Real life experience of a BPD crisis – and the application of the DSM IV criteria


Panic Attack or Anxiety PTSD

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In hindsight I actually find some of the stuff that has happened over the last few weeks funny (although those things cannot be seen in this description of the events) and in another way it’s truly terrifying to look back at these things and see just how much of a ‘text-book BPD case’ I really am.

I’m not going to go into detail of some of the more personal elements as they are just too personal to share publicly but suffice to say it has been a strange time and almost certainly a ‘crisis’ phase, that (hopefully) I have (with the help of my best mate and fiancée) averted before it reached the point where I had spiralled out of control completely – although it did come very close to that point.

Anyway, I’m now going to explain a little of the situation in terms of the BPD reactions to illustrate how ‘text-book’ the events became without me even realising! And how quickly it suddenly came to a head…

Trigger

So, as is always the case with these things there is something that is a ‘trigger’ for the difficult BPD emotions, reactions and actions that cause so much trouble.  In this case I believe that the trigger happened a while ago, my return to work. At the time this was a very positive move which I and almost everyone else thought was a helpful step forward following my most recent crisis (which had spiralled completely out of control and almost destroyed not only my life but the lives of others around me, whom I care about deeply and had no intention of hurting – but I did hurt them much to my disappointment in myself). Thus, initially the return was good, it got me out of the house, focussing on progress and doing something ‘positive’. However, as I described in another recent post, I was having difficulty with it from the start due to anxiety.

The anxiety continued to build.

I increased my writing… I was spending more time in the pub…

Then I had a break for 3 weeks holiday.

During this time I was reading so many books, which should be a good distraction technique, and my writing continued to increase.

I came back from holiday and went back to work, which didn’t go well and my anxiety went through the roof. I was sending more time in the pub than ever… I almost stopped writing…

Emotional reaction

I believe that initially I dissociated from my emotions as I can not describe a single emotion from that early phase of this crisis, other than the anxiety. But, as I thought the anxiety was a ‘normal’ as opposed to BPD reaction to returning to work I blocked it out, along with it all other emotions were blocked as well, to compensate for the lack of emotion writing, reading and socialising became a ‘crutch’ (coping mechanism?).

Returning from holiday to face difficulties at work escalated my anxiety and other emotions began to surface, guilt, fear, failure… the list goes on, but they were all negative emotions. To add to this my crutch’s became difficult to manage and were causing conflict in other areas of my life, which increased the negative emotions and led to the resurfacing of abandonment issues, which triggered further negative emotions. The conflict over my time at the pub and certain aspects of the socialising this comprised led to a very reasonable attempt by my fiancée at setting boundaries. Now considering I had only recently written a post about boundaries it was shocking to me when I decided to read that post again yesterday and discovered I had had EXACTLY the wrong, inappropriate (but expected) BPD response to my fiancée setting boundaries! I had reacted in precisely the way I described in that post – rejecting, refuting and going into conflict over the attempt to ‘control me’.

After all this build up, things were reaching fever-pitch. My emotions were out of control, feeling close to abandonment and as though I was being told what I can and cannot do… My DBT ‘wise-mind’; the Transactional Analysis (TA) ‘Adult self’ (or ‘good Sharon’ as we jokingly refer to this extreme of my personality) was lost in translation. The ‘Free-child’ (TA), ’emotional mind’ (DBT), ‘Bad Sharon’ had taken control of the situation – although we did not realise this and despite the nastier, snipey comments that should be a clear sign of ‘bad sharon’ being around were there, they were layered with a sugar coating that disguised some quite manipulative, controlling demands as ‘reasonable’, when in fact they were unreasonable and a clear-cut case of someone wanting to ‘have her cake and eat it’ – “accept me as I am, warts and all, because any potential change or improvement is a ‘what-if’ scenario and if you can’t cope with me like this, but I stay like this forever, then you should get out now”.  Good Sharon wants to get better and is willing to try, but clearly Bad Sharon has other plans – an element of not believing I can get ‘better’, twisted with a bit of not wanting to try, and of course the ‘freedom’ to do as I please regardless of the consequences… it all adds up to chaos…

