Bisexuality and BPD – Make a Plan and Stick to It

Borderline Personality Disorder (BPD) – Pathological personality traits in Disinhibition – impulsivity: acting on a momentary basis without a plan or consideration of outcomes (DSM5).

The Problem

                As mentioned in previous blogs, over 2% of the population have some degree of Borderline Personality Disorder (BPD) and roughly a third of those with BPD are also bisexual. There are no stats for the reverse – the number of bisexuals with BPD – but my guess is it would be even higher. We often engage in harmful behaviours to ease distress in the short-term, despite the possible serious negative consequences in the long-term. Of the BPD population 8 to 10% of us eventually commit suicide – this rate is more than 50 times the rate of suicide in the general population and 10 times the rate in people diagnosed with Depression, and that does not even include those of us who depart because of drug overdoses. One of the defining traits that is connected with suicide attempts is impulsivity. In this blog we are going to take a look at how this trait of BPD affects us as bisexuals and we are going to focus on developing plans and strategies with due consideration of outcomes. First let’s take a look at the science to see what we are up against.

The Science

                Cackowski and others[1] used self-reporting to study 31 unmedicated women with BPD and 30 healthy matched women controls using measured response inhibition under resting conditions and after experimental stress induction.  Patients with BPD reported higher impulsivity under both conditions. They concluded that there is a significant impact of stress on self-perceived state impulsivity and on response disinhibition in females with BPD.

                So what is happening in the brain? Leyton and others[2] studied 13 medication-free men and women with borderline personality disorder and 11 healthy controls using positron emission tomography (PET Scans) during a survey of go/no-go commission error activities. In both men and women, negative correlations with impulsivity scores were identified in the medial frontal gyrus, anterior cingulate gyrus, temporal gyrus, and striatum. They concluded thatsynthesis capacity in corticostriatal pathways may contribute to the development of impulsive behaviors in persons with borderline personality disorder. In the male subjects, low trapping was also observed in the medial frontal cortex extending into the orbitofrontal cortex, as well as in the corpus striatum. These sites correspond to regions that seem to be involved in  mediating the planning, initiation, and inhibition of goal-directed behaviors, working memory, and emotional affect.

What it Means

                So what does this mean in plain English? Well friends, we have a problem. Not only do we engage in risky behavior, not only do we seem to intentionally neglect to plan ahead, but under stress we seem to forget all the plans that have been planted in our brains by past experiences and the good intentions of therapists. As bisexuals this is often connected to our sexual behavior. We tend to seek encounters to relieve stress and we tend to avoid safe sex to add a risk factor that adds a level of excitement and pleasure. There is a reason for this. It is the way we are wired. Because of our genetic predisposition to be over sensitive, and the environmental factors that have shaped our behavior patterns, we now have a brain that says run like hell from pain, indulge in pleasure, and to hell with the consequences. The brain scans indicate that both men and women have difficulty reacting to sensory information to controlling emotions (corticostriatal pathway). Women seem to rely more on an emotional response whereas men run into further difficulty when we try to organize that information for decision making (frontal cortex extending into the orbitofrontal cortex). We both end up in the same place with seeking emotional relief usually by avoiding pain and seeking pleasure regardless of the consequences (temporal cortex, limbic areas). This seems to be particularly relevant under stress. As bisexuals we actually seek the pleasure and stress that goes with is rather than try to avoid it. So how do we combat our natural reactions, especially under stress?

Here are my five suggestions for bisexual borderliners:

1. First line of attack is to control your stress and anxiety levels. To do that you have to learn to read your body signals and stop the anxieties in their early stages before they blow up and you lose control. After that – game over until next time.

2. The best way to relieve anxiety is to get out of your emotional mind (corticostriatal pathway). The best way to that is to shut down all thought because at this stage thought leads back to emotion. You can do this by deep breathing. By concentrating on your breathing you interrupt the flow of negative energy into your brain. I recommend the thirty second breathing activity (in the past I said eight for anxiety relief, but science now suggests thirty for healing and building new brain patterns). Take a deep breath and then slowly let it all out (I recommend a stop watch rather than counting). When there is no air left, hold that until the 30 seconds are up. Keep doing this until you feel a sense of peace, calmness and control.

