Borderline Personality Disorder and Anxiety


(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 and Episodal Dysphoria


This is the ninth in a series on BPD and Bisexuality

Today we want to take a look at the sixth symptom  for Borderline Personality Disorder on the DSM IV, namely: “affective instability due to a marked reactivity of mood (e.g. intense episodic dysphoria, irritability or anxiety, usually lasting a few hours and only rarely more than a few days)”. In the DSM 5 the symptoms are covered in pathological personality traits in the domains of negative affectivity, emotional liability, anxiousness, separation insecurity and depressively. Each of these seven traits (anxiety is the only trait specifically listed in both) deserves to be treated individually; so today we will begin with episodic dysphoria.

Episodic refers to episodic memory which is our life story that we play over and over again in our minds. It includes major events, places, and experiences. Dysphoria on the other hand is when everything in life seems to be falling apart, like the world is working against us.  This seems to suggest that our life story itself is filled with feelings of continuous failure, shame, hopelessness and helplessness.

Speaking from my own experience, I simply ignored my life story until I could no longer hide from the pain that was always there just below the surface. For many years, I survived by will, religion, and the comfort of my marriage and family. I buried my past. All my accomplishments including numerous awards, athletic achievements, and three university degrees I simply looked at as failures because they lacked perfection and only perfection would allow me to feel proud of myself.

After I crashed, I finally looked at my roots and came to terms with the cause of my episodic diaspora. I began to see my accomplishments as amazing achievements overcoming the odds of being born in poverty to a single parent mother with nine children.  But above all, I was able to look at my self and see that I had a beautiful mind and an even more beautiful soul. I began to truly live and enjoy the life I had been given.

I was also able to accept my bisexual gender not as something that added to my shame, but as a tremendous gift allowing me to make intimate connections with both men and women. 

My five suggestions for bisexuals:

  1. We need to be more gentle with ourselves.
  2. We con rewrite our life story. We can  take a look at the events in our life with a new perspective. We can visit things that are equated with shame and and remorse and see how we did the best we could under the circumstances. There really is a silver lining.
  3. If there are areas that still stand out, we can forgive ourselves. It’s okay to make mistakes as long as we learn from them.
  4. We can learn to see ourselves as beautiful creatures with beautiful minds and beautiful souls.
  5. When we reshape our story, we can put in positive outlooks throughout the years, total self acceptance in the present, and dream about the possibilities of a bright future. 

Borderline Personality Disorder, Disinhibition, and Suicidal Behavior

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, Bisexuality, and Suicidal Behavior

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.

 

Borderline Personality Disorder and Relationships

SHIRT & TIE [small] (final)(This is the fifth in the series on the relationship between bisexuality and Borderline Personality Disorder [BPD].)

In previous blogs, we have established a link between BPD and bisexuality. We have looked at two symptoms for BPD on the DSM4: symptom 1 –  fear of abandonment, and symptom 3 – identity disturbance or poor self-concept.  Today we want to look at the second symptom which is “a pattern of unstable interpersonal relationships characterized by alternating between extremes of idealization and devaluation”. The DSM5 describes it as, “Intense, unstable, and conflicted close relationships … alternating between over involvement and withdrawal”.  From my review of the literature, it appears that difficulty in interpersonal relationships may be connected to problems with the mechanisms involved with bonding. This goes back to childhood issues such as abuse or neglect.

The relations between parental bonding and attachment constructs and borderline personality disorder features were examined by Nichol et al in 2002[1].  In a sample of 393 18-year-old’s, low parental bonding and attachment scores were associated with borderline features including insecure, anxious, or ambivalent attachment, and a perception of a relative lack of caring from one’s mother.

So what is happening biologically for people with BPD.  Bartz et al investigated the effects of intranasal oxytocin (OXT) on trust and cooperation in borderline personality disorder (BPD)[2]. Their data suggests that OXT does not facilitate trust and pro-social behavior in BPD’s but may actually impede it. They suggest that this may be due to possible neurochemical differences in the OXT system.

