on the border...
well. i got diagnosed with borderline personality disorder today.
i don't really know what it is, so i figured i would research it online and put my facts in my journal for my people to read.
i'm not a severe case....
but its still a little scary.
What is a personality disorder?
A pattern of thinking, feeling and way of behaving that is essentially problematic. We all have personalities and they define the way that we think about things. A 'disordered' personality is simply one which has a characteristically different (and rigid) way of looking at things, which can lead to problems in many situations.
Where does the 'borderline' bit fit in?
It DOESN'T mean someone only nearly has a personality disorder, or that they only marginally have a personality. please...i have enough personality for 2343786 people.
The name was first coined back in the 1930s (1938 by a guy called Adolph Stern if we're being exact) to describe a group of patients who didn't precisely fit an already existing diagnosis. Psychs at the time classified patients as either neurotic or psychotic, however it soon became evident that there was a group of patients who didn't quite fit exclusively within either of those terms - their symptoms seemed to include features of both. These patients tended to be more 'ill' than neurotics, but less 'ill' than psychotics - that is they lay on the border between neurosis and psychosis. And that is precisely where the name came from. i'm a balenced sort of crazy....
However, since then this whole concept has been dropped but the name has stuck. BPD is a fully recognised diagnosis in its own right these days, although it remains a very contentious diagnosis with some psychiatrists who will deny its validity. There is also some pressure to change the name to 'Emotionally Unstable Personality Disorder', the name often used in Europe, which describes it very accurately and removes all the uncertainty as to what it is exactly that's borderline (which in the end turns out to be nothing anyway!). lovely. i am a clinically diagnosed unstable person.
i need five out of the following ten to be a "real" borderline.
1. Abandonment and Rejection
'Frantic efforts to avoid real or imagined abandonment'
Could stem from:
The hallmark of a borderline tends to be incredibly low self-esteem. hello. i think i have that.
This can stem from years of invalidating experiences where a fragile individual learnt she is inherently bad or worthless.
Many BPs, although loaded with talents and positive qualities, fail to see anything good or positive about themselves. yep.
This means I can't understand why anybody would spend time with me and I sense abandonment and rejection at every possible opportunity.
The feeling that someone will leave me thereby stealing part of who I am and confirming all my fears about my deep deep unloveability is one of the worst and most terrifying feelings in the world.i'm not so sure about this abandonment thing. i'm not sure i have this strong of feelings about someone leaving me; i can stand on my own two feet.
Actions/Behaviours:
The 'frantic efforts' can involve a range of behaviours and feelings, often starting with:
'hyper vigilance' - seeking out any possible clue, however tiny, that someone is going to leave (abandon) or be rejecting. If you know someone with BPD then you might realise they have an uncanny ability to read non-verbal cues such as body language, tone of voice and facial expression to gauge someone else's mood. i don't think so....
normal things - asking people what's wrong, ignoring my troubles in favour of theirs, trying always to be nice to people and never upset people, never letting people know if they've hurt or upset me etc. But it's not working, they're still going...
frantic things - allowing things to happen that aren't really wanted for the sake of not losing someone; becoming hysterical; stealing a loved one's passport or hiding their the car keys; physically not letting go of them; apologising profusely and promising to change; cutting or injuring oneself; threatening suicide etc.
paradoxical things - the old "I'll hurt you before you can hurt me" game: "Fair enough, I'll show you - you think YOU can hurt me? Well think again!! You think I need you? Well think again!! I need NO ONE and I hate you, in fact I never loved you in the first place. You're weak, pathetic and, quite frankly, I'm better off without you anyway." no.
However:
Not all borderlines are wildly out of control stamping out all their friendships or relationships before they get past a certain point.
It's a trait that some of the borderline's relationships might escape from altogether, whereas others may suffer from it irreparably. Generally the closer someone is, the more hurt they can cause, therefore the stronger the fear of rejection and the greater the hyper vigilance.
2. Idealisation and Devaluation ('Black and white thinking)
'A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation'
Black and White thinking = Splitting - what is it?
The world is actually really inconsistent along with all the people in it. People have good moods and bad moods, good days and bad days, people do good things and
bad things. Everything becomes divided into extremes and only one end of the extreme is perceived at any one time (known as 'splitting'). In other words, many people
with BPD can't, in psychobabble, 'tolerate ambivalence' this makes sense to me...
The impact:
In terms of relationships this means that a BP will tend to see someone as 'all good' or 'all bad' and treat them accordingly.
A person can be idealised as the embodiment of everything that the BP needs at that moment in time (love, support, encouragement, protection etc.). This person could be put on a pedestal and almost worshipped, or at least very highly respected. However, a small mistake or some perceived/anticipated rejection can turn that same person into the opposite - evil, danger, threat and oppression incarnate. i couldn't see doing this to someone i was dating, but i could/can see it happening to friends and family.
- the borderline wants increased closeness to someone they're idealising, but then increased distance when that same person is seen to let them down, reject or hurt them.
Actions/Behaviours:
Arguments dispersed between 'good' times.
Alternating between intense closeness (verging on clinginess) and vast distance or break-up.
Ignoring anything inconsistent with perfection in an individual (e.g. sticking up for someone vehemently even if they've done something wrong, offering excuses for someone so a bad act doesn't seem so bad).
