Enemies Are Welcome Here.

As I was creating my working model this afternoon, I came across some words of wisdom that were put so well:

As Longfellow said, “If we could read the secret history of our enemies, we should find in each man’s life sorrow and suffering enough to disarm all hostility.” This applies not just to outer enemies but inner ones too. All parts are welcome.

-Richard Schwartz

This message rings true for me and for those I’ve worked with. Sometimes I feel “ick” or angered by certain people, and sometimes I feel those sensations towards parts of my self, or my history. But in the end, all parts and persons have a story, and if we could disarm hostility, we can begin to love and accept even the “ick” people and parts of ourselves.

But what of changing those awful, icky parts?

Through my studies, I’ve learned that we are all inevitably drawn to higher qualities of living and being when we feel safe, when we feel non-judged, and when we feel accepted as we are. Loving are enemies is not a natural human instinct, but cultivating this practice is what transforms others and ourselves.

When Your Loved One Hurts You

We’ve all been there. We are talking with a loved one and out of the blue something inside of us gets triggered by what they say. Our thoughts and body begin moving faster than we can process and we get that feeling of discomfort deep in our gut or a racing in our chest.

“What did they mean by that?” “Are they trying to say that it’s my fault?” “Are we on the same team or are they seeing me as the bad guy?”

Our defenses go off. Many of us instinctively go to one or a combo of the following:

1. Avoid. I’ll just pretend like it didn’t bother me until this feeling goes away.

2. Fight or defense. I’ll try to defend myself with logic, attack them, or bring the focus to their faults to take the pressure off of me.

3. Flee. I’ll remove myself physically or mentally from the situation. I’ll go to the door, or change the topic, or check out in my head. It’s better to run from these issues than to fight about them.

However, these approaches aren’t connecting or healing in the long run. In fact, when couples get caught in these types of responses they create distance and disconnection to protect themselves and decrease their ability to be real and intimate with each other. It’s hard to be close to someone when our walls are up, or we run the moment things get uncomfortable.

So what can couples do in those “heated moments” to increase connection?

Name it to tame it. This concept was popularized by relationship researcher and neuroscientist Dr. John Gottman and Dr. Dan Siegel. When we are triggered by our partners, one way to increase closeness is to get real with them. Let them know that for whatever reason things are moving fast and something feels not okay. Name our emotion, to tame it. The research shows that it’s empowering and calming for us as humans to own and describe our feelings (good and bad) to another person.

An example might be saying something like, “Honey, for some reason that comment just felt bad/icky/uncomfortable to me and I’m not sure why… could we try slowing things down and talking in a way that feels safe for the both of us?”

Doing this slows the conversation down and increases our personal feelings of calmness and chances for understanding & connection with our partner…

What about when we feel REALLY heated and sophisticated words go out the window?

Then it may be a good time to take a self time-out and calm yourself before going through the name it to tame it process. An example would be saying, “I’m sorry honey. I need a self time-out, things are feeling blah right now… Let’s talk about this in 10 or 20 mins after I’m able to feel more grounded.” In that 10-20 min space, you can take time to do something that is self-soothing to you (cleaning, going for a walk, reading, a bath, video games, etc.) until you’re feeling a bit more calm and able to think and THEN try to name your emotion and express those feelings when you and your partner come back together and you’re able to think more clearly.

Like the scenario above, leaving a situation isn’t always a bad thing,  especially when you are feeling extra flooded (that feeling of really intense emotion that impacts your ability to put yourself in someone else’s shoes or problem-solve). The difference here is that there’s a safety net of telling your partner when you’ll come back to the conversation and that it won’t be something that’s left unresolved.

Naming our hurt or discomfort gives our partner the chance to understand and know that part of us. On the receiving end, it feels good to have our partner open up to us about their triggers and give us the opportunity to re-word things or let them know that we are on their side even if we disagree. It’s not that healthy couples don’t fight or disagree, but that they use those moments to practice care for a person’s differences and to embrace the messier parts of each other. In doing this, we are able to increase intimacy and our feelings of “I can really be myself around my partner, the parts I feel good about and the more insecure parts”.  For being able to really be ourselves, and love someone when they are trying to heal and understand their messier parts is a beautiful thing that every human deserves.

 

 

When Happiness Feels Bad.

Although millions of people search endlessly and spend copious amounts of money searching for the key to “happiness”, some people find happiness to be a really anxiety-provoking emotion. This is because happiness is an extremely vulnerable emotion. As people review their lives in their head they start to think, “Life is good right now…the family is good right now…the job is good right now… I feel happy… But what bad thing will happen next? When will the next shoe drop?”

