Does it Always Come Back to Abandoment?

I recently asked myself...does it always come back to abandonment issues?  Well, the answer is primarily yes for those of us with borderline personality disorder or those with those traits.  The number one criteria for this diagnosis is "frantic efforts to avoid real or imagined abandonment."  It is a key or The key issue for those with borderline personality disorder, so much of our life revolves around it making live quite difficult.

Recently, with my husband working 6 days per week, 10-15 hours per day has been difficult and I realized that it had kicked up my fear of abandonment issues and issues in my past.  I thought that I was doing well as I was not fragmenting, was flexible and was supportive and understanding.  Well, because I am working on my eating disorder and keeping a log of what I eat.  My therapist and I noticed a pattern that when things with my husband's schedule became more unpredictable I would eat less and numb out, not feeling abandoned or disappointed.  I'm still working on feeling...sigh!!

Last weekend, my therapist was out of town, so I didn't see him on Friday as usual.  Again, I thought that I was okay with this even with my husband working on Saturday.  Saturday was the day that I really did not eat much.  Not a good way of coping.  When he returned Monday, he informed me that the week before Memorial Day that he was going to be out of town Thursday through Sunday.  This really kick up my abandonment fears as I usually see him on Thursday and Friday.

Then, to add to all of this, he is on jury duty and he was called to be seated for a trial.  This means that I won't see him and that we will only have telephone sessions this week.  I know that it seems like a little thing, but I feel like I'm losing some of my grounding and up comes the irrational thoughts of "he doesn't care, he is rejecting me, he doesn't want to see me, he is glad to take a break from me....and the list goes on."

I also did not realize that this past weekend that I was a bit more agitated and needed to take my PRNs.  Duh!!  My feeling and thoughts of abandonment and anger are going to be there and are unavoidable because that is just where my brain goes.  The key is to accept it and manage it from there instead of trying to numb, deny or let my irrational thoughts and feelings take over.  I am learning how to manage them, but right now I usually just numb out which is not a desirable way to deal with it.

Additionally, with my sprained ankle, I had to cancel a long ago scheduled lunch with two of my friends, but they had not responded back to me.  I didn't receive a response until the night before which was prompted by my leaving a voice message.  I know that they have been really busy with work, but I feel angry like I wasn't worth it.

It all goes back to I was abandoned before and think that there is something wrong or "bad" with me and that I am abandonable...it is all about me without regard to the actual circumstances...at times...I am getting better.

So, yes my brain is wired to go back to abandonment.  I need to just accept myself that I will go down this path and then make adjustments.  I get stuck in my anger or that I am "bad."

Tell Me Who I Am

I'm not sure if I've written about this or not, so please forgive me if I have.  I am in the process of gathering references for a doctoral program in Clinical Psychology (Psy.D). I've decided to apply in one to three years.  Because has been so long (20+ years since I graduated, I am losing contact with my professors and work references due to just simple loss of contact especially since I haven't been working, retirement or passing away.  The programs understand my situation and are accepting my reference letters early and will hold them until I am ready to apply.

One thing that has come out of this is incredible turmoil related to Borderline Personality Disorder in that they have difficulty with self-identity, so they are constantly looking for approval from anyone especially those in positions of authority.  My experience during this process is reading criticism and abandonment or self-worth and abilities into response or lack there of. 

I have been assuming that those who don't respond do not believe that I can succeed in grad school or don't like me.  With this mind set, I have been having much emotional turmoil.  Some people that I ask that have given me lots of compliments for my work have declined to assist me even after they said they would be happy to help me in any way.  One person, did not give an explanation even though I've left voice mail messages and sent emails.  Others have not responded.  These have all brought up my thinking that I'm not worth it or they were lying before when they said that they liked my work.  There are actually some explanations for some.

My former supervisor, has known me most of my career as she has hired me for three different jobs totaling more than ten years of supervision.  Before and after, I left, under less than desirable circumstances, she started to snipe at me, was cold, short with me and wouldn't respond to me at work including emails for work related information. Even so, I hoped that after three to four years that she could get it together enough to realize my potential as she had often encouraged me to go to grad school...no response what so ever.

I realized that I based my self-worth by responses or lack of them.  I've done that my whole life as I didn't get this as a infant/child, so I'm still seeking it.  What should have happened is mirroring, which I've previously discussed.  Mirroring give child a sense of self and self identity.  Because of how I grew up, I didn't get a solid sense of it and because of that I developed an identity that I am "bad," and worthless.  Which I am usually able to manage, but these issues were quite strong in finding references.

However, a few happy and unexpected things have happened.  One psychologist that I worked closely with and one family will each write a letter.  Two of my most significant professors are more than happy to write letters, even though one stated that he doesn't usually do this for students from this far back.  What I nice feeling.  And...they both remembered me....wow!!

Previously, I hadn't been able to write this post as the feelings of disappointment and self-hatred were so very strong, but I am now able to write about it.  Thanks for reading my long story.

Borderline Personality Disorder: 2 Keys

I am learning that there are two factors that must be present for a person to develop a borderline personality disorder.  Do not take any of this as criticism or a judgement as most who have a borderline personality disorder, including myself, might do.  The two factors are a highly sensitive person (HSP) and an invalidating environment.  Dr. Elaine N Aron wrote the book and coined the term Highly Sensitive Person.

From the Highly Sensitive Person:

A highly sensitive child is one of the fifteen to twenty percent of children born with a nervous system that is highly aware and quick to react to everything. This makes them quick to grasp subtle changes, prefer to reflect deeply before acting, and generally behave conscientiously. They are also easily overwhelmed by high levels of stimulation, sudden changes, and the emotional distress of others. Because children are a blend of a number of temperament traits, some HSCs are fairly difficult--active, emotionally intense, demanding, and persistent--while others are calm, turned inward, and almost too easy to raise except when they are expected to join a group of children they do not know. But outspoken and fussy or reserved and obedient, all HSCs are sensitive to their emotional and physical environment.

