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Mar 182013
 

Borderline Personality Disorder is a psychological problem I think is poorly named, it seems to many people to mean “on the border of a personality disorder” rather than an actual disorder. Actually this disorder was named back when they did think it was on the “border of” more serious disorders.

This, like many psychological problems can range from “mild” to “very severe” and can cause many disruptions in the afflicted person’s relationships and life. And, like with most mental illnesses or personality disorders can also be one of several diagnoses that the person also has.

For some reason, more females seem to be diagnosed with BPD than males, even though many of the symptoms can over-lap with Anti-Social personality disorder. Like most of the personality disorders, though it is difficult to treat and the earlier treatment is started, the better chance of positive results.

The US Library of Medicine website says:

People with borderline personality disorder often have difficulties controlling their emotions and impulses, and find it hard to keep relationships. They can experience feelings of emptiness, suffer quick changes in mood and they may harm themselves. Problems coping with abandonment and a rapidly changing view of other people can form part of their difficulties.

It has been my experience that many girls with the diagnosis of BPD also have “dual diagnoses” of substance abuse, which may be a way of “self medication” for their emotional problems and fears of abandonment.

Cutting or other forms of self mutilation and suicide ideation, suicidal gestures, as well as actual suicides are also frequently seen in individuals with BPD. Any signs of self mutilation or suicide threats should be taken seriously and treatment immediately sought.

An adolescent with BPD may demonstrate problems in school as well as at home and may become defiant of authority or show conduct disorders as well. The overlap of symptoms in many of the disorders of adolescence is confusing to parents and educators alike. The explosive moods and vacillation of moods may be very confusing to parents seeing symptoms in their child. Are these symptoms simply the “normal” emotional upheavals of the adolescent separating themselves from their parents or are they something more troubling?

Unfortunately, many times adolescents with BPD or any other number of behavioral problems end up violating the law or engaging in dangerous behavior that can have serious, life changing consequences.

It isn’t that these adolescents have not been taught “right from wrong” or that they don’t know “right from wrong” it is that their emotions and lack of impulse control overcome good sense.

In adolescence, peer pressure is extreme, and may increase risk taking behaviors that may put the adolescent in physical danger or serious violation of the law. I know as a parent myself that when my own son first started violating the law, I was frantic to find a way to open up his skull and pour in some good sense. Some way to show him how serious things could be if he did not reverse course in his behavior. Of course not all rebellious adolesents end up becoming psychopaths by any stretch of the imagination, but way too many young people do end up with a criminal record.

One of the young men who lived in my neighborhood when my kids were growing up became one of the most obnoxious and rebellious teenagers I have known, and there were times I wanted to throttle him. In the end, though, he “rowdied on down” and became a Wal Mart Manager. Other kids from the same neighborhood besides my son have done some prison time for theft and drugs.

I  know the pain that their parents and siblings as well as their mates and children have experienced because of these behaviors. Both the pain and anxiety of the parents of those kids who did straighten up and the pain of the parents, like me, who lost a child to the prison doors slamming shut.

Having worked with people of all ages with BPD I know that it is difficult to treat, but not impossible to help the person learn to cope, but it does take long term therapy, and should start as soon as early symptoms display themselves.

Joyce Alexander, RNP retired

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  10 Responses to “Borderline Personality Disorder”

  1. I find the term Borderline Personality Disorder or Personality Disorder far too wide to have any meaning at all. It applies to drugs addicts, people with anger management problems, sex offenders, people with anxiety attacks, PTSD, depression, agoraphobia, OCD and a host of other types of abnormal behaviours.