These fears can make happiness and joy a really bothersome emotion. Some people even stifle their happiness with hopes of not feeling too hurt when bad things do happen. This is especially true for people who have suffered through a lot of unprocessed chaos and trauma — their brain’s start to rewire to think, “How can I protect myself? FEAR and NUMBING, that’s the trick! (although when we numb painful emotions, the happy/joyful ones get numbed too)”. However, stifling our joy or happiness does not make the messy or sad parts of life any more tolerable, better, or easier to endure — it just kills our ability to really soak in our happiness.

So what can we do if we struggle to fully embrace our happiness without fear that something bad will happen next?

Gratitude. Gratitude puts us back into our emotion and into the moment in an active way. It replaces our fear of happiness with honoring that emotion and thanking it for it’s presence in our lives.

So, the next moment you feel a blip of happiness  — say a little thank you to it, and let yourself enjoy where you are. Bad things will happen, yes. But it’s best to not let that put a damper on the good moments, because it does far less healing of the negative moments when they do arrive (and sometimes may subconsciously chase more negativity into our lives…. and ain’t nobody got time for that). Be happy, be grateful, be well!

I’m not here to fix you.

As a therapist-in-the-making, I am here to embrace you. The good, bad, messy, silly — all the parts. So many clients come to therapy saying “Fix me!” or “Just help me erase or get rid of these painful memories!”or “Make me better!”, especially when they’ve been struggling with pain from trauma, grief, a break-up, or feeling rejected.

But here’s the thing – my clients are incredibly amazing people and I can’t erase their traumas even if I wanted to. Even more so, I whole-heartedly believe that there is so much growth we can derive from digging deep, feeling the pain, and allowing ourselves to be imperfect as we heal from our past hurts. Trauma will happen. Life will happen. Pain will happen. This isn’t a way of minimizing trauma or it’s effects but to show people that it’s okay to be sad, angry, anxious, depressed and otherwise out-of-sorts when we’ve experienced a lot of trauma and the addition of pressure to not feel pain, to simply get over things, or to “feel normal” only hurts us more.

When a person gets stuck in trying to “fix” themselves — they often go to the shame cave. The shame cave usually is accompanied by or proceeds feelings of not being good enough, not mattering, not getting it right, or of something being “dysfunctional” about ourselves compared to other people. Often our attempts to “fix the problem” becomes the problem. The shame cave often results in numbing behaviors such as addictions, becoming overly involved in another person’s life or a relationship, and in depression.

So what do I  do when my clients are hiding out in the shame cave?

I try to get them back in touch with their true selves. That is, the parts of them that are hidden beneath their feelings of inadequacy. The parts of themselves that are fueled by love and not fear. It can often take some time to get to know these parts of ourselves, especially if we’ve been running a script that has been fueled by fear for years (which is fairly common for people with traumatic histories). This fear-driven part of ourselves is usually created to protect ourselves from future traumas, but now, playing out in non-trauma life moments, can really hinder us from being ourselves and reaching our potential. When fear is driving the bus, we can start to feel on-edge in every day life, and not even sure of what safety is or means. We may try to control things in an effort to feel a false sense of safety and power. And if we don’t know what to do with those feelings of being “on-edge” whether it exhibits itself as anger, anxiety, or depression — well, then we are really in trouble.

So no, I’m not here to FIX you. I’m here to find you. That true self that isn’t afraid, the parts of you that come out when you feel truly safe and valued. It may take some time to get there for many reasons, but boy, is it worth the journey. You are worth it.

What’s the big D-eal about Vitamin D?

Odds are YOU are vitamin D deficient. It’s estimated around 85% of Americans are (even those who take multi-vitamins religiously).

And although we still walk, talk, and breathe just fine without it–this little vitamin is crucial for optimum health and well being over the long haul.

In fact, Vitamin D deficiency has been tied to:

  • Autoimmune Disorders
  • Mood Disorders (depression & anxiety)
  • Premature Aging (wrinkles and cell damage)
  • IBS
  • Increased levels of stress
  • Decreased levels of energy

So, if you’re interested in becoming more youthful, happy, and healthier run by your local whole foods or vitamin shoppe and pick out some Vitamin D-3. Now the 3 there is crucial, because it’s the REAL DEAL. The vitamin D-2 stuff is synthetic, less potent, and overall less useful to our bodies and partially why vitamins get a bad rep these days.

The older RDI’s (recommended daily intakes) are from the 70’s, and the newer research suggest that humans need about 5,000-10,000 IUD’s of Vitamin D-3 to really reap the benefits and not be deficient (that’s why your normal multi-vitamin likely isn’t cutting it).

Other ways to get some quality D-3 is from eating salmon, lean meats, and mushrooms.

Oh, and you can soak up some rays on a sunny day–that does the trick too.

So why are beach bums typically on the “chill, youthful, and happy side”? Vitamin D-3, bro.
Until next time,

J out.

