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Last edit of this page 21/05/08
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'Mental illness' is anything in human mentality greatly disliked by the person describing it.
BPD - borderline personality disorder (or dyslymbic brain function)
Here are personality tests for personality disorders. 1.0 Diagnosis
This diagnosis has been used for decades to stigmatise so called untreatable patients who upset therapists and yet could not be pidgeon holed.
Borderline is not a description of a personality type but a prosaic label that was invented to fill a gap in the diagnostic map. The person whose behaviour exhibits features that was both neurotic and psychotic, someone on the border between. The need for a gap filler demonstrates the problem of categorization by committee.
In my experience the sudden mood swings and affect dysregulation, fear driven impulsiveness, catastrophic thoughts and obsessions, terror of abandonment real and imagined, habitual self-harm and compulsive aggression in relationships, are best explained by one or a combination of:
- child sexual abuse or abusive neglect or
- other traumatic injuries in childhood leading to
- complex post-traumatic stress disorder
- a brain malfunction of the lymbic system
- interactions with other behavours like OCD or Bi-Polar that have strong genetic footprints
- interactions of nervous system chemistry with food and food intolerances or food allergies
- reciprocal influence of any of the above with overbreathing (intolerance for carbon dioxide) and
- inadequate hydration (i.e. intolerance for water)
Self-managing the symptoms is half the battle. Getting there is the other half.
You may think dehydration is an odd one but consider any list of symptoms caused by the body's drought management system. Rapid breathing itself is a symptom of dehydration. Rapid breathing and the less obvious, overbreathing result in too little carbon dioxide in the blood.
CO2 is a smooth muscle relaxant (blood vessels, airways, gut) and is one of the body's main regulators, not just a waste product of breathing. Lack of it can provoke anxiety, panic attacks and other psychological symptoms.
Carbon dioxide plays essential roles in the take up and availability of oxygen by the body, regulation of the acid/alkaline (pH) balance of body fluids, ability of smooth muscle (eg blood vessels, airways, gut) to relax, and normal functioning of nerve cells. It is also involved in biochemical pathways involving nearly all minerals, vitamins and enzymes and in the biosynthesis of amino acids, carbohydrates and fats. Low levels of carbon dioxide caused by over-breathing can therefore impact on a huge range of symptoms or poor physiological functioning.
2.0 Triggers for distress
2.1 External triggers
There are external triggers (e.g. rejection; repeat of trauma) and internal triggers (e.g. symbolic rejection or something symbolic of a past trauma). Each can take on a life of its own and can set up a damaging cycle of distress.
Trauma triggers are usually from both sources - i.e. the body responds to a real event with alarm, the physiological arousal is further cause of alarm. Then catastrophic thoughts kick in about those physiological reactions (like this is never going to end) and build an escalating positive feedback loop.
Awareness of these triggers early in the climb is half the battle - managing them before they take on a life of their own.
The willingness to be aware of them and then self-managing them is the other half.
In an intimate relationship the triggers can be quite subtle, apparently unintentional and yet follow a well worn path leading to: 'you're too sensitive - it was a joke', or 'you're paranoid' or 'crazy' or 'if you keep on behaving like that I'm leaving'.
2.2 Internal triggers
Internal symptoms of dehydration and of low carbon dioxide in the blood stream (from overbreathing) may act as internal triggers for catastrophic fears and emotions. Some describe this as clasutrophobia, like the room closing in on them. Even a mild symptom may be perceived as life threatening and this produces a desperate cascading of other effects in the person diagnosed with bpd.
You would not be surprised how many of my clients, their partners or parents have just read right over the top of this information, discounted it and then later when I have repeated it to them in the office in the context of their own lives, they get it. Hearing in context is often more influential than just reading it on a web page, so maybe read it again adn perhaps read this PTSD forum thread.
There is more info here on caffeine toxicity and scientific evidence of food intolerance in case your therapist thinks the food link is crackers. This is especially important if your self-harming child has been diagnosed with BPD. Sydney's Royal Prince Alfred Hospital Food Allergy Unit is a world leader in food intolerance reactions, some of which can mimic psychological disorder in children and adults.