    Nevertheless all these abnormal behaviors can have a metabolic abnormality in common. Working as an Probation and Parole officer and having to write Pre-Sentence Report to judges in courts, I have been able to test many offenders with help of doctors with a Glucose Tolerance Test (GTT) for hypoglycemia, as distinct from a test of diabetes. The test is explained at:

    Testing for Hypoglycemia,
    http://www.hypoglycemia.asn.au/2012/self-help-website-for-personal-growth/#Testing

    Most of these offenders that could be described as having a Personality Disorders (in fact we were discourage from labelling offenders) proved positive to the GTT and thus would give some reason for judges to give supervision orders allowing offenders to attend rehabilitation groups that I conducted, instead of serving a jail sentence. Having regard to the fact that most offenders (about 85%) in my group have drug addiction as a comorbid condition to their offences, the majority of members in my groups were addicts. But exactly the same program applied to a host of other offenders, such as sex offenders, gamblers, violence-prone people, kleptomaniacs and so on.

    The advantage of being diagnosed hypoglycemic is that it provides a treatment without resort to drugs and sometimes without psychotherapy by simply adopting the hypoglycemic diet (http://www.hypoglycemia.asn.au/2011/the-hypoglycemic-diet/).

    The reason for his illness playing such a paramount role in mood disorders is that it interferes in the production of biological energy called adenosine triphosphate (ATP), without which the body cannot produce the feel-good neurotransmitters such as serotonin and dopamine. The brain is entirely dependent on glucose – derived from mainly carbohydrates in food – to produce ATP. Without it, the brain would starve and die within minutes.
    When the brain experiences brain starvation it will trigger the release of stress hormones – such as adrenaline and cortisol – to feed the brain again with glucose from glucose stores in the body (glycogen). .

    But internally driven stress hormones are responsible for most signs of mood disorders, anxiety, delusions, hallucinations, anger outbursts, depression, phobias and addiction to drugs.

    To complicate matters a bit further, hypoglycemia is not the only illness that contributes to mood disorders. There are as host of other “silent diseases” (http://www.hypoglycemia.asn.au/2011/silent-diseases-and-mood-disorders/) apart from or in addition to hypoglycemia that are responsible for mood disorders. These need to be diagnosed and treated by a special class of specialists in nutritional biochemistry or nutritional doctors. Each of which may have to specialize in certain fields again.

    However, fortunately, hypoglycemia is the most prominent one and this means that people can help themselves by simply adopting the hypoglycemic diet.

    Thus it can be envisioned that in the near future persistent criminal behaviour or recidivist behavior will become the subject of a new profession by psychologists and psychiatrists and other professionals that are trained not only in sociology, psychology but also importantly in nutritional biochemistry.

    It is not easy to create the need for such specialists in a world that is still largely ignorant about nutritional influences on behaviour, in a society that still believes in the supremacy of the mind over matters (over one’s body) as is the practice among psychologists now-a-days. We need to educate the population at large and especially the victims of professional ignorance such as families of convicted offenders, before the need to reform in the mental health industry will take place.

    It does not mean that psychotherapy such as CBT is superfluous, but for it to be effective we need FIRST OF ALL treat the biological aspects of behaviour before applying psychotherapy.

    The first step in all such treatments if the adoption of the hypoglycemic diet!

    • Jurplesman, ATP is the “energy” molecule necessary for cells to function. Many various nutritional things can interfere with the Kreb’s cycle in the cells. Back in my days as a chem major I had to memorize all those various molecules and the kreb’s cycle. LOL UGH! It does answer for a lot of things in psychological functioning, though, but in the years since I went to university to study physiological chemistry, research has made some dramatic changes in the way we look at things. Some of them actually reinforced the “old way” of thinking, and others have completely changed. For example, back when I was at University we thought the brain could not grow or adapt, and now we know that is NOT TRUE. The brain itself is “plastic” and environment turns on and off certain genes so that if you have a gene for X, it may not be “expressed” unless Y environment happens.

      I wish I could agree with you that hypoglycemia has as much effect on psychopathology as you seem to think it does, but recent research seems to counteract that view.

