BPD BEHAVIORS: Dissociation and Dysphoria

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[geroldmodel]

It strikes me that the borderliners in our lives have so much negative behaviour in common.

A couple of weeks ago I came to a conclusion that most of that behaviour is due to a single defense mechanism with lots of faces: Dissociation.  I have been reading about dissociation ever since.

Common behaviour:
- Daydreaming, fasing out = dissociation
- depersonalised sex = dissociation
- "Black and White" thinking = dissociation
- Self mutilation, cutting = dissociation
- Remembering things differently than others do, lying = dissociation
- Raging = dissociation

We all have our occasional dissociation in the form of daydreaming, meditation, dancing on music until we get in a trance state... But I believe BPD's do it quite often without having control over it as we do; and their dissociation does not limit itself to occasional daydreaming; it has a lot of different faces.

If the feelings of the BPD do not match the situation or reality, the BPD will alter the situation/reality to the point it does match.  They do this because they do not want to be confronted with their out-of-place feelings.

PS: This is a personal conclusion.  Maybe I see a pattern that is incorrect. Please feel free to comment.


Wikipedia:
Dissociation is a psychological state or condition in which certain thoughts, emotions, sensations, or memories are separated from the rest of the psyche. For this reason, it is sometimes referred to as "splitting."

French psychiatrist Pierre Janet:
The French psychiatrist Pierre Janet (1859-1947) coined the term in his book L'Automatisme psychologique; he emphasized its role as a defensive maneuver in response to psychological trauma. While he considered dissociation an initially effective defence mechanism that withdraws the individual psychologically from the impact of overwhelming traumatic events, a habitual tendency to dissociate would, however, promote psychopathology.

The American Psychiatric Association:
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition considers symptoms such as depersonalization, derealization, and psychogenic amnesia to be core features of dissociative disorders. However, in the normal population mild dissociative experiences are highly prevalent, with 80% to 90% of the respondents  indicating that they have had dissociative experiences at least some of the time. [citation needed]

Dr. Richard Moskovitz
What is the difference between BPD and the spectrum of dissociative disorders?

In normal consciousness, we experience an exquisite and seamless integration of a variety of neurological functions. We are perceiving input via all five of our senses and integrating these perceptions into a meaningful picture of reality. Current experience is also influenced by memory traces from the past that are automatically called into awareness according to their relevance to the present. New memory traces are constantly being created and stored. And we must remember that we are not merely passive recorders of our environment but interact with it via our various motor functions, altering both our surroundings and our perceptions of them. Finally, to distinguish us from the computer on which I record this message, we experience emotions, which further color and individualize the content of consciousness.

Dissociation describes any conditions in which one or more of these functions fail to integrate and are split off or dissociated from the mainstream of experience. The dissociated piece may be a small fragment of a function, for example a specific memory of a single event in time, or it may be of more sweeping consequence, such as amnesia for the essential elements of one's identity.

Dissociation may affect memory creation or retrieval, any aspect of sensory input and interpretation, the capacity to execute motor functions such as movement or speech, and the emotional coloring of experience. The cognitive and emotional aspects of experience can be separated in more than one way. The perception of one's surroundings may be robbed of all emotional tone as in depersonalization. On the other hand, emotion can so dominate consciousness that it blots out current reality as might occur in the flashbacks that occur in Post-traumatic Stress Disorder.

Most of the dissociative disorders that have been defined are well-circumscribed in scope and may, in turn, originate with a single intense or traumatic emotional experience. There may be amnesia covering a specific event or period of time. There may be a discrete alteration of sensory input, such as tunnel vision or even an episode of psychogenic blindness (often interpreted as an unconscious unwillingness to view something painful). Motor functions may be affected as in the paralysis of a limb or an inability to speak (which may be understood as unconscious recognition that something is unspeakable). Such alterations of sensory or motor functions that are not based upon physical diseases characterize the conversion disorders along with pseudo seizures and other non-organic neurological dysfunctions. There may even be apparent alterations of the individual's usual cognitive abilities.

Any of the dissociative symptoms may occur in BPD. Dissociative experiences are a hallmark of BPD. They are generally more varied, more complex, and often more persistent than the single symptoms that characterize many dissociative disorders. All people with BPD dissociate. Only some people who dissociate have BPD.
At the other end of the complexity spectrum is Dissociative Identity Disorder. In Chapter 4 of Lost in the Mirror, I compared multiple personalities to the channels of a radio or television. With this model, the tuner would be governed by current circumstances and emotions, determining which personality would be tuned in at any given time.