So where does this difference originate and how does it occur? First of all, we have to view OXT not only as a hormone generated by the pituitary gland but also as a neuromodulator. In plain English, that means that OXT affects the functions of the brain. This is usually done through the excitement or suppression of neurotransmitters.  In other words, OXT works differently in people with BPD by suppressing rather than exciting the transfer of messages within the brain and from the brain to the rest of the body.

We know that OXT is involved in bonding and that bonding to one’s mate creates aversion to any other potential sexual partner. When we look at aversion, we can get some clues from the rats and wolves[3].  In the case of wolves, one experience with tainted mutton made them swear off sheep for the rest of their lives. We all have experienced a nauseating sensation after an intense emotional experience and what could be more emotional than feeling rejected by one’s own mother? Could it be that when the outflow of OXT between mother and child during early childhood is accompanied by rejection that it literally leaves a bad taste in the mouth of the child by affecting the digestive system?

So how does this apply to our sexuality? We  know that sexual attraction usually involves a release of OXT. We also know that OXT can result in aversion and even nausea when presented with an opportunity for sex with members of the opposite sex for gays and lesbians and that some heterosexuals experience similar reactions about have same sex experiences. Could this indeed be the workings of OXT?

Gays, lesbians, and heterosexuals usually have no trouble bonding, and it is the work of the bond that creates the sense of aversion, and it is the aversion that creates the emotional reaction. What about bisexuals? Because we have difficulty bonding we also have no aversion mechanisms. Therefore, we can have sex with either men or women without experiencing overpowering negative emotion. We still have the OXT rush but not biologically imprinted restrictions. We have no difficulty devouring the delirious meal set before us.

What I am suggesting is the people with BPD have difficulty forming lasting relationships because we have difficulty bonding. The OXT release has the opposite effect, we simply associate it with rejection and have an aversion to bonding itself. We enjoy sex for the sake of sex but reject the bonding that goes with it. We burn our bridges and walk away from potentially painful experiences.  That does not mean, however, that we cannot have lasting relationships. It just means that we have to work harder to form stronger and more encompassing emotional and mental bonds in spite of the negative flow of OXT.

My five suggestions for bisexuals.

  1. We don’t give up on the bond. We can still  form mental and emotional bonds by creating and repeating feelings of love for our partners .
  2. If we feel emotional aversion, we can accept it, face it, and understand where it is coming from. We can then choose to recreate a feeling of love. Every time we do this, it reinforces our love bond.
  3. We do not let our aversion feelings interfere with our sex life. We focus on the physical and emotional pleasure and use this experience to again reinforce our love bond.
  4. We keep focusing on the positive aspects of our relationship and consciously build our mental-emotional bond.
  5. We do little things to show our partner we love them. Flowers and chocolate works for women and a good back rub does wonders for a man (by the way men like chocolate too, and women like back rubs).

 

 

[1] Angela D. Nickell, Carol J. Waudby, Timothy J. Trull, (2002). Attachment, Parental Bonding and Borderline Personality Disorder Features in Young Adults. Journal of Personality Disorders: Vol. 16, No. 2, pp. 148-159. https://doi.org/10.1521/pedi.16.2.148.22544

 

[2] Bartz, Jennifer; Simeon, Daphine; Hamilton, Holly; Kim, Suah; Crystal, Sarah; Braun, Ashley; Vicens, Victor; and Hollander, Eric. Oxytocin can hinder trust and cooperation in borderline personality disorder. Social Cognitive and Affective Neuroscience, Volume 6, Issue 5, 1 October 2011, Pages 556–563, https://doi.org/10.1093/scan/nsq085

 

[3] Gustavson, Carl R.; Sweeney, Michael; and Garcia,John. Prey-lithium aversions. I: coyotes and wolves 1. Behavior Biology, Vol 17, 1976.

Borderline Personality Disorder and Bisexuality 4

SHIRT & TIE [small] (final)(This is the fourth in the series on the relationship between bisexuality and Borderline Personality Disorder [BPD].)

In the previous blogs, we have established a significant correlation between bisexuality and BPD. In the last blog, we looked at the first symptom for BPD from the DSM4 which was, “Frantic efforts to avoid real or imagined abandonment”. Today we want to look at the third symptom, “identity disturbance: markedly and persistently unstable self image or sense of self”.

