Why is She Mad at Me – Part 2

Due to the high positive correlation between bisexuality and Borderline Personality Disorder, we are attempting to get a better understanding of the impairments listed in the DSM 5. 

Today we  will look at Impairment 6 – Compromised ability to recognize the feelings and needs of others.

Why is She Mad at Me – Part 2

The fact that we have a difficult time recognizing the feelings and needs of others at the unconscious level simply means we will have to train ourselves to do it consciously. We train ourselves to watch for tone and body language and respond accordingly. To read more: https://lawrencejwcooper.ca/why-is-she-mad-at-me-part-2/

Why is She Mad at Me

Because we are so concerned with our own safety, we fail to see the feelings being expressed by others, especially those nearest to us, who have the potential to inflict the greatest emotional pain. We fail to meet their needs because we are obsessed with our own need to be accepted and loved.

Read more at: https://lawrencejwcooper.ca/why-is-she-mad-at-m/

I Guess I’ll Be a Doctor – Part 2

My Sad Story

BPD Impairment 5 – Instability in goals, aspirations, values, or career plans

 

Up until the summer after my grade twelve graduation, I had planned to be a priest. Part of this was, of course, to please my mother who was convinced that I was special because I was the seventh son, and being special, of course, meant the highest calling, the priesthood. I also attended an all-boys Catholic high school where I was taught by priests (with the exception of my Physics teacher who was a lay person). About twice a year, Father Gocarths would come around and interview and counsel and encourage the boys who had hopes of becoming priests. Because of my near perfect grades he informed me that I would spend one year in a novitiate in Ottawa and then move on to studies in Rome. However, it was during my Grade Twelve year that I discovered women.

Read More at: https://lawrencejwcooper.ca/i-guess-ill-be-a-doctor-part-2/

I Guess I Will Be a Doctor

We move on to the second section on impaired personality functioning –  on the DSM 5 – Self-direction. The description is, “instability in goals, aspirations, values, or career plans”. We are really stuck on this one so we will just wing it. I have no experience with it as it is one of the few descriptors that I did not check off in my survey. I had a one, no problem. In addition, I could not find any research studies on the topic. Let’s take it one step at a time and hope it adds up to something that we can hang our hats on.

Read more: https://lawrencejwcooper.ca/i-guess-ill-be-a-doctor/

Poet Laureate

Two Mondays later, and after a lot of fun and fear, I have been awarded the position of Poet Laureate of the Comox Valley District. I would like to thank everyone involved and congratulate all the candidates for two evenings of remarkable poetry.  I would like you all to stay tuned and start posting with the hashtag #ComoxValleyPoetry or #lgbqtpoetry on Instagram, and please send me your poetry so I can start a new page just for poets. The following is my newsletter regarding the position:
Read more:
https://lawrencejwcooper.ca/new-comox-valley-poet-laureate-lawrence-cooper/

– Dissociative states under stress – Part 2

This is the part two on the fourth impairment for Borderline Personality Disorder as noted in the DSM5. As previously noted there is a strong correlation between bisexuality and BPD.

Another Sad Story

In January, right in the middle of my depression, my mother died. She was ninety-two. Somewhere along the way I had lost touch with her. Yes, I visited her once or twice a year, but we never hugged or kissed. When she died, I did not feel anything: no longing, no regret, no love. We were a very large, five-generation, French Catholic family. During my eulogy, tears erupted from all corners of the packed church. These moments require tears to wash away the pain of separation, the pain of lost opportunity to somehow fix something that had been broken. My voice broke, but I could not cry.

To read more:
https://lawrencejwcooper.ca/dissociative-states-under-stress-part-2/

Me Lawrence, and my other me Lawrence, and my other me Lawrence

We have come to the last, and perhaps most difficult to describe and comprehend, symptom on this section of impairments in personal functioning on the DSM 5, namely: “Dissociative states under stress”. When we see this definition, we immediately think of dissociative identity disorder (me Lawrence, and my other me Lawrence); however Borderline Personality Disorder, although having some similarities, is essentially quite different.

