The Processing of Praise for pwBPD

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Latest Neuroscience findings

Dr Jill Hooley, Professor of Psychology at Harvard University, presented very recent neuroscience research on significant differences in brain activity for people with BPD when compared to a normal population sample.  In the anterior cingulate, an area of cognition and attention, there is no activation for a person with BPD, as compared to significant activation in the normal population when praise is given.  The praise goes nowhere, effectively.  In the insula, an area of introception, providing feeling in the body, there is significantly less activation. The area of rewards and punishment, the putamen and the caudate, shows initial activity in the caudate; however, it  drops off sharply just as the area is being activated.  The putamen is virtually shut off, compared to great activity in this reward area for the control group.  People with BPD do not feel praise, they are not attentive to it and so the social world is experienced as far less rewarding.  These unique BPD neurological underpinnings explain Will's ephemeral nature, his enjoyment to simply observe and to enjoy that stance.  He was a born mystic, a shaman.

Other recent neuroscience findings on the connectivity of the anterior cingulate to the amygdala were presented by Dr Konigsberg, Professor of Psychiatry at Mount Sinai School of Medicine.  This region is responsible for emotional control mechanisms.  People with BPD do not habituate to negative experiences, meaning that people with BPD find it much more difficult to get used to difficult situations, compared to the normal population.  The shaman concept resonates again, as shamans and mystics were always protected and sheltered from the hurly-burly of daily life. 

In the presention, Abnormal Affective Startle Habituation to Cue-Specific Unpleasant Pictures in BPD, Erin Hazlett, Research Professor of Psychiatry at the Mount Sinai School of Medicine, demonstrated the mis-match between what people with BPD  say they are feeling and what they are actually feeling physiologically.  In fact, borderlines experience an excessive reaction to emotional stimuli.  They tend to say the feeling is less aversive than what they are actually feeling.

This is all info from the NASSPD/NEA-BPD conference.  This is info I copied, so I am hesitant to post until I have the hard copy, but the key details are accurate.

I thought this information was so interesting and shed light on pwBPDs behavior and struggles.

Reality

[Reality]

Latest Neuroscience findings

Dr Jill Hooley, Professor of Psychology at Harvard University, presented very recent neuroscience research on significant differences in brain activity for people with BPD when compared to a normal population sample.  In the anterior cingulate, an area of cognition and attention, there is no activation for a person with BPD, as compared to significant activation in the normal population when praise is given.  The praise goes nowhere, effectively.  In the insula, an area of introception, providing feeling in the body, there is significantly less activation. The area of rewards and punishment, the putamen and the caudate, shows initial activity in the caudate; however, it  drops off sharply just as the area is being activated.  The putamen is virtually shut off, compared to great activity in this reward area for the control group.  People with BPD do not feel praise, they are not attentive to it and so the social world is experienced as far less rewarding.  These unique BPD neurological underpinnings explain Will's ephemeral nature, his enjoyment to simply observe and to enjoy that stance.  He was a born mystic, a shaman.

Other recent neuroscience findings on the connectivity of the anterior cingulate to the amygdala were presented by Dr Konigsberg, Professor of Psychiatry at Mount Sinai School of Medicine.  This region is responsible for emotional control mechanisms.  People with BPD do not habituate to negative experiences, meaning that people with BPD find it much more difficult to get used to difficult situations, compared to the normal population.  The shaman concept resonates again, as shamans and mystics were always protected and sheltered from the hurly-burly of daily life. 

In the presention, Abnormal Affective Startle Habituation to Cue-Specific Unpleasant Pictures in BPD, Erin Hazlett, Research Professor of Psychiatry at the Mount Sinai School of Medicine, demonstrated the mis-match between what people with BPD  say they are feeling and what they are actually feeling physiologically.  In fact, borderlines experience an excessive reaction to emotional stimuli.  They tend to say the feeling is less aversive than what they are actually feeling.

This is all info from the NASSPD/NEA-BPD conference.  This is info I copied, so I am hesitant to post until I have the hard copy, but the key details are accurate.

I thought this information was so interesting and shed light on pwBPDs behavior and struggles.

