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. 
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A Matter of Severity: Controversy in BPD – Part 2

I thought to add this to the previous post, but I’m adding things as I find them so …. Another controversy revolves around the question:

Is it possible to distinguish between a normal personality and a personality disorder, how do you do it, and where do you draw the line?

Without a clinical measurement of severity in personality discrepency it’s difficult to recognize where you draw the line between a healthy, relatively normal personality and something severe enough to be considered a disorder. Not only that, but who’s to say what is normal for one person is not normal for another? Unfortunately {in terms of diagnosis} people are all different so it’s nearly impossible to devise a steady measurment from patient to patient. So how do you decide on a distinguishing factor…
“It has become increasingly clear that some form of severity assessment is necessary to decide on the priorities to use for the management of personality disorder. The notion of severe personality disorder is central to much of the work in the area of forensic psychiatry. What is clear from empirical research studies is that those with more severe personality disorder do not have stronger manifestations of one single disorder as often postulated, but instead their personality disturbance extends across all domains of personality. Although severity is not normally taken into account when classifying mental illness, it is important in personality disorders, as normal personality and personality disorder are both on the same continuum. Unfortunately, there is no measure of severity for personality disorder in the DSM or ICD classification, and the absence of these measures is of significant concern. Indeed, treatment is justified when it is likely to ameliorate distressing or disabling syndromes, even when the patients fail to meet the full diagnostic criteria of psychiatric disorders and, consequently, the measure of severity is highly relevant to the planning and provision of treatment. A reliable way of assessing personality disorder is to use 3 levels of severity (SeeTable Below). By using this measure of severity, it is possible to use the cluster system to get a measure of severity and this measure is also relevant in assessing those with the most severe personality disorders in forensic psychiatry.”

I think this ties into the idea that recognition and diagnosis of BPD is not stable. With so many different aspects and potential combinations of symptoms it’s difficult to pin point what are the distinguishing characteristics for BPD if some symptoms present, but only to a mild degree, wheras others present with much greater prominence. If something is less inhibiting should it be consider part of the dysfunction? Should only the most severe problems be included in diagnosis? Or should all manifestations be addressed and lumped together? I personally thing the 3rd is the best idea. However noting which problems are the most harmful to a persons functionality can provide a guideline for psych/therapists to map out a course of treatment addressing the most prominent features sooner.

Does Borderline Personality Disorder exist? – Controversy in Borderline Personality Disorder

 

There is a lot of myth and controversy surrounding Borderline Personality Disorder. This is due to the fact  that the nature of BPD is very complicated.
Controversy ranges from Diagnostic criteria, usefulness of medication, effectiveness of therapeutic techniques, gender discrepancy, possibility of recovery, Axis location, terminology, and whether it even exists as an actual disorder at all. There are many, many more. I can’t say I’m surprised though, we’re a pretty controversial group of people.
This will be the beginning of a series of entries surrounding the controversies with BPD.
So to start; I think it’s appropriate to begin with:
Does Borderline Personality Disorder even exist?
One of the myths I’ve found is that there is no such thing as BPD. However more than three hundred research studies and three thousand clinical papers provide ample evidence that BPD is a valid, diagnosable psychiatric illness.
The question about the existence of BPD comes from several claims.
1.)     The first being shear ignorance of current psychological research. Definitions and diagnosis of BPD have changed drastically in the decades that it has been recognized as a disorder and some clinicians may be overwhelmed, or choose, to focus on many other areas of specialization and just not know how this subject has developed.
2.)    Some clinicians believe that it is not a separate disorder. They believe it is a collection of symptoms that are better encompassed by Bipolar Disorder or Post Traumatic Stress Disorder.  I’ve talked about PTSD before {here} and why I believe these are different disorders.  Bipolar II is a bipolar spectrum disorder characterized by at least one hypomanic episode and at least one major depressive episode; with this disorder, depressive episodes are more frequent and more intense than manic episodes. As far as Bipolar is concerned; I can see how Borderline Personality Disorder could be confused with Bipolar II (Bipolar depression) from a mood disorder standpoint. People with BPD tend towards a chronic depressive state with instance of hypomania (this certainly fits me). However BP II doesn’t the address the “instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts,” markers that define BPD. (More on Bipolar II)
3.)    Some simply reject labeling because of the stigmas associated with BPD and find all psychiatric diagnosis limiting and misleading. This one in particular I find to be ignorant. Yes, BPD does have a lot of associated stigmas (which I will also discuss in a later post), and avoiding stigmas is beneficial to the personal interactions of a patient in the outside world. However, by refusing to provide a diagnosis it can be very difficult to provide a clear course of action in therapy. By extension, it makes it more difficult to find a path to recovery. Not to mention, someone with BPD doesn’t have to tell anyone that they have been given this diagnosis, which will also allow them to avoid the general stigmas. If the psychiatrist/ologist/therapist holds onto these stigmas, it’s best for the patient to find a professional that is better equipped to handle the challenges associated with the present symptoms.
4.)    Another reason stems from the fact that the categorical diagnosis and causes for BPD are often disputed among professionals.  While the DSM does provide a list of criteria, there isn’t a single dimensional model that clearly maps how to identify traits and how, or if, they correlate to one another. This means there is dispute over the importance of various criteria, whether they are related to one another at all or just coincidentally present in the patient, existing as distinct problems or pieces of various other disorders. So the root causes that are traditionally used to classify BPD are called into question.  
“There continues to be some debate as to which personality variables should be assessed to make a diagnosis of personality disorder in the normal/abnormal personality continuum. It would seem to be appropriate in this approach to choose those personality variables more likely to be personal and concerned with functioning, in order to assist in understanding the patient’s disabilities and obtain strong clues about them. The difficulties encountered in the diagnosis and study of personality disorder include inconsistencies in assessment across both instruments and raters. “