To read more:
https://lawrencejwcooper.ca/me-lawrence-and-my-other-me-lawrence-and-my-other-me-lawrence/

Impairment – Chronic Feelings of Emptiness – Part 2

Back to my case study of my “self”. I had continuous feelings of emptiness as far back as I can remember into childhood. I remember as an eight-year-old one day stopping at the Catholic Church (where I was an altar boy) and just sitting in the pew staring at the flame that indicated that Christ was present just so I would not feel alone. However, I was different than most people with feelings of emptiness; I was also able to feel extreme anxiety and anger. It would switch from one to the other, feelings of emptiness followed by feelings of anxiety. Therefore I had one foot on the path of anxiety and suicidal thoughts but the other on the path of hopelessness. Read more at:
https://lawrencejwcooper.ca/impairment-chronic-feelings-of-emptiness-part-2/

Borderline Personality Disorder – My Story

 

shirt-tie-w-out-white-background-final-13A Sad Story – A Case Study of One*

Please Note: I will use this section to add a personal application to all the technical stuff. It is my hope that if you have BPD you will realize that you are not alone and that if I can make it than you gotta believe that you can too.)

 

A was born into a single parent family with eight children. I was the ninth child and the seventh son. I later found out that everyone else’s father was not my father. When George (everyone else’s dad) left mom to raise the kids by herself, she was pregnant at the time, and her stress brought on a premature baby who never really got her feet under her. She died at about eighteen months due to infection from complications with teething. Looking for support, she had an affair and got pregnant with me. When I was born, she had a physical and mental crash. The other eight kids went into the orphanage and I went to live with my 76 year old grandmother. After several months, mom recooperated (pun intended), got her kids back and started to put her life back together again. Mom never bonded with me because I was her mortal sin, according to The Catholic Church, and God would soon take me anyway. Just about at that time my grandmother died and I lost my bond we shared. My thirteen year old sister quit school to raise me while mom tried to make a wage to feed her family.  She never came to my games or school events although I excelled at both. I cannot remember my mother kissing or hugging me until my fortieth birthday.

Because of this rough beginning, I never developed a solid sense of self. I tried to please everyone in the hope that they would approve and show some form of acceptance and love towards me. I became a perfectionist believing that if I showed the world just how good I was they would have to accept me and love me. I must have a powerful constitution (HS) because I managed to survive for fifty-five years. That’s when I was forced to go into an extensive eighteen week, five hours a day, five days a week intensive, group therapy program. That’s when they nailed me with the BPD label, which was okay, because that allowed me to go on long term disability and still collect my salary. Paid vacation. Not.

I have been a student of BPD ever since which led to my quest to understand it, leading to the thirty-seven traits I have identified from the DSM 5* (aside:  totally unscientific but makes sense to me. There I go, apologizing again – impairment 2 – for something that needs no apology. In fact, it’s a damn good idea. When I count them up looking back to those days just before the crash, I had a nine or ten on seventeen of the impairments and traits and an overall score of 242. Bet you can’t beat that.) Above all, I had a poorly developed and unstable self-image. Give me a ten on this one. That’s enough for now. Believe me, hang in there, it does get better as we will see in the following chapters.

Creative Moments

Please Note: I think it’s time to leave the research and theories behind for a while and look at BPD from an emotional point of view. Feelings from the heart instead of ideas from the mind. So here goes. The play within the play whereby I’ll catch the conscious of the king (me)(Hamlet).

During one weekend, I attended a writer’s workshop that focused on owning our work and feeling good about it. One of the activities really hit home. We were to carry on a written dialogue with the child within. The voice of the higher self (adult) was expressed by writing with the dominant hand and the voice of the child with the other. The following is what I came up with:

Child: It’s dark in here.

Adult: Where are you?

Child: I don’t know. Mom left me here alone a long time ago.

Adult: I was always there with you.

Child: No you weren’t. I didn’t see you.

Adult: I was watching safely from a distance.