The not-so-tough bully: how to feel empathy for those who hurt us.

“Hurt people hurt people”. It’s a quote I really had to think about before the concept sunk in.

There have been times in my life, the not-so glamorous times in which I have felt justified hurting others because of the hurt I was feeling. Now, although I FELT justified.. the truth is, I wasn’t…but that I was also unaware and ill equipped to deal with the unavoidable pain in life in healthier, constructive ways. Bullies are often guilty of this as well.

When you really let it sink in, it makes sense.

Sadness, fear, and guilt/shame/rejection are all secondary emotions of anger. When someone is angry, it is usually coming from a place of feeling one of these emotions and anger is an “easier” emotion to feel (and often more socially acceptable) than the others. Bullies often have a background of being bullied, rejected, or shamed (whether by their families or others). They’ve learned to bully as an effective strategy for temporarily alleviating these feelings (though like other ineffective coping strategies, putting others down doesn’t actually help a bully accept these emotions, and they typically resurface time and time again).

It’s important to remember that when it comes to people being mean, it’s typically more about THEM than it ever is about you. When I find myself feeling bad feelings towards others, I often question what part of me is really needing to be heard and nourished–because it’s always about my own hurt feelings and unresolved anxieties (hey, we are human after all).

Just a little psych empathy tidbit on a Monday evening–catch ya later!

J

Addiction Nation Pt. 1: Anxiety

I remember having a conversation with a peer who confessed that while she loves to work with people struggling with personality disorders, working with people struggling with addiction seemed as appealing as getting ice water poured over her head every session.

Well, as unfortunate as that may be it seems that addictions have only increased (new types, higher prevalence) throughout our nation.

The question I wondered was, “Is it even possible to avoid addiction in the field of understanding human behavior/psychology?”

If not personally struggling at a current time by an addiction, many of us can at least name ONE person in our lives who IS struggling with some sort of addiction.

It’s easy to pull out the more common addictions such as alcoholism, drug abuse, and sex addicts–but what about those more common (“seemingly tame”) addictions that many of us struggle with in modern American society?

* I am aware of the controversial nature of this blog, as well as the fact that these disorders are not classified in this way in the DSM, therefore feedback is welcome as I am trying to piece together the information I have learned, experiences, and build upon newer lines of thought.

The crazy web of ANXIETY. 

I realize that anxiety is portrayed as a disorder in the DSM, however, there is also an addictive state to it that shows it’s face in many forms.

 

In fact, after I began writing this I started to feel an overwhelming amount of information that fell into these categories (aka I have a feeling I’ll be writing a more in depth blog on this one!) and I place them all under anxiety since they all inter-relate to each other and the nature of anxiety itself.

 1. The glamorization of constant “busy-ness”

This is so common in America. The phrase, “I work ___ hours per week” tends to define more than the hours we work. For many, it also defines work ethic, if they are “lazy”, and how “good they are allowed to feel about themselves”.

I often think of the mom/dad who does it all and gives no time for themselves–all while never breaking a sweat (that is the glorification of what I like to call: the pursuit of misery)

2. Perfectionism. When learning more about the nature of perfectionism, you might be surprised to find that many perfectionists (while some OVER do everything) some under do most things/don’t finish or take on projects. Why? Because their perfectionism is so overwhelming that they can’t simply do a task “good enough” they have to do above and beyond (want me to start working out?… I’ll do it perfectly, twice a day, forever!) It’s that sort of thinking that actually makes beginning new things… well, impossible. Perfectionism is impossible. It also stems from anxiety with the ambiguity of life. Dr. Thomas H. Habib wrote, “Peope who suffer from the energy-robbing problems of perfectionsism don’t know how to effectively handle anxiety. They’re susceptible to this behavior because they have difficulty accepting the ambiguity and doubt inherent in life itself.” They struggle with wanting an “absolute” in life, when none is to be found. It feels safer living in the confines of control/making lofty goals that are typically unobtainable, and when obtained, only to be followed by the next “lofty goal”.

3. Shame. This may sound a bit nutty, but I also think that we breed a culture with an addiction to the shame we feel as a result of not being wonder woman/man 24/7 with a cherry on top. Instead of feeling guilt (i.e. I DID something bad) our brains commonly default to shaming us into (I AM something bad). One psychologist remarked that if we could read signs over people’s heads about how they truly feel about their relationships with others, it would read “Am I good enough?” for 90+% of the population. So how does this relate to anxiety?… Well, this shame actually prevents us from being authentic. From letting people know how we really feel, who we really are and ultimately prevents us from connection, creativity, and being our best selves– all bred from the anxieties that result from shame. In fact, I think another issue many americans face is the struggle to be “Authentic” when we live in a world of technology that constantly tells us to put our “best faces” out there, and leave out our imperfections (you can see how these all inter-relate in the web of anxiety).

