Category: Bisexuality and Suicide

Bisexuality and Loneliness

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Finally some scientific evidence to support what I have known since my first teenage orgasm. My bisexual life was one of a deep sense of aloneness. There was no one I dared talk to, no one who would truly understand my deepest thoughts and feelings. I was very popular on the outside, but no one knew how lonely I was on the inside.

A recent study by Mereish etal. (2017)[1], indicates that loneliness is a contributing factor in a bisexual individual’s poor mental health leading to a possible greater risk of suicide. As expected, this study confirmed previous research that bisexuals were more likely to experience prejudice from heterosexuals and other members of the LGBQT communities. This can lead to feelings of isolation that contribute to loneliness.

Of special interest are the findings that bisexuals with internal stressors, such as desires for heterosexuality and orientation concealment, were also more likely to report loneliness. The amount of spare time to ruminate and possibly engage in self-loathing mental gymnastics was also a factor. Being a student or unemployed or part–time employed contributed to a feeling of loneliness. Individuals who were single were also more likely to conceal their orientation which is another contributing factor to loneliness. And the catch twenty-two, bisexuals with post graduate degrees were less likely to conceal. and therefore more likely to come out, and therefore more likely to experience prejudice and subsequent professional isolation and loneliness.  There is no correlation between the internal and external stressors; in other words experiencing prejudice is not necessarily related to internal struggles for bisexuals (although such is not the case for other members of the LGBQT community). We can experience both but one does not necessarily lead to the other; yet, both can lead to a feeling of loneliness and therefore mental anxiety and suicide.

Feelings of experiencing external and internal prejudice and loneliness are compounded by the lack of resources that are designed for bisexual individuals. Our needs are often overlooked, possibly because of external factors like prejudice but more likely due to the fact that we do not express our needs and are often unwilling to have our needs made public.  We are reluctant to join support groups or enter mentorship programs because of our needs for privacy. What is needed is an on-line program that protects anonymity while being able to share and experience connection with another individual or group of individuals. We need to be heard and understood before we will begin to listen to and understand ourselves.

(Please note: my on-line program will be up and running in a few months so stay tuned.)

Here are my five suggestions for bisexuals:

  1. If we are experiencing internal stressors and cannot seem to escape them – we should get help. I strongly suggest you try my on line program that will be up in a few months. It is designed to build up our self-image and self-concept as bisexuals. It centers on the belief that we have a higher self with an unlimited source of power to live amazing and satisfying life. It focuses not on our problems but on our resources in the form of twenty virtues that we can develop to bring unending joy into our lives.
  2. It would appear that internal stressors may be equal to or an even greater source of anxiety and depression than experiencing prejudice. It would appear that it is worth the possible sorrows that may come from coming out than suffering through the loneliness of concealment. We should consider accepting, acknowledging, and telling significant others about our orientation and believing in them and our relationship. It may take time but we will be better off in the long run.
  3. If we have not done so already, we can admit to ourselves that we are bisexual with desires for sexual relationships with both women and men. We are not heterosexual but we can engage in heterosexual relationships. Likewise, we are not lesbian or gay but we can also engage in lesbian or gay relationships. We have a choice. If we are single we can indulge but we should be seeking love as well as sex.
  4. If we are in a relationship, and we are struggling with desires and occasional encounters, this concealment can be a major source of mental anxiety and can lead to a complete collapse. If we share our desires, hopes and failures with our partner, we can convey to them that we love them and are sharing this information in the hope that we can have a more honest and satisfying relationship. If they choose to leave, we have to be prepared to let them go.
  5. Above all else, we have to be true to ourselves. Once we learn to love and care for ourselves, we can begin to enjoy ourselves regardless of prejudice and what others think of us. We are worth it.

[1] Mereish, E., Kzrz-Wise,S, and Woulf3,J..Bisexual-Specific Stressors, Psychological Distress, and Suicidality in Bisexual Individuals: the Mediating Role of Loneliness. Crossmark. 2017.

( https://link.springer.com/epdf/10.1007/s11121-017-0804-2?author_access_token=HmXzCxYOGPXlpyLFkEh2Sfe4RwlQNchNByi7wbcMAY69fGsGy82K2FqKswjcCp_4lquu_M_wYRCb68kZNDamLFIvZBapABKj2WauzK0QwYj51DicENdDF4V1osJGNKNJ7f4EV4qD7AeKrzNK6d3Ww==).

Why Doesn’t Anyone Hear Me?

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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. 

 

In conclusion, both distrust and neediness are calls for help. Even though distrust and anger are hard to live with, they are better characteristics than neediness. These people with BPD are still fighting it. It is the ones with excessive neediness that I am most concerned about. They are just one step away from hopelessness which is one step away form suicidal behavior.

To read more: https://lawrencejwcooper.ca/why-doesnt-anyone-hear-me/

Borderline Personality Disorder and Anger

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We now move on to Symptom eight on the DSM IV, namely, “Inappropriate, intense anger or difficulty controlling anger.” On the DSM 5, it is listed under pathological personality traits in antagonism and includes “persistent or frequent angry feelings”, and “anger or irritability in response to minor slights and insults.” Some articles describe this out of proportion anger as “BPD rage”. There is a relatively small sample of research on the topic, but I have located two well designed projects that should shed some light on the topic.

Cackowski et al, in a small sample of twenty-nine female BPD patients, 28 ADHD patients and 30 healthy controls, found that BPD patients reported higher trait aggression and hostility, a stronger tendency to express anger when provoked, and a tendency to direct anger inwardly. They concluded that there may be a significant impact of stress on anger in BPD patients; however, it appears to be directed towards the self rather than to others.

