Tears forget. That's more than I can do. 'Cause they don't wash away, all the things that we've been through...

I don't really feel like doing this right now, but whatever I guess. I'm not going to have time to later.

So I gave you insight to my crappy life yesterday, but I didn't really give you definitive BPD information. Only how it relates to me or whatever. So this post, I'm just going to go over things I've found online about it. Mostly because well... the Internet is my only real source of information. But before I do that, I'd like to interject something. It is symptomatic for a borderline to feel, bad or evil. Like they are bad people or whatever. Well.. Most therapists, and definitely movies, are really bad about reinforcing such thoughts. For instance, most therapists won't treat BPD, as I stated in the last post. Because of our tendency towards violence and uncooperative nature. But BPD has a horrible stigma attached to it. And because of that stigma, most either will not even attempt to treat us, or they do so in a cold, uncaring, or even defensive way. Here are a few examples (sources will be noted under each insert):



"The trouble about being a client with the diagnosis of borderline personality disorder (BPD) is anytime you speak up for yourself, take a stand in regards to your treatment, ask for a change, ask for another opinion, another case worker, another therapist or Dr., you are commonly accused as exhibiting "borderline" behavior.

The stigma for people with BPD is so bad that when you initially step into your (Dr.'s, Therapist's, Caseworker's, Nurse Practitioner's) office, they are waiting for you to "step out of line." Their "guns are already drawn and they are ready to fire.

It doesn't much matter at what level of recovery you are existing at. That thing that counts is your diagnosis.

Many mental health professionals have a big stigma against borderlines because what their co-workers have said. Where did their co-workers get that information? From their co-workers.

am sure that they can tell you some gruesome stories about "these borderlines" but what they are talking about are people who have the diagnosis of the BPD and they have it very severely and they also have other mental disorders along with it that the person telling the story did not mention because that part was never mentioned.

Or perhaps they are judging you because of their past patients and what they forget is they are not dealing with a past patient, they are dealing with me, or you. It is as if they sit back and wait for that "borderline behavior" to pop out. So, if we have any level of intelligence (for some reason those of us with the BPD seem to have a higher than average level of intelligence from what I have noticed) and ask them to explain their treatment decisions, etc. they put that in their big bag of "expected borderline behavior."

Just recently I received two emails from mental health professionals that were extremely abusive to all BPD patients, and they were sent in the guise that they wanted to understand people with BPD better. I could not believe what I was reading. "Borderline patients are always manipulating staff and burn staff out and so many staff have left just do to the borderline behaviors."

Number one, this is clear splitting - black and white thinking. It is only the borderlines that are burning them out. I have been a social worker for almost 10 years and I can tell you I am burnt to a crisp but it is not due to one single population. If a mental health professional gets burned out, they are burned out on being a mental health professional with any population. That is burn out.

This sort of stigma in the mental health system is "contagious." When I was a social worker I would roll my eyes when someone mentioned BPD. Why? Because that is what all of my co-workers did. I was educated by my co-workers of how horrible borderlines were. Did I have my own experience with them? Nope. Did they? Nope. But if you rolled your eyes you were showing others that you were well educated about this population. You knew enough about this disorder to know that the borderlines were horrible people and hard to manage. When in real life, I knew nothing of this disorder.

This stigma is not only false but is very dangerous for people with BPD in regards to treatment. When my husband told his psychiatrist his wife had the BPD, what did he do? He rolled his eyes. Seriously! Did he know much about the BPD? No, he kept borrowing our books. This is common! Most Drs. and psychiatrists don't have a clue about the BPD and thus have no idea how to treat it! "

Above quote came from: http://www.borderlinepersonalitytoday.com/main/art35.htm

"What Is Stigma?

Stigma is a perceived negative attribute that causes someone to devalue or think less of the whole person. People tend to distance themselves from individuals in stigmatized groups, to blame individuals in these groups for the perceived negative attributes, and to discriminate against and diminish the stigmatized individuals.
Many individuals with mental health difficulties are perceived as weak, inhuman, or “less than” because of their psychological symptoms. Of the major mental illnesses, individuals with BPD are perhaps among the most stigmatized. Individuals with BPD are often blamed for their symptoms by both professionals and laypeople.
To give one example of stigma and mental illness, consider public perception of mental illness and violence. Research has shown that the American public is twice a likely to believe that people with mental illness tend to be violent than they were in 1950.

What Are the Consequences of Stigma?

The consequences of stigma are far-reaching. Research has shown that people from stigmatized groups are more likely to distance themselves from others, and they may start to believe what others say about them, thinking of themselves as incompetent, weak, or unreliable. These negative self-beliefs may have worse consequences than the mental illness itself, in some cases.
In addition, people from stigmatized groups may be less likely to seek treatment because of the possible consequences of being labeled with a disorder. Many people will not seek treatment for fear that getting a diagnosis will interfere with their ability to get a job in the future.
Stigma also makes it difficult for people with mental illnesses to find the social support they need to successfully manage their illness. There is evidence that social support is one of the key factors in successful recovery from mental illness, but individuals from stigmatized groups may have trouble finding that social support."

