Borderline Personality Disorder

[BadgerJelly]

https://en.wikipedia.org/wiki/Borderline_personality_disorder

BPD's causes are unclear, but seem to involve genetic, brain, environmental, and social factors.

This just made laugh and then made me think.

Really what is being said here is "life" causes BPD's. It reminds me of a certain reductionism involved in evolutionary thinking when they say the "genes" do it, and of course the society and environment matters too, but we just focus on the genes.

Psychological problems are caused by life. They are not reducable to physical matter nor to some form of "spiritualism". Things happen and we kame choices, some directions lead us further from our sense of self and others lead us more toward a sense of self.

Does anyone really disagree with this and find the above quote amusing?

note: of course I am aware that we possess a certain "disposition."

[Serpent]

What's a personality? How is it supposed to be ordered? How can you tell when it's disordered? Where is the border between ordered and disordered personality?
WTF is BPD?

Other than that, no, I'm pretty much okay with what you said.
Of course, when things go awry, it's easier to study the quantifiable factors, and that tends to lead, at least part way, to the neglect of factors that haven't been recorded or counted.
And may labeling, even as vaguely as this, helps put something that's gone awry in a perspective that's easier than deal with than "life".

[Lozza]

Really what is being said here is "life" causes BPD's. It reminds me of a certain reductionism involved in evolutionary thinking when they say the "genes" do it, and of course the society and environment matters too, but we just focus on the genes.

Not quite, but I appreciate your perspective. I come from a background of managing these people in a psychiatric setting, and those of us that are experienced in doing this are of the opinion that it is mostly environmental, specifically poor parenting skills. The way we manage them, is to provide clear boundaries, consequences for unacceptable behavior and consistency. These three things are what seem to be missing in their lives.

A BPD functions emotionally like a 2 year old child in that they are demanding and will have a tantrum (which we call "histrionic behavior") if denied their demand(s). This is a learned behavior. Allow me to give you an over-simplified example...a parent that gives in to the demands of their child all of the time, is actually creating a BPD, for they are teaching that child that they can get whatever it is they want by throwing a tantrum. The rest of us learn that having a tantrum is futile and that there are other means in which to get what we want such as performing some household chores (like making our bed, putting our clothes away etc) to be rewarded with what it was we wanted, or sometimes, we just have to accept that we just can't have what we want. We emotionally mature though this process. BPD's do NOT emotionally mature, for they are continually rewarded for their tantrums, thus they are locked-in at the emotional age of a 2-3 year-old child. They don't mature emotionally.

Now if we amp-up that bad environment by now calling it "bad parenting" instead of only "poor parenting skills" and include beatings and/or inconsistent physical punishment (whereby parent(s) responses to behaviors are based upon their mood and/or level of intoxication), we get a full-blown PBD. Thus, statistically, we find that one or both parents have a level of PBD as well.

The reason we don't see BPD so much in older people is because the life expectancy of a PBD is about 40. They cannot hold down a job, and in fact, don't want to, as they believe the world owes them a favor. So they are predominately involved in low level criminal activities, and will die commonly from a drug overdose, accidental suicide or by being murdered by someone they have pissed-off. I say "accidental suicide", because they are renowned self-harmers, which is attention-seeking, not a legitimate suicide attempt.

What's a personality? How is it supposed to be ordered? How can you tell when it's disordered?

I think you know what a personality is, but you are breaking things down too much. We use the term "disorder", but we do not use the term "ordered". "Disorder" only means that there's something amiss when compared to the "norms" of society and how the average individual functions. "Normal" is a mathematical term that merely speaks of "statistical mean average". That's all that "normal" means in psychology/psychiatry. So anything outside of that average is "abnormal", but not necessarily debilitating or dysfunctional. For example, people with an above average IQ are "abnormal" because they are outside the norms, just as people with below average IQs are. "Disorder" pertains more to the medical aspects of a person, and that there is something dysfunctional occurring internally that is adversely affecting that person's life compared to the average person in society.

I'd like to also note that there is no such thing as a "normal person", there are just norms of function and behavior, and it is these that are the benchmark for establishing what is "normal" or "disordered" etc.

I hope that has been helpful.

[BadgerJelly]

Lozza -

I was laughing at the line I quoted. It basically says it is something to do with nature and nurture ... no shit!

I’m well aware that many genetic factors are triggered by certain environmental conditions. No doubt some people are more prone to defeloping this way or that.

Things like this make me laugh becasue when you look at what some people say it merely looks like they’re saying something when they’re saying nothing at all. Maybe they were asked to write a minimum number if words? Idk?

Haha!

[Serpent]

I think you know what a personality is,

I also think you know what a personality is, but if put to the test of articulating our knowledge, your definition will probably differ from mine in some significant ways. If we asked five other people to articulate their knowledge, their definitions would all differ. Yours wins, being clinical.

BUT

We use the term "disorder", but we do not use the term "ordered".

This is a serious problem. Very much like using "dysfunction" without describing the "function" that's being dyssed. Recently, when someone called dysfunctional three marriages that I consider normal, I asked this in all earnest: What are you comparing to? What does a functional relationship look like? They never answered, and I still don't know what anyone's benchmark is for a non-dysfunctional relationship.

"Disorder" only means that there's something amiss when compared to the "norms" of society and how the average individual functions.

An even bigger problem. The norms of a severely troubled society as the standard will distort what-all's amiss even further than having no base-line for any of your measurements.