3. Once you have achieved this sense of peace, you are now free to confront your emotions. Self-talk your way through the process. I recommend doing this out loud as this will engage more of your brain and bring some organization processes to the emotional center. Tell yourself why you are seeking sex. If it is for pain relief or to alleviate stress, don’t do it. Find a better way to deal with the pain. If it is for pleasure and you have considered the consequences (besides just pleasure) than go ahead and enjoy. Bisexual women are naturally good at this. They are usually more emotionally intelligent than men and allow themselves the freedom to explore their emotions with their sex partners resulting in an emotionally and physically pleasing experience (sorry for the sexism but there is some truth in it). Bisexual men tend to shut down their emotions all together and just focus on the physical pleasure and may miss out on the broader pleasures that come with intimacy.  

4. Now that your emotions are under control, you are ready to tackle the problem that caused the emotional reaction. This is where your orbitofrontal cortex comes in. You can do this in two parts. First see where the event fits into your life story. You may gain insight into what has happened in the past to cause you to react this way. You can then decide what it is you wish to build into your life in the present and future through your sexuality. By looking at the whole picture, the top down approach, you can see where individual decisions fit into the greater good for yourself. You can then bring your sexuality and the emotions connected with it into your bigger life picture thus adding meaning and purpose into your sexuality.

5. You can then go on to making a plan and putting gates and strategies in place for when these kinds of situation occur in the future. Men are good at this; it’s the emotions that they cannot handle. Both men and women bisexuals with BPD need to build new thinking and behavior patterns. If your plan does not seem to be working, and if you seem to be sabotaging your own goals and happiness, you may need to seek professional help. Whatever strategies you put in place don’t give up on them. It took me sixty years to develop my self-defeating thought and behavior patterns and it took me two years of constant vigilance to change them. Just keep believing in yourself, learn to say you are sorry (including to yourself), learn from the experience, reset your goals and strategies if needed, and remember that you can do this. You are a beautiful and powerful spirit being. Your sexuality is there to bring pleasure, intimacy, and love into your life. Keep the goal in mind and work towards that goal one step at a time.  


[1] Cackowski, S.; Reitz, A.; Ende, G.; Kleindienst, N.; Bohus, M.; Schmahl, C.; and Krause-Utz, A.. Impact of stress on different components of impulsivity in borderline personality disorder. Cambridge University Press.  March, 2014.

https://www.cambridge.org/core/journals/psychological-medicine/article/abs/impact-of-stress-on-different-components-of-impulsivity-in-borderline-personality-disorder/E8AF2E2CB9606F30E1F3AA9EF7F12679

[2] Leyton, Marco; Okazawa, Hidehiko; Diksic, Mirko; Paris, Joel; Rosa, Pedro; Mzengeza, Simon N.; Blier, Pierre; Benkelfat, Chawki.  Brain Regional α-[11C]Methyl-L-Tryptophan Trapping in Impulsive Subjects With Borderline Personality Disorder. The American Journal of Psychiatry. Vol 158, Issue 5, 2001

Published Online:1 May 2001 https://doi.org/10.1176/appi.ajp.158.5.775

 

Bisexuality and BPD

          During this Christmas season it may be particularly difficult for some of you in dealing with the borderline personality symptoms that many of us bisexuals have to deal with on a daily basis. If you are like me, this pandemic is making it even more difficult to get the support we need to keep on going. Today I just want you to know that you are indeed special. Hang in there. You have the potential to live a life beyond your wildest dreams.

