As I stated in my recent post I have been experiencing a period of relative stability for a while now. Whether this is remission, recovery or will last remains to be seen but for now it’s all good. I thought it would be helpful, to me and others, to examine the DSM IV criteria for BPD and how I stand in relation to each currently…
The DSM IV Criteria for BPD:
- Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-injuring behaviour covered in Criterion 5
- A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
- Identity disturbance: markedly and persistently unstable self-image or sense of self.
- Impulsivity in at least two areas that are potentially self-damaging (e.g., promiscuous sex, excessive spending, eating disorders, binge eating, substance abuse, reckless driving). Note: Do not include suicidal or self-injuring behavior covered in Criterion 5
- Recurrent suicidal behavior, gestures, threats or self-injuring behavior such as cutting, interfering with the healing of scars or picking at oneself (excoriation) .
- Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability or anxiety usually lasting a few hours and only rarely more than a few days).
- Chronic feelings of emptiness
- Inappropriate anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
- Transient, stress-related paranoid ideation, delusions or severe dissociative symptoms
1. Abandonment –
I am not having any issues with avoiding real or imagined abandonment. I guess this is related to the lack of emotionally connected relationships mentioned below. With no close, intense connection to another person I am having no issues with fears of being abandoned, and therefore not making frantic efforts to avoid this.
2. Unstable Relationships –
I’m the first to admit this was probably my biggest issue and the trigger for many of my other BPD symptoms and behaviours. The intense, deep emotional connections of close personal relationships seem to bring about the instability and splitting problems. The fact that I am not currently in any relationship may be a huge part of why I am coping so well in all areas, but I’m actually comfortable being single for now. There is a guy who has recently been in my life, but we are not in a relationship and neither of us want that, so the emotional connection that seems to be at the root of my problems in this area is not there. We are both satisfied with what is more like a close, friends with benefits arrangement, although even that is currently on hold, I sent him home and have no expectations as to if/when I will see him again. There are people who seem to disapprove of our situation and I can see and understand why they are concerned as they probably do not realise I have not forged the kind of connection here that leads to me getting hurt. Their misgivings given they don’t know are justified, the problem is that they don’t seem to hear me that I am not in a position to get hurt by this, if it stays as it currently is, which I expect it will. Sure, I am aware of the possibility of change, developing more feelings and the potential for an emotional connection to establish which could lead to a different experience, but I cannot do anything to stop that happening. So, if it does I just have to hope I will be able to deal with it. For the time being though i don’t think it is likely so I am not going to allow ‘what if’s?’ to manifest an issue that does not exist. In summary there are no: ‘unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation’ in my life at this time…
3. Unstable sense of self and image –
In regards to physical self-image the last indication of instability in this area would be when I got my last tattoo, lip pierced and had my hair done back in March. Since then I have not made any alterations to my appearance, I have just maintained my hairstyle in the same short (but growing slowly) black style with my red, blue and purple colour streaks. I removed the lip piercing as it was annoying because I chewed on it and messed with it constantly to the point I was making my mouth sore. Constantly setting myself endless lists of ‘must-do’ goals was also I think not helpful in this area, be they small things like uploading my cd’s to my laptop or bigger things like writing x amount of words for my book in a week, goals are supposed to be useful targets but for me they became a pressurizing obsession, which I punished myself for if I did not achieve what I wanted on time – even though no-one other than me expected it. With regards to the other indicators of unstable sense of self the main one has always been my constantly changing career aspirations. I can’t really say if there is much going on there as I am just looking for a job at the moment without any major aspirations as to what it should or shouldn’t be. I have applied for various roles, anything that interests me at the time I am looking basically, and I have applied for a college course for September to continue a teaching qualification I started a while ago. It ‘feels’ like this aspect of my personality is currently stable, what do you think?
4. Impulsivity – I am going to divide this one into a couple of sections as each needs addressing in it’s own right and it is in a criteria that specifies ‘in at least 2 areas’…
General impulsivity –
Okay, so in general I have often gone through spells of excessive spending, drinking heavily, spending too much time in the pub and poor eating habits. I haven’t been drinking much for ages, on the odd occasion I have a drink now I have not had more than 4 drinks on a night out, which is very well controlled drinking I think? I have not been spending excessively in any area, most often this would normally be buying lots of new clothes, books, CD’s and DVD’s none of which I have spent a lot on for some time. And my children would gladly report that I am not spending as much time in the pub now, which has the knock on effect of being at home to eat properly more often. I do have the odd day where I don’t feel like eating as much, but it is much better than it was and I am generally eating at least two proper meals each day.