The enteric nervous system in our guts is a small independent brain of enormous complexity. It operates separately to the central nervous system. Managing the food, air and water side of these health issues requires considerable self-discipline. It's a good idea to facilitate a food approach in adults with both a dietitian and somatic psychotherapist, both attuned to the guts of mental health. One such somatic psychotherapy is that devised by the late Gerda Boysen.
Here are useful neurobiological views of bpd and one linking brain organisation with psychodynamics, and the psychopharmacology of personality disorder and a fourth on the effect of depression on the brain.
Science daily's is a source of up to date research news.
3.0 The experience from inside and out
Here is a list of experiences from bpd central that might help you work out if you or another are struggling with BPD.
Take care making judgements based on anecdotes and first impressions. We have an automatic tendency to pay attention to or seek out information that agrees with our preconceptions and to ignore, avoid or distort information that contradicts them. My notes on jargon and personality typing and in therapy.
Nietzsche observed that a society ruled by priests needed sin, because sin is the "handle" and grip for power. Szasz indicated a similar function of mental disorders in the psychiatric industry. In my experience, people identifying with BPD are NOT untreatable, difficult patients rather they are people in difficulty, heroes and villains at the edge of sustainable frailty and dignity.
- BPD411
- BPD central
- A description with experience of a clinician familiar with child abuse and PTSD
- Helen's World particularly her film and fiction list with exaggerated BPD characters like that in 'Fatal Attraction'
- My trip to oz and back - a heart wrenching open letter to a former bpd lover
- Cognitive training program at the Moodgym, ANU, Canberra
- A list of maladaptive schemas or core beliefs that structure thoughts and perceptions
- Scholarly view of recovered memories especially if your self-harming child has been diagnosed with BPD
- Children and adult children of BPD parents
- Joan Lachkar article on mediation with the narcissist borderline couple where one is dominated by mirroring needs and the other by fears of abandonment
4.0 BOOKS
- Surviving a Borderline Parent: How to Heal Your Childhood Wounds & Build Trust, Boundaries, and Self-Esteem by Kimberlee Roth, Freda B. Friedman, Randi Kreger.
- The Angry Heart: Overcoming Borderline and Addictive Disorders : An Interactive Self-Help Guide by Ph.D. Joseph Santoro, Ph.D. Ronald Cohen, Ronald Jay Cohen
- Stop Walking on Eggshells; Coping When Someone You Care about Has Borderline Personality Disorder by Paul T. Mason, Randi Kreger
- Lost in the Mirror, 2nd Edition : An Inside Look at Borderline Personality Disorder by Richard Moskovitz
- I Can't Get over It: A Handbook for Trauma Survivors Aphrodite Matsakis Editor: New Harbinger Publications 1996
5.0 Anger management links
6.0 Interview
Below is the beginning of an interview with Kelly Anderson from the point of view of family members of a person with BPD. Go to www.aapel.org for the whole interview.
Q: Could you first of all talk a little about you and your experience in mental health research and / or in the BPD treatment?
Thank you for talking with us here at BPD411. At BPD411, we don't work with people who have the disorder, rather we work with the other members of their families and other close associates. While there are many organizations focused on the needs of those with the disorder, there are only a few groups, all online, that focus on the needs of the other family members. When we can help the family members to understand the disorder, this often creates a situation where they stop enabling the poor behaviour of those with the disorder. This results in the borderline getting help, or more commonly, it results in the family member getting the help they need.
In a few words very simple to everyone (not DSM)
Q: "What is the Borderline personality disorder ?"
In our minds, there are actually two things called borderline personality disorder. There are the low functioning borderline patients that are hospitalised, that cut themselves, and who are the primary focus of many of the studies and more effective therapies.
Then there are the high functioning borderline patients that to all the world seem normal, or even saintly. Princess Diana is reputed to be one of these high functioning borderlines as is Martha Stewart. High functioning borderlines are seldom hospitalised, and create a situation of unbearable suffering for their families. The reason for this is that the families are not believed when they tell friends about the suffering they go through. This leads to further isolation and an unbearable feeling of being alone. In addition, since it most often goes undiagnosed, there is no therapeutic support in most cases for high functioning borderlines, so they most often never get better.
The online groups have found a niche in helping the family members of the high functioning borderline. That's because online, you can get validation, and share the experience of living with someone with traits of the disorder without the judgment that so often faces these people in the real world. Online, your friends are not subjected to the distortion campaign that so often is part of the disorder.
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