S32/U3/L11. Biosocial Theory and Validation Key Notes.
Very quick screenshots notes this time and few links as I am up against it time wise and this wix blog app is driving me fucking insane but this will give any visitors a taste of what this session entailed. It was a good session:
A good mindfulness exercise about pleasant sensations and allowing ourselves to embrace them challenging out automatic self punishing resistance to pleasurable things with Kathryn C. Holt M.A., LCSW, PhD. ⬆⬆⬆
Keywords and phrases:
BACKGROUND: Patients with borderline personality disorder (BPD) show a high prevalence of early adversity, such as childhood trauma. It has also been reported that prenatal adverse conditions, such as prenatal maternal stress, drug taking, tobacco smoking or medical complications, may be associated with an increased risk of mental disorders in the offspring. Prenatal adversity is investigated here for the first time as a potential risk factor in the diagnosis of BPD. Method A total of 100 patients with a DSM-IV diagnosis of BPD and 100 matched healthy controls underwent semi-structured interviews about the course of pregnancy, maternal stressors, birth complications and childhood trauma. Further information was obtained from the participants' mothers and from prenatal medical records.
RESULTS: Borderline patients were significantly more often exposed to adverse intrauterine conditions, such as prenatal tobacco exposure (p=0.004), medical complications (p=0.008), prenatal maternal traumatic stress (p=0.015), familial conflicts (p=0.004), low social support (p=0.004) and partnership problems during pregnancy (p=0.014). Logistic regression analyses revealed that the reported prenatal risk factors accounted for 25.7% of the variance in BPD. Prenatal tobacco exposure [odds ratio (OR) 3.37, 95% confidence interval (CI) 1.49-7.65, p=0.004] and medical complications (OR 2.87, 95% CI 1.29-6.38, p=0.010) emerged as important predictors. After controlling for childhood adversity and parental socio-economic status (SES), prenatal risk factors predicted relevant borderline subdomains, such as impulsivity, affective instability, identity disturbance, dissociation and severity of borderline symptoms.
CONCLUSIONS: This study provides evidence of an association between prenatal adversity and the diagnosis of BPD. Our findings suggest that prenatal adversity may constitute a potential risk factor in the pathogenesis of BPD.
Emotional amplified antennas
Impulsivity - trouble regulatingemotion.
Cortisol brain damage - brain development
OBJECTIVE: Borderline personality disorder (BPD) is a prevalent, complex, and serious mental disorder involving multiple symptoms and maladaptive behaviour. The underlying psychobiological mechanisms involved are not yet fully understood, but increasing evidence indicates that changes in hypothalamic-pituitary-adrenal stress axis (HPA) activity may contribute to BPD. Whilst various studies have demonstrated elevated levels of cortisol (the end-product of the HPA axis) in BPD sufferers, others have presented opposite findings. Inconsistent findings may be attributable to comorbidities, collection and measurement methods, gender, and sample size. Considering these discrepancies, the aim of this systematic review and meta-analysis was to assess available studies in the scientific literature examining basal/ baseline cortisol levels in patients diagnosed with borderline personality disorder compared to non-psychiatric controls.
METHODS: A systematic literature review was conducted with descriptions of primary studies in addition to a meta-analysis of studies with a control group. Meta-analysis was performed using Comprehensive Meta-analysis software (CMA version 2). The effect size (Hedges' g) was calculated with random-effect model.
RESULTS: A systematic literature search identified 16 studies that met the eligibility criteria from a total of 1076 unique records initially examined. Twelve studies (N = 546; 278 borderline personality disorder and 268 non-psychiatric controls) fulfilled the inclusion criteria for meta-analysis. The standardised mean difference (Hedges' g) of basal cortisol level between BPD and control groups was -0.32 (pooled data from 12 studies; 95% confidence interval -0.56 to -0.06, p = 0.01), indicating significantly lower mean cortisol level for the BPD group.
