Hidden suffering of the Psychopath…

I saw this article and was intrigued. Especially as the Conlcuding paragraph is this:
It is extremely important to recognize hidden suffering, loneliness and lack of self-esteem as risk factors for violent, criminal behavior in psychopaths. Studying the statements of violent criminal psychopaths sheds light on their striking and specific vulnerability and emotional pain. More experimental psychopharmacological, neurofeedback and combined psychotherapeutic research is needed to prevent and treat psychopathic behavior.

The current picture of the psychopath, which is reflected in the leading diagnostic criteria of psychopathy offered by Cleckley (1982) and Hare et al. (1990), is incomplete because emotional suffering and loneliness are ignored. When these aspects are considered, our conception of the psychopath goes beyond the heartless and becomes more human.

It’s not an incredibly recent article but it does take a look at psychopathy from a perspective other than witch burning and untreatable. I wonder if clinicians generally ignore research like this on purpose or discount it automatically in favor of perpetuating the stigma.

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ElectroShocking

Shocking news about Electroshock therapy. Then again, maybe it’s not so shocking afterall… Regardless, I’m rather fascinated so I thought I would share. Enjoy!

Hyperactive Nerve Cells May Contribute to Depression
Identification of cellular mechanism could lead to novel and effective treatments
Scientists at BNL, Cold Spring Harbor Laboratory, and the University of California, San Diego (USCD) School of Mediciine, have identified hyperactive cells in a tiny brain structure that may play an important role in depression. The study, conducted in rats and appearing in the February 24, 2011 issue of Nature, is helping to reveal a cellular mechanism for depressive disorders that could lead to new, effective treatments.
The research provides evidence that inhibition of this particular brain region – the lateral havenula – using implanted electrodes can reverse certain behaviors associated with depression, and also provides a mechanism to explain this effect. These findings lend support to the use of deep brain stimulation as a clinical treatment for people with long-standing, treatment-resistant depression.
This research was supported through Laboratory Directed Research and Development at BNL, and by the Simons Foundation, the Dana Foundation, the National Institute of Mental Health, and a Shiley-Marcos endowment at UCSD.
“This research identifies a new anatomical circuit in the brain that mediates depression, and shows how it interacts with the brain’s reward system to trigger a  constant disappointment signal – which certainly would be depressing,” said Fritz Henn, a neurobiologist and psychiatrist at BNL and Cold Spring Harbor laboratories and a co-investigator on the research. “But,” he added, “identifying this circuit and how it works may open new doors to reversing these effects.”
For example, said co-investigator Roberto Malinow, a professor of neurosciences at the USCD School of Medicine, “It’s possible that the genes specifically expressed in these neurons could be targeted genetically or pharmacologically in order to manipulate them and reduce depression.”
Scientists have known that cells in the lateral habenula are activated by negative or unpleasant events, including punishment and disappointment, such as when you don’t get an expected reward. It may seem intuitive that such negative stimuli can lead to depression, but not everyone who experiences disappointment collapses into a state of  helplessness. To explore this connection, the scientists took a closer look at the brain circuits.
Overall, the results showed that these lateral habenula nerve cells were hyperactive in the depressed animals but not in the control subjects. Furthermore, the degree of hyperactivity coincided with the degree of helplessness.
To explore whether electrical stimulation could potentially reverse this reward-dampening effect, the researchers placed a stimulating electrode in the lateral habenula and measured the effects on the brain cells leading to the reward center. They found that electrical stimulation of hyperactive habenula brain cells markedly decreased excitatory activity leading ot the reward center.
“The study provides a cellular mechanism that may explain the hyperactive of the lateral habenula nerve cells observed in depressed  humans and animal models of depression, as well as why ‘silenceing’ these circuits, whether surgically or pharmacologically, can reduce depression-like symptoms in animals,” Henn said.

