There is still so much that triggers me.

triggers

Even after a year in intensive psychodynamic therapy, various (and some kind of crazy) self-therapies before that, spirituality, and blogging for two years, there are times when I feel like I’ve made no progress at all.

So many things still upset and trigger me.   I’m still hypervigilant, even to the point of paranoia at times; hypersensitive to criticism, don’t have a very good handle on my crippling anxiety and depression; and am envious.  I’m still socially awkward and avoidant; and terrified of rejection, abandonment, and disapproval.    I don’t handle other people’s anger very well, and often find myself automatically jumping on the defensive, even when there’s no reason to.  I still apologize for things that weren’t my fault, and take things too personally.   I still fret about what other people think of me.   I still have very low self esteem and feel like a complete loser much of the time.   I still do and say things that tend to self-sabotage and keep me from moving forward.

At least I know now where all this comes from, and at least I’m aware these feelings are just feelings and not facts.  They were part of my programming in my toxic family.  But knowing this doesn’t stop me from being triggered easily and resorting to primitive and self-sabotaging defense mechanisms.

But some things really have changed.    While I still have difficulty regulating my emotions sometimes, I don’t feel emotionally “dead” as often as I used to and I do regulate my emotions better than I did before I acquired that thin protective narcissistic defense layer (which I think accounted for the “dead” feeling).   I also don’t have as many (or really, any) scary and disorienting dissociative episodes anymore (those disappeared along with the emotional numbness, which is interesting).  I’m less angry than I used to be and I don’t act out against others the way I used to.  I don’t drink too much, do drugs, eat junk food compulsively, or otherwise try to “self-medicate” the way I tended to years ago.   While I can still be envious, it’s not as painful or crippling as it used to be–it’s something I can handle now.  I have more motivation and feel like my life might actually be leading somewhere.   I feel like I’m not completely useless and don’t think of myself as a “bad person” or a “useless person” anymore.

I’m also seeing the good qualities I’ve always had that I either couldn’t see before or didn’t think were good qualities.   After losing the thin protective narcissistic layer (“fleas,” I guess) that disconnected me from my own emotions, I realized I actually have a great deal of empathy.   That surprised me.   I never thought of myself as particularly empathetic before.  Part of the problem was also that I was always so focused in on myself and my turbulent and constantly changing emotions that there was simply no room left for me to care about anyone else.    I have a great sense of humor, which fortunately is something I never really lost and the ability to laugh at things might have kept me from going completely insane.   Now my sense of humor has gotten even better and is less bitter and cynical.   I’m open-minded and don’t think I’m very judgmental at all.     I’m also coming to realize that my innate sensitivity– which I used to be so ashamed of–is really a great thing once you know how to use it.

I’ve come to accept that I may never be completely healed (after all, it took my whole life to get that way), but I think I can live with that.  No one is perfect.  So I’ll just keep working at getting better and try to be the best I can be.  That’s all I can do.  That’s all anyone can do.

 

Death, Prince, “the void,” and loss of control.

thanatophobia

A few days ago, I wrote an article about my fear of death for my other blog. I fear death for a lot of reasons, which the post explains in detail, but I think my biggest fear is the prospect of complete ego loss, which for me means dissociation which inevitably leads to panic.

But my fear has been getting out of hand lately, and becoming obsessive. Not to the point where I can’t function, but to the point where it interferes with my being able to enjoy life or even think for very long about anything else. So I’d say it’s a problem, or becoming one. It’s one thing that’s getting worse rather than better.

I talked about this tonight in session. It’s nothing new, but it’s been with me for a long time, always lurking in the back of my mind no matter what I’m doing. It’s so much a part of my reality that it never even occurred to me to bring it up before. But tonight I did because Prince’s death triggered me and now my obsessive fear is about 10x worse. If a healthy, fit 57 year old man could suddenly just die of a routine illness that hardly kills anyone (unless there was foul play involved, which I do suspect), then life is incredibly fragile and the same could suddenly happen to me. I fear what’s on the other side because it’s unknown.

