Now, now, let’s not get… hysterical

Continuing on our journey into common Characterists and Traits of Borderline Personality Disorder:

Hysteria is inappropriate over-reaction to bad news or disappointments, which diverts attention away from the problem and towards the person who is having the reaction.

This is especially notable in Histrionic Personality Disorder but the Borderline is no stranger to it either.

Hysterical people take everyday situation and elevate them to a level that is inappropriate, unhelpful and diversionary. They may sometimes appear more comfortable in a crisis than in a calm situation. They are the kind of people who threaten, bluster, overreact, take it up a notch, go to extremes.

Out of the Fog talks about this being a systematic approach used to seek attention.

“Many people enjoy 15 minutes of fame. But for a Drama Major or Drama Queen, obtaining and holding other people’s attention is more than a flight of fancy – it is something which they seek out using a systematic approach.

The goal of a hysterical person is to draw attention to themselves and to their plight – primarily from people who do not know them well and who are more likely to present a sympathetic response. Basically, it is a way to manipulate strangers into serving a person’s emotional need.”

This may be true for the Histrionic but from my experience I can’t say it’s true of my particular experience of Borderline. It’s almost impossible to ignore someone that is hysterical.  The end result may absolutely gain attention but becoming hysterical is never something I’ve planned to do, it just happens.

Hysteria describes unmanageable emotional excesses. Do I even need to describe this? For me, this is what accompanies panic and severe anxiety attacks. Panic attacks is probably closest. The ceiling feels like it’s closing in on me, there’s not enough oxygen in the room, the world is aligning against me and nothing I can do will pull my life out of the shit hole that it’s managed to fall into because of some event beyond my control. Last instance I recall is when I panicked about my job, wanted to quit, and an outright panic attack at Therapist (read: healthy outlet where I should be releasing these emotions), declared to Roommate and friends at large that I was done with engineering and would be exploring new occupation avenues because it felt like my life couldn’t continue on in the direction I’ve been going. And nothing could convince me otherwise. There is no consoling, no rationalizing. All there is, is the feeling that what’s happening right now, is taking over.

Current psychiatric terminology distinguishes two types of disorders that were previously labeled ‘hysteria’: somatoform and dissociative. Somatization disorder is a psychiatric diagnosis applied to patients who persistently complain of varied physical symptoms (like phantom back pain) that have no identifiable physical origin. The dissociative disorders include dissociative amnesia, dissociative fugue, dissociative identity disorder, depersonalization disorder, and dissociative disorder not otherwise specified. The origin of Borderline hysteria is probably much more easily identifiable as the direct result of, or perceived result of,  loss, abandonment or conflict {internal and external} and the inability to regulate emotional responses.

Hysteria can encompass symptoms of psychiatric phenomena that have been linked to psychological trauma. This brings me back to something that needs a little reiterating. Borderline Personality Disorder doesn’t just happen. It may have biogenetic origins, but it’s exacerbated and encouraged by the often traumatic environment that the borderline experiences growing up.

Recent neuroscientific research is even starting to show that there are characteristic patterns of brain activity associated with these states.  These disorders (somatoform and dissociative) are thought to be unconscious, not feigned or intentional malingering. So while the physical result may be to garner attention, act out, even manipulate a specific reaction from someone… It’s a temperamental predisposition, not necessarily some devious plot thought out in advance.

NOTE: This is not a justification and these reactions are something that can and should be tempered and controlled. Understanding what is going on though is key to bringing it under control. Recognizing that these things are unconscious, that is, of the mind, can help in the realization that these things are not real, or that these feelings are exaggerated. In recognizing this, hopefully it is possible to get ahold of these runaway feelings and ground them with the knowledge that they will pass and aren’t actually going to end the world.

Amusing origin story:

Freud was an idiot.

Historically, the ancient notion of hysteria, is of the “wandering womb.” Derived from the Latin histrionicus, “pertaining to an actor.” Ancient Greeks thought that excessive emotionality in women was caused by a displaced uterus and sexual discontent. Christian ascetics during the Middle Ages blamed women’s mental problems on witchcraft, sexual hunger, moral weakness, and demonic possession. By the 19th century, medical explanations proposed a weakness of women’s nervous system related to biological sex. Thus, “hysteria” reflected the stereotype for women as vulnerable, inferior, and emotionally unbalanced.

