innerlight

bpd notes

disclaimer: Following is an evolving compilation of readings by others, which I resonate with, as well as some observations and theories of my own on the nature of Internalized Borderline Personality Disorder (BPD). I am not a medical professional.

bpd ingredients:

in my own words, here’s how I would describe the foundation of BPD:

emotionally vulnerable person   +   invalidation   =   invalidation trauma   =   BPD

internalized bpd is all the internal patternings of bpd, but so well hidden that few people know until a crisis is reached, and the person is either discovered or forced to reach out. In my case, this became an epic turning point that ended years and years of private suffering and shame.

emotionally vulnerable person

From An Overview of Dialectical Behaviour Therapy in the Treatment of Borderline Personality Disorderby Barry Kiehn and Michaela Swales (based on the work of Marsha Linehan):

An ’emotionally vulnerable’ person in this sense is someone whose autonomic nervous system reacts excessively to relatively low levels of stress and takes longer than normal to return to baseline once the stress is removed. It is proposed that this is the consequence of a biological diathesis.

It’s interesting to me that one might also describe an artist this way — sensitive, emotional, intuitive, deeply affected in order to be moved to create. I see this as a form of being gifted. (See my post ‘The Gift and the Curse‘)

invalidation:

The [Linehan’s] term ‘Invalidating Environment’ refers essentially to a situation in which the personal experiences and responses of the growing child are disqualified or “invalidated” by the significant others in her life. The child’s personal communications are not accepted as an accurate indication of her true feelings and it is implied that, if they were accurate, then such feelings would not be a valid response to circumstances. Furthermore, an Invalidating Environment is characterised by a tendency to place a high value on self-control and self-reliance. Possible difficulties in these areas are not acknowledged and it is implied that problem solving should be easy given proper motivation. Any failure on the part of the child to perform to the expected standard is therefore ascribed to lack of motivation or some other negative characteristic of her character.

Linehan suggests that an emotionally vulnerable child can be expected to experience particular problems in such an environment. She will neither have the opportunity accurately to label and understand her feelings nor will she learn to trust her own responses to events. Neither is she helped to cope with situations that she may find difficult or stressful, since such problems are not acknowledged. It may be expected then that she will look to other people for indications of how she should be feeling and to solve her problems for her. However, it is in the nature of such an environment that the demands that she is allowed to make on others will tend to be severely restricted. The child’s behaviour may then oscillate between opposite poles of emotional inhibition in an attempt to gain acceptance and extreme displays of emotion in order to have her feelings acknowledged. Erratic response to this pattern of behaviour by those in the environment may then create a situation of intermittent reinforcement resulting in the behaviour pattern becoming persistent.

Linehan emphasises that this theory is not yet supported by empirical evidence but the value of the technique does not depend on the theory being correct since the clinical effectiveness of DBT does have empirical support.

trauma

… is a subjective experience

invalidating environment + predisposition (creative, sensitive, gifted or all of the above) = trauma

From the above article:

Patients with BPD frequently describe a history of childhood sexual abuse and this is regarded within the model as representing a particularly extreme form of invalidation.

There are many research findings on this subject that are inconclusive. That is, while most people with BPD have experienced childhood sexual abuse, this is not the case with all people with BPD.

The underlying truth I have concluded is that trauma is a subjective experience, as well as the outcome in a person’s personality. An event that does not traumatize one person may traumatize a person who is emotionally vulnerable. See my post ‘trusting perception + trauma is trauma.’