The DSM5 describes self-identity under “Significant impairments in personality functioning”. The markers are “Markedly impoverished, poorly developed, unstable self-image, often associated with excessive self-criticism; chronic feelings of emptiness; and dissociative states under stress.” The key here is self-identity. There was a catch phrase in the 1980’s that said, “he is trying to find himself”. For us bisexuals, this can be a lifetime pursuit. Not only do we often have to deal with BPD, but we also struggle with our sexual identity.

In my definition, there are two aspects to self-identity; namely, how I present myself to others, and how I view my own sense of being. The first is usually defined by occupation, family roles, and societal roles. People with BPD usually try to be everything to everybody in order to please. Unfortunately, we lose our sense of our inner self. When our outer self is threatened, we have nothing to fall back on so we crash.

When we look at some of the other descriptors, we see “impoverished and unstable self-image”. There is no, or only a limited, sense of inner self. As seen in a previous blog, these feelings usually originate due to abuse or neglect during childhood. The bonding with our parents gives us a foundation, a sense of having a loving bond that we can build on during childhood, teen years, and early adult life. We gradually sort it out and come up with a feeling of who we are and what we stand for. However, without this firm foundation, the self-structure is limited and usually lacks confidence and a sense of what it feels like to be loved.

The next descriptor is “chronic feelings of emptiness”. We lack confidence in our self and have difficulty building on past successes. We reject positive compliments and focus on  the negative.  The result is that we go from moment to moment looking for affirmation but never really digesting it. We look for love but never really accept that we are indeed lovable and worthy of being loved.

The last point is “dissociative states under stress”. This is the one where our bisexuality really complicates the matter. Because we lack a sense of self, we tend to have difficulty dealing with stress, especially when it comes to our sex life. It seems that in order to function as heterosexuals, we have to create a heterosexual identity, and when we enter the gay or lesbian world, we create a significantly different persona. Bisexual men tend to seek love and intimacy and bisexual women tend to seek and protection and security in the heterosexual relationships, and when we want power and passion, we go gay or lesbian. When we are under stress and need to restore our chemical balance by going from the sympathetic to the parasympathetic system, we usually go for same-sex erotica. This helps us escape anxiety for a few precious moments, and also stimulates the pleasure centers or our brain.  We then form a dissociative relationship between the two identities to cope with the stress and avoid guilt and shame. This works for awhile, and then we will inevitably crash.

Let’s face it, there are a significant number of bisexuals who have to deal with the BPD component of their psychological makeup. The key is to bring the two sexual identities together. We can do this by creating neural pathways involving feelings of acceptance and gratitude to replace the feelings of guilt and shame.

My five suggestions for bisexuals:

  1. If you are bisexual and have no self-identity issues and no BPD problems – enjoy.
  2. If we struggle with self-identity, 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. We become our own parent.
  3. We flood our self with self-love from the higher self. We practice looking in the mirror and seeing the higher self within. We tell our selves we love our self over and over again until we believe and feel the higher self healing and cleansing the neural pathways of our brain.
  4. When confronted with a moment of self-hate, self-loathing, or self doubt we stop it. We tell ourselves that we are better than that; in fact, we are beautiful, powerful, and in complete control of our emotions and feelings. We make a conscious decision to let go of the negative feelings of self-loathing and shame and embrace the positive feelings of love from our higher self.
  5. We bring the two sexual identities together and accept our bisexuality as part of our self, and yes, even, or especially, a part of our higher self. We release the power of our sexual identity and sexual passion  as a motivator for loving our self and sharing our love with others.

Borderline Personality Disorder and Bisexuality 3

SHIRT & TIE [small] (final)(This is the third in the series on the relationship between bisexuality and Borderline Personality Disorder.)

 

As we have seen in the studies quoted in past blogs, there is a definite connection between Borderline Personality Disorder (BPD) and Bisexuality. The first symptom listed on the DSM4 is Fear of Abandonment.