The cure of course, was to go to your local physician and have these sexual tensions ‘relieved’. Now there’s a cure ::smirk::. Talk about gender bias for Histrionic PD too. I’d say it’s pretty obvious where that came from.

The concept of a hysterical personality was well developed by the mid-20th century and strongly resembled the current definition of histrionic personality disorder. The first DSM featured a symptom-based category, “hysteria” (conversion) and a personality-based category, “emotionally unstable personality.” Haha, recognize this?!? Borderline. DSM-II distinguished between hysterical neurosis and hysterical (histrionic) personality.

To me this seems like a characteristic that borders between Histrionic and Borderline or one that keeps them identifiably intertwined. So I guess really, Hysteria is two related things: a personality characteristic whereby someone is a hysterical person in general (histrionic) and/or a situational state of being; as in having a hysterical incident.

Personally, while I may have panic attacks, I am not a hysterical person. This is a trait I associate more with Low-Functioning Borderline.

Living in Denial

Living in denial is a way of life for someone with Borderline Personality Disorder.

I’m sure I lived in denial of my actions and circumstances for years. I may still be doing so, but if so I can’t exactly see it, because the only perspective I have is my own and I can’t see how other people see me. It’s all speculation from my perspective. 

Denial is a defense mechanism in which a person is faced with a fact that is too uncomfortable to accept and rejects it instead, insisting that it is not true despite what may be overwhelming evidence.

An excerpt from Out of the Fog:

Most people find themselves in denial in everyday living situations, particularly in handling threatening situations, grief or loss. This is quite normal not to face reality – or pretend it does not exist, as one struggles to cope with difficult circumstances.

Denial can result from experiences, memories or information which contradicts our world view resulting in 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.

However, with personality disorders, there is a phenomenon known as dissociation – which is a more pervasive, destructive form of denial – where a person is not merely disregarding, neglecting or avoiding the truth but rather forms a conviction or belief around a fictitious set of beliefs and attempts to impose, force or project that fictitious version of reality onto others.

Examples:

A family member calls you on the telephone and 5 minutes later insists that it did not happen.

A spouse commits an act of violence and later refuses to acknowledge it.

A child cannot recall an incident of parental abuse.

A divorced woman lives as though her ex-spouse is still living with her.

What Not to Do:

NT’s can sometimes be stunned to discover that the personality disordered individual in their lives completely believes a completely false reality they have invented. It is common for NT’s to spend a great deal of effort fruitlessly trying to reason, cajole or argue with a personality disordered individual into “snapping out of it”, “waking up and smelling the coffee” or “facing the facts”. It can be hard for NT’s to accept that for a person who is dissociating, the denials they are expressing are the facts – at least at that time – for them.

Under such circumstances, standard communication or negotiation techniques are ineffective – since they are built on the premise that both parties can agree on what the facts are, have the ability to reason and can work towards a common interest or compromise.

What To Do:

Accept that each person’s reality is their own property and everyone has the right to believe what they want to believe, think what they want to think and experience their own world without intimidation, control or persecution. That applies to the personality-disordered individual in your life and it also applies to you. That will mean you may have to “agree to disagree” on important facts, history or conclusions.

Remind yourself that one person’s opinion of you does not define you. You are you. Seek out the counsel of wise, caring and supportive people who you can trust to help you rebuild your self-esteem.

If someone says something which you believe isn’t true, it is appropriate to declare “I don’t see it that way”. Once!

{ -What I like about this is that it is non-confrontational way to approach a disagreement. Often when you are in disagreement with someone as emotionally volatile as one with a Borderline Personality Disorder they will react strongly and lash out at any affront to their world view or perception. “I” statements, do not imply anything wrong with the other persons perspective, only that you are coming from a different place. – Haven }

If you, or any children in your care, are being exposed to abuse of any kind, take appropriate action to protect yourself and your children.

After that it is appropriate to walk away from any further discussion and go about living your life in an emotionally and physically safe, healthy, and productive way.