Above quote from : http://bpd.about.com/od/livingwithbpd/a/stigmabpd.htm

As bad as the stigma is from Mental Health professionals about BPD, the media is even worse. Ever seen The Crush? (SPOILERS!!!) Alicia Silverstone's all crazy, obsessive with her teacher and tries to kill him and his girlfriend? Or Chloe even, with Amanda Sigfreid. (sp?) She seems like a somewhat normal hooker, and then goes all crazy, obsessive stalker, scaring the hell out of that family. Both girls are supposed to portray "borderlines". Seriously dude? Okay, yes I personally tend to obsess over things, especially people. And yes I have serious fear of abandonment... but I am NOT a stalker. And I would never do even half the crazy crap either of those girls did. Honestly BPD was somewhat less offensively portrayed in Girl, Interrupted. Susanna Kaysen (Winona Rider), was supposed to be a borderline. She didn't act like a total psycho most of the time. At most, she responds to things as anyone in that situation would. With a "why the hell should I tell you anything about me" kind of attitude and occasionally, she verbally attacks the doctors or nurses, but seriously, who wouldn't? If someone threw me in a cold bath... They'd be lucky if verbal abuse was ALL they got from me.
My point is though, people suck in general when it comes to BPD.

Anyway, here are the Internet facts about BPD that I've found over time. The first article is the very first one I ever read. Again sources will be below the insert. Enjoy.

"

What causes Borderline Personality Disorder?

It would be remiss to discuss BPD without including a comment about Linehan's work. In contrast to the symptom list approaches detailed below, Linehan has developed a comprehensive sociobiological theory which appears to be borne out by the successes found in controlled studies of her Dialectical Behavioral Therapy.
Linehan theorizes that borderlines are born with an innate biological tendency to react more intensely to lower levels of stress than others and to take longer to recover. They peak "higher" emotionally on less provocation and take longer coming down. In addition, they were raised in environments in which their beliefs about themselves and their environment were continually devalued and invalidated. These factors combine to create adults who are uncertain of the truth of their own feelings and who are confronted by three basic dialectics they have failed to master (and thus rush frantically from pole to pole of):

• vulnerability vs invalidation
• active passivity (tendency to be passive when confronted with a problem and actively seek a rescuer) vs apparent competence (appearing to be capable when in reality internally things are falling apart)
• unremitting crises vs inhibited grief.

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

Kernberg's Borderline Personality Organization

Diagnoses of BPO are based on three categories of criteria. The first, and most important, category, comprises two signs:

• the absence of psychosis (i.e., the ability to perceive reality accurately)
• impaired ego integration - a diffuse and internally contradictory concept of self. Kernberg is quoted as saying, "Borderlines can describe themselves for five hours without your getting a realistic picture of what they're like."

The second category is termed "nonspecific signs" and includes such things as low anxiety tolerance, poor impulse control, and an undeveloped or poor ability to enjoy work or hobbies in a meaningful way.
Kernberg believes that borderlines are distinguished from neurotics by the presence of "primitive defenses." Chief among these is splitting, in which a person or thing is seen as all good or all bad. Note that something which is all good one day can be all bad the next, which is related to another symptom: 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.
Other primitive defenses cited include magical thinking (beliefs that thoughts can cause events), omnipotence, projection of unpleasant characteristics in the self onto others and projective identification, a process where the borderline tries to elicit in others the feelings s/he is having. Kernberg also includes as signs of BPO chaotic, extreme relationships with others; an inability to retain the soothing memory of a loved one; transient psychotic episodes; denial; and emotional amnesia. About the last, Linehan says, "Borderline individuals are so completely in each mood, they have great difficulty conceptualizing, remembering what it's like to be in another mood."

Gunderson's conception of BPD

Gunderson, a psychoanalyst, is respected by researchers in many diverse areas of psychology and psychiatry. His focus tends to be on the differential diagnosis of Borderline Personality Disorder, and Cauwels gives Gunderson's criteria in order of their importance:

• Intense unstable relationships in which the borderline always ends up getting hurt. Gunderson admits that this symptom is somewhat general, but considers it so central to BPD that he says he would hesitate to diagnose a patient as BPD without its presence.
• Repetitive self-destructive behavior, often designed to prompt rescue.
• Chronic fear of abandonment and panic when forced to be alone.
• Distorted thoughts/perceptions, particularly in terms of relationships and interactions with others.
• Hypersensitivity, meaning an unusual sensitivity to nonverbal communication. Gunderson notes that this can be confused with distortion if practitioners are not careful (somewhat similar to Herman's statement that, while survivors of intense long-term trauma may have unrealistic notions of the power realities of the situation they were in, their notions are likely to be closer to reality than the therapist might think).
• Impulsive behaviors that often embarrass the borderline later.
• Poor social adaptation: in a way, borderlines tend not to know or understand the rules regarding performance in job and academic settings.