With bisexuals and other members of LGBQT community, this fear usually originates in childhood abuse or neglect. In the object (relations) constancy theory, the child develops a psychological representation of the parent that satisfies the need for contact when separated. With neglectful parents the child may not be able to develop relations constancy and therefore may suffer from separation anxiety that could eventually lead to fear of abandonment. The DSM5 defines this fear as “Separation Insecurity”. It includes “fears of rejection by – and separation from – significant others, associated with fears of excessive dependency and complete loss of autonomy”. There are two significant aspects to this symptom, namely fear of rejection and dependency.

Some degree of abandonment fear can be normal, but when fear of abandonment is severe and frequent, it can lead to a whole host of problems. A person who has experienced abandonment may be more likely to have long-term mental health issues. They may have mood swings or be unable to control their emotions. Self-esteem can also be affected making it harder to feel worthy or to be intimate. These fears could make a person prone to anxiety, depression, co-dependency or other issues.

Abandonment fear usually affects a person’s ability to form, lasting relationships. They may feel “other” or disconnected from those around them. They may have difficulty trusting others, and in extreme cases, may exhibit some form of paranoia. Adults who are afraid of being abandoned may over work to keep their partner from leaving or, in the case of bisexuals, we may go to extremes to hold onto the relationship often abandoning our own physical and emotional needs. People with the fear of abandonment may tend to display compulsive behavior and thought patterns that sabotage their relationships. Any slight may be interpreted that their partner no longer loves them. From the partner’s point of view, the sudden personality shift seems to come from nowhere. She may be confused as to why her partner is suddenly acting clingy and demanding, smothering her with attention, or pulling away altogether.

If the fear is mild and well-controlled, one may be able to control it simply by becoming educated about their tendencies and learning new behavior strategies. For most people, though, the fear of abandonment is connected to deep seated issues. Therapy may be needed to build the self-confidence needed to truly change destructive thought and behavior patterns.

My five suggestions for bisexuals:

  1. We get in touch with our higher self and practice self-love and self-care and make sure our own wants and needs are met.
  2. It is important to talk about our fears. we need to have at least one significant other who is bisexual and who understands the issues we face.
  3. We may wish to be a part of a support group that deals with abandonment issues.
  4. We can become passionate about our own lives. We systematically build self-confidence and believe that we are strong enough to cope with whatever life throws our way.
  5. If we cannot control our fears we can seek therapy. We can search for therapists who use Dialectical Behavioral Therapy (DBT)  which is designed specifically to help those with BPD. Therapy sessions provide skills and practice focusing on stress management, emotion regulation, and interpersonal skills.

Borderline Personality Disorder (BPD) and Bisexuality 2

SHIRT & TIE [small] (final)

(This is the second in the series on the relationship between bisexuality and Borderline Personality Disorder.)

A study by Zubenko et al [1], using the sexual histories of patients who met standardized criteria for borderline disorder, found that 17 of the 61 men (21%) were homosexual, and 4 (5%) were bisexual compared with 7 (11%) of the 61 women. They concluded that homosexuality was 10 times more common among the men and 6 times more common among the women with borderline personality disorder than in the general population or in a depressed control group. Another study by Reich, and Zanarini,[2] concluded that same-gender attraction may be an important interpersonal issue for approximately one-third of both men and women with BPD. There were no significant differences between homosexual or bisexual orientation.

We can see from these studies that about a third of the people with BPD have some form of same-sex attraction. I was not able to locate information on the reverse to see how many bisexuals would be diagnosed with BPD, but I think we can extrapolate that the number is indeed significant. It is my belief that the majority of bisexual men and women may exhibit at least “some” of the BPD symptoms, even if they do not reach the level of a disorder where it would seriously affect their ability to function psychologically and socially.

So let’s take a look at the symptoms listed in the DSM4 (this appears to be much clearer that the DSM5). In general, it is, “A pervasive pattern of instability of interpersonal relationships, self image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five(or more) of the following:

  1. Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
  2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
  3. Identity disturbance: markedly and persistently unstable self image or sense of self.
  4. Impulsivity in at least two areas that are potentially self damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or selfmutilating behavior covered in Criterion 5.
  5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
  6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
  7. Chronic feelings of emptiness.
  8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
  9. Transient, stress-related paranoid ideation or severe dissociative symptoms “

The first of these is a fear of abandonment. We will look at this one in detail next week.