Reality

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[Rapt Reader]

Thank you so much for this info, Reality... .   My dBPDs36 has his 3rd Neurofeedback Therapy session tomorrow (Tuesday), and I think I might send his Therapist this information... .   She is VERY good, passionate about her work, and I think he's responding positively (though lots of his miserable BPD symptoms are still intact). She's worked with patients with the rest of his many diagnoses (ADD, Clinical Depression, Social Anxiety, SI issues, past SA issues), but never with someone actually diagnosed with BPD, so she's actively researching with her Mentor who has more experience than she does in order to help my son as best she can. What you've posted does seem relevant, and will be interesting to her I'm sure

[BioAdoptMom3]

Wow, what you have posted here could explain something!  A couple of months ago 13 y/o DD was at a church choir rehearsal helping prepare for an upcoming music festival in our church.  She is a member of the choir and was accompanying the choir on her oboe for 3 pieces of music.  After the instruments rehearsed, the choir, while she was still standing proceded to ask her questions about her age, her grade, etc. and were telling her how marvelously she played, that she sounded like she was in HS and such.  A few minutes later she sat down to rehearse while I waited.  Within about 10 minutes she was motioning for me to take her home, looked like she would cry any minute.  I took her and she did cry most of the way home.  I couldn't explain it other than to assume she was calming down after playing though she normally doesn't get very nervous when she plays or sings.  The next day she told a friend how upset she had become when the choir kept talking to her, said they made her feel uncomfortable.  Based on what I just read it sounds like she probably couldn't process the praise.  No wonder she was so uncomfortable!

[sunshineplease]

Hey, BAMom3 -- Same type of thing here! My ud18 used to play violin beautifully, and any praise just seemed to freak her out. I think she knew she "should" be happy to hear the nice words, but they never landed well. Who knew?

[Rapt Reader]

Hmmmmmm... .   same thing here with dBPDs36~~He's a VERY talented artist who everyone thinks is gifted. His self-esteem is so on the rocks that he hasn't picked up a paintbrush in months. Doesn't matter WHO tells him his work is great; it's not perfect so he won't believe the praise from anyone... .   This really could be at least one reason. Amazing how this info seems to feel somehow "right" to so many of us 

[griz]

Count me in on this one.  DD has many talents.  She is a fine artist and and wonderful writer.  When she was in her first year of HS the director of the school literary magazine asked her to train as the editor after seeing one of her pieces. She never wrote another piece for the magazine.  I find if I compliment her on something she finds a way to deflect the compliment.  Not being able to process this makes so much sense.  She is most happy when she is drawing or writing and no one sees it. She has even told me that complements make her very uncomfortable.

Griz

[Reality]

Yep, my son was truly a star, handsome, tall, intelligent and very funny, not to mention loveable, yet he thought he wasn't good at anything.  He never processed praise.  Now I know.  

Plus he never expressed the level of intense emotions he was feeling, so we didn't know how much emotional pain he suffered.  I know this now, because I suffer truly unbearable physical, emotional pain from the grief of losing him and yet I never harm myself in any way.  So that tells he that he was in truly unbelievably intense emotional pain when he cut himself.  So tragic... .

Reality

You know, griz, she hears the words, yet she can't process the information.  It must feel very spooky or at least strange to hear something and not know, feel or process the meaning of the words.  No wonder they feel badly about themselves.  The praise, the nice compliments don't touch our children.  In a way, they do live in an alternative universe, don't they?  

[Rapt Reader]

Wow, Reality... .   I'm so sorry for what you've had to go through; that really is the worst thing in life for a parent to have to deal with :'(  I often wonder how I'd deal with it, myself, if my son ever ended up going through with his SI when he's in that dark space... .   It's very generous of you to share your story, and to provide all the insights and information that you do. Thank you, from the bottom of my heart   

[Reality]

Hi Rapt Reader,

Thank you for your kind words.  I was trying to point out how disconnected the outside appearance is from the inside reality of a pwBPD, in terms of the intensity of emotional pain. 

I am convinced that my son experienced more emotional pain than I am feeling, even now.

I think he isolated himself, to restrict the imput from outside, so that he could protect himself from negative experiences which he would have felt more acutely than others.  It makes sense. 

Reality

[crazedncrazymom]

This is amazing and confirms what I've always seen with my daughter.  I've never seen her beam happiness when she has been praised.  It's like there is no difference when I say wow! that was wonderful!  You are so good at... .   and please pass the butter.

[griz]

And then SI makes sense.  The ability to actual feel something. Something that brings out an emotion. 

Griz

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[mamachelle]

This is amazing and confirms what I've always seen with my daughter.  I've never seen her beam happiness when she has been praised.  It's like there is no difference when I say wow! that was wonderful!  You are so good at... .   and please pass the butter.

Thanks for this great insight Realty and all others.

So that is why, when we used to "try to catch SS10 being good" It never worked.  a haa moment 

[Reality]

griz,

They do process aversive feelings, big-time.  They never habituate to negative events.  Yet, they do not process praise. 

I can't figure out what you mean with your last post.

How does SI make sense from this perspective? 