---

Hm. I agree for the most part but not about the dissociative tie in. I do have a pretty severe dissociative disorder and I don’t agree that it is a form of denial. Not in the way they phrase it, “… forms a conviction or belief around a fictitious set of beliefs and attempts to impose, force or project that fictitious version of reality onto others.”  In my experience, dissociation is not something I can choose to do. It’s a slipping out of my reality. I can ‘check in’ and know that I am actually in reality but I feel other. It’s not a choice by any means. It’s something that happens in order to remove me from a painful or uncomfortable experience, but I can still perceive the world around me in a way that is not delusional. It’s also not something I project, or even can project, onto anyone else. It’s a sense of being detached and removed from others, not imposing onto others. I talk a lot about dissociation, depersonalization, and derealization.

Anyways.

Denial. This is pretty much how I lived in my relationship with Evil-Ex. I wanted to believe the lies and manipulations he told me to keep me, which were in complete opposition to how he acted, in complete opposition to what I believed I deserved, in complete opposition to what I wanted from a significant other. I knew how he was treating me, but I couldn’t reconcile it with my emotional attachment to him, what I wanted from him, and lived in a state of perpetual denial. I also lived in a state of denial that my actions and reactions were appropriate; for most of my life really. Instead of being able to see {in reality} what I was doing, I was/am only able to feel how it affects me. I know the circumstances that ‘caused’ these feelings, and from there how I reacted was ‘justified’.  I may have been overreacting but I wasn’t wrong. I was the wronged. In my relationship with Evil-Ex I actually was the wronged. However, my relationship with my parents and siblings growing up, this was not the case. I was wrong and in utter denial that the way I functioned in my world was not appropriate.

I want to make this clear. Just because we have a Personality Disorder does not make us always wrong in our perceptions. They may be skewed, but like anyone else in this world we occasionally are on the receiving end of misbehavior which is not a product of our disordered reality.  I also want to say that denial is generally subconscious and not intentional. In order to heal, we must get out of denial.

*NT = Neuro-Typical. I use this to refer to people that are not Personality Disordered. A lot of places use Non {BPD} as well.

Ghost of friendship present

Well, there was that.

I’m starting to spiral down again. Have been all week, slowly. Spent most of last weekend with Friend. I was alternatingly irritable, anxious, avoidant, and numb.

Friday, staring at the TV watching Aladdin {of all things?} was all that kept me from bitching at the wife. There’s only so many times I can tolerate being cut off before I’ve completed a thought process.  I shut up, retreated inwards, and refused to look at anyone.

Friend and I went to see Sucker Punch. If you like cute girls in short skirts with multitudes of weapons and excellent explosions and no expectations that it will be much more than fun eye candy and escapism, this movie is for you. I thought it was a ton of fun. The empty space surrounding the beginning and end of the movie though… It was odd for me, before the movie it was like talking to someone I knew a long time ago but now I’m not sure if we have any common ground anymore. I feel no connection to him. Afterwards was equally as strange. I could have been talking to a random stranger that had seen the same movie, who coincidentally happened to like all the same parts I did.

Next day I went over to work on a project. He wanted to bump up the start time, but I hadn’t pulled myself out of bed yet and still needed to go to the gym. I told him I could be over an hour later than he wanted which he was fine with, but sent me rushing around like a mad woman. Hauling ass out of bed, rushing to the gym, cutting my workout in half, just so I could get home, shower, and get over there. Why I felt compelled to rush myself like mad, sending myself spinning in a free fall of temporal anxiety is beyond me. I always do this. I don’t care, but I can’t say no, or in my own time. At least Friends wife was gone. Every time I go over there now, it feels like I’m there for the first time. That I know where everything is, is a strange sort of déjà vu. Everything looks familiar, but I walk in the house seen through a glass wall from the outside in, through a museum of rooms I’m not supposed to sit in. Never be a part of. I’ve completely lost my connection to it all. I’m pretending to be someone I think I’m expected to be. Going through the motions of caring. About {everyone}. It’s exhausting and grates my nerves. I’ll be alone if I don’t. If I don’t act the way I’m expected to, play in an acceptable way – there’s no point being there at all, b/c all I’ll do is push people away.  I could walk away from it all and feel like I was never there in the first place. 