      I am very much interested in nutrition, both as a teacher of patients with diabetes and hypoglycemia and as a diabetic type II patient myself. I use only diet and exercise to control my blood sugar. I knew I had the gene, but I allowed myself to gain too much adipose tissue (that’s fat to everyone else not medically inclined LOL) and the gene expressed itself in my blood sugar. Now that I have lost some of that weight, exercise and eat better, my blood sugar is fine.

      I’m in fact, quite a bit of a “health nut” about diet and nutrition, going so far as to raise my own meat because I do not like to eat the junk turned out by factory farms here or injected with excess salt and water since the meat processors have learned that salt and water is cheaper to produce and sell than meat!

      My oldest son was born ADHD and rather than treat him with drugs, I used the Feingold diet of no artificial colors or flavors and his problems with hyperactivity were essentially corrected. BTW ADHD and the genes for psychopathy frequently are found in the same individual, but my son, Andrew, is ADHD but NOT a psychopath, where his brother Patrick (the one in prison) is not ADHD but IS a psychopath. The current research on psychopaths being done by several universities using fMRI scans, shows that the brain make up of the psychopaths versus typical individuals is considerably different. Studies of identical twins raised separately from birth show that between 50-80% of the time if one child is a psychopath, so will the other one be.

      Medical science had noticed for several decades that there was a higher rate of behavioral problems in adopted children than in biological children raised by their parents. At the time it was thought that children were born blank slates upon which environment ALONE wrote the outcome. It was thought that the very act of being “abandoned” at birth and adopted was the psychological push that made these children become higher in personality disorders on average. Now, though that science has finally come around to realizing what every farmer, livestock, or dog breeder in the world knows, is that personality is genetically influenced to a high degree.

      Just as the Spanish fighting bulls have a different temperament than your family’s dairy cow, or your Pit Bulldog has a different temperament than your Border Collie (in general, though there are exceptions) people also have tendencies to behave more aggressively if their ancestors were more aggressive. My own family history speaks to this in spades. My biological father was a psychopath, an extremely violent man who was also a murderer. His mother was very highly narcissistic, and his grandfather a bigamist. On my maternal line, my mother’s brother was a severe alcoholic who was a wife beating fool, who if his crimes had been known and prosecuted would have put him in prison for life. He was the grandson of a man as violent as he was. On that line, I can trace the family back for 6 generations of violent men and passive women. My son Patrick is very much like my biological father (who did not raise me and whom he has never met.)

      There is also evidence that testosterone levels, both before birth and at puberty have a distinct role in psychopathy. This may be one reason that fewer women are diagnosed as psychopaths than men, but there is discussion about Borderline Personality Disorder being the “female” version of psychopathy.

      Of course in all levels of any “disorder,” be it diabetes or psychopathy or depression, there are graduations of degree of severity. Dr. Simon Baron-Cohen who is a researcher of autism mostly, but who has done extensive research on empathy, points out. The autistic individual may have little or no empathy (visualize a bell curve with 0 being on the left end) but they don’t try to hurt others because of this lack of empathy. However, the psychopath may have the same degree of lack of empathy, yet they seem to enjoy duping or hurting others. Most of us, fortunately, land pretty much in the middle of the bell curve, and have a typical amount of empathy. Too much and we would never be able to function, and too little and we are a psychopath. Lack of empathy and lack of conscience appears to be the hallmark of the personality disordered, in varying degrees at least.

      Also, the amount of empathy we display depends on circumstances as well. If you are driving by a homeless man and you had too much empathy you would stop your car and give him the keys to your car and your home, and without some empathy, you would feel no sadness that he was homeless.

      One thing about your discussions of offenders that I note is your HIGH LEVEL OF EMPATHY for other human beings. I am also very empathetic toward others, and in fact, that was why I was so easy to be hoodwinked by not only my psychopathic son, but by others who were would be or actual abusers. Learning to distinguish between the sincere contrition of an offender and the crocodile tears of a psychopath is not an easy thing to do. Even Dr. Robert Hare, a Canadian who is one of the premier researchers in personality disorders says that he is still fooled by the talented psychopaths. You can read some of his writings at his website and he is easy to find on Google.