Ignoring anything inconsistent with total devaluation (e.g. 'not counting'/remembering past acts of kindness, attributing underhand/ulterior motives to past acts of kindness).
Some BPs will actually look for a flaw in someone who is becoming increasingly close to them so they can take on that 'all bad' persona and then the BP can feel better about ending the relationship and getting rid of the source of risk and potential hurt.i don't think i've ever done this.
However:
BPs don't react like this in every friendship or relationship they have, and once again there are various extremes. There are also anger issues here - when the rest of the world is seen as 'all bad' some BPs will 'act out' their anger, whereas some won't express it at all (or only against themselves - known as 'acting in').
Therefore some will row and argue viciously, hurling accusations, whereas others will simply become very quiet, cold and withdrawn (the 'silent treatment'). yep. i am the queen of the silent treatment. However it's expressed, I'd say it's generally the people closest to the borderline (who have most potential to hurt them) who are most likely to experience this idealisation and devaluation.
Splitting outside of relationships:
'Black and white' thinking doesn't just relate to relationships. BPs most easily see extremes in all things. For example relating to food, an eating disordered BP may only be able to contrast total starvation with morbid obesity, and fear of the latter may result in strict conformity with the former. yeah, i feel like since i'm not working out/ purging my food, i am going to gain a ton of weight. when in all actuality, i will stay the same size. Whereas we all know that there are diets in-between that lead to a healthy weight and lifestyle.
And for the borderline?:
This leads to a really bizarre world view - everything is black or white and what was once black can become white, but you can't remember how it looked when it was black until it becomes black again, by which time you've forgotten what it was like when it was white. And that's hard going because the world jumps around all the time. woah. intense.
3. Lack of 'Core' Identity
'Identity disturbance: markedly and persistently unstable self-image or sense of self'
This means:
BPs lack a true sense of who they are and often feel like they're nobody or there's not really anything to them.
This element is really hard to explain because most people would find it hard to come up with a definition of themselves, or to look inside themselves and describe what they see.
But for most people the difference is that they don't do this introspection (unless asked) because they don't feel that definition is something they lack. I personally think that a sense of self is something that you are more aware you lack than you are aware you have.
Impact:
Borderlines are very good 'social chameleons', blending in with the people around them to maximise likelihood of acceptance and to disguise their sense of 'being no one'. yep. i would totally agree.
Why?:
Many BPs have an intrinsic sense of a 'rotten' core - they feel they are an essentially bad or worthless person (often, but not always, resulting from an abusive or invalidating past). yep. i feel rotten inside, and if people know the "real me" than they would dislike me.
It's easy then to ignore anything you want or like because it's bound to be wrong, bad, selfish, or unpopular. In time you can switch off these preferences and learn to pick up on other people's, whose you feel to be more valid than your own.
It's understandable then that a BP would try to mask this inner flaw to stop people 'finding them out'. However, the BP can then become trapped in a vicious cycle - how do you become someone when you firmly believe you're already no one important and won't believe a positive word anyone says about you?
4. Impulsivity
'Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)'
Could stem from:
A borderline's emotions can be very intense, overwhelming and painful, anything that relieves these feelings is extremely welcome.
Often taking risks or acting impulsively can be a way of acting out the internal dramas going on in the BP's mind or a way of distracting from the pain and confusion inside. Paradoxically most of these coping mechanisms result in further problems and add to the confusion rather than reduce it.
This tendency to act on impulse is driven by the need for relief or escape now because certain emotions or triggering situations seem too hard to handle. i can see this...
Also it's believed that at times of high stress the chemistry of the brain can alter sufficiently so as to produce cognitive impairment - i.e. the borderline genuinely can't think 'properly' or logically. It therefore becomes difficult to think through a course of action to its logical conclusion.
Actions/Behaviours:
Impulsivity in ways that are potentially self damaging:
e.g. substance abuse, violence, over-spending, reckless driving, promiscuous sex, binge eating, gambling etc. Self harm can also be a very impulsive thing, however (and I've never understood why this is) it isn't covered by this criteria. yep. yep. yep.
Consequences:
Impulsive behaviours often take on a life of their own and cease to be purely the coping mechanism they first started out.
Potential to hide someone's BPD. It's easier for clinicians to work on the visibly problematic behaviours . Often it will take a series of failed treatment programmes for psychs to start questioning their original diagnosis and to start focussing treatment more helpfully. i think this is what happened with laura/dr. fox.
The risk and danger involved in many of these behaviours contributes to the high mortality rate among borderlines, with between 9-15% of borderlines dying at their own hands - intentionally or otherwise. uh oh.
5. Suicidality and Self Harm
'Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour'
.
Suicidality - Why?:
This again is an especially dangerous feature of BPD and a very frustrating one for clinicians and loved ones.
In attempting suicide a borderline may not wish to die, but rather just to feel differently and not so god damn miserable, or they may simply wish to communicate their distress. yep. i remember the one time i almost did it, i didn't want to die.....
The impulsive nature of BPD means that when I want relief I want it now and not on Monday morning during office hours, or after 3 weeks on anti-depressants. The solution has to be instant. Control can also be an important element in suicide attempts - I finally find some way of controlling my ultimate destiny which otherwise seems so random and out of my hands.
Suicide as Manipulation?:
Suicide - thoughts, feelings and attempts - is another way for the borderline to cope. In a treatment setting this can be especially frustrating, as BPs often make unsuccessful suicide attempts which marks them out as awkward attention seekers - 'the diagnosis that cried wolf'.