Sexual promiscuity –
My promiscuous, impulsive, risk taking sexual behaviour was probably on of the last of my BPD behaviours to subside. In my last episode of acting this way I slept with a different guy each night for three nights in a row. The last one of those is the one who is currently still in my life and like the non-relationship side of our connection sex is not a massive part of things either. Yet, I am not experiencing the urges that were previously leading me to want to have sex with as many guys a possible, nor am I constantly pestering for sex with this guy, we do have sex but it is currently not such a vital element of my existence in the way it was before…
Substance Abuse –
Now this is the one are that is a bit grey and could be disputed as being the area that I am still presenting a clear BPD characteristic, and while I agree the unset of what is happening here was almost certainly a BPD impulsive, self-harming action, I’m not sure that is still the case (or maybe I am in denial – always a possibility I suppose!?). I shall explain… During an impulsive knee-jerk reaction to a communication from my ex that he had taken a particular drug and implying that it was ‘my fault’ he had done this due to ‘breaking his heart’ I took some drugs myself, in a pathetic response to basically rub it in ‘how do you like it? you blamed me for you doing it so now I’ve done it, how does it make you feel being blamed for someone else’s choices?’ – pathetic, childish, immature and wrong, I know. The thing is while that time was a reckless impulsive action a while later, in a rational state of mind I chose to take this drug again, it was not an impulsive choice at this time, and while I knew/know the risks and dangers of taking drugs of any kind and if I take this drug again I can not honestly say I won’t do it. I know that any attempts to justify my actions here will be in vain and I don’t intend to do so, no excuses, no bullshit. Currently this is not having any negative impacts on my life, but I am very aware how easily things could change if I take it again, but at the moment I’m not taking it and don’t have plans to do so, that is as much as I can say…
5. Suicidal Behaviour and Self-harm –
I have not experienced suicidal ideation for a couple of months now and similarly my self-harming (cutting) has also ceased for about the same length of time.
6. Unstable Moods –
My moods have been fairly stable for some time now, I have not been experiencing any intense swings, highs or lows. Irritability, anxiety and dysphoria have all been absent. I have been quite mellow and not markedly affected by things in the ways that I would have previously.
7. Emptiness –
Boredom and emptiness appeared to be persistent features of my daily life, probably up to just about the same time the sexual impulsivity ceased. This boredom and emptiness were likely a huge part of why the sexual activities were occurring – a need to fulfil and feel through instant gratification. To have a close, intense physical connection to another person without the hurtful emotional connection. I’m not entirely sure when the emptiness and boredom ceased but like I say I suspect it was around the same time I stopped ‘needing’ sex to feel alive. Now, even if I have little or nothing to do I am not chronically bored or empty. I can get a little bored at times but I believe this is now much closer to what non-bp’s can and do experience, after all everyone gets bored occasionally at least, don;t they? It’s just that now, for me, it does not spiral out of control and promote emptiness and the impulsive recklessness that would normally develop as some vain attempt to quash the dullness away.
8. Anger –
As I originally explained in my post about anger and BPD before, for me the anger issues were basically always about internalizing this difficult emotion and taking it out on myself in the form of self-harm. It was, and still is, very rare for me to express my anger externally, even less so to take it out on others, there were a couple of exceptions to this general rule earlier this year (Don’t take my phone and pub brawl)that had me concerned I might be entering a new phase of ‘lashing out’ that was even more BPD and less ‘me’ than ever before. Thankfully, those were one off incidents with extreme provocations! I have experienced some minor anger of late (or is it more annoyance or frustration?) but nothing that has led to strong, inappropriate or difficult to control rage or provoked any kind of outburst or internalisation.
9. Paranoia/dissociation –
This criteria was probably the one I experienced the least anyway and I can categorically state I have not experienced any symptoms of this for at least two months.
So there we have it, the breakdown of my current BPD experience, I think I am right in saying that assessment at the present time would not result in a BPD diagnosis as I am not exhibiting at least 5 of the criteria, heck if anything I am experiencing only 1 at the most, would you agree?
or am I in denial?
My therapist seems to agree that I am not exhibiting BPD characteristics anymore but then she only hears what I have to say – am I deceiving us both?
I don’t think I am, but then who knows what BPD has up it’s sleeve for me, this whole thing could be BPD lulling me into a false sense of security about my own capabilities and stability – now there is a bit of paranoia for you! lol
Nah, it’s not paranoia, it’s just honest caution.
I have to be careful not to assume too much based on a few months of being ‘okay’!
Here’s to a lasting period free of BPD symptoms and a happy future – I wish the same for all of you too!
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- Are you Borderline or do you have BPD? (authorjaenwirefly.wordpress.com)
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- Borderline Personality Disorder in comorbidity with the effects of Narcissistic Personality Disorder. (astoryoflight.wordpress.com)
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- BPD, Sex, and Impulsivity (gypsy116.wordpress.com)
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