Child: Why didn’t you come and play with me? I was scared.

Adult: I’m not sure. I cared for you, but something seemed to be holding me back. Where was your mother?

Child: I never had a mother. There was a woman. She made my meals. We watched TV together but she was not my mother.

Adult: How do you know?

Child: She never held me. She never kissed me. She never said she loved me.

Adult: What about your father?

Child: I never had a father.

Adult No one?

Child: Just you. But you never held me, or kissed me, or said you loved me either.

Adult: But I was there. I didn’t do those things because I wanted you to be strong, to grow up to be a man. Surely you must remember my visits, those poems I wrote to you over the years?

Child: Yes, thank you. I still have all of them. I read them when I feel lonely.

Adult: I am sorry I neglected you. Please forgive me.  But there is still time. Perhaps you can be the child of my mature years, like my grandson?

Child: Yes, I would like that. Do you have time to play now?

Adult: Yes I do, all the time in the world. We can have our own special time every day after lunch until before dinner. Would you like that?

Child: Oh yes! That would be fun. But not golf. I hate golf. How about tag or hide and seek? I can hide someplace in the dark and you can come and find me.

Adult: And yes, and we can both run for home…

Child: And yell HOMEFREE!!

Adult: Yes let’s do it.

Child: And you can hug me and say you love me.

Adult: Yes, I promise. I do love you, you know?

Child: I know.

The Silver Lining

What can we take from this? Most of us borderliners with BPD have had to survive with a wounded child, often because of childhood neglect or abuse. Because of what we have experienced, we now have the opportunity through the power of our Higher Self, to use these experiences to grow into conscious beings, to use our trials to give insight into what it means to awaken to the infinite possibilities of the universe. Once we deal with our problems with self-esteem and develop a positive self-concept, we will be miles ahead of the rest of the population who haven’t yet faced their demons and discovered their Higher Self. We can now revisit those days again and do some healing, and then pass this knowledge on to others.

My five suggestions for borderliners

  1. If you have no self-identity issues and no BPD problems – enjoy the read.
  1. If you are one of us who struggles with poor self-identity and poor self-image, you are not alone. We* can learn to accept ourselves just the way we are. We can seek a new foundation. We bond with ourselves. We bond the fragile ego-self with the spiritually powerful higher self (HS). We become our own parent and give ourselves a hug whenever we need one.
  1. We flood our self with self-love from the HS. We practice looking in the mirror and seeing the higher self within. We do this until we can look ourselves right in the eye and say “I love you”, and mean it, and feel it. It will feel like a rush as the HS accesses the pleasure center of the brain. When we do this, we bring the two identities, the mind self and the higher self, together. We enter into the awareness of the infinite power of our Self-identity as body, mind, and soul.
  2. We tell ourselves we love our self (body, mind and spirit) over and over again day after day after day, until all the old feelings are permanently erased.  When confronted with a moment of self-doubt, we stop it. We tell ourselves that we are better than that; in fact, we are beautiful and powerful beings in complete control of our emotions and feelings. We make a conscious decision to let go of the negative feelings associated with low self-esteem, and embrace the positive feelings bathed with love from our higher self. We do not blame our negative mind self, we thank it for being diligent and assure it that things will be different from now on.
  3. Set aside fifteen minutes a day for meditation with a purpose; namely to become aware of and appreciate the presence of our higher self.

 

* (Last aside in this chapter: I like to use “we” because using “you” can really be hard on borderliners with an already a poor self-image that says that any kind of unwanted advice is criticism, and intervention is useless. “We” means we are not alone; we are in this together. You may wish to sign up to my newsletter and attend some of my webinars at lawrencejwcooper.ca. These are free services that I offer, because, like the Ancient Mariner, I feel compelled to tell my story to anyone who will listen.)