The Diagnostic Interview for Borderlines, Revised

Gunderson and his colleague, Jonathan Kolb, tried to make the diagnosis of BPD by constructing a clinical interview to assess borderline characteristics in patients. The DIB was revised in 1989 to sharpen its ability to differentiate between BPD and other personality disorders. It considers symptoms that fall under four main headings:

1. Affect
   • chronic/major depression
   • helplessness
   • hopelessness
   • worthlessness
   • guilt
   • anger (including frequent expressions of anger)
   • anxiety
   • loneliness
   • boredom
   • emptiness
2. Cognition
   • odd thinking
   • unusual perceptions
   • non delusional paranoia
   • quasi psychosis
3. Impulse action patterns
   • substance abuse/dependence
   • sexual deviance
   • manipulative suicide gestures
   • other impulsive behaviors
4. Interpersonal relationships
   • intolerance of aloneness
   • abandonment, engulfment, annihilation fears
   • counter dependency
   • stormy relationships
   • manipulativeness
   • dependency
   • devaluation
   • masochism/sadism
   • demandingness
   • entitlement

DSM-IV criteria

The DSM-IV gives these nine criteria; a diagnosis requires that the subject present with at least five of these. In I Hate You -- Don't Leave Me! Jerold Kriesman and Hal Straus refer to BPD as "emotional hemophilia; [a borderline] lacks the clotting mechanism needed to moderate his spurts of feeling. Stimulate a passion, and the borderline emotionally bleeds to death."

Traits involving emotions:

Quite frequently people with BPD have a very hard time controlling their emotions. They may feel ruled by them. One researcher (Marsha Linehan) said, "People with BPD are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement."
1. Shifts in mood lasting only a few hours.
2. Anger that is inappropriate, intense or uncontrollable.

Traits involving behavior:

3. Self-destructive acts, such as self-mutilation or suicidal threats and gestures that happen more than once
4. Two potentially self-damaging impulsive behaviors. These could include alcohol and other drug abuse, compulsive spending, gambling, eating disorders, shoplifting, reckless driving, compulsive sexual behavior.

Traits involving identity

5. Marked, persistent identity disturbance shown by uncertainty in at least two areas. These areas can include self-image, sexual orientation, career choice or other long-term goals, friendships, values. People with BPD may not feel like they know who they are, or what they think, or what their opinions are, or what religion they should be. Instead, they may try to be what they think other people want them to be. Someone with BPD said, "I have a hard time figuring out my personality. I tend to be whomever I'm with."
6. Chronic feelings of emptiness or boredom. Someone with BPD said, "I remember describing the feeling of having a deep hole in my stomach. An emptiness that I didn't know how to fill. My therapist told me that was from almost a "lack of a life". The more things you get into your life, the more relationships you get involved in, all of that fills that hole. As a borderline, I had no life. There were times when I couldn't stay in the same room with other people. It almost felt like what I think a panic attack would feel like."

Traits involving relationships

7. Unstable, chaotic intense relationships characterized by splitting (see below).
8. Frantic efforts to avoid real or imagined abandonment

• Splitting: the self and others are viewed as "all good" or "all bad." Someone with BPD said, "One day I would think my doctor was the best and I loved her, but if she challenged me in any way I hated her. There was no middle ground as in like. In my world, people were either the best or the worst. I couldn't understand the concept of middle ground."
• Alternating clinging and distancing behaviors (I Hate You, Don't Leave Me). Sometimes you want to be close to someone. But when you get close it feels TOO close and you feel like you have to get some space. This happens often.
• Great difficulty trusting people and themselves. Early trust may have been shattered by people who were close to you.
• Sensitivity to criticism or rejection.
• Feeling of "needing" someone else to survive
• Heavy need for affection and reassurance
• Some people with BPD may have an unusually high degree of interpersonal sensitivity, insight and empathy

9. Transient, stress-related paranoid ideation or severe dissociative symptoms
This means feeling "out of it," or not being able to remember what you said or did. This mostly happens in times of severe stress.

Miscellaneous attributes of people with BPD:

• People with BPD are often bright, witty, funny, life of the party.
• 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.
• They frequently have difficulty tolerating aloneness, even for short periods of time.
• Their lives may be a chaotic landscape of job losses, interrupted educational pursuits, broken engagements, hospitalizations.
• Many have a background of childhood physical, sexual, or emotional abuse or physical/emotional neglect.

"

Source from: http://www.palace.net/llama/psych/bpd.html

Alright, so that was only one article, but still I think you probably get the point by now. If not, just google "borderline personality disorder". Trust me there are no shortages of information. However, that was probably the best article I have ever found. It was most informative. Anyway, I need to go do things I don't want to do.

Brandi Evans