However, it is wrong and cruel to suggest that borderlines attempt suicide to seek attention, or threaten suicide to manipulate others. To paraphrase Marsha Linehan on this one: 'It is wrong to say borderlines are manipulative, as this implies they are skilled at managing other people, when in fact the exact opposite is the case'. Borderlines are not good at managing other people hence they resort to such extremes. dude, i can hardly manage myself.
In fact many borderlines do succeed in their attempts (recall the 9-15% mortality rate mentioned previously), which I think highlights the pain, suffering and crushingly low self esteem involved in this disorder that so many can think of no other way out.
For the borderline:
It is hard to have to respond to a chronically suicidal patient, friend or relative, it becomes very frustrating and emotionally draining. In these times we can't recall ever having felt differently (remember black and white thinking) and it seems like no one cares, understands or is prepared to listen. yep. i have felt like this. If you don't have BPD then think about how that must feel. It's not nice and it's very hard to deal with.
Self Harm - Why?:
Moving on to self harm, I actually think it is inappropriate to group suicide and self harm together as if they are somehow linked. If you speak to anyone who self harms they will often say it has nothing to do with suicide or dying. In fact it's usually more to do with surviving. i agree. when i used to cut (its been about 3-4 mths now) it wasn't a suicide attempt.
Yup - once again it's another coping mechanism, although from the outside I'm sure it looks infinitely more like a problem than a solution. you mean slicing your body ISN"T a logical way to solve your problems?? Research is quite scant into why people self harm and what happens to the body when someone injures themselves. However, one appealing theory is that self-harm creates an adrenalin rush and the pain sensation (which some self injurers actually don't feel) releases the body's natural pain killers - endorphins - which help to restore a feeling of calm and well-being.
6. Affective Instability
'Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)'
Translated means:
This is a posh way of saying BPs suffer unstable moods. and all this time i just thought i was exciting.
Borderlines never do anything by halves, so we don't feel sadness we feel despair, we don't feel frustration we feel utter pointlessness, we don't feel anger we feel rage, we don't feel happy we feel hyper or manic, and so on jumping around the ends of the extremes. hellllo mania.
However:
Many borderlines can react appropriately and proportionately to most things, but some of our triggers are especially sensitive producing a rapid shift in how we're feeling. Also we're good at hiding how we're really feeling behind smiles and laughter, so not all these mood changes are easily detectable. The words 'illogical' or 'irrational' are definitely not applicable, emotional is more appropriate.
Why?:
Recent research has indicated that the brain in patients with BPD could react differently to emotion than the brain in non-BPD individuals.
A more easily digestible reason is that various experiences have all taught us different things about what is threatening and what our best reaction is.
Too many BPs have seen anger in others too easily turned into anger at them, and therefore it is rightly scary in that context. thanks dad.
Too many times have good things turned bad, so it's understandable to feel untrusting and sad when things are going well. thanks to a bunch of people.
Too many times have pain and sadness lasted too long, so it makes sense to feel despairing.
7. Chronic Emptiness
'Chronic feelings of emptiness'
Could stem from:
This seems to link a lot with criteria 2 - lack of 'core' identity.
Not having a central identity leaves you feeling very empty inside - like there's nothing there, no love, no emotion, no anything. It's a very powerful feeling, and every borderline fitting this criteria probably feels it differently. i remember feeling like this before i started treatment for my ed.
What's it like?:
It's something very hard to describe. I tend to feel empty, devoid, purged of all emotion, sometimes almost like everything inside has been sucked out of me. Many borderlines are easily bored, often because activities don't feel very satisfying or fulfilling. When you're very empty, it's hard to find anything interesting or engaging - nothing reaches inside and catches your attention or can raise any emotion.
Chronic?:
The fact that it's chronic simply means it's always there, nothing seems to shift this feeling. Occasionally we will feel 'complete', like when we're being impulsive or if we've fallen completely in love or if we're on some manic high. However, it doesn't last.
8. Anger
'Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)'
What does it involve?:
Difficulty with anger is a big borderline problem. Problems expressing and controlling anger are common among borderlines, and oddly both over and under-expression of anger are equally problematic and stem from very similar feelings of inner rage.
'Acting in' versus 'Acting out':
Some BPs 'act out' and take their anger out on other people, whereas others do the opposite and 'act in', only taking their anger out on themselves. Individuals who act in are often too scared of really losing control and not being able to hold in their anger that they daren't express any at all. i think i "act in". haha.
Acting out can mean: repeated displays of violence, fights, 'slanging matches', provoking arguments, damaging property etc. um, no.
Very cutting/vicious sarcasm or verbal 'sniping' can also be an expression of anger. not unless provoked by my two pet peeves. or sticking up for someone.
Those who act out may deliberately provoke retaliation from others. i don't know what this means.
People who act in find it very hard to express their anger and will suppress it or take it out on themselves: e.g. withdrawing, retreating, the 'silent treatment' so as to avoid losing their temper, direct violence against the self. yep. this is me. i don't mean to pout, and i think that can be others interpretations. i just get an overwhelming feeling of sadness and want to hide, be quiet and small. ie: me hiding in ashley's closet.
Fear of retaliation can encourage suppression of anger in BPs who have a tendency to act in.