There were points in our project that I wanted to rip things out of his hands. I needed things to be a certain way. That he was doing it and not me, he was doing it wrong, and my stomach kept twisting into knots, tighter and tighter.  Barely controlled anxiety I could tell him to do things differently, though it would have been so much easier to just do it myself, but I’m trying to act inclusive so I don’t. Finally we finished up and I was actually pretty happy with the results, but then…

I had nothing to focus my attention on. I had rushed out of my house so fast that I forgot all my stuff to distract me with. I just felt blank. Blank and out of place. I wanted to go home and get my stuff but then there wouldn’t have been any point coming back and I didn’t want to not be there. I didn’t necessarily want to be there either, but spending the rest of the day/night alone was not acceptable. I just, couldn’t leave. It made me anxious to stay, anxious to go. Stuck. Stuck. Split. Without other things to do I felt like I would have no excuse but to interact. I don’t know why this bothered me so much. I needed something else to focus on that wasn’t directly interacting with him, which is stupid b/c {essentially} it was just me and him. Hyper aware of when we sit to close. Usually touching someone is grounding for me, even just feet touching curled up on opposite ends of the couch. A physical connection that brings me back down to earth. Not now. Trying to hold onto a shadow of something sitting further off into the light. I did what I would normally do all day and didn’t feel attached to any of it. My Self floating and drifting somewhere outside of me. Everything dizzy and slightly surreal.

I get so sick of feeling like this.

I left rather abruptly. As soon as I left the house though my energy started to ramp up. By the time I got home I was much too hyper than a 10 minute drive should allot for. 

My therapist says I’ve detached from my emotions. I can’t have completely because the irritation, anger and anxiety are still there. I don’t know how to get back. I want to have functional friendships. I can see myself pushing away, but refusing to let go.

Maybe if I keep trying, keep pretending like everything is normal, I’ll eventually convince myself that it is. Delusional. This never works. All it does is work to make me lose myself more. I am the only one I truly need to hold onto.

The next day I did stuff I knew I was supposed to do but slightly detached from everything. Wine helps, even though I know it shouldn’t. This week though I’ve been ok, but I feel myself slowly sinking. It’s getting harder and harder to drag myself out of bed again. I feel weighted by invisible hands holding my head down. Suffocating on the very air I need to breathe. Don’t want it, can’t live without it.

I’m defective.

Spiral out, Keep going.
Spiral out, Keep going.
Spiral out, Keep going.

Post Traumatic Stress Disorder – Stats and Facts Part 3

Approximately 25% of those with BPD/ERD also meet the criteria for post traumatic stress disorder.

So let me tell you a story. I had to go to a counseling session because I made a very poor decision concerning alcohol and driving. I had to have a psychological evaluation and talk to a social worker about my past and stuff. First off, let me tell you that I hate, HATE, talking to shrinks that are not of my choosing. I don’t believe it’s any of anyone’s business to ask me such personal questions, intimate, details of my life. Especially when they inevitably make snap decisions and diagnosis because one session is not enough time to understand anyone. So anyways, I had this session. The guy (the only male counselor other than my psych I’ve ever talked to) started asking me questions off of a list of psych questions. It was clear that he cared precisely zero about me as a person. He just needed to get through his checklist. Throughout the interview he ask me questions, then instead of letting me talk, cuts me off and proposes his own theories and tangents. So he’s asking me these questions when he gets to the section on pysical/mental/emotional abuse. It’s at this point I’m debating whether or not I want to tell him the truth or just get him to skim past this. I decided that the truth would work to my benefit as it was part of why I landed there in the first place. So as soon as I start saying yes to some of his questions his eyes light up and he proclaims that I have Post Traumatic Stress Disorder. WTF? He didn’t even ask me to elaborate on the situations he was asking about. He just went on and on about PTSD, cutting me off when I tried to elaborate, and got way to excited about my potential mental disorder. It was clear that PTSD was his pet subject. So while I have technically had a diagnosis of PTSD, I don’t believe it. It makes me wonder how accurate some diagnoses are too. People are human and therefore subject to their own biases.

And while I might fit the technical criteria for PTSD, the incidents that made him jump to this conclusion had less lasting traumatic effect on me than did a really bad car accident I was in while I was at university (years after my BPD emerged).

