Read this article in Time magazine and much of it turned me into a typical borderline. I was offended by quite a bit I read there but it’s not their fault that was how we poor folks were perceived. I think they did a pretty good job of describing the disorder and the pain we feel. I have never been a cutter, but many are I understand. I’m too adverse to pain for that. I find myself reacting in my typical emotional way though, feeling rejected because I’m like that, feeling unaccepted. Who knew that article would be such a trigger?

Ah well, I’m counting on my wonderful new Wise Mind to see me through my reaction to it. I think it’s well written, personally though I could have skipped hearing about how we were once seen as the bane of personality disorders. Nothing like making you feel like a freak. And an untreatable one at that! I know, I know, it wouldn’t have been a balanced article without the history. That history makes me appreciate how far we’ve come with treatment options at least. And at least they followed it through to where treatment, and hope, stands today.

I’ve heard that depression can change your brain. I wonder if Borderline Personality Disorder does too? I read this article at NIMH (National Institute of Mental Health) that says studies have shown that the grey matter functioning in BPD patients is impaired in an emotion regulation circuit (I can vouch for the fact that mine is faulty!). Since I’m a believer that our upbringing  causes this disorder, then I have to assume  that the trauma we under went caused changes. Either that or we were born with this shortcoming which in turn caused our caregivers to be so totally annoyed with us that we ended up with BPD. I have to give that theory some weight because I was surely more intense and high-strung than anyone else in my family. My problems go back farther than my memory does so I have no way of really trying to analyze that. Not that it makes any difference in the fact that this is something we have to live with but maybe it gives me a sense of legitimacy. Maybe I can let go of some of the shame of having such an untreatable, horrible disorder that even the mental health community looked at me with disdain.

While I’m at it I’ll mention another article just to show that untreatable myth is slowly changing. Age is supposedly on my side too. I wouldn’t really know since for the most part I live the life of a recluse. It’s not Borderline problems that cause me to isolate, it’s my complete loss of confidence in myself. I can tell you that is a hard thing to get back. When I was in my twenties and bouncing from one problem to another, I still tried. It took a huge toll, having to project the image that I was okay and had things under control (when I clearly didn’t). I used to be so much gutsier than I am now. I am not flighty like I was when I was young, I am more stable in some ways. As far as emotion regulation? I spent over two years in DBT (Dialectical behavioral therapy) supposedly learning how to regulate my emotions, and I still have no clue how to actually do that. What sends me off the deep end?  Well, the DSM-IV-TR puts it this way “Frantic efforts to avoid real or imagined abandonment.”, I say rejection (or perceived rejection) pure and simple. Some times it’s real, many times I believe it’s only in my head. I don’t frantically try to avoid it, as I did in my youth, I avoid getting close enough to risk feeling that way in the first place. Not a great solution but it does keep me stable and out of the hospital and even non-suicidal.  That makes it worth it to me because I hate it with a passion when I get that traumatized, out of control, awful feeling.

I believe the day will come, if we don’t manage to destroy ourselves first, when they not only will know which areas in the brain cause or contribute to certain mental illnesses, but that they will know how to treat them much like they treated my brain tumor. In fact, I’d volunteer now to have those faulty areas rewired or removed!

Objectives Effectiveness

Getting your objectives or goals in a situation

• Obtaining your legitimate rights
• Getting another to do something
• Refusing an unwanted or unreasonable request
• Resolving an interpersonal conflict
• Getting your opinion or point of view taken seriously

Questions

1. What specific results or changes do I want from this interaction?
2. What do I have to do to get results? What will work?

Relationship Effectiveness

Getting or keeping a good relationship

• Acting in such a way that the other person keeps liking and respecting you
• Balancing immediate goals with the good of the long-term relationship

Questions

1. How do I want the other person to feel about me after the interaction is over?
2. What do I have to do to get (or keep) this relationship?

Self-respect Effectiveness

Keeping or improving self-respect and liking yourself

• Respecting your own values and beliefs: acting in a way that makes you feel moral
• Acting in a way that makes you feel capable and effective

Questions

1. How do I want to feel about myself after the interaction is over?
2. What do I have to do to feel that way about myself? What will work?

I’m feeling too lousy to go into discussing this and besides, I couldn’t say it any better

Attending to Relationships

• Don’t let hurts and problems build up.
• Use relationship skills to head off problems.
• End hopeless relationships.
• Resolve conflicts before they get overwhelming.

Balancing Priorities vs. Demands

• If overwhelmed, reduce or put off low-priority demands.
• Ask others for help; say no when necessary.
• If not enough to do, try to create some structure and responsibilities; offer to do things.