Here are my five suggestions for bisexuals:

  1. Do an inventory on the nine symptoms. Give yourself a rating between 1 and 10 with 10 being severe and frequent.
  2. If your score is 25 or greater you may have a Borderline Personality Disorder.
  3. If so you may wish to consider getting counselling.
  4. Write down the symptoms that you have noted. We will be covering these items in future blogs.
  5. If you know someone with BPD you may want to give them this website address.

[1] Zubenko, George S.George, Anselm W.; Soloff, Paul H.; and Schulz, Patricia. Sexual practices among patients with borderline personality disorder. APA PsycNet, 2018.

 

[2] D. Bradford Reich, MD; Mary C. Zanarini, EdD. Sexual Orientation and Relationship Choice in Borderline Personality Disorder Over Ten Years of Prospective Follow-Up.  Journal of Personality Disorders December 2008. Guilford Press Periodicals. Vol 22, Issue  6. 2018

Read More: https://guilfordjournals.com/doi/abs/10.1521/pedi.2008.22.6.564

Creative Imagination and Bisexuality

SHIRT & TIE [small] (final)(This is the sixth in the series on applying Napoleon Hill’s principles for financial success to how we can shape our bisexuality into creating a life that we would truly love to live.)

According to Napoleon Hill, there are two types of imagination – synthetic and creative.[1] Synthetic imagination involves the arranging of old concepts, ideas, or plans into new combinations. To use this form of imagination, we have to rely on the words and actions of others combined with our own past experiences. This is what the brain typically does best. It takes in new information and uses synthetic imagination to build on past experiences to make moderate changes to enhance life. This works well if we love the life we are living; however, if we feel a deep discontent with our past and present, we will need to make a paradigm shift. This requires creative imagination which inevitably will bring us into conflict with our ego mind which wants to maintain the status quo with only moderate changes.

This yearning and discontent can then be transformed into desire and become a powerful energy source for change. This activates our higher self which will always operate for our higher purpose. It then sets to work using creative imaginations to create new ideas.  Eventually, these ideas can come together to formulate specific goals and plans. Hill suggests that when we put our plans into detailed writing with a specific time frame, the higher self then connects with the infinite intelligence causing our minds to vibrate at higher frequencies. The universe or infinite intelligence then seems to give life and guidance to our ideas that can help us transform our plans into reality.

So how does one then apply creative imagination to our sex life? As bisexuals, we often feel strong discontent with ourselves and the lives we are living.  We often feel powerless in making the changes we will need to make in order to bring about the necessary changes. In fact, it is change that we fear most. This is where we have to allow our discontent to transform into a desire for change. Once this desire is strong enough, our higher self will get engaged to bring us back to our life purpose which is to grow and expand through love for self and love for life. Once this desire grows in vibration, the higher self will begin to call in direction and knowledge from the infinite intelligence. The higher self then employs creative imagination to turn these vibrations into ideas. From these ideas we can begin to make plans to change our lives and create the kind of life that we would truly love to live.

Here are my five suggestions for bisexuals:

  1. We can allow our discontent to surface until it becomes a desire for change. We allow our higher self to take control and employ creative imagination to formulate plans for change.
  2. We put them in writing and set a timeline for change.
  3. We put these words someplace where we will remember to read them just before going to bed so that the higher self can work with the infinite intelligence to bring this plans into reality even while we sleep.
  4. We review the plan again in the morning and wait upon the higher self to give direction through hunches and insights. We can act upon these insights and keep doing this until the plans have all been brought into the physical world.
  5. We celebrate our victories and make new goals and plans. We are now in the process of creating the life we would truly love to live.

 

 

[1] Hill, Napoleon. Think and Grow Rich. Dover Publications INC.. New York. 2015

 

Knowledge and Bisexuality

SHIRT & TIE [small] (final)(This is the fifth in the series on applying Napoleon Hill’s principles for financial success to how we can shape our bisexuality into creating a life that we would truly love to live.)