Clash of the Realities – Cognitive Dissonance

Cognitive Dissonance – is a psychological term for the discomfort that most people feel when they encounter information which contradicts their existing set of beliefs or values. People who suffer from personality disorders often experience cognitive dissonance when they are confronted with evidence that their actions have hurt others or have contradicted their stated morals.
“It’s is an uncomfortable feeling caused by holding conflicting ideas simultaneously. The theory of cognitive dissonance proposes that people have a motivational drive to reduce dissonance. They do this by changing their attitudes, beliefs, and actions {or holding on to past beliefs, attitudes, and actions in favor of more logical, update, or fully functional ones}.  Dissonance is also reduced by justifying, blaming, and denying. A closely related term, cognitive disequilibrium, refers to the experience of a discrepancy between something new and something already known or believed.
Experience can clash with expectations. In a state of dissonance, people may feel surprise, dread, guilt, anger, or embarrassment. People are biased to think of their choices as correct, despite any contrary evidence**. This bias gives dissonance theory its predictive power, shedding light on otherwise puzzling irrational and destructive behavior. For instance it can lead to this pattern: one desires something, finds it unattainable, and reduces one’s dissonance by criticizing it. Jon Elster calls this pattern ‘adaptive preference formation’.”
**People with personality disorders are not only biased, but their inability to relinquish previous choices is ingrained in their character. It’s not simply a choice to not change something. It’s a mental predisposition to create a steady, unalterable whole.
“Another overarching principle of cognitive dissonance is that it involves the formation of an idea or emotion in conflict with a fundamental element of the self-concept, such as “I am a successful/functional person”, “I am a good person”, or “I made the right decision.” The anxiety that comes with the possibility of having made a bad decision can lead to rationalization, the tendency to create additional reasons or justifications to support one’s choices. A person who just spent too much money on a new car might decide that the new vehicle is much less likely to break down than his or her old car. This belief may or may not be true, but it would reduce dissonance and make the person feel better. Dissonance can also lead to confirmation bias, the denial of dis-confirming evidence, and other ego defense mechanisms.”
This may be a big contributor to why it is so difficult for someone with a Borderline Personality Disorder to accept change, or why we fight against it so hard.
Constant confliction. When it’s so hard to make a decisions, finally having one set decision, a solid belief, even something small is like a little life raft, something stable to hold onto in a wash of turbulence. When you’re confronted by something that threatens to dislodge that stability it can be panic inducing.
Imagine standing in a river. The current is never steady. Sometimes it rushes faster, sometimes it pushes gently. You’re not ever sure what to expect, what resistance to offer; how to brace yourself.  Forming a solid belief, wanting to believe something definite, is like finding a big rock to hold onto in that river. No matter what the force of the current, that rock can keep you from drowning. When someone presents you with evidence contrary to the belief, it’s like applying an oily film to that rock. It’s like having someone slowly/quickly chip away at that rock. You may recognize that this rock is no longer going to provide that safety it had before but it’s held you up for so long, been the only thing keeping you from getting swept away so you instinctively try to hold on. The erosion of this belief means part of you is set adrift again and you’re not sure when or where your feet will touch bottom.
It may also lead to the degradation of our beliefs in general. At least temporarily. Because then it makes you question what other beliefs you held that may not be correct. And slowly everything starts to crumble. Question everything. All or nothing thinking. If I’m wrong about this, I must be wrong about everything. If I can be right about that, then I’m probably right about everything else. Everything fits. Everything has a place.
When you have one belief, and then are presented with another, it’s easy enough to see how the new belief logically applies so you may want to adopt it (let go of the rock in favor of one that’s not being chipped and eroded away), but at the same time you still want to hold onto the one that has made so much sense to you for so long.
Cognitive dissonance can explain a lot of the fear and anxiety in someone with a Borderline Personality Disorder. So much of our lives revolve around other people, our relationships to people, our own sense of identity, etc. All of which, normally, are constantly evolving and changing things. However someone with BPD, gets comfortable with one idea, one person, one trait, so when it changes it calls into question everything we knew about it, almost as if it left the course of natural continuum. Like, it’s not the same thing evolving, but one thing now being different, the old thing lost. Trying to hold onto the thought that this thing is still the same thing, but also different, and just because it’s different doesn’t mean we have no relevance with it, we do still have a place/hold with it, and change is not necessarily a bad thing… it’s so very difficult. When you’re used to, or afraid that changes will lead to abandonment, the abandonment of ideas and beliefs while also seeing the relevance of incorporating new ideas is one massive anxiety ridden conflict.

Be Specific, please.

Hazy Recall as a Signal Foretelling Depression
By ALASTAIR GEE
OXFORD, England — The task given to participants in an Oxford University depression study sounds straightforward. After investigators read them a cue word, they have 30 seconds to recount a single specific memory, meaning an event that lasted less than one day.
Cues may be positive (“loved”), negative (“heartless”) or neutral (“green”). For “rejected,” one participant answered, “A few weeks ago, I had a meeting with my boss, and my ideas were rejected.” Another said, “My brothers are always talking about going on holiday without me.”
The second answer was wrong — it is not specific, and it refers to something that took place on several occasions. But in studies under way at Oxford and elsewhere, scientists are looking to such failures to gain new insights into the diagnosis and treatment of depression. They are focusing not on what people remember, but how.
The phenomenon is called overgeneral memory, a tendency to recall past events in a broad, vague manner. “It’s an unsung vulnerability factor for unhelpful reactions when things go wrong in life,” said Mark Williams, the clinical psychologist who has been leading the Oxford studies.
Some forgetting is essential for healthy functioning — “If you’re trying to remember where you parked the car at the supermarket, it would be disastrous if all other times you parked the car at the supermarket came to mind,” said Martin Conway, a cognitive psychologist at the University of Leeds in England. But, a chronic tendency to obliterate details has been linked to longer and more intense episodes of depression.
Now researchers at Oxford, Northwestern University in Illinois and other universities are conducting studies with thousands of teenagers to determine whether those with overgeneral memory are more likely to develop depression later on. If so, then a seemingly innocuous quirk of memory could help foretell whether someone will experience mental illness.
There are already some clues in this direction. In lab experiments Dr. Williams has induced an overgeneral style in subjects by coaching them to recall types of events (“when I drive to work”) rather than specific occasions (“when I drove to work last Saturday”). He found they were suddenly less able to solve problems, suggesting that overgeneral memory is capable of producing one symptom of depression.
And an unusual paper suggests that overgeneral memory is a risk factor for post-traumatic stress disorder. Scientists at the University of New South Wales in Sydney, Australia, assessed 46 firefighters during their initial training and again four years later, when all had experienced traumatic events like seeing comrades injured or killed. Those who could not recall the past in specific detail during the first assessment were much likelier to have developed the disorder by the later one.
“People with P.T.S.D. tend to ruminate at a very categorical, general level about how unsafe life is, or how weak I am, or how guilty I am,” said the lead author, Richard Bryant. “If I do that habitually and then I walk into a trauma, probably I’m going to be resorting to that way of thinking and it’s going to set me up for developing P.T.S.D.”
Dr. Williams stumbled across overgeneral memory by chance in the 1980s. He had asked research subjects to write down the memories elicited by certain cues, and when they left the page blank he thought he had given unclear instructions. Soon he began to wonder about the significance of the omissions.
Usually people seeking a particular memory traverse a mental hierarchy, Dr. Williams said. They begin by focusing on a general description (“playing ball with my brother”) and then narrow the search to a specific event (“last Thanksgiving”). Some people stop searching at the level of generality, however and are probably not conscious of having done so.
This is sometimes a helpful response, which is perhaps why overgeneral memory exists in the first place — it can be a useful way to block particular traumatic or painful memories. Researchers at Leuven discovered that students who did poorly on exams and were more specific took longer to recover from the disappointment than those who were more general. The overgeneral students thought less about the details of what happened and so fared better, at least in the short term. “
“But these researchers say problems can arise when overgenerality becomes an inflexible, blanket style.
Without detailed memories to draw upon, dispelling a black mood can seem impossible. Patients may remember once having felt happy, but cannot recall specific things that contributed to their happiness, like visiting friends or a favorite restaurant.
“If you’re unhappy and you want to be happy, it’s helpful to have memories that you can navigate through to come up with specific solutions,” Dr. Williams said. “It’s like a safety net.”
Some experts think such insights could also be helpful in treating depression. For example, Spanish researchers have reported that aging patients showed fewer symptoms of depression and hopelessness after they practiced techniques for retrieving detailed memories.
“When we have a disorder like depression, which is so common and so disabling for so many people, we need to increase the tools in our tool kit,” said Susan Mineka, a clinical psychologist working on a study by Northwestern University and the University of California, Los Angeles, that is testing for depression and anxiety risk factors, including overgeneral memory. “If we could change their overgeneral memory, maybe that would help even more people stay better for longer.”
Dr. Williams has found that specificity can be increased with training in mindfulness, a form of meditation increasingly popular in combating some types of depression. Subjects are taught to focus on moment-to-moment experiences and to accept their negative thoughts rather than trying to avoid them. It may help by making people more tolerant of negative memories and short-circuit the impulse to escape them, which can lead to overgenerality.
Meditation means that for some, the past is no longer such a heavy burden.
“I always tried to forget the past, the very bad past that made me depressed when my husband died,” said Carol Cattley, 76, who attended a mindfulness course here taught by Dr. Williams. “I’m much more interested in it now.”
I found this interesting, and relatable. I cannot recall a single period of being happy because generally what I remember is being depressed. I can remember instances and events when I’ve been happy, but I have to work much harder to draw on these and they don’t span any length of time. My depressed moods are overarching where my happy moods are temporary injections.The negative experiences and emotions I’ve had seem to permeate the expanses of my mind and coat the good instances in cyanide. No sugar coating here. I do notice that I think back to things and stop at a certain, more general, point instead of continuing to the more specific. For instance, I’ll think about spending time at movie night with Friend. In general I remember being withdrawn from the crowd, irritable, and depressed. I have to push myself to think of specific nights or hours or minutes where this was not how I felt. I have had a lot of great times hanging out, laughing, joking and just being goofy with Friend and my other friends that come along, but these aspects of recollection are not what immediately springs to mind.  I experience happiness, but my recollection of it is muted. I have to put in that little added effort to bring up the happy moments. It makes sense that this kind of memory generalization would lead to or contributes to depression. It’s weird. For as much as I focus on how different my BPD brain is from your average persons’, it still strikes me just how different other people experience the world and just how much those little quirks in our biology can morph our entire perception and interaction in the world.