About BPD and depersonalisation and dissociation:
http://www.aapel.org/bdp/BLdissoUS.html

About BPD and lying, remembering facts different than others:
http://www.aapel.org/bdp/BLlieUS.html

About BPD and "black and white thinking"
http://www.aapel.org/bdp/BLsplittingUS.html

[daughter1124]

In the glossary of the DSM it says "A disruption in the usually integrated functions of conciousness, memory, identity, or perception of the environment. The disturbance may be sudden or gradual, transient or chronic."

In another thread nearby w/a title something like  "can borderlines be psychotic" - I  just gave an example of my mom's dissociative behavior that I witness last week. I'll see if I can copy/paste it below.

The DSM lists borderlines as experiencing "transient stress-related paranoid ideation or severe dissociative symptoms". The key here, I think, is transient and stress-related. I've seen this in mom, usually when she's flipping out over some perceived abandonment - like when I'm leaving on a vacation OR like now, where she's worried/stressed (and rightly so) about where she's going to be living in the near future (we are looking for some place different, and the anxiety of not knowing the final outcome is flipping her out). But it comes and goes. For example, when we visited a Personal Care Home last week and she was pretty much ok in the car on the drive there but once she got out of the car and went inside, she was so preoccupied w/her own thoughts of worry that she was a bit removed from reality - dissociated. Her focus was so narrowed on herself and her internal worries that she really didn't see the home or appropriately interact w/the people.

I can also recall many occassions, like holidays or special events, where mom has said afterwards that she doesn't really remember the details of the event. This is even when I didn't think she looked too out of it during the event.

Just now reading the definition, I see it mentions memory. I guess that explains it. At those events, she was not so dissociated as I would notice (like last week's trip to Personal Care Home) but her brain was clearly not integrating/merging her memory w/her conciousness and perceptions. Basically, the fact that she was a bit nervous, but not so wigged out that it showed, still had the effect of messing w/her memory of the event.

Another psychiatric glossary that I have calls it a kind of defense mechanism that may defer or postpone experiencing some kind of emotional impact.

[bethree5]

I had periods of dissociation throughout puberty, usually just lasting a few minutes, and not necessarily triggered by anything. (I didn't know what to call it & never shared it w/anyone until I described it to my tdoc later in life-- she ID's it as dissociation).  Sometimes I would get a kind of clammy-hands whirring-in-ears onset, similar to when you're about to faint. Or it would just start instantly. Basically you feel removed from your body & life by a few feet-- almost as if your universe/life was a story unrelated to you, being shown on a movie screen a few feet away. If you look at your hands or feet, they belong to someone else and you know you are not in them. Kind of like the way out-of-body experience is described. I found disassociation terrifying, and eventually learned to deal with it by simply lying down, closing my eyes, and waiting for it to go away!  The truth is I still get it (it just happened today) but I completely ignore it because I know it is similar to self-consciousness-- it will disappear as soon as I am involved in an activity.

[GENERAL ANNOUNCEMENT]

GENERAL ANNOUNCEMENT This board is intended for general questions about BPD and other personality disorders, trait definitions, and related therapies and diagnostics. Topics should be formatted as a question. Please do not host topics related to the specific pwBPD in your life - those discussions should be hosted on an appropraite [L1] - [L4] board. You will find indepth information provided by our senior members in our workshop board discussions (click here).

[rock_scissors_paper_2]

I disassociated for about a year.

It's weird. It's actually really pleasant in a way.

Imagine an emotional crisis as being like the turbulence of a raging sea, and disassociating as sinking into the quiet oblivion below. You just give up the struggle and let yourself go.

When you start trying to resurface, though, it's like getting the bends if you come up too fast. Because all that trauma is still there, it didn't go away. And now you have to deal with it all at once.

[Numbnut]

My BPD ex-fiancee had classic disassociative episodes, where she would start one of her uncontrollable rages, screaming and wailing at me and then, after I fled for my safety and returned the next day, would claim not to remember anything of what happened.  Those were generally accompanied by drinking too.  On one occasion where she physically attacked me and caused my arm to bleed, she didn't even believe that the episode happened, until I showed her the marks the next day.  Scary.

[Numbnut]

I believe that the difference between a disassociative episode and a psychotic break is one of degree.  Disassociative episodes are "blackout" type experiences, in general, while psychotic breaks are literally where the person is manifesting psychotic behavior and disconnection from reality and not necessarily accompanied by a blackout, although often is.  When my current g/f gets home (who ironically enough is a clinical psychologist (Ph.D) who works with many borderlines albeit in an eating disorder context) and see if she can shed more light on it.

