dialectical Behavior Therapy (DBT) is a treatment for borderline personality disorder (BPD). Yet, it also can be helpful for non-BPDs and for people with problematic emotional states. Today, I will talk about a DBT skill called “Teflon Mind”.

What is Teflon Mind?

Teflon Mind is a skill within the Core Mindfulness Module of DBT. DBT is comprised of 4 “modules”:

1. Core Mindfulness
2. Emotional Regulation
3. Interpersonal Effectiveness
4. Distress Tolerance

Teflon Mind is part of the “Observe” portion of DBT’s Mindfulness. Teflon Mind is intended to prevent emotional dysregulation, defensiveness and judgmental responses. When we use Teflon Mind you:

• Notice what is happening around you and not react immediately or reflexively.
• Let thoughts, emotions and sensory experiences pass through our mind like clouds passing over a clear sky.
• Focus your attention on the present experience (which is also important in another skill “One Mindfully” which I will cover later) and not allow past disappointments or future fears to color the experience.
• Attend to internal thoughts and feelings as they arise within you.
• Don’t “latch on” to the resulting emotions and don’t follow action impulses to react in an ineffective way.
• Let the emotional experience pass and not take root so that the emotions lead to resentment or ruminating.

Teflon Mind can be a very effective skill when your amid and among others who are expressing powerful emotions.

Related posts:

1. Wise Mind and DBT
2. Borderline Emotional Anaphylactic Reaction: Mindfulness and Acceptance
3. Baby You Can Drive My Car

In trouble again

Actress Lindsay Lohan was arrested outside a New York nightclub on an assault charge early Thursday after she punched another woman in the face, police said.

Bon: Oh, Lindsay… time to get some minders. It’s been a while since I wrote anything on celebs with possible BPD. For more info about Lindsay click here.

Lindsay Lohan arrested in New York, accused of punching woman

REUTERS – Actress Lindsay Lohan was arrested outside a New York nightclub on an assault charge early Thursday after she punched another woman in the face, police said.

Lohan and the 28-year-old unidentified woman had some sort of dispute inside the club Avenue in Manhattan around 4 a.m., police said.

Lohan, who has faced a series of legal and financial troubles in recent years, punched the woman in the face multiple times, said New York Police Sergeant John Buthorn, who said the other woman sustained “minor, minor injuries.”

Lohan refused medical attention and was arrested on a third-degree misdemeanor assault charge. She will have to return to court at a later date to face the charge, police said.

The arrest came during an already rough week for Lohan, whose latest performance as Hollywood screen legend Elizabeth Taylor in the TV movie “Liz & Dick” was panned by critics. Cable TV channel Lifetime said on Monday that a modest 3.5 million Americans watched the film that premiered last weekend.

Read the article

Related posts:

1. Amy Winehouse gets off easy – but maybe not with her dad
2. Amanda Knox was accused of being Borderline in trial
3. Interesting Statement from Judge in Lindsay Lohan Case

Thinking Clearly About Personality Disorders
By BENEDICT CAREY

For years they have lived as orphans and outliers, a colony of misfit characters on their own island: the bizarre one and the needy one, the untrusting and the crooked, the grandiose and the cowardly.

Their customs and rituals are as captivating as any tribe’s, and at least as mystifying. Every mental anthropologist who has visited their world seems to walk away with a different story, a new model to explain those strange behaviors.

This weekend the Board of Trustees of the American Psychiatric Association will vote on whether to adopt a new diagnostic system for some of the most serious, and striking, syndromes in medicine: personality disorders.

Personality disorders occupy a troublesome niche in psychiatry. The 10 recognized syndromes are fairly well represented on the self-help shelves of bookstores and include such well-known types as narcissistic personality disorder, avoidant personality disorder, as well as dependent and histrionic personalities.

But when full-blown, the disorders are difficult to characterize and treat, and doctors seldom do careful evaluations, missing or downplaying behavior patterns that underlie problems like depression and anxiety in millions of people.

The new proposal — part of the psychiatric association’s effort of many years to update its influential diagnostic manual — is intended to clarify these diagnoses and better integrate them into clinical practice, to extend and improve treatment. But the effort has run into so much opposition that it will probably be relegated to the back of the manual, if it’s allowed in at all.

Dr. David J. Kupfer, a professor of psychiatry at the University of Pittsburgh and chairman of the task force updating the manual, would not speculate on which way the vote might go: “All I can say is that personality disorders were one of the first things we tackled, but that doesn’t make it the easiest.”

The entire exercise has forced psychiatrists to confront one of the field’s most elementary, yet still unresolved, questions: What, exactly, is a personality problem?

Habits of Thought

It wasn’t supposed to be this difficult.

Read the entire article at NY Times

Related posts:

1. Experts Argue that BPD should be an Axis I disorder
2. DSM-5 Field Trials Generate Mixed Results
3. New approach could more effectively diagnose personality disorders

Neuropsychiatric Mechanisms of Change in Mentalization Based Treatment of Borderline Personality Disorder (MENTAB)

Purpose:

Borderline personality disorder (BPD) is a complex psychiatric disease of uncertain aetiology and pathogenesis. A key mechanism of disease susceptibility and treatment response could be epigenetic changes in DNA methylation patterns. However, no study has yet demonstrated that psychotherapy can exert its therapeutic effect through epigenetic mechanisms. The main aim of this study is to analyze the promoter methylation pattern of genes considered to be related to the development and psychopathology of BPD, in particular the brain-derived neurotrophic factor (BDNF) and glucocorticoid receptor genes, and the effects of mentalization based treatment (MBT) on changes. Associations to changes in BDNF serum levels and salivary cortisol levels, as well as key components of BPD aetiology and core treatment targets in MBT, will also be investigated. Should epigenetic mechanisms have importance for BPD pathology and effects of treatment, there is potential use of DNA methylation patterns as valid biomarker measures of diagnosis, prognosis, and treatment response.

