Borderline Personality Disorder

Borderline personality disorder (BPD) is a personality disorder rather than a Trauma Stressor-Related or Dissociative Disorder, but it could be called a distant cousin in some respects. After an individual has borderline personality disorder, they can become overwhelmed by Structural Dissociation. The overwhelming is due to a build up of unprocessed trauma memories. When this happens, then the person with borderline personality disorder will have some dissociative symptoms. Unfortunately, unlike the trauma and Dissociative Disorders, resolving unprocessed memories and integrating the created states that resulted from Structural Dissociation will only fix the trauma related (dissociative) symptoms. The borderline personality remains. ^[1]

Structural DissociationStructural dissociation (SD) is one of the three accepted etiological ideas for the etiology of dissociative identity disorder. {{Rp|158-165}} It also explains other specified dissociative disorder, dissociative forms of borderline personality disorder, and dissociative posttraumatic stress disorder {{See also| Structural dissociation}}Structural dissociation of the personality is a theory that describes the effect of trauma on the personality. It applies to PTSD, complex PTSD, other specified dissociative disorder and dissociative identity disorder. in borderline personality disorder

Each bullet addresses a "box" on Chart C, and this diagram shows how Structural Dissociation happens in an individual who has borderline personality disorder. The only major difference, at least that would be outlined in a brief form as is here, is that the person already has the mental disorderThe DSM-5 psychiatric manual defines this as "a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expected or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above."{{Rp|20}} and it is not caused by Structural Dissociation. ^[2]

• An individual already has borderline personality disorder - It is important to understand that Structural Dissociation does not cause borderline personality disorder. ^[3]

• "The mind seeks input" - A trauma event occurs and the mind is unable to process it, and it sends a signal to the brainThe brain is a approximately a 1300-gram organ containing 100-billion neurons. It is the control center of the central nervous system. The mind and brain are not the same thing. (see mind) The mind emerges out of interactions between the brain and relationships during the earliest years of childhood. Different child-parent attachment relationships form differing physiological responses, patterns for interpersonal relationship and how an individual views the world. {{Rp|9}} (see attachment) for more information. ^[4]

• "The brain is unable to respond to the mind" - The brain does not know what to tell the mind because it's confused. ^[4]

• "A secure attachmentThe communication of emotion between an infant and their primary caregiver(s) is essential to shaping the developing mind. "Emotion serves as a central organizing process within the brain. In this way, an individual's abilities to organize emotions - a product in part, of early attachment relationships directly shapes the ability of the mind to integrate experience and to adapt to future stressors." {{Rp|9}} Interruption in the attachment pattern of young children with their caretaker(s) has been shown to be a primary precursor to Dissociative Disorder pathology. (see etiology) {{Rp|85}} {{Rp|97}} was never formed in childhood with a primary caregiver" - Any individual who has obtained a secure attachment with a primary caregiver during childhood will eventually be able to process their trauma memories even if it takes a few weeks, but not someone that never formed an attachment with a primary caregiver. For them the cycle continues. ^{[4] [3]}

• "Trauma memories are not processed" - The mind and brain attempt communication back and forth, until the signals fade to where they are almost negligible. ^{[4] [3]}

• "The brain seeks information from the mind" - The brain asks for information from the mind and the mind does not answer, and so the brain sends out signals that cause the individual distress. ^[4]

• "The mind, brain and individual are overwhelmed" - The mind becomes overwhelmed, followed by the brain and then ultimately the entire individual. ^{[4] [3]}

• "Structural Dissociation occurs" - Overwhelming of the individual results in Structural Dissociation and the personality "splits" into two divisions, one part only dealing with daily life activities (ANPA distinct state who performs the job of daily activities and does not hold trauma memories. Dissociative identity disorder is the only mental disorder where an individual can have two or more ANP. {{See also| structural dissociation}}) and the other that handles the trauma memories (EPAn state that holds trauma memory. A term used in structural dissociation. {{Rp|38-39}}). ^{[2] [3]}

• "The trauma cycle repeats until the trauma memories can be processed, and the resulting ANP and EP have integrated" - It's important to understand that processing trauma memories and integrating the ANP and EP will not fix borderline personality disorder, but it will relieve the dissociative symptoms the individual is experiencing. ^{[2] [3]}

Trauma history

Severe, early traumatization and attachment disturbances are frequent in people with BPD. ^[5]:1.

Dissociative symptoms will exist only if Structural Dissociation has occurred

Emotional distress and harm

The term "self-mutilating behavior" is more commonly referred to as self injurySelf-injury (direct self-harm) with non-suicidal intent., self-harm and sometimes non-suicidal self-injurySelf-injury (direct self-harm) with non-suicidal intent. (NSSISelf-injury (direct self-harm) with non-suicidal intent.). SelfThe DSM-IV uses the term identity in its definition of dissociation. (see identity) {{Rp|127}}-harm and repeated suicide attempts are one of the eight criteria for the diagnosis of borderline personality disorder, and only five of the eight are required. ^[1]

Physical symptoms and health issues

Health problems may include autoimmune disorders ^[6]:63, chronic fatigue syndrome ^[6]:63, gastroesophageal reflux disease ^[6]:63, irritable bowel syndrome ^[6]:63, headaches,^[7]:130 morbid obesity ^[6]:63, chronic pelvic pain ^{[8] [7]:130}, joint pain, ^[8] and non-epileptic seizures ^[7]:130 (PNES).

States in DID that "act" like they have BPD

The same individual cannot have both borderline personality disorder and dissociative identity disorder, but individuals with dissociative identity disorder can have states that "act" like they have borderline personality disorder.