Lows are low, Highs are high

My moods, have been in major fluxuation. I’ve noticed this pattern before. Often, actually. I’ll slowly slide down. Work myself up with anxiety, with actually sinks me further until one day I have a complete breakdown, massive anxiety attack, or temporary distortion of my reality. Bottom out. Utterly. Then the next day I’m up in a way that I haven’t felt like in ages. My mood is more optimistic, my energy is ramped up, the sun is brighter, the sky bluer… and I can ride this for a few days.
I was ready to give up my life and lifestyle, everything I’ve worked towards… two nights ago. Today I’m renewed. I’m tackling problems and projects one thing at a time. I have plans for what I can do to get the information I need. Plans to further my knowledge and increase my proficiency. I feel like I have the ability to get the work done that I need to do.  I might not know everything yet, but I have the capability to get it. And I will. It’ll just take some time. Time, time, who’s got the time? I need more of it, but not in a projected sense. More of it right on top of the time I already have now. Overlapping experience.  Time on top of time on top of I want to do so much more at once than one limited body is capable of.
With just the barest twinges of anxiety lurking around the edges of my consciousness.
Everything feels hyper focused too. The sun is brighter. Peoples voices are more focused. My thoughts are racing a little faster. It feels like information, ideas, to-dos, are bouncing off each other inside my mind vying for priority.
Everything is starting to feel a little rushed too. I have so much I want to do, that I have to spread it out over time in order to accomplish it… is an angle of anxiety. Like things can’t be collected fast enough. I can see exactly how all these things will fall together, I know what I need to do to get them, if only I could rush faster, push harder, I could have all of them already and then things would slip to place. That time seems so far away, like I can almost touch it with my fingertips but then I have to reach for something in a different direction. I just can’t get there fast enough because I know there are so many steps I have to take first and those first steps don’t flow fast enough.  Fast enough. I want things to move faster. Faster. That they don’t makes me anxious. But not debilitating anxious, motivating anxious.
I want another one of me. With a connected consciousness so that my other body and this body can both collect more information and coalesce the results inside one mind. That would be optimal. Much more efficient. Having only one body, being able to only do one thing at a time is frustrating. Frustrating. I want to be there already. Yesterday, actually.  
I feel slightly like I’m floating to project myself in so many directions.
But, upwards! Haha, and that’s better than downwards any day.
There’s just so much I want to do! I’m motivated and productive at work. Things that pull my attention away are actually disconcerting because there’s so much I want to accomplish and figure out. I want to be home; reading, writing, painting. Did I mention I started painting? I’ve never done it before in my life so last Friday I went to the craft store and bought a set of acrylics and brushes. It’s fun and freeing, playing with color and texture. There’s just so much to do at any given time. So much, so much.
It’s so lovely out as well.
This is actually something I worry about being on mood stabilizers. They stabilize from the bottom up so you don’t feel so depressed, but they also stability from the top down, dampening the good. I don’t have so much good that I want to squash that side of it. Especially since I’m starting to see someone new. I want to feel the highs that could come of it. Seem to be coming of it. I don’t want my moods to be mottled by medicine when I see an ok place.  I want to be receptive to all the good! I want to throw myself in and ride the wave of newness and excitement. I want, I want.
Lots to want. Lots to do. Lots to hope for.  