Triggers?:
Anger triggers tend to be very sensitive in people with BPD and each individual will have different things that leave them feeling angry.
Common triggers could include: feelings of failure; feeling ignored, not believed or not listened to; feeling scared; being hurt; feeling a sense of injustice...etc. i will act out if i feel a sense of not being believed/listened to, or injustice. i act in when i feel i am being ignored, not good enough, like a failure.
Could stem from:
Anger may be such a problem for many BPs due to their past history. yep.
Many have suffered very invalidating experiences where they were made to feel insignificant and unimportant. i would agree. Later on in life this can lead to lots of angry feelings - examples might include: anger at the self for not having been stronger at the time, anger at the perpetrator for whatever they did, anger at people who hurt or abuse others, anger for what they may have missed out on because of how they came to feel about themselves, anger for nobody having prevented it or 'saved' them and so on.
What's it like for the borderline?:
An angry borderline may not be a nice person to know, but it may well be a very scared and fragile individual reacting to intense pain they simply don't know what to do with any more. i am not an angry borderline.
Raging borderlines can be impossible to reason with, literally - the brain chemistry in state of high stress or arousal can severely restrict the ability to reason. This leaves room for an intense sense of remorse 'after the event', because at the time the borderline may well have been out of control and unable to calm themselves down or to stop lashing out. yep. i can remember the few times i've actually been mad, there was no talking to me. kinda like my dad.
9. Paranoid Ideation and Dissociation
'Transient, stress-related paranoid ideation or severe dissociative symptoms'
At times of high stress or increased emotional arousal some borderlines can become very paranoid or will dissociate.
Paranoia:
Brief psychotic episodes characterised by intense paranoia can occur in some people with BPD. The fact that it's transient simply means that it's passing or temporary. not really.
Dissociation:
Dissociation is a well-recognised mechanism whereby the brain effectively protects itself from painful thoughts, feelings and memories. When being overwhelmed by sensory information or emotions the brain can 'switch off' so an individual feels distanced from reality.
Many BPs report various dissociative symptoms, such as feeling unreal, feeling like they're not in their own body, feeling like they're outside of themselves 'looking in', feeling like time has slowed or stopped, not recognising themselves in a mirror, losing time, feeling completely numb, not being able to work out what's going on around them etc. yep. i relate alot to this paragraph. even the part of not recognising myself in the mirror.
Dissociation can be a very frightening experience, or it can be very calming. It can contribute to a BPs sense of a discontinuous, disjointed reality and make it difficult to see themselves as constant throughout time. Dissociation can mean that a BP is unable to recall certain events or may remember a version of events differently to someone else who was also with them.
Rather than trying to pretend they didn't know what happened or trying to make someone else look like a liar, it is actually possible that the experience of dissociation blocks or skews certain memories.
The fact that this happens at times of increased stress makes intuitive sense, since this is when the BP is being bombarded by various feelings and may feel least able to cope. yep. i can't remember a huge hunk of my childhood from when my dad was sick in the hospital. i wonder if thats because of this...
10. Other Commonalities
There are other things that are common to people with BPD but do not form part of the official diagnostic criteria (although I'm sure they could be linked in somewhere).
Intense dislike of change:
Many borderlines have an intense dislike of change - be it from buying new clothes, to moving the furniture around, to redecorating, to moving house or changing job etc. i get so manic and want to change everything about me and my world. so i'm not sure this relates.
Ability to appear 'normal':
One way a lot of borderlines do themselves no favours is in their ability to appear 'normal' to a large number of people. In many areas of their lives BPs can function very well showing no clues of their inner turbulence and despair.
There is a distinction drawn between high and low functioning borderlines, where the former can appear normal a substantial majority of the time, but the latter have more problems in carrying out the everyday tasks of living. A BP's level of functioning can change depending on current stressors and most will have seen both ends of the extreme likely many times each.
Small number of friends:
With respect to friends you'll be hard pressed to find a borderline with a broad circle of close friends. I find it very hard to have and keep friends, consequently I have one or two close friends and some acquaintances. i have a million aquantences and like...one best friend. Sadly not everyone with BPD can find that well deserved person to offer them understanding.
Problems with memory:
Memory problems are common to many borderlines. Short term memory problems can stem from dissociation or from the fact that borderlines often have a lot going on in their head all the time. i have no memory.
Long term memory problems can once again stem from dissociative experiences, or from a phenomenon known as 'over-generalised memory recall'. This evolves as a mechanism to protect the borderline from painful memories and means that memories are often recalled only in the most general sense, lacking in precise detail.
Sleep disturbance and peculiar dreams:
Sleep problems, particularly very vivid dreams, are common in people with BPD. This can stem from the 'over activity' in the borderline brain , which doesn't stop even at night. i have some crazy ass dreams, really vivid.
And the good bits... :
Loads of people with BPD are, very intelligent, sensitive and perceptive people. Caught in the right mood we are very good listeners (very little shocks many of us - most of us will have been there already anyway), good at empathising and good at working out how someone else is feeling. Although this has primarily evolved as a survival instinct, it can come to good use in other situations too. i am going to be ok. :)
if i had to choose the five catagories that i feel my behavior best represents, i would choose:
#2
#4
#5
#6
#8
#9
uh oh, thats six. guess i really do have it.
sorry for the extended entry, i just needed to have all my information in one place.
love--- your crazy allison.
i don't really know what it is, so i figured i would research it online and put my facts in my journal for my people to read.
i'm not a severe case....
but its still a little scary.