*If this really hits home for you, an excellent resource for shame studies/ideas would be Dr. Brene Brown.*

 4. Distraction/Technology. Do you ever get that feeling of being “naked” without your phone? I certainly have. Technology, while bringing many wonderful advancements to our modern society has also become a huge distraction (for better and worse) for people throughout America. While we used to distract ourselves with imagination and creation, now many find solstice in their instagram, facebook, video games–you name it.

While social media and technology is not inherently bad, it’s how people use/abuse it to distract themselves from…. well, themselves. Many who suffer with anxiety find solstice in distracting themselves out of it. I, myself, am extremely guilty of this (as I blog… haha, I digress). The difference is, whether or not we have programed ourselves to become so distracted that moments in which we are without distraction are not “zen” like a bhuddist monk who practices meditation every day but likely the exact opposite. Boredom is painful. Meditation is anxiety provoking. Stopping distractions means a whole bubbling up of other distractions.

 

It looks like the person who sits down to meditate, only to go through the laundry lists of to-do’s (this also plays off the whole glamorization of busy-ness thing!). Our brains can actually become addicted to this cycle of distraction. It’s a crazy cycle that perpetuates itself (ahh!).

How can we change it? Well, while first order change or incessantly trying to stop these patterns (i.e. distract ourselves, think “happy thoughts”) seems like the right response–it actually perpetuates anxiety and only provides temporary relief. What works? Acceptance of these thoughts. While that sounds simple, it most certainly effort. It takes being able to be okay through the discomfort of negative thoughts, accepting their presence (and that they likely stem from somewhere rational), and that it’s inevitable that these feelings/thoughts will change. Meditation, DBT, and ACT therapies are all popular modalities for treating anxiety.

If anxiety is a pervasive issue for you (which it seems to be for most of us at one point or another), I would highly encourage addressing it through therapy or self work. Therapists can help you (via their training and third person perspective) better understand, accept, and work through your own personal “anxiety cycle”. Furthermore, therapy can provide you with tools to manage the discomfort and attack some of the more “root issues”–I say this only because I truly believe that many people use anxiety as a coping mechanism/response to some real/believed threat/trauma they’ve experienced or are currently going through.

Any way–in my efforts to be brief, feedback is welcomed and I’ll dive into other “under the radar” addictions in America in future posts.

Until next time,

J out.

“Love me, hate me–but don’t you dare leave me.” The Borderline, Narcissistic complex.

To understand the complex combination of Borderline Personality Disorder (BPD) and Narcissistic Personality Disorder (NPD), one must first understand the differences between the two.

Often confused for the other, I will briefly lay down the diagnostic criteria for each alone and then explain some key constructs that differentiate BPD from NPD.

It is after this explanation, that the picture of combining the two unfolds with distinction and we can begin to understand the often co-morbid (25-37% rate) and complex case of the BPD/NPD combination.

So let’s get at it!

According to the DSM, to be diagnosed with BPD one must present with 5+ of the 9 following criteria: (*If you’d like a more in depth analysis of BPD, check out my other post by clicking HERE*)

  1. Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in (5).
  2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. This is called “splitting.”
  3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
  4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in (5).
  5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
  6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
  7. Chronic feelings of emptiness.
  8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
  9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

For NPD, one must present with at least 5 of the 9 criteria:

  1. A grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
  2. Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  3. Belief that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
  4. Requires excessive admiration
  5. A sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
  6. Interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
  7. Lacks empathy:  is unwilling to recognize or identify with the feelings and needs of others
  8. Envious of others or believes that others are envious of him or her
  9. Arrogant, haughty behaviors or attitudes

Similarities:

  • A perceived lack of concern for how their behavior impacts others (while those with BPD typically show concern AFTER they hurt someone, NPD’s show no concern altogether).
  • A fear of abandonment. Both fear abandonment, but it stems from different motives. BPD’s fear losing the connections they have with others, while NPD’s fear losing the “ego” they receive from others.
  • Having complicated relationships with people, work, and themselves.
  • Displaying overly emotional and over-the-top behaviors.

And some Distinctions:

1. Rates of Self-Harm.

While those with NPD are not immune to self-injury/self-harm altogether, those with BPD are much more likely to engage in suicidal ideation, self-harm behaviors like cutting/binging, etc. and impulsive behaviors that are self-destructive.

2. Feelings of grandiosity.

One of the core features of NPD is believing that one is above others. Those with NPD indulge in talking about their achievements and talents, and expect to be treated as superior to others. Those with BPD alone, don’t have a pattern of feeling superior and in fact, often describe how they feel victimized/as if life is against them & for some a sense of “emptiness”.

