Nature vs Nurture

[maxsterling]

Just musing here -

While I recognize BPD has a range of cases from moderate to severe, and is described by a symptoms rather than cause, I'm thoroughly convinced that in the more severe cases there has to be something fundamentally wrong in the brain.  I've seen the studies that indicate this, but after my experiences the past few days, I'm more convinced than ever this is more than just a "behavior" problem.  And while it's mentioned here many times sometimes as an analogy, it literally seems that the pwBPD has never grown out of the mindset of a small child. 

I witnessed my dBPD fiancé three times this week completely dysregulate, which culminated in her laying on the sofa, screaming, kicking her legs and flailing her arms.  Exactly like you have seen children throw tantrums in the middle of the floor.  And some of what she was dysregulating over were things like being hungry and not being able to make up her mind what she wanted to eat, just like a child who you try to feed and they refuse to eat anything because whatever you give him/her is the wrong thing.  Other things she dysregulated over were adult annoyances for sure, such as her computer not saving the work she had done, but her reaction and coping mechanism was destructive.

Most kids in the 2-6 year old category act this way.  But for some reason we grow out of it.  I'm not sure why.  Maybe we learn those methods don't get us anywhere.  Maybe something changes in our brain biologically.  Maybe we get good enough at language and realize that is a better tool for solving our problems.   But after this weekend, it seems clear to me that at least in some BPD, for whatever reason they still hold onto those very early behaviors.  In her case, I don't think it is just an issue of not learning that these methods are ineffective.  She's 38, and lost job after job and boyfriend after boyfriend.  And she rationally knows that if she kicks and screams she won't get what she wants.  My feeling is that there is a neurological pathway or chemical imbalance that either releases more of the emotional brain chemical that causes her extreme distress, or her brain cannot constructively deal with that chemical.  We all get angry.  But in most of us, the extreme emotion seems to pass rather quickly, or we don't get so angry to completely overwhelm our rational thoughts (most of the time, at least).  I'm really starting to think that there really is no healing this for her.  She can probably develop conscious methods to help her deal with distress, but the urges to kick and scream will always be there.

I've noticed another thing, too.  When she gets in that state, the only thing that gets her out of it is time.  I think it helps to get her away from whatever triggers her and change the scenery.  But it totally seems like there is some kind of hormone preventing her from calming down - and it needs to simply dissipate.  And once she calms a little - maybe after 30 minutes or an hour or two, then I or someone else can try talking to her and helping her.  Again, much like a child.  Sometimes you just have to let them throw their tantrum, knowing you won't get anywhere with them until they calm down a little.  And the good think is, lately she has acted somewhat remorseful later, and actually apologizing.

Anyway, I'm at work today enjoying the calm and peace and quiet.  I've got a ringing in my right ear from her screaming.  Unfortunately, leaving the house wasn't a good option during the worst of her rage.  She wasn't really directing the rage at me, and she was exhibiting strong self harming behaviors and I thought it best to not leave her alone.

[RELATIONSHIP PROBLEM SOLVING]

RELATIONSHIP PROBLEM SOLVING This is a high level discussion board for solving ongoing, day-to-day relationship conflicts. Members are welcomed to express frustration but must seek constructive solutions to problems. This is not a place for relationship "stay" or "leave" discussions. Please read the specific guidelines for this group.

[KateCat]

It sounds as though her core goals involve being a teacher and being a mother. . . so this is particularly heartbreaking.

[maxsterling]

@Kate.  At least on the face, those are her goals.  But digging deeper, I think her goals are about feeling like she is worth something.  Being a teacher and keeping a job makes her feel like she is worth something and that her life is not a waste.  Same goes for being a mother.  She once told me that she wanted to be a mother so that she would always have someone who loved her and would never leave her.  It's all about trying to fix herself.  The reality is, getting a full time teaching job hasn't made her feel any better.  And I suspect the same would be true of she had a child - maybe temporary relief at times, but the issues would still be there.  In fact, the issues could get worse and her self loathing could escalate.  She seems to feel worse when the tries something to help her feel better and it doesn't work.  In a way, I think she actually feels worse because she is with me.  I'm a nice guy who is supportive, she can't simply dismiss her relationship issues on her partner being a "jerk" anymore. 

