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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.
Showing posts with label Cognitive-Behavioral Therapy. Show all posts
Showing posts with label Cognitive-Behavioral Therapy. Show all posts

Tuesday, August 5, 2008

Borderline Personality Disorder ~ Part V ~ Common Traits

To close my Borderline Personality Disorder Series, I wanted to review some common traits and terms relating to BPD. I hope the series was informative and helpful. Some of the information below comes from two books that I highly recommend which are Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder and Surviving a Borderline Parent: How to Heal Your Childhood Wounds & Build Trust, Boundaries, and Self Esteem. They will be noted in parenthesis as Eggshells and Surviving.

Undefined Boundaries: Because the person with BPD has such a blurred sense of self in relation to others, enmeshment, or emotional entanglement, is common. Borderline parents may treat their children as an extension of themselves, almost like one of their limbs, expecting them to wear the same style clothes, hold the same opinions, or to side with them in disagreements with a spouse or other family members.

The person with BPD may be jealous of the child’s relationship with the other parent and extended family members. The thought process appears to be, ‘If you love your father, you must not love me,’ ‘If you want to spend time with someone else, you’re abandoning me. If you have a relationship with someone else, you’re disloyal to me.” (Surviving)

Although I do not seem to have a problem in this area, my mother sure did. As I stated in an earlier article, I often felt like I was an extension of her. We do/did have similar taste in clothing however. And if she likes a certain food item, she is certain that I will even though I have already told her I don’t. She will insist I eat it. But, it really showed when it came to disagreements, she would often complain to me about my step-father or other people and unless I took her side, she would become angry at me. So, I always took her side even if I disagreed. She does this with everyone in the family to this day.
Lack of Object Constancy: One of the necessary, but painful tasks that children need to learn is object constancy. It is the ability to know that mommy and daddy exist and love me even when I don’t see them. This also teaches them to soothe themselves rather than to rely on others. However, a person with BPD has difficulty if that person is not physically present. To them they just do not exist on an emotional level. They will require or demand things to make sure you are really there such as excessive telephone calls and may become anxious if their spouse isn’t on home right on time. To alleviate and cope with the fears and anxiety of perceived abandonment they may use pictures, letters, colognes, etc. It is much like a child uses a favorite blanket or toy to represent the nurturing parent.

For me, this was and is an extremely painful area because I have an extremely shaky sense of object constancy especially with my therapist. Not seeing him on the weekends is hard and when he goes on vacation I almost always feel abandoned. This is why I have a pillow from his office that I take to and from my sessions. When things were really tough, I had voice recordings and greeting cards from him. The pillow is comforting to me and I sleep with it by my head and it went with me to every group meeting when I was in the hospital. Now, I still have difficulty with vacations and holidays and long weekends, but they are a little easier. I still feel really uneasy inside and a little ungrounded though.
Situational Competence: “Some people with BPD are competent and in control in some situations. For example, many perform very well at work and are high achievers. Many are very intelligent, creative and artistic. This can be very confusing for family members who don’t understand why the person can act so assuredly in one situation and fall apart in another. This ability to have competence in difficult situations while being incompetent in seemingly equal or easier tasks is known as situational competence.

By way of explanation, one borderline woman says, ‘We know deep within that we are defective. So we try so hard to act normal because we want so much to please everybody and keep the people in our lives from abandoning us.’ But this competence is a double-edged sword. Because they can appear so normal, high-functioning borderlines often don’t get the help they need.” (Eggshells)

This fits me perfectly which has frequently created difficulties, but none bigger than during this current major depressive episode which I’ve been writing about. I’ve received many comments about how I could work during all of what was going on. Well, I did and when I needed hospitalization, it came as a surprise to everyone and my co-workers all had to assist with keeping my caseload up to date just as we would for anyone. Well, apparently during my three and a half week hospitalization and one month off after that, which wasn’t enough (but I had to prove I was okay to myself ), I did not return to a supportive environment.

I returned to a more demanding and hostile environment. I was expected to take on my own duties and additional duties my first day back. And, I was informed that my co-workers were resentful as it was like I left things a mess and took a vacation. Now, these are social workers and all knew that it was a psychiatric hospitalization. They thought that I was just trying to get out of work. It was an extremely painful way to return and resulted in further decompensation. I won’t go into details, but the union was assisting me.

Narcissistic Demands: “Some people with BPD frequently bring the focus of attention back to themselves. They may react to most things based solely on how it affects them. Some people with BPD draw attention to themselves by complaining of illness; others may act inappropriately in public. These self-involved characteristics are defining components of narcissism.

