Friday, 11 January 2013


Anyone who has suffered through a mental illness knows all too well that it is not something you just "get over" or "snap out" of.  Mental illness is real and tangible suffering.

Need proof?  Here is a link to a very excellent science blog that lists hundreds of recent studies, tests and trials that scientists are working on around the world: The Neuroscience of Borderline Personality Disorder.

The more research that is done on BPD and other psychiatric conditions, the more that science is unfolding the physiological structures of the brain that contribute to their symptoms.

From the bits and pieces I've read so far, when it comes to BPD symptoms, the overwhelming trends are prefrontal cortex and amygdala dysfunction relating to structure and reactivity. 

When we talk about balancing Emotion Mind with our Reasonable Mind - in order to use both and be in our Wise Mind - it's possible to understand the regions of the brain that affect each.

Studies are able to show BPDs often have a smaller and hyperreactive amygdala.  This is the organ in the brain that plays a crucial role in emotional learning, memory and responses.

It's even been demonstrated that the larger your amygdala, the larger and more complex your social circle is likely to be.  This doesn't mean that BPDs are unpopular, but rather that we are more likely to struggle with emotional activities like intense social interactions, and so perhaps do them less.

The prefrontal cortex of the brain (essentially the forehead part) is responsible for the type of executive-level thinking that makes us humans as opposed to just cavemen by giving us the ability to visualise what is not physically visible - for example, the future consequences of making a decision. This means you need this part of the brain to work well in order for decision making, planning, moderating social and emotional behaviours, impulse control and goal setting.

Research in this area has shown that BPDs often demonstrate difficulty in getting parts of the prefrontal cortex to coordinate with other parts of the brain, especially the amygdala.

Generally speaking, this means it's possible to see on MRI scans the physical aspect of the struggle between Emotion Mind and Reasonable Mind when someone with BPD is emotionally triggered.

While it might be some time before we fully understand the neuropathophysiologic (yes, that's a word apparently!) basis of BPD, there is no doubt as to its existence, and no one should ever be made to feel that their mental health is any less "real" that their physical health.

Thursday, 3 January 2013

BPD & Object Constancy, Or, Why I Love Presents

Anyone in therapy or studying a form of psychology might be familiar with the concept of "object constancy".  This refers to a person's ability to recreate or remember feelings of love that were present between themselves and another person after the other person is no longer physically there.
For as long as I can remember, this has been something I have struggled with.  Even in primary school, I can recall how much I'd treasure scraps of notepaper from class that would "prove" I had interacted with a friend via some scribbles, or any other token or souvenir that could only be attained by being someone's friend.  Photos or presents are ideal.  Whatever the keepsake, I never have enough.  It never feels like enough.
This is because of my ineptness at maintaining object constancy.  I always struggle to feel loved by a person unless they are in the process of demonstrating it to me - I just can't feel it unless I'm seeing it, touching it, or hearing it.  Otherwise I feel totally disconnected, and potentially abandoned.

It's not that I don't love or appreciate the aspects of relationships that have lasted over time, it's just that I just can't remember them on my own.  I need prompting.  I have to be reminded of individual events, stories, and resulting emotions from throughout the relationship to get the full benefit of them having occurred. 

I can only imagine how exhausting this is to those who love me.  My relationships are a never-ending quest for the other person to prove their loyalty, devotion, and caring.

But because my brain can't preserve those efforts, it's the emotional equivalent of typing up a Microsoft Word document that can't save.  Every time you close the window, whatever you've written is gone, and you have to start again.

I'm not sure who gets the worst end of the deal with this symptom.  My loved ones, who can never do enough, or myself, given I can never feel permanently loved.

It's entirely feasible that a boyfriend of years has met a new partner since I saw them two hours ago, or that a best friend hates me after one cranky text message, or that a family member has disowned me because I didn't give them a Christmas hug.  It's feasible that people would do this to me, because I could do it to them.

It's that classic BPD trait of being able to "switch" or "split" and see someone as either all good or all bad.  Lacking object constancy is a big part of what makes this possible.  It's easy to switch to hating someone for one wrong move if you're unable to remind yourself of the many, many times they've done something right.

In reverse, I can honestly say that it is entirely possible for me to love a friend I have known for one day as much as a friend I have known for one decade, if the chemistry is right and if I view them as "all good".
Researchers have linked problems with object constancy to dysfunction in the area of the brain that deals with emotional memory.  The memories are there, but some parts of the brain just aren't talking to each other for me to be able to access them.
Dealing with this symptom is just another case of having to intervene in my thought processes manually, where a mentally healthy person would enjoy it on automatic.  

For me, I find it helpful to carry around pictures and notes from loved ones, as well as any gifts I've been given. Also, on the more extreme end of things, I've got my four closest family member's names tattooed on my back.  Every morning I look in the mirror and am reminded.

If I come up with other ways to deal with this, I'll be sure to post them here.