Krauch et al used functional MRI to observe brain scans when twenty BPD and twenty HC adolescent participants were exposed to scripted imagery. They found that adolescents with BPD showed increased activity in the left posterior insula, the left dorsal striatum, and the left inferior frontal cortex. The insula is connected to our old friends the amygdala and the thalamus and is part of the limbic system involved in processing emotions. It is also believed to be involved in the processing of physical and emotional pain in an attempt to create homeostasis or balance during interpersonal relationships.  The striatum is part of the forebrain that is believed to be involved in the reward system, inhibitory control, and impulsivity. The inferior frontal cortex is, of course, our administration center that employs mind states to solve problems.

So what does this mean in layman’s terms? Quite simply, it shows that we unfortunate souls with BPD have overactive brains in the areas involving negative emotions and subsequent behavior. When our emotions are activated by minor conflicts, we have a difficult time processing the information and calming our overactive brain. We tend to react with frustration and anger, but since we are so dependent on our relationships with other for our sense of self-worth, we direct this overcharged anger against ourselves. This often shows up in self-harm activities and suicidal behavior.

So what does all of this mean? First of all, let’s deal with the data from these studies. Even though Cackowski et al’s study was carried out with women, I think we can safely employ these results to men. We have a tendency to experience the same emotions but deal with them in different ways. We tend to suppress causing an increased buildup of negative energy. When we reach our boiling point, we explode more violently than women. Therefore, even though women have more suicidal attempts than men, we tend to be more successful at killing ourselves, because we use more violent means like jumping off tall building or using a gun to blow our brains out (interesting-one way to stop the over active and pain-filled brain). Women on the other hand use peaceful means such as overdosing which, by the way, leaves a possible back door to escape.

When we look at the brain scans, they are just that. It is not definitive. It just shows what parts of the brain are active. The old orbital frontal cortex is just searching vainly for solutions from past experiences. If we believe this part of the brain is “us”, then we have a problem. However, if we believe that we are something beyond the electrochemical impulses, neural pathways, and mind states, than there is hope. If we defer to the Higher-Self, we can begin to see solutions beyond the mind states and schemas of the OFC, stop all the turmoil and impose a homeostasis or balance on the insula, and nudge the dorsal striatum to let go and complete the happy pleasure route by choosing to smile at our absurd reaction to a minor conflict. We use our higher self to pat ourselves on the back and say “there, there” and we begin to see solutions where there did not appear to be any. We can then experience an amazing surge of positive power and energy to forge a new path, not only to create balance, but to carry on with the expansion and growth of our being.

Here are my five suggestion for people with BPD and anger and impulse control problems:

  1. We recognize that we have anger issues. And we thank the universe (and yes I mean thank) that we still have the ability to have an emotional response to the feeling of rejection and interpersonal disagreements. If we ever lose that, it means we have quit trying to interact and may now be vulnerable to the second and more dangerous cause of suicidal behavior – hopelessness and helplessness. We always look for something to be thankful for. It gets us in touch with our higher self.
  2. We let the people who are important in our lives know that we have a “rage” problem. We alert them that we may have to tell them from time to time that we are experiencing a rage episode and may have to excuse ourselves from a situation with a promise to come back and resolve the issue once we have ourselves back under control.
  3. When confronted with a conflict, we take a deep breath and smile (if appropriate – does not work with partners during an argument) rather than responding to our brain’s emotional reaction.
  4. Whenever we feel the conflict beginning to turn into the rage, we remove ourselves (if we can) from the situation before it blows up to unmanageable proportions and additional shame inducing behavior that will complicate our ability to resolve the conflict. If we can’t leave the scene, we may have to eat crow (amazing birds) and shut up and take it. It helps to say “yes madam” to the boss and “yes dear” to our partners.
  5. We refuse to turn the anger against ourselves. We keep it objective. We find a quiet spot and employ deep breathing and self-talk. We analyse the situation and our over-heated response. We make a plan to resolve the conflict. If we have followed steps 1 to 4, we pat ourselves on the back and say, “Well done”.
  6. If we lose it and blow up again, we are kind to ourselves and recognize that this is part of a bigger problem. We analyze the situation to see what we can do better in the future. We apologize and restore the relationship. This should be easy to do  if  we have done step 2.

 

Cackowski, Sylvia; Krause-Utz, Annegret; Van Eijk; Klohr, Julia; Daffner, Stephanie; Sobanski, Ester; and Ende, Gabriele. Anger and aggression in borderline personality disorder and attention deficit hyperactivity disorder – does stress matter? Borderline Personality Disorder Emolt Dysregul, 2017. 17.

Krauch, Marlene; Ueltzhoffer, Kai; Brunner, Romuald; Kaess, Michael; Hensel, Saskia; Herpertz, Sabinen C; and Bertsch, Katja. Heightened Salience of Anger and Aggression in Female Adolescents With Borderline Personality Disorder—A Script-Based fMRI Study. Front. Behav. Neurosci., 26 March 2018 | https://doi.org/10.3389/fnbeh.2018.00057

Borderline Personality Disorder and Chronic Feelings of Emptiness

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shirt-tie-w-out-white-background-final-13As we continue on with our investigation into Borderline Personality Disorder and its relationship to bisexuality, we arrive at symptom seven on the DSM IV: chronic feelings of emptiness. On the DSM5 it is listed under: Significant impairments in personality functioning manifest by:

“Identity: Markedly impoverished, poorly developed, or unstable self-image, often associated with excessive self-criticism; chronic feelings of emptiness; dissociative states under stress.”

When we seek to define emptiness, we come up with adjectives such as hopelessness, loneliness, and isolation.

In a study by Klonsky[1], he concluded that emptiness is characterized more by low positive affect rather than high negative affect. In layman’s terms, it is not so much having negative thoughts and feelings related to negative events, but rather just being empty of, or having a lack of, positive aspects to our lives. Klonshy came up with some interesting observations. As expected, he noted a substantial overlap between emptiness and hopelessness, a subsequent robust relationship with depression, and an important relation to suicidality. By including a sub study on self-harm through self-cutting, he noted a pattern that suggested that chronic emptiness contributes to the development of suicidal thoughts and feelings, but may not predict progression to an actual suicide attempt.