Additionally, those with NPD feel that they are “special” and can only be understood by “like-minded superiors”, while those with BPD feel abandoned and misunderstood by any one regardless of their “status”.

3. Gender.

While I wouldn’t put too much emphasis on this, the current stats do show that women outnumber men in the BPD population, and men outnumber women in the NPD population. (From a totally non-scientific opinion, I often wonder if perhaps the differentiation in gender presentation has more to do with societal ideology. It is MUCH more acceptable for a man to present as “narcissistic” in general, and for a woman to present as a “victim”–again just a side thought from a developing psych nerd)

4. Empathy.

Someone with NPD presents as having every emotion EXCEPT for empathy. While those with BPD, tend to present with empathy to a fault of their wellbeing and often those they are “empathizing”.

Because NPD and BPD’s stark differences in empathy, the fear they hold for abandonment is handled in different ways. As Alexander Burgemeester put it, “The BPD will dump on you while the NPD dumps you altogether.”

What about the 25-37% of dual-diagnosis?…

Here’s the scoop on the NPD/BPD also commonly called the “outward-attacking Borderline”.

To meet criteria for being both NPD/BPD, one must meet BOTH 5 of 9 of the DSM criteria for each (see above for reference).

So, what exactly does that look like?

As Randi Kreger expertly puts it, “They masquerade as a giant, but they feel like a kid living in a world of Goliaths.”

Those with BPD/NPD while harsh, menacing, and scary on the outside are often as “fragile as eggshells (hence “walking on eggshells”) on the inside. Although they are adults, the way they deal with emotions often feels like how it does to a child ~6 years old. As a result, the “adult tantrum” feels like a necessary response and can be very hard for loved ones to understand.

The NPD/BPD presents with both extreme emotions they don’t know how to handle AND feelings of superiority. They often do not feel remorse for their emotional displays AND will continuously believe that they are superior to those around them.

Kreger, further demonstrates how the BPD/NPD juggles the intricacies of 3 different concerns:

1. What people did to them. 

2. What people did NOT do to them.

3. When someone hasn’t done ENOUGH for them. 

Because these concerns come from the BPD/NPD’s own experiences/thoughts, loved ones will never do ENOUGH for the BPD/NPD.

It is important to remember this, not to give up on them–but to embrace this understanding of their experience and discover ways to healthfully respond and interact with individuals with this struggle:

Ways to healthfully cope, respond, and support loved ones with  BPD/NPD: 

1.  Look into your own “stuff” first, and try to make an extra effort to temper these traits/behaviors around the BPD/NPD. Because they are extra sensitive, it is helpful to make sure you are relating to them in the healthiest/boundary honoring ways possible. Being reactive around the BPD/NPD only adds fuel to the confusing emotions they are experiencing.

2. Become a team and negotiate together during periods of calm. When you use statements like “I know we are upset right now, but I know these issues our important to US and WE can get through this TOGETHER” can be very reassuring to someone who is emotionally reactive. When the BPD/NPD is in a calmer state of mind it’s helpful to negotiate boundaries together to continue that “team” sense of security.

3. Curb the sarcasm and jokes. Because of the sensitive nature of BPD/NPD’s you can assume they’ll respond like a Vulcan and take it seriously. Again, the way their brain processes can filter out certain social cues and hone in on other SENSITIVE material, it’s like their wiring is geared to magnify criticism and selectively focuses on any signs in their environment.

4. Do not try to change them. As much as you could want a BPD/NPD to be different, it is important to remember that this is part of their structural wiring. If they want to make changes, it has to come from their own experiences. If we try to change them it only hurts us in the end. Again, focusing on your own “stuff” proves a lot more helpful in changing the reaction/responses of others (and to feeling good about ourselves at the end of the day).

5. Get creative in postponing responses to mean outbursts. If you can delay it, sometimes you can discuss it with less emotion/fire/intensity. For example, if you’re on the phone you can state, “Oh, someone is at the door–let me call you back.” Although this is not ALWAYS an option, it can be a useful skill for avoiding heated arguments.

6. Lastly, empathy is the key to loving them. Remember, they lack empathy. And remembering that it’s really an issue of their wiring, and not an insult to you can be EXTREMELY helpful when they seem like a monster out to rip apart your emotions. While yes, their behavior can be terrible, it is important to remember that it stems from anxiety/sensitivity/and a wave of emotion that come from their brains. Remembering their emotional capacity mocks a 3-6 year old, can often help you think of holding that child instead of abandoning them or retaliating.

On that note, I will be writing an empathy piece next, but wanted to address this concern first (as requested by readers). I hope this clarifies the NPD/BPD debate, and look forward to hearing any concerns, q’s, and feedback.

Until next time, Jenny out.