"Poor parenting skills" or even the more honest "bad parenting" simply brings down to the personal level a systemic, structural instability, wherein "the average" person must function amid any number of contradictions and inconsistencies, discontinuities and cognitive dissonances.

Really, all you are measuring is the proportion of individual capability to cope with the life in which they're stuck. Symptoms such as substance abuse, self-harm, domestic, sexual, random and group violence, vandalism, narcissism, depression, eating disorders, OCD, PTSD and every other kind of disorder will continue to rise - and the statistical norm will continue to shift accordingly - as the society which provides these benchmarks sinks into decline.
I would have hated to be a shrink in the final decades of the Roman Empire!

[wolfhnd]

You can be clinical and even scientific about it but if you denigrate free will you are not helping. What characterizes the end of the Roman Empire as much as anything is the shift from a responsible citizenry to the administrative state.

[Serpent]

I wasn't denigrating anything. Free will is another one of those immeasurable qualities that no clinician can standardize or use as a benchmark.
Whether its root causes are military overextension, administrative state, depleted resources, cultural rift, ethnic diversity of population, moral exhaustion or misallocation of power (I see those as rather 'and' than 'or' factors), the symptoms of societal breakdown tend to be similar.

In any case, the individual, whatever he or she might will, is usually swept up in the much greater forces of economics and politics. So, what the clinician measures is each individual's ability to cope, and that has just as many contributing factors as the systemic instability in which they exist.

[wolfhnd]

I wasn't denigrating anything. Free will is another one of those immeasurable qualities that no clinician can standardize or use as a benchmark.
Whether its root causes are military overextension, administrative state, depleted resources, cultural rift, ethnic diversity of population, moral exhaustion or misallocation of power (I see those as rather 'and' than 'or' factors), the symptoms of societal breakdown tend to be similar.

In any case, the individual, whatever he or she might will, is usually swept up in the much greater forces of economics and politics. So, what the clinician measures is each individual's ability to cope, and that has just as many contributing factors as the systemic instability in which they exist.

Those conditions exist at all times more or less, it is the point of liberal democracy in which the individual and individual responsibility are the counter measure.

[TheVat]

A couple moderator points:

1. This is a science thread, so we need citations for assertions meant to be factual.

2. If we stray too far into political theory or the philosophical issues of determinism/FW, it may be best to take up those meanders in the PCF section where there are already many extant threads on those topics.

Any links on BPD that are NOT from wikipedia would be most welcome!

[Serpent]

Those conditions exist at all times more or less,

More or less. It's those quantities, in absolute terms, as they relate to each individual in a society, that determine how much psychological dysfunction they experience.

it is the point of liberal democracy in which the individual and individual responsibility are the counter measure.

Insofar as that liberal democracy is functioning within its design parameters. It also makes some difference how stable the societal structure is over time - that is, how much change in the daily lives of citizens takes place within a generation. One can only "parent" according to one's cultural norms; one cannot prepare one's children for a radically different future. This is why historical breaks, such as a war, economic collapse or famine, and lifeline breaks, such as a traumatic event or migration to some other part of the world opens such wide generation-gaps.

Note on science: I've read a couple of (popular, not scholarly) articles on BPD and I have serious issues with the diagnosis. Looks to me like another catch-basket like schizophrenia used to be.

[Risk factors:]
- Family History. People who have a close family member, such as a parent or sibling with the disorder may be at higher risk of developing borderline personality disorder.
- Brain Factors. Studies show that people with borderline personality disorder can have structural and functional changes in the brain especially in the areas that control impulses and emotional regulation. But is it not clear whether these changes are risk factors for the disorder, or caused by the disorder.
- Environmental, Cultural, and Social Factors. Many people with borderline personality disorder report experiencing traumatic life events, such as abuse, abandonment, or adversity during childhood. Others may have been exposed to unstable, invalidating relationships, and hostile conflicts.

https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml

[Serpent]

A little more framework
https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2816919/

There is still quite a lot of work to be done, and co-ordinated before a consensus is reached on diagnosis, classification, treatment and - of significance here - etiology.

[wolfhnd]

Fair enough back to the original topic. Mild depression is related how? Doesn't seem to me that unhappiness is a new phenomenon only how it is expressed?

[Serpent]

Fair enough back to the original topic. Mild depression is related how? Doesn't seem to me that unhappiness is a new phenomenon only how it is expressed?

I don't think unhappiness or sadness about something that's happened is diagnosed as depression. That word is for an unexplained, uncontrollable sense of oppression, helplessness, worthlessness, debility, etc. I do sort of understand how depression works, from a close friend who's suffered from it for three decades now, despite every effort to overcome it. They've learned, eventually, to cope with - live around, as it were - the symptoms, but not to cure the illness. I think theirs was classified moderate, as they're not suicidal, which would be severe.
I don't know where mild depression leaves off and moderate begins.

Anyway, that doesn't typify BPD, which appears to be more like what elderly laypersons used to call being immature or, less kindly, childish. The POTUS exhibits at least five of the 9 major symptoms, and that - along with the behaviours depicted in television advertising - prompts me to be leery of the "statistical norm" as a base-line for determining pathology.

[wolfhnd]

Fair enough back to the original topic. Mild depression is related how? Doesn't seem to me that unhappiness is a new phenomenon only how it is expressed?