Balancing the Wants-to-Shoulds

• Look at what you do because you enjoy doing it and “want” to do it; and how much you do because it has to be done and you “should” do it. Try to keep the number of each in balance, even if you have to:
• Get your opinions taken seriously.
• Get others to do things.
• Say no to unwanted requests.

Building Mastery and Self-Respect

• Interact in a way that makes you feel competent and effective, not helpless and overly dependent.
• Stand up for yourself, your beliefs and opinions, follow your own wise mind.

These are pretty self-explanatory I think. Relationship skills can be a problem for many people, Borderlines or not. I don’t know one person that couldn’t benefit from these classes I’m taking. And then I know a few that may need it worse than me For me the difficulty is more about me doubting the validity of me and my right to feel however I do. I can handle many situations just fine in areas that I don’t lack confidence in myself.

Listening to these women talk about experiences so totally like mine was very reassuring and freeing. I spent so many years receiving negative feedback even from the mental health community that was supposed to be there to help me, it’s uplifting to know that some people do recognize the pain we feel.

When I basically became non-functioning in California in 1995 I sent my kids back to Michigan to stay with friends of mine. I gave them guardianship for the school year. A few months later I decided to move back to Michigan, and that meant back to my parent’s house. When the school year ended the courts wouldn’t give me guardianship back because I had no job and no place of my own. So they gave guardianship to my parents. (that’s a whole ‘nother story) I was in and out of the hospital and it was the worst time of my life.

I eventually got SSDI retroactively and had the money to rent a house so I went to court to ask for guardianship again. This lawyer who represented my kids was there (my kids weren’t there) and he was totally rude and hostile and said if he had his way I’d never see my kids again. I was floored. Especially since he never once talked to either of them. Miranda asked to talk to him months before and he wouldn’t/didn’t for whatever reason. Considering that she was 16 at the time you’d think he might have considered her input. She wrote him a long letter at one point and he never responded to that either. Luckily for me and my kids, the judge said he saw no reason they couldn’t be back with me. I still have no clue why that lawyer felt that way, except that my diagnosis of BPD was that looked down on. He never bothered to talk to me either so I guess he was into making sweeping judgments.

The hopelessness of that time, both the situation and the medical outlook, has changed much for the better. I was always a good mother, but I’ll concede that I had very little to offer for a while. It would have been nice to have had some support that helped me and my kids together, but that sure wasn’t happening. After the anguish (and guilt) I felt losing my kids like that, all I can say is I am so glad those days are past me.

The mindfulness segment of DBT training consists of “What” and “How” skills,

What:

1. Observe
2. Describe
3. Participate

How:

1. Non-judgmentally
2. One-mindfully
3. Effectively

What Skills

Observe is sometimes a tough one for me. Just notice the experience without getting caught up in it. Have a “Teflon Mind” letting feelings and thoughts come into your mind and slip right back out. Push nothing away, cling to nothing. Notice everything with all of your senses. Be alert to every thought, feeling and action that comes into your mind.

Describe is just that. Put words on the experience. Say in your mind “I’m suddenly sad” or “a thought that ‘I can’t do this’ has just entered my mind” or “my stomach is queasy” Call a thought just a thought. A feeling just a feeling, don’t get caught in content.

Participate is jumping on in. Enter into experiences, getting completely involved. Act intuitively from wise mind. Actively practice your skills until they become a part of you. Practice changing harmful situations, changing your harmful reactions to situations, accepting yourself and situations just as they are. (boy that last one is a toughie!)

How Skills

Non-judgmentally means to see but don’t evaluate. Focus on what, not “good” or “bad”. Unstick your opinions from the facts. Accept each moment. Acknowledge the helpful but don’t judge it. Acknowledge the harmful but don’t judge it. When you find yourself judging, don’t judge your judging! Whew, that can be hard!

One-mindfully means to do whatever you are doing completely. If you are eating, eat. If you are worrying, worry. Do it with all of your attention. If other thoughts or actions distract you, let go of those distractions and go back to what you were doing, again and again. Concentrate your mind. If you find yourself doing two things at once, stop and go back to one thing at a time. Another tough one. How many of you drive the same route to and from work and barely remember the drive?

Effectively is to focus on what works. Do whatever you need to for each situation. Stay away from fair, unfair, right, wrong, should, should not. Play by the rules. Act as skillfully as you can in the situation you are in. Not the situation you wish you were in, not the one that is just, not the one that is more comfortable. Keep in mind your objectives in the situation and do what is needed to achieve them. Let go of vengeance, useless anger and righteousness.

