Tag Archives: Mental Health

Identity Disturbance…

Identity Disturbance is a relatively and equally fascinating new term to me and since I haven’t researched it to my satisfaction to be able to write about it, I thought I would begin here by re-blogging this article from The Bernard Bert-A Borderline Adventure.  This author did a great job of streamlining and breaking down the components of this condition.  Hoping this continues to shed some light on the many shades of mental illness and reduce the stigma attached.~~Thanks!  Little L~~

broken heart

 

Identity Disturbance, November14, 2013

Identity disturbance: markedly and persistently unstable self image or sense of self.

“Identity disturbance has many different aspects/features making it a very complexed issue even if it is a lone problem, but with the added factor of other BPD symptoms, it can be an overwhelming and complicated thing to understand and deal with!

In a 2000 study of patients with identity disturbances, Tess Wilkinson-Ryan, and Drew Westen identified four types of identity disturbance:

Role absorption (in which patients tend to define themselves in terms of a single role or cause),

Painful incoherence (a subjective sense of lack of coherence),

Inconsistency (in thought, feeling, and behavior),

Lack of commitment (e.g., to jobs or values).

A stable sense of identity means being able to see yourself as the same person in the past, present, and future.Identity is quite broad, and includes many aspects of the self and is probably made up of your beliefs, attitudes, abilities, history, ways of behaving, personality, temperament, knowledge, opinions, and roles.

A healthy identity includes the ability to choose an appropriate avenue for industry, achieve intimacy with another, and find a place in the larger society by having developed a sense of continuity over time; emotional commitment to a set of self-defining representations of self, role relationships,and core values and ideal self-standards;development or acceptance of a world view that gives life meaning; and some recognition of one’s place in the world by significant others.

“Who are you?”  – If asked this question, many people with BPD would be unable to answer and will only be able to reply with – “I don’t know”, “I’m not sure” or “It depends on who I’m with.”  This uncertinaty makes them feel empty and lost, confused and lonely.

Considering that identity is comprised of stability, continuity, understanding and acceptance of ones self over time, it is painfully obvious to see why this doesn’t happen in the self identity of someone with BPD.Nothing is stable, everything is changing and totally reactive; all that is left is a fragmented self left with a chronic feeling of inner emptiness caused by the inability to integrate into a coherent sense of self identity.

These unanticipated changes can range from relatively minor things, such as changes in appearance, to aspects central to the life of the individual, such as gender, sexuality and life goals.

People with Identity disturbance may experience:

Experiencing frequent changes in sense of self-worth.

Difficulty committing to roles and occupational choices.

Feeling conflicted or unsure about own gender or sexuality.

Feels as though he or she is a different person depending on who they are with.

Does not know who own self is.

Tends to feel empty inside – hollow, something ‘missing’ and a desire to fill the void.

Who they would like to be are unstable and ever changing.

Views & feelings of self change rapidly or unpredictably .

Has memories only available under certain states sometimes feels unreal.

Tends to feel like a “false self” whose social persona does not match inner experience.

Some of the noticeable changes for those who know the person with the identity issue are:

Lack of consistently invested goals, values, ideals, and relationships.

Their personality changes dramatically periodically.

They are “chameleon-like” depending on who they are with.

Values tend to change frequently / does not seem to have a constant set of core values.

Difficulty choosing and committing to an occupation.

Beliefs,actions and behaviors often seem contradictory.

Has trouble committing to long-term goals or aspirations.

As a way to ‘fit in’ they may:

Identity seems to revolve around a “cause” or shifting causes.Defines self in terms of a label that provides a sense of identity.Depend on relationship to a charismatic other. Tends to be in the orbit of a strong personality.People with BPD can be very “chameleon-like” in an effort to integrate.

The tendency to confuse one’s own attributes, feelings,and desires with those of another person, especially in intimate relationships, means that when a breakdown in a relationship occurs it can lead the person with BPD to fear a loss of personal identity.

The large inconsistencies in behavior,over time and across situations, lead to difficulty integrating multiple representations of self, a lack of a coherent life narrative or sense of continuity over time;and a lack of continuity of relationships that leaves significant parts of the BPD’s past “deposited” with people who are no longer part of the individuals life , and hence the loss of shared memories that help define the self over time.

One contributing factor to borderline identity disturbance is dissociation.  When we compartmentalize our experiences rather than integrating them into one meaningful whole, our sense of self fragments causing  us to feel lost, empty, and confused.