      Thank you for your contributions, Jurplesman, I appreciate your information and enjoy discussing psychology with you. How’s your weather down under now? I’ve never been to your lovely country but would like to some day. I did spend quite some time in South Africa in the 1960s as a wild life photographer and met quite a few from your country both there and here in the US.

  2. Hi Joyce,

    Well we are at the end of our summer time. But it certainly was not a normal summer, with massive rains and floods affecting the country whilst in the south we had severe bush-fires destroying some whole villages. If we don’t wake up to climate change, it may solve all our problems on earth.
    Coming back to psychology, I believe I am a little more optimistic than you about being able to help people with mood disorders. I know that genes play a big role in human behaviour. But overall, it plays not so much a role. I believe genes can be beaten by environmental means. You cannot do much when you know that certain genes affect people’s behaviour. I have detected a diabetic gene in whole families creating what is called a dysfunctional family blamed for much of behavior. But getting the whole family on a hypoglycemic diet can turn things around. If you want some research of insulin resistance on behaviour please look up:

    Research Evidence for Hypoglycemia
    http://www.hypoglycemia.asn.au/2011/research-evidence-for-hypoglycemia/

    I don’t like the use of labels such as “psychopathy” and “psychopath” which implies something genetically permanent. Labels do not mean much to me, because whatever label you use, it does not fit in with the person so categorized most of the time. It conflicts with the concept of Biochemical Individuality
    The few that I have met, can be explained by the principle of “Anaclytic Reaction” as explained at:
    Anaclytic Reaction and Parrotting
    http://www.hypoglycemia.asn.au/2012/sexual-abuse-and-treatment/#Awellknown

    These are people who have problems empathizing with their fellow creatures, very prominent among sex offenders and other so-called “cruel” offenders.

    Now you will say these are not psychopaths, but the very few I have met, I have been able to to socialize in our psychotherapy groups.

    Furthermore, the public can be protected to some degree by the typical “con men” who are masters of manipulation. Manipulation may be effective when a person suffers from a low self-esteem and craves compliments. People with a healthy self-esteem are very difficult or even impossible to manipulate. Look up my book or http://www.hypoglycemia.asn.au and search for “manipulation”.

    Amazingly enough “empathizing” can be taught as explained in my article. Also via a Counseling training course. People who learn to empathize say to me they feel “liberated” because it often opens up a new world to them.

  3. Let me say this, Jurplesman, if you take a wolf pup and remove it from it’s mother and suckle it on a goat from birth…what will it be when it grows up? A goat? a dog? Or a wolf?

    While genetics are not “destiny” they ARE strong predictors of personality and instinctive behaviors. Humans are mostly “mongrels” rather than pure breds but for thousands of years they have been breeding dogs to be stronger in one instinct or another and one personality or another because these things are STRONGLY heritable.

    Some things in genetics must be “turned on” at a prescribed time in the animal’s life. For example. A kitten is born with its eyes shut. It opens them slowly over a few days about 10 days old. If you taped the kitten’s eyes shut until it was a month old and then removed the tape, the kitten would be FOREVER BLIND because it had to have light at a specific age to “turn on” the genes that formed the final connection between the eye ball and the brain. Without that happening THEN at THAT TIME it never would.

    Wolf pups “bond” with their packs between 12 and 16 weeks of age. If they do not bond at THAT age, they never will fully bond to a pack.

    Psychopaths are not born blank slates, but have the GENETIC POTENTIAL to have those genes turned on by environment. No child is born a blank slate, every child has genetics for eye color, for general temperament, shyness or aggressiveness, risk taking or not, etc. then environment plays upon these genes turning on this or that one. If a child is abused it may turn on X gene, but if the child is nurtured Y gene may be turned on. Physical and sexual abuse does turn on some pretty negative genes, but not ALWAYS. Not every abused person becomes an abuser. Not ever raped person becomes a rapist. etc.