 

Borderline Personality Disorder and Dissociative States

shirt-tie-w-out-white-background-final-10We have come to the last, (and perhaps most difficult to describe and comprehend) symptom on the DSM IV, namely: “transient, stress-related paranoid ideation or severe dissociative symptoms”. The DSM 5 includes it under significant impairments in personal function with a similar descriptor of: “Dissociative states under stress”. When we see this definition we immediately think of two severe disorders, paranoid schizophrenia and dissociative identity disorder; however Borderline Personality Disorder (BPD), although having some similarities, is essentially quite different.

First the semantics. Transient merely means that the symptom is not continuous but comes and goes depending on the levels of stress and subsequent anxiety. The term ideation refers to negative mind states or thinking patterns involving negative past experiences that, again, may come to the surface under stress.  Paranoia here is much gentler than the kind of paranoia that we see in Paranoid Schizophrenia. By my own experience, I would describe it as a feeling that I do not belong, and the world out there is a dangerous place that required that I was always perfect, vigilant, and careful in my interactions with people. This leaves us with the term dissociative that we will examine more closely in the rest of this blog.

One study, although quite different in design, seems to bring what is happening into focus.  Ludascher et al (2007) applied electric stimulation on the right index finger with twelve female patients with BPD and twelve healthy controls. They found significantly elevated pain thresholds in patients with BPD, with a significant positive correlation between pain thresholds and dissociation, as well as between pain thresholds and aversive arousal. In a follow-up study, Ludascher et al (2010) using script-driven imagery, produced dissociative states in participants with BPD. These states on fMRI’s were characterized by decreased pain sensitivity and significantly increased activity in the left inferior frontal gyrus (part of the OFC) which is at least partially responsible for empathy, processing pleasant and unpleasant emotions, self-criticisms, and attention to negative emotions.  From these two studies we see suppression of emotional pain and interference in the functioning of some of the sections of the orbitofrontal cortex (OFC).

Typically when an emotional situation takes place (usually involving intimate relationships or high self-worth activities like work and some sports), the OFC and amygdala are activated, thus empowering us to take action and resolve the situation. Once it is resolved, these impulses are then channeled through the pleasure center of the brain producing a sense of joy and accomplishment. Serotonin and endorphin neural circuits are then activated giving us a sense of peace and euphoria.  However, if the emotional situation is too intense (such as a break-up), we will eventually but a block in place along those neural circuits connected to the images and thoughts and feelings.  This is a natural body function that is usually put in place to block the neurotransmitters that are coming from intense pain. The neurons simply withdraw their receptor docks, thereby preventing the messages from proceeding from the painful neural pathways to the OFC of the brain. Out of sight, out of mind. Works for most people.

But if this process has been corrupted by severe emotional problems during childhood such as emotional neglect, coupled with a supersensitive genetic predisposition, the OFC will not be able to process any additional emotional insult. The whole emotion processing system gets shut down. This theory is supported by Jones et al (1999). They assessed twenty-three patients with BPD, and 23 matched controls, with the Autobiographical Memory Test (AMT) and self-report measures. As expected, participants with BPD scored significantly higher than the control group on measures of depression, anxiety, and trait anger. However, they also scored higher in dissociative experiences that appear to be connected to general memories on the AMT. They concluded that patients with BPD had difficulty in recalling specific autobiographical memories, perhaps related to their tendency to dissociate, which may help them to avoid reliving memories that may have been emotionally painful.

These studies suggests that under stress, we lost souls with BPD tend to shut down emotional pain sensations because of our past painful experiences. Again, in my own case, whenever I was personally or professionally challenged by someone, and I felt my self-worth was at stake, I could actually feel a sense of numbness flowing through my brain and through the rest of my body. Quite simply, this suggests that some of us with BPD may have developed some kind of defense mechanism to interrupt the flow of pain within our brain. Because this pain is emotional in nature, it might indicate that we bypass our amygdala thus having an interrupted or numbing response when faced with an emotional situation.