In therapy, I suddenly drew a parallel. I’ve never really lived because of the emptiness at my core, which isn’t really empty at all but is full of the unseen and unknown. Chair Girl lives in the void, and she’s somewhat accessible to me now, but whatever else dwells in the rest of the void, which is vast like the universe, is very much hidden from my awareness. I often wake up with a feeling of terrible emptiness inside and am filled with overbearing dread, despair, and unbearable loneliness. The only way I can handle these “black mornings” is to get up (escape). I’ve compared the feeling before with what I imagine death to feel like.

As therapy progresses, I’m closer to unearthing the contents of the “emptiness” than ever before. An analogy can be drawn to death here. As I age, I’m closer to death and the revealing of what’s on the other side. But in my mind, I’m equating confronting what’s in my void with death and the unknown in general. My obsession with death is a way I try to “control” the uncontrollable. Of course that makes no sense logically, but it “felt right” to me that control is what’s behind the obsession. Of course in order to get well I have to surrender and relinquish control, just as I will have to do the same when I die.

Where did BPD stigma come from?

stigma_truth

In recent years, BPD has earned a very disagreeable stigma, so disagreeable that people who have a BPD diagnosis are refused treatment, being told they cannot get better or feared by professionals who might treat them. NPD too, hasn’t always been as demonized as it is right now. NPD and BPD have become almost interchangeable in the narc-abuse community. I don’t recall it being that way in 1996 when I got my BPD diagnosis, and I don’t remember ever being told I was hopeless or unredeemable or evil or anything like that. I was treated pretty much like any other psychiatric patient, and was given therapy and put on antidepressants. I was obliged to take a DBT class, which at the time I blew off. (DBT is like CBT but exclusive to Borderlines–and it does work. The fact it worked for me makes me think maybe I *did* have BPD but no longer do!)

BPD was always classified as a Cluster B disorder, ever since its introduction into the DSM in 1980 (it was recognized, however, for much longer than that, and popularized as a disorder in the 1960s because of the research of Otto Kernberg, a German psychologist who studied “the narcissistic and borderline personalities,” and other “disorders of the self.”).* All “Cluster B” means really is the person has a weak, fragmented or nonexistent sense of self. Not being able to access a “true self” means they become either cut off from or cannot regulate their emotions. One of the results of this is a lack of empathy (but BPDs are the most empathetic of all the B’s, and some have normal levels of empathy). In NPD, a strong false self takes the place of the true one, which is a very dissociative symptom. In BPD, there’s not a strong false self like with NPD, but there is a weak and unstable one, and the person isn’t ALWAYS showing that false self. Some BPDs act quite a bit like over-emotional or unstable narcissists (or narcissists in the midst of a breakdown due to loss of supply). Others act like covert narcissists or just act neurotic and insecure but are otherwise nice people. Some feel their emotions too much, including empathy. A few are antisocial. I’m not sure why BPD (and maybe NPD) isn’t classified as a dissociative disorder, because essentially the person is cut off from their “self” in some form or another and that is what dissociation means. I’m not sure what the mechanics are in ASPD (antisocial personality disorder) but they are very different from either Borderlines or narcissists because they aren’t dependent on others to boost their weak egos. They are psychopathic and just do what they want.

bpd_stigma_quote

So the Cluster B’s, including BPD, were already around, but until the mid-1990s, no one thought of them as anything but mental illnesses or for ASPD, a kind of “adult conduct disorder.” They were psychiatric labels and nothing more. The narc abuse community started in 1995 or so, and Sam Vaknin was pretty much the first one online who wrote about it. Of course, he has NPD but even so, he first called attention to the “evil”-ness of NPD/narcissism (actually it was M. Scott Peck but at the time he wrote “People of the Lie” in 1983, the term “malignant narcissism” wasn’t in vogue yet and there was no connection of “evil people” to people with NPD. There was also no Internet to spread Peck’s concepts like wildfire the way they could have been in 1995 and later. But over time, M. Scott Peck’s book has become one of the most popular in the narc-abuse community) After Vaknin established his online narcissistic abuse community and wrote his popular book “Malignant Self-Love,” more narc-abuse sites got established (many or most of them started by victims, who were understandably angry at the narcissists who had abused them). Soon “narcs are evil” became a sort of meme, and by association, so did all the Cluster B disorders earn a “evil” reputation.

