Fearful and hurting : understanding underlying feelings that lead to BPD reactions.

The radio programme that I linked to on Borderline Personality Disorder yesterday was very interesting to me.  BPD may be one of the most highly stigmatised and most misunderstood of psychological diagnoses out there, with sufferers treated so poorly and often re abandoned because the intense and extreme symptoms they present with such as phyical self harm and intense emotional reactions that can ‘appear’ to be out of proportion and be feared by others and sufferers are then judged.  The person interviewed on yesterday’s programme spoke of how often she spent 6 to 12 hours in the emergency department being eyeballed by nurses and denied treatment or aid to attend to her cuts because others injuries were not self inflicted but the result of “real trauma” as opposed to self inflicted harm, if only they knew how alone the person was feeling inside and were responded to with empathy would sufferers really be forced to suffer even more?

The intense traumas BPD sufferers endured from the past are often hidden, they lead to a brain that the specialist in programme yesterday spoke of as an out of control car.  If the breaks failed on your car, would you be blamed for crashing it?  This a good analogy for BPD.  The brain difficulties are the result of trauma, hyper-reactivity, hyper vigilance and attention to cues which may be benign but are perceived as a threat to sufferers due to them triggering memories or flashbacks of past traumas, lack of love and attention or abadonment experiences or abuse.  That said reactions to triggers can be worked with once the sufferer becomes more aware.

The other very interesting issue discussed was the difficulty BPD sufferers have in understanding, regulating and expressing emotions and most especially those of hurt, frustration and fear.  I have never been formally diagnosed with BPD but I feel I do have a form of it, my therapist prefers not to use labels and often tells me we are all on the borderline spectrum somewhere.   I know how I have struggled to express my own emotions in a family where emotions were often ignored or acted out in extreme ways. My mother would suddenly go psychotic with rage in some circumstances and there were certain looks that struck the terror of annilation into us and made us hypervigilant to threat. It did’nt happen all the time, and was unpredictable.  My father would just laugh the whole thing off or ignore her as well as the impact it was having on us.  When my older sister tried to take her life after her husband left her, my father was in the garden for hours while her body was just laying there, Mum discovered her when she came home from work.

Learning to work with our emotions to understand when and why they are being triggered,  learning not to over react when we are feeling hurt or scared or triggered are essential skills for those suffering from BPD.   It is hard for us to say “when you looked at me like that I felt ashamed, as though you were judging me and as if I had done something wrong.”

I am sure most readers with BPD know all about Dialectic Behavioural Therapy, there is also something to be said for acknowledging the depth of multiple or major traumas that led us to react in such a way.

People with BPD experience intense emotions which appear out of proportion to others who do not know their history.  Abandonment fear is a major underlying scar that leads us to react in certain ways to percieved abandonment and we are adept at scanning the person’s face and body for non verbal cues that we may be ‘in danger’.  And while we can be hypersenstive to our own feelings and have empathy for others, we may also lack insight into others due to the fact our attention is so deeply engaged on our own suffering and wounds from the past.  We may be reacting to one cue from a person that we the globalise into making that person all bad and then sidelining them from our lives. Healing for us involves working with and when our black and white splits are triggered, developing better inter personal boundaries and a greater awareness of other’s defensive or hostile reactions to us when we are deep pain ourselves.  It is healing work that cannot be done quickly and we need help with it most importantly from those who understand our reactions make sense  in the light of our past trauma.   Trust may be a big issue for many with BPD because we were failed in significant ways growing up.  We may have witnessed or endured traumas or losses others have not which lie unspoken and compound deep within.  Unpacking all of this takes time and insight, work with professional or group or caring others who are willing to extend themselves into our reality. But it also involves taking responsiblity for the way we are reacting in the here and now to real traumas from the past.