This brings out an interesting point about the progression of BPD symptoms to suicide and other self-harming activities. It would appear that there may be two aspects to poor self-image that may lead down two different paths. As we have seen in past blogs, there is a strong correlation between BPD, anxiety, depression, and suicide. Traits such as self-criticism and dissociative states may lead to chronic anxiety and down the path to suicide; whereas the emptiness trait may lead to a form of self-harm where one is attempting to create some feelings to jar them back to a functional reality. And then, because no two people are exactly alike, there are numerous combinations of traits.

Back to my case study of my “self”, I had continuous feelings of emptiness as well as self-criticism. Therefore I had one foot on the path of anxiety and suicidal thoughts but the other on the path of hopelessness. To resolve my problem, I shut down my own wants and needs and stubbornly plowed forward trying to cure and heal anyone I could get my hands on, never getting any real satisfaction for doing any good for anybody. During profound periods of emptiness, I tried to fill it up with dangerous, risk taking gay sex. It worked for me for twenty-five years until my mind became overwhelmed and crashed. Even though I had suicidal thoughts, I never really took any steps to actually doing away with myself. I just grinned and bared and waited for the shoe to fall.

Looking back here is what I should have done. My five suggestions for bisexuals with BPD and with symptoms of emptiness:

  1. We find some way to fill up the emptiness and the way to do that is to simply remove the veil that is keeping us from seeing that we have a higher self.
  2. We simply shut down the noise of our wounded ego, the woe is me voice, and open our mind to the always present presence and power of out higher self.
  3. We wait for the emptiness to be replaced by a sense of this presence. We will always feel a sense of joy when our higher self sends an impulse through the pleasure centers of our brain.
  4. Whenever we feel down we repeat this process until we sense our higher self.
  5. We fill up and expand our sense of fullness on a daily basis. We spend fifteen minutes a day in mediation by focusing on the power and beauty of our higher self.

[1] Klonsky, David E. WHAT IS EMPTINESS? CLARIFYING THE 7TH CRITERION FOR BORDERLINE PERSONALITY DISORDER. Journal of Personality Disorders, 2008.

Borderline Personality Disorder and Anxiety

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(This is the second in the series on exploring mood and anxiety dysfunctional traits for  Borderline Personality Disorder (BPD) on the DSM 5, and symptom six on the DSM IV . In the last issue, we looked at episodal dysphoria; today, we will take a look at generalized anxiety.)

In a study involving ninety-two hospitalized patients diagnosed with BPD[1], Grambalet et al. concluded that BPD patients were significantly more likely than the people in the control groups to suffer from a wide range of anxiety disorders including: panic disorder, social phobia, generalized anxiety disorder, mixed anxiety/depression disorder, adjustment disorder, and post traumatic stress disorder. In addition, one in five patients had two or more of these disorders. Excessive levels of anxiety correlated with reduced quality of life in mental, social, and work domains.

Each of these anxiety disorders deserves to be examined in isolation, keeping in mind that we may have two or more disorders functioning at any given time. Today we want to take a look at generalized anxiety disorder.

Ninety percent  of people with BDP have clinically high rates of anxiety[2] . Generalized anxiety makes it difficult for us to maintain our ability to function in our home and work environments, thus increasing the risk of suicide and self-injury. I remember a friend of mine explaining why she had taken the whole bottle of clonazepam, an antipsychotic medication, thus ending up once again in the psych ward at the University Hospital. She said she did it because she could no longer stand the constant feeling of anxiety. As in the case of my friend, I have noticed that many suicide attempts are due to extended anxiety attacks rather than the more commonly held belief that they are due to depression. 

I am sure that this story of anxiety resonates with most of us with BPD; we all know that we  have constant anxiety issues in trying to survive and thrive in our own corners of the world. Like most of us with BPD, I have had to learn to live with a constant form of generalized anxiety. Some days are worse than others, depending on the stress levels. Sometimes during the day, usually after teaching my classes in psychology, I will stop for a moment and realize just how tense my body is. I have learned to read the signs and diffuse my anxiety episodes, usually by engaging in deep breathing exercises. At other times, the anxiety will create the sensation of having an elephant on my chest. This anxiety is physical as well as mental. Once this level of anxiety occurs, my brain and body will slip into the sympathetic system thus increasing the sugar levels for the energy needed to flee or fight,  salt levels to raise my blood pressure to get the sugar to my muscles, and driving the administrator section of my brain to concentrate on the unknown threat rather than being able to rationally go about the business of living.     At these times, I have to take a walk while concentrating on breathing,  consciously engaging and forcing my mind to take control again, easing my brain into the parasympathetic system, and thus allowing my body and brain to burn off the excess energy.

Living with BPD means living with anxiety. We cannot eliminate it, but we can control it. We can take control of our minds and bodies, eliminate the anxiety, and then deal with the cause of the stress. If the stress is a normal part of our daily lives, we simply monitor and proceed. If the anxiety becomes uncomfortable, we take a break and reduce the anxiety levels and then get back to work. If we are going through a period of prolonged stress, we need to build in breaks and maintenance days off.  If the anxiety leads to crisis, we engage in crisis management. We get help. We take whatever medication is necessary until the crisis has past. For some of us, we will need to stay on medication for the rest of our lives. In other words, we learn to read the anxiety levels in our brain and body and then take the necessary steps to reduce the anxiety so we can function normally at home, and at work.