I don't think unhappiness or sadness about something that's happened is diagnosed as depression. That word is for an unexplained, uncontrollable sense of oppression, helplessness, worthlessness, debility, etc. I do sort of understand how depression works, from a close friend who's suffered from it for three decades now, despite every effort to overcome it. They've learned, eventually, to cope with - live around, as it were - the symptoms, but not to cure the illness. I think theirs was classified moderate, as they're not suicidal, which would be severe.
I don't know where mild depression leaves off and moderate begins.

Anyway, that doesn't typify BPD, which appears to be more like what elderly laypersons used to call being immature or, less kindly, childish. The POTUS exhibits at least five of the 9 major symptoms, and that - along with the behaviours depicted in television advertising - prompts me to be leery of the "statistical norm" as a base-line for determining pathology.

You just can't let the politics alone can you. I can imagine how psychoanalyitcal opinion on Obama's relationship with his father would go over here.

[Lozza]

I think you know what a personality is,

I also think you know what a personality is, but if put to the test of articulating our knowledge, your definition will probably differ from mine in some significant ways. If we asked five other people to articulate their knowledge, their definitions would all differ. Yours wins, being clinical.

It's not complicated...we're all individuals, thus possessing a unique set of traits as well as many common ones. That's our "personality".

We use the term "disorder", but we do not use the term "ordered".

This is a serious problem. Very much like using "dysfunction" without describing the "function" that's being dyssed. Recently, when someone called dysfunctional three marriages that I consider normal, I asked this in all earnest: What are you comparing to? What does a functional relationship look like? They never answered, and I still don't know what anyone's benchmark is for a non-dysfunctional relationship.

You're too focused on the linguistics. If I was to use the word "ordered" to describe someone, that is describing a behavior or a thought process, but not necessarily describing the fact that the person has no issues. "Normal" does that. So it's not a problem at all, except to the uninitiated.

"Disorder" only means that there's something amiss when compared to the "norms" of society and how the average individual functions.

An even bigger problem. The norms of a severely troubled society as the standard will distort what-all's amiss even further than having no base-line for any of your measurements.

Society is an evolving thing, therefore so are the "norms". There's no "god" to refer to for the "perfect" person or society, so the best we have are the averages.

"Poor parenting skills" or even the more honest "bad parenting" simply brings down to the personal level a systemic, structural instability, wherein "the average" person must function amid any number of contradictions and inconsistencies, discontinuities and cognitive dissonances.

That's true, and will always be the case.

Really, all you are measuring is the proportion of individual capability to cope with the life in which they're stuck. Symptoms such as substance abuse, self-harm, domestic, sexual, random and group violence, vandalism, narcissism, depression, eating disorders, OCD, PTSD and every other kind of disorder will continue to rise - and the statistical norm will continue to shift accordingly - as the society which provides these benchmarks sinks into decline.

Yes. What else would like to be measured?

I would have hated to be a shrink in the final decades of the Roman Empire!

Hahaha! Then become one now...we're in the decline of the Western Empire.

[Serpent]

[S -- Anyway, that doesn't typify BPD, which appears to be more like what elderly laypersons used to call being immature or, less kindly, childish. The POTUS exhibits at least five of the 9 major symptoms, and that - along with the behaviours depicted in television advertising - prompts me to be leery of the "statistical norm" as a base-line for determining pathology.]

You just can't let the politics alone can you.

No, it's not about the politics. It's about the behaviours. The clinical description of what's dysfunctional (identified as symptoms of BPD) includes many traits and actions that are commonly and increasingly seen in mass media, in celebrities and in public officials. I think that normalizes those behaviours, which casts in doubt whether they're pathological. I suspect many of them are simply normal reactions to the stimuli of these people's environments.

I can imagine how psychoanalyitcal opinion on Obama's relationship with his father would go over here.

I have no idea. Is there something clinically interesting about it? Does it manifest in observably aberrant or peculiar behaviours?

[wolfhnd]

You win this is insane. Next...

[Brent696]

BadgerJelly » October 3rd, 2017, 3:17 am

BPD's causes are unclear, but seem to involve genetic, brain, environmental, and social factors.

What seems apparent and seems indicative of our present culture is the need to blame our problems, even the refusal to grow up, on external factors, and this lumping together as seen in the Wiki site seems to be enabling such.

There seems to be three areas of our life (psyche) that can mature of not mature independently of each other, Intellectual, social, and emotional. Often people can excel at intellectual or even social in as much as they are compensating for their lack of emotional maturity, as a builder I have worked with psychiatrists on a personal level away from their offices and seen them whine like children, yet they have a plaque on their wall attesting how they have it all together.

Emotional maturity is the hardest, and that challenge is most dramatic in young adulthood, just about the time the BPD above is said to be manifesting. This is the time we leave our parents and become responsible for parenting ourselves.

I always liked the truism that states "we are born kings and queens, we cry and we get fed, held, and changed. Then we spend the rest of our lives and thousands of dollars in therapy trying to figure out why our whining does work anymore."

Obviously there are many people with real trauma, real deficiencies, and not to diminish those, but BPD is just so broad and poorly defined.

Often I think the challenge we face in maturity is that of understanding the nature of our own feelings and intellect, feelings do not give a very accurate view of reality, the gestalt of the emotional experience places as as if we are the center of the universe. If we are angry, then to us the whole universe is angry, it is a challenge of self denial to understand our feeling nature, and yet strive to understand the truth of our reality, our situation, through our intellect and not sell out our higher vision to pacify our emotions.