There are benefits to this, of course. Victims are being more heard than ever before. People are paying attention and avoiding narcissistic abusers. But some people who carry a Cluster B label are being hurt too, especially Borderlines (or people–usually women–who were erroneously diagnosed with it). Some experts want to get rid of BPD and just re-label BPD as Complex PTSD (probably not a bad idea). There are MANY similarities. The vast majority of BPDs are not anything like malignant narcissists and are not sociopathic at all. Most just act extremely insecure, needy, and maybe “high maintenance.” They can be manipulative or act out to avoid rejection. They may collude with people with NPD, however. But it’s possible to find these same types of behaviors in many people with Complex PTSD. Are they actually the same thing?

Another reason for the BPD stigma could be the tendency for narcissists and borderlines to form partnerships or be attracted to each other. In such a pairing, the Borderline is almost always the abused or codependent partner. In several “couple killings,” one of the criminal partners, usually the female, has had a BPD diagnosis. But they may have been so brainwashed by their abusers they were coerced into colluding with them against others (a form of Stockholm Syndrome).

Finally, a number of high profile criminals and serial killers have labels of NPD or BPD. But they almost always also have a comorbid ASPD diagnosis. Media icons like Joan Crawford who were known to scapegoat their children also had a BPD diagnosis. In Crawford’s case, she was also diagnosed with HPD (Histrionic Personality Disorder). It wouldn’t surprise me at all if she had NPD (malignant) or ASPD as well, as her behavior was very sociopathic behind closed doors.

Why am I “defending” people with BPD if I don’t have it?  Several reasons:

  1.  I was diagnosed with it and carried that diagnosis for two decades.   I have personally experienced being rejected by therapists once they saw my “red letter” on paper.
  2. Just because my current therapist thinks I don’t have it doesn’t mean I don’t.  Or maybe I did have it and no longer do.  If I no longer have it, that means BPDs are not “hopeless.”
  3. Maybe BPD isn’t a valid diagnosis.
  4. Many people I have cared about who were slapped with “BPD” have been hurt by it.

These are just my rambling thoughts about this matter; I’d be interested in hearing your opinions.

* Timeline of BPD

Kaleidoscope self.

kaleidscope
60FPS Kaleidoscope Hypnotic Snakes Animation (watch on Youtube)

I’ve been doing a lot of thinking about my various “disorders”–both diagnosed and self-diagnosed–and can see where the confusion arises. C-PTSD and BPD seem to be used interchangeably,. I think if C-PTSD did not exist, I might have gotten a nebulous label like “anxiety disorder NOS” or “personality disorder NOS.” No one needs a “diagnosis” like that! (I think the fact I’m paying out of pocket made it easier for my therapist to give me an “unofficial/experimental” diagnosis because no claims are being submitted for reimbursement.)

I also found it interesting that in its Wikipedia entry, and elsewhere, C-PTSD has been compared a lot to Dissociative Identity Disorder (DID–-what used to be known as Multiple Personality Disorder). Dissociation in various forms is very common symptom in patients with both PTSD and C-PTSD. It’s also a common symptom in BPD and sometimes also NPD (during a narcissistic crisis or depression following a loss of supply, usually).

The proposed diagnosis of Covert or Fragile NPD has confused things further and once again, the symptoms can be very similar to those of someone with BPD/C-PTSD. Covert Narcissists don’t act arrogant and entitled like classic/grandiose NPDs but they are every bit as manipulative and their goal is to get supply.