Lucid Analysis: Trials in Therapy

 
Yesterday was stress beyond reason; read to quit my job, quit engineering, become a librarian, or a personal trainer, open a yoga studio, ANYTHING, that was not the pressure I have at work.  I looked into certification programs and e-mail department heads about enrollment. I couldn’t see the point of continuing on. Everything I’ve done until now, pointless, useless, futile. My LIFE is pointless. Not worth living or having if I can’t do this {one} thing right. I grabbed at options, ideas. Even as I did so I realized just how much is required to achieve those and I know just how I’ll be able to do it all but it all seems to big, too overwhelming. I see all the obstacles, I have no sense of time…I can see how long it will take, but the dread and anxiety of not having it achieved, the uncertainty, is paralyzing. I don’t have it done now so it feels futile. Like I’ll never get there before I even begin. Fortunately I’m not so out of control that I quit things on the spot.
I can’t say I’m not still thinking about finding a new profession, but I’m less stressed out today.
Let’s go back shall we. The focus of yesterday’s therapy session was my anxiety attacking about work. I am the newest engineer on my team. Everyone else has been here for years. I hired in a couple years after the project began. Everyone knows more about this project than I do. I feel incredibly behind in my knowledge. I’m afraid that I won’t measure up to the demands that are required of me because I don’t know everything already. I’m afraid this will reflect poorly on my ability and on my intelligence… because somehow I have not jacked in and assimilated all prior knowledge generated on this project. This fear paralyzes me. I can’t move forward. I’m mired down in the belief that I’ll never be good enough because everyone else will always know more, have accumulated more, knowledge. I don’t have the history of collection to be of a standard proficiency for what I perceive is my position.  
Once I’m stuck, I beat myself down harder into the muck. I’m afraid to even open drawings and my design programs for fear that I will look at it and have no idea what is required of me. Like suddenly everything will have changed and become completely foreign; every e-mail will be a judgment or termination.
I want to flee from the potential failure into something I won’t be so open to criticism with.
Therapist brought me around to things I might enjoy doing. Her immediate suggestion was to pursue costume design. Find a theater company and hire on to create costuming. I immediately slammed my foot down on this. I’m not a professional seamstress. I’ve never had schooling for fashion. I don’t want to move. I don’t want to live in the city.
Why didn’t I go to culinary school… b/c I’d have to do this, and it would make me hate that, and I wouldn’t have the freedom to do what I really love about cooking in the first place,…  
Stop.
I mire myself in all the details. Bombard myself with the ‘why nots’.  I see the end before anything has a chance to even begin. I psych myself out of ever beginning. If I don’t start, I can’t fail. Can’t let anyone down.
Therapist asks who I’m afraid I’ll let down if I don’t succeed? If I were to choose a different career?
Myself. My father. My friends.
Everyone jokes around about my genius; they introduce me to new people as Haven the rocket scientist, etc etc. I hate it. It just feels like more pressure to be something I don’t believe I’ve earned. Don’t believe I’ve earned <~~~ is a problem all of it’s own. I have multiple engineering degrees, was the sole female graduate in my Master’s program… and yet, I still don’t believe what I do is good enough. More specifically it’s my father. I’ve mentioned before how critical my father is, even though he was not actually discouraging. He never said anything like ‘you suck, you can’t do that, you’re not good enough”. It was always, everything I did could be better. Nothing was ever perfect, or just good on it’s own, or good enough. It was “that’s good, but here’s what you can do now, or should do next, or how it can be improved, how it can be better”… how you can be better. I don’t believe I’m good enough at anything. Everything about me is flawed. As a result everything I do is somehow deficient. I enter into everything believing that I won’t be able to do it good enough, that I won’t be good enough.
Trigger. Therapist made a point of recognizing that this is something that triggers me severely. Specifically my Unrelenting Standards schema.
Unrelenting Standards Schema: The underlying belief that one must strive to meet very high internalized standards of behavior and performance, usually to avoid criticism. Typically results in feelings of pressure or difficulty slowing down; and in hyper-criticalness toward oneself and others.  Must involve significant impairment in:  pleasure, relaxation, health, self-esteem, sense of accomplishment, or satisfying relationships.
Unrelenting standards typically present as:  (a) perfectionism, inordinate attention to detail, or an underestimate of how good one’s own performance is relative to the norm;  (b) rigid rules and “shoulds” in many areas of life, including unrealistically high moral, ethical, cultural, or religious precepts; or (c) preoccupation with time and efficiency, so that more can be accomplished.
When I’m met with any kind of criticism or something I perceive as criticism I freeze. I set my standards so high, put so much pressure on myself, that when anyone presents me with any though/critique/opinion in opposition or enhancement to what I’ve done, it feels like an attack on the rigid standard I’ve set for myself. I destroy myself, debase my accomplishments, and my immediate response is “I’ll never be good enough, I should quit now before everyone sees how incompetent I am.” When in reality this is not true. My Punitive Parent kicks in and I mentally and emotionally punish myself.
Punitive Parent – The Punitive Parent schema mode is identified by beliefs of a patient that they should be harshly punished perhaps due to feeling “defective”, or making a simple mistake. They may feel that they should be punished for even existing when “punitive parent” takes over the psyche. Sadness, anger, impatience, and judgmental natures come out in “punitive parent” and are directed to the patient and from the patient. Even a small and solvable issue or unrealistic perfectionist expectations and “black and white thinking” all bring forth the “punitive parent.” The “punitive parent” has great difficulty in forgiving oneself even under average circumstances in which anyone could fall short of their standards. The “Punitive Parent” does not wish to allow for human error or imperfection, thus punishment is what this mode seeks and what it desires.
Lesson: Recognize triggers!
I was ready to quit my job, sink to devastation about disappointing everyone in my life, lose hope and hold on my life completely. Recognizing the things that trigger me is so crucial in order to gain control of them. In recognizing them I can work to prevent their reoccurrence. Even when I can’t prevent them entirely I can work to form strategies for dealing with them. Therapist wants me to make sure I don’t let the Punitive Parent reign. I need to take a step back and remind myself of all the things I have accomplished, that I am good at, that I am skilled with. I’m the only one that sets my limits. In second guessing myself, berating myself… I, I, am the one that holds me back and keeps me down. No one else believes these things of me. Hell, most everyone else probably has a clearer picture and better appreciation of my skills than I do. They don’t limit me. They aren’t keeping me down. I am.
Homework: Work on silencing the inner punitive voice that constantly demeans me. Counter the self-doubts with positive affirmations. This! This, is not a quick process. This is in fact, one of the major overarching goals of therapy for BPD. It’s good to know your goals though =)

…but beautiful.