BPD involves one distinct state and it's always conscious until the individual is in distress, and then two less than distinct states show up together, but unlike C-PTSD these less than distinct states do not take over consciousness. The distinct state always remains with them. There are no flashbacks or other symptoms caused from unprocessed trauma events in BPD like there are in all the other disorders mentioned so far, but there are other dissociative symptoms. In "image B", this fMRIA type of neuroimaging. Neuroimaging is an approach that allows researchers to view areas of the brain that become active during behavioral events such as emotion, perception and cognition. It is part of the science of in psychophysiology. scan shows a distinct state switchingFull dissociation is when an alter switches with the alter currently in executive control, resulting in amnesia for that alter. (see executive control) {{Rp|4-6}} In full dissociation, there is complete amnesia between dissociated states, which is a {{Rp|228}} criteria for a diagnosis of dissociative identity disorder in the DSM-5. {{See also| Dissociation}} with an other distinct state, which is only possible in DID, because this is the only disorder with two or more distinct states. "Image A" shows three less than distinct states which are the parts that manage "unprocessed trauma," and react to it with vehement emotion. This is obviously an fMRI scan of DID since it shows there are two distinct states and three less than distinct states. In OSDD fMRI scans reveal only one distinct state is possible, and it switches with less than distinct states randomly, and the distinct state also switches in response to a "triggerA reactivating stimulus in trauma disorders. A stimulus in the present which is a reminder of a part of a traumatic [[memory]], which can cause the part of an individual that hold the trauma (EP) to feel as if it is reliving past trauma experience. {{Rp|166-186}} Also known as a trauma trigger.." In contrast to DID, every single state can literally be conscious (lit up) at one time, but in response to a trigger, all but one state will leave consciousness, which is again in contrast with DID. In PTSD there is only one less than distinct state and one distinct state, and both stay conscious until a trigger causes the less than distinct state to respond, (flashbackA flashback is a reactivated traumatic memory experienced as intrusive thoughts, feelings, or images associated with past trauma, but lacking a sense of being from the past. {{Rp|30}} It is experienced by the state referred to as the EP. {{See also | Grounding techniques}}, fear, anxiety or other like symptom) and when it does the distinct state leaves consciousness. In the complex version of PTSD there are always two less than distinct states, and one distinct state. The less than distinct states are polarized, staying together, with both always conscious at the same time, but otherwise behave the same as simple PTSD. ^{[9] [2]}

Diagnostic manuals

Diagnostic manuals like the DSMPublished by the American Psychiatric Association as the standard classification of mental disorders used by US mental health professionals. It consists of diagnostic classification, the diagnostic criteria sets, and descriptive text. The DSM-II listed multiple personality disorder as a symptom of hysterical neurosis, dissociative type. The DSM-III (1980) moved Multiple Personality Disorder from a symptom to its own disorder. The DSM-IV changed the name to dissociative identity disorder (1994) and the DSM-5 (May 2013) updated the listing to current standards. {{Rp|384}} and ICD are not meant to be used to understand any mental disorder. Their intent is to give the minimum criteria needed to diagnose a disorder. The criteria listed here is paraphrased, as proper etiquette demands.

References

1. ^ a b c American Psychiatric Association, (2013). . APA.
2. ^ a b c d Vanderhart, Onno (2006) (coauthors: Nijenhuis, Ellert; Steele, Kathy). . New York:Norton. 13: 978-0393704013.
3. ^ a b c d e f Mosquera, Dolores; Anabel Gonzalez, Andrew M Leeds (2014). Early experience, structural dissociation, and emotional dysregulation in borderline personality disorder: the role of insecure and disorganized attachment. Borderline Personality Disorder and Emotion Dysregulation, volume 1, issue 15. (doi:10.1186/2051-6673-1-15)
4. ^ a b c d e f Lanius, Ulrich (2014) (coauthors: Sandra L. Paulsen, Frank M. Corrigan). . New York:Springer Publishing Company. 10: 0826106315.
5. ^ a b Mosquera, Dolores; Gonzalez, Anabel, van der Hart, Onno (2011). Borderline personality disorder, childhood trauma and structural dissociation of the personality. FUNDAP. Personality Argentine Foundation for Study and Treatment of Personality Disorders, volume 11, issue Supplement 1, page 44-47.
6. ^ a b c d e Brand, BL; Loewenstein, RJ (2010). Dissociative Disorders: An Overview of Assessment, Phenomenology and Treatment. Psychiatric Times, volume 27, issue 10, page 62-69.
7. ^ a b c International Society for the Study. Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision. Journal of Trauma & Dissociation, volume 12, issue 2, 28 February 2011, page 115–187. (doi:10.1080/152947)
8. ^ a b Nijenhuis, E. R. S.; van Dyck, R.,Ter Kuile, M. M., Mourits, M. J. E., Spinhoven, Ph, van der Hart, O (2003). Evidence for associations among somatoform dissociation, psychological dissociation and reported trauma in patients with chronic pelvic pain. Journal of Psychosomatic Obstetrics & Gynecology, volume 24, issue 2, page 87-98.
9. ^ Schlumpf, YR; Reinders, AATS, Nijenhuis, ERS, Luechinger, R, van Osch, MJP, et al. (2014). Dissociative Part-Dependent Resting-State Activity in Dissociative Identity Disorder: A Controlled fMRI Perfusion Study. PLoS ONE, volume 9, issue 6, 2014. (doi:10.1371/journal.pone.0098795)