Ultimately emotional maturity only comes through choice, the willingness to accept pain even when their is no personal benefit. To decide to choose and actualize ourselves and not live merely as a reaction to that situation in which we find ourselves.

[Serpent]

Wolfhnd -- You win this is insane. Next...

It wasn't a contest or an argument.
My contention is that "insane" is the human norm.
Any definition of mental illness (independent of neuro-pathology) is arbitrary and has, perforce, to ignore homicidal, suicidal, irrational and inappropriate decision-making on the individual, collective and international scales. Not just now, but all through history.

It also habitually ignores the daily stimuli to which each individual is subjected. I don't think it's crazy to fear abandonment when a child has been abandoned, or to act impulsively when caution and thoughtfulness are devalued in his culture and all his role models are risk-takers, or to overspend when his nation's economy runs on gambling and debt, or to be emotionally volatile when his diet consists of 30% sugar and 10% caffeine, or to lash out when he's surrounded by violence and unceasing news and depictions of violence.

The reason I keep asking "What's normal?" and "What's functional?" is exactly that psychiatric diagnoses assume a steady state that most people simply don't experience.

[Lozza]

Wolfhnd -- You win this is insane. Next...

My contention is that "insane" is the human norm.
Any definition of mental illness (independent of neuro-pathology) is arbitrary and has, perforce, to ignore homicidal, suicidal, irrational and inappropriate decision-making on the individual, collective and international scales. Not just now, but all through history.

If I turn on the TV, I can appreciate how you arrive at that conclusion, but no, that's not correct, but you're not too far from being correct. We're all a little different and all have our own host of problems in life, while harboring our own little quirks and idiosyncrasies. It is when any one or more of these "quirks" starts to overtake our life to the point whereby we can no longer function, or are finding it difficult to function within society, that we have a "problem". It's not arbitrary as you declare, but unfortunately, it is subjective.

It also habitually ignores the daily stimuli to which each individual is subjected. I don't think it's crazy to fear abandonment when a child has been abandoned, or to act impulsively when caution and thoughtfulness are devalued in his culture and all his role models are risk-takers, or to overspend when his nation's economy runs on gambling and debt, or to be emotionally volatile when his diet consists of 30% sugar and 10% caffeine, or to lash out when he's surrounded by violence and unceasing news and depictions of violence.

No it doesn't, but articles we read do, as they are only overviews.

The reason I keep asking "What's normal?" and "What's functional?" is exactly that psychiatric diagnoses assume a steady state that most people simply don't experience.

That's your assumption, but not the actuality of how the industry works. The industry completely understands that there are ebbs and flows in people's lives because guess what...it is staffed by people too. We do not seek "perfection", nor does the industry seek "sameness", we merely seek to resolve issues for someone that is afflicted with a debilitating condition causing them to be unable to cope. It's as simple as that.

[Serpent]

[S - My contention is that "insane" is the human norm..... Not just now, but all through history.]

If I turn on the TV, I can appreciate how you arrive at that conclusion, but no, that's not correct, but you're not too far from being correct.

I'm not sure what this means. Humans are not crazy apes, but they're almost crazy?

It is when any one or more of these "quirks" starts to overtake our life to the point whereby we can no longer function, or are finding it difficult to function within society, that we have a "problem".

A fifteen-year-old boy climbs to the top of a tree and catapults himself as far as he can go. If he survives... he becomes a fisherman or a beggar, depending on the extant of his injuries. A seven-year-old girl sails across the Channel to marry a thirty-year-old prince to whom her father pledged her hand (and other bits), in return for his military support against another king. Thousands of Germans kill thousands of other Germans, because the new duke remained Catholic and those people were Protestants. These are all perfectly normal behaviours in their societal contexts.
Sanity is measured - according to your earlier post - by what the average is doing.

It's not arbitrary as you declare, but unfortunately, it is subjective.

What isn't arbitrary? The societal norm or the labelling of a disease process?
All you can measure is how well an individual adjusts to the prevailing craziness of his or her society.

[The reason I keep asking "What's normal?" and "What's functional?" is exactly that psychiatric diagnoses assume a steady state that most people simply don't experience.]

That's your assumption, but not the actuality of how the industry works.

Industry?
Not focusing on linguistics (even though the label they put on a person marks that person for life) or having much in the way of definitions, as you've demonstrated.
When the discipline works, it does so by helping an individual cope with their particular circumstances. The industry works by diagnosing unfortunate lives as disorders and selling a lot of pills.

The industry completely understands that there are ebbs and flows in people's lives because guess what...it is staffed by people too. We do not seek "perfection", nor does the industry seek "sameness", we merely seek to resolve issues for someone that is afflicted with a debilitating condition causing them to be unable to cope. It's as simple as that.

It's obviously not as simple as that, because an awful lot of people are walking into crowded schools, restaurants and churches and shooting random strangers. How can you help people fit into that?

[Lozza]

[S - My contention is that "insane" is the human norm..... Not just now, but all through history.]

If I turn on the TV, I can appreciate how you arrive at that conclusion, but no, that's not correct, but you're not too far from being correct.

I'm not sure what this means. Humans are not crazy apes, but they're almost crazy?

