Part 2: More about BPD and AC

*******  2  *******

I was a listener. I listened to people who needed my help a lot. I also wanted somebody to listen to me so badly but at the same time, I had a doubt that someone could accept me if I showed the real myself, including that one who has been screaming for help deep inside.

And I knew I also have some BP traits in me. They were hidden but I knew they were there. Most likely nobody noticed usually. But I know that.

To be officially diagnosed as BPD, the individual has to meet 5 out of the 9 criteria which are written in the DSM-IV-TR. I don't quite have 5 of them so I have never been diagnosed and my therapist also said, "I don't think you are with BPD. And whatever the name is, I'd like to focus what is inside you, rather than the classification. The reason why you needed to develop the thinking patterns or responding patterns. Many people with BPD also have needed to learn the distorted thinking pattern to survive in their hard circumstance when they were little. I personally believe that the diagnosis itself doesn't help much. But we can release the distorted thinking patterns by listening to the voice or scream inside" (I appreciate this her approach a lot. Truly helped me.)

In any case, I knew 3 of traits I have/had in me.

Here are the 9 criteria of BPD: (from the site: http://www.palace.net/llama/psych/bpd.html )

1. Shifts in mood lasting only a few hours.

2. Anger that is inappropriate, intense or uncontrollable.

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.

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."

7. Unstable, chaotic intense relationships characterized by splitting.
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."

8. Frantic efforts to avoid real or imagined abandonment
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

-----
I see, I have (had) the 5, 8 (not exactly but some parts), and 9 in me. I was diagnosed as Depersonalization Disorder because of 9 but I have been wondering if it's more like one of BP traits. My therapist has treated me as a person who has been struggling for PTSD or as a child abuse survivor/ Adult Children (AC). I think many people develop BPD have also experienced difficult childhood. So, for me, the line between BPD and AC is really vague. And some AC traits are overlapping with BP traits too. Here is excerpt from "A Primer on Adult Children of Alcoholics" by Dr. Timmen L. Cermak

1. Fear of losing control.
ACoAs maintain control of their feelings and behavior. In addition, they try to control the feelings and behavior of others. They do not do this to hurt themselves or others, but because they are afraid. They fear their lives will get worse if they lose control and they become uncomfortable and anxious when they cannot control situations, feelings, and behaviors.

2. Fear of feelings.
Since childhood and continuing as adults, ACoAs have buried their feelings (especially anger and sadness). In addition, theyʼve lost the ability to feel or express emotions freely. Eventually they fear all intense feelings, even good ones such as joy and happiness.

3. Overdeveloped sense of responsibility.
ACoAs are hypersensitive to the needs of others. Their self-esteem comes from how others view them. They have a compulsive need to be perfect.

4. Guilt feelings.
When ACoAs stand up for themselves instead of giving in to others, they feel guilty. They usually sacrifice their own needs in an effort to be “responsible.”

5. Inability to relax/let go/have fun.
Having fun is stressful for ACoAs, especially when others are watching. The child inside is terrified; exercising all the control it can muster to be good enough just to survive. Under such rigid control, spontaneity suffers.

6. Harsh, even fierce, self-criticism.
ACoAs have very low self-esteem, regardless of how competent they may be in many areas.

7. Denial.
Whenever ACoAs feel threatened, their tendency toward denial intensifies.

8. Difficulty with intimate relationships.
To ACoAs, intimacy equates to being out of control. It requires love for self and expressing oneʼs own needs. As a result, ACoAs frequently have difficulty with sexuality. They repeat unsuccessful relationship patterns.

9. Living life as a victim.
ACoAs may be either aggressive or passive victims. They are often attracted to other “victims” in love, friendship and work relationships.

10. Compulsive behavior.
ACoAs may work compulsively, eat compulsively, become addicted to a relationship or behave in other compulsive ways. ACoAs may drink compulsively and become alcoholics themselves.

11. Tendency to confuse love and pity.
Because they donʼt differentiate between these two emotions, ACoAs often “love” people they can pity and rescue.

12. Fear of abandonment.
In order not to experience the pain of abandonment, ACoAs will do anything to hold on to a relationship.

13. Tendency to view issues in terms of black or white.
When they are under stress, the gray areas of life disappear and ACoAs see themselves facing an endless series of either/or alternatives.

14. Tendency toward physical complaints.
ACoAs suffer higher rates of stress related illnesses (migraine headaches, ulcers, eczema, irritable bowel syndrome, etc.) than the general population.