I think people who are chronically and/or traumatically invalidated at the core of their being are set up to experience chronic insecurity, confusion and emptiness, with an abnormal need for reassurance and validation, though my experience of BPD means that people around me would rarely know this about me. In the past, this aspect of me has come out more through a compulsive obsession to over-compensate for feelings of smallness and insecurity, through excessive drive, ambition, perfectionism and over-achievement. The concept of ‘Precocious Ego Development,’ which I first came across in Charles P. Cohen’s Psychotherapy of the Quiet Borderline, is what I feel is the outward expression of my BPD experience. See my post ‘precocious ego development‘ to read more about this dynamic, which is also referenced and further described in Allice Miller’s The Drama of the Gifted Child.

traditional description

from Wikipedia:

Unstable interpersonal relationships, affective distress, marked impulsivity, and unstable self-image are the primary features of BPD.[1]

Individuals with BPD tend to experience frequent, strong and long-lasting states of aversive tension, often triggered by perceived rejection, being alone or perceived failure.[n 3] They may show lability (changeability) between anger and anxiety or between depression and anxiety[6] and temperamental sensitivity to emotive stimuli.[7]

The negative emotional states specific to BPD fall into four categories: destructive or self-destructive feelings; extreme feelings in general; feelings of fragmentation or lack of identity; and feelings of victimization.[8]

Individuals with BPD can be very sensitive to the way others treat them, reacting strongly to perceived criticism or hurtfulness. Their feelings about others often shift from positive to negative, generally after a disappointment or perceived threat of losing someone. Self-image can also change rapidly from extremely positive to extremely negative. Impulsive behaviors are common, including alcohol or drug abuse, promiscuous and intense sexuality, gambling and recklessness in general.[9] Attachment studies have revealed a strong association between BPD and insecure attachment style, the most characteristic types being “unresolved”, “preoccupied”, and “fearful”.[10] Evidence suggests that individuals with BPD, while being high in intimacy- or novelty-seeking, can be hyper-alert[11] to signs of rejection or devaluation and tend toward insecure, avoidant or ambivalent, or fearfully preoccupied patterns in relationships.[12] They tend to view the world as generally dangerous and malevolent.[11]

less-recognized types of bpd

In the process of searching for a diagnosis, I related to many descriptions of inner dynamics, but not at all to the outward expressions of them; and this baffled and confused me. Others who had known people with BPD before said that I couldn’t possibly have BPD because I was NOTHING like those they had known.  People were quite adamant about this opinion, and even the psychologist who gave me an initial pending diagnosis of Bipolar II stated that she could not see me as a person with BPD.

For the most part, the information out there about BPD portrays and describes the outwards and ‘low-functioning’ type, who are often in and out of the hospital for self-harming behaviors, frequently arrested for impulsive and violent acts, and often the subject of hollywood horror films.

As I researched and learned more, I discovered some sparse writings on terms like Quiet, Internalized, or High-Functioning Borderline.

I personally do not view the world as dangerous and malevolent, though I am naturally apprehensive and fearful of life. Also, I have never abused drugs, alcohol or viewed myself as chronically promiscuous. It’s always been very important to me to maintain an image of being a responsible person, even to my own detriment; and a big part of my recovery lies in allowing myself to show my imperfections, show my fragility so that I am not an island of fake facades, and I do not continue to suffer alone. I am finding circles of people who are open-minded and have lived enough to appreciate more authentic expressions and definitions of what is normal. In my new location, I am known as a person who is a survivor and struggles with consistency and regulation; as well as someone who is extremely creative and insightful. The key is that people do not expect me to be “normal.”

Here’s one description of possible outcomes of BPD from borderlineblog:

(… Though you may fall into the BPD diagnosis constellation, there are many different ways in which your BPD affects you, your life, and those around you.

Before I go any further, let me preface the following list of BPD variations by stating that I am not a mental health professional, nor qualified in any way to offer a BPD diagnosis. My thoughts are my own opinion gleaned from casual research on the internet and any commentary and feedback I get from blog readers.)

That said, here are 5 different types of Borderline Personality manifestations:

Low Functioning Borderline – The “Low Functioning” borderline is what most people think of when they are first introduced to the condition. Low functioning BPDs are a living train wreck. They have intense difficulties taking care of their basic needs, are constantly experiencing mood swings. They also have an extremely hard time managing any sort of relationship with another human being. Low Functioning BPDs are often hospitalized more than other BPD types, for the very reason that they can’t live productively without constant coaching and supervision. These patients are challenging for all but the most experienced psychiatrists. Unless otherwise treated, low functioning borderlines lead self destructive lives and attempt to manipulate those around them with desperate acts, including self harm (cutting, etc.).

