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/

Nobody Likes Me

Impairment – Chronic Feelings of Emptiness – Third in a series related to Borderline Personality Disorder (BPD) based on the impairments and personality traits listed in the DSM5.

When we seek to define emptiness, we come up with adjectives such as hopelessness, loneliness, and isolation. But it is more than that; we feel emotionally dead, no excitement, no joy. Being alone is very difficult so we fill time up with work addiction and an unending stream of activity. At some point, we become mentally and emotionally exhausted. 

Read more at
https://lawrencejwcooper.ca/nobody-likes-me/

The Borderliner Survey

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We have been looking at ways to live better and healthier lives as bisexuals. We discovered that a large percentage of us have had to learn to live with Borderline Personality Disorder. By looking at the impairments and traits listed on the DSM5, we can define areas that we can work on so that we can overcome issues related to our sexual orientation. I have devised the following self-administered survey to help us pinpoint some issues that we may wish to work on.

Self-administered Borderliner Survey

Give yourself a score for each item with 1 being “never, no problem” and 10 being “always, this really sucks”.    When you are finished add up the scores.

37 – 50               No problem

50 – 100             Might be a few things I need to work on

100 – 150           There are some issues here that require my attention

150 – 200            I may need to seek counseling to work on some of my issues

200+                    I need to take action. I am definitely at risk for depression and self harm                              or  suicidal behavior.

  1. Markedly impoverished, poorly developed, or unstable self-image, ______
  2. Excessive self-criticism; ______
  3. Chronic feelings of emptiness; ______
  4. Dissociative states under stress ______
  5. Instability in goals, aspirations, values, or career plans ______
  6. Compromised ability to recognize the feelings and needs of others ______
  7. interpersonal hypersensitivity (i.e., prone to feel slighted or insulted); ______
  8. Perceptions of others selectively biased toward negative attributes or vulnerabilities ______
  9. Intense, unstable, and conflicted close relationships; ______
  10. Marked by mistrust, neediness; ______
  11. Anxious preoccupation with real or imagined abandonment; ______
  12. Close relationships often viewed in extremes of idealization and devaluation; ______
  13. Alternating between over involvement and withdrawal. ______
  14. Unstable emotional experiences and frequent mood changes; ______
  15. Emotions that are easily aroused, intense, and/or out of proportion to events and circumstances.    ______
  16. Intense feelings of nervousness, tenseness, or panic, often in reaction to interpersonal stresses;   ______
  17. Worry about the negative effects of past unpleasant experience and future negative possibilities;  _____
  18. Feeling fearful, apprehensive, or threatened by uncertainty; ______
  19. Fears of falling apart or losing control; _____
  20. Pathological personality traits in negative affectivity; ______
  21. Fears of rejection by – and/or separation from – significant others; ______
  22. Fears of excessive dependency and complete loss of autonomy; ______
  23. Frequent feelings of being down, miserable, and/or hopeless; ______
  24. Difficulty recovering from such moods; ______
  25. Pessimism about the future; ______
  26. Pervasive shame; ______
  27. Feeling of inferior self-worth; ______
  28. Thoughts of suicide and suicidal behaviour; ______
  29. Acting on the spur of the moment in response to immediate stimuli; ______
  30. Acting on a momentary basis without a plan or consideration of outcomes; ______
  31. Difficulty establishing or following plans; ______
  32. A sense of urgency and self-harming behavior under emotional distress; ______
  33. Engagement in dangerous, risky, and potentially self-damaging activities, unnecessarily and without regard to consequences;    ______
  34. Lack of concern for one’s limitations; ______
  35. Denial of the reality of personal danger. ______
  36. Persistent or frequent angry feelings; ______
  37. Anger or irritability in response to minor slights and insults. ______

 

#bisexualityandBPD

Checkout my website lawrencejwcooper.ca

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.