As this empty feeling and loss of inner self becomes more problematic and chronic (in some cases) a refuge world or fantasy self can at times take the stage by means of dissociation from the painful reality the BPD is forced to live in if they remain in their current state consciousness/awareness – making it similar but not the same as DID  – Key points of difference are that those who suffer DID (dissociative identity disorder) usually remain unaware of their other fragmented selves (referred to as alters) which are more concrete, unique individuals, accompanied by blacked out memories/loss of time, whereas BPD’s remain more coherent through their changes in persona.

Identity disturbances in individuals with BPD usually reflect efforts to preserve a sense of self-worth in the presence of interpersonal turmoil.

Because of the inconsistencies in what the person with BPD is doing and saying, non BPD’s may accuse them of “faking it” “Lying” or “putting it on” but this really isn’t the case, they just may not be aware of it and by saying these things to them may actually hinder their progress in changing thier behaviour by making them doubt themselves,their worth and their relationship with you and others.

Other issues that may arise are eating disorders, substance misuse or reckless/impulsive behaviours, (these may also a seperate issue for people with BPD regardless of whether or not the have identity disturbance); all which may feel like a form of control over their lives that they are lacking in other areas.

If you have the associated,emotional instability,impulsive behaviour and black and white thinking of BPD you may have difficulty forming a coherent sense of self because your internal experiences and outward actions are not consistent. In addition, many people with BPD come from chaotic or abusive backgrounds which may contribute to unstable sense of self. If you determine who you are based on others’ reactions to you, and those reactions have been unpredictable and/or scary, you have no framework for developing a strong sense of identity.

However, it’s not all bad, on the positive side of things not knowing who you are allows you to start from scratch, experiment, explore and to build yourself up into the person you want to be!

So how do we tackle this issue and find out who we are?

Treatment/therapy with a trained professional is the most highly recommended way to deal with these issues as they can help to guide you through the process of self discovery; but there are also things you can do yourself too.

One way is by observing your own emotions, thoughts, and feelings, in addition to others’ reactions to you.

Questions and reflection on things like:

How do I want to be seen by others?

What are the things most imporant to me?

Who do I admire and what positive traits do they possess that I respect and could incorperate into my own life?

What am I passionate about?

What talents/attributes do I have?

Another way is to try and work out which areas you would like/need to focus on by writing a list which includes:

Intimate

Relationships

Parenting

Family

Friendships/Socializing

Education/Personal

GrowthCareer

Recreation

Spirituality/Religion

Physical Health

Helping Others

Goals

Values

How would you like to act/react to each section? What can you do to make this possible?

These are the things that help to give us identity and allow us to form a more stable sense of self. Due to the complexity of the issue, the road to ‘finding yourself’ is a life long journey of discovery and one which may take you to some upexpected, intense and even pleasurable places emotionally!

No one can tell you who you are, they can discribe you but ultimatly it is up to you, you are the one who can make the changes, the one who can decide as to how you act and what you believe and stand for.  Who/whatever you decide to be/do, remember that you are worthy of love, to be treated with respect and to live a life that you want and deserve.

I hope that this helps explain a little of what and why we feel this way and, fingers crossed, we can start to finally build the jig-saw of ourselves that has been in so many pieces for so long! ~ Emma.”

The Bernard Bert

 

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Make BPD Stigma-Free! words of poetry…..

There is hope after despair and many suns after darkness~Rumi~

 

 

This post is about highlighting the work of a woman who is making it her mission to dispel the myths surrounding Borderline Personality Disorder as well as mental health issues in general.  I find most everything she writes about spot on as far as the struggles the traumatized face in their journey to become whole.  Joyce maintains a blog, Make BPD Stigma-Free!  on WordPress as well as a Facebook page.  It is worth taking a look-see if you or someone you love fights the good fight against mental illness.

And I would encourage readers to take this one step further.  Look deep into these words.  Try to see past the fear you may feel when reading such powerful messages from a dark place within a person.  See if you can connect with their fears, desperation to express and be heard, deepest desires to be whole and worthy.  I believe we can begin to work past our fears of mental illness and all its implications by reading poetry such as Joyce’s.  Inside, there is a beautiful being speaking some tough but enlightening truths.  If you can get past those fears, see the traumatized person with love, the outcome can be the highest expression of divine compassion.

*****

Every morning, I put on my armour,

To protect me from their poisoned tongues,

Each arrow pierces my soul,

 

With each one I die a little more each day,

How much dying can one take till they are truly dead?

 

I am not full of life,

I am not dead,

I am numb and feel nothing.

I am past feeling the pain,

Eventually you don’t feel anymore.

 

How does one feel so hollow, so empty?

A shell of a person?

 

How do you get past pain to nothingness?

How do you feel less than nothing?