I'm not sure what you want me to say, outside of the fact that the world is and always has been a crazy place. Psychology/psychiatry doesn't attempt to address that, it merely attempts to address the individual's ability to cope. It doesn't attempt to dictate terms to society, as there's no "template".

It is when any one or more of these "quirks" starts to overtake our life to the point whereby we can no longer function, or are finding it difficult to function within society, that we have a "problem".

A fifteen-year-old boy climbs to the top of a tree and catapults himself as far as he can go. If he survives... he becomes a fisherman or a beggar, depending on the extant of his injuries. A seven-year-old girl sails across the Channel to marry a thirty-year-old prince to whom her father pledged her hand (and other bits), in return for his military support against another king. Thousands of Germans kill thousands of other Germans, because the new duke remained Catholic and those people were Protestants. These are all perfectly normal behaviors in their societal contexts.
Sanity is measured - according to your earlier post - by what the average is doing.

Overall, yes. But here's the thing....if you were living in those places and times that you exampled, you too would quite likely be involved the very same behaviors. So to look back and judge from this time and society isn't really all that fair, is it? Look, even in my lifetime, society when I was 20 was totally different to what it is today. Different social values, different influences, different technologies...many of which has influenced these social changes. Do I like most of the changes? I like some of the technological advancements and some of the human rights we have developed, but most of the other changes, for me, are for the worse, not the better. But that's all driven by profits, self-interests and the Global Village becoming the Global Marketplace, not psychology/psychiatry.

[The reason I keep asking "What's normal?" and "What's functional?" is exactly that psychiatric diagnoses assume a steady state that most people simply don't experience.]

That's your assumption, but not the actuality of how the industry works.

Industry?
Not focusing on linguistics (even though the label they put on a person marks that person for life) or having much in the way of definitions, as you've demonstrated.

If a person has cancer, isn't that a label as well? What do want us to do, not use labels but vague descriptors that continuously change so that no-one becomes "labelled"?!? The label is for our use in order to relay a clear description of the problem in a way that then identifies treatments and for some, medications, as there are often other professionals involved in therapy. It's no fault of psychology/psychiatry that laypeople misuse labels and use these labels to denigrate others.

FYI, the terms "crazy", "lunatic" and "madness" used to all be official terms, but due to society's misuse of these terms and the subsequent negative connotations that they created, the terms had to be changed. This is now happening today with terms like "psychotic" and "neurotic" because of the same misuse within the media and pop culture. So blame laypeople, not the profession.

When the discipline works, it does so by helping an individual cope with their particular circumstances. The industry works by diagnosing unfortunate lives as disorders and selling a lot of pills.

Psychiatrists may prescribe medication, psychologists however, cannot.

And here's one of the main reasons that psychiatrists seemingly prescribe so much...it takes an enormous amount of work and effort to change one single simple aspect of our life. A behavior, an addiction, whatever. You cannot eradicate a behavior, you can only replace it with a positive behavior, and this requires a lot of work on the individual's part. Most people don't want to do the work and just want a pill. They view the problem like having an infection and taking an antibiotic for it, or like a headache tablet for a headache. Again, it's not the fault of psychology/psychiatry that the average person doesn't want to do the work.

The industry completely understands that there are ebbs and flows in people's lives because guess what...it is staffed by people too. We do not seek "perfection", nor does the industry seek "sameness", we merely seek to resolve issues for someone that is afflicted with a debilitating condition causing them to be unable to cope. It's as simple as that.

It's obviously not as simple as that, because an awful lot of people are walking into crowded schools, restaurants and churches and shooting random strangers. How can you help people fit into that?

Yes it is as simple as I stated, psychology/psychiatry doesn't attempt to "cure" the world or the prevailing society, it only attempts to give the individual better coping mechanisms.

Yes, there are a lot of disenfranchised people out there, but that's a corporate/political issue creating social issues....manufacturing moving to Asia, creating a lot of unemployment and the subsequent sense of disenfranchisement being felt by more and more people, some then acting in the extreme. Plus I don't live in a country whereby any idiot can lay his hands on a firearm, let alone an assault weapon, so that's something for you take up with your government, the NRA and the industrial military complex if you're in America.

[Serpent]

I'm not sure what you want me to say, outside of the fact that the world is and always has been a crazy place.

No, it isn't. H. sapiens is a crazy species. The world - physics, chemistry, biology - defines what's functional; humans routinely deviate from that base-line.

Psychology/psychiatry doesn't attempt to address that, it merely attempts to address the individual's ability to cope. It doesn't attempt to dictate terms to society, as there's no "template".

And that's what makes it not a science, but an industry. As an industry, psychiatry is in the business of whipping non-conformists into line and punishing the rebellious. (Leave us not recite its dismal history!)
As a discipline, it alleviates the some of the pain of non-conformity, much of the damage inflicted by a society's madness.

[S -- Sanity is measured - according to your earlier post - by what the average is doing.]
Overall, yes. But here's the thing....if you were living in those places and times that you exampled, you too would quite likely be involved the very same behaviors. So to look back and judge from this time and society isn't really all that fair, is it?

No, but I didn't want to get "political" by mentioning any more of presently prevailing insanities.
Anyway, I'm not 'judging' them; I'm using them as examples, any of a million readily available examples of human craziness. Of course, if I lived in another society, the shrinks (shamans, wise-women, juju-men, pastors) of that society would attempt to adjust me to their normal... Well, except religious Germany - if the psychologists were Jewish, persecuted by both Protestants and Catholics; it would have been hard for them to predict which of the normals would win.