Most professionals agree that the symptoms that compose Borderline Personality Disorder are part of one clinical diagnosis. The symptoms themselves are not deniable. No doctor or therapist would look at a patient talking about their problems and tell them these issues do not exist. That is not the question. The question is mostly one of definition and categorization. Regardless of what anyone thinks, the problems are real and having the ability to recognize the distinction of various symptoms is an important tool in order to deal and work to recover.

Co-Morbid Symptoms: Borderline Personality Facts and Statistics Part 5

– On the Minnesota Multiphasic Personality Inventory (MMPI), ERD patients do not show a common profile. Personality traits appear to be a combination of histrionic, narcissistic, and antisocial personality.
The MMPI is one of the most frequently used personality tests in mental health. The test is used by trained professionals to assist in identifying personality structure and psychopathology. I don’t actually know much about this test so I’ll be sure to do more research on this in the future.  However it doesn’t surprise me that BPD displays with a combination of personality disorder traits.  Since personality disorders encompass all aspects of a person’s life, the environmental and emotional factors that are experienced often overlap.  The very nature of BPD is a collection of problems that display together…




– Co-morbid conditions in BPD may also affect the ability to act responsibly.
BPD is not a single issue.  There is no single thing that you can point to and say, yep, that’s BPD. BPD is often referred to as a ‘catch-all’ personality disorder because there are so many influencing factors.  Rather than the type of symptom, are the number of proliferative psychiatric or medical symptoms that are diagnostically relevant. These multiple psychiatric symptoms appear to manifest as numerous comorbid Axis I and II diagnoses.  
       
Axis I:  Clinical disorders, including major mental disorders, and learning disorders
<!–[if !supportLists]–>          <!–[endif]–>Axis II: Personality disorders and mental retardation (although developmental disorders, such as Autism, were coded on Axis II in the previous edition, these disorders are now included on Axis I)

Axis I disorders – Clinical ( Mental ) Disorders are used to report various disorders or conditions, as well as noting other conditions that may be a focus of clinical attention. Clinical Disorders are identified into 14 categories, including:  Anxiety Disorders, Childhood Disorders, Cognitive Disorders, Dissociative Disorders, Eating Disorders, Factitious Disorders, Impulse Control Disorders, Mood Disorders, Psychotic Disorders, Sexual and Gender Identity Disorders, Sleep Disorders, Somatoform Disorders, and Substance-Related Disorders. Other conditions, known as Adjustment Disorders, may also be a focus of clinical attention includeMedication-Induced Movement Disorders, Relational Problems, Problems Related to Abuse or Neglect, Noncompliance with Treatment, Malingering, Adult Antisocial Behavior, Child or Adolescent Antisocial Behavior, Age-Related Cognitive Decline, Bereavement, Academic Problem, Occupational Problem, Identity Problem, Religious or Spiritual Problem, Acculturation Problem, and Phase of Life Problem.