I do this some, but not anymore than the average person. However, my mother does do these type of things, in fact, my husband commented once that she was like a child in public with her being inappropriate like swinging between two carpet sample stands. I may act silly, but usually not inappropriate per my husband. (So, not just my opinion…although, he may be biased.)
Manipulation or Desperation?: Loved ones of a person with BPD often feel manipulated and lied to by their BPD loved ones. Their loved one with BPD may feel like they are controlling, taking advantage or them via their rages, suicidal threats, gestures and attempts. It is often viewed as manipulation by the non-borderline loved one instead of a means to cope with intense painful feelings or a way to get their needs met. Their intention is not to harm someone else. They are acting out of fear, loneliness, desperation and hopelessness in the only way they know how to get their needs especially for comfort met.

This one is a tough one for me to answer and it isn’t because I don’t have an answer, it is because I am embarrassed and feel bad about how I act sometimes. In terms, of my mother, I’ve already answered this more than enough. But, when it comes to me, I really haven’t written about the “ugly” side of my being borderline. Five years ago, when most of this started, it was really difficult for my husband and I. He says that he was not sure that he could handle it.

I would go into these rages and pick fights with him from daily to three times per week. Without provocation, I’d me like my mother, I would be yelling and screaming at him for every little thing. I know now that I was trying to make him feel as badly as I felt. Sometimes, I would just start throwing things, not at him…just throwing. I felt so out of control. I really felt like I was going crazy because it was like I had no control over how angry I was or what I did. It was really, really stressful for both of us. My therapist really helped him to understand what was going on with me and to handle things and reassure him that it wasn’t him. I was afraid I was going to be just like my mother; however, it was pointed out that I would always eventually realize what was going on and apologize.

Through therapy and because of working through some of my anger, I am now much more aware and do not do this anymore to that degree. I may try to pick a verbal argument, but nothing more and my husband knows how to handle it so it doesn’t last long or happen frequently. It still happens, but it isn’t as intense.

Acting In, Acting Out: “Those that act out tend to function well in public; they are doctors and managers, lawyers and parents, best friends and board members; they’re politicians and teachers. They are often fun to be around. They may be ambitious, successful professionally, the life of the party, sociable and great storytellers. They may have a knack for putting others at ease. Once out of the public eye, however, they direct their negative emotion at others-usually family members-pointing an accusatory finger, making impossible demand, and inflicting verbal, emotional and sometimes physical abuse on loved ones. (Some adult children recall being told as adolescents that they were ugly, unpopular, and wouldn’t amount to anything, for example.) From outward appearances, the person with BPD may seem the model of competence and normalcy.

Others with BPD act in, tending instead to turn negative emotion inward, resulting in self-destructive behaviors such as cutting, self-mutilation, abusing alcohol or drugs, feeling intensely guilty for circumstances and events beyond their control, setting unreasonable high standards for themselves, or attempting suicide. They tend to be heavy utilizers of the mental health, and health care systems, and may have difficulty keeping a permanent job.” (Parent)

My therapist explained that BPD is about rage and which direction it gets turned. My mother’s obviously is completely turned outward and mine for the most part is turned inward. The difference from this description from me is that I also had the high degree of competence, so there was a lot more pressure that I placed upon myself. I left very little room for my anger to go anywhere, but inward and sometimes outward toward my husband.

One thing I do want to highlight is that many of the people that are similar to me you would never know that they were BPD unless they were in an unusually stressful situation because they are high achievers and may be the at the top of their fields as physicians, CEOs, teachers, psychologists, social workers, psychotherapists, psychiatrists, pastors, pastor’s wives, managers, lawyers, etc…I am one of those types and it is very difficult to maintain the over-functioning which is a defense from feeling what is really going on inside.

Dissociation:
a mental process that causes a lack of connection in a person’s thoughts, memory and sense of identity. Dissociation seems to fall on a continuum of severity. Mild dissociation would be like daydreaming, getting “lost” in a book, or when you are driving down a familiar stretch of road and realize that you do not remember the last several miles. A severe and more chronic form of dissociation is seen in the disorder Dissociative Identity Disorder, once called Multiple Personality Disorder, and other Dissociative Disorders. (definition taken from
www.MentalHealthAmerica.net) My therapist and I also refer to dissociation as “going away” or “leaving.” Remember it is on a continuum.


This is something that I do frequently especially when experiencing intense emotions. 20 years ago, in therapy, there were times when I would just go away for the whole session. It wasn’t safe for me to talk. Recently, I am beginning to realize how frequently I have done this my whole life. There are times now when I have some time gaps or don’t remember a conversation. This doesn’t happen very often and doesn’t seem to interfere with my daily activities most of the time.