 

What a curse it is,

To take on the world’s pain upon your shoulders,

Their anger, their fear,

 

To feel the darkness of a million souls,

All screaming in your head,

And filling your heart.

 

To feel it as your own.

 

And you can never stop the floodgate of emotions that wash over you,

Consuming you,

Draining you.

 

Dragon flames licking at your heels,

As you try to climb out of the hell that’s your life,

Only to be pulled back by your demons to be tortured anew,

When will it end?


– By Joyce Savage.


the letters in my life….

Recently my life has been a world salad.

My family and I have recently been throwing around letters of treatment modalities combined with prospective and already assigned diagnosis.  In an effort to be an well informed consumer as well as keeping our minds and hearts open to whatever ensures that our family and I are getting the most help, we’ve tried many therapies.  Some more interesting and helpful than others, we’ve journeyed down the road full of letters and abbreviations designed to add brevity to a complex and confusing situation.

These recent conversations in our home were very timely accented by a thread on Facebook where Terri, owner at Bone Sigh Arts, asked  her audience what therapies helped the women survivors….I feel compelled as always, to help my fellow woman survivor and this is a partial list from that thread with some of my own thrown in…

  • EFT ~ Emotional Freedom Technique ~ Gary Craig
  • NAET ~ Nambudripad Allergy Elimination Technique ~ created by Dr. Devi Nambudripad
  • DBT ~ Dialectic Behavior Therapy ~ created by Marsha Linehan
  • Energy Medicine ~  created by Donna Eden
  • Herbal remedies for physical and emotional conditions
  • EMDR ~ Eye Movement Desensitivation Response
  • IB ~ Inner Bonding ~ created by Margaret Paul 
  • Hypnotherapy
  • Cranial-Sacral Therapy ~ John Upledger

Homeopathy, acupuncture, massage therapy and the list goes on of top notch healing modalities….

Now here are some of the letters attached to me….SA (sexual abuse) survivor, PTSD (post traumatic stress disorder), DID (disassociative identity disorder) , CFIDS (chronic fatigue and immune dysfunction syndrome), LD (Lyme disease), EBV (Epstein-Barr) and the recently suggested but not confirmed BPD (borderline personality disorder).

I prefer to think that these letters will set me free instead of inducing more confusion although the process of maneuvering through them can be confusing.  I am putting this post mostly for reference, there aren’t any conclusions here.  I have found that the technique is as almost as good as the practitioner.  For example, my NAET practitioner is excellent.  She is kind, intuitive and skilled out the whazoo.   The woman who did EMDR for me was just okay and I didn’t pursue working with her.  One has to follow their instincts strongly here and find a practitioner that you can trust implicitly when doing this type of work.

Next week, I begin working with a woman (who was a fabulous fit by the way) who will be teaching me DBT.  It’s high success rate makes it not only a perfect technique for those with BPD but for many less labeled individuals.  We begin our work even without the controversial label of BPD which actually is one reason I agreed to see her.  She isn’t interested in the diagnosis just the outcome.  That sealed the deal for me.

Just to cover all the bases and to shut some people in my life up, I saw my MD/psychiatrist who yawned and scratched his face when I told him of my plans to start DBT and did he think I had BPD.  He didn’t really answer me but asked me if I had a firm, concrete plan for my suicide to which I replied no.  He handed me some anti-depressant samples and told me to come back in a month.  My answers hadn’t compelled him to jump to any conclusions nor hospitalize me.  I can’t say that I was disappointed by his lack of conclusion because it was pretty much the way I saw it too.  His apathy may have done me a favor.

That doesn’t mean I don’t know that things are amiss with me sometimes.  One can’t go through this type of trauma and not come out with swiss cheese for a brain on occasion. My family and I have been through times of hell that forced growth and compassion on us whether we liked it or not.  DBT (dialectical behavior therapy) has as one of its cornerstones the concept of radical acceptance which I immediately latched on to.  It feels really kind to learn to accept myself for exactly as I am and because of what I have been through.  What a beautiful thought to understand the strengths and limitations brought to me by this situation, accept it and go on to be the best person I can be.  And of course, my hope that my family and friends also learn the concept of radical acceptance but its not required for my success.

And by the way, this work takes time.  One of the mantras that I hear over and over from sensitive practitioners and support people is that it took a lifetime for us to get this way so be patient with the recovery.  Its so true for me that being gentle with myself has been one of the most important approaches to these life changing therapies that I would place very near the top.  That and a good dog.

This post touches on many, many topics.  Digest them slowly, stay informed and be gentle with yourself.  Otherwise you may find yourself drowning in word salad.


Are you isolating yourself?

Silhouette of a woman in a cave looking at her...

