May '22 - Borderline Personality Disorder

I have long hated the name "Borderline Personality Disorder," or BPD. The name is rooted in the belief that those suffering with it are 'borderline crazy' - either neurotic or psychotic. When my clients ask me if they have BPD, I always tell them that what they actually have is Abandonment Disorder as a result of abuse or neglect by their caregiver(s). I explain that the nine symptoms of BPD are all signs of serious attachment wounding, which is NOT their fault/

 

BPD's symptoms include:

• risky behaviors like reckless driving or substance abuse
• suicidal tendencies
• mood swings
• feelings of emptiness
• out-of-control
• anger
• frantic efforts to prevent real or imagined abandonment
• extremes of idealization or devaluation of others
• stress-based paranoia

unstable self-image or sense of self

I also love recommending the book, Sometimes I Act Crazy, by Jerald Kreisman. It is about Lady Diana’s battle with BPD. It explains in detail how she suffered from all nine symptoms and how the cause of Diana’s mental health issues was maternal and paternal abandonment. Because she is such a beloved figure, it helps those who are diagnosed with BPD to feel less shame. It also offers a much more hopeful prognosis than Kreisman’s previous work. It is crucial that we de-shame these clients, as well as their symptoms, while working hard to heal the attachment wounds that are causing their miserable symptoms and relational problems.

Far too many clinicians believe healing is impossible for people suffering from Borderline Personality Disorder. I could not disagree more. If we can heal their attachment and childhood trauma, as well as their adult trauma(s), (which are often trauma bonds from the neglect and abuse they are so familiar with), we can alleviate BPD symptoms. I have tracked the nine DSM symptoms of the BPD clients I have treated thoroughly with Brainspotting. A large percentage of them no longer meet BPD criteria after having cleared their traumas and negative cognitions. I have found the combination of an SSRI and Brainspotting to be incredibly effective.

Below are the Brainspotting set-ups that I have found to be most helpful for those suffering from deep attachment wounds and Borderline Personality symptoms/diagnosis

 

CORRECTIVE ATTACHMENT EXPANSION SET-UP

Frontloading: Who made you feel the most loved as a child? Who made you feel important or special? How do you feel about this lonely 5-year-old part of you?

1. Can you imagine giving that very lonely and abandoned child part of you everything you know they needed and wanted either from you or others in whatever way makes sense to you?

2. Where in your body do you feel the love and support the child is receiving right now in your body?

3. How strongly do you feel the child being cared for and loved (0 to Infinity).

4. Find the Brainspot with Inside Window or by asking where in the room that part is. If the client tells you where that part is they can gaze at that part in the room.

5. Mindfully process the corrective attachment experience on the Brainspot. (If another part comes up, ask where that part is and continue.)

6. Check in with the strength of feeling loved or move to a different part needing a corrective attachment experience.

7. Check in with all of the parts to be sure they are where they desire to be

Reminder to client: Can you ask the wounded child part where they want to go and with whom? (Often total healing is impossible without the child being removed from the abusive or neglectful home.)

PART SPOTTING QUESTIONS (Developed by David Grand)

1. Once the Brainspot is found by Gazing at the specific wounded part, ask these questions:

a. Is that part of you in the room? I am going to invite you to look at this part of you.

b. Where is this part in the room? (If the part is internal, ask if it would be okay to interact with the part inside of the person.)

c. Can you ask this part if we have permission to work with them? (If yes, continue.)

d. How old is this part of you? (Guide the client to speak internally to the part.)

e. What are they wearing? What are on their feet?

f. What is the look in their face, eyes, mouth, and their body posture?

g. How do you feel towards this part as you look at them? (Assess for any positive feelings coming close to empathy. If there is only loathing work with that first.)

2. Mindfully process with this part and any other parts that show up. Do steps 1-7 with all parts.

3. At the end of session, ask every single part where it wants to go as you finish. (Inside the body? Stay on my lap? Stay with Grandma? etc.)

4. Check in with all the part to be sure they are where they desire to be at the end of the session. Make sure needs are met for each part.