For the record. This morning I kicked myself in the ass. Opened up my software and had the first analysis model done within an hour. The second I will have completed by the end of the day. I have no one else to remind me that I’m competent. No, I don’t know everything. It is impossible for me to know everything. In fact, no one expects me to know everything. Not even everything about all the things I’m assisting in. I put this pressure on myself. Life is a learning process.
Note: Sleep on it. I was much more rational in the morning.
And as a more pleasant aside. Went on a date with my new Lady Friend last Saturday. She bought me a book – a mix of Sci-Fi, humor, and Eastern Wisdom. I’m seeing her again this weekend =) It was a really, really nice night. I was all butterflies and nervous. The hostess thought we were the most adorable things ever.
I’m seeing Psychiatrist next Tuesday =P

It’s a catastrophy! No, it’s – Catastrophizing

Look over your shoulder to see the little devil riding there. Whispering in your ear.
Catastrophizing – is the habit of automatically assuming a “worst case scenario” and inappropriately characterizing minor or moderate problems or issues as catastrophic events.
Most people see catastrophizing as simply “over-reacting”, but it’s more. Catastrophizing, is, in essence, the habit of characterizing situations as worse than they are, or the tendency to automatically assume the “worst case scenario” in everyday situations”.

“…Catastrophizing is an irrational thought a lot of us have in believing that something is far worse than it actually is. Catastrophizing can generally take two forms:
The first of these is making a catastrophe out of a situation. For example it’s believing that if you make one small mistake at your job, you may get fired. This kind of Catastrophizing takes a current situation and gives it a truly negative “spin.”
The second kind of Catastrophizing is closely linked to the first, but it is more mental and more future oriented. This kind of Catastrophizing occurs when we look to the future and anticipate all the things that are going to go wrong. We then create a reality around those thoughts (e.g. “It’s bound to all go wrong for me…”). Because we believe something will go wrong, we make it go wrong.
Falling prey to Catastrophizing is like striking out in your mind before you even get to the plate. Both of these types of Catastrophizing limit your opportunities in life, work, relationships and more. It can affect our entire outlook in life, and create a self-fulfilling prophecy of failure, disappointment and underachievement.
Both may lead you to self-pity, to an irrational, negative belief about the situation, and to a feeling of hopelessness about your future prospects. Further, both of these types of Catastrophizing will define either the presence or absence of alternative possibilities, and possibly paralyze you from going further with efforts toward your goals in life…”
From my experience there is a distinct difference in how this manifests between High Functioning and Low Functioning Borderlines (though this kind of behavior is not limited to BPD and is in fact quite common in all Cluster ‘B’ Personality Disorders). Low Functioning Borderlines will often lose control of this kind of though and outwardly project their fears. They may have a very difficult, if not impossible, time realizing that these feelings aren’t rational. While a High Functioning Borderline may not be able to stop these thoughts and feelings, there is an awareness that this kind of thinking is out of proportion and there is a greater possibility that we can keep these thoughts internal.
That awareness does not make it ok though. It doesn’t diminish the sensation of it. I know these thoughts are out of proportion. It still feels like the world is going to end. Everything I say can be second guessed; could be wrong, could make someone upset, or so exacerbated, or annoyed that they simply give up and go away. On the one hand I don’t really care what people think about me, but on the other hand I don’t want to drive people away. Everything I say or do, could lead to it though. If I don’t know the answer to something, I’ll be judged as incompetent and fired. If I need help for something, I’m just a burden and worthless. If I don’t know everything, can’t be happy, can’t do this, or that, what’s the point in having me around? What do I have to offer if I can’t offer everything?
Then I try to hide my ‘failings’ or ‘flaws’. Which only increases the paranoia another degree. I know it’s there, so now I’m waiting for someone else to discover it. Waiting, holding that secret, hiding that secret, increases the anxiety as time goes by. The longer you hold onto something the less likely that it will go unnoticed. There is statistically less time that it can remain hidden. It’s only a matter of time before it’s unburdened, whether you want it to be or not. Then that one little thing will make it all crash and burn.
It spirals. It spirals up. It spirals out. Until my head is so spun I can no longer see straight.
I do this a lot. I do this so much it’s beyond unreasonable. I try not to externalize this, I rarely verbalize this… I’m positive if I did people would think I was paranoid and look at me like I’m crazy. And maybe that’s what a lot of this is. It’s a constant low-grade paranoia driven fear.
It may start off small, but it ends up paralyzing.
So what can you do about it? Being aware that you’re doing it at all is certainly the first step. I’m honestly not very good at following these sort of multi-step processes for long, but hey, maybe you have a longer attention span than I do, hah.
Dr. Elisha Goldstein, Ph.D. suggests 3-steps to breaking this cycle.
1.)    Acknowledge Catastrophizing – The first step to doing anything is awareness of what is happening. We must first notice and acknowledge when our mind is spinning with worry about the future. Then label it catastrophizing or worrying, whichever word works best for you. The trick is not to get caught up in the content; we’ll get to that later.
2.)    Anchor the present moment – There are a myriad of ways to do this. Many people like to use the breath as an anchor because it is always with us and keeps us alive. So you can bring your attention to this and just saying to yourself, “in” as your breath comes in, and “out” as your breath goes out. If this is too difficult, you can bring attention to the bottom or your feet (farthest place from your worrying mind) and just notice factual sensations. You can even just choose to close your eyes and listen to sounds, noticing the pitches and tones rising and falling.
3.)    Intentionally play the what if’s game – This is very different than the mind spinning about this. Actually ask yourself, “what if this happened?” Think about it and then provide and answer. With that answer, you may have another “what if” question, and intentionally ask and answer that one. Go ahead and do this until there are no more questions. It often helps to write this down.