What is a personality disorder?
A pattern of thinking, feeling and way of behaving that is essentially problematic. We all have personalities and they define the way that we think about things. A 'disordered' personality is simply one which has a characteristically different (and rigid) way of looking at things, which can lead to problems in many situations.
Where does the 'borderline' bit fit in?
It DOESN'T mean someone only nearly has a personality disorder, or that they only marginally have a personality. please...i have enough personality for 2343786 people.
The name was first coined back in the 1930s (1938 by a guy called Adolph Stern if we're being exact) to describe a group of patients who didn't precisely fit an already existing diagnosis. Psychs at the time classified patients as either neurotic or psychotic, however it soon became evident that there was a group of patients who didn't quite fit exclusively within either of those terms - their symptoms seemed to include features of both. These patients tended to be more 'ill' than neurotics, but less 'ill' than psychotics - that is they lay on the border between neurosis and psychosis. And that is precisely where the name came from. i'm a balenced sort of crazy....
However, since then this whole concept has been dropped but the name has stuck. BPD is a fully recognised diagnosis in its own right these days, although it remains a very contentious diagnosis with some psychiatrists who will deny its validity. There is also some pressure to change the name to 'Emotionally Unstable Personality Disorder', the name often used in Europe, which describes it very accurately and removes all the uncertainty as to what it is exactly that's borderline (which in the end turns out to be nothing anyway!). lovely. i am a clinically diagnosed unstable person.
i need five out of the following ten to be a "real" borderline.
1. Abandonment and Rejection
'Frantic efforts to avoid real or imagined abandonment'
Could stem from:
The hallmark of a borderline tends to be incredibly low self-esteem. hello. i think i have that.
This can stem from years of invalidating experiences where a fragile individual learnt she is inherently bad or worthless.
Many BPs, although loaded with talents and positive qualities, fail to see anything good or positive about themselves. yep.
This means I can't understand why anybody would spend time with me and I sense abandonment and rejection at every possible opportunity.
The feeling that someone will leave me thereby stealing part of who I am and confirming all my fears about my deep deep unloveability is one of the worst and most terrifying feelings in the world.i'm not so sure about this abandonment thing. i'm not sure i have this strong of feelings about someone leaving me; i can stand on my own two feet.
Actions/Behaviours:
The 'frantic efforts' can involve a range of behaviours and feelings, often starting with:
'hyper vigilance' - seeking out any possible clue, however tiny, that someone is going to leave (abandon) or be rejecting. If you know someone with BPD then you might realise they have an uncanny ability to read non-verbal cues such as body language, tone of voice and facial expression to gauge someone else's mood. i don't think so....
normal things - asking people what's wrong, ignoring my troubles in favour of theirs, trying always to be nice to people and never upset people, never letting people know if they've hurt or upset me etc. But it's not working, they're still going...
frantic things - allowing things to happen that aren't really wanted for the sake of not losing someone; becoming hysterical; stealing a loved one's passport or hiding their the car keys; physically not letting go of them; apologising profusely and promising to change; cutting or injuring oneself; threatening suicide etc.
paradoxical things - the old "I'll hurt you before you can hurt me" game: "Fair enough, I'll show you - you think YOU can hurt me? Well think again!! You think I need you? Well think again!! I need NO ONE and I hate you, in fact I never loved you in the first place. You're weak, pathetic and, quite frankly, I'm better off without you anyway." no.
However:
Not all borderlines are wildly out of control stamping out all their friendships or relationships before they get past a certain point.
It's a trait that some of the borderline's relationships might escape from altogether, whereas others may suffer from it irreparably. Generally the closer someone is, the more hurt they can cause, therefore the stronger the fear of rejection and the greater the hyper vigilance.
2. Idealisation and Devaluation ('Black and white thinking)
'A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation'
Black and White thinking = Splitting - what is it?
The world is actually really inconsistent along with all the people in it. People have good moods and bad moods, good days and bad days, people do good things and
bad things. Everything becomes divided into extremes and only one end of the extreme is perceived at any one time (known as 'splitting'). In other words, many people
with BPD can't, in psychobabble, 'tolerate ambivalence' this makes sense to me...
The impact:
In terms of relationships this means that a BP will tend to see someone as 'all good' or 'all bad' and treat them accordingly.
A person can be idealised as the embodiment of everything that the BP needs at that moment in time (love, support, encouragement, protection etc.). This person could be put on a pedestal and almost worshipped, or at least very highly respected. However, a small mistake or some perceived/anticipated rejection can turn that same person into the opposite - evil, danger, threat and oppression incarnate. i couldn't see doing this to someone i was dating, but i could/can see it happening to friends and family.
- the borderline wants increased closeness to someone they're idealising, but then increased distance when that same person is seen to let them down, reject or hurt them.
Actions/Behaviours:
Arguments dispersed between 'good' times.
Alternating between intense closeness (verging on clinginess) and vast distance or break-up.
Ignoring anything inconsistent with perfection in an individual (e.g. sticking up for someone vehemently even if they've done something wrong, offering excuses for someone so a bad act doesn't seem so bad).
Ignoring anything inconsistent with total devaluation (e.g. 'not counting'/remembering past acts of kindness, attributing underhand/ulterior motives to past acts of kindness).