CONCLUSION: Cortisol as a biomarker of the HPA axis is an important and helpful measure in the study of stress disorders such as BPD. However, considerations of potential confounding factors must be considered.
What makes a brain Borderline? For the last two decades experts have been trying to find out. The old adage about two people being on different wavelengths appears to be true, with MRI scans revealing stark differences between healthy brains and the brains of individuals with Borderline Personality. The diagram above is a case in point. On the right we have a ‘normal’ brain, on the left the brain of someone with BPD. The heat signatures, show for the first time the neurological basis of a serious but all too common mental health condition.
But what do these heat patches actually mean? We begin in the limbic system; all brains have one. It the emotional control centre for human beings, and it is here that trauma, mental illness, and neural circuitry intersect.
The primitive part of the brain which regulates fear and aggression. In the general population it’s a vital tool for survival; even in the comfortable, safe, clockwork cities of modernity, emotions can be lifesaver. However:
Brain scans have shown people with BPD have amygdala’s that are noticeably smaller than the general population, and may even have undergone atrophy. The smaller the amygdala, the more overactive it is.
This means when people with Borderline Personality Disorder, experience an emotion, they do so more intensely than the general population, and the ‘cooling down’ period takes much longer.
Latin for ‘seahorse’ the hippocampus is a pair of seahorse shaped tubes located in left and right hemisphere of the brain. Associated with long and short-term memory, spatial-orientation, and most importantly emotional reactions, it is the body’s data processor. This means, when an enviromental event is relayed via the visual cortex, the hippocampus decides the correct emotional response. Approach or avoidance.
For people with Borderline Personality Disorder, the hippocampus is in a state of continuous hyperarousal. Uncoordinated and dysfunctional, it consistently misinterprets threats, and relays faulty messages back to the amygdala.
This means people with BPD are more than likely to encounter other people, and the world around them, as threatening, when this very well may not be the intent or the reality.
A complex name for three interconnected glands: The hypothalamus, the pituitary, and the adrenal gland all interact with each other. Especially in managing the pressures of daily life and maintaining homeostasis.
The ‘Hypothalamic-pituary adrenal axis’, is primarily responsible for the body’s production of cortisol. Cortisol is a natural chemical released during times of stress. Studies have shown people with BPD have abnormal levels of cortisol in their bloodstream.
Too much Cortisol production, means stress levels in daily life are always overwhelming. Psychologically, resilience and coping skills are undermined, chemically, the body is overwhelmed.
The prefrontal cortex is the pinnacle of human evolution, not only because it’s responsible for reason, rationality and decision-making but because it is also inhibits our primal nature.
People with BPD have prefrontal cortexes which are inactive and inefficient. This is one of the reasons for some of hallmark symptoms of BPD including impulsivity.
As Francisco Goya said, the ‘sleep of reason breeds monsters,’ and with a sleeping prefrontal cortex, individuals with BPD find themselves assailed by emotions, which make us feel out of control.
Of course this appears a raw deal for someone suffering Borderline Personality Disorder: After all, we are stigmatised with pejorative labels as it is without needing mental impoverishment added. But heres the twist: The heritability of Borderline Personality Disorder is estimated to be 40–60%, however, 70% of BPD sufferers have experienced some form of childhood trauma; often sexual, physical or emotional abuse.
It remains to be seen whether structural abnormalities in the borderline brain, are the cause of the condition, or a consequence of trauma. An indelible imprint on our brain of suffering.
To give just one example of why it is feasible the brain is ‘injured’ by trauma, is in the chemical cortisol. As we’ve already seen, cortisol is released in a response to stress; and so it goes to reason, extreme stress, especially experienced in childhood and over long periods of time, will lead to abnormal levels of production. Furthermore:
The reason for the atrophy of the amygdala and hippocampus, and prefrontal cortex, is because high levels of cortisol have eroded parts of it away.
This is the cruel irony: The brain is a mirror to life, and if cortisol has chemically eroded the most prized assets of the mind, then this is because stress has eroded core aspects of our lives.