 

Life, Death, Rebirth and Renewal… Tattoo

I got my new tattoo this past Saturday. I got to the shop around 1p, left around 7p. Total time spent working on the outline was 4.5-5 hours. Keep in mind this is only the outline. It will be fully colored but the outline needs to heal first, and I will most likely have to do 2 more sittings of similar duration to complete the color. A lot of the color will be freehanded so there is no outline for that. The depth and shading, the fire aspects, none of which can be seen now, though hopefully you can see where this is going.  It did not hurt at all. Currently it itches like mad. I always forget what the healing stage is like.  I’m not sure how long I’ll keep this post public as I feel like I’m basically naked on the internet. I also can’t take a picture of my back so you can use your imagination to fill in the rest of the wing going up my back.


Tattoo:
This is a Skeletal Phoenix. It is a marriage of two concepts that have been a part of my life for nearly as long as I can remember; the Phoenix and Death. What they represent to me is something I need to keep with me. I tend to lose my ability to hold onto things, people, concepts… and this is something I need to never forget. I need to constantly remind myself so that I do not fall to hopelessness with I am prone to. Talk about a need for some permanence.  
Every year, or two, or three, my life starts over. I crash, or burn, or both and I have to pick up and begin anew. Each time a little different than the time before, but it keeps going.
Phoenix – Phoenix imagery is just that: renewal and rebirth from the ashes of the past. I can never fully forget my past, but I can learn from it; leaving the char behind me and hopefully heal into a better place than I had been before.
Death – I’ve also been constructing my own Tarot deck. Meditating and drawing each card. While working on my Major Arcana, I got to my Death card and {a variant of} this image came to me immediately. I sketched the basic idea the minute I thought of it and knew I had to have this as a permanent reminder for myself.
If you’ve ever studied the Tarot you will know that Death, is not representative of physical death. Interpretations vary slightly by deck but some of the meanings include:
Ending of a cycle – Loss – Conclusion – Sadness – Transition into a new state – Psychological transformation – Finishing up – Regeneration – Elimination of old patterns – Being caught in the inescapable – Good byes – Deep change.
Typically it implies an end, possibly of a relationship or interest, and therefore implies an increased sense of self-awareness. An opening of new opportunities from the ending of those previous. When one region in your life empties, there opens a space to allow something new to replace it.
The banner the Firebird holds says ‘ Bás ’ which is Gaelic for ‘Death’.
The Death card is generally depicted as skeletal so the combination of this imagery along with the phoenix inspired this idea of a skeletal phoenix.
In my struggles with my BPD, my life, becoming who I will become, the nature of life in general; it is strikingly obvious to me why all of these things are a part of me.  This is a card of change. Transition. In the death of one thing springs the potential life of something else. Endings are not only endings, but also beginnings. Endings bring change. In change there is hope. With hope there is the possibility for a better life. A life worth living.
So here you go.


Lucid Analysis: Trials in Therapy

I missed therapy last week because I was in Chicago. The brakes on my car went out so I missed therapy this Monday too, but my therapist was too concerned to let me go a whole other week and squeezed me in late last night.
I’ve been a serious mess. I missed my psychiatrist appointment some time ago b/c they didn’t call to remind me like they always do. I haven’t rescheduled. I don’t know if I want to go back. I decided I wasn’t going to take the Respirdal. Having not rescheduled my Pdoc appointment I’m almost out of my Lamictal, which I’m fine with. I’m weaning myself off. For the last few months I’ve been having really bad night sweats (gross, I know), and for the last two months I haven’t had my period (no, I’m not pregnant). I’ll go back eventually I’m sure.  The thought of going back is making me really anxious and I don’t want to. I have been massively depressed the last few days but idk if this is because I’m coming off my meds or because the last week or two is just catching up to me and I’ve been exhausted. Anyways.
One of the first things my therapist said to me when I sat down was, “Wow, have you lost weight? You look like you’ve lost a lot of weight”.  She didn’t really know me before I put on all the weight from the Symbyax so she doesn’t recognize this as being closer to my normal weight. However, my periodic bulimia has also become not so periodic. I’ve been binging, or just purging what I perceive as having eaten too much… almost every night for the last week. My weight loss has not actually been in any way dramatic in the last week though, so it’s probably a combination of that and my steady, healthier, weight loss.  Last night was the first night I was really able to monitor myself and I didn’t throw up.  She’s especially concerned because this is clearly an indicator of underlying emotional issues. I’ve been bored and lonely and I feel like I can’t fill up the time alone in my head. Food is there,  it’s something to do, it keeps me busy, it’s comforting and satisfying, it fills me up physically… until it isn’t, and I realize I’ve gone too far and I’ll be paying for it in the morning. Then there’s the release, and I feel calm, and more in control. Release. Calm. Control. This is not the right way to go about finding these things.
She thinks a lot of my underlying issues still revolve around Friend and how I’m trying to maintain one aspect of our relationship (our friendship) while repressing and shutting down the feelings that came with the physical/emotional aspect of it. She thinks this conflict is causing me a lot of distress. I think I’m sick of all of it. I’m lonely. I’m very, very lonely.  I need to accept the fact that Friend can not be the kind of friend I am used to and want to have. Accept this on all levels, not just the part where I obviously know this cognitively. I’m afraid to lose my friend, that I’ll lose one of the very few strong connections I have. A connection that I already feel is falling away from me. I can’t reconcile wanting to be friends with him and wanting to not be affected by him. I just want to enjoy the friendship and interests we have in common, but another part of my brain is yelling about how hurt it still is and won’t let me let go of it so I can just relax back into the comfortable space we used to share. It feels like a physical clashing inside my head. I’m lonely. I’m alone. I have no control over this feeling or this state.
From Myself towards Friend I want: To be free of the emotional baggage, have my friendship, and not feel used by everything that went on.
For Myself I want: Someone that I enjoy spending time with, that cares about me, and can be the kind of person that I need to have in my life.
Two separate things, of two separate sources.
Speaking of… I have a date Saturday =) I’m so out of the loop on this whole dating thing. I am really looking forward to it though. We seem to have a lot in common and she really does seem to be a warm, caring, positive person. One day at a time concerning her, but she’s someone to look forward to. If nothing else, a new friendship is healthy.
My therapist is hopeful. That I’m trying is even more important though. It’s so easy to stay locked in the same ruts and routines, regardless of how unhealthy they’ve become. It’s hard for me to pull myself away from something so familiar. I fall into those patterns because they’re predictable, they don’t change, I know what is coming next … even when it inevitably isn’t exactly what it was the time before. I have no way of predicting things I haven’t done before.
I don’t even know how to explain the anxiety that comes with the unexpected. What I’ve had before might not be good but it’s not surprising, there’s some line connecting the dots of the past, present, and future. I can’t predict everything, but I have some semblance of where my feet will fall. Pulling myself away from that familiarity… could lead down a path of wonderful adventures, but it’s all an unknown. What if it doesn’t work out and then I can’t find my way back? If I stop my patterns from before, I won’t be able to pick up where I left off. My connection will have slipped and I’ll be foreign there too.
What irritates me is I’m not a timid person. I’m not shy. I don’t let others lead me by the hand. I don’t balk at beginning new projects or endeavors… except when it comes to people. I’m still holding on to those last shredded threads of what had been this relationship. I don’t know how to let go and not lose all of it forever. I don’t know how to leave behind what something was and let it evolve into what it will be. It’s a leap of faith I need to take in myself.
All I can do is try.
           