Some BPs will actually look for a flaw in someone who is becoming increasingly close to them so they can take on that 'all bad' persona and then the BP can feel better about ending the relationship and getting rid of the source of risk and potential hurt.i don't think i've ever done this.
However:
BPs don't react like this in every friendship or relationship they have, and once again there are various extremes. There are also anger issues here - when the rest of the world is seen as 'all bad' some BPs will 'act out' their anger, whereas some won't express it at all (or only against themselves - known as 'acting in').
Therefore some will row and argue viciously, hurling accusations, whereas others will simply become very quiet, cold and withdrawn (the 'silent treatment'). yep. i am the queen of the silent treatment. However it's expressed, I'd say it's generally the people closest to the borderline (who have most potential to hurt them) who are most likely to experience this idealisation and devaluation.
Splitting outside of relationships:
'Black and white' thinking doesn't just relate to relationships. BPs most easily see extremes in all things. For example relating to food, an eating disordered BP may only be able to contrast total starvation with morbid obesity, and fear of the latter may result in strict conformity with the former. yeah, i feel like since i'm not working out/ purging my food, i am going to gain a ton of weight. when in all actuality, i will stay the same size. Whereas we all know that there are diets in-between that lead to a healthy weight and lifestyle.
And for the borderline?:
This leads to a really bizarre world view - everything is black or white and what was once black can become white, but you can't remember how it looked when it was black until it becomes black again, by which time you've forgotten what it was like when it was white. And that's hard going because the world jumps around all the time. woah. intense.
3. Lack of 'Core' Identity
'Identity disturbance: markedly and persistently unstable self-image or sense of self'
This means:
BPs lack a true sense of who they are and often feel like they're nobody or there's not really anything to them.
This element is really hard to explain because most people would find it hard to come up with a definition of themselves, or to look inside themselves and describe what they see.
But for most people the difference is that they don't do this introspection (unless asked) because they don't feel that definition is something they lack. I personally think that a sense of self is something that you are more aware you lack than you are aware you have.
Impact:
Borderlines are very good 'social chameleons', blending in with the people around them to maximise likelihood of acceptance and to disguise their sense of 'being no one'. yep. i would totally agree.
Why?:
Many BPs have an intrinsic sense of a 'rotten' core - they feel they are an essentially bad or worthless person (often, but not always, resulting from an abusive or invalidating past). yep. i feel rotten inside, and if people know the "real me" than they would dislike me.
It's easy then to ignore anything you want or like because it's bound to be wrong, bad, selfish, or unpopular. In time you can switch off these preferences and learn to pick up on other people's, whose you feel to be more valid than your own.
It's understandable then that a BP would try to mask this inner flaw to stop people 'finding them out'. However, the BP can then become trapped in a vicious cycle - how do you become someone when you firmly believe you're already no one important and won't believe a positive word anyone says about you?
4. Impulsivity
'Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)'
Could stem from:
A borderline's emotions can be very intense, overwhelming and painful, anything that relieves these feelings is extremely welcome.
Often taking risks or acting impulsively can be a way of acting out the internal dramas going on in the BP's mind or a way of distracting from the pain and confusion inside. Paradoxically most of these coping mechanisms result in further problems and add to the confusion rather than reduce it.
This tendency to act on impulse is driven by the need for relief or escape now because certain emotions or triggering situations seem too hard to handle. i can see this...
Also it's believed that at times of high stress the chemistry of the brain can alter sufficiently so as to produce cognitive impairment - i.e. the borderline genuinely can't think 'properly' or logically. It therefore becomes difficult to think through a course of action to its logical conclusion.
Actions/Behaviours:
Impulsivity in ways that are potentially self damaging:
e.g. substance abuse, violence, over-spending, reckless driving, promiscuous sex, binge eating, gambling etc. Self harm can also be a very impulsive thing, however (and I've never understood why this is) it isn't covered by this criteria. yep. yep. yep.
Consequences:
Impulsive behaviours often take on a life of their own and cease to be purely the coping mechanism they first started out.
Potential to hide someone's BPD. It's easier for clinicians to work on the visibly problematic behaviours . Often it will take a series of failed treatment programmes for psychs to start questioning their original diagnosis and to start focussing treatment more helpfully. i think this is what happened with laura/dr. fox.
The risk and danger involved in many of these behaviours contributes to the high mortality rate among borderlines, with between 9-15% of borderlines dying at their own hands - intentionally or otherwise. uh oh.
5. Suicidality and Self Harm
'Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour'
.
Suicidality - Why?:
This again is an especially dangerous feature of BPD and a very frustrating one for clinicians and loved ones.
In attempting suicide a borderline may not wish to die, but rather just to feel differently and not so god damn miserable, or they may simply wish to communicate their distress. yep. i remember the one time i almost did it, i didn't want to die.....
The impulsive nature of BPD means that when I want relief I want it now and not on Monday morning during office hours, or after 3 weeks on anti-depressants. The solution has to be instant. Control can also be an important element in suicide attempts - I finally find some way of controlling my ultimate destiny which otherwise seems so random and out of my hands.
Suicide as Manipulation?:
Suicide - thoughts, feelings and attempts - is another way for the borderline to cope. In a treatment setting this can be especially frustrating, as BPs often make unsuccessful suicide attempts which marks them out as awkward attention seekers - 'the diagnosis that cried wolf'.