Emotionally, Highly Sensitive People (HSP) are mainly seen as shy, introverted and socially inhibited (or can be socially extroverted). They are often acutely aware of other's emotions. Sensitive people learn early in life to mask their wonderful attributes of sensitivity, intuition and creativity.

Physically, HSPs may have low tolerance to noise, glaring lights, strong odors, clutter and/or chaos. They tend to have more body awareness of themselves and know instinctually when the environment they are in is not working for them.

Socially, introverted HSP may feel like misfits. They actually enjoy their own company and are totally comfortable being alone. Both introverted and socially extroverted HSP often find they need time alone to recover after social interactions.

Psychologically, HSPs compensate for their sensitivity by either protecting themselves by being alone too much, or, by trying to be 'normal' or sociable which then over-stimulates them into stress.

Work and career is particularly challenging for HSPs. They are often overlooked for promotions even though they are usually the most conscientious employees. They are excellent project oriented employees because they are responsible and thorough in their work.

Relationships can be difficult. In relationships they may be confronted with their unresolved personal issues. They can however, offer their partner the gifts of their intuitive insights.

Culturally, HSPs do not fit the tough, stoic and outgoing ideals of modern society and what is portrayed in the entertainment media.

Childhood wounds have a more devastating effect on HSPs. It is important for them to heal their past hurts because they cannot just forget them and go on in denial.

Spiritually, sensitive people have a greater capacity for inner searching. This is one of their greatest blessings.

Nutritionally, HSPs may need more simplicity in their diet. They may be vitally aware of the effects of food on the health of their body and their emotional stability. 

HSP students work differently from others. They pick up on the subtle things, learning better this way than when overaroused. If an HSP student is not contributing much to a discussion, it does not necessarily mean they do not understand or are too shy. HSPs often process things better in their heads, or they may be over-aroused. This can be the reason for their not contributing. HSPs are usually very conscientious but underperform when being watched. This also applies to work situations; HSPs can be great employees—good with details, thoughtful and loyal, but they do tend to work best when conditions are quiet and calm. Because HSPs perform less well when being watched, they may be overlooked for a promotion. HSPs tend to socialize less with others, often preferring to process experiences quietly by themselves

Linehan theorizes that borderlines are born with an innate biological tendency to react more intensely to lower levels of stress than others and to take longer to recover. They peak "higher" emotionally on less provocation and take longer coming down.

At first, when my therapist said that I was a highly sensitive person, I immediately thought of it as a "bad" thing, but it is just a way to describe a type of personality that is neither "good," nor "bad."  But, in reading about HSPs, I recognized and felt validated instead of just different than others...I'm not the only one.  Most are drawn to helping professions which can fit their personality well.  My therapist is an HSP as well.  Did you recognize yourself in any of the above? :-)

The second key is growing up in an invalidating environment where a child does not get their emotions acknowledged in a positive way (judged) or is ignored or attacked .  An abusive especially sexual abuse are invalidating environments.  Other characteristics include ridiculing (teasing).  Bottom line is that the child learns that their feelings are "bad."  This can also result in numbing, confusion or distrust of a one's own emotions.  Familiar theme to those with borderline personality disorder, huh.

An invalidating environment usually has a high significance 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.

Again, in order for a borderline personality to develop, an invalidating environment with and a highly sensitive person must be present.  I fit this.  My therapist says that my environment wasn't just invalidating, but annihilating. 

"Mother's Words In My Head"

 

Click here to see full size or make your own courtesy of Wordle.net.

I hope this helps those with a borderline personality disorder or those with loved ones.

Abandonment Issues

In addition to what I've already wrote this week, during this period, my husband was also working crazy hours.  12-14 hour days, 21 days in a row, weekends, etc which brought up feeling of abandonment.  (BPD issue)  I've never really done this before, but I started to worry that he wasn't coming home and getting angry.  The day would change as it went, so one hour I thought that he would be home and have such and such day off only for it to change the next minute or hour.

I discovered that it really tapped into a reservoir of feelings that my mother wasn't coming home or that I didn't know when she would.  Also, it tapped into my feelings of "but you promised."  So many broken promises by so many in my life.  I was trying to keep the two separated the feeling of the present versus the past with some success.  Even so, this remain a big issue for me.  It is expected that he will go through a period like this again this year and at the beginning of next year.

My husband as well as my therapist provide a significant source of grounding for me, so this has been particularly difficult.  Both have been extremely supportive.  I'm trying to learn to find grounding in myself and not others...I should have learned this from my mother like so many other things.

Denial

As I mentioned on Monday, I've been having a difficult time since my birthday in August.  In addition to my aunt not acknowledging my birthday in any way shape or form, neither did my mother.  I know that this isn't true, but both doing this resulted in my feeling like I don't exist or that something is wrong with me.  This is also part of having a Borderline Personality Disorder.  Those with BPD look for others to validate their existence, obtain self worth and use others as a mirror to tell them who they are.  This occurs because those factors that form a stable identity were not provided by the primary caretaker, usually the mother.

Yes, indeed these thoughts and feelings are still a struggle.  Additionally, it has been about a year since I wrote my letter to my mother.  She has not responded to me either which makes me realize that she really can't deal with reality and, as others have put it, doesn't have a maternal instinct.  It is like the letter didn't exist once again ignoring my needs and problems.  I do realize that she really cannot manage this, but it still stirs up lots of feelings and thoughts.

Sorry, to be so vague, but what I'm dealing with is difficult to go through and tough to write and talk about. 

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.

On Being Borderline ~ Poem

***TRIGGER WARNING***  ***TRIGGER WARNING***

I originally posted this last week, but it really wasn't finished.  I was in a rush to post it.  So, now I'm posting the most finished one.  I usually don't write poetry, but sometimes I get into this mode where my head keeps "writing," so I end up writing a poem.  The poem is in my head and writes itself, so it takes very little time except for the stuff that I add. 

ON BEING BORDERLINE

Thoughts of suicide fill my head

Too often wishing that I were dead?