15. Suffering from delayed grief.
Because the alcoholic family does not tolerate intensely uncomfortable feelings (such as sadness and anger), children in such homes rarely, if ever, grieve over their losses. Losses in their adult lives usually cannot be felt without calling up these past feelings. As a result, ACoAs are frequently depressed.

16. Tendency to react rather than to act.
As children, ACoAs became anxious and hyper vigilant. They remain so in their adult lives, constantly scanning the environment for potential catastrophes. Problem solving and stress management techniques are something they consider after the fact if at all.

--------

Yes, I have (had) many AC personality traits.
Also, there are subtypes of BPD which is unofficial (I have read so) but I have seen lots of people who suffer for BPD have talked about it in the online supporting groups. And I learned they are very intriguing to know. And I believe that someone who suffers for BPD, knowing this might help too. Anyway, here they are:

Low Functioning Borderline―The “Low Functioning” borderline is what most people think of when they are first introduced to the condition. Low functioning BPDs are a living train wreck. They have intense difficulties taking care of their basic needs, are constantly experiencing mood swings. They also have an extremely hard time managing any sort of relationship with another human being. Low Functioning BPDs are often hospitalized more than other BPD types, for the very reason that they canʼt live productively without constant coaching and supervision. These patients are challenging for all but the most experienced psychiatrists. Unless otherwise treated, low functioning borderlines lead self destructive lives and attempt to manipulate those around them with desperate acts, including self harm (cutting, etc.).

High Functioning Borderline―The High Functioning Borderline Personality shares many core aspects of the low functioning borderline personality, except for the fact that they can manage their lives, appear to be productive, and generally keep their relationships civil (even diplomatic in nature). High Functioning borderlines can appear to be normal, driven people one moment; then moody, inconsolable, and manipulative the next. Somehow, there is a mechanism within the minds of High Functioning Borderlines that allows them to lead somewhat “competent” lives, despite the fact that they are in a constant battle with BPD. High functioning BPDs are no better than low functioning: itʼs basically the same face wearing a different mask.

Extroverted Borderline―Anyone familiar with the Meyer-Briggs personality tests will understand the psychological differences between extroversion and introversion. When these characteristics are mixed with BPD, there are two different results. The Extroverted Borderline pushes all their feelings, fears, manipulation, rage, and moodiness outward to the people around them. In essence, if you are around an extroverted BPD, you feel like youʼre living through their emotions while coping with your own at the same time. Further, extroverted BPDs will attempt self abusive acts in plain view of others in order to avoid abandonment or to express their rage. For example, an Extroverted BPD might cut themselves and then immediately share it with family and friends around them, hoping to gain sympathy or attention. In most cases, these types of behaviors frighten non-Borderlines, and they wonder whether or not the Extroverted BPD should be committed to a psych ward.

Introverted Borderline―Contrary to popular belief, “introverted” doesnʼt necessarily describe someone who is a recluse (agoraphobic). Instead, introversion is characterized by experiencing life in a self-reflective, private, and at times distant manner. To others, introverts may appear shy or lacking in people skills. This might be true, however, introverts make up for their lack of social skills with rich inner lives, thoughts, and deep thinking. As a result, the introverted Borderline primarily focuses all their BPD emotions and reactions inward. Instead of having a rage episode in public, they might retreat to their rooms and cry for hours on end, perhaps even cutting themselves for their own amusement or as stress relief. Introverted Borderlines live in an odd world: on one hand, they spend most of their time in personal thought and reflection, looking to fill themselves with a viable sense of self; but on the other, they are conflicted by emptiness and the bottomless emotional pit that BPD produces. Introverted BPDs might be harder to “spot” unless you happen to know one personally, in which case you might notice occasional depressive symptoms and evidence of self harm.

Transparent Borderline―The Transparent Borderline is a bit of a mix between a high functioning borderline and either extroverted or introverted tendencies. In plain terms, Transparent Borderlines live double lives: on the surface, “in public”, they appear one way, but in private, amongst immediate family and friends, they appear completely different. As a result, they may or may not be high functioning due to this conflicted state of mind. Transparent Borderlines spend most of their emotional energy trying to balance the personality demands of Dr. Jekyll and Mr. Hyde, the both of which experience strong BPD emotions like anyone else with the disease. Like Introverted Borderlines, Transparent Borderlines are harder to spot, and often only confess their true disposition after a harrowing rage, major break up, or other severely traumatic event that brings all their BPD
feelings to the fore.

-------------------------

(to be contined)