&….

Of course, kudos to my awesome sources:

http://www.apadivisions.org/division-39/publications/reviews/narcissistic.aspx

BPDcentral.org 

Psychologytoday.com, Author Randi Kreger

http://thenarcissisticlife.com/the-difference-between-borderline-and-narcissistic-personalities/

Borderline Personality Disorder: Understanding the often misunderstood.

When I first thought about Borderline Personality Disorder or BPD. A few things came to mind: fear, that it was a “woman’s issue”, but mostly that it was a VERY difficult disorder to have or treat.

Since my often wrong “first thoughts”, I have learned a lot about BPD, and with exposure, reading, and opening my neural pathways I have grown to understand that although it has a bad wrap in society, it is a very interesting and important disorder to treat and understand.

Per usual, some Psych Myth Busters:

1. Only women get BPD.

While the vast majority of BPD cases are in fact female, 2 out of 10 cases are male. 20% is a large number to look over, and researchers have also stipulated that men tend to not seek help for mental health issues as often as women. Thus, as far as we know–gender doesn’t play a significant role in BPD.

2. All people with BPD are liars and/or manipulative.

While some with BPD may feel one thing one moment, and say another the next–the words are very much a part of their reality and not an intentional “lie”. While a pathological liar can also have BPD, it is not a trait or characteristic of the disorder.

3. There is no help for those with BPD.

Like most mental illnesses, there is no “cure-all”. However, with time, therapy, medication, and dialectical behavioral skills training, many with BPD can mitigate most of their symptoms and learn to healthfully interact in relationships. There’s also evidence that suggests some BPD people “outgrow” parts of their illness by the age of 40. While this is still under review, it may be important in understanding some of the cognitive processes impacting BPD.

4. Those with BPD enjoy hurting people and are attention-seekers.

SO WRONG. Although it is an unfortunate side-effect for some, most people with BPD are usually trying to cope with really difficult emotions and in doing so, can often hurt the ones they love most. Again, it is not intentional, and understanding that critical distinction provides a space of empathy that is much needed to heal this population.

Theories on causality:

1. Genetics: Nature likely takes a role as there is ~65% likelihood of inheriting BPD from a BPD parent.

bioofbpd

2. Cognitive processes: Although these processes haven’t been explicitly identified, there is evidence showing abnormal brain activity for those with BPD in various regions including the amygdala and executive functioning (AKA handling emotions, perception, decision-making, and organizing information regions).

3. Environmental factors: One common theme among the research indicates that neglect, poor parenting, or trauma in childhood has been a key correlation to this disorder. While I rarely encourage putting psych disorder blame on parents, it is important to understand the role in making a child feel safe and loved in childhood to develop into healthy adults. Many theorize that those with BPD saw emotion regulation displayed in an unhealthy way, and in turn, perhaps developed those traits and saw love as equivalent to unhealthy emotional displays.

What we do know is that it is VERY likely a combination of all these factors. I like to say it takes a “cake” to create a disorder. The genetics are the eggs, the cognitive processes are the milk, and the environmental factors are the flour (so to speak).

Diagnosis:

Those with BPD have to meet 5 out of the 9 criteria listed below. This means that there are 200+ combinations/manifestations of BPD.

bpddsm

Some other signs and symptoms include:

bpddsm2

Every case of BPD is unique. Below are 4 common divisions (according to Theodore Millon) that only begin to breach what various combinations may look like:

1. The Discouraged BPD: This type tends to look like how a lot of us were in middle school. Go with the crowd, clingy, a bit codependent on the thoughts of others, but inside very disappointed. They often feel anger, unrealistic rejection, and a lack of a sense of self. When this anger does surface it’s often turned inward and manifests in self harm and suicidal ideation.

2. The Petulant BPD: This type is torn between relying on others and pushing them away for fear of rejection (the “If I push you/hurt you first-I protect myself” mentality). This often manifests in complaining and irritability to full blown aggression and hostility. They often experience both feelings of unworthiness and anger towards others, making it very difficult to control their emotions.

3. The Impulsive BPD: This type sounds just like the name: they are thrill-seekers with charm that get themselves into a whole lot of trouble. The best metaphor I have is like a person who is drunk and a lot of fun, but has lost their inhibitions and thus, engages in wreckless activities. While this type is often the most fun to be around, their disorder can lead to very serious consequences.

4. The Self-destructive BPD: This type is particularly difficult to have. Whether conscious or not, BPD’s that are self-destructive manifests by self-harm ranging from cutting/physical self harm to social self harm (performing humiliating acts, quitting their jobs, poor hygiene, wreckless driving, etc.

While this is just a SMALL sample of the differences in BPD manifestations, the one take away is (like with most mental illness) every case is different!