Hypothesis:

The formation and maintenance of symptoms in BPD is mediated through neuropsychiatric mechanisms that can be affected through psychological treatment. Specifically, aberrant epigenetic regulation of neuropsychiatric genes related to behavioural control and affect regulation, as well as BDNF and cortisol levels, is ameliorated by therapeutic processes.

Method:

Fifty female patients diagnosed with BPD will undergo a year of intensive MBT that is designed to target domains of BPD pathology. The patients will be assessed at baseline and every 6 months over the treatment period. Matched healthy control subjects will be assessed at 6 month intervals to compare changes in DNA methylation, BDNF serum levels, salivary cortisol levels, and neuropsychological test performance. To link components of the neuropsychiatric mechanisms underlying the onset of illness, course, and response to treatment, patients will undergo assessment of clinical symptoms, comorbidity patterns and psychosocial impairment. Patients and control subjects will at baseline undergo assessment for childhood trauma, self-harm, suicidal behavior, early maladaptive schemas, and personality traits, and within the 1-year study period also undergo continuous assessment for changes in symptoms of dissociation, depression, and personality dysfunction.

This study is currently recruiting participants

Related posts:

1. Mentalization Based Therapy Shows Promise with BPD
2. One Way to Identify Borderline Personality Disorder Is by Testing “Mentalization” Skills
3. Does Evidence-Based Medicine Discourage Richer Assessment of Psychopathology and Treatment?

What I Inherited

Want to know if genetics plays a role in both addiction and mental illness? Just take a glance at my family tree.

By Amy Dresner 11/04/12

When I was young and full of hope and promise, I didn’t think twice about all the mental illness and addiction throughout my family. I was an only child and I thought, “I will be the exception to the rule.” And I really believed it. But as I got older and the therapists, medications and rehabs started to pile up while the answers dwindled, I began to be more interested in the genetic basis for my problems. I was keenly aware of people who had much worse upbringings than mine but were considerably less fucked up. What gives? Was I weaker or just more sensitive or simply wired wrong? I had to know.

Over the years, I’ve been diagnosed with borderline personality disorder, bipolar 2 and, of course, addiction. Before I ever picked up hard drugs at 24, I struggled with depression and anorexia/bulimia. Eating disorders were my first addiction—my first attempt to control the chaos within by doing something without. But when I found methamphetamine in my mid-twenties, I thought I’d stumbled upon the answer to all my problems. Suddenly I felt energized, confident, happy, prolific. It was only after I was completely strung out on tweak—grey and emaciated at 25—that I found out that my mother had been addicted to prescription amphetamines and valium from the ages of 15-37, that her brother was addicted to speed his entire life and that my mother’s Uncle Rudy had died of a prescription drug overdose. So that’s why amphetamines felt so “right”: I was genetically set up to be addicted to them.

Read the entire article at The Fix

Related posts:

1. Story of an Artist with BPD
2. Your Life: Mental illness should not ‘lurk in the shadows’
3. Spanking linked to increased risk of mental health problems

Specific Brain Region Tied to Empathy (read the Article at PsychCentral)
By TRACI PEDERSEN Associate News Editor
Reviewed by John M. Grohol, Psy.D. on October 26, 2012

An international team of researchers has demonstrated, for the first time, that a particular area of the brain — called the anterior insular cortex — is where human empathy originates.

“Now that we know the specific brain mechanisms associated with empathy, we can translate these findings into disease categories and learn why these empathic responses are deficient in neuropsychiatric illnesses, such as autism,” said Patrick R. Hof, M.D., a professor in the Department of Neuroscience at Mount Sinai Medical Center in New York.

Over the past decade, scientists have used powerful functional MRI imaging to identify several regions in the brain that are associated with empathy for pain. The current study, however, firmly indicates that the feeling of empathy originates in the anterior insular cortex.

“This will help direct neuropathologic investigations aiming to define the specific abnormalities in identifiable neuronal circuits in these conditions, bringing us one step closer to developing better models and eventually preventive or protective strategies,” said Hof.

For the study, participants viewed color photographs of people in pain. Three of these patients had lesions in the anterior insular cortex, caused by the removal of brain tumors. Nine patients had lesions in other areas of the brain, and 14 patients (the controls) had neurologically intact brains.

The researchers found that patients with damage only in the anterior insular cortex had difficulty feeling empathy.

“In other words, patients with anterior insular lesions had a hard time evaluating the emotional state of people in pain and feeling empathy for them, compared to the controls and the patients with anterior cingulate cortex lesions,” said the researchers.

This study provides the first evidence suggesting that the empathy deficits in patients with brain damage to the anterior insular cortex are strikingly similar to the empathy problems found in several psychiatric diseases, according to Xiaosi Gu, Ph.D., who originally conducted the research.

These include autism spectrum disorders, borderline personality disorder, schizophrenia, and conduct disorders, suggesting potentially common neural deficits in these illnesses.

“Our findings provide strong evidence that empathy is mediated in a specific area of the brain,” said Gu, who now works at University College London. “The findings have implications for a wide range of neuropsychiatric illnesses, such as autism and some forms of dementia, which are characterized by prominent deficits in higher-level social functioning.”

The research suggests that behavioral and cognitive therapies can be developed to compensate for problems in the anterior insular cortex and its related functions.

The study is published in the journal Brain.

Source: Mount Sinai Medical Center

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