So let’s take a look at what PTSD is (and how I potentially fit the criteria):

Causes – Psychological trauma:

“PTSD is believed to be caused by either physical trauma or psychological trauma, or more frequently a combination of both. PTSD is more likely to be caused by physical or psychological trauma caused by humans such as rape, war, or terrorist attack than trauma caused by natural disasters. Possible sources of trauma include experiencing or witnessing childhood or adult physical, emotional or sexual abuse. In addition, experiencing or witnessing an event perceived as life-threatening such as physical assault, adult experiences of sexual assault, accidents, drug addiction, illnesses, medical complications, or employment in occupations exposed to war (such as soldiers) or disaster (such as emergency service workers).  Traumatic events that may cause PTSD symptoms to develop include violent assault, kidnapping, sexual assault, torture, being a hostage, prisoner of war or concentration camp victim, experiencing a disaster, violent automobile accidents or getting a diagnosis of a life-threatening illness. Children or adults may develop PTSD symptoms by experiencing bullying or mobbing. Preliminary research suggests that child abuse may interact with mutations in a stress-related gene to increase the risk of PTSD in adults.”

Criteria:

The diagnostic criteria for PTSD, stipulated in the Diagnostic and Statistical Manual of Mental Disorders IV (Text Revision) (DSM-IV-TR), may be summarized as.

A: Exposure to a traumatic event

– This must have involved both (a) loss of “physical integrity”, or risk of serious injury or death, to self or others, and (b) a response to the event that involved intense fear, horror or helplessness (an event was “outside the range of usual human experience.”).

Yep. Definitely had a few such instances involving abuse and a particularly bad car accident.

B: Persistent re-experiencing

– One or more of these must be present in the victim: flashback memories, recurring distressing dreams, subjective re-experiencing of the traumatic event(s), or intense negative psychological or physiological response to any objective or subjective reminder of the traumatic event(s).

You be the judge. I often have distressing dreams but they’re no longer terrorizing. Intense negative responses: If you consider an inability to let most guys touch me without utter revulsion, freaking out and regretting any instance where it occurs outside of my comfort zone, constantly disavowing any intimate male companionship (this never sticks) and quickly second guessing, overanalyzing their motives… or… when I’m a passenger in someone else’s vehicle I often have knee jerk reactions with braking too hard, or getting to close to other vehicles. This causes me to pull back, hard knees to chest, my heart rate to speed up, grabbing onto the ‘oh shit’ handle and my breath catching in my throat. I prefer to drive.

C: Persistent avoidance and emotional numbing

This involves a sufficient level of:

– avoidance of stimuli associated with the trauma, such as certain thoughts or feelings, or talking about the event(s);

– avoidance of behaviors, places, or people that might lead to distressing memories;

inability to recall major parts of the trauma(s), or decreased involvement in significant life activities;

– decreased capacity (down to complete inability) to feel certain feelings;

– an expectation that one’s future will be somehow constrained in ways not normal to other people.

Heh. After some such events I severed contact with certain people, wanting nothing to do with them or those that are involved with them. Avoiding situations where I might even have the possibility of running into them. Not places that I was sure they would be (though of course I won’t go there) but places they might be, where there is even a small chance of it. After one incident in my early 20’s I completely repressed events, only recalling it years later after I found a journal that I had written immediately after and then completely forgot about. I still only have flashes of this, not a full recollection. Decreased capacity to feel certain feelings. ::smirk:: I often have a complete inability to feel feelings at all. This problem is what lead to the diagnosis of my Dissociative Disorder. When I have extreme stress, loss, and/or conflict I depersonalize and derealize from my life and even my own body. I do absolutely expect that my future will be constrained. My present is currently constrained in ways not normal to other people. I have a Borderline Personality Disorder. I’m pretty sure, by definition, this qualifies for ways not normal to other people.  I believe this has more to do with my depression than any traumatic experience that I suffered after this problem began.

D: Persistent symptoms of increased arousal not present before

-These are all physiological response issues, such as difficulty falling or staying asleep, or problems with anger, concentration, or hyper vigilance.

Long posts need more pictures

I think they need a better phrase than ‘increased arousal’. This did not immediately inspire thoughts of heightened awareness if you know what I mean. I have always had extreme difficulty with sleep. I had insomnia for years that still occasionally creeps back (last night for example – so freaking tired). Even with the prescribed medication that I’m on specifically to help me sleep I have a hard time falling asleep, staying asleep, and once I wake up, calming my brain down enough to return to sleep.  Anger, hah, see this post. My therapist just brought up my sense of hyper vigilance yesterday as a form of self protection. All of these things, however, were a problem well before any real trauma that I suffered and were not the result of bad experiences that I can recall. I imagine that some of the experiences I’ve had since the onset of this most likely exacerbated the problem.  