My five suggestion for dealing with BPD:

  1. We learn to read and monitor our anxiety levels.
  2. We develop a strategy like deep breathing. I use a four point square visualization technique:
    1. Four breaths in deeper and deeper until full
    1. Hold for four seconds.
    1. Four breaths out until completely empty
    1. Hold for four seconds
    1. Repeat until experiencing a release of anxiety.
  3. When stress leads to conflict (internal or external) and an anxiety attack, we:
    1. Remove ourselves from the situation,
    1. Take a walk and work off the physical side effects of the anxiety.
    1. Return to the situation and work on it until there we feel it has been resolved. This will usually be experienced in a washed out feeling accompanied by peace and joy.
  4. If we have a period of prolonged stress, we will need to remove our self from the situation and take a maintenance break.
  5. If we are experiencing extreme anxiety over a significant length of time, measured in months or years, we may have to make major life changes.

[1] Grambal, A;  Prasko, J; Kamaradove, D; Latalova, K;Holubova, M;Sedlackova,Z.; and Hruby, R..    Quality of life in borderline patients comorbid with anxiety spectrum disorders – a cross-sectional study. Dovepress. 2016.

[2] Harned, Melanie s.; Valenstein, Helen R..  Treatment of borderline personality disorder and co-occurring anxiety disorders. F1000Prime Rep. v.5; 2013.

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Borderline Personality Disorder, Disinhibition, and Suicidal Behavior

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img_1394-1(This is the third in the series linking Borderline Personality Disorder (BPD) with Suicidal Behavior. In the first blog, we established the link between BPD and suicidal behavior in general, and in the second blog we looked at the correlation with childhood sexual abuse.)

A study conducted by Brodsky et al [1] involving 214 inpatients diagnosed with BPD, concluded that Impulsivity was the only characteristic of borderline personality disorder that was associated with a higher number of previous suicide attempts. Could it be that impulsivity by itself, leading to risk taking, is the leading cause of suicidal behavior among those diagnosed with BPD? I think not, at least not in isolation.

So why are we splitting hairs when it comes to the causes of suicidal behavior and BPD? We know there is a link with BPD and suicide, and we know there is a link with suicide, impulsivity, and risk taking. Whether or not suicidal thoughts and behaviors are a symptom of BPD or not is not the issue. The issue is that people with BPD  are dying because of their risk taking. This is especially evident in the case of the flirtation with death through street drugs. Why are we doing that? Why are we taking risks with drugs we know are, or may be, laced with fentanyl? Why have we gay and bisexual men engaged in unsafe gay sex when it may have led to AIDS? Why such a disregard for our own lives?

Speaking from personal experience, impulsivity was not my major cause of suicidal thoughts. It was my sense of failure and hopelessness. I never made an attempt on my life but I certainly took risks that I hoped might end it for me. Perhaps, it is the combination of other affects in conjunction with impulsivity, in other words,  a kind of global personality disorder, including impulsivity, that puts us at risk not just for suicidal thoughts but for actual suicidal attempts. Perhaps it is merely not wanting to live our lives anymore because there is too much pain coupled with a desperate sense of helplessness and hopelessness.

So what can we do about it? Therapy should begin not with what has happened in the past, and not the sense of hopelessness in the present.  We have to start with finding something to be thankful for, and what a better place to start than with life itself. We have to stop viewing life through the eyes of our damaged egos and begin to see the possibilities of a life we would love to live that is being offered by our higher self. We have to close our eyes and ears to the message of hopelessness and helplessness and open ourselves up to the message of hope and love from our higher self. We should be focusing on what life can be, not what it was not. We have to learn to dream again and see the possibilities of a life of peace and contentment, a life that we would truly love to live. There is a light at the end of the tunnel; we just have to open the eyes of our higher self to see it.

Here are my five suggestions for bisexuals with BPD:

  1. We can look deep inside ourselves and find that sweet spot at the center of our being, the home of our higher self. We can do this through meditation where we seek out that especial place that is within all of us.
  2. During the day, we just stop the madness for a few minutes and enter into a state of short meditation where we seek the presence of our higher self. It will give us a moment of peace.
  3. If we stay in the moment, our higher self will begin to heal our wounds and dissolve our sorrows. It may be just a quiet knowing, or it may be an emotional charge as old feelings come to the surface and are let go. We do not try to analyse where the feeling comes from; we just acknowledge it and let it go. It’s okay for us men to cry.
  4. We begin to search for and recognize our inner voice. We choose to silence the voice of our mind and welcome the voice of our spirit. It will always say I love you in a thousand different ways.
  5. We recognize that we are in essence love and that love starts with love for our self. We tell ourselves that we are proud that we have survived the pain and we give our self a hug.

[1] Brodsky, Beth S.; Malone, Kevin M.; Ellis, Steven P.; Dulit, Rebecca A.; and Mann, Hohn J..

Characteristics of Borderline Personality Disorder Associated With Suicidal Behavior. Am J Psychiatry 1997; 154:1715–1719)

 

 

Borderline Personality Disorder, Childhood Sexual Abuse, and Suicidal Behavior Behavior

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SHIRT & TIE [small] (final)(This is the second in the series linking BPD with Suicidal Behavior)

The DSM 4 lists “recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior” under symptom 5 for Borderline Personality Disorder; however it is listed as a separate category under Axis 6 in the DSM 5. Granted, suicidal behavior does indeed merit a separate category; however, we should be aware that people with BPD are at higher risk for suicide attempts.

Research suggests that suicidal behavior is a consistent possible threat when combined with BPD, PTSD, Clinical Depression, and Bipolar Disorder; however, it would appear that people with BPD are at a greater risk. In a study by Yen et al[1] involving 621 patients with a variety of psychological disorders, they concluded that only BPD and Childhood sexual abuse predicted suicidal behavior. The risk of adult suicidal behavior in BPD was increased by antisocial traits, severity of BPD, hopelessness, or comorbid major depressive episode. Other studies indicate that there is a definite correlation between suicide attempts and some BPD personality traits such as poor or no sense of self, hopelessness, and impulsivity.

