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A key word that you will see:

Fragmentation: a mental process where a person becomes intensely emotionally focused on one aspect of themselves, such as “I am angry” or “no one loves me,” to the point where all thoughts, feelings and behavior demonstrate this emotional state, in which, the person does not or is unable to take into account the reality of their environment, others or themselves and their resources. This is a term that my therapist and I use and is on the continuum of dissociation.

Monday, November 15, 2010

Trying to be Real...again

Well, for over a month, I kept writing that I wasn't up to writing about what has been going on for me as it has been a very difficult time which basically started on my birthday which was in August.  Much of it has to do with my mother and my aunt not acknowledging my birthday in any way shape or form.  (click link for information regarding my situation with my aunt: http://clinicallyclueless.blogspot.com/search/label/Family%20Drama; situation with my mother: http://clinicallyclueless.blogspot.com/search/label/letter%20to%20mom.)

Part of my difficulty is with my aunt not responding is that she was emotionally my mother growing up. But, in looking at her behavior and reactions over the past years, I have realized that she too has a Borderline Personality Disorder. My therapist and I have been working on my feelings of abandonment, disappointment, reality versus fantasy, grief, anger...etc.  It has been really hard work.

When I first had the thought that my aunt may have a Borderline Personality Disorder, I was immediately able to go through the criteria in my head and confirm my thoughts. I actually felt sick and quite disheartened, but it made everything make sense.  But, I wanted to scream, "NO!!"

I want to again review the DSM criteria for Borderline Personality Disorder and how my aunt meets the criteria. (I've already written about how my mother and I fit it...sigh)

According to the DSM the criteria to meet borderline personality disorder the five of the following features must be present:
1. frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
3. identity disturbance: markedly and persistently unstable self-image or sense of self.

2. a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

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 self-mutilating 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

1. Frantic attempts to prevent feelings of actual or preceived abandonment or rejection. People with BPD rely on others for their feelings of worth and emotional caretaking. The fearfulness can be so strong that they often act in ways that bring about the abandonment and rejection they are trying to avoid (and which therefore validates and reinforces their fears). They panic and may have burst of rage or beg the person to stay.

My aunt has definitely developed this type of relationship with her partner, but I won't share details.  There are many instances.

2. Patterns of relationships that are intense and unstable; repeated tendencies to shift between extremes of loving and hating another person. This is referred to as splitting, people with BPD have difficulty experiencing two feeling states at one time. An example would be that some is all bad and ungiving versus all good and idealized. It may happen without any provocation or even any interaction.

Recently, due to my interactions with my aunt and my pushing her away in the process I've become "all bad" to her.  Additionally, I am trying not to believe that she pushed me out of her life for fifteen years...somehow, I denied that it was ever important.  Reality sucks!! And is painful.

3. Difficulty describing the self, interests, or aspirations; frequent shifts in self-perception. Depending on who they are with, they may change their opinion, thoughts and even values to please the other person. There is a chronic feeling of emptiness. Roles played could be the over-achiever, the victim, the helper or caretaker. They need someone else to tell them who they are.

I've seen this happen over the years with different family members and not to an extreme sense with her partner.  It has also been demonstrated in her work in the medical field.

4. Impulsive, often reckless, self-harming behaviors in areas such as substance abuse, binge eating, overspending, promiscuous sex, reckless driving, shoplifting, etc. All of these are addictive behaviors and temporarily fill the emptiness. There is a very high connection between BPD and substance abuse.

Denial can be quite powerful as I completely thought of her behavior as normal and not problematic in this area.  I believe that she eats emotionally.  She has always spent beyond her means and has had serious consequences as a result. She definitely has had problems with road rage to a point that she really scares me. Also, all the family tells of the incident where she became so enraged with her brother that she threw a knife at him intending to kill him...denial what a concept.

5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. The suicide rate is high for this disorder at 8%-10% of those diagnosed with BPD. People with BPD have many, many, many periods of overwhelming uncontrollable emotional pain. Self-mutilation is a coping mechanism used to release or manage these emotions. Usually they are feelings of shame, anger, sadness and abandonment. Self-mutilation may release the body’s own opiates, known as beta-endorphins. These chemicals lead to a general feeling of well being. Self-mutilation may include, but is not limited to cutting, burning, breaking bones, head banging, needle poking, skin scratching, pulling out hairs, and ripping off scabs – all without suicidal intent.

To my knowledge this does not seem to fit her, but I don't know her as well as I thought.

6. Frequent mood swings and intense emotional reactions, irritability or anxiety of changing duration – anywhere from a few hours to a few days. A Dr. Jekyll-Mr. Hyde situation with switching from happy and loving to furious, fearful, or depressed within hours or less. Often, the person himself doesn’t remember–or claims not to remember-what was said or done during this state. When most people feel bad, they can take steps to feel better. They can also control, to some extent, how much their moods affect their relationships with others. People with BPD have difficulty doing this.

Let me just say that this fits her.

7. Ongoing or frequent feelings of being hollow, empty or fake; chronic feelings of emptiness. People with BPD commonly report a deep sense of boredom or a profound emptiness, which is why they may turn to drugs or alcohol, become obsessed with money and possession, or harm themselves. Lacking a strong core, a sense of self they can trust, they feel out of control and dependent upon others, forever victimized. Despite their sometimes larger than life, hard to ignore exterior, those with BPD are sometimes described by loved ones and clinicians as seeming hollow and as putting up a façade.

I think that she fills herself with her relationship with her partner who basically gives her a role to play, just as she did with my mother and myself.
 9. Brief extreme periods of mistrust, paranoia, of feelings of unreality (numbness, disconnection, dissociation).

8. Either underexpressed or overexpressed feelings of anger, seen in frequent displays of temper, rage, recurrent physical fights, or extreme sarcasm or withdrawl. Rages. Many adult children know them all too well, whether the trigger is a coat hung askew in the closet, a spilled drink, a loud TV, sickness, the suggestion that the person with BPD doesn’t remember something the way others do, or a request for divorce. Whether precipitated by something seemingly trivial or serious, the storm-not uncommonly comprised of verbal assaults or physical abuse-can subside just as quickly as it rolled in.

I think that some of things that I've already mentioned fit this criteria.  Additionally, at work, they know her as very sweet, a hard worker, patient with others and gets along well.  However, the whole family speaks of her TEMPER and she is extremely sarcastic!!!

I generally think that she mistrusts others and is protective of herself mostly when not necessary.

In general, ironically, I am disconnecting and becoming numb writing this.  It is painful to realize that she really has pushed me out of her life and that her above behavior is actually problematic and that she doesn't even realize it.  Her partner reinforces this by not seeing my aunt as having problems...it is always someone else's responsibility or that it is just circumstances. 

I also think that realizing that she is sick and that I know what it feels like to have BPD that it saddens me.  It also makes me realize that she has really made choices about me in her life.  I feel like I don't exist to her and in turn I have difficulty feeling like I exist.

Also, it brings up feelings about my relationship with my mother who chose my step-father over my well being and now my aunt is choosing her partner over me.  I also have to look at how my behavior has added to my aunt's reactions to me.  I am also quite angry about how her partner has "painted me as ALL bad," and that my aunt doesn't take into account what she really knows about me.  (Yes, I know what doing that is like; however, it is to keep things calm with her partner who also has a BPD)

Okay, there is some of what I have been and am trying to deal with...finally I've been able to put words to it and share it.


Evan said...

It must be very hard re-evaluating in this way.

I hope your therapist is a good support - and that you have others too.

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