I’ll try to wrap this post up at this point, but I look forward to delving in deeper in Part 2: “What it’s like to have BPD” and “How you can support a loved one with BPD”.

Until next time, J out.

Kudos to: http://www.psychologytoday.com, http://www.healingfromBPD.com, and BPDcentral.com for content ideas.

Debunking Depression: myths, solutions, and how we can help.

Okay, this is a pretty lengthy one, chock-full of a ton of info broken down..

So let’s dive in!

Some myths:

1. Anti-depressants are the cure-all for depression. No, not really. Hardly at all. Recent research has indicated that while some people show improvements from anti-depressants, most users don’t experience a decrease in depressive symptoms and the success rates are comparable to the “placebo” effect. While I wouldn’t count out the meds completely, I would be cautious to solely rely on what a 9.9 billion dollar industry is trying to feed you.

2. Depression is not about a person’s character. People who are depressed are not simply lazy, prone to pessimism, or just being selfish. It is a biochemical disease, much like Cancer is not a symptom of someone’s character. However, I will say that having certain characteristics will help in recovery and resilience, character alone is not the cure, cause, or answer.

3. Depression does NOT equal sadness. Many people associate depression with having the blues. While yes, being sad is ONE symptom of depression. Every person with depression experiences it differently. We’ve also learned in psychology that there are a lot of secondary emotions that in essence are another version of “sad & hurt”. Anger, fear, and anxiety are just a few emotions that sometimes = sadness and can also be seen in people with depression. You’ll also hear some people describe their depression as not sadness, but simply “not caring”/ apathy. I’ve also heard depression defined as being the opposite of a state of playfulness.

In a mind-body approach, I’ve also heard of there being 3 forms of depression: 1. An airy one, 2. A hot one, and 3. A heavy one. The airy one manifests in always buzzing around, anxiety, issues with sleeping enough, and perfectionism (it’s often body-wise felt like a lack of being grounded). 2. The hot one manifests as anger, being easily irritated, and easily blowing up on people/things (it often feels body-wise like being very tense–like I need a massage stat!, and hot). The last one, heaviness, manifests in sleeping a lot, eating a lot, doing less/lack of motivation, and feels like a “heaviness”.

The important takeaway from this is to realize that depression may manifest itself in many ways and is UNIQUE to every individual. (Sorry textbook definition–you’re kind of limited!)Here are some key indicators: lack of interest in things once interested in, changes in appetite and sleep (either increases or decreases), manifestations in the body/health, a pattern of sadness & moodiness not tied to normal situational things, loss of motivation, falling behind on obligations, losing things, self deprecating thoughts, OTHER’s deprecating thoughts, (negative talk about self, others, and situations), feelings of fear, anxiety, becoming overly busy, anger, and all of these things are pervasive.

Textbook-wise there’s multiple types: dysthymia (mild, but pervasive 2+ years), major depressive disorder (extreme symptoms of depression for 2+ weeks), postpartum (common after birth due to physiol./hormone changes), SAD which strikes people during winter when it is colder/lack of sunlight, Bipolar (with euphoric highs and lows), and PMDD which occurs in women who have exceptional hormone changes during their menstruation.

Needless to say, depression is versatile… and impacts a lot of people in the US (many undiagnosed and high functioning).

Some Solutions:

While we know there is no single “cure-all” for depression and it’s many forms YET, the research shows that there are many things we can do to combat its symptoms, severity, and longevity.

1. Exercise! (I know I probably talk about exercise like they pay me for it–I wish!–but it’s so true..) Exercise has been linked to decreasing depression more effectively than anti-depressants (and producing a longer effect even after just one session). While the “whys and hows” are still up for debate, many think that increasing your endorphin levels and the decrease in the brain’s inflammation are some ideas of why going for a jog can be so helpful. I’d recommend getting involved in a group class–that way for the depressed person who likely needs the motivation to get there, having people hold you accountable might be a helpful way to ensure you get to the gym. If you’re REALLY not ready to take on the gym yet–having a friend or dog join you for a daily walk (45 minutes is the ticket) can be very helpful as well.

2. Diet. While this may be a hard thing to change for someone lacking motivation, simply changing your diet to a whole food diet can do wonders. Whole food= real food. Think any thing produce, organic/local meats, and healthy fats you find in nature (nuts, avocados, and coconuts). Even changing your diet from 0 to 50% whole foods can start changing the way your brain thinks.