But what is supply? Supply is something to fill an empty hole inside, and the emptiness comes about because a person was not mirrored appropriately (or at all) as a child. I feel like I often need “supply” to boost my ego (to some extent everyone does). Because my personality fits the profile for Covert NPD, I spent a long while sure I was one. I was very relieved my therapist does NOT agree with that. (He said I always try to take care of HIS feelings–probably a codependent trait–-and I have too much empathy)

The treatments and therapy techniques used for C-PTSD and Personality Disorders are very much the same. My therapist is a trauma/attachment therapist and as such, treats people with BPD and NPD, as well as C-PTSD, PTSD because all of these disorders have their roots in trauma and faulty attachments to caregivers. DID and other dissociative disorders also have their roots in childhood trauma. All of them are disorders where there is a weak, fractured, or nonexistent sense of self and a yawning emptiness inside. My therapist thinks my sense of self is there, but is fractured and mixed up with pieces of other “identities” I’ve taken on (sounds like BPD!), including my NPD mother.

I picture my “self” as a kaleidoscope full of broken shards of glass and mirrors, constantly shifting but without an organized pattern, completely confusing to me and everyone else. My therapist is trying to get me to start sorting out the pieces, trying to figure out which ones are “me” and which are not. We’re continuing with the chair work with me talking to my mother asking what it is she wants from me. I feel more comfortable keeping her there in the chair as the sad, vulnerable little 1930s-era girl she once was, rather than the brittle, hollow shell she has become. She was only mirrored by her father–but for all the wrong reasons. Her mother would have nothing to do with her at all.

The waif inside.

bigeyedchild

Tonight’s therapy session definitely made up for the one I had on Monday, which I felt wasn’t very productive because I seemed to be deflecting and avoiding talking about my feelings.   I asked my therapist to stop me if I did that again, even if I get angry.   He agreed to this and tonight I dove right in.

We were talking about myself as a little girl, especially the way I was never allowed to express my emotions, especially anger.  He wanted to know what I did with all that anger.  I thought about it for a minute, and told him I turned it toward myself, and that’s why I started to become so depressed and why I started to hate myself .  He asked me to put my mind inside the mind of “little me” and describe how she felt and what she looked like.

We came up with a picture.  I described her as a waiflike child, like those paintings from the ’60s of those sad, big eyed little kids, dressed in rags, with a gray, unhealthy pallor.  She is always sad, almost always crying.  She’s afraid of everything.  She feels completely defenseless and in fact she doesn’t have any defenses.   She was never allowed to grow up.

I was asked how I felt about her.  I said I didn’t hate her, that in fact I felt protective of her and had to keep her safe from harm.    She also makes me feel angry when she comes out without my permission because she’s too vulnerable and defenseless and that makes me feel ashamed.   I have to protect her, but I also have to protect myself by keeping her hidden away so she doesn’t embarrass me.

It was harder to talk about her feelings about me, the way she views me.   All I could come up with was that she felt like I kept her safe but wishes I’d let her out more.  I realized then that it was easier to describe my feelings toward her than to describe her feelings toward me.   I’m not completely disconnected from my true self, but dissociation is present.

He asked me what good qualities she has that I want to protect.  I said she has a kind, gentle soul and a big heart.  He asked what she wants.  I thought about it and said, “all she wants is to love and be loved, and to belong.”  I got emotional at that point and started tearing up.  I wasn’t able to describe the emotions I was feeling at all, but I knew we’d made some progress.   He wants to start seeing me more often.   Somehow I’m going to find a way to afford it.   This type of inner child work is hard, but it’s amazing.

Staying grounded.

magnificent_tree
Photo Credit: No I’m Not OK

Sometimes I feel ungrounded, dissociated. Sometimes I feel like a gust of wind could blow me into nonexistence. I was raised in a harsh, chaotic, abusive environment and was blown from there into a harsh, chaotic, abusive marriage. As a result, I never was able to form strong roots. But to be grounded in life, to be able to bend and not break, adapt but not lose yourself, remain strong even when the cold winter winds blow, you need those roots.