            I have borderline personality disorder (BPD). If you do not have BPD, you may not understand where I am coming from. Let me clarify. For most people fear, anger, and the other emotions protect the person from harm. For me my emotions do not protect me from harm; if I let them, they will destroy me. There is no middle ground. If I give into fear, any fear, it will immobilize me. Having BPD means that those fears are not just fears, they are potential catastrophes. Life threatening. Likewise my anger is not just anger. It is an explosion; IF I LET THIS CAT OUT OF THE BAG, IT BECOMES A MOUNTAIN LION that will consume me and anything or anyone in its path. Likewise shame is not just shame, it takes over my whole body with a depth of despair that leads me down the path of self-loathing and self-destruction where the only escape is drugs or death. I can’t entertain these thoughts because they will reconnect me to the old feelings and that path leads back to depression and suicidal thoughts. There is only one way for me to experience the joys of life and that is to focus only on the joys of life. The only way to keep that focus is to take complete control of my mind and live continuously from my heart and soul. So to me mental health is not about changing my thoughts and beliefs, it is about finding a whole new way of life.

I have walked this path back from the edge of self-destruction. It started with intense therapy – five hours a day, five days a week, for eighteen weeks, along with heavy medication. It restored my chemical balance and gave me some strategies for dealing with my self-destructive thoughts but it did not deal with the pain that existed just below the surface. It took me two years in a mountain village in Costa Rica with daily meditations that took hours a day but I have eventually healed the wounds behind the pain. No anger. No fear. No anxiety. No chemical imbalance. No medication. No negative thought and behavior patterns. No dysfunction. No disorder. No symptoms of BPD. No therapy. I am living proof of the power of miracles that quietly waits to be awakened within each one of us.

Bruce Lipton in his book, The Biology of Belief, made an interesting comment about physiology and treatment of so-called disorders through medication: “they identify deviations in physiology (psychology) from some hypothetical norm as unique disorders or dysfunctions, and then they educate the public about the dangers of these menacing disorders, and then they medicate the symptoms.” Bruce has a point about how BPD is treated; however, I disagree with the underlying premise that  many people have that there is no real problem and we just have to get over it or learn to think better thoughts. In the case of those of us with BPD, we have been led to believe that the leading cause of our BPD is a combination of anxieties, and the best way to deal with these anxieties is through medication. There is a problem with that; it does not address the cause of the anxiety. Cognitive therapy has an answer to that, a better one, but still based on the premise that our BPD is a combination of dysfunctional thought processes and the answer is therefore cognitive therapy. These strategies come from people who may have experienced other disorders like PTSD and depression, but they do not understand BPD. It is much more complex than that.

This is where our BPD mind comes in. Our conscious mind is our rational self, and our subconscious mind runs the programs we have developed since we were babes. Our conscious mind creates negative energy in the form of negative thoughts and our subconscious mind creates negative energy in the form of negative feelings. These together form my negative mind states. Another name for these mind states is beliefs. My beliefs are complex bodies of neural pathways that involve multiple parts of my brain including the amygdala (emotion) and the hippocampus (memory) and as such contain a hundred times more energy than my individual thoughts. When it comes to an argument between my conscious mind and my subconscious mind, my rational mind, even with all the new cognitive strategies, will lose every time. Getting rid of symptoms of BPD and other mental disorders is not just learning to think good thoughts. To truly live a life free of anxiety, I have to change my subconscious mind that is saying I am not good enough, or I can never do anything right, and I am unworthy of anything good happening in my life.