E: Duration of symptoms for more than 1 month

– If all other criteria are present, but 30 days have not elapsed, the individual is diagnosed with Acute stress disorder.

How about years? Does years count? Acute stress disorder seems more accurate to me though.  Don’t ask me why. Maybe I just don’t want to have PTSD too.

F: Significant impairment

– The symptoms reported must lead to “clinically significant distress or impairment” of major domains of life activity, such as social relations, occupational activities, or other “important areas of functioning”.

– I’ve had significant distress and impairment in social relations since I was 12 years old. This was at the onset of my clinical depression and anxiety disorder. Both precursors to my BPD. By this point my abandonment issues were also in full swing. But, again, not due to an experiences that could be considered very traumatic. I think it has more do to with a predisposition to feel things in a way that is not normal to most – BPD.

So yeah, after this very long personal assessment, I am still not a psychologist or psychiatrist and am therefore not qualified to diagnosis myself. Thoughts?

Abuse is very common in the lives of people with BPD. It is often one of the root environmental contributors to the emergence of the borderline disorder. I do not have any doubt that many people with BPD also suffer from PTSD. Recognizing this is very important for treatment because it helps understand some of the underlying factors that need to be worked through and healed.

I do wonder if PTSD leads to BPD, or if being predisposed to BPD leads to an increased sensitivity to situations that feel traumatic but would not normally be considered a traumatic event required to define PTSD.  Then again, if something feels a certain way, a situation is perceived a certain way, doesn’t that make it reality for the person experiencing it? Therefore the event occurring is in fact something very traumatic.

I don’t know.  Most likely it is a co-morbid issue building and feeding off of each other.

Therapeutic Break Through…

Talking to my therapist yesterday. I’m always worried that if I don’t see someone for an extended period of time I’ll lose my connection to them. That I will lose the emotional attachment that I had. That the memories and feelings that I had for someone will dissipate and disappear. That what they hold of me will disappear. I’ll dissociate from them completely. This is a valid fear, because it is something I do.

I struggle with this because I often need to be alone. But I’m afraid that if I don’t go out, I will be forgotten and I will lose that connection. Feel abandoned. Being around people can be painful though, especially when I’m feeling so much loss from a particular source. I have to fight the conflict of putting myself in a situation that might cause me pain, or withdrawing and fighting with my dissociation and feelings of falling away. Lose, lose.

Something my therapist told me to try was this: You have memories of Person X. Remember a time when you were with that person, that you felt happy, warm and cared for. You still have those memories. That the time has passed does not change the fact that at one point you felt that way. Since your relationship has changed, you may feel a loss in the intimacy or the connection now, but that doesn’t change what was there before. You’re grieving and grieving is healthy. It takes time to get through. When you work through understanding your relationship with Person X, struggle with wanting to be around them or staying away, try this: Hold onto that feeling, that memory of when you shared good times, hold it close in your heart and continue to hold onto that, and then envision the paths that you could potentially take. Removing yourself from their life, even for a time to take space, walk through the possibilities of what might happen, how you would feel if this person was no longer around, how you imagine they will feel and react, but don’t forget that what you had was real. In many aspects is still real. Life may change, but it doesn’t change the fact that the memories you had were important to you. Imagine what it will feel like to be around that person, who is still a stable point in you life, the pain and comfort that you still find, but don’t lose sight of those good memories that you hold close. They’re still there, still real. Work through all the situations you can imagine and know that they don’t change what was once there. It will help you understand how to proceed with what is best for you. 

Everyday, I need to work on this. Just because I can’t maintain a continuum of feelings and events, this is not how other people function. Holding onto those thoughts and memories that I have, holding them dear to me as I struggle with the changes that I am going through will help me stabilize and form a lasting bond to people.

The sum of my relationships are not based solely on our last interaction. It is all the things we’ve been through, done together, and shared.

As she was walking through this process with me, I could feel myself understanding what she meant, actually feeling it. It helped provide a sense of clarity and calm. Less alone.

Lack of Object Constancy

“Borderlines have problems with object constancy in people — they read each action of people in their lives as if there were no prior context; they don’t have a sense of continuity and consistency about people and things in their lives. They have a hard time experiencing an absent loved one as a loving presence in their minds. They also have difficulty seeing all of the actions taken by a person over a period of time as part of an integrated whole, and tend instead to analyze individual actions in an attempt to divine their individual meanings. People are defined by how they lasted interacted with the borderline.”