There's a harsh and sad reality here that I think she is aware of.  There is no way she can be a productive teacher or mother unless she can manage the stress.  The household environment over the weekend would be traumatizing for a child, and it would be nearly impossible to raise a healthy child with that going on.  And once you get to know her, she is about the most lovable person you could ever meet, but the BPD behaviors scare most people off.  I just wish there was a medication that was effective and simply diffusing the anxiety.  It doesn't seem like she would need much, just something that would work well enough to let her rational brain kick in before she quickly melts down. 

[Mono No Aware]

The human being, when considered for the sake of detail to be separate from the rest of reality, is a design that relies exclusively on a complex electrical-chemical-based control system. In the lump of fattty tissue in it's head is a tangled web of neurons, transmitting to each other tiny electrical signals which are facilitated or suppressed by the presence (in the precise right amounts at the right times) of various chemicals, themselves complex and delicate organic compounds secreted and/or synthesized in the fatty lump or elsewhere in the body... .or out of a bottle, ha ha. These signals form an information matrix, some of which is stored via more signals and chemicals, but is mostly a stream-of-consciousness of the human control system.

Everything we sense, feel, say, think, do, experience, etc - its all neurons firing. Everything.

One critical point is the amazing adaptive and learning functions of the control system. External input not only triggers both hard-wired/pre-programmed/instinctual responses (i.e., "nature) but also examines the continual cause and effect of responses to develop a database of learned behavior ("nurture". The system also employs many-layered fuzzy logic to broadly apply it's lessons to new input. However, the weakness is that during the decades-long growth and development process ALL the external input actually contributes to the growth directions of the system - we know this all too dearly because excessively negative input at early and early-middle stages has been shown to warp the heck out of it.

We don't know the specific details, but we see behaviors that do not occur with a healthily developed system. We figure that certain neurons are firing/not firing properly - the chemicals to fire/suppress them are not hitting in the right amounts or at the right times. We learn that the subject's childhood was alternating neglect and verbal abuse, and observing their current state we see behavior patterns emerge that ring true along the 9 Symptoms of BPD. The control system's development in dealing with attachment/abandonment did not go well, too much extreme negative input during growth times and it's effectiveness at control is now greatly reduced. Perhaps the failure point is not being able to release whatever chemical shuts down runaway paranoid thoughts, or dumping too much panic-transmission chemicals into the system. So "nurture" is at fault.

Now there have been many recorded cases of humans whose control systems went awry even though (ahem, we assume) their development phase contained no extreme abuses - we can only surmise that some genetic fault is the root cause of the seemingly normal person's desires to behead friends and family. So "nature" can be at fault too.

But the two intertwine. Let's assume my uBPDw's grandfather had a wonderful childhood but a defective-from-birth brain leading to giving his normal-brain son a traumatic childhood with harsh treatment and alcoholism... .warping terribly the poor son's development. Time turns, the son grows up to having a birth-normal but development-warped brain leading to give his daughters, normal brains or not, awful traumatic childhoods.

So nature & nurture are two sides of the same coin. There may be some natural defects, and they may propagate along generations right along with the nurturing defects they can cause. We don't really have a handle on the mechanisms here, the source data is always muddled.

This the year 2014. If we were talking about brain surgery instead of brain chemicals, we would be debating using the new-fangled saw or the trusty ol' hammer - that is the current state of our technology in relative terms. We know how to package one or two chemicals in a pill that the patient eats and digests, spreading them thinly over every freakin' cell in the body, hoping that the right amount will hit one exact part of the brain and help fire/suppress certain neurons - temporarily at best - while also hoping that the side effects on the other sections of the brain it also hits aren't too bad. I'm sure many bright people are working on (ahem, profit-goal-oriented) advances in this field, and I look forward to a better future. But in the meantime, I will continue to beat my fatty lump against the same brick wall and steadfastly recommend that my uBPDw go to therapy.