Too young to have these thoughts as a child

Instead, I just smiled

Not wanting to feel rage or pain

Hopelessness continues to fill me again

Inside numbing, dissociating and dying

I vowed no one will ever see my crying

Wanting comfort, care and not to feel so alone

Unable to obtain even when she was home

I found comfort in many forms of addictions and self-abuse

Sometimes, trying other things is what I refuse

Emptiness that aches so much

But, so afraid to be touched

Never without a suicidal thought filling my head
Pain and rage is what I need to express instead

Suicide and self harm are not for attention
It means that my feelings need healthy expression

Hoplessness sometimes runs so deep
Most of the time I just cry and go to sleep

Fragmenting is so hard to manage
Sometimes, causes unwanted damage

Relationships a rollercoaster and a mess
Fear of abandoment is what makes me stress

I push those away that I want close is what I do
Then, panicking when feeling they might leave is my issue

Feelings of abandonment is constantly what I fear
From even those I know hold me dear

Too many intense feelings inside and too many thoughts in my head
Makes me want to scream and scream instead

Sometimes, emotions in such chaos and a blur
That I don’t care what I do or what occurs

Emotions and thoughts that seem to run amok
And, sometimes what I do or say indicates I don’t give a fuck

Wanting desperately for someone to completely understand
Which is something that is only in Fantasyland

Trust no one is what I learned

Remains a huge issue as I don’t want to get burned

Ambivalence is a key issue for a Borderline

I’m constantly saying I’m just fine

I see my world filled with “good” and “bad”

All the time knowing that I am bad and feel sad

I don’t know who I am you see

So I try to get you to tell me who to be

Please tell me what I feel
Because suppression is my deal

Trying to hide from everything

Including just being

When will I ever be well

Sometimes, never is what I can tell

Being Borderline really sucks

I still feel so fucked up

People tell me that I am strong

Inside I say they are wrong

Memories that still haunt me

Makes me feel that I can’t be

Trying to hide from everything

Including just being

When will I ever be well

Sometimes, never is what I can tell

Thank God for the Father above

For he is teaching me about self-love

Be courages He reminds

Sometimes, that I cannot find

He has promised to turn my mourning into dancing

At times, this I feel and other times I feel nothing

It is by faith in myself and God I must take

Even though I may feel like a fake

Your continually teaching me to trust

Even when I fuss

In Your arms, I need to be

Even when that may mean through human arms I see

© 2010 ClinicallyClueless

What else would you add?

It Sucks To Be Borderline!!

Did you know that your therapist is human? Humans make mistakes.  Humans can hurt your feelings. Humans can totally miss what you are saying. Humans also can think about what isn't working and look at themselves.  They can also apologize and take responsibility for their part of the interaction...Thank God!!  My therapist is human!!!

Since my birthday, I was becoming increasingly depressed and hopeless about therapy.  Part of it was that there were many abandonment issues surrounding my aunt not acknowledging my birthday at all.  As expected, my suicidal thoughts and self-injury urges became stronger due to what I was working through in therapy.  I was also becoming more fragmented and hopeless about continuing therapy.

I did not realize it while it was happening because most of it was subtle, but my therapist was cutting me off, invalidating or not validating my feelings and also expecting me to be able to provide myself with validation and comfort which at this point I am unable to do.  These were also extremely subtle and neither of us were aware what was happening, but I was really depress and hopeless.  I won't go into detail of what he said or did that was not helpful or hurtful.

Last week was the worst of all of it as it really kicked up my abandonment issues which my therapist pointed out.  ***Warning Borderline Behavior*** On Wednesday, I was so angry and hopeless after session that I left a nasty message stating that "my suicidal thoughts and self injury urges are way up and I'm angry, thinking that I'm bad and hopeless. Therapy is not working, so I'm terminating. I keep ending up in the same place and like you said I won't meet my life's goals if I continue what I am doing. So, you agree with my friend about my friend just saying get over it was not realistic because today it seemed like that was what you were telling me to do. I'm never going to be able to go back to school.  Yes, I know that I'm fragmenting, but I'm still not coming back. I don't care anymore, don't care, don't care."

The next day, I left another message that saying that I was sorry for the message that I left.  I know that I am making myself miserable and probably taking my anger out on you instead of my aunt and trying to get you to call me.  I'd like to see you this evening if you have time.

Later, I left another message saying that I was terminating and don't bother to call. [I also was aware that he had a class all day from 8 am to 3 pm.]  When he called me back and asked if I wanted to see him, I said, "no."  He said okay, but if you change your mind call me. Then, I asked if we could have a telephone session which we scheduled for that evening.

Then, I left a message cancelling the appointment saying that it was hopeless anyway and that I was going to feel worse afterward, so it was a waste of time and that I was terminating therapy.  Then, I asked if I could see him instead of a telephone session.  He called back and said that we could have a face to face session.

[I was one borderline out of control, being manipulative, ambivalent, pushing away and trying to draw close, etc... It wasn't pretty.  I was a mess.]

Once there, I didn't feel so angry.  He had me say what I wanted to and then gave me an explanation of what he thought was going on.  He validated my feelings and listed several things that he said or did that led me to be more depressed, hopeless, abandoned, angry and hurt.  He took responsibility for it and apologized.  He indicated that if he could he would take it back.

However, when these things happen once I'm thinking, I am always able to see how those types of "therapeutic misses" tell something or are helpful, no matter how painful.  I thought about how during such a short period that not having validation and feeling abandoned by him cause me to feel more depressed and hopeless.  I realized that this is how I lived my life, so no wonder I have issues with validation and abandonment and have been depressed all of my life.  I also realized that my feelings developed because I didn't get what I needed.  I felt sad about it.

One other lesson or aha moment was when I realized that although I was angry when each "incident" happened that I couldn't have said anything because it seemed I went from hearing what was said directly to shutting down.  There was no cognitive or emotional awareness of feeling angry.  It is like that mechanism is missing from me when it comes to anger.  Need to work on this.  I can advocate and become angry when it has to do with someone else especially when working, but when it comes to me I'm lost. 

I felt so good and relieved that I saw my therapist in person and that he was able to explain what he thought happened.  But, it also sucks to be borderline!!!