How do I do this? It is a simple one-step process but one that is so hard to do. There is comfort in wearing a label and just letting ourselves flow with conventional thought. We have a reason and perhaps an excuse for our thoughts and behaviors but it does not heal the pain that is inside us. To have true healing, I have to accept that I have a third level of consciousness beyond just my rational and subconscious mind – a super consciousness, my higher self, my soul – where I can experience a world full of love and joy rather than a world of fear, anger, and shame. Whenever I experience powerful negative feelings attached to my subconscious beliefs, I do not argue with them; I accept them for what they are. In my new reality there is nothing to fear, no Sabre toothed Tiger. There is no real danger out there that can harm me, except my own thoughts. There is no battle that needs to be fought except the one created by my own mind, created by negative thoughts fueled by negative feelings. I simply turn over the situation to my higher self. I do not suppress; I accept my fears and shame; I embrace them; and I thank my mind for its due diligence. Then I reconnect the present situation to new feelings powered by my heart which has an electromagnetic energy a hundred times more powerful than the energy of my conscious and subconscious minds combined. This creates a powerful surge of energy that activates the pleasure center of my brain producing feelings of elation throughout my whole nervous system resulting in tears of joy. I use this joy to create the building blocks of a new mind state. I fill this mind state with the belief that I am a truly powerful and beautiful creature. I use these feeling of joy to reattach the feelings of fear to feelings of power, to reattach feelings of anger to feelings of compassion, to reattach feelings of guilt and shame to feelings of pride and love for who I am and for the person I have grown to be. At first it is not easy, but if I am consistent, daily, and sometimes moment by moment, seeking the good in what seems hopeless, I begin to build and reinforce these new pathways until they become the automatic response of my subconscious mind. Then my brain gets the message and voila! Homeostasis. Peace.

By believing that we have a higher self that is in complete control of our lives, we get complete control of our lives. By believing that life is good and we have the power to enjoy it without changing it, we begin to appreciate the life we now live. En”joy” the day.

Bisexuality and Shame

We continue to look at the psychology of bisexuality and its link to borderline personality disorder.

Pathological personality traits in negative affectivity – Depressivity: Pervasive shame (DSM5).

            Over the years in writing this blog, I keep coming back to the role of shame in borderline personality disorder, and each time I get a deeper understanding of the role shame has played in my life. Even though I have learned to survive and even thrive with BPD, there are still moments when my mind recreates a moment of shame from my past and the full emotional load of that shame expresses itself throughout my body.  Unfortunately, most of my shame involves my same-sex tendencies and experiences preventing me from enjoying by beautiful mind and body. So let’s take another look at what science is now saying about shame.

            First of all let’s look at the neuropathways involved in shame. Michl and others (1) employed functional magnetic resonance imaging with 14 healthy subjects while using shame-related and neutral stimuli. They found that shame involved activations in the frontal lobe in the medial and inferior frontal gyrus. During the imagination of shame, frontal and temporal lobes were responsive regardless of gender. They concluded that frontal, temporal, and limbic areas play a prominent role in the generation of moral feelings. So why is this important? My take is that the human brain is designed to help us stay within the protection of our family and in line with our group norms. In other words, shame is part of the normal physical make-up of our human brain that helps us grow and take our place in society. Unfortunately our bisexuality can be a major source of shame if we let society’s biased norms affect our sense of shame. But we are no longer children; we are adults, and we can take control of our shame mechanisms.

            The question is then – what goes wrong with the normal shame mechanism in those of us bisexuals with BPD that results in a pathological trait? An overactive shame mechanism can take two paths – self-loathing and/or anger. Brown and others (2) looked at the relationship of shame with self-inflicted injury (SII) among 77 women with borderline personality disorder. They used self-reported shame and nonverbal shame behaviors involving recent episodes of SII. They found that self-reported state shame and assessor ratings of shame were associated with prospective SII, but not after controlling for other emotions. The last part of that is interesting. This suggests that shame by itself is manageable for those of us bisexuals with BPD as long as we do not allow it to activate the amygdala and other emotional responses. This suggest that shame that involves emotional episodes may be responsible for self-injury and suicidal behavior.  On the other hand, there is hope if we take steps to deal with the emotional overload.

            The other side of the shame-coin is uncontrolled anger where the person with BPD directs the shame outward instead of inward. Scot and others (3) focused on associations between BPD symptoms, shame, and anger-related behaviors (hostile irritability) in adolescent girls using ecological momentary assessment. They discovered that greater BPD symptoms of shame were associated with more hostile irritability but only in the case of girls of average socioeconomic status (not receiving public assistance). Again this suggests an interesting side-bar to this study. We can surmise that adolescents who receive public assistance may be getting support and counselling to help them deal with the emotional issues surrounding outbursts of anger. They concluded that shame may be a key clinical target in the treatment of anger-related difficulties among adolescent girls with BPD symptoms. When it comes us bisexuals, we often turn that anger inward.