3. Meditation. Learning to cultivate calmness and “being in the moment” can be very helpful (esp. for those struggling with the more perfectionistic/anxious type). It can also help calm people with disturbing thoughts and can ease pain/fear. Although it can often sound sort of new wave/hippie-ish meditation has shown to be very effective, I’d suggest seeking out a yoga that incorporates this or seeing if there are classes/groups that can help you get started if the whole mediation thing is new or scares you (honestly, it still scares me–but let’s leave my own growth potential out of this for now ;P)

4. Therapy and CBT. Cognitive Behavioral Therapy. Conditioning/re-framing your thoughts. Sometimes it can be helpful to become curious about our negative thoughts. “That girl didn’t wave to me because she doesn’t like me” could be followed by a CBT tactic of curiosity: “Maybe she’s having a bad day… Maybe she’s running late and focused on something else… Maybe she didn’t see me…” all could be a different way of framing this thought. It’s very helpful for people who are stuck in a place where every situation seems to revolve around them in a negative way. “I’m so lame. No one likes me. This day sucks…” could all be challenged by other thoughts. Practicing these re-frames could help end some of the negative thought loops that feed perfectionism, depression, and the over-all condition of “not enough” that plagues our society.

5. Gratitude. Recently I heard something really great about gratitude. It’s not simply about “counting your blessings” that is truly effective (because to me it always felt a bit over-the-top to be grateful for the same general things, every day) but to put a real, specific spin on gratitude that really changes life. The newest research shows that naming ~5 things that happened in the last 12-24 hours that you’re grateful for is so much more impactful than spouting off generalities like “I’m grateful for my health, my family, etc.” every day. This could be especially helpful in training/challenging the depressed brain to give some sort of meaning that’s relevant to the “here and now” of their experience. So readers, if you’d really like a challenge: what are some things you’re grateful for in the last 10 minutes? *(I’m grateful my hands have been keeping up with my thoughts, I’m grateful I have a cozy blanket around my feet, and that I’ve been able to keep my focus for the last 10 minutes)*

6. Increasing social support. Yeah, this one is EXTREMELY hard to do when depressed but really important. It’s hard to be around people when it’s hard to be around yourself, but if one can push back that discomfort, it can lead to gaining support in ways that you can’t provide for yourself–it’s especially helpful to be around SAFE people who understand the nature of depression and what they can do to help (SEE BELOW for some tidbits on “how to help”). This also may look like volunteering for some people who need just a second-order change to get them out of their head and feeling supported (I would only recommend this to people dealing with mild/moderate depression–if you’re in the deep slumps this is likely the last thing on your mind, and understandably so.)

7. Medicine…potentially. Although I am cautious about this one, medicine under the supervision of a knowledgeable Psychiatrist can be really helpful and aid in people beginning to delve into the other solutions. By all means–if you need it, please take it! However, I wouldn’t recommend this as a long-term fix unless the depression is severe, pervasive, and the participant has already tried other treatments with no luck.

How can we help?

1. Help care for them. Some people with depression lose track of taking care of simple, daily tasks. Helping them clean their clutter, doing the laundry, all those things that can fall to the way side when someone is battling their mind and just struggling to survive/get through the day.

2. On that note, encourage them to delve into self-care. People with depression while seemingly “self-focused” can often forget how/the importance of self care. Encourage them to do things that are self focused on healing–watch some comedy, get a massage (definitely a big advocate for this one–body work does wonders!), go to the gym (this goes with taking them out for walks), and so on.

3. Reassure them you are there for them, can handle their feelings, and that you are interested in trying to understand their experience. The isolation of depression can often be one of the bigger roadblocks to recovery. Many feel alone. Being interested in understanding a person’s experience can create a connection in a world that feels very disconnected to the person dealing with depression. This can do wonders.

4. Hugs, laughter, repeat. After trying to understand and reassuring someone you are there, making jokes, making play, and hugging someone (if they’re okay with physical touch) are all ways to physiologically get a depressed person out of their mindset for a bit. Developing a pattern of play can really turn things around–but only in the right context/after you’ve validated their experience.

5. Like the CBT tactics above, provide an example for challenging their negative thoughts/beliefs. When trying to understand their experience, it may also be helpful to get to know some of the negative thoughts a person is experiencing. It may be helpful to acknowledge their thought and then become curious about it. Challenge the white/black thoughts by providing some real life examples. This can help a depressed brain become curious about other thoughts to be thought.

6. Tell them why you love them/their strengths and encourage them to think of what they like/believe their strengths are for themselves.  Simply telling them why you love them can also be incredibly supportive. Sometimes people stuck in depression can’t see those truths behind the things that make them lovable, and that they are “enough”. Encourage them coming up with a few things on their own to also spark some change in their thoughts. What are 10 things you like/find to be strengths about yourself?

There is still much to be learned about this incredibly complex mental phenomenon, but it is still incredibly beneficial to utilize what we know to take strides in making it just a little better for those struggling with this common illness.

I only hope to continue to enrich my understanding in the psychological and medical world of “debunking depression”.

Until next time, J out.