Look, even in my lifetime, society when I was 20 was totally different to what it is today. Different social values, different influences, different technologies...many of which has influenced these social changes. Do I like most of the changes? I like some of the technological advancements and some of the human rights we have developed, but most of the other changes, for me, are for the worse, not the better. But that's all driven by profits, self-interests and the Global Village becoming the Global Marketplace, not psychology/psychiatry.

Your job is just to adjust people who are incorrectly aligned.

[The reason I keep asking "What's normal?" and "What's functional?" is exactly that psychiatric diagnoses assume a steady state that most people simply don't experience.]

If a person has cancer, isn't that a label as well?

Good example! When I'm diagnosed with cancer, the pathologist knows exactly what a healthy squamous cell looks like and how it normally functions. That's the clearly defined base line from which the unhealthy cells deviate in a very specific way - demonstrably, visibly, measurably.

What do want us to do, not use labels but vague descriptors that continuously change so that no-one becomes "labelled"?!?

That's precisely what I want you to do! I want you to treat each person as an individual, not as an illness. Many unhappy people are unhappy for very solid, rational reasons; many are too sane to accept their society's norms; many are collateral damage to some big event while others are products of societal mismanagement - there are an awful lot of cracks to fall through.
What you have now is vague descriptions that continuously change (refer to your own comment above), from which you collect a group of approximately related characteristics

Fear of abandonment. People with BPD are often terrified of being abandoned or left alone. ...
Unstable relationships. ...
Unclear or unstable self-image. ...
Impulsive, self-destructive behaviors. ...
Self-harm. ...
Extreme emotional swings. ...
Chronic feelings of emptiness. ...
Explosive anger.

not all of which need be present in each patient to make the diagnosis, and some of which may be appropriate responses to actual life events, and you pretend that comprises a disease entity akin to cancer.

The label is for our use in order to relay a clear description of the problem in a way that then identifies treatments and for some, medications, as there are often other professionals involved in therapy. It's no fault of psychology/psychiatry that laypeople misuse labels and use these labels to denigrate others.

That's not the concern I expressed. The patient himself - the hyperactive or ADHD child, the manic-depressive, the sexual deviant - has to bear the treatment/punishment; has to wear the label, even in the mirror, even in their sleep. If the norms of society catch up with their normal - well, oops, the joke's on us; if society's norm shifts in the other direction, they make easy targets.

FYI, the terms "crazy", "lunatic" and "madness" used to all be official terms, but due to society's misuse of these terms and the subsequent negative connotations that they created, the terms had to be changed. This is now happening today with terms like "psychotic" and "neurotic" because of the same misuse within the media and pop culture. So blame laypeople, not the profession.

Nobody could have foreseen this... Just as the financial industry couldn't be held responsible for, or expected to predict the meltdown.

Yes it is as simple as I stated, psychology/psychiatry doesn't attempt to "cure" the world or the prevailing society, it only attempts to give the individual better coping mechanisms.

Like dog-training. Adjust the animal to the unnatural environment in which it has to perform.

All I'm asking is that you consider the possibility that a person who doesn't fit comfortably into an insane, dysfunctional, counter-survival environment isn't necessarily the one that's sick.
And that, maybe the these BPD symptom-clusters are an attempt by individuals to fit meet the demands of a crazy environment. If/when all the symptoms become average, the disease entity will no longer exist.

[TheVat]

When I worked in the field, I met a fair number of people who didn't slide easily into clinical categories. Worked with a couple of fellows who got the BPD label, but were more in the area of recovering from TBI that had done some damage to what's called the Default Mode Network, which allows the brain to travel into the past and future, imagine events, and create scenarios that deal with prospective actions and handle the emotional challenges posed. Their condition was depriving them of that "resting" state, that calm and reflective state of the brain that started to be better understood when PET scans studies started to focus on the resting state (rather than just task-oriented studies). For them, things had become rather fraught and short-term and it was difficult for them to really reflect on scenarios in which mature behavior helped them cope. The common expression "getting your act together" seemed particularly apt as a description of what they simply couldn't manage. When your adult persona falters, what emerges are more volatile responses that strike people as childish.

A healthy personality, and psyche generally, requires times during the day of relaxed reflection, electronic devices turned off, outside stimulation generally dampened, so that the DMN can effortlessly do its thing. I remember being in a museum with a friend, and her sitting for 45 minutes in front of a Monet. She told me later, it wasn't that fascinating a picture, it just provided a place for her to sit and reflect.

[BadgerJelly]

-1-

This seems like an attack rather than a considered and levelled headed view of a whole field of interest. Psychology is certainly not an accurate science. It has uses though in roughly delineating problems and with the advances in neuroscience has also allowed some correlation between physiological conditions and behavorial aspects of humans exploed via psychology. Psychariatry is now more about the application of chemical medicines rather than therapeutic means for helping people cope. The crossover between this areas is messy to say the least because humans come in many shapes and sizes.

[wolfhnd]

Most every professional I have come in contact with in my life has been dismissive of psychology. Most were of course STEM people because of my occupation. I have never understood exactly what they thought should take the place of psychology or if they even saw the need. It isn't as if they were entirely empiricist because they were often interested in art, music and literature (some religion which could be a subset of the other three). I suspect that art, music and literature may be a form of therapy along with self medication primary alcohol among the people I have known. It could simply be that self reliant people do not feel a need or desire for others to meddle in their ego. It doesn't hurt that they are relatively successful I suspect, people with severe mental problems probably falling out of professional life.