Object Constancy – They may have problems with object constancy. When a person leaves (even temporarily), they may have a problem recreating or remembering feelings of love that were present between themselves and the other. Often, BPD  patients want to keep something belonging to the loved one around during separations.

My therapist tells me I have a lack of object constancy.

Out of sight, out of mind: For me, I don’t believe people hold me in their memories. If I’m not around, or I am not in some form of contact/communication with them, I don’t exist in their world. I have an extraordinarily hard time holding onto the thought that people remember me, hold me dear or care for me when I am not in their physical presence. Out of sight, no longer connected. I’m sure to most people this is not how they perceive relationships (be it friendship, dating, familial). I think it should be a consistent progression of emotions and experiences that build together to form a deep bond. I also have a hard time holding onto the strong emotions I feel for those I care about, and when I do manage to I also manage to convince myself that I am the only one that feels this way and no one else could possibly share my depth of emotion though I desperately hope they do. This creates a feeling of panic and loss for something that may actually be there and I need to find a way to reaffirm these feelings in myself and others every time I am back in contact with them. It’s a maddening cycle of doubt, loss, connection and disconnection.

Holding Time:  I have a hard time holding together one event after the other. I remember events just fine, but holding onto the sentiment of events in series that something is bound. It doesn’t always feel to me that everything is connected. One thing may happen after another, but it does not seem like things hold together in essence after the former has passed. Like if I’m gone too long, that I was there before will cease to be relevant. There is no continuum of events. Everything is like a single instance in time and I have to completely reestablish how I am connected to the event, the environment, the people every time.  It’s very difficult for me to remember that everything is NOT a series of individual events. They ARE a continuum. The attachment of one event bleeds into the sentiment of the next giving life to yet another. That continuum is what binds memories, sentiment, and relationships. Yes? At least that is what I imagine it should be. I imagine so, I don’t feel it.

I often have terrible anxiety when people leave. There’s a desperate need to understand how others feel about me, hold me to them, our connection, because I can’t hold onto this concept myself. On the other hand, when people do leave, abandon me, never to return, after a while it’s as if they were never in my life. I have memories of experiences with people, but no emotional connection to the memories. It’s like I’m remembering a story someone else told me. Sometimes this happens immediately, other times it takes weeks of panic at the loss before I break from the emotional attachment I’ve been able to build. Lately though, I notice this happening more and more quickly, with less time spent obsessing over every instance that lead to the break.

My dissociation helps me here because after the initial fear and anxiety, my emotions deaden. I become numb to the experiences I have just been through. I feel detached from my own body and it becomes logical that others wouldn’t be attached to me when I am not even attached to myself.

How attached are things, moments in time, events, really? How does it feel to be so strongly bound by sentiment that you feel indefinitely connected by a series of things? I simply don’t know.

Surrealizing – Criteria 9 / Part 4: Derealization

The final segment of my Criteria 9: Dissociated series is Derealization. Derealization: is an alteration in the perception or experience of the external world so that it seems strange or unreal.

For me this comes across as an unnatural brightness, things are too in focus. Hyperfocused. The outline of objects, things, houses, horizons, are too sharp. Sun is too bright, the air is too bright, colors are too crisp.  Everything has a stark contrast and I feel like I’m removed from the scene, like it was erected and I’m walking through a movie set. There lacks a depth to the reality. There’s no deeper attachment to anything because it’s as if those things weren’t placed there long enough ago to have formed an attachment to them.  

It’s oddly beautiful as a surreal observation.

This happens relatively often but it’s not as intense as my depersonalization. For example, I was in my Eating Disorder Anonymous meeting the other day. The room itself was hyper lit and it looked like a herd of children had vomited crayons all over the walls. The room itself was very vivid but the sheer brightness triggered me right into a derealized state. It was almost dizzying. It felt like something encompassed my brain, pressing to a common center point.

Or another time, I was simply driving home in the late afternoon. The sun was low enough to be just over the horizon. There were trees closely spaced on the side of the road. As I would pass each tree the sun would blot out, then flash bright as I drove past an gap. From my peripheral vision I would see flash bright, dark shadow, flash bright, dark shadow like an old 8mm film reel being played on the edge of my vision. It made me feel almost as if I was floating.