Strong roots may not be with your family of origin, who should have nurtured you so you’d grow them. That may not be possible. But it doesn’t mean you can’t develop them.

I read a post today that inspired me because of the incredible photographs of an old Ficus Macrophylla tree, a beautiful and majestic tree with roots that could probably withstand an earthquake. I mean, just look at those roots! It’s incredible the way nature can adapt to almost any condition. There are trees that live on the cliffs of coastal California that grow vertically because of the strong winds that constantly buffet them. The trees have grown to adapt to their harsh conditions. They have grown stronger because of them.

We can also grow stronger because, not in spite of, the harsh conditions we might have been raised in. We can take inspiration from the trees by grounding ourselves and knowing how strong we really are, and that will prepare us for almost anything life can throw at us.

Take a walk. Look at some trees. Become conscious of your feet on the ground, your connection with the earth. Meditate on these things and try to stay in the present. Don’t worry about the future or the past. Turn off all the noise in your head, even for only a few minutes a day, and just be, like the tree.

“If Looks Could Kill: Anatomy of a Borderline”

littlegirlwithacurl

People with BPD, like all the Cluster B disorders, can at times seem demonic, especially when raging. I used to have these episodes of uncontrolled rage, in which I’d dissociate pretty severely. It was as if an actual demon inside me was unleashed and I couldn’t control my actions or my words, even though I knew I’d wind up regretting it and apologizing profusely hours later, hanging my head in shame. I think these rage episodes scared me as much as they scared everyone else, but there didn’t seem to be anything I could do about them. They were far too big for me to handle. Although no one ever told me I looked “evil,” I probably did during these episodes.

DBT and mindfulness tricks helped me get things under control, but I do seem to have mellowed in general with age. That seems to happen with some BPD women (some even become spontaneously “cured” after their childbearing years end), which makes me wonder if BPD is really a personality disorder at all, or something more biochemical. Since abuse or neglect in childhood is almost always present in Borderlines, maybe abuse causes brain chemistry to change for people who develop it, and this affects the female hormones in some way.

The emotional numbness is still there, but that’s nothing new–and it could be my PTSD rather than BPD. “Zombie” used to be my default setting in between rages so severe I seemed possessed. With increasing self awareness I’m becoming more able to access real emotions without losing control. The emotional numbness is lessening but the rages of my younger years have not returned. I’m not sure which emotions are still under wraps but I think it’s closer to sadness over some undefinable loss than rage.

This article accurately describes the Borderline’s ever-shifting emotional extremes and just how black their dark moods really can be.

If Looks Could Kill: Anatomy of a Borderline

By Shari Schreiber, M.A.
GettinBetter.com

There was once a little girl who had a little curl, right in the middle of her forehead. When she was good, she was very, very good–but when she was bad, she was horrid.

My other articles on Borderline Personality Disorder speak to elements in the Borderline that seduce you and keep you enraptured, despite their push-pull emotional gymnastics, disruptive come here/go away cycles, and confusing, crazy-making behaviors. This piece exposes the volatile, frightening dark side of this individual who has gotten you under their spell and won’t let you go, but also uncovers the root cause of these issues. There’s a comprehensive list of features/traits at the bottom, which can help you determine if you’re involved with someone who has BPD–or it may serve as a self-diagnostic tool.

While many BPD people have killer looks, not all Borderlines are beautiful or handsome–but that doesn’t make them any less seductive or diabolical. It’s much easier for a great looking man or woman to find continuous streams of narcissistic supply via adulation and romantic pursuit from others, and until this ego fuel isn’t obtainable, they won’t consider therapy. Why should they? Humans don’t change, until what they’ve been doing doesn’t work for them anymore–or they’re in enough pain, to re-direct their energies and efforts toward seeking the help they need to get truly well.

Read the rest of this article here.

Lost in a hall of mirrors: inside the mind of a narcissist

hall_of_mirrors_tor
Hall of Mirrors–“Tor,” funded by the Pentagon

When you’re safely in your house
you look out of clear windows that show you the great outdoors
and solid doors that open so you can step outside and take in the sun and rain

…I have no such amenities
for I don’t know where to look
Are they even there at all?
Everything is a reflection of a reflection of a reflection of a…

ad infinitum.