[Serpent]

I've been on both sides of the tissue dispenser (not couch). I was referred to an excellent psychiatrist when I had some problems in my early 20's, and he was very helpful. I think he took me on out of curiosity: he was treating a close friend who considered me their default next of kin. I had a lot of respect for him. I have also admired mental health care workers since then, in a number of different capacities.
For a while, too, I did student counselling in a technical college - not as a psychologist; merely an instructor, taking up some slack.

I'm not dissing the profession or the discipline. It's very often flying blind and having to make subjective assessments, and yet is a lifeline for some troubled people.
But I have serious issues with the industry and the institution.

[Brent696]

On the subject of nature/nurture as regards BPD,

In my understanding, observing it through the context of emotional maturity, specifically the resistance to, I would conclude that the treatment (in most cases) revolves around the same principles as seen in AA and the like where one must begin consciously choosing to put into effect such principles as an honest assessment of self, personal responsibility, etc...

I also recognize some impediments to their psychological improvement in the form of, and I am not always sure what to call theses, but during our adolescence when we are forming the basic layout of our prefrontal thinking, we imbibe what seem to be "laws", or "rules". A girl who is consistently abused, even verbally, by a particular sex, might establish a "rule" in her psyche that all people of that sex are unsafe. So trauma does come into place. Hopefully later on in life these rules can be reevaluated and replaced with more accurate rules, often it seems like good psychotherapy helps us trace back to finds this "beliefs", "demons", "faulty mis-perceptions", thus helping to relieve us of the fears that might haunt us and side track our lives.

So people with BPD are basically living in fear, hence the heightened emotional responses they are subject to. To say as the forward article does that they experience stronger emotions is a no brainer, they simply feel threatened, but such threats are often of an exaggerated or imagined kind.

Now to look at the prefrontal cortex, that which is said to repress such emotions, and as such to be dysfunctional in BPD sufferers. From a psychological aspect the prefontal cortex, that part of the brain in which resides our model of reality, and where those rules or laws are to become part of the psychological structure of our thinking in its executive role, I would expect to find, for lack of a better word, bad connections. If one feels threatened, and they release their emotions as part of a psychological defense strategy, then the specific area of the brain that inhibits those emotions I would expect to see not being used. I can believe in a type of atrophy in the brain like a muscle might, but neurons never seem to reach a level of zero activity as a muscle would, such a part of the brain might not show "hot" in a scan but it is still firing millions of synaptic impulses.

So I will paste the URL to the article, and paste also its conclusion, and what I would like someone to explain if they know, if this statement about cortisol chemically eroding a part of the brain is actually viable, brain scan seem to pick up a contrast for high activity, but no part of the brain even seem dead or eroded.

https://medium.com/@KevinRedmayne/its-all-in-your-head-borderline-personality-disorder-and-the-brain-c14b66eb0966

Conclusion
Of course this appears a raw deal for someone suffering Borderline Personality Disorder: After all, we are stigmatised with pejorative labels as it is without needing mental impoverishment being added. But heres the twist: The heritability of Borderline Personality Disorder is estimated to be 65%, however, 70% of BPD sufferers have experienced some form of childhood trauma; often sexual, physical or emotional abuse.

It remains to be seen whether structural abnormalities in the borderline brain, are the cause of the condition, or a consequence of trauma. An indelible imprint on our brain of suffering.
To give just one example of why it is feasible the brain is ‘injured’ by trauma, is in the chemical cortisol. As we’ve already seen, cortisol is released in a response to stress; and so it goes to reason extreme stress, especially experienced in childhood and over long periods of time, will lead to abnormal levels of production. Furthermore:

The reason for the atrophy of the amygdala and hippocampus, and prefrontal cortex, is because high levels of cortisol have literally eroded parts of it away.
This is the cruel irony: The brain is a mirror to life, and if cortisol has chemically eroded the most prized assets of the mind, then this is because stress has eroded core aspects of our lives.

In order to address these startling discoveries about the brain, we need to acknowledge the nature of labels. That BPD is not someone twilight state between sanity and insanity, but a mind that has been worn by developmental trauma. When we aknowledge this then progress can be made. For now, I’ll just have to keep listening to society telling me: Just look at the brainscan, it’s all in your head!’

Be sure to check out my new BPD support site www.skylarkrecovery.com for more information, advice and guidance.

[wolfhnd]

On the subject of nature/nurture as regards BPD,

In my understanding, observing it through the context of emotional maturity, specifically the resistance to, I would conclude that the treatment (in most cases) revolves around the same principles as seen in AA and the like where one must begin consciously choosing to put into effect such principles as an honest assessment of self, personal responsibility, etc...

I also recognize some impediments to their psychological improvement in the form of, and I am not always sure what to call theses, but during our adolescence when we are forming the basic layout of our prefrontal thinking, we imbibe what seem to be "laws", or "rules". A girl who is consistently abused, even verbally, by a particular sex, might establish a "rule" in her psyche that all people of that sex are unsafe. So trauma does come into place. Hopefully later on in life these rules can be reevaluated and replaced with more accurate rules, often it seems like good psychotherapy helps us trace back to finds this "beliefs", "demons", "faulty mis-perceptions", thus helping to relieve us of the fears that might haunt us and side track our lives.