If you have a minute, could you clarify for me, please.

They feel pain big-time, so maybe the SI is a way to express the pain because they can't do it verbally.  One of the research projects showed that their verbal expression of pain does not fit the actual intensity of pain they are feeling.  They are feeling way more pain than they express with words to others.  Maybe the blood is the art-medium, the way to tell the story, to express the terrible pain.  To me, this makes sense.  Almost a primordial art expression.

Reality

[griz]

I was thinking along the lines that when the hear praise or positive words and they don't have the ability to process it there is an absence of emotion. ie:  I should be feeling something but I am not.  I need to feel an emotion so I resort to the one I can feel: be it pain, anger, fear.  The need to feel.

Griz

[Reality]

Thank you, griz.  Yes, that makes sense.

Reality

[mikmik]

Reality,

I think this may have already been tied in a bit.  But our pwBPD are such keen observers.  They see everything, sense everything (sometimes to degrees we can't fathom).

I wonder, if seeing the joy (what is joy?) others experience at receiving praise, how it boosts self esteem in OTHERS is a "clue" to our pwBPD in how they "should" feel when receiving praise, and when the contray occurs within them, is doubles the angst.  They observe the joy in others, and see the reaction in others, it is positive.  And I do think our kids crave the positive.  When they get praise, the lack of "joy" (or as griz says, is replaced with other feelings) derails them.  It causes them pain, not joy.  They must wonder, why does Suzy smile and giggle and lap it up, and why does praise make me want to hide under the table and cry?  It shuts them down, not lifts them up.  And we as parents know what happens when they are derailed.  How can a world that wants to express to these people how fabulous they are, be held accountable for the reaction for such a positive intent?  That is another question... . oops.

Maybe doing some cognitive therapy around joy and praise would be good for all our kids.  What happens when you are praised, and go from there, layer by layer by layer.

mik

[lbjnltx]

Since individualism plays a part in the disorder as well as BPD being a spectrum disorder it is important to understand that not all pwBPD experience the same stimulus the same way.

I often read here that pwBPD are unable to be empathic... .   not true for all, true for some.

Not all pwBPD react negatively to praise.  Some may benefit from the way we express praise for their achievements.  Very sensitive people who receive praise expressed in a general way "you are so smart" may process this as an expectation which will cause them stress.  Praising the effort "I can see you worked really hard studying for that test" praises the effort and points to the positive consequence.  

My d beams when praised for being who she is and having her efforts noticed.

[griz]

lbjnltx:

I love the praising the effort and when I thought about it you are right.  DD does respond positively to this.  I used it this morning.  DD is coming down with a horrible cold.  She was miserable last night and couldn't sleep.  This morning I was having alot of anxiety over waking her up for school anticipating an argument... .  . I can't go... .  . I'm so sick... .   etc.  I woke her up and she told me she was miserable.  I offered to make her a cup of hot tea or coffe and told her I would meet her downstairs. Low and behold she actually got dressed and with little complaints was ready to go.  My praise went like this, "I'm sorry you are not feeling so well, it must have been really hard to get up this morning". Her response, "yea, I just wanted to pull the covers over my head and stay in bed".  me: " I'm sure you did, should we make a quick stop at 7-11 and pick up a cold slurpee, it might help your throat".  "No thanks mom, I'm OK".

Just as you said, no expectation to have a great day.

Thanks,

Griz

[mikmik]

Not trying to split hairs here, but one effort to acknowledge sounds more like validation (I see that you worked hard to prepare for this recital, and it really paid off), while saying you are a brilliant muscian, or your art is outstanding may cause some different reaction as Reality suggests.  Of course, we are all individuals. And as some of our kids share some similar personality issues, others don't.  My dd can be very empathic, to the point where she uses it to deflect from looking at herself, it has become a coping tool it seems.  While I am sure there are those whose kids on this board have a hard time expressing empathy.  It is just the way the water flows with this disorder.

I hear from lbj, and griz, that when acknowledgement (praise) comes in the form of validation, their pwBPD respond wonderfully.  Maybe it is what we need to do, but still, I think for those of us whose children don't respond well to overt praise (becoming overwhelmed, crying, unable to process it), we need to help them discover why they react the way they do.  Just another piece of the BPD puzzle that needs to be open for discussion and consideration.

mik

[lbjnltx]

Just another piece of the BPD puzzle that needs to be open for discussion and consideration.

mik

That is my point mikmik.  What applies to one does not apply to all.  Overgeneralizing can close doors that are best remained open.