However, it is wrong and cruel to suggest that borderlines attempt suicide to seek attention, or threaten suicide to manipulate others. To paraphrase Marsha Linehan on this one: 'It is wrong to say borderlines are manipulative, as this implies they are skilled at managing other people, when in fact the exact opposite is the case'. Borderlines are not good at managing other people hence they resort to such extremes. dude, i can hardly manage myself.
In fact many borderlines do succeed in their attempts (recall the 9-15% mortality rate mentioned previously), which I think highlights the pain, suffering and crushingly low self esteem involved in this disorder that so many can think of no other way out.
For the borderline:
It is hard to have to respond to a chronically suicidal patient, friend or relative, it becomes very frustrating and emotionally draining. In these times we can't recall ever having felt differently (remember black and white thinking) and it seems like no one cares, understands or is prepared to listen. yep. i have felt like this. If you don't have BPD then think about how that must feel. It's not nice and it's very hard to deal with.
Self Harm - Why?:
Moving on to self harm, I actually think it is inappropriate to group suicide and self harm together as if they are somehow linked. If you speak to anyone who self harms they will often say it has nothing to do with suicide or dying. In fact it's usually more to do with surviving. i agree. when i used to cut (its been about 3-4 mths now) it wasn't a suicide attempt.
Yup - once again it's another coping mechanism, although from the outside I'm sure it looks infinitely more like a problem than a solution. you mean slicing your body ISN"T a logical way to solve your problems?? Research is quite scant into why people self harm and what happens to the body when someone injures themselves. However, one appealing theory is that self-harm creates an adrenalin rush and the pain sensation (which some self injurers actually don't feel) releases the body's natural pain killers - endorphins - which help to restore a feeling of calm and well-being.
6. Affective Instability
'Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)'
Translated means:
This is a posh way of saying BPs suffer unstable moods. and all this time i just thought i was exciting.
Borderlines never do anything by halves, so we don't feel sadness we feel despair, we don't feel frustration we feel utter pointlessness, we don't feel anger we feel rage, we don't feel happy we feel hyper or manic, and so on jumping around the ends of the extremes. hellllo mania.
However:
Many borderlines can react appropriately and proportionately to most things, but some of our triggers are especially sensitive producing a rapid shift in how we're feeling. Also we're good at hiding how we're really feeling behind smiles and laughter, so not all these mood changes are easily detectable. The words 'illogical' or 'irrational' are definitely not applicable, emotional is more appropriate.
Why?:
Recent research has indicated that the brain in patients with BPD could react differently to emotion than the brain in non-BPD individuals.
A more easily digestible reason is that various experiences have all taught us different things about what is threatening and what our best reaction is.
Too many BPs have seen anger in others too easily turned into anger at them, and therefore it is rightly scary in that context. thanks dad.
Too many times have good things turned bad, so it's understandable to feel untrusting and sad when things are going well. thanks to a bunch of people.
Too many times have pain and sadness lasted too long, so it makes sense to feel despairing.
7. Chronic Emptiness
'Chronic feelings of emptiness'
Could stem from:
This seems to link a lot with criteria 2 - lack of 'core' identity.
Not having a central identity leaves you feeling very empty inside - like there's nothing there, no love, no emotion, no anything. It's a very powerful feeling, and every borderline fitting this criteria probably feels it differently. i remember feeling like this before i started treatment for my ed.
What's it like?:
It's something very hard to describe. I tend to feel empty, devoid, purged of all emotion, sometimes almost like everything inside has been sucked out of me. Many borderlines are easily bored, often because activities don't feel very satisfying or fulfilling. When you're very empty, it's hard to find anything interesting or engaging - nothing reaches inside and catches your attention or can raise any emotion.
Chronic?:
The fact that it's chronic simply means it's always there, nothing seems to shift this feeling. Occasionally we will feel 'complete', like when we're being impulsive or if we've fallen completely in love or if we're on some manic high. However, it doesn't last.
8. Anger
'Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)'
What does it involve?:
Difficulty with anger is a big borderline problem. Problems expressing and controlling anger are common among borderlines, and oddly both over and under-expression of anger are equally problematic and stem from very similar feelings of inner rage.
'Acting in' versus 'Acting out':
Some BPs 'act out' and take their anger out on other people, whereas others do the opposite and 'act in', only taking their anger out on themselves. Individuals who act in are often too scared of really losing control and not being able to hold in their anger that they daren't express any at all. i think i "act in". haha.
Acting out can mean: repeated displays of violence, fights, 'slanging matches', provoking arguments, damaging property etc. um, no.
Very cutting/vicious sarcasm or verbal 'sniping' can also be an expression of anger. not unless provoked by my two pet peeves. or sticking up for someone.
Those who act out may deliberately provoke retaliation from others. i don't know what this means.
People who act in find it very hard to express their anger and will suppress it or take it out on themselves: e.g. withdrawing, retreating, the 'silent treatment' so as to avoid losing their temper, direct violence against the self. yep. this is me. i don't mean to pout, and i think that can be others interpretations. i just get an overwhelming feeling of sadness and want to hide, be quiet and small. ie: me hiding in ashley's closet.
Fear of retaliation can encourage suppression of anger in BPs who have a tendency to act in.
