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THE PSYCHOLOGY OF PERSONALITY DISORDERS
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Author Topic: BPD BEHAVIORS: Dissociation and Dysphoria  (Read 70558 times)
geroldmodel
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« on: March 08, 2007, 09:09:45 AM »

What is Dissociation and Dysphoria?
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daughter1124
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« Reply #1 on: March 13, 2007, 06:22:40 PM »

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."

Quote
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.
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rock_scissors_paper_2
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« Reply #2 on: March 14, 2007, 06:40:08 PM »

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.

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Numbnut
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« Reply #3 on: March 16, 2007, 02:56:18 AM »

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.
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Numbnut
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« Reply #4 on: March 16, 2007, 08:52:41 PM »

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.
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Alana
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« Reply #5 on: March 16, 2007, 09:37:15 PM »

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
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turquoise
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« Reply #6 on: March 17, 2007, 09:39:56 AM »

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).



www-page-not-found-net


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"

www.aapel.org/BPD/BLdissoUS.html

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Alana
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« Reply #7 on: March 17, 2007, 07:36:22 PM »

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
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Clouded North
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« Reply #8 on: June 19, 2007, 01:40:22 PM »

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).
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snowwhite
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« Reply #9 on: June 19, 2007, 08:34:57 PM »

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.
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