So people with BPD are basically living in fear, hence the heightened emotional responses they are subject to. To say as the forward article does that they experience stronger emotions is a no brainer, they simply feel threatened, but such threats are often of an exaggerated or imagined kind.

Now to look at the prefrontal cortex, that which is said to repress such emotions, and as such to be dysfunctional in BPD sufferers. From a psychological aspect the prefontal cortex, that part of the brain in which resides our model of reality, and where those rules or laws are to become part of the psychological structure of our thinking in its executive role, I would expect to find, for lack of a better word, bad connections. If one feels threatened, and they release their emotions as part of a psychological defense strategy, then the specific area of the brain that inhibits those emotions I would expect to see not being used. I can believe in a type of atrophy in the brain like a muscle might, but neurons never seem to reach a level of zero activity as a muscle would, such a part of the brain might not show "hot" in a scan but it is still firing millions of synaptic impulses.

So I will paste the URL to the article, and paste also its conclusion, and what I would like someone to explain if they know, if this statement about cortisol chemically eroding a part of the brain is actually viable, brain scan seem to pick up a contrast for high activity, but no part of the brain even seem dead or eroded.

https://medium.com/@KevinRedmayne/its-all-in-your-head-borderline-personality-disorder-and-the-brain-c14b66eb0966

Conclusion
Of course this appears a raw deal for someone suffering Borderline Personality Disorder: After all, we are stigmatised with pejorative labels as it is without needing mental impoverishment being added. But heres the twist: The heritability of Borderline Personality Disorder is estimated to be 65%, however, 70% of BPD sufferers have experienced some form of childhood trauma; often sexual, physical or emotional abuse.

It remains to be seen whether structural abnormalities in the borderline brain, are the cause of the condition, or a consequence of trauma. An indelible imprint on our brain of suffering.
To give just one example of why it is feasible the brain is ‘injured’ by trauma, is in the chemical cortisol. As we’ve already seen, cortisol is released in a response to stress; and so it goes to reason extreme stress, especially experienced in childhood and over long periods of time, will lead to abnormal levels of production. Furthermore:

The reason for the atrophy of the amygdala and hippocampus, and prefrontal cortex, is because high levels of cortisol have literally eroded parts of it away.
This is the cruel irony: The brain is a mirror to life, and if cortisol has chemically eroded the most prized assets of the mind, then this is because stress has eroded core aspects of our lives.

In order to address these startling discoveries about the brain, we need to acknowledge the nature of labels. That BPD is not someone twilight state between sanity and insanity, but a mind that has been worn by developmental trauma. When we aknowledge this then progress can be made. For now, I’ll just have to keep listening to society telling me: Just look at the brainscan, it’s all in your head!’

Be sure to check out my new BPD support site http://www.skylarkrecovery.com for more information, advice and guidance.

I would also like to see confirmation and clarification on physical damage. I know that there is physically damage in the case of "wild children" to speech centers in the brain so it is plausible or maybe even certain. The question is how significant.

[Brent696]

wolfhnd » November 21st, 2018, 12:26 pm

I would also like to see confirmation and clarification on physical damage. I know that there is physically damage in the case of "wild children" to speech centers in the brain so it is plausible or maybe even certain. The question is how significant.

Sometimes scientists of whatever ilk seem so zealous to be able to state a cause they put the effect in its place, and that seems to be the case here in many respects. Cortisol does effect the hippocampus (not necessarily the prefontal lobes)and does effect memory, but only as it is a stress hormone released by the adrenals. All this is after the fact, "Stress" comes from the perception of feeling threatened.

An adolescent that does not get to go to a party the so desire can literally feel like their world is crumbling, the "self" desire is exaggerated to the point whereas not to achieve it settles them into a mental state of feeling threatened. This is not a disease or so much a psychological dysfunction as it is a phase or mental development, a phase that when stunted, and carries over into adulthood, and now takes on the moniker of BPD, which can be misleading unless you stress the "D" as it refers to "Disorder".

BPD might be seen as the emotionally reactive side, but beneath this we still see Narcissism. There are I am sure, many tests out there, but self examination is actually quite simply, at least for those not given wholly to the trait, First, am I easily offended, Secondly, how do I react. Such reactions can be generalized into three categories.

1 "Guilt, Shame, and manipulation" In this includes everything from the temper tantrums to blame shifting, to the subtleties of passive aggressiveness.
2 "Compliance" This is where one agrees to go along, but simultaneously harbors resentment, secretly hating which can also manifest as passive aggressive behavior but in a very subtle form.
3 "Withdrawal" or as I like to phrase it, "I taking my toys and going home"

The child that throws the temper tantrum in the checkout line at the store because they can't get a piece of candy is not merely a "uncontrollable" mental state of response, it is a [b]reinforced response that has worked consistently for them, even if the decision control has become an unconscious conditioning.

Culturally "blame shifting" seems to have become a universal phenomenon, even if I was concussed as a child, and thus killed someone later in life in a fit of emotional rage, I am still responsible. If I were to surrender my responsibility, as many have for their behavior, then I would by default surrender my autonomy, my choice, my independence to actualize myself, instead moving into a "reactive" state of being.

A thief can never trust another because to him all men are thieves, a shamer subjects himself to the shame others would impose on him, What critical thinking is to the mind, responsibility is to the emotional body.