[Reality]

Just another piece of the BPD puzzle that needs to be open for discussion and consideration.

mik

That is my point mikmik.  What applies to one does not apply to all.  Overgeneralizing can close doors that are best remained open.

lbjnitx,

Where were the overgeneralizing statements?  I do not understand what you mean.  I thought mikmik had a point differentiating between praise and validation, actually a very important point.  

Reality

PS Did your daughter have a diagnosis of BPD?  She often seems to be so different from the rest of the pwBPD here?

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[lbjnltx]

Just another piece of the BPD puzzle that needs to be open for discussion and consideration.

mik

That is my point mikmik.  What applies to one does not apply to all.  Overgeneralizing can close doors that are best remained open.

lbjnitx,

Where were the overgeneralizing statements?  I do not understand what you mean.  I thought mikmik had a point differentiating between praise and validation, actually a very important point. 

Reality

Overgeneralizing the concept that all pwBPD don't process praise positively.

Some do, some don't, some may one day and not the next depending on their emotional state, some may develop the ability after treatment, some may depending on who it comes from.

Praise is validation in many ways, it is recognizing the efforts, skills, characteristics, accomplishments of another person. 

[Reality]

lbjnitx,

PS Did your daughter have a diagnosis of BPD?  She often seems to be so different from the rest of the pwBPD here?

(From former post of mine)

Dumb question on my part.  Obviously, your daughter has had treatment, effective treatment, so she no longer meets criteria for BPD.  She has recovered.

As Perry Hoffman, of the NEA-BPD says, BPD is the diagnosis with the good prognosis.  Once  a pwBPD recovers, there is seldom a remission.

So your daughter no longer functions as a pwBPD.

Sorry for not thinking this through.

Reality

[lbjnltx]

No, she was not diagnosed with BPD.  She was diagnosed "emerging BPD" due to her age.  She met 6 of the 9 criteria for over a year at the time of inpatient psych testing.

I have read here several time that members question the diagnoses by professionals because the pwBPD in their lives don't self harm or don't rage like they read about in the  majority of the stories here on the site.

The meeting of criteria is 5 of 9 for a diagnoses... .  this leaves the room for the individual expression of the disorder.  The individual may be higher functioning than others or lower functioning, they may exhibit waif like behaviors, queen or hermit... .  

BPD is as complex as the individuals that suffer from it.  This makes it difficult to diagnose with all certainty and also makes it difficult for the non's to be validated by other's outside the "know" and even for us to validate ourselves sometimes.

[js friend]

yES BPD is definitley a complex disorder and no 2 pwBPD are exactly the same .  My dd18 absolutley thrives on prasie. Actually she told her t that she  was never praised for anything good she did when she was growing up.That isnt true at all, but I guess that is how she felt.

My dd needs to hear that she is doing something well and that that others have noticed. it almost gives her a kind of glow when she is praised. She loves it. When she was working  for a short time the only thing she told me was how much the customers loved her and the nice things they said about her.

Idk if that was the NPD part of her at work there telling me all that stuff, but just like everyone else she loves being told that we have recognised her efforts and it seems to work for her in the same way that validation does.Now i make a conscious effort to praise her, so she knows she is going in the right direction!

bioadoptmom3 my dd would have probably cried too because she hates to be the centre of attention which is the BPD side to her than the NPD . When she was 5yo I held a birthday party for her and she cried all the way through it.The more people that arrived, the worse she got and by the end she was a blubbering wreck. She is just the same now.Iam pretty sure that if I held a suprise party for her now she would hate it. She has told me before that she hates being the centre of attention and people asking her questions.I can visably see her getting overwhelmed, and uncomfortable when it happens. I think I would have to put this down to my dd suffering more from social anxiety, and feeling scared and anxious = stress,rather than her not enjoying the praise 

[griz]

jsfriend:

I remember my DD's 3rd birthday party.  Everyone was having a great time except for her.  It overwhelmed her and she did not participate at all until most guests were gone.  Interestingly enough she is the first one to throw a party for one of her friends and is is truly happy doing so.

This year for her 18th birthday her friends threw a surprise party for her.  It was just 18 friends at a restaurant.  No pressure.  She smiled and laughed the whole time but in the end she told me she was miserable.  hates being the center of attention and getting all the attention.  She graciously thanked them all but I was sorry she couldn't enjoy it.

Griz

[mamachelle]

I was recently,last week, filling out questions in neuro psych surveys to find out if my SS10 might be on the autism spectrum as suspected.

Some of the questions were worded like:

Does your child ever compliment or praise others?

Does your child respond to compliments or praise appropriately?

Just wanted to add, not sure what it all means in relation to neuroscience, autism, BPD or this thread... .