High Functioning Borderline – The High Functioning Borderline Personality shares many core aspects of the low functioning borderline personality, except for the fact that they can manage their lives, appear to be productive, and generally keep their relationships civil (even diplomatic in nature). High Functioning borderlines can appear to be normal, driven people one moment; then moody, inconsolable, and manipulative the next. Somehow, there is a mechanism within the minds of High Functioning Borderlines that allows them to lead somewhat “competent” lives, despite the fact that they are in a constant battle with BPD. High functioning BPDs are no better than low functioning: it’s basically the same face wearing a different mask.

Extroverted Borderline – Anyone familiar with the Meyer-Briggs personality tests will understand the psychological differences between extroversion and introversion. When these characteristics are mixed with BPD, there are two different results. The Extroverted Borderline pushes all their feelings, fears, manipulation, rage, and moodiness outward to the people around them. In essence, if you are around an extroverted BPD, you feel like you’re living through their emotions while coping with your own at the same time. Further, extroverted BPDs will attempt self abusive acts in plain view of others in order to avoid abandonment or to express their rage. For example, an Extroverted BPD might cut themselves and then immediately share it with family and friends around them, hoping to gain sympathy or attention. In most cases, these types of behaviors frighten non-Borderlines, and they wonder whether or not the Extroverted BPD should be committed to a psych ward.

Introverted Borderline – Contrary to popular belief, “introverted” doesn’t necessarily describe someone who is a recluse (agoraphobic). Instead, introversion is characterized by experiencing life in a self-reflective, private, and at times distant manner. To others, introverts may appear shy or lacking in people skills. This might be true, however, introverts make up for their lack of social skills with rich inner lives, thoughts, and deep thinking. As a result, the introverted Borderline primarily focuses all their BPD emotions and reactions inward. Instead of having a rage episode in public, they might retreat to their rooms and cry for hours on end, perhaps even cutting themselves for their own amusement or as stress relief. Introverted Borderlines live in an odd world: on one hand, they spend most of their time in personal thought and reflection, looking to fill themselves with a viable sense of self; but on the other, they are conflicted by emptiness and the bottomless emotional pit that BPD produces. Introverted BPDs might be harder to “spot” unless you happen to know one personally, in which case you might notice occasional depressive symptoms and evidence of self harm.

Transparent Borderline – The Transparent Borderline is a bit of a mix between a high functioning borderline and either extroverted or introverted tendencies. In plain terms, Transparent Borderlines live double lives: on the surface, “in public”, they appear one way, but in private, amongst immediate family and friends, they appear completely different. As a result, they may or may not be high functioning due to this conflicted state of mind. Transparent Borderlines spend most of their emotional energy trying to balance the personality demands of Dr. Jekyll and Mr. Hyde, the both of which experience strong BPD emotions like anyone else with the disease. Like Introverted Borderlines, Transparent Borderlines are harder to spot, and often only confess their true disposition after a harrowing rage, major break up, or other severely traumatic event that brings all their BPD feelings to the fore.

my own path to wellness so far:

  • 1 week in the hospital
  • diagnosis
  • 1 month living with compassionate friends
  • relocation
  • codependents anonymous (meetings, sponsor & 12-step work))
  • systemic family constellations workshops
  • supported unemployment since may 2011, living in a supported residence via one parent (without this, I would not be anywhere)
  • expressive art therapy through classes at a local studio in African dance, drum as well as yoga, singing / chanting (classes supported through work trade)
  • counseling 1X / week at VIHA
  • diary cards
  • blogging here
  • a growing community of friends in the recovery / alternative health milieu (most others have fallen away)
  • longstanding friendships with 3 individuals with trauma / mental health / counseling backgrounds
  • radical honesty, truth and acceptance
  • daily prayer & meditation
  • 50 mg of Zoloft / day


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9 thoughts on “bpd notes

  1. Hi.

    I’m glad you stopped by my blog because this was an interesting read. I just wanted to say I can relate so much of what you say here, and a lot of your theories are similar to my own theories. Your story about the initial BP II diagnosis sounds so much like mine too. I have a friend, a close friend, who told me she finally got diagnosed with BPD about two-three years ago. This same friend is one I used to go to shows, party with, bum a little coke from every now and again. And one of those days when I was reading about BP and BPD, I realized the similarities were startling.