[Alana]

Hi folks, I didn't see this thread til just now, and thought I'd add my perspective. From what I've read about dissociation (& derealization) there can be chronic and short term dissociation. Neither are amnesia-like usually, but the person's perspective is altered so, memories can be different than what others remember.

I have had chronic dissociation since my childhood. I remember exactly when it became permanent, but am no longer sure how old I was. Until recently, I thought I was 11 or 12, but now I think I must have been 8 or 9. I was very scared when it wouldn't go away, and told my dad, but it was never discussed again. Soon, I just accepted it as me, and didn't think about it for years (decades?) at a time. (I'm 43.) I had no idea what it was until a few months ago.

I assume that everyone who has this is slightly different. But I'll try to describe my experience. It's like living in a 3-D movie that I can interact with. It's not my senses per se, but it is more centered on my vision than hearing or touch. If I close my eyes, and concentrate I feel closer to reality. When it first began it was episodes that I could 'pop' out of. I would have to concentrate really hard on something that I could see, and 'convince' myself that it was really there in front of me. When it worked, it was like a light switch. 'Pop'. All at once, everything became more vibrant and 'closer', if that makes any sense at all. Imagine wearing tinted glasses all day long, then taking them off.

When it became permanent, I couldn't pop out. It was late in a chaotic day, and I was very tired. And I thought that maybe it would just be gone in the morning. It wasn't, and I could never get out again.

I will say that I am very emotional, even though I am chronically dissociative. It's hard to for me to imagine that this blunts my emotions, though I guess it does. (Scary thought.) Now that I know what my problem is, and that it is possible that I can break free from it, I'm trying to do that. I am also now aware of 'the veil'  most of the time. You'd think I'd have known this before, but the intensity varies quite a bit. I have come close to breaking through once, and I was suddenly terrified, and pulled back. Other times I feel that it's very 'thick', to the point that it's hard to concentrate. (It's similar to how you might feel under severe sleep deprivation.) That has happened most frequently as I read books related to BPD, sometimes when reading here, and when I'm with my T.

Anyway, I hope this helps someone understand more what chronic dissociation feels like. I feel like I've 'outed' myself. This is not something I've talked about much. My dad when I was a kid, and my H and my T just recently. I didn't go into this kind of detail though. Frankly, it so weird and hard to understand and embarrassing (?), that it's not something that most people would want to know about anyway.

Alana

[turquoise]

Technically dissociation is defined as follows:  The capability or process of separating thoughts, emotions, affects, or experiences from one another either purposely or involuntarily.

For BPD's it is usually a defense mechanism.

Allow me to copy and paste dissociation vs BPD from this French BPD site.

Turquoise


DSM / Dissociation in borderline disorder

During periods of extreme stress (e.g., perceived or actual abandonment), these individuals may experience transient paranoid ideation or severe dissociative symptoms (e.g., depersonalization).

BPD Central

Dissociation is the state in which, on some level or another, one becomes somewhat removed from "reality," whether this be daydreaming, performing actions without being fully connected to their performance ("running on automatic"), or other, more disconnected actions. It is the opposite of "association" and involves the lack of association, usually of one's identity, with the rest of the world.

Data studies (statistics, prevalence, comorbidity, co-occurency)

"The percentage of patients with borderline personality disorder who also have dissociative identity disorder is unknown"

"It is estimated that one-third (33%) of patients with dissociative identity disorder also have borderline personality disorder"  (apa)

* van der Kolk BA, Hostetler A, Herron N, Fisler RE - Trauma Clinic, HRI Hospital, Brookline, Massachusetts
1994 Psychiatr Clin North Am - Trauma and the development of borderline personality disorder.

Dissociation have a high correlation both with the degree of borderline psychopathology and with the severity of childhood trauma

Dissociation is a way of coping with inescapably traumatic situations by allowing the person to detach from the reality of the situation. Often there is a loss of the memory and the relief of pain for the situation, the person can feel numb or spaced out. For some people this becomes a conditioned response to stress even if the situation is not inescapably stressful

* Jonas JM, Pope HG.
1984 Psychiatr Dev- Do patients with borderline personality disorder (BPD) display psychotic symptoms as part of their syndrome?

Broadly defined psychotic,symptoms, such as depersonalization, are much more often reported in BPD, but many of these symptoms have also been reported frequently in patients with non-psychotic disorders and in normals. Thus, the evidence for psychotic symptoms in BPD remains equivocal.

* Zanarini MC, Ruser T, Frankenburg FR,... - Lab Study of Adult Development, McLean Hospital, Belmont, MA
2000 Compr Psychiatry - The dissociative experiences of borderline patients.
290 borderline patients. Result : 42% with a moderate level of dissociation, and 26% of BPD patient have a high level similar to that reported by patients meeting criteria for dissociative disorders

When, how ?