In order to address these startling discoveries about the brain, we need to acknowledge the nature of labels. That BPD is not someone twilight state between sanity and insanity, but a mind that has been worn away by developmental trauma. When we stop blaming individuals, we may start looking more at society. For now, I’ll just keep listening to the experts telling me It’s all your head. When I look at the brain scan I can’t help but agree.
Damaged linear thinking;
Unable to achieve goals - this is me me me. this explains a hell of a lot despite the fact I have a certain amount, my ability to focus, think linearly, plan, remember things and see things through from a to Z is monumentally affected when I am under the BPD cosh or affected by the "black dog" or emotionally stressed. I mean anything! I am KO'ed.
Emotional dependent behavior - impulsivity - frontal lobe damage - unregulated actions - offline frontal lobe paired with overactive amygdala.
Creativity - a silver lining to the above SNAFU's.
Triggers - gene related BPD triggers. BPD "traits" "turned on" by trauma, environmental factors.
DBT skills are THE answer to this condition in the main part.
I'm not going to say to much about this section here on my blog and keep my bits and bobs on this private, in session as it involves talking about people who may very well read this blog from time to time, or not. probably not to be fair. Probably don't even know it exists.
I will say though that this issue, invalidation has and is massive for me, detrimentally and causes me a lot of angry sometimes raging resentment that only damages myself at the moment but has indeed damaged others through my sick, angry, abusive behaviors related, hand in hand to this here topic. I inherited the invalidating behaviors and when i got ill, it all came bubbling hot to the surface and it was a mess. my insight had melted away under all the heated rage and I drove away cherished people.
I now have insight back, I am not out of control and I now know how and why this happened. Validation/invalidation are KEY issues I am working on.
On my road to forgiveness which I can not quite find in me yet, getting my head around this stuff and learning the techniques and mastering the skills to rewire the bits of my neural pathways which are ineffective, is vital, the goal, painful and scary.
Key words and phrases:
Parents - 🤬
Doing their best - people have their own fucked up back story too hence unskilled parenting
Some don't though - selfish big baby syndrome
Gave me the fucking ache addressing the stuff above ⬆⬆
Attention seeking behaviors is a grim expression but they happen and they happen mainly for a reason too and for good reason but the way these behaviors manifests can be ugly and very messy which is in the main part, not a fault of their won entirely. People must own it but it's often, mainly in the case of emotionally challenged people, because they are the victims of invalidating treatment from parents, guardians, friends, peers, authority figures etc etc. Intentional or not.
"bad attention is better than no attention" - attention seeking
Fear - invalidated life
Key words and phrases:
Be open to correction
Lack of self
I don't exist sensations
Private conversation ⬆⬆⬆⬆
Key words and phrases:
LISTEN - fucking listen and shut up, stop butting in with your should s and should not's and listen! 🤬 - I have areal gripe with certain people who can not stop and make an effort to listen and understand instead of just hearing and throwing in flippant throw away ill thought through boring bullshit. Listen. Listen.
Reflect back agreement or disagreement but compassionately rather than hard nosed and judgmentally.
Remember, it's real for me and other people have things that are real for them. Real.
Human compassion matters
Self harm validation and forgiveness - understanding why.
NVC - NON Violent Communication:
Very interesting topic and one the resonates with me. Start here:
Key words and phrases:
It's no catastrophe, it can be okay - pause - breath - skill up - sooth. self soothing.
Hurts but survivable.
CHECK THE FACTS - stop - breath - check the enviroments around you - check the facts - breath - skill up - start again slowly.
Check the facts vs Validation - temper the two to find a wise mind head space.
Part two of our homework assignments is to write about an example of how we have employed validation skills in a recent event or situation or argument or whatever.
Well, that i certainly have and its not been an easy one and its private and not for a publicly published blog entry. That one will remain private. it's done though and submitted else where!
That'll do for this DNT session insight. Helpful, interesting and a bit triggering but needs must!
Happy earth day 2020! 😍🌍