Borderline Personality Disorder & Abandonment

I’ve been writing quite a bit about unresolved abandonment issues and which it is the core of the borderline personality disorder. What does abandonment feel like? This question was asked by my therapist. I answered, “Like someone has ripped my heart out. An aching all over. Like I want to throw a tantrum. Like no one is every going to respond to me.”

My therapist responded with “those are descriptions and not feelings.” He encouraged me to just be with the feeling…urg!!! With tearful eyes, I answered, “alone, painful and rageful.” Then, I started to sob and talk about when I felt abandoned. He told me to stay in the feeling and not defend by my cognition. What kind of therapist do I have to encourage me to feel!!! :-)

The key is attachment to the primary care-giver which is usually the mother. When an infant or toddler does not attach to the mother due to the mother’s actions inadequate attachment occurs. There are various types of attachment. They are ambivalent, avoidant, anxious and secure. Given what I have already written about my life, my attachment was ambivalent. Everyone experiences some attachment difficulties, but for some it does not interfere in one’s life. However, for some it significantly impacts their emotional, relational, cognitive and behavioral issues. The earlier the injury usually means that it has more impact on a person’s life.

This is related to the criteria for borderline personality disorder in the DSM-IV-TR:

“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 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”

What does a child need to form a secure attachment? The following is a table from Understanding the Borderline Mother by Christine Ann Lawson:

Variations in Maternal Functioning

The Ideal Mother versus The Borderline Mother

1. Comforts her child versus Confuses her child.

2. Apologized for inappropriate behavior versus Does not apologize or remember inappropriate behavior.

3. Takes care of herself versus Expects to be taken care of.

4. Encourages independence in her children versus Punishes or discourages independence.

5. Is proud of her children's accomplishments versus Envies, ignores, or demeans her children's accomplishments.

6. Builds her children's self-esteem versus Destroys, denigrates, or undermines self-esteem.

7. Responds to her children's changing needs versus Expects children to respond to her needs.

8. Calms and comforts her children versus Frightens and upsets her children.

9. Disciplines with logical and natural consequences verses Disciplines inconsistently or punitively.

10. Expects that her children will be loved by others versus Feels left out, jealous or resentful if the child is loved by someone else.

11. Never threatens abandonment versus Uses threats of abandonment (or actual abandonment) to punish the child.

12. Believes in her children's basic goodness versus Does not believe in her children's basic goodness.

13. Trusts her children versus Does not trust her children.

Abandonment also includes sexual abuse, physical abuse, neglect. One thing that people with borderline personality disorders do is try to find someone who will fulfill these needs which is why they become involved in the type of relations and avoid at any cost feeling abandonment and become involved in abuse relationships. This is an attempt to fulfill our infantile wishes which everyone has to some degree.

Without the important above needs, they will also split a relationship to all bad or all good. They will also try to have someone tell them what they feel and who they are as they have little sense of self. It also results in depression, hopelessness, worthlessness, feeling helpless, feeling needy, personality disorders and feelings of abandonment which included emotional and physical.

If one has experienced one of the most painful experience of all it can turn your life upside down and around and around. Each and every loss feels like abandonment and adds more layers of pain to repressed pain and unresolved grief. This can also result in rage, pain and terror.

What I am discovering in therapy is that my unresolved abandonment results are well defended by self-injury, eating disorders, over-functioning, relationship problems, and more. They are defenses against feeling the rage, terror and pain of my abandonment. This also keeps me from thinking that it was all my fault versus the other person is responsible for their decsions.

Most recently, I have felt abandonment in many areas that are made more difficult due to my unresolved feelings about my being abandoned. It adds to the intensity and I also am more effected by feeling that I am “abandoned” even if it isn’t true. My birthday is one example, my grandmothers death, my relationship with my aunt, my husband working extra hours, etc. One area that has always been quite difficult with me is whenever my therapist takes time off even if it for the weekend. Sometimes, I even think that he is purposely trying to hurt me which I know isn’t true, but it is not what it feels like.

Feelings of abandonment is partly a psychobiological process. The brain at a young age develops neuropath ways that are automatically followed. The good news is that you can train your brain to take a different path which is known as neuroplacisity. Also, it is becoming aware of your thoughts before you act and choose to act differently.  However, both take hard work and it is worth it.

For me, therapy and medication have been the most helpful. Medication brings me to a point where it dials down my thoughts and feelings, so I can actually do the work necessary in therapy.

I can write much more on this topic, but I will stop here as this is becoming very long. I hope that it helps you to understand yourself and others.

Abandonment: Pain, Rage & Terror

I used my non-dominant hand. I am working through some of these issues and feelings in therapy now. During one of the sessions, I said that I feel like coloring." The colors are a bit washed out. The colors are a red-orange and purple-blue.

Abandonment rage is a very significant part of, even possible the core, of the Borderline Personality Disorder condition.  It is what makes us "act out" our anger toward others or ourselves.  Working through these issues is key in really getting better; however, it takes a long time to reach this point.  Most terminate before reaching this point.  But, it does get better...I promise.  In spite of the pain of working it through, it is well worth it.

Borderline Personality Disorder ~ What is Emptiness?

DSM-IV-TR criteria 7 for Borderline Personality Disorder:
chronic feelings of emptiness.

What does emptiness feel like? It is described by professionals as boredom, loneliness, social alienation and apathy.  I find these definitions lacking the proper words to describe what emptiness feels like to me.  It is actually difficult to describe, but is related to self- identity difficulties.

This is very simplified. But, what is supposed to happen when you are a young child is that the primary caretaker responds to a child's needs and mirrors back the child's feelings in an appropriate manner which includes love and comfort.  As for myself, I was responded to with abandonment, aggression, abuse or ambivalence.  So, the message I received basically was hostile or abandoning which is what I do now.  I'm either full of self-hatred and/or abandon my needs.

With abandonment, as a child I am left to feel empty inside...someone please tell me who I am.  Yet, it isn't the same feeling as abandonment.  I feel like there is nothing inside of me just a hole in my gut and heart.  Like a hole in my soul. A hollowness. Distressful.