            Fortunately, all is not lost. Recent studies have shown it is possible to reduce shame about a specific event over a short period of time. Through constructive psychology practices, we can bring attention to the event causing the shame and learn to dissect and cope with the event before it is emotionally loaded and locked into long term memory.

My five suggestions for bisexuals with BPD:

1. Embrace the shame. When shame occurs, instead of trying to fight it, let it flow. This will take you out of the sympathetic mode and give you time to process the circumstances involved with the shame.

2. In processing the shame, involve the body as well as the brain. Vocalize it with a mantra. I like to use the words, “There is no blame; there is no shame. There is only love for myself and for….” If you are having difficulty doing that, find a friend, someone you trust, who will listen without judgement and who will let you process the situation and the thought patterns without interrupting.

3. In cases of habitual shame, journal it. This adds another constructive body and brain modality. Enter a state of relaxation and let that flow into a state of mindfulness. Record your thoughts on paper as they are formulated in your mind. Be sure to continue the process until you come to the resolution where there is no blame; there is no shame.

4. If your shame leads to anger, first of all, let me say that anger is better than self-loathing. But it still needs to be addressed. Do not let your mind turn shame into anger at yourself. Again, get control of the feelings. Practice deep breathing until you feel calm. Then process the situation. If it involves anger because you have given in to your impulses, give yourself room to explore and enjoy your sexual impulses for what they are. Try to figure out where the shame is coming from. Remember you are an adult and you are free to make your own decisions.

5. If you find that you cannot control your shame mechanisms and that you are thinking of harming yourself, get professional help. Find a psychologist or psychiatrist that employs constructive psychology practices.

(1) Michl, Petra; Meindl, Thomas; Meister, Franziska; Born, Christine; Engel, Rolf R.; Reiser, Maxililian; and Hennif-Fast, Kristina. Neurobiological underpinnings of shame and guilt: a pilot fMRI study. Social Cognitive and Affective Neuroscience; Vol 9. 2014. https://doi.org/10.1093/scan/nss114

(2) Brown, Milton Z.; Linehan, Marsha M.; Comtois, Kathryn Anne; Murray, Angela; and Chapman, Alexander L.. Shame as a prospective predictor of self-inflicted injury in borderline personality disorder: A multi-modal analysis. Elsevier, Behavior Research and Therapy, Vol 47. 2009.

(3) Scott, L. N., Stepp, S. D.; Hallquist, M. N.; Whalen, H. J.; Wright, A. G. C.; and Pilkonis, P, A. . Daily shame and hostile irritability in adolescent girls with borderline personality disorder symptoms. Personality Disorders: Theory, Research, and Treatment. 2015. https://doi.org/10.1037/per0000107

 

Bisexuality, Borderline Personality Disorder, and Pessimism

We continue to look at the psychology of bisexuality and its link to borderline ersonality disorder. Pathological personality traits in negative affectivity – Depressivity: Pessimism about the future (DSM5)

            There is a phenomena called the Law of Attraction. If we think positive thoughts, good things happen. If we think negative thoughts, we invite bad things into our lives. As bisexuals with BPD traits, our feelings are often based on a poor self-image and the belief that we are unworthy of attracting good things into out lives. Our feelings create our thoughts; our thoughts create our actions; and our actions create the pessimistic lives we inadvertently choose to live.

             Korn and others[1] designed a research study in which 21 BPD patients and 79 controls predicted the outcomes in 45 adverse life events. The BPD patients first demonstrated more pessimism, but like the controls, became more positive after receiving further information about the life events.