"Cutting often occurs during periods of dissociation.
I have a personal belief that dissociation, when it occurs with BPD is actually a panic symptom" (mhsanctuary.com)

"Dissociation occurs in certain personality disorders (eg depersonalization during self-mutilation episodes in borderline personality disorders) as weel as in eating disorders (eg derealization during binging episodes) etc." (Alain brunet Ph D 2001)

"There's always hope. Sometimes the mind disconnects from the body. This is called dissociation. Those are times when the body being hurt does not look or feel to be your own. It is hard to stop. With treatment, dissociation can be relieved, especially with DBT" (Melissa Ford Thornton: Author of the book: Eclipses: Behind the Borderline Personality Disorder)

"Often when something does hurt, or frighten them they do not know why. Much of the borderline experience carries with it differing levels of dissociation. This means that borderlines often experience things in the present as if they were things in the past. A sudden loud noise outside, for example, which likely has no consequence in the borderline's life, in the present, will be perceived as a threat" (Ms aj mahari)

"In some of the more severe individuals with bpd there is a complete fragmentation.  It becomes really confusing since so many statements and behaviors appear to be contradictory" (Kathi Stringer)

"BPD - Some individuals develop psychotic-like symptoms (e.g., hallucinations, body-image distortions, ideas of reference, and hypnagogic phenomena) during times of stress" (HealthyPlace)

Aapel view of dissociation and borderline personality disorder

Here is our feelings about dissociation and BPD

For us, the BPD diagnosis does not include Dissociative Disorder

In our thought, that's mean that "only BPD" people don't have multiple personalities (each personality ignoring the other(s)

In a more clear way a BPD person is not "several persons in one body"

Bpd people doesn't know who he is, he seems to have several personalities, but in fact he's looking for its personnality.

When he is docteur Jekyll he knows this and remember that when he is mr hide  (and the opposite)

It is the mood swing which create the feeling that he has both personalities, but they aren't
Dissociative episodes

In our opinion bpd people can experiment dissociative / depersonalization episodes in these circonstances

- Child trauma (empty memory. Sometimes the trauma has been "erased" from memory)
- Self-harm , self mutilation, self injury (no pain during cuting, burning, scratching...)
- Suicide attempt
- Bulimia
- Dysphoria(out of his mind)

We are also asking ourself if BPD people could have transient dissociative episode during panic attack (rage attack)
The answer seems "yes"

http://www.aapel.org/bdp/BLdissoUS.html

[Alana]

For BPD's it is usually a defense mechanism.

"It is estimated that one-third (33%) of patients with dissociative identity disorder also have borderline personality disorder"  (apa)
* van der Kolk BA, Hostetler A, Herron N, Fisler RE - Trauma Clinic, HRI Hospital, Brookline, Massachusetts
1994 Psychiatr Clin North Am - Trauma and the development of borderline personality disorder.

For anyone, dissociation is a defense (coping) mechanism.

Alana

[Clouded North]

My T is very experienced in the complex trauma (C-PTSD) disorders which can be very similar to most personality disorders.  Not the same as PTSD.  She is very familiar with dissociative symptoms and says it's very likely with people who have experienced complex trauma in their early childhood are dissociating on a high-functioning level when experiencing stress in their lives...and can account for the feeling that we nons feel we "don't exist" at times...b/c we really don't to them.  My T has mentioned this before to me while I was involved with my ex the other times I would just not hear from her for days...I used to take it very personally, but learning to just be content with the fact that it had nothing to do with ME, and everything to do with her disorder(s)...as a result of her childhood trauma (which was very disturbing).

[snowwhite]

I have pictures of my ex-husband (BP) when he is dissociating while standing next to me.  You can actually see on his face that he is just not mentally there.  I cannot imagine what the stressful part of the situation was since we were spending the 4th of July at an amusement park with my family. 
I also remember passing him in the hall of our home when I swear he did not realize I was there.

[Serenity.]

Another interesting thread.  I too can relate to this.  My xbf specifically told me that he cannot remember 2 years of his childhood.  He has absolutely no recollection.

This IS a very interesting topic especially since ex was diagnosed with dysphoria.

My ex said he couldn't remember many years from his childhood either. He doesn't remember anything before the age of 11 (that's the age he was when he told me his father tried killing himself).
Makes you wonder exactly what went on in that house!