I live in a very strange house.

I see shadowy, spectral images of people who look much like myself
who are they really?
Are they ghosts of what I could have been
or want I want to be?
Or are they showing me what I have become?

Where can I escape from this nightmare of myself?
I feel lost and afraid
I just keep trudging around in circles like I’m caught in some endless mental time loop

I can’t close my eyes against the horror
for this is my reality looking inside myself
Eternal torment that will never let me rest.

infinity_mirror_room
Installation of Via Negativa II by Lee Bul, New York City, NY

Wandering aimlessly around in circles
in the shattered labyrinth of my broken mind
like walking through a plane crash
or ancient crumbling ruins
these broken shards of glass are glued to every surface
twinkling from some unseen silvery light
piercing the inky blackness that swallow up everything real
each jagged shard reflects broken pieces of me
on and on and on into an infinity of insanity

I feel like screaming.

There’s really nothing there at all
Reflections have no substance
Maybe this is hell and I’ve already died and gone there
doomed to wander forever alone in this glittering hall of mirrors that mocks me at every turn
thousands of mirrored facets laughing and taunting as I move down the halls

I know the way out is here somewhere
After all I built this mirrored prison with my own hands
Long ago I built a door
but I have forgotten how to find it
The mirrors obscure reality and memory.
But I remember I built it and someday I will find it.
I will.

Derealization and depersonalization in NPD and BPD.

Worlds_Collide___Phaeton___by_Meckie
Worlds Collide-Phaeton: by Meckie at Deviantart.com

A common symptom of both NPD and BPD is dissociation: a splitting or fragmenting of the personality not very different from what occurs in the Dissociative disorders such as DID (Dissociative Identity Disorder) and Psychogenic Fugue. It usually happens in response to a severe loss of supply or major narcissistic injury, or a sudden awareness of oneself as not oneself (realizing your false self is not who you really are–which happens when a NPDer becomes self aware). These disorders themselves, especially NPD, are dissociative in nature because a split in the personality has occurred. In the narcissist, it’s a substitution of the original personality for a false one.

Borderlines, rather than having a false self per se, are more like chameleons, adapting their personalities to fit the people and situation around them. That’s why Borderlines can seem so changeable.

I first started to experience dissociation as a young child. I remember at age 4, waking up for breakfast and walking down to the kitchen where my parents were already eating, and seeing colored specks like glitter falling all around me. When I asked my parents if they saw the “glitter,” they just looked at me like I was crazy. I also had dreams that would continue after I awoke and often felt I was living in a dream. Maybe that’s the case with most young children though. I also remember hearing music from TV shows late at night after everyone was asleep that couldn’t possibly be coming from anywhere, as this was in the 1960s and no one had the capability to record a show on VCR yet, nor was there TV after midnight or so–all we’d get in those days was a test pattern until morning.

I remember at around the same age, banging my head against the wall in the family room to relieve some kind of congestion in my head. I think it may have been to relieve those odd feelings of unreality–not much different than the way a Borderline will sometimes cut herself to “feel alive.” In fact, this may well have been an early symptom of my BPD (and I always thought it was autism).

Most people have probably experienced dissociation, perhaps under the influence of a drug. Sometimes people experience it on hearing shocking news that could be either tragic or fortuitous–like hearing one’s child just died, or winning the lottery.

But for people who have certain personality disorders (as well as people with various dissociative disorders and psychotic disorders like schizophrenia, and also those with PTSD and C-PTSD), dissociation is both common and chronic. It’s also severe enough to sometimes interfere with functioning.

Q: So what does dissociation FEEL like?
A. Because something so ungrounded in the tangible and everyday reality is so hard to explain in words, I’m not sure if these descriptions of what it feels like will make a lot of sense, but I’ll try.