            Let’s break this down into the two aspects of the trait of pessimism for those of us with BPD. First of all it shows once again our tendency to view life negatively. This creates negative energy which places us automatically in a defensive fight or flight mental framework. This in turn causes us to see life as a threat filled with negative consequences for most of our actions. This can lead to a tendency to slip into the helplessness and hopelessness of depression. The good part of this study is that this is merely a trait, we can overcome our pessimistic outlook by learning as much as we can about ourselves, our traits, and the possible positive outcomes of future events in our lives. We begin to focus on the positive. We change the Law of Attraction so that it begins to work for us instead of against us.

            I recently read an article by Emily Esfahani[2] in which she refers to a series of studies by psychological researcher Shelly Gable and her colleagues where they brought young adult couples into a lab to discuss recent positive events from their lives (unfortunately I was unable to find the original articles). They found that couples responded to each other’s good news in four different ways that they labelled as: passive destructive, active destructive, passive constructive, and active constructive. They noticed that people who were focused on criticizing their partners missed approximately 50 percent of positive things their partners were doing and they saw negativity when it was not there. By interviewing these same people two months later, they discovered that people who deliberately ignored their partner or responded passively damaged the relationship by making their partner feel minimized and unheard. People who treated their partners with contempt and criticism destroyed the love in their relationship, but they also hampered their partners’ ability to fight off viruses and cancers. They concluded that being mean is the death knell of relationships. However, they also discovered that the more someone receives or witnesses kindness, the more they will be kind themselves, which leads to a mentally and physically healthier relationship. I think we can conclude that when we employ active constructive responding it frees us to change our outlook from pessimistic to positive which in turn lets us savor our partner’s joy and gives us an opportunity to grow positive bonds.

                I know it is difficult for those of us bisexuals with BPD to break these pessimistic outlook patterns, but by simply practicing Active Constructive Thinking, specifically generosity and kindness, we can begin to change and pour new life into our relationships. If we truly love the person we are with, we need to stop focussing on the probable loss of our life-partners and begin to appreciate them for who they are in the present. In reality we do not live in the past or the future; we live in the present. We need to keep our focus on what is happening around us and in our relationship in the now and begin to see, appreciate, and communicate our joy in their successes and our sorrow in their losses. Secondly we can stop beating ourselves up because of our same sex attractions. Our bisexuality is a tremendous gift that lets us see the complexity and beauty of sexuality and the role it plays in our sense of self and well-being.

Here are my five suggestions for Borderliners:

1. Embrace your pessimism. It is a part of your genetic makeup and your early life experiences. It is part of you. Recognize it for what it is. It is merely the tendency to see the possible negative outcomes of an action. This is not a bad thing. In fact, it can be a good thing that can keep you from doing things that could have disastrous consequences. In other words, think positively about your pessimism.

2. Think positively about your bisexuality. It is what it is. Begin to look at it as a gift instead of a burden. Begin to notice your feelings, your desires, and why you have those desires. This is mainly a desire to connect with another human beings and to share the joys of sexual union.

3. Avoid the one night stand, the rushed hook-ups, and the anonymous encounters. Have sex with a person with a face and a heart instead of just a genital organ. Seek out people with whom you can have regular heart to heart relationships. Do not be afraid of these relationships. They are probably having the same hopes and fears that you have.

4. Make a conscious positive decision on how you want to live your life. Focus on the potential joys rather than the possible fears and losses.

5. If you have a secret second life, do not let the one destroy the other. Enjoy each relationship for what it is. If you have a life partner, begin to listen to what they say and try to recognize the feelings behind their words. Just the fact that you are truly listening will begin the healing process. Pay special attention to their positive feelings and actions. Celebrate their victories. Invite them into celebrating the joy of the positive things in your life.


[1] Korn, Christopher w.; Rosee, Liobala; Heekeren, Hauk R.; and Roepke, Stefan. Processing of information about future life events in borderline personality disorder. Psychiatry Research. 2016, Pages 719-724

[2] Esfahani, Emiily. Sciencesays lasting relationships come down to – you guessed it – kindness and generosity. The Atlantic. 2014.