Yet, it does not seem void of feeling.  If I allow myself to feel it, it is extremely painful.  But, very difficult to describe. I do know that the words above do not fit, at all.  I am not bored, lonely, feel isolated or apathy inside. I can feel empty in a room full of people and can even be engaging with others.

As a Christian, it isn't the "God shaped hole" for Him to fill...I already know that emptiness.  Despite what other Christians think, it isn't about just letting God fill it.  It doesn't happen that way with everything. I know that the majority of it is filled with self-hatred and self-destructive.  As those layers are given up or healed in my life, my emptiness feels more real.

If I allow myself to feel empty, I feel like I'm going to die. Maybe, it is that hole that was supposed to be filled with love, comfort and care.  If that is the case and I never received it on any consistent basis than I am truly left with a hole that needs to be filled with love, comfort and care.  This time, not from the outside but within which means I need to provide this for myself.  This is what God does provide and is an example of.  It is difficult to learn how to do this for myself.

The alternative for many people including myself often leads to numerous addictions in an attempt to fill the emptiness. Addictions to eating disorders, alcohol, drugs, television, shopping, sex, busyness, work, gambling, self-injury and falling in love  are all used to fill the emptiness or to distract us from the pain.  But, they don't work...you just end up needing more to fill the emptiness again and again...they become true addictions.

So, the question remains what does emptiness feel like?  What are your thoughts, feelings and experiences?

Borderline Personality Disorder Stigma...Why?

In the past, I have written about the stigma of borderline personality disorder and some of the reason for it. However, Brain Blogger: Topics from multidimensional biopsychosocial perspectives, has one of the best articles, Psychiatry Discriminates Against People with Borderline Personality Disorder, that I have read and I want to share it with you.  I will later follow up with posts on abandonment, self-image and the brain. 

The stigma regarding Borderline Personality Disorder is probably the highest out of all mental illnesses combined.  While in college and in my career, my colleagues and I have often groaned when I find out one of my clients are diagnosed as such.  When I was diagnosed with it, I was quite scared because of the stigma which is clearly explained in Brain Blogger: Topics from multidimensional biopsychosocial perspectives.  As explained in the article, many professionals will not treat those individuals with borderline personality disorder.

However, I believe that there is hope.  For me, I have learned to manage my symptoms and understand them.  But, it has taken a very long-time and psychiatric hospitalizations and medication.  I continue to improve. My therapist is very committed to my becoming healthy and treats me as a person first and explains what behavior, thinking and emotions are common in people with borderline personality disorder.  I takes a huge commitment one the patient and professionals regarding borderline personality disorder.

Brain Blogger: Topics from multidimensional biopsychosocial perspectives, is a fantastic site and one that I follow one a consistent basis.  It addresses professional issues and psychological issues from many disciples in a way the someone not in the mental health permission can understand. Okay, I'll stop rambling and let you read the article. With permission the following is an article reprinted for this post:

Psychiatry Discriminates Against People with Borderline Personality Disorder
By Elise Stobbe

Borderline Personality Disorder (BPD) is characterized by a pattern of unstable relationships, a self-image that is always changing, and poor impulse control. The person suffering from BPD fears abandonment and will go to any lengths to prevent this, including threats of suicide. Self-harm is a characteristic.

There may be no other psychiatric diagnosis more laden with stereotypes and stigma than Borderline Personality Disorder. People who live with this label — the majority being female — often have problems accessing good mental health services. (1) Unlike the stigmatization that society puts on mental illness, the stigma associated with BPD often comes from mental health professionals and their patronizing attitudes.

Many psychiatrists will not treat BPD patients, or they may limit the number of BPD patients in their practice or drop them as ”treatment resistant.” Often attempts to treat borderlines fail, and some professionals blame the patient for not responding to treatment. (2) It is often undiagnosed, misdiagnosed, or treated inappropriately. According to Dr. Joel Dvoskin, former Commissioner of the New York State Office Of Mental Health,

“Why would psychiatry and psychology turn so viciously against people they call mentally disordered? Apparently the greatest sin a client can commit is poor response to treatment. What is apparently so wrong about these unfortunate souls is that they have yet to demonstrate the ability to get better in response to our treatment. Thus, they don’t make us feel very good. With a few notable exceptions, we have simply given up on helping people who desperately need us to do a better job of helping them.” (3)

Many mental health professionals discriminate against BPD patients because of what their co-workers have said about them. They watch other professional people “rolling their eyes” when someone mentions BPD. This is just evidence showing others that “everyone knows that people with BPD are horrible people and hard to manage”. (4)

Clients who come to services with a diagnosis of BPD “may already be disliked before they have even been seen. Clients in treatment are often embroiled in clinician attitudes which are derogatory or denying the legitimacy of their right to access resources. Studies have demonstrated clinicians having less empathy for people meeting diagnostic criteria for borderline personality disorder than other diagnostic groups and making more belittling comments.” (5)

Support services for consumers and families are woefully inadequate. The public is generally unaware of the disorder due to the lack of educational materials available from various mental health organizations. No celebrity has yet come forward to put a face on BPD, probably because BPD is the most stigmatized of all mental illnesses today. (6)

Recent research studies have demonstrated the effectiveness of individual cognitive behavioral therapy along with group psychoeducation and skills training that teach emotional regulation skills, distress tolerance, improved interpersonal relationship behaviors and awareness (mindfulness). This, combined with careful medication management, may allow the patient to achieve significant progress. (7)

Effective treatment can reduce symptoms and improve quality of life. There is also considerable short-term fluctuation in symptoms and distress, and the long-term outcome for many patients is often better than originally thought, even without treatment. (8) A fairly new psychosocial treatment termed dialectical behavior therapy (DBT) which was developed specifically to treat BPD is available. But without willing professionals, people with BPD are denied the help they need.

References


(1) Nehls, N. Issues Mental Health Nursing. “Border Personality Disorder: Gender Types, Stigma and Limited System of Care“. Abstract. Entrez PubMed.