Derealization.
I’ve actually experienced this the most. The world seems odd and dreamlike. Reality seems somehow “off” the way things are in a dream. In a dream, a familiar scene can look the same as it does in reality, but at the same time there’s this feeling of offness and otherworldiness about it. When I was younger and used to ride the subway, sometimes I couldn’t look up at the people because they all seemed like masks…sinister, somehow. It’s a very weird feeling but not always unpleasant. Sometimes that dreamlike oddness about everything is sort of compelling and interesting.

Depersonalization.
This definitely causes me serious panic attacks. I first had episodes of this at about age 9 or 10 and thought I was going crazy. I felt oddly disconnected from my body, like I was floating. People talking to you sound like they’re coming from either a great distance or out of a tube. You can’t focus on what they’re saying because you’re freaking out and panicking but trying to hide it to keep from appearing as crazy as you feel.

I think people with NPD and BPD (as well as the Schizoid, Schizotypal and Paranoid PD’s) who do not improve or try to change, are probably at high risk for developing psychotic disorders and even schizophrenic like conditions when things are going badly for them, there’s been a massive loss of narcissistic supply, or when the person becomes gravely ill or very late in life.

Are BPD and complex PTSD the same disorder?

Originally posted on Lucky Otter’s Haven on June 29, 2015

age_3_1961_2
Me at age 3 in the zone. Was the template for my BPD already laid down?

Ruji, a new commenter on this blog (and the maker of the personality disorder buttons I have featured on my other blog), made an interesting observation–that BPD should be divided into at least two subtypes: Empathy Challenged/Character Disordered (closer to NPD/ASPD) and Highly Sensitive Person with Emotional Dysregulation (closer to the type I have, although at different times in my life or when extremely stressed I have displayed the more character-disordered subtype). I agree with her. Ruji’s idea is remarkably similar to The World Health Organization’s two subtypes of BPD:

1. F60.30 Impulsive type
At least three of the following must be present, one of which must be (2):

–marked tendency to act unexpectedly and without consideration of the consequences;
–marked tendency to engage in quarrelsome behavior and to have conflicts with others, especially when impulsive acts are thwarted or criticized;
–liability to outbursts of anger or violence, with inability to control the resulting behavioral explosions;
–difficulty in maintaining any course of action that offers no immediate reward;
–unstable and capricious (impulsive, whimsical) mood.

2. F60.31 Borderline type
At least three of the symptoms mentioned in F60.30 Impulsive type must be present [see above], with at least two of the following in addition:

–disturbances in and uncertainty about self-image, aims, and internal preferences;
–liability to become involved in intense and unstable relationships, often leading to emotional crisis;
–excessive efforts to avoid abandonment;
–recurrent threats or acts of self-harm;
–chronic feelings of emptiness.
–demonstrates impulsive behavior, e.g., speeding, substance abuse

Psychologist Theodore Millon has gone even further, proposing that BPD should be divided into four subtypes:

1. Discouraged (including avoidant features): Pliant, submissive, loyal, humble; feels vulnerable and in constant jeopardy; feels hopeless, depressed, helpless, and powerless.

2. Petulant (including negativistic features) Negativistic, impatient, restless, as well as stubborn, defiant, sullen, pessimistic, and resentful; easily slighted and quickly disillusioned.

3. Impulsive (including histrionic or antisocial features) Capricious, superficial, flighty, distractible, frenetic, and seductive; fearing loss, becomes agitated, and gloomy and irritable; potentially suicidal.

4. Self-destructive (including depressive or masochistic features) Inward-turning, intropunitively angry; conforming, deferential, and ingratiating behaviors have deteriorated; increasingly high-strung and moody; possible suicide.

Millon’s Types 1 and 4 would correspond to the Highly Sensitive Person/Emotional Dysregulation type mentioned above (and therefore closer to the Avoidant/Dependent PDs); Type 2 sounds very much like NPD; and Type 3 seems closer to ASPD or Histrionic PD.

complex_ptsd
BPD symptoms are almost identical to those of Complex PTSD.