She wanted to give me a journaling assignment and I could see her wanting to come up with something revolving around my bulimia but she decided against it. Instead:
Homework: Journal. Think about the therapeutic relationship I have with my therapist, whether I feel the space is safe, I feel she understands me, respects my boundaries, etc.
The things that immediately come to mind:
1.)    I still don’t feel a connection to my therapist. Clearly I know and recognize her, but I don’t have any real attachment to her. I doubt this is her fault.
2.) I don’t think she sees me for me at all. However, I also think this is because my view of myself is so distorted. I’m not sure I actually see me for me.  I’m a depressed, terrible, flawed person. I know all of my faults and imperfections. I see them all clearly. She tells me that I’m a role model for how well I treat those around me, for all that I’ve accomplished, that I’m capable of doing etc. What she sees in me, I don’t see in me. Is this her failing or mine? Probably mine.  She chooses to focus on the positive. I almost exclusively see the negative. I feel like she’s ignoring the negative because she wants to see the positive, but I’m beginning to wonder if she’s really just trying to get me to see myself in a more rounded way. She obviously works with me on the imperfect parts of my life. She’s not ignoring that. Maybe she just doesn’t have as hard a time remembering the other aspects of my life that I don’t seem to be able to hold onto.
3.) I’m not sure I have boundaries. If she doesn’t push my boundaries how am I going to uncover what I need to figure out about myself? If anyone should be able to pull me out of my comfort zone and confront the aspects of myself that I don’t want to face, it should be her. Right?
Those are my thoughts for today. I’m a little out of it. Distinctly depersonalizing more often, again.

Bordering on Sociopathy?


A reader from another blogged asked me a question that roused my curiosity: Are people with BPD always sociopaths, never sociopaths, or some of each?”

 
My immediate response was never. I don’t think I’ve ever heard anyone say that someone with BPD is sociopathic. Though clearly we’re grouped together in the spectrum of Personality Disorders. Sociopathy is classified under Anti-Social Personality Disorder which is Axis II, Cluster B along with Borderline Personality Disorder.

There are reasons as to why we are grouped alongside one another.

So, after a few seconds contemplation my response changed from ‘never’ to; there are some shared characteristics, but still no.

Dictionary Definition of a Sociopath: “Someone whose social behavior is extremely abnormal. Sociopaths are interested only in their personal needs and desires, acting without empathy, without concern for the effects of their behavior on others”. I’m not even going to bother explaining how inadequate of a definition this is for describing sociopathy. It’s the same thing as grabbing a two sentence definition of Borderline. Let’s run with this though shall we…

A case could be made that BPD has sociopathic traits: Our behavior is extremely abnormal, we have a skewed sense of empathy, we act with regards to our immediate needs without concern for how it will affect others (most notably with Low Functioning BPD; High Functioning BPD we may want to act this way but we can often restrain the impulse), we’re impulsive, manipulative, etc.
But seriously, welcome to the world of personality disorders. There’s bound to be some overlap between a great deal of these traits. While both disorders may display many common traits, our motivations, intentions, reactions, perceptions, and presentations are very different. For someone with a Borderline Personality Disorder we are often moved to do the things we do out of a need for attention, sympathy, closeness, reassurance… while the sociopath is not going to have these things as their driving force.

Where the sociopath will have a very limited sense of empathy and low emotive threshold, the borderline is almost the complete opposite. We have a heightened sense of emotional response. Responding to things too quickly in a way that is out of proportion to the situation that has provoked the response.
This reader also had questions regarding our potential penchant for sadism (masochism), and being able to empathize or take pleasure in the injury and suffering of others. I don’t believe this is generally the case. Personally, unless it’s someone I care for, I rarely feel anything for strangers and therefore have a neutral, uninterested view of such things. I may not be interested in their suffering but I don’t’ relish in it either. Now, if it’s someone I’ve split into an all Bad category because of how they’ve treated me poorly in the past; I may take a certain amount of satisfaction in their pain. I’m willing to bet that this crosses the line to how many normally empathic people feel though. No one’s perfect, and most people have some small vindictive streak.

Not happy to go off of my own guesses and assessments I tried to find something already written about this. I found a LoveFraud article (don’t get me started on her bullshit) but as it was submitted by a private psychotherapist names Steve Becker I gave it a read. The title of the article is: The Borderline Personality as Transient Sociopath.