Axis II disorders – Personality Disorders and Mental Retardation are recorded so the clinician will give consideration to additional intervention and treatment choices. Personality is the qualities and traits of being a specific and unique individual. It is the enduring pattern of our thoughts, feelings, and behaviors, it is how we think, love, feel, make decisions and take actions. Personality is determined, in part, by our genetics and also, by our environment. It is the determining factor in how we live our lives. Individuals with Personality Disorders have more difficulty in every aspect of their lives. Their individual personality traits reflect ingrained, inflexible, and maladaptive patterns of behaviors that cause discomfort, distress and impair the individual’s ability to function in the daily activities of living. In Mental Retardation problems in brain development have usually occurred and virtually will affect all aspects of the individual’s cognitive functioning. Borderline Intellectual Functioning, as well as Learning Disabilities, may also be a consideration for clinical focus.
Common Axis II disorders:

Antisocial Personality Disorder.
Avoidant Personality Disorder.
Borderline Personality Disorder.
Dependent Personality Disorder.
Histrionic Personality Disorder.
Mental Retardation.
Narcissistic Personality Disorder.
Obsessive-Compulsive Personality Disorder.
Paranoid Personality Disorder.
Personality Disorder Not Otherwise Specified.
Schizoid Personality Disorder.
Schizotypal Personality Disorder.
I’ve mentioned co-morbid symptoms before as I have a metric butt-ton of these: Clinical Depression, General Anxiety Disorder, Eating Disorder (Bulimia), Dissociative Disorder, Sleep disturbance, Sexual/Gender Identification ‘issues’ (I don’t find this to be an issue at all), and possibly substance abuse problems (alcohol). Not to mention the obvious DSM criteria that qualify me for the Axis II Borderline Personality diagnosis.
When there are so many issues, so many overwhelming features to BPD it’s not at all surprising that it’s difficult for someone with BPD to act responsibly. It’s a lot to keep in mind, a lot to try to reign in. These are not issues that can be flipped on and off like a light switch, easily kept in check. You don’t get to choose when your emotions affect you, or how they affect you. And this CAN happen at the flip of a trigger in almost any situation. All of these things contribute to what makes BPD so difficult to control, and that lack of control comes out when we don’t want it to. 

Brutal Ideation – Criteria 8 / Anger Part 2

The one thing I don’t do but I fantasize about constantly:
Fighting.
I grew up fighting. I was heavily involved in the martial arts ever since I was young. I had an outlet, a channel for my aggression in a safe, healthy, constructive environment. Because I’ve moved so often in the last few years I haven’t had the ability to find a new place to continue my study.
It’s come in handy a couple times in the real world when guys have tried to press their advantage with me only to have their wind knocked out and taken aback by someone half their size. I’ve never been in out right fights though, like bar room brawls, in the real world, though I fantasize about it constantly. Especially when I’m running. If I want to amp up my energy, creating a scenario in my mind where I’m rescuing a pretty girl from some drunken brute, or disarming someone that has me at gun point with less than honorable intentions… it sets my heart pounding, adrenaline pumping through my veins.
I’m not afraid of damaging myself. Some days I even welcome it. I know how much my body can take and I’ve survived the worst that can be done to it. Short of death I have no fear of injury because I already know I can survive anything that I’m dealt. And I do mean anything. I don’t fear pain. The thought of taking a blow to the face, the stomach, the chest, doesn’t deter me, it makes me gasp and come back stronger, attack more fiercely. My anger boiling and bubbling over until all I am is a fury of fists and feet.
In my visions I never escape unscathed, I take my hits, bruised and sometimes broken, but I’m never beat down, never relent. I always get back up and I always end up on top. Some day I’ll push this into reality and see just how well my fantasies match up to reality….

Through a Looking Glass, Shattered.

Hello. I am Haven. My hopes for this blog is to reach out, to connect, to touch you in some way that will increase awareness of what it means to have a Borderline Personality Disorder.
I promise nothing but an attempt, an honest look into the experience and insights of someone that walks through this world in a way other than you may do so yourself.
I do not claim to be representative of BPD. In fact, I don’t believe there is such a thing as a general representation. As one of the predominant features of my disorder is my dissociative condition, I feel almost no attachment to a group of individuals whatsoever. I hope to convey just how separate, other, this worldly experience is. Raise awareness, increase understanding, and challenge the perception of what is commonly held as the social norm of being.

Let us begin, shall we? Through a Looking Glass, Shattered.