I get this question a lot.

Probably because I spend a great deal of time alone, in some people’s minds too much. Its not that I want to be isolated, I just find that I am.  In fact, I’ve become an expert on non-isolation techniques, as in, I have figured out how to participate in life beyond my physical and emotional disabilities.

I love being with people. I always have. I see the same traits in my daughter, she loves being around her friends and gravitates toward busy jobs brimming with people.  The best job I ever had was at a women’s clinic where there was this awesome nest of women, all shapes and sizes, backgrounds and beliefs….it was heaven.

Then, came the losses to an already compromised emotional soul, each taking their chunk of me until I resemble a slice of swiss cheese.  The holes are huge and deep and gaping and oozing and I work every day at keeping myself from seeping out all over the place.

Isolation comes when one’s body breaks down, keeping you from your work, livelihood and friends where one begins to fade into the distance. The old adage…out of sight, out of mind is true.

Isolation comes when your family can’t look at who you are anymore, your emotional disease gives them plenty of reason to hate you and not come around, after all, being in pain isn’t pretty no matter how hard you try to gloss it over.

Isolation comes to visit again when faced with your child rejecting who you seem to be and not seeing who you really are.  On most days, I can still pray for her and our broken relationship while reframing the unrelenting ache of how much I want her in my life.

Isolation comes when your partner looks at you differently because the toll of you has surpassed what he expected and what he believes he can handle.  The look isn’t completely devoid of love; resembling more a doggedly loyalty and disappointment as to how life isn’t fair for him.

Its odd how the question of “are you isolating yourself” is presented to me.  Its almost as if I haven’t already climbed the tallest skyscraper to have a full and functioning life.  And it seems that its overlooked that I’ve walked across hot coals and  practically begged myself into different groups of people in order to keep that phobia at bay, forcing myself to hurdle over the fear/anxiety/warped thinking that wants to win and plunging straight into activities that sometimes work out and sometimes don’t.  I know what brings me joy and being acknowledged for who I am and invited to join an activity makes my heart soar.  Especially if it comes from any member of my family.  And that doesn’t sound like someone who tries to isolate herself.

Now here’s the tricky part.  This is where the psychiatric world has been called in to address my pain and isolation.   Its been decided that my love for people is an attachment of a pathological form.  Something I feel as a warm glow from my heart has been labeled as an aberrant way of avoiding my extreme fear of rejection of course, stemming from my childhood abuse and neglect.  My desire to love and not be isolated is now a bad thing.  Its now being presented, rather callously I may add, that I have borderline personality disorder to which in some parts I don’t disagree with.  The message has some merit but the delivery so far has sucked.

Wikipedia defines borderline personality disorder as “prolonged disturbance of personality function characterized by depth and variability of moods”.  It seems to be one of the scariest, time consuming and all around unsatisfying diagnosis for the psychological/psychiatric profession to deal with.   Joke among therapists… “How do you get rid of the annoying, troublesome patient from your caseload?  Tell them they are BPD and they will become so angry they will leave!”  Apparently even the non BPD want to be labeled BPD.  While some people laugh at this, I find this profoundly sad.

Wiki goes on to say that there is concern about social stigma; “the severe disapproval of or discontent with a person on the grounds of characteristics that distinguish them from other members of a society”.  Apparently some members of the profession get that this particularly disease tends to ostracize the very people who are more than capable of doing that to themselves.  Hmmm….I’m getting some irony here….Wouldn’t it make sense to surround these people with love and acceptance for who they are while not enabling the disease.  Aren’t we back to the last post where I ranted about separating the person from their behavior?  Love the person, hate the disease?

Thank the universe for Marsha M. Linehan who has led the field in therapies for the BPD patient and added a whole lot of humanity to their situation.  Dialectical Behavior Therapy (DBT) is proving to be not only the best choice for recovery but accessible to those therapists choosing to change their elitist views on treating the sickest of the sick.  Marsha herself was/is a BPD patient subject to the most inhumane and cruel treatment at the hands of the psychiatric profession.  She schooled herself, becoming a PhD and led the way toward a kinder, gentler way of viewing the sick.

Those closest to me have learned to scorn me in a very obtuse sort of way. If they find me hurting and difficult, they leave.  If others see me alone too much, they say I isolate too much.  If I am anxious about an upcoming separation where I will be completely alone for several days, they tell me I am too attached and fear rejection.  If I object to and confront a situation that feels wrong (even though I’m told to take care of myself and my boundaries), then I’m labeled hostile and aggressive.

And as always, I reflect continually, my behavior, my nuance, the energy I project and constantly wonder….Am I really the crazy one?


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