    But I could never see myself as BPD just because I always though of my friend. “But I don’t act as extreme as her. I would never act out so badly and embarrass my husband like that(if I had one). I wouldn’t say it so mean, not in that way that she did, I went to college. I might even be able to keep a job if I had the chance” etc. And I wasn’t downing her, I just couldn’t relate to some of her actions. In this sense, I couldn’t relate to some of her outward expression of her BPD, like you say, “I related to many descriptions of inner dynamics, but not at all to the outward expressions of them” and “I was NOTHING like those they had known.”

    In regards to my friend, I realized maybe though our similarities is what made us bond and care for each other so closely. I always felt she could know exactly what I meant, what I felt without having to say much. Just today I was reading about low functioning BPD vs. high functioning BPD. And I thought, that’s it! You might say I’m more of a high functioning and she would be more on the low functioning. But that doesn’t mean my struggles and difficulties aren’t just as intense or pronounced or that they haven’t screwed up my life as much.

    We’re both also extremely intelligent women as you appear to be. 🙂

    Kudos. Look forward to reading more. 🙂

  2. p.s. Can I refer to this post for my next entry about my recent diagnosis? I’ll definitely link you!

  3. PAZ,
    I’m so glad you found this helpful, especially as you explore what the diagnosis means for you.
    Yes, I keep being struck by how many highly intelligent and talented people also struggle with mental illness — the whole process has really opened my eyes to the MASSIVE puplic mis-perception of what mental illness is, and what a fine line there is between it and the effects of trauma.
    It was good for me to re-read this too, and identify myself more clearly in the descriptions of the introverted and the transparent borderlines.
    I’m glad to find another kindred spirit, and of course you may link or reference me.
    I look forward to reading more from you as well, and I hope you find what’s useful in a label to heal, and leave the rest behind 🙂 Yesssssssss.

    • Underground,
      Thank you! WordPress never gave me a little orange announcement thing when you replied so I didn’t know you had until I decided to revisit your blog today!

      I’ve been reading more about the “transparent” borderline and find that its description outlines my expressions of the disorder so well. I will definitely link you when I get around to writing part two (I’m so behind on posts I thought I’d write, blegh). And I’ll add you to my pet blogs.

      Later 🙂

  4. emotionally vulnerable person + invalidation = invalidation trauma = BPD

    Thank you very much … I am 54 years old, male and diagnosed with 1. Borderline Personality Disorder, 2. Dysthymia, 3. Major Depressive Disorder, 4. Post Traumatic Stress Disorder and 5. Social Anxiety Disorder … This pattern rings so bloody true with me … I personally would have said it a little bit different but you idea is spot on … Genetic predisposition + Environmental Trauma = ( In my case), Borderline Personality Disorder. Not being diagnosed or treated for close to 50 years helped every thing else just fall in line after that … I don’t even how I’m still alive !!! Never the less, the BPD was the first thing with various other traumas and issues piling on after that … People have always called me a “survivor” though I really don’t feel much like one …

    • We deserve an award for staying alive, surviving life. I am lucky to be alive too, and it is miraculous. The gift of it is that we experience life on a deeper level — more painful at times, but also more joyful and richer in our connections. On a good day, I say this, on a bad day … well, we both know those. I’m glad things have fallen in line for you, but sorry you had to suffer through 50 years undiagnosed. I commend you! 🙂 And thanks so much for visiting and commenting. Until next, Underground.

  5. I like how you have a path to wellness written down. Makes is seem more substantial. I think I’m going to try that. I have BPD, too, but have been really struggling with things. The latest thing my therapist says is that I have Parasympathetic Shock, which researching led me to your blog. Coincidence? I think not.

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