(2) Bogod, Elizabeth. Mental Health Matters. “Borderline Personality Disorder Label Creates Stigma“.


(3) CAMI Journal on BPD, Vol 8 cited by TARA Association, “Understanding Borderline Personality Disorder“.


(4) Fleener, Patty, M.S.W. BPD Today. “Stigma and Borderline Personality Disorder“. (2002).


(5) Krawitz, Roy and Watson, Christine. Mental Health Commission Occasional Publications: No. 2. “Borderline Personality Disorder: Pathways to Effective Service Delivery and Clinical Treatment Options.” (October, 1999).


(6) Porr, Valerie. TARA Association. How Advocacy is Bringing Borderline Personality Disorder Into the Light“. (Nov. 2001).


(7) TARA Association, “Understanding Borderline Personality Disorder“.


(8) Livesley, W. John, M.D. The Canadian Journal of Psychiatry. Editorial: “Progress in the Treatment of Borderline Personality Disorder“. (July 2005).

So what is your experience with being diagnosed with borderline personality disorder or what have you known about the stigma surrounding this disorder?

Don't forget to check out Brain Blogger: Topics from multidimensional biopsychosocial perspectives.  You will be glad that you did. Follow it for a while to see the vast number of posts including funny research.  Thank you for Brain Blogger for giving me permission to post their article.

Anger and Pain: Family distance!! ~ BPD in Action!!

If you remember, I stated somewhere that last week left me emotionally exhausted. I couldn't write about it then, but I'll try now. (Remember, I have a Borderline Personality Disorder)  Current, commentary in the emails are in purple brackets.  Let us start by identifying the key people.

Coleen:  Me

Adrian:  Husband

Arleen:  Aunt

Judy:     Arleen's partner
Grandmother:  Grandma; Masaye

Key definitions:

Fragmentation ~ the person is all emotion with no reality based thoughts; emotionally reactionary verses thoughtful and responsive; 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. [Judy and I are fragmenting during the following interaction and are all feeling and reactionary.  Judy is significantly fragmenting and demonstrating a Borderline Personality Disorder feature.  We all do this, but it is especially difficult for someone with BPD to manage.]

Mirroring ~ "copying" another persons affect or thoughts. Basically, demonstrating agreement with another, so that they feel like you think and feel the same thing. In infants and children, this is extremely important. When this phase does not take place, a person will try to do this with adult relationships. [This whole thing started by a simple interaction were I didn't have the same opinion as Judy. Look at links below for details. It may seem like it is my reaction to Arleen, but, in fact, I didn't not fulfill her infantile fantasy that someone will mirror me exactly the way I want them to. BPD characteristic.]

Alignment ~ attempts at having another person think and feel the same way. This is a part of infantile fantasy and mirroring. Infantile fantasy is that everyone and everything align or agrees with how you think and feel. [BPD attempt at getting what they didn't get when they were very young...for me as an infant.]

Splitting ~ black and white thinking; everything is all good or all bad; polarization of people, ideas, and things. All or nothing statements are symptoms of this. (always, never, every time, etc..) [Judy is splitting me.  Once, I was all good to her and could do nothing wrong, but now everything I say, do, or once said and did is view as that I am all bad. Tough BPD issue to manage.]

Projection ~ a person projects their own feelings, emotions or motivations onto another person without realizing that their reaction is really more about themselves rather than it is about the other person. [Judy is doing this in the interaction. This is especially characteristic of someone with BPD.]

Transference ~ is when an someone associates something that is said or done in a past experience and so relives the emotions of that past experience in the present. [Both of us are doing this in the interaction.]

Some background:  During last year, Arleen and Judy were extremely supportive of me after about 15 years of almost no communication.  Judy reports that my mother had told them that I was a very conservative Christian and felt that their marriage was an abomination.  She told me that they were uncomfortable with my being a Christian.  None of which is true.  I am actually a gay rights supporter. I think that they were projecting the "media church's" view on homosexuality on to me.  Additionally, I think I was a threat to their relationship as I was extremely close to Arleen.  She basically raised me and was emotionally my mother.

At the start of this year, there was a situation where all communication had been cut off between Arleen, Judy and I.  (See the following posts: http://clinicallyclueless.blogspot.com/2010/01/family-drama-anger-pain-fragmentation.html, http://clinicallyclueless.blogspot.com/2010/01/drama-continues.html, http://clinicallyclueless.blogspot.com/2010/01/drama-and-depression.html, http://clinicallyclueless.blogspot.com/search/label/Family%20Drama ). 

However, due to my Grandma's illness and subsequent passing away, Judy and Arleen had extensive communication with me and seeing one another at the events following. Judy had even called crying when her father passed away, her mother passed three days later and Grandma the day after.  The last conversation Adrian and I had we were in the middle of praying for her when she suddenly had to talk a call from her son.

Everything seemed fine during the events surrounding my Grandma's death.  My husband noted the same.  However, I emailed or sent an ecard to Arleen and Judy about one time per week since Grandma's passing (Feb 1st).  I had not had any response and received indication that she received, but did not open the emails or ecards.  Then, I received the following:

(It should be noted that Judy screens all of Arleen's mail, email and telephone calls addressed to Arleen.  It is very obvious that "Arleen's responses" to me are written by Judy especially as Arleen does not speak or write in the manner which they were written. She also is not awake during the hours that they were received.)

Received 4/26/10; Sent to Adrian, Arleen and myself; From Judy

Coleen and Adrian,

I thought my parameters were clear with Coleen, after Coleen left that horribly cruel message to Arleen on her cell phone some months ago. [see links above for details] Prior to that call to Arleen, I had put myself "out there", to be genuinely supportive and loving to and for Coleen. Arleen and I have been treated poorly by Coleen, through her behavior and actions toward us both, months ago. My feelings of extreme disgust especially over Coleen's treatment of Arleen, have not changed.  [This all stems from my setting a limit with Judy, but she is focusing on my statement toward Arleen which was quite nasty, but Arleen accepted my explanation and apology.]