Today, we want to look at the other aspect of the Yen et al study, namely the relationship between BPD, childhood sexual abuse, and suicidal behavior. Even though Childhood sexual abuse is not listed as a symptom, it is definitely related to suicidal behavior when combined with other BPD symptoms. Soloff et al.[2] in a study of 61 criteria-defined BPD patients concluded that with the occurrence and severity of childhood sexual abuse, patients with BPD were over 10 times more likely to attempt suicide. The study accounted for other variables such as neglect and other types of childhood trauma. It was definitely sexual abuse that seemed to be the most important determining factor.

It would appear that the risk for suicidal behavior is somehow related to negative coping mechanisms involved in BPD and that these symptoms are common in people who have suffered from childhood sexual abuse. If childhood trauma is treated and handled wisely and compassionately, the child may be able to learn to deal with the trauma and live a healthy and successful life. However, if they also have, or develop, other BPD personality traits, it can lead to self-doubt, self-blame, self-loathing and hopelessness, all symptoms of BPD and potential precursors  to suicidal behavior.

Just about everyone I know with BPD has entertained thoughts of suicide sometimes in their lives. When we are looking at diagnoses of BPD, we cannot overlook the possibility of suicidal behavior.  However, if the BPD symptoms also include childhood sexual abuse,  extra precautions need to be put in place. We can explore these possibilities as we go through the process of mental and emotional healing.

My five suggestions for bisexuals with BPD:

  1. If we ourselves have been diagnosed with BPD, and we have experienced childhood sexual abuse, we must be honest with ourselves to see if we have latent suicidal thoughts that could come to the fore if our life circumstances deteriorate.
  2. We need to build a safety net that will serve as a buffer between suicidal thoughts and suicidal attempts. We can share these thoughts with friends and loved ones on a regular basis.
  3. If our friends or loved ones demonstrate  symptoms of BPD, they are at a very high risk for suicidal behavior. We need to support them in any way we can.
  4. We should explore their history with them in a caring and loving manner and make sure they are not entertaining suicidal thoughts. If they are, we can help them build a safety net of people they love and trust. We let these people know that our loved one is at risk and together we set up a support schedule and set of activities to help them get through the rough times.
  5. If our loved one has experienced sexual abuse  and is still exhibiting symptoms of BPD, they will probably need professional help to deal with the issues involved. We can get them to commit to seeking help and then arrange for professional intervention.
[1] Yen, Shirley; Shea, Tracy M.; Sanislow, Charles A.; Grilo, Carlos M.; Skodol, Andrew E.; Gunderson, John G.; McClashan, Thomas H.; Zenarini Mary C.; and Morey, Leslie C.. Borderline Personality Disorder Criteria Associated With Prospectively Observed Suicidal Behavior. The American Journal of Psychiatry. 2004.
[2] Soloff, Paul H.; Lynch, Kevin J.; and Kelly, Thomas M.. Childhood Abuse as a Risk Factor For Suicidal Behavior in Borderline Personality Disorder. Journal of Personality Disorders. June 2002 .
Read More: https://guilfordjournals.com/doi/abs/10.1521/pedi.16.3.201.22542

 

 

Borderline Personality Disorder, Bisexuality, and Suicidal Behavior

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SHIRT & TIE [small] (final)In previous blogs, we have established the highly significant link between Borderline Personality Disorder (BPD) and Bisexuality. Due to the epidemic of suicidal behavior and related drug overdose, in the next five blogs, we will try to explore the links between BPD, suicidal behavior, and risk taking. Today we want to explore the association with BPD in general.

At first glance, there appears to be a conflict between the DSM 4 and the DSM 5 on the inclusion of Suicidal Behavior as a symptom for BPD. The DSM4 includes it as the fifth symptom, “recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.”  However, it only appears in the DSM5 under the broader title of Disinhibition – Topic B – Risk Taking – which includes “Engagement in dangerous, risky, and potentially self-damaging activities, unnecessarily and without regard to consequences, lack of concern for one’s limitations, and denial of the reality of personal danger.”

First, let’s be clear about the connection between suicidal behavior and BPD. Black et al (2018) [1] discovered that at least three-quarters of people diagnosed with BPD have attempted suicide, and approximately 10% have died tragically. These are truly significant figures. If we recall that patients have to have five significant traits for diagnosis, even if one of these was suicidal behavior, there is still enough evidence that BPD people are definitely at risk. Borderline sufferers (and believe me, we do suffer) at greatest risk include those with prior attempts, an accompanying major depressive disorder, or a substance use disorder. Each of these by themselves are a major concern for suicide, but taken together with BPD, they seem to create the perfect storm. Other BPD personality traits that are associated with Suicidal Behavior are hopelessness, impulsivity, and a turbulent early life. They further conclude that clinicians must avoid the mistake of thinking that a pattern of repeated attempts indicates attention seeking or a call for help. According to Black et.al, this behavior is a genuine attempt to end life.

I think to clearly understand the thoughts and emotions that lead to suicide, we have to take a closer look at the definition above that includes gestures, threats and self-mutilation. For today, let’s take a closer look at gestures and threats. From my personal experience, almost everyone with BPD has entertained thoughts of suicide sometime in their life. In my own case, I struggled with the usual feelings of helplessness and self-loathing, especially when connected to my bisexual desires. It was not until I decided to inform my wife about my struggles, and the subsequent divorce, that I entertained suicidal thoughts, but unlike 75% of my fellow BPD sufferers,  I still could not pull the trigger. Instead, I engaged in all kinds of reckless behavior with the thought that I would welcome death if it happened. I also  made threats to myself and informed others that I was having suicidal thoughts but never reached the point of an actual attempt.  So what is the difference between thoughts and actions?