“Knowledge will not attract (our desire) unless it is organized, and intelligently directed, through practical plans of action to the definite end of (living the life that we love to live)”.[1]

If you are reading this article, it is probably because you are seeking knowledge about bisexuality. But how much do we actually have to know in order to live the life we would love to live? What we are seeking is not knowledge but to actually educate ourselves. The Latin word educo means “to draw out or develop from within”. That knowledge on how to live the life that we would love to live is already there inside of us; we just have to draw it out.

According to Hill there are two types of knowledge – general and specialized. What you are seeking in this article is specialized knowledge. I am a psychologist and a bisexual; therefore, by processing the information I have gathered and applying it to my own life, I hopefully have some specialized knowledge to tell. In truth, yes, I do have some specialized knowledge, but my main goal is to help you educate yourself by helping you draw out what you already know and applying it to your own life.

First of all let’s decide on the sort of specialized knowledge we require and the purpose for which it is needed. Yes, it helps to know that we are not alone, and approximately five percent of men and 15 percent of women heterosexuals have at some time experimented with same sex relationships. If we do the math. one of every ten people may be considered bisexual. Knowledge will also help us know where we can meet other bisexual people for relationship, companionship, and just general support in developing new thought patterns. But what else is really necessary?

What we really want to do is develop our general knowledge. We need to somehow come up with a new thought about ourselves and how we can handle the circumstances of our present situation. If we are burdened with a bunch of negative thoughts and feelings about ourselves, we have to somehow change the way we think. We have to overhaul our general knowledge mechanisms. We need to think new thoughts.  This new thought then has to be nurtured and organized into a new self-concept that we are indeed worthy, powerful, and beautiful.

The place to start is with our discontents and dissatisfactions. What is impeding us from being the people we want to be? We need to take inventory. Every time we have a negative thought about ourselves, we have to challenge it. We need to apply some good old cognitive therapy. For example, “I hate myself,” becomes, “I have a negative feeling whenever I think about gay or lesbian sex”. Okay, we are making progress. Now we can challenge that thought “Why do I feel bad whenever I think of gay or lesbian sex?” The answer might be, “Because my friends make a lot of gay jokes, and if I want to be with my friends, I have to stop having these thoughts.” Aha! Now we are getting somewhere. Where do these thoughts come from? Well they come from our basic biological make up and have developed over time to being a core part of our being. We can therefore conclude, “If my friends are real friends, they will have to love me for who I am, if not they are not real friends anyway.” Whenever we challenge our negative thoughts, we should always come back to the essential core belief of generalized knowledge, namely, “I am in complete control of my mind; I can control and direct all my thoughts; I am powerful and I am beautiful; and my bisexuality is a gift to be nurtured and enjoyed”. All our thoughts have to be in harmony with this core belief.

We can then use the power of our imaginations to organize and put this new knowledge to work. The next step is to take action. We tell our friends how we feel and engage them in some honest discussion. They may respond with their own feelings and fears. Women do this naturally, we men have to work at it to make it happen. Above all, we make a commitment to ourselves to live honestly, walk tall, and speak from the heart. In other words we have “organized, and intelligently directed” our thoughts and formulated “practical plans of action to the definite end” of living the life we would truly love to live.

[1] Hill, Napoleon. Think and Grow Rich. Dover Publication, Inc. 2015. (Page 64).

My five suggestions for bisexuals:

  1. We challenge our negative thoughts and turn them into positive ones.
  2. We develop our self-concept by understanding ourselves, the way we think, and how we organize our thoughts. If our self-concept is negative we change it. If it is positive we celebrate.
  3. We refuse to accept anything that lowers our self-esteem. We actually should learn to admire ourselves for what we have accomplished and the hardships we have overcome or are in the process of overcoming.
  4. We put our new self-concept and our new self-esteem into action. We deal with issues and with our relationships with confidence. We do not fear criticism; we welcome it. It is our opportunity to grow.
  5. We plan our life and take steps to make it the kind of life we love to live.