It’s never an out of body experience or anything such as that. I always maintain a focus that I am doing whatever it is that I’m doing, but my perception is hyperfocused and surreal.

Dissociated Emotions

In the moment they are real, outside of the moment they are gone.

Here, There, Nowhere – Criteria 9 / Part 2: Dissociative Disorders

The next episode in our Criteria 9 series is Dissociative Disorders. 

Dissociation is one of my more severe challenges. I will cover this in three parts. The general Dissociative Disorder. Depersonalization, and Derealization (this spectrum also covers things like Dissociative Identity Disorder, Dissociative Fugue and DD non-specified… but since those aren’t my issues I’m not going to cover them now).

What is a Dissociative Disorder? Dissociative Disorders are defined as conditions that involve disruptions or breakdowns of memory, awareness, identity and/or perception. Dissociation is a partial or complete disruption of the normal integration of a person’s conscious or psychological functioning.  The hypothesis is that symptoms can result to the extent of interfering with a person’s general functioning.

It’s actually pretty normal for people to feel brief instances of Dissociation such as Psychological numbing. Psychological numbing is a mental mechanism to prevent psychological trauma. The mind chooses to ignore thoughts or emotions relating to a specific event, occurrence or body of knowledge, emotions, or ideas. It’s an important function for sanity when someone whose basic moral principles or ideology would be destroyed by comprehending the full implications of an action or occurrence.

When this feeling state becomes persistent, that’s when it’s identified as a disorder.

So what causes Dissociative disorders? In short, it’s a defense mechanism. At least that’s thought to be the primary reason for it. It’s a way for the mind to protect itself from extreme emotional trauma, prolonged stress and anxiety or alternatively, a response to drug use. Part of your mind and memory are compartmentalized to a different feeling state so you can process them separately, or not at all.

My version of Dissociation (Depersonalization and Derealization to a lesser extent) isn’t like a total break from reality. I don’t have amnesiac fugue states or multiple personalities. I can always, ‘check in’ and know that I am actually in the real world, I just don’t ‘feel’ like I am real. This is Depersonalization….

Madness of the Mind – Criteria 9 / Part 1: Paranoid Ideation

I’m skipping ahead to DSM IV criteria 9. This will be at least a four part series.

Criteria 9: transient, stress-related paranoid ideation or severe dissociative symptoms.

Just because you’re paranoid, doesn’t mean they’re not out to get you.

For a Borderline personality that has such a tenuous grasp on connectivity, every little social queue is up for interpretation. Always on the look out for a sign that abandonment looms, that what you’ve been told is a lie, any reason why the people you fear to lose are actually out to hurt you. There’s a dozen different places a turn of phrase could be taken depending on how the inflection falls or the way body language speaks. A Borderline personality will think of them all, and often settle on the worst. Expect the worse, and you can prepare for it. Hope for the best, and you’ll be disappointed. It doesn’t help that he/she is often right. Doing so a BP may also set her/himself up for that fall by creating the circumstances for that very thing to happen. Self-fulfilling prophecy.

If I have an inordinate amount of stress or very unstable relationships, then I begin to second guess everything. My hold on what people said vs. what they meant becomes nebulous. Everything has a potential double meaning. Did they really mean that? Yes? No? No. They’ve only told you this thing, allowed you in, to get your hopes up, so they can turn around and take it away, hurt you. You could lose everything you’ve struggled so hard to hold onto.

In short, I over think EVERYTHING. The downside of being too smart is it’s possible to consider too many possibilities. See every fork of every thought and ruminate on all the potential paths that could possibly be.

Normally, however, I take almost an opposite extreme. I can be too literal in my interpretation of people, thoughts, and things. I choose to accept what people say at face value and expect them to live up to their word. Don’t confuse this with trusting what people say, because I rarely do, but in order to lessen the paranoid ideation, I take words for what they are and act on them as such. This allows me to control the obsessive ruminations and removes my responsibility for when other people don’t live up to what they say.

How do you make these thoughts, stop? You can’t. At least, I’ve never found a way. Speaking up, communicating the irrational thoughts that buzz through your brain, helps. Start your sentence with, “This may not be rational but I have this {insert thought} in my brain, can you help me figure it out so I can move past it….” This way the people around you understand and can clarify an interpreted intent.