However, there was a period where, I was almost not able to drive because I was becoming disoriented in familiar places. It was like I had no idea where I was or what to do. That was really scary and was due to the intensity of therapy at the time. I’ve mostly just highlighted the most severe experiences, but there are little ones all along the way…like when I’m typing a post, like this one.


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.

A good example of this is above where I discuss my anger with my husband. Also, there are times when I feel bad and no matter what anyone says or does, I will twist it into something that makes me bad regardless of my reality. Also, when I become angry with my therapist, there are times when it is not going to matter what he says, because I will interpret it as an attack. These instances are very painful and emotionally very intense. I will also do things like cancel appointments only to change my mind.

It is quite embarrassing, but it is part of the borderline splitting everything is bad or good and I can’t find any middle ground. The hard part is that I can’t access the part of my brain that knows differently, but I am getting better. One thing that has helped tremendously is that I have reached a new level of trusting my therapist and when in this type of situation I keep telling myself, “This is Geoffrey and we can talk anything through. He is not angry, is not going to harm me, is not going to yell or hit me.” Yes, the internal state of a borderline is quite intense and painful. This is why so many with BPD terminate therapy prematurely. I’m really glad I’m sticking it out…it is so worth it, but extremely painful and difficult.

Okay, I’ve revealed what I would call the “ugly” side of my being borderline, but all borderlines experience this pain and confuse themselves and others with their behavior. There are a multitude of areas and topics which I did not cover. Some include what to do if you have a borderline personality disorder. I did not cover it because it is very individualized and I want to encourage anyone who is experiencing difficulties to discuss it with their physician and/or to seek out treatment from a qualified professional. If you want to know more information, please look at my book suggestion list on the side bar and/or do a worldwide web search. For those with a borderline personality disorder, I hoped this series helped you to understand yourself better and gave you hope that things will get better. Also, for those with loved ones with borderline personality disorder or for those who had a parent with BPD, I hope you were encouraged and will seek assistance and support as necessary. Now, I’ll go eat my chocolate and chocolate chip cookies!!

Tuesday, July 1, 2008

Mindfulness ~ An Introduction

Lots of people have been talking about mindfulness and it is a growing trend in cognitive-behavior therapy especially for depression and bipolar mood disorders. Mindfulness is an English translation from Eastern practices. I thought that I would intoduce it on my blog since I believe in its usefulness on many levels.

Wikipedia states, "Mindfulness is awareness of one's thoughts, actions or motivations. Mindfulness (Pali: Sati; Sanskrit:smṛti स्मृति ) plays a central role in the teaching of the Buddha where it is affirmed that 'correct' or 'right' mindfulness (Pali:sammā-sati; Sanskrit samyak-smṛti) is an essential factor in the path to enlightenment and liberation. It is the seventh element of the Noble Eightfold Path, the sadhana of which is held in the tradition to engender 'insight' and 'wisdom' (Sanskrit: prajñā)."


I also think of this in terms of Christian ideas, which I won't get into here. To me, Examples are practicing Gods presence, silent prayer, Quakers, being still before God. However, mindfulness differs in that you are not trying to hear God, but hear yourself. But, in order to really hear God, you have to hear yourself and be quiet. To me, mindfulness, is the step just before you hear or sense God's presence. Now, remember this is my opinion. I'm not looking for or up to a debate. Please go to another blog for that.

I saw this on Swirls in my head - Thoughts from a mental mind and liked the explanation. It is the best simple one I've seen in a long time.

  1. Mindfulness is the English translation of the Pali word 'Sati.' Sati is an activity.

  2. Mindfulness is awareness of one's thoughts, actions or motivations.

  3. Mindfulness points one in the direction of being aware of the present moment.

  4. Mindfulness points to: Being aware of and paying attention to the moment in which we find ourselves.

  5. Mindfulness is a generalization about paying attention and being aware in the present moment , it occurs only in the individual.

  6. Mindfulness means you are not judging, reflecting or thinking.

  7. Mindfulness is mirror-thought. It reflects only what is presently happening and in exactly the way it is happening. There are no biases.

  8. Mindfulness is nonconceptual awareness. It is not thinking. It does not get involved with thought or concepts. It does not get hung up on ideas or opinions or memories. It just looks.

  9. Mindfulness registers experiences, but it does not compare them. It just observes everything as if they were occurring for the first time.

  10. Mindfulness is non-egoistic alertness. It takes place without reference to self.

  11. Mindfulness is awareness of change. It is observing the passing flow of experience. It is watching things as they are changing.

  12. Mindfulness, one watches the universe within.

  13. Mindfulness is participatory observation. The meditator is both participant and observer at one and the same time. If one watches one's emotions or physical sensations, one is feeling them at that very same moment.

  14. Mindfulness is not an intellectual awareness. It is just awareness.

Isaiah 49 :15 -16

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