That is it for the mindfulness section but it’s a lot! I’m getting better at this but I think it’ll take me years for it to just be second nature. Then start adding on all the other segments and it’s easy to feel pretty overwhelmed with it all. I am such a work in progress

Sometimes I lie awake at night, and ask, ‘Where have I gone wrong?’ Then a voice says to me, ‘This is going to take more than one night.’~ Charles M. Schulz

In most cases Borderline Personality Disorder is caused by childhood abuse or neglect. People with BPD are more likely to have been:

• verbally, emotionally, physically, and sexually abused by caregivers.
• having caregivers deny the validity of their thoughts and feelings.
• failure to provide needed protection.
• neglected their child’s physical care.
• parents were withdrawn from the child emotionally, and treated the child inconsistently.

I personally can vouch for the reasons behind it but I surely don’t understand that treatment of a child you bring into the world. I have 2 beautiful daughters and I couldn’t imagine treating them that way. There is no understanding the reasons that I can find and I believe that is not important anymore. I just reckon they didn’t like me much and thought that shame, scorn and criticism would somehow make me toe the line and behave like them. The image here shows where we strive to be.

And just maybe it does explain some things. Say your family are all these stoic, logical and unemotional people (reasonable mind). Then along comes a highly emotional, screaming, squalling baby that you have no idea how to handle (emotional mind).

What we are striving to learn is to apply both and end up in the wise mind state. Seems good, but part of me still thinks that I should somehow be able to be a perfectly reasonable mind. Throw those emotions out completely! Of course that’s because I was taught that my emotions were not acceptable. So yes, I am learning that it is okay to feel whatever it is I feel at any given time. This is our reminder for the Mindfulness section to learn to watch our reactions and BE mindful. We do funny little exercises; sometimes drawing, a walk, building a card house, and the point of it is to be mindful in the moment, doing just what you are doing in a nonjudgmental way. I do pretty good but I do get judgmental about my inability to write poetry when that’s the exercise

We go through the lessons and have homework every week. It usually consists of a conflict with someone and recognizing your emotion, deciding what is most important in that relationship (i.e. self-respect, maintaining the relationship, etc.) and the ways of resolving it. The homework part is tough for me because I live like a recluse. Sometimes I pick some nasty time in my past and work through how I could have handled it in a better way.

Now I’ll leave you with a poem I DID write! (just to show off my mad skillz)

Strange Game

There once were these dudes from afar
who were all three tres bizarre,
They went out in full force
to the local golf course
to see if they could break par.

They were atrociously clad
in the most awful plaid;
one carried a purse,
the second was worse,
his shoes made you think egad!!

The third was a swinger,
he’d come back with a zinger
that’d turn your face red.
When I saw them I said
“Ack! Here I’ll not linger!”

So I got out, I got out fast. As fast as I could go sir!
I wasn’t scared, but pants like that I did not care for, no sir!

(last 2 lines from Dr Seuss – What was I scared of)

“Those who do not know how to weep with their whole heart don’t know how to laugh either.” ~ Golda Meir

Criteria for Borderline Personality Disorder

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.

I’ve been diagnosed with this and personally that dx makes me REALLY angry! haha
Seriously, it’s embarrassing to be such a loser. I do seem to have pretty much all the symptoms except the anger. All my anger is directed at myself.

What causes Borderline Personality Disorder?

Marsha Linehan has developed a comprehensive sociobiological theory which appears to be borne out by the successes found in controlled studies of her Dialectical Behavioral Therapy.

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. 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 and who are confronted by three basic dialectics they have failed to master (and thus rush frantically from pole to pole of):

* vulnerability vs invalidation

* active passivity (tendency to be passive when confronted with a problem and actively seek a rescuer) vs apparent competence (appearing to be capable when in reality internally things are falling apart)

* unremitting crises vs inhibited grief.

DBT tries to teach clients to balance these by giving them training in skills of mindfulness, interpersonal effectiveness, distress tolerance, and emotional regulation.

Linehan has it nailed actually. I’m in a DBT group and have been for a couple of years. Whether I have the ability to actually learn and change at the age of 54 is another matter. I find my biggest obstacle to be my total lack of self-esteem. Or has my therapist likes to put it, my shame. I don’t like to even admit I feel shame. It makes me feel ashamed :p The only reason I am stable is that I’m a recluse for the most part. When there’s nothing to upset you you don’t get upset. Duh!

I also have a brain tumor and have had 2 surgeries on it but I’ll tell you, I’d take 100 brain tumors to have never had BPD. That is how much I despise this mental illness.

“Sometimes I lie awake at night, and ask, ‘Where have I gone wrong?’ Then a voice says to me, ‘This is going to take more than one night.”~Charles M. Schulz