Again we need to look at the old formula – beliefs beget thoughts, thoughts beget feelings, and feelings beget actions. In my case, I think I shared the same beliefs with my suicide- attempting brothers and sisters. We believed that we were failures; we hated ourselves; and we no longer wanted to live out our painful lives. I think we probably shared the same thought patterns. That leaves feelings as the major component in the difference between thinking suicidal thoughts and actually carrying them out. And again, I think we probably shared the same feelings, but it was the depth of the feelings that made a difference. For these souls, hopelessness became despair; self-loathing became indifference; wanting to end the pain became the only solution, which was, of course,  the final solution. In my case, I was willing to ride it out, not believing that any good could come out on my life, but simply deciding to go through the motions and continuing in high risk behavior. Fortunately, in my case, time, the ultimate healer, eventually made the pain more bearable, and I waited around on this planet long enough that I began to sense that perhaps life was not so bad after all.

In my review of the literature, I have found some of the causes of the deeper feelings of hopelessness. The links between suicidal behavior and other factors such as childhood sexual abuse, depression, and substance abuse will be clearly defined in future blogs. For the time being, I think it is safe to say that BPD has several causal or at least correlational factors that may lead to suicidal behavior. We need to take steps that might help these people go through their life and death struggles.

Here are my five suggestions for bisexuals with BPD:

  1. We never give up. When life gets too hard to bear, we seek help.
  2. While we are still functioning, we find a kindred spirit, preferably someone who has been there, or we make a pact with a fellow sufferer that we will not go ahead with the final solution until we have sat down and talked and cried together one last time. Just expressing the negative feelings is the first step to accepting them as part of our lives that are painful but not necessarily hopeless.
  3. If there is no light at the end of the tunnel, we create one, be it ever so small, such as we wait for some event in the future that we can look forward to such as a graduation or our grandson’s birthday, something that we can celebrate.
  4. We begin to rebuild our belief system by finding and focusing on some positives in our life such as, perhaps, our creative abilities. I knew I was a good writer, and writing poetry was a way for me to survive the night and wake up the next day and start over again.
  5. We recognize that we have a higher self that is powerful and beautiful. And when life is just too difficult, we spend a few moments seeking out the person within, and we cry together.

 

[1] Black, Donald W.; Blum, Nancee; Pfohl, Bruce; and Hale, Nancy. Suicidal Behavior in Borderline Personality Disorder: Prevalence, Risk Factors, Prediction, and Prevention.  Journal of Personality Disorders > Vol. 18, Issue 3. 2018.

 

Bi-gender and Transsexual Procedures

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SHIRT & TIE [small] (final)In a recent article in Newsweek[1], Borreli noted that sex change increased by 20 percent from 2015 to 2016 in the U.S., with more than 3,000 operations performed in 2017. She also reported that some male to female transsexuals felt they would never be liked or accepted as real women. Borreli also reported that there is a lack of pre and post counselling, and that a significant number of male to female trans wanted to reverse the procedure.

A group of researchers in Sweden[2]discovered that the mental health of transsexuals after surgery was not what we would expect it to be. In a follow-up survey of 324 sex-reassigned persons (191 male-to-females, 133 female-to-males), they discovered that the overall mortality, particularly death from suicide, for sex-reassigned persons was higher during follow-up than for controls of the same birth sex. Sex-reassigned persons also had an increased risk for suicide attempts and psychiatric treatment. They concluded that physically changing the birth sex may not be sufficient for treating transsexualism, and advocated for improved psychiatric care after sex reassignment.

With the increased frequency of sexual reassignment and the data on mental wellbeing after transition, one must take a long serious look at this life-changing procedure. Many of the people involved in sex reassignment have been previously married and in a heterosexual relationship. In my mind this makes them bisexual, or to put it more accurately, bi-gender. Many do not make the transition for sexual reasons with little or no desire to experience sex in their new sexually reversed bodies. Most of the issues are gender related not sexual. As we have seen, gender feelings come from a genetic predisposition and then shaped and molded by life and cultural experiences. Perhaps it is enough to be like the hijra and just take on the clothing and gender roles without the sex change.

More and more of the sexually reassigned are young people, many of them in their teens. This may not be a good time for a sex change. Sexuality seems to be quite fluid at this age with many, especially women, experimenting with bisexuality. They may need to resolve these feelings and explore their gay or lesbian nature before deciding on a sex change. They may also want to experiment with gender role change before starting hormone treatments.

Sexual reassignment begins with hormone treatment. One person Borreli interviewed felt it was the hormones that made him act impulsively and go for the surgery that he later regretted. Hormone treatments affect the whole body not just the genitals. They also serve as neuromodulators thus affecting the neural circuits of the brain causing a major shift in mental functioning. These dramatic physical and mental changes may lead to massive confusion in the creation and changing of neural pathways. This may lead to depression, anxiety, and suicidal thoughts.

 

My five applications for bisexuals:

  1. Look for clarity in our sexuality. We can define ourselves sexually as heterosexual, bisexual, gay or lesbian. We can then seek sexual gratification based on this knowledge.
  2. Look for clarification in our gender roles. Are we masculine, or feminine, or are we bigender with fluid flow from male to female feelings of orientation? If we feel we are a man in a woman’s body, or a woman in a man’s body, or if we alternate from one gender role to another, we can explore and enjoy same sex and opposite sex relationships by changing our gender roles without hormones or sexual reassignment.
  3. If we truly want and need to experience sex, not as gay or lesbian, but truly as our transgender nature, than proceed with the sex change.
  4. If we are in a love relationship or we want to experience a love relationship according to our transgender nature, then have a sex change.
  5. Give it time. Be absolutely sure that this is how you want to live the rest of your life. Seek pre and post transition counselling. Make sure you have a professional and personal support system in place before starting the hormone transition.

 

[1] Borreli,Lizette. Transgender Surgery: Regret Rates Highest in Male to Female Reassignment  Operations. Newsweek. April, 2018.