Triggers?:
Anger triggers tend to be very sensitive in people with BPD and each individual will have different things that leave them feeling angry.
Common triggers could include: feelings of failure; feeling ignored, not believed or not listened to; feeling scared; being hurt; feeling a sense of injustice...etc. i will act out if i feel a sense of not being believed/listened to, or injustice. i act in when i feel i am being ignored, not good enough, like a failure.
Could stem from:
Anger may be such a problem for many BPs due to their past history. yep.
Many have suffered very invalidating experiences where they were made to feel insignificant and unimportant. i would agree. Later on in life this can lead to lots of angry feelings - examples might include: anger at the self for not having been stronger at the time, anger at the perpetrator for whatever they did, anger at people who hurt or abuse others, anger for what they may have missed out on because of how they came to feel about themselves, anger for nobody having prevented it or 'saved' them and so on.
What's it like for the borderline?:
An angry borderline may not be a nice person to know, but it may well be a very scared and fragile individual reacting to intense pain they simply don't know what to do with any more. i am not an angry borderline.
Raging borderlines can be impossible to reason with, literally - the brain chemistry in state of high stress or arousal can severely restrict the ability to reason. This leaves room for an intense sense of remorse 'after the event', because at the time the borderline may well have been out of control and unable to calm themselves down or to stop lashing out. yep. i can remember the few times i've actually been mad, there was no talking to me. kinda like my dad.
9. Paranoid Ideation and Dissociation
'Transient, stress-related paranoid ideation or severe dissociative symptoms'
At times of high stress or increased emotional arousal some borderlines can become very paranoid or will dissociate.
Paranoia:
Brief psychotic episodes characterised by intense paranoia can occur in some people with BPD. The fact that it's transient simply means that it's passing or temporary. not really.
Dissociation:
Dissociation is a well-recognised mechanism whereby the brain effectively protects itself from painful thoughts, feelings and memories. When being overwhelmed by sensory information or emotions the brain can 'switch off' so an individual feels distanced from reality.
Many BPs report various dissociative symptoms, such as feeling unreal, feeling like they're not in their own body, feeling like they're outside of themselves 'looking in', feeling like time has slowed or stopped, not recognising themselves in a mirror, losing time, feeling completely numb, not being able to work out what's going on around them etc. yep. i relate alot to this paragraph. even the part of not recognising myself in the mirror.
Dissociation can be a very frightening experience, or it can be very calming. It can contribute to a BPs sense of a discontinuous, disjointed reality and make it difficult to see themselves as constant throughout time. Dissociation can mean that a BP is unable to recall certain events or may remember a version of events differently to someone else who was also with them.
Rather than trying to pretend they didn't know what happened or trying to make someone else look like a liar, it is actually possible that the experience of dissociation blocks or skews certain memories.
The fact that this happens at times of increased stress makes intuitive sense, since this is when the BP is being bombarded by various feelings and may feel least able to cope. yep. i can't remember a huge hunk of my childhood from when my dad was sick in the hospital. i wonder if thats because of this...
10. Other Commonalities
There are other things that are common to people with BPD but do not form part of the official diagnostic criteria (although I'm sure they could be linked in somewhere).
Intense dislike of change:
Many borderlines have an intense dislike of change - be it from buying new clothes, to moving the furniture around, to redecorating, to moving house or changing job etc. i get so manic and want to change everything about me and my world. so i'm not sure this relates.
Ability to appear 'normal':
One way a lot of borderlines do themselves no favours is in their ability to appear 'normal' to a large number of people. In many areas of their lives BPs can function very well showing no clues of their inner turbulence and despair.
There is a distinction drawn between high and low functioning borderlines, where the former can appear normal a substantial majority of the time, but the latter have more problems in carrying out the everyday tasks of living. A BP's level of functioning can change depending on current stressors and most will have seen both ends of the extreme likely many times each.
Small number of friends:
With respect to friends you'll be hard pressed to find a borderline with a broad circle of close friends. I find it very hard to have and keep friends, consequently I have one or two close friends and some acquaintances. i have a million aquantences and like...one best friend. Sadly not everyone with BPD can find that well deserved person to offer them understanding.
Problems with memory:
Memory problems are common to many borderlines. Short term memory problems can stem from dissociation or from the fact that borderlines often have a lot going on in their head all the time. i have no memory.
Long term memory problems can once again stem from dissociative experiences, or from a phenomenon known as 'over-generalised memory recall'. This evolves as a mechanism to protect the borderline from painful memories and means that memories are often recalled only in the most general sense, lacking in precise detail.
Sleep disturbance and peculiar dreams:
Sleep problems, particularly very vivid dreams, are common in people with BPD. This can stem from the 'over activity' in the borderline brain , which doesn't stop even at night. i have some crazy ass dreams, really vivid.
And the good bits... :
Loads of people with BPD are, very intelligent, sensitive and perceptive people. Caught in the right mood we are very good listeners (very little shocks many of us - most of us will have been there already anyway), good at empathising and good at working out how someone else is feeling. Although this has primarily evolved as a survival instinct, it can come to good use in other situations too. i am going to be ok. :)
if i had to choose the five catagories that i feel my behavior best represents, i would choose:
#2
#4
#5
#6
#8
#9
uh oh, thats six. guess i really do have it.
sorry for the extended entry, i just needed to have all my information in one place.
love--- your crazy allison.