[colonel]

Hi, I want to know about developing alters while disassociating. I understand the spacing out and detaching thing from stressful situations. I saw and was told about that numerous times with my bp friend. That seems to be a common bp thing. Recently though she was given a diagnosis of Disassociative identity disorder as well as bp and now suddenly after that diagnosis she has alters. Separate identities inside her each with different names and slightly different personalities. It's weird. she doesn't even call herself by her own name now but has made up a new identity. Says the original person, who she actually is before all this crap developed and still is,  couldn't cope went to sleep inside her and never woke up. So now this new identity and others look after her. I'd really love some info on this or comments from anyone that has experienced something similar because at the moment I can't really find much that explains it. I don't even know if it's a real thing or something she's made up, on one level part of me thinks it's made up but I don't know enough info about this form of disassociation to know anything for sure about it.

[geroldmodel]

Found a diagram explaining cutting and dissociation.



Source http://www.selfharm.org

[Serenity.]

I don't even know if it's a real thing or something she's made up, on one level part of me thinks it's made up but I don't know enough info about this form of disassociation to know anything for sure about it.

No, they're in a lot of pain. It's real to them. They're confused and hurt inside. I think when they disocciate they can't deal with the hurt (perceived usually) in front of them. BPD is a serious and very real, painful illness. My heart breaks for my ex but he showed me too much hell to stick around.


Geroldmodel,
Thanks for the info on dissociation. I saw this time and time again, also my ex explained this to me. He said he went to his warehouse to drink as much as he could to deal with his pain when he would bolt out on me to stop his pain.

[geroldmodel]

she doesn't even call herself by her own name now but has made up a new identity. Says the original person, who she actually is before all this crap developed and still is,  couldn't cope went to sleep inside her and never woke up. So now this new identity and others look after her. I'd really love some info on this or comments from anyone that has experienced something similar because at the moment I can't really find much that explains it. I don't even know if it's a real thing or something she's made up, on one level part of me thinks it's made up but I don't know enough info about this form of disassociation to know anything for sure about it.

That sounds like Multiple Personality Disorder, which is an extremly rare disorder... the most extreme form of dissociation disorder.

[colonel]

hey geroldmodel - disasociative identity disorder is the new name for multiple personality. Apparently they disassociate to the extreme so much so that they need new identities or "alter's" to keep them functioning. I know a number of bp's have disasociation in terms of not feeling connected to themselves and numb but mine seems to have taken that to a whole new level. Just another thing for both of us to learn to cope with :

[StayingAfloat]

Thanks Joanna.  I never ran into this workshop until now.

I've long thought that much of BPD can be credited with dissociation. It seems very apparent to me that our pleasant, loving BPDs have to dissociate in order to rage.  Otherwise, how could they feel ok about themselves while they're obviously causing great harm to the people around them, whom they depend on?

And once they're done raging (or having whatever kind of meltdown), on their way back from the dissociation... they end up dissociating again, because their minds can't cope with how much pain they've caused others.  So they find a way to dissociate from that t0o.  I think that's why it's such a terrible cycle...  BPD causes them pain, they dissociate which causes themselves/others more pain, so they dissociate further.  It really is a black hole that is incredibly difficult for them to climb out of; I can only imagine.

For us nons, it leads to a lot of unresolved feelings of bitterness and resentment, because our feelings never get dealt with by our BPDs.  Because it causes too much pain, and they detach.  And we keep hanging on, hoping that they'll magically take responsibility for all of the terrible treatment they give us.

When really, we need to be taking care of our feelings instead of hoping they will take care our feelings for us.  They can't...

[Peaceful.]

I wonder if what I was witnessing recently in my wife is dissociation, or if it just some new meds, or the only way that she can remain in control through a difficult time - by checking out?

When talking through mediation or issues with me, she appears to have on a very tranquil mask, slighly monotone, uninterested...not entirely with it.

I plan on doing some research, but just wanted to see what others know about dissociation.

• It is a violent process, or something subtle?
  
• Can it be recognized?
  
  • Can it be controlled by the person with BPD?
    
  • Does it last a long, or short time?

[Ruby_Slippers]

Peaceful; With Therapy, better coping skills and routines, some BPD's can learn to control their dissociative episodes. My husbands events were all stress induced (perceived or real). He would sort of glaze over, start to sway and slow sink to the floor. It was very frightening to witness. Before he was finally diagnosed with BPD we went through several years of medical tests, numerous medications even wearing a heart monitor...no one could find a medical explanation.

At it's worst he was hospitalized with what they diagnosed as transient amnesia. He did not know where he was, who he was or who I was for 4 days. Slowly things came back but not the memory of what happened to him.

I hope this is helpful to you. I will keep you both in my prayers.

Ruby