[2] Dhejne, Cecilia; Boman,Marcus; Joohansson,Anna l.; Langston,Niklas; and Landen, Mikael. Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden. Plos. February 22, 2011.

 

The Virtue of Discernment and Human Sexuality – Revisited

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SHIRT & TIE [small] (final)Fear is the chief emotion that keeps us from reaching for self-actualization. It creates coping mechanisms that are subconscious in nature. These fears and mechanisms eventually become ingrained to form our belief systems. These are extensive neural pathways that subconsciously are activated by stress that impede our natural body and soul desires. To live with fear we create group and individual stories to make sense of our chaotic world. Once we understand our own story and how we use that story to survive, we can begin to understand how everyone else is living in their own illusions and fears. Thriving is this environment is not easy, but once we master the virtue of discernment, we can actually enjoy living in the chaos.

Animals are so lucky.  They mainly live in the moment through instinctual reactions to their senses.  They have some memory, particularly for smells, faces, and some rudimentary signs, but they simply respond according to their instincts. They do not have to evaluate and judge before making a decision. We humans, however, have a control mechanism in the frontal cortex that we can refer to as the administration center, the mind, or the ego. The mind directs the brain to create neural pathways in our amazing cerebral cortex, linking new sensory information with past memories to create a platform for interpretation of the information coming from the senses. Important new information that is needed for survival or excelling is then linked to emotions and stored in memory.  The accumulation of information leads to the forming of concepts which we link together to create beliefs, attitudes and values. In our own reality, every thought is grounded in a collection of experiences and memories that create a story and as such is more like a fantasy novel than a real life experience. This has been a good thing for surviving and avoiding saber-toothed tigers, but too much of a good think can become a bad thing, and perhaps even a curse.

In a sense, we are no better than the animals in that we automatically respond through our subconscious beliefs. Because we live in a complex society with complex relationships and feelings, the mind is forever on the alert, always judging and deciding the best route to avoid danger, and forging the best path to becoming alphas in our pack. Because of the immense anxieties related to our new roles, we have lost the ability to act and adapt. We are stuck in the circle of thought that is governed by our beliefs; we are living in an on-going fiction novel. We no longer have the ability to perceive reality naturally, let go of the mind, and just experience life through our senses. We now have to find ways to do this consciously while avoiding the saber-tooth tigers in our minds.

The hardest part about discernment is being able to discern between the truth and the fiction coming from our own minds.  The only way we can do this is through developing the powers of discernment. In order to live contented and peaceful lives we have to stop the insanity of the never ending story. To do this we simply stop the mind and open up all our senses without judgement or the need to react.  We just let ourselves relax into the moment. Only then do we begin to perceive reality.  Only then do we begin to see ourselves as beautiful creatures endowed with tremendous physical, mental, and spiritual power and beauty. Only then are we able to decipher between the chaos of the story and the order and peace of reality, and only then are we able to judge and make decisions based on this true reality.

The key then is to use the power of discernment to become aware of these negative feelings and vibrations coming from within, and from others, and take measures to understand and counter balance them with positive vibrations from our higher self. The rational mind cannot be trusted as it will inevitably channel its decisions through the emotions and through memory of past experiences.  We cannot trust our emotions. When we are branching out to new territory there will always be an element of uneasiness and even fear. At times like these, we have to rely on the tools of the higher self which are imagination and intuition or discernment. We can learn to trust our “gut feeling” by listening to our feelings.  Our feeling are always binary in nature. We will either have a positive or negative feeling about a situation. If it is negative we should examine it to be sure that it is not just the work of our mind and its emotions. We subdue our emotions then ask our higher self for clarity, empty our mind, and wait for a response. If it is still negative we stop or put the decision on hold. If it is positive we forge ahead with power and confidence thereby setting out with our whole being (body, mind, and spirit), towards the next challenge in our never-ending process towards self-actualization.

Discernment and Sex.

Once we have mastered control over our own story, we can begin to understand our sexuality and our sexual relationships. But before we do that, we have to realize that we are also a part of a group story.  Society is composed of group stories and fears resulting in a group mind-set designed to desperately hold onto the safety of the status quo. To maintain the status quo, society depends on control and power exercised through the institutions of family, church, education, the media, and the government. When our sexual desires threaten these basic structures of society, we can expect a negative reaction in the form of prejudice and discrimination. Fear will turn to shunning, marginalizing, or anger and hate for anyone that threatens that security.

There are two views coming from society and neither is true or healthy.  Society’s views on sex, especially from the media is one of sexual freedom regardless of the effect on the soul. We are encouraged to explore sex just for the pleasure without seeking deeper levels of intimacy. Having multiple partners is not only accepted but held up as the natural standard of human behavior. This sexual freedom suggests that all forms of pleasure can be indulged in without thought of consequence. This includes pornography, prostitution and the wide range of fetishes. If we use our power of discernment and rely on our gut feeling, most of us would feel uneasy in indulging in some of these behaviors.

The second comes through family and religion and is based on the need to control sexual behavior for the good of the group. It is based on the concept that sexual freedom is dangerous and unhealthy. It relies on the church to establish guidelines that we can refer to as mores or morals. The key is to restrict sexuality which usually becomes the responsibility on women to control where and when sexual relationships are allowed. The idea is often conveyed that sexual behavior is somehow dirty and should be reserved for human procreation and preferably under the confines of family values. If we use the power of discernment, we realize that human sexual experiences are also the property of the mind and soul as well as the body. There is an element of pleasure for the body, happiness from the heart, and intimacy from the spirit. These forms of joy may be experienced in isolation or together. There are no restrictions from the body on the number of relationships or experiences; however, we only arrive at true bliss through a combination of all three.