  4. Hi Joyce,

    I have not been here for a while so i don’t know whether this debate is still alive.

    I can see the difference between you and me. You seem to view personalities with a great emphasis on genetics, whereas I see personality with more emphasis on the nutritional aspects followed by psychotherapy.

    When I meet a person asking for help, I assume that every person is capable of changing their personality as a matter of attitude, not of reality. Because obviously not all people can be changed. I think the attitude is important. If I were to believe that a person could not be changed because he is a genetic “psychopath” controlled by his genes, I would soon leave that person to his own devices.

    I have dealt with people in a jail situation with characteristics of what you call “psychopath” and yet that person was able to change his behaviour with the tools taught in my group: namely a combination of nutritional- and pycho-therapy .

    Have you ever considered the possibility that your “diagnosis” of somebody being a “psychopath” may influence your attitude towards that person, rendering any hope of therapy a remote possibility.

    Let us face any science dealing with genetics may be of great interest but provides very little applications to the rehabilitation of criminal behaviour. Genetics can explain but not change human behaviour.

    If I would have suffered much disappointment in my ability to teach psychonutritional therapy – which is implied in your approach emphasising genetics – I would probably not have wasted so much time in trying to pass on my experiences to others, despite the scepticism I have encountered from my fellow social workers.

    The so-called “psychopaths” are too few in numbers to stop using psychonutritional medicine for the vast majority of people who can benefit from this approach. Perhaps “psychopaths”, like schizophrenics and bipolar people, may benefit from nutritional medicine, although it may not at this stage amount to a total cure.

    At this stage the vast majority of prisoners are dug addicts (about 75%) and if we stop treating them by psychonutritional means they will soon outnumber the non-prison population.

  5. jurplesman,
    I agree that a person’s nutritional state can most certainly affect their background emotions or mood and trigger different behaviors. Its a good thing that you are doing this work because, just as we acknowledge that hungry children don’t learn well in school it, would apply that hungry psychopaths are more likely to rage. Although in my experience feeding them food only placates them temporarily.

    I knew one person, whom I would describe as having various PD’s including borderline PD, who would rage often. Out of nowhere he would become venomous. It finally began to dawn on me, that he was hungry and couldn’t feel it. He was so disconnected from his emotions and his feelings that he couldn’t feel hunger as a physical sensation, instead he felt only the accompanying “bad mood” we all get in, when hungry. I explained to this man that he was hungry, he agreed but was still hungry and mad. Then he ate and he said, “You’re right, I’m happy now.” and smiled. So as not to create a narcissistic injury, I explained to him that it was probably his “inner caveman” that made him angry when he was hungry — it made him angry enough to kill, so he would have something to eat. He was pleased at that idea. The truth is, I think it was an infantile reaction, raging so his mother would feed him.

    Another psychopath I knew, was a pure, primary psychopath and he went through a phase for a couple of years, in which he was always checking his blood sugar with test strips: Before meals, in between meals and after meals. I asked him if he couldn’t feel his blood sugar rise and fall, like I did. Then he would check mine too. Now I realize that, like the borderline guy, he also couldn’t feel his physical sensations very well. He told me that he had no thirst mechanism, never felt thirsty. This psychopath was aware that he was different and made extreme efforts to compensate for his defects, using intellect. He didn’t want to end up a diabetic like his mother. But although he was in control, it didn’t stop him from planning my destruction for 25 years, slowly, methodically. He couldn’t eat food at home because he had poisoned most of it with small amounts of strychnine, just enough to keep me sick but not enough to kill.

    For both of these guys as well as a woman who is a BPD, I went out of my way to teach them about nutrition, encouraged them to eat gluten free, grass-fed, organic, advised them on supplements. All of them improved their health because of my efforts and all of them were planning to kill me. The woman, is my sister and hoped to drive me to suicide. The psychopath was trying to inherit my house but failed, he was also hoping for a suicide. He told everyone that I was suicidal. The other BPD just thought it would be fun I guess, so he greeted me at the gate with his gun in his pocket one day. He was surprised that I had brought the police.