There are so many diverse–almost opposite–symptoms that can appear with this disorder that one person with BPD can be very different from the next. In fact, you can take 10 borderlines and they will all seem very different from each other, with barely any similarities in their behavior at all. One will be shy, fearful and retiring, never making waves, acting almost like an Aspie or an Avoidant; while another may break the law, lie constantly, and act obnoxious and rage whenever things don’t go their way. A borderline could be your raging boss who drinks too much and ends every annual Christmas party with one of his infamous rages, or it could be the sweet and pretty schoolteacher who goes home every night and cuts herself. She could be the come-hither seductress or the nerdy computer programmer. He may have few or no friends or a great many.

This diversity is not the case with the other personality disorders, which have more cohesiveness in the symptoms their sufferers display. So I wonder–is BPD really a personality disorder at all? Does it even exist, or is it really just a group of trauma-caused symptoms the experts in their ivory towers stuck in a single box called “BPD” because they didn’t know how else to classify them?

In fact, all these diverse subtypes have one thing in common–they are all very similar or identical to the symptoms of someone with complex PTSD (C-PTSD). People with C-PTSD are often misdiagnosed as Borderlines because their behaviors can be just as baffling and manipulative, and both disorders also include dissociative, almost psychotic episodes. Extrapolating from that, I wonder if ALL borderlines actually have C-PTSD.

Earlier today I posted an article outlining 20 signs of unresolved trauma, and I was struck by how similar these were to the symptoms of BPD. And there is also this article that Ruji just brought to my attention that also describes how remarkably similar the two disorders are, but that the idea of fear of abandonment (which is recognized as the root cause of BPD) is not recognized as a factor in causing PTSD and that may be part of why they have been kept separate.

The BPD label, like any Cluster B label, is very damaging to its victims because of the “evil and character-disordered” stigma it carries. One psychologist has even included us, along with narcissists, among the “People of the Lie”!

Yes, it’s true some borderlines do act a lot like people with NPD or even Malignant Narcissism or ASPD, but most probably do not, and are really much more similar to people with Avoidant or even Dependent personality disorders, which hurt the sufferer more than anyone else. But if you have a BPD label, people start backing away from you slowly due to the stigma. Therapists are reluctant to treat you because they assume you will be either difficult and hateful in therapy sessions, or will never get better. Insurance companies won’t pay claims where there is a BPD diagnosis, because it’s assumed there is no hope for you. I’ve had this problem when I’ve tried to get therapy. I remember one therapist who I had seen for the intake session, who told me he needed to obtain my psychiatric records before we could proceed. The session had gone smoothly and I felt comfortable with him. A few days later I received a phone call and was told he did not treat “borderline patients” and wished me luck. So that’s the kind of thing we’re up against if we’ve had the BPD label slapped on us.

Also, as an ACON blogger who works with a lot of victims of narcissistic abuse, my BPD label sometimes makes people wary of me and they begin to doubt that my motives here are honest. At first I was reluctant to talk about my “Cluster B disorder” here, because I knew it might be a problem for some ACONs, who think borderlines are no better than narcissists. But I eventually decided that to hide it away like an embarrassing family secret would be misleading so I “came out” about having BPD (I never actually lied about it, but played it down in the beginning and rarely mentioned it). I’m glad I fessed up, but there have been a few people who left this blog after I came out about it or began to doubt my motives. So there’s that stigma and it’s very damaging.

Both C-PTSD and Borderline PD are caused by trauma. Both are complex defensive reactions against future abuse and both involve things like splitting, dissociation, psychotic episodes, self-destructiveness, wild mood swings, and behavior that appears to be narcissistic and manipulative.

The way I see it, the only real difference between C-PTSD and BPD is that the traumatic event or abuse happened at an earlier age for someone with BPD, perhaps during toddlerhood or infancy, while all forms of PTSD can happen at a later age, even adulthood. But the symptoms and defense mechanisms used to avoid further trauma are the same for both.