Because society’s obsession with sexuality, members of the LGBQT still face discrimination and hate. Because hate has now been stifled by popular opinion, it has gone underground and resurfaced in inappropriate humor, indifference, or even pity, all of which contribute to our feelings of isolation and helplessness. We are even willing to accept the label of “queer” out of defiance and misplaced pride. The gay movement, however, has made huge inroads in the basic institutions, to the point where the external fight appears to be basically over. Most families have accepted their gay children, most of the churches have welcomed us back into their folds, the media is trying to exorcise its demons by giving us special treatment, and the laws have been changed. However, the suicide and depression rates are actually increasing.  We have won the right to marry but our divorce rates for lesbians (gay men seem to do better than heterosexuals but there is some controversy about the results) are twice that of the heterosexual population [1].  We are still suffering from extreme loneliness and many (and perhaps most) of us feel or have felt some degree of helplessness and hopelessness. Why?

I think it is probably because we are being tolerated and not really accepted by society. The fear often turns to indifference and even pity, both of which tend to make us feel isolated and misunderstood. This includes those we love the most.  Our loved ones tend to avoid the issue of our gay or lesbian side or they question us as if they are trying desperately and unsuccessfully to understand our behavior. The uneasiness, intricate voice tones, and the body language that we perceive subconsciously are wearing us down. In one article I read, our mental-emotional state is being compared to soldiers who are suffering from PTSD.  Subconsciously we are in a battle for survival. It is not one big trauma but a lifetime of small traumas that have worn us down. We are constantly receiving negative vibrations from our heterosexual friends and family, and even from our own tortured gay and lesbian companions. These vibrations wear on our nervous systems until we crash.

Here are my five steps on developing the power of discernment:

  1. We take time to build up our self-image and self-esteem before going to work, or church, or visiting members of our family. We take time to stay physically and emotionally healthy through diet, exercise, and scheduled quiet times. A healthy body and mind will make discernment and clarity mush more likely.
  2. We have to be 100% sure that we are indeed beautiful and wonderful spiritual human beings. This provides a constant flow of positive energy that can balance the negative energy coming our way throughout the day.
  3. If we have trouble changing the story, we persist. We use repetition until the new story replaces the old story. We need time to do this. After mediation I like to take time (while my mind is at rest and my spirit is active) to contemplate, challenge, and change, if necessary, my belief systems.  I like the mornings. I simply review my  experiences and beliefs of the previous day. I then set a new course for the new day.
  4. It is usually not a good idea to ask others about our beliefs as they will respond from their own mind set. It is better to trust our inner self which will respond to our own needs out of genuine self-concern and self-love.
  5. We seek knowledge. We become a student of life, especially our own life. If there is an area of concern, we find reliable information from books and other programs. We learn to discern where the authors are coming from with their own traits and biases. We try to integrate this information into our own new belief systems.

Here are my five suggestion for discernment and sexuality:

  1. We acknowledge that our sex drive is a good thing. It is healthy and natural. No ifs or buts. No blame or shame. If we do not have a healthy and enjoyable sex life it is probably because we do not have a good healthy story. We do not destroy the story; we simply rebuild it with checks and balances. In other words we control it; it does not control us.
  2. We seek those who are like-minded and like-souled for intimate relationships. It can be sexual or nonsexual, but it has to be within the higher self, beyond the urges of the body and the sorrows of the ego.
  3. We shut down the control center to step outside the story and just respond to the beauty and the energy of our sex drive. We set out to deliberately live an active and satisfying sex life.
  4. W realize that sex  is not just the sensuous pleasures of the body  but also includes the oxytocin bonding that forms the happiness feeling from the heart, and those wonderful spiritual feeling s of joy that we can feel as we lie in close contact with our lover after orgasm.
  5. And finally, we enjoy! The purpose of life is to enjoy, to be spontaneous.

 

Here are my five suggestion on discernment for the LGBQT community

  1. We are not just “queers”; we are  beautiful people. We are the ones who can see both sides of the equation. We are the ones with answers to some of life’s most difficult questions. We are the ones with the genes that need to be passed on to the next generation if this species is to survive.
  2. We have to see and understand the reality of our sexuality. It is a biological process of copulation and reproduction, and yes, if we take our cues from the animal kingdom, that includes same sex attraction. But we have made it part of our story. We have created theories of orientation and gender. We don’t need it and if we employ the powers of discernment we will come to the conclusion that we don’t want it. It robs us of our ability to be spontaneous and to enjoy the wonderful senses associated with sex and relationship.
  3. As members of LGBQT community, we have developed a very complex story in order to survive. We can stop the story. Whenever we hear the cues like, “I will never be good enough”, or, “it’s no use”, or, “it’s all my fault”, we stop the story immediately, recognize the belief or lie, and then state the true reality: “I am a magnificent human being”, “I am always good enough”, “I can do anything worth doing”, “there is no fault, there is only trial, error, and the accumulation of knowledge and wisdom”.
  4. Because our sex drives are different, the straight population will experience some degree of uneasiness when we are around them or their children.  We must understand that their uneasiness is based on fear and is subconsciously a threat to their beliefs and mindset, and therefore to their ego’s sense of survival. We must recognize their struggle and conflict of beliefs and emotions. We accept the uneasiness and try to eliminate the fears. We send our positive energy to them in the form of love to balance the negative energy of fear. We continue our relationships and perhaps even increase the time we spend with them. We use the time to naturally express our own feelings and encourage them to express and unconditionally accept theirs, while maintaining the positive flow of love energy from the higher self. Eventually the fears will break down allowing genuine bonds of love.
  5. If we are bisexual with a heterosexual partner, we have to understand they may be struggling to understand and accept us just the way we are. We have to be patient with their struggles and realize they are trying to settle some of their subconscious fears. We respond gently and lovingly. Sometimes we or they may break down because of the triggers that may reopen old wounds. We have to accept that these will happen and that they are an opportunity to heal and even to go deeper in the relationship.