    The cycle of idealize, devalue and discard seems to be set in them. As long as they do not have power, they will idealize you. When they gain control, they devalue. When you no longer offer supply, they discard you. This process could take place over a period of days, months or even decades — as in my case.

  6. All I can say is that I can not identify with these guys. I have not met any such people. They are either motivated or not to change their personality. (Read: http://www.google.com.au/books?id=cIbpj59s-KAC&lpg=PR3&ots=raIs2LZ1Xy&dq=Getting%20off%20the%20Hook%20Foreword&pg=PA3#v=snippet&q=motivation&f=false)

    BTW testing your blood sugar levels when you have so-called “hypoglycemic episodes” is not the correct way of testing blood sugar levels (BSL). By the time you start measuring your BSLs , adrenaline has already rebalanced BSLs. See: (http://www.hypoglycemia.asn.au/2011/research-evidence-for-hypoglycemia/#PSEUDOHYPOGLYCEMIA)

    When testing one’s BSLs we are only testing the fluctuations of BLS over time say 6 or 4 hours. We use the 4 hour tests because testing for BSL over time can be very upsetting to hypoglycemic people. One client did attack the lab scientist when given a six hour test.

    It is not so much feeling hungry that can cause violent behaviour, but being hypoglycemic. Hungry people do not always become violent, but hypoglycemic people may for sure. It is a question of testing them for hypoglycemia as explained here (http://www.hypoglycemia.asn.au/2012/self-help-website-for-personal-growth/#Testing).

  7. jurplesman,
    have you read “The Mask of Sanity” by Hervey Cleckley? He didn’t address nutrition but he did describe people similar to what I describe.

    I do believe that they have nutritional problems, my own experience confirms this. Unfortunately, the problems may have had to be addressed early in life.

    The psychopath is extremely willful. He exerts his will power over himself as well as others.

    For example, when I decided to change my diet because of the pain I was in, which was due to poison, unbeknownst to me, I begged him to quit smoking for my sake. But he refused. Then one day, I was looking for him and stopped by a phone booth (before cellphones) and saw it littered with cigarette butts. I just knew they were his. When I caught up with him, I told him, “I know where you spend all your time making phone calls because there were hundreds of your cigarette butts on the ground.

    After smoking over 25 years, he quit. His desire to stay “under the radar” and be “untraceable” is his motivation. He told me HOW he quit cold turkey. Like any psychopath, he convinces himself of whatever he needs to. Usually they will choose a lie that 180° opposite of the truth. So he told himself that he LOVED the withdrawal symptoms, he reveled in the pain of it.

    Psychopaths can do anything they want to do, as long as they give themselves the right motivation. They can obey the law as long as they tell themselves that it will offer them the opportunity to cheat somewhere better. My ex-spath even mentored meth-addict spaths on getting clean and starting businesses, so that they could be useful to him in his schemes. One of those meth addicts (in 1991) now works for Homeland security and is married to my sister. He bought a million dollar life insurance policy on her before they were even married. Also, he got his law degree — using her credit of course.

    All of these psychopaths consumed hefty amounts of sugar and coffee, until I corrected them. No alcohol for the ex-spath, (he’s still a coffee sugar holic) but the cop and my sister did drink quite a bit. I think that they need the sugar to keep their brains fueled in that constant plotting and planning, but their bodies pay the price in the long run.

    My exspath was not testing during hypoglycemic attacks, he was testing through out the day and keeping records of his baseline, his rise and his return after meals.

    • I can not make any further comment because i have no personal contact with the person you are discussing. But it seems to m that you describing hypoglycemia people. I would like to have them tested before I make any further comments.

  8. Here’s an interesting article about both BPD and Bi-polar, and comparing the two and looking at the co-morbidity of the person with BPD also having bi-polar.

    http://www.psychiatrictimes.com/display/article/10168/1427380?pageNumber=2

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