While Masaye was ill and during the meetings of the family after she passed, I was appropriately as civil as I could manage to be, with consideration to all parties affected by her loss. [This is quite an over statement and may not even be true.  Remember that people with BPD don't see things as they really are and inflate and feed into their own anger...I know and it is difficult to be thoughtful instead of reactionary.] Somehow, this decision (my decision not to be cold or distant with Coleen at the hospital, service, Mom's home etc., ) was either greatly misinterpreted, or in my opinion, used as an excuse to proceed as if "nothing ever happened."

I asked not to be send e-cards and yet, this persists. I expressed my hurt over incidences with you personally, Coleen... and I expressed my infuriation and revulsion over your behavior and verbal dissection of Arleen. She is the last person on the earth who deserves your cruelty. Your behavior was absolutely inexcusable. [Each email that Judy has sent regarding the "incident" becomes bigger and bigger as demonstrated by her own words.  Also, begin to see how she uses splitting by all, nothing, never...etc.  This is definitely a BPD characteristic and quite difficult to manage and learn to be thoughtful rather than reactionary.  I'm getting better at it.]

As to the gift card you sent for my birthday, I am informing you that I have given it to Arleen because I'm not comfortable accepting it from you. It will be considered her birthday present from you to her for May. [This demonstrated how fused Judy and Arleen are with one another.  She is not dictating what I am to give Arleen for her birthday.  I'm going to send Arleen a gift of my own. I figure that Judy can do whatever she wants with my gift.]

I leave Arleen to speak for herself, if and when she chooses to do so, as always. As for me personally, to be perfectly clear Coleen, please do not email me, send ecards, call me or contact me in any way. It is well known that "fragmenting" is no excuse to treat people like shit only to expect that others roll under the weight of it. I believe you knew exactly what you were saying and while you truly experience "fragmenting" at times, you also employ it as a tactic to behave in ways so that you can escape responsibility for your actions by claiming "it" as the culprit. [Long discussions with my therapist over this paragraph.  Bottom line is that this is not true, but is for Judy who is projecting. She doesn't seem aware of her own behavior and this is actually more true for her than for me.]

We have been through the worst months of our lives and I will not allow these "issues" to persist. Please show some respect and let me be. I wish you both well.

Sincerely,

Judy

[Judy is BPD and has demonstrated many of the characteristics of such.  One of the issues we face with BPD is that we act and say things in ways to make the other person feel as we do. (projection).  So, my reaction was anger bordering on rage when I first received this.  However, I have stopped reacting to her anger which was directed at me.  Basically, she is angry about my setting a boundary with her and is rageful, so is trying to make me feel as angry as she is.  Classic BPD symptom. Tough one for me to deal with.]

Sent: 4/26/10; To: Arleen; BCC: Adrian

Arleen,

Do you feel the same as Judy in regards to me? Do you not want any contact

with me? If you do not answer as Judy made reference to, I will interpret a

lack of response from you that you do not want me to contact you via mail,

email, telephone calls, ecard, or to contact you in any way. I just want

some clarification about where I stand with you.

Love,

Coleen

Received 4/26/10; To: Me; BCC: Judy, Adrian

I do love you, you are my family and always will be, that can't be changed. I'm sorry that we can't have as close a relationship as before, because of what you said to Judy and me. I have forgiven you for me, but can't forget that somewhere inside of you, the real you, you must really think that about me. I love you, Coleen and always have! We can continue to email and ecard between the two of us, if you would like.

Love,

Arleen

[This email is obviously written by Judy as it does not sound like Arleen and sounds like Judy.  The other evidence is that it was written at a time when Arleen is quite far from being awake.]

Sent 4/26/10; To: Arleen; BCC: Adrian; From: me

I do love you too. I also am also angry and sad that you can't get past what was told to you by Judy. Especially, as you indicated in response to my email explaining my telephone call to you that you understood. I became scared when you wrote something like you both did not want any telephone contact with me. Although I know that it wasn't true, it meant to me that you were abandoning me and that you were cutting ties with me. What I stated, in anger, was not, is not and never has been what I really think of you. Often, most people say things out of anger that they really don't mean in an effort to really hurt someone. I am sorry that I hurt you, but that really isn't the way that I think about you. I'm sorry that I cannot count on you to be there for me...you and Judy were the only ones in the family that I could. So, you just throw away many years over this situation and basically don't want contact with me. Sounds a bit harsh. I guess, if I go into the hospital again, Adrian will notify you by email. How long are you both going to punish me for which I have already apologized. Is this a lost cause that I cannot do anything more about? I guess, we will go through the rest of our lives via email. I love you.

Love,

Coleen

[Okay, now I am reacting and not being thoughtful.  However, I was slightly aware of this and didn't care because I was so angry. But, there is progress as I was aware that I was making a choice.  A year ago, I was far from being able to do this.]

Sent 4/26/10; To: Arleen; BCC: Adrian; From: me

I am sorry if I hurt your feelings in the last email. But, I think, I am trying to obtain something that I will never have with you which is an open, loving, caring, supportive and understanding relationship.

Love,

Coleen

[Not a very wise thing to say...now, I am fragmenting more]

Received 4/26/10; To: Me; BCC: Judy, Adrian

Coleen! You didn't JUST hurt my feelings...you stabbed me in the heart and disrespected my love for you...how can that ever be completely healed???? And before you ask for an open, loving, caring supportive and understanding relationship you need to look deep within your own heart and soul...are YOU really capable of this yourself???? As I said I will love you and care about you always, but a relationship works both ways. I have tried to be so open and honest with you, but you obviously are hiding many things from me and everyone else...how do you expect to heal your soul by hiding and lying to yourself. I hope you read this and can understand, if not, then good luck with your life and be well and try to love the man that has stood beside you thru all this.

Love, Arleen

[This is definitively written by Judy who is escalating in her fragmentation.]

This is a part of what I was dealing with last week and it continues.  I had six hours of therapy four is the norm and a scheduled appointment with my psychiatrist. I also promised not to respond/react to Arleen or Judy without speaking with my therapist first, so as to stay out of "trouble." Needless to say, I am very angry and hurt by the above. It is mostly untrue.  I also demonstrated BPD characteristics by only seeing Judy as bad and I was feeding my own anger by ruminating about it.  Additionally, I thought that I was a "bad person."  Once, I was able to stop this I was able to be thoughtful about the emails.