 “It is not unusual in my clinical experience to see, sometimes, some quite chilling sociopathic activity from my “borderline personality-disordered” clients. When someone has a “borderline personality,” it’s quite likely, among other things, that he or she will present with a history of emotional instability; a pattern of chaotic interpersonal relationships; and poor coping skills under stress, reflected in self-destructive/ destructive acting-out and a tendency to suicidal behaving.”

Quite likely, huh? I’m fair certain by definition we are likely, nay expected, to present with a history of emotional instability. Of all the criteria we may present with, this is the one overarching issue we share in common. How do you diagnose someone with BPD without this?

“A question I’ve found myself considering is: When the borderline personality is acting, and looking, like a sociopath, is it the case that he or she, in these states, effectively is a sociopath?

It should be noted that behaviors per se are never sociopathic, only the individuals perpetrating them. Sociopathy is a mentality from which antisocial, exploitative behaviors gestate and emanate with a destructive, historical chronicity. But one can infer the presence of the sociopathic mentality from a telling pattern of behaviors.

Clearly there are fundamental differences between borderline personalities and sociopaths, differences which I appreciate. At the same time, when the borderline personality’s rage or desperation is evoked, one sees (and not rarely) responses that can closely correspond to the sociopath’s calculating, destructive mentality.”

I’m not saying I can’t be calculating and destructive, but this combination doesn’t take over in the moment of provocation. Destructive, quite likely. Calculating comes when the storm has subsided and I can think clearly. I also won’t say this is all borderlines. We are obviously all different, but I’m not immune to barbing and hurting those that I care about. I talked about Alienation the other day and this certainly comes into play there. It’s one of the things I know beyond most others that I’m trying to stop.

“Once inside this mentality, I’m suggesting that borderline personality-disordered individuals can lapse into a kind oftransient sociopathy. Commonly, victims of the “borderline’s” aberrant, vicious behaviors will sometimes react along the lines of, “What is wrong with you? Are you some freaking psychopath?” They will say this from the experience of someone who really has just been exploited as if by a psychopath.”

Just because someone doesn’t understand the reaction someone with BPD has, does not mean we’re actually psychopaths. Especially considering the base motivator is emotive and therefore not anything resembling the emotionless drive of a psychopath. Also, just because some person mentions the world psychopath, does not make for an actual diagnosis.   

“Because this isn’t the borderline personality’s default mentality (it is the sociopath’s), several psychological phenomena must occur, I think, to enable his temporary descent into sociopathy. He or she must regress in some way; dissociate in some fashion; and experience a form of self-fragmentation, for instance in response to a perceived threat—say, of abandonment.”

Our ‘vicious’ aberrant behavior is not someone with BPDs default mentality. I do agree with this. For the entire stigma and the accusation that a borderline is labeled with, our bouts of anger, impulsive lashing out and frenetic behavior are rare compared to our day to day state. However, that these things do occur is a hallmark of our disorder. This is part of what classifies us as Borderline. I’m willing to bet that most Sociopaths aren’t on the constant prowl to manipulate and victimize everyone around them. Day to day they probably just live their lives. The make up our personalities are predisposed to acting the way we do and those actions are what define our different disorders. That there is cross over does not mean that we slip into the mental state of the other. It is becoming increasingly more clear to me that this guy knows practically nothing about Borderline Personality Disorder and is simply trying to fit a square peg into a Sociopath shaped hole.

Several psychological phenomena must occur… if these are really the criteria that define slipping into a transient sociopathic state, than I might as well embrace the title. I live a good majority of my life in this comorbid ‘regression’; dissociation, unstable sense of identity, fear of abandonment… how do these characterize sociopathy?

“These preconditions, I suggest, seed the borderline personality’s collapse into the primitive, altered states of self that can explain, among other phenomena, his or her chilling (and necessary) suspension of empathy. This gross suspension of empathy supports his or her “evening the score” against the “victimizer” with the sociopath’s remorseless sense of entitlement.”

Now this does peak my interest. I do relate to these periods of suspended empathy. This is a product of my dissociation and detachment though. When I’m feeling like this, or more accurately not feeling like anything, ‘evening the score’ is not on my mind, because in not feeling anything for myself or for anyone else, I can’t care. I may not empathize; not feel for someone else; not care about what they’re going through… but I also don’t feel for myself, and I certainly am not thinking to plot some revenge. I can see where this ill formed train of thought may come from though. As is especially the case in Low Functioning BPD, when something triggers a borderline and they do rage, and lash out, unable to control their emotional state, they will focus that hurt and aggression on those they love. I don’t think this is due to a lack of empathy though. No, they’re not thinking about the other person’s needs or well-being, this is true, but it’s not for lack of wanting to. Their own emotions are so heightened and out of control that they can’t see beyond their own scope. I’m not saying it can never happen, but the detachment of empathy and the lashing out against the victimizer are often separate feeling states, not maliciously aligned.

In my states of detached emotion and lack of empathy, my mind may roam to places that I don’t care what happens to another person/people, but at the same time, since I am not clouded by emotional responses I am at my most rational and don’t think to act on my lack of empathy. My motivation to lash out is void because the emotional drive is absent. However, my responses to people may be more callous, less guarded. This is almost always how I think though. It’s not some transient state I’ve slipped into, but a removal of the veil I no longer care to hold up. Normally, instead of acting out on my impulsive thoughts, I hold them in. Where someone more low functioning would act out and then need to apologize profusely to regain the favor of those around them, I generally manage to tame my temper outwardly. It’s my understanding of social interaction that stays my responses so I don’t alienate the people I desperately need in my life. This doesn’t mean the feelings aren’t always there, but my awareness of my actions guides my behavior.

This article is just one more way of demonizing someone with Borderline Personality Disorder under the guise of gleaning a better understanding of what BPD is. Personality disorders are demonized enough; do we really need the mutant hybrid versions too?  

In conclusion, do I think someone with Borderline Personality Disorder is Sociopathic? No. I do not.

Do I think this psychotherapist is an idiot? Yes, yes I do.

There’s a lot of bullshit out there about all the PDs. It’s no wonder people are so quick to judge.