Now this sounds like a perfectly good way to deal with overwhelming emotional situations, but there is a major drawback, which brings me to the last study in this section.  Ebner-Priemer et al (2009) used an aversive differential delay conditioning procedure with 33 unmediated patients with BPD and 35 healthy controls. They discovered patients that BPD with high state dissociative experiences and showed impairment in responding to emotional learning. They concluded that emotional, amygdala-based learning processes, may be inhibited in acquisition and extinction processes in therapy and should be closely monitored in exposure-based psychotherapy. It would appear that we do not respond well to traditional therapy methods. The amygdala, and parts of the OFC mentioned in these studies, are designed to provide the plan and the power to solve problems, including highly emotional ones. It is part of a circuit that leads to resolutions, a trip through the pleasure center of the brain, and to a nice comforting flow of serotonin. When we shut down these mechanisms, we shut down our ability to solve problems and to feel the joy and contentment of growing through our experiences.  And, unfortunately, we do not respond well to therapy.

So what is the answer? Again, I can only refer to my personal experience. I underwent an extensive  therapy including group, cognitive, and an assortment of other strategies, with only limited success. My true healing took place when I begin to see myself as a higher self in conflict with a mind self (talk about dissociative disorder). Only then, with the support of my higher self, was I able to explore my past emotions, cry with some, yell and scream at others, and feel the hurt and loss with the rest. It allowed me to  accept them, be thankful for their part in making me strong, and put them behind me. Then when old feeling returned, and I felt the numbing sensation coming on, I would connect to my higher self, and allow it to flood my mind and soul, cry, and move on.

Here are my five suggestions for those of us with a dissociative element in our BPD:

  1. We face our emotions. We notice that numbing sensations when we begin to shut down. We seek a quiet moment and allow the feelings to surface.
  2. We call upon our higher self to give us courage and strength to face them, deal with them, cry if we have to, or be angry with the people involved. We then allow the higher self to complete the circuit as the serotonin pathways are activated and endorphins are released.
  3. We continue to process these past emotions through contemplative therapy. In my case, I entered a state of meditation where I become aware of my higher self. I then allowed my mind to bring up past pains and deal with them. I did this on consecutive days until all the old wounds were healed. It took me several weeks before I felt the issues had been resolved.
  4. Whenever they resurface, I thank my mind for bringing it to my attention. If the time and space are appropriate, I give it permission to experience the old emotions. I soothe it with my higher self. “There, there it’s okay to feel this way. It’s okay to cry.  it’s okay to be angry.”
  5. If the timing is not appropriate or if an emotional reaction might lead to further conflict and pain, I allow my mind to suppress the emotion with the promise to resolve the issue and the emotions behind it during the next day’s meditation. Once I feel comfortable with, and in control of my emotions, I will bring it up at the next opportunity with my intimate friends and family. If it just an acquaintance from work or community, I may just let it pass and chalk it up to experience.

 

 

 

 

 

 

Ludascher, Petra; Valerius, Gabriele, Stiglmayr, Christian; Mauchnik, Jana; Lanius, Ruth A; Bohus, Martin; and Schmahl, Christian. Pain sensitivity and neural processing during dissociative states in patients with borderline personality disorder with and without comorbid posttraumatic stress disorder: a pilot study. J Psychiatry Neurosci. 2010.

 

Ludascher, Petra; Valerius, Gabriele, Stiglmayr, Christian; Mauchnik, Jana; Lanius, Ruth A; Bohus, Martin; and Schmahl, Christian. Elevated pain in thresholds correlate with dissociation and aversive arousal in patients with borderline personality disorder. 2007.

 

Jones, B; Heard, H; Startup,M; and Swales, M. Autobiographical memory and dissociation in borderline personality disorder. Psychol Med. 1999. Psychiatry Research. 2007.

Ulrich W. Ebner-Priemer, PhD, Jana Mauchnik, PhD, Nikolaus Kleindienst, PhD, Christian Schmahl, MD, Martin Peper, PhD, MD, M. Zachary Rosenthal, PhD, Herta Flor, PhD, and Martin Bohus, MD. Emotional learning during dissociative states in borderline personality disorder. Journal of Pschiatry and Neuroscience. 2009.