I am beginning to realize that Arleen is choosing to be in an emotionally abusive relationship which saddens me as I am unable to speak with her directly without going through Judy who has effectively cut off communication with me.   I am angry at both of them, but really disappointed that I cannot communicate with Arleen.

So there is my Monday!  I'm not through with the exhaustion of my week yet...sheesh.  I know that this is long, so for those who read it "thank you."  I also hope that it helped you to understand more about the issues and challenges that those with  Borderline Personality Disorder face, all the time.

Borderline Personality Series ~ Overview 2010

May is borderline personality disorder (BPD) awareness month and this is how it is experienced by those with BPD. This diagnosis is difficult as there is so much stigma attached to it and it takes a real committment and a lot of patience for a therapist to provide services and for the patient to perservere. Many therapists will not treat those with borderline personality disorder. I am diagnosed with this disorder and it is treatable, but takes a very long time.

The prevalence of BPD is about 2% of the general population. It is seen in 10% of psychiatric outpatients, and 20% of psychiatric inpatients. This disorder is more frequent in females (about 75%) than males. Emotional instability and impulsivity are very common in adolescents, but most adolescents grow out of this behavior. Unfortunately, for some, this emotional instability and impulsivity persists and intensifies into adulthood; thus they become diagnosed with this disorder. As with other mental disorders, the causes of borderline personality disorder are complex.

The name arose because of theories in the 1940s and 1950s that the disorder was on the border between neurosis and psychosis. But, that view doesn't reflect current thinking. In fact, some advocacy groups have pressed for changing the name, such as calling it emotional regulation disorder.

Meanwhile, the cause of borderline personality disorder remains under investigation, and there's no known way to prevent it. Possible causes include:

• 
  
  Genetics. Some studies of twins and families suggest that personality disorders may be inherited.
• 
  
  Environmental factors. Many people with borderline personality disorder have a history of childhood abuse, neglect and separation from caregivers or loved ones.
• 
  
  Brain abnormalities. Some research has shown changes in certain areas of the brain involved in emotion regulation, impulsivity and aggression. In addition, certain brain chemicals that help regulate mood, such as serotonin, may not function properly.

Personality forms during childhood. It's shaped by both inherited tendencies and environmental factors, or your experiences during childhood. Some factors related to personality development can increase your risk of developing borderline personality disorder. These include:

• 
  
  Hereditary predisposition. You may be at a higher risk if a close family member — a mother, father or sibling — has the disorder.
• 
  
  Childhood abuse. Many people with the disorder report being sexually or physically abused during childhood.
• 
  
  Neglect. Some people with the disorder describe severe deprivation, neglect and abandonment during childhood.

Marsha Linehan theorizes that borderlines are born with an innate biological tendency to react more intensely to lower levels of stress than others and to take longer to recover. They peak "higher" emotionally on less provocation and take longer coming down. People with BPD are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement. In addition, they were raised in environments in which their beliefs about themselves and their environment were continually devalued and invalidated. These factors combine to create adults who are uncertain of the truth of their own feelings.

I also agree with A.J. Mahari's theory that compliments Linehan. Mahari states, "It is the core wound of abandonment in those who have been diagnosed with Borderline Personality Disorder (BPD) that is the source of insecure or non-existent attachment that leads to the toxic and unhealthy ruptured relationships that have at their centre emotional enmeshment and an insatiable need for love. These broken relationships, often rupture under the weight of the child-like behaviour and needs of the borderline still searching for the much-needed unconditional acceptance, validation and love of a parent as the result of unmet early childhood developmental needs.

Most, if not all, borderline behaviour is driven directly or indirectly by fear of abandonment and the fear of re-experiencing the intolerable pain of your original core wound of abandonment. What feels like it keeps happening to you, is in fact, a triggered, dissociative, regressed re-experiencing of what initially happened to you in the very early and formative developmental years of your life." With borderline personality disorder your image of yourself is distorted, making you feel worthless and fundamentally flawed. Your anger, impulsivity and frequent mood swings may push others away, even though you yearn for loving relationships.

Individuals with BPD seem to have a much higher stigma than individuals with other disorders even within the mental health community and there is debate as to whether or not they are treatable. Many professionals will not treat people with BPD or must limit the number of patients. In order for treatment to be successful, it requires a significant commitment from the therapist and patient. My personal belief is that people with BPD can be treated. I, for one, have been receiving treatment and am near a point where I will no longer meet the criteria.

But, it has been a long time of much tumultuous and extremely painful hard work for both my therapist and I. There were times when I think both of us wanted to quit. Persons with BPD are often described, by the DSM as deliberately manipulative and difficult with extreme inner pain and turmoil, powerlessness and defensive reactions with extremely limited coping and communication skills. My translation, they take tremendous energy, extra attention, consistent limit-setting, terminate treatment prematurely and may return, and have a love/hate relationship with the therapist. But, there is hope.

And, I, for one, am getting there; however, it has taken a very long time and much commitment and painful work. I can see why people "give up" treatment. But, the reward for sticking it out is priceless. Well, really not priceless...therapy and medication is expensive, but that is a whole other issue. Don't even get me started.

Below is a Polyvore collage that I put together expressing how having a borderline personality disorder sometimes feels for me. I know the image is difficult to see, but if you click on the link below the picture you will be able to see it more clearly.

Fragmentation by ClinicallyClueless on Polyvore.com

The text in this post is an excerpt from my blog Clinically Clueless. Last year, I wrote a five part series about borderline personality disorder so if you want to see more please click on the "Borderline" picture on the right sidebar. Thoughout the month of May, I will be adding different types of posts related to this disorder, so keep your eye out on my blog.

I hope that this gives you a better understanding about borderline personality disorder and breaks some misconceptions. Any and all questions welcomed. How does this post effect what you thought or didn't know?