Impulsiveness and recklessness

So, with the ‘free-child’ (Bad Sharon) in control fighting against a ‘nurturing-parent‘ (my fiancée) setting reasonable boundaries, impulsiveness and recklessness kick in as the urge to ‘escape’ the confines sets panic alarms flaring and the ‘fear’ of abandonment triggers ‘pushing away’ responses. The fear of losing everything is the greatest fear at this time, but rather than a resolve to try to prevent this happening it feels so inevitable and irretrievable that impulsive, reckless behaviours feel like a fair and justified way to cope with ‘grieving’ for the loss that is believed to have already occurred – why fight for something that can’t be saved? you may as well just enjoy yourself. ignore the rules, take risks, as the consequences are entirely unimportant as there is nothing left to lose.

Only, the reality is there is still something to lose, nothing has changed, nothing has been lost – but behaving this way there is a HUGE possibility that you are going to lose it all…

Free-child (Bad Sharon) doesn’t see this, doesn’t care, to her it’s already too late…

So, she sets off to play…

Climax

Chronic feelings of emptiness, and being ‘dead inside’ have been pervasive across this whole time. everything is black and white to me, it’s either one way or another, no in-between, no middle ground, all or nothing…Ultimatums, demands and ‘f*ck you’s’ have been issued by Bad Sharon, to give her free reign to escape the boundaries and cope with the loss she believes has already occurred. You are the bad guy now, devaluation has reached it’s peak – this is all your fault… my fiancée the man who loves me unconditionally, copes with my erratic moods and behaviour, who I love so much and ‘idealize’ most of the time, is now trapped at the wrong end of the BPD ‘splitting’ extremes (everyone if either a hero or villain – no inbetweeners; now he is the villain…). Your best-friend also steps in, in a less confrontational manner you believe, she agrees with your view on certain things, but of course she’s only heard your spin on these things. She tries to show you where you going too far, crossing the boundaries, she tells you off, in a nurturing parent way – the balance is different to how it is when he says these things, why?

Then, as suddenly as it all came to reach this point – he snaps himself, who can blame him – he demands answers, he is hurting, he is angry, he love’s you so much it is killing him to see you do this – but amazingly he still wants to save it, again! he doesn’t see the BPD in it, thinks that is just an excuse to have your own way… you panic, you thought he understood the BPD now, thought he would be able to recognise the symptoms of a crisis as you knew you were not yet able to control them yourself – you want to die now, the only way out now that all those fears that have been causing all this disgraceful behaviour are becoming really real. You carve at your arm while he is talking to you, with the only thing you have to hand – your car key, until he notices and takes it away. Somehow, from somewhere deep down ‘good sharon’ manages to resurface and is holding bad sharon to ransom now, holding her just beneath the water’s surface –  wishing she would drown and never return but knowing that isn’t likely, you can only hold her down for so long… The wise-mind of good sharon fights to hold onto her love and life. Together, as a couple you discuss warts and all of the past few weeks, good sharon begins to link the pieces together and re-establish the desired safe limits boundaries that may help keep bad sharon at bay, whilst acknowledging that we cannot control her, but must be more vigilant of her attempts to manipulate and control us both – we both hate bad sharon…This time we regained control before bad sharon was able to ‘really’ do anything that would cause irreparable damage – but she came close, as always, with her impulsive, reckless ways.

Conclusion

So, now we are working on a way forward from these events, good sharon is back in control. But we are left with questions…

How do we recognise when this cycle is beginning? the trigger?

How do we prevent things escalating? dealing with and reigning in the emotional reactions?

How do we recognise the ‘bad sharon’ has resurfaced? she’s not that easy to spot, as after all she is still me…

How do we stop it getting out of control? the impulsive, reckless behaviour?

Summary

Here is a summary of the crisis cycle in terms of BPD and DSM IV criteria…

  • Triggers – Work +Anxiety, and most of all FEAR

Criteria in order of appearance….

  • Criteria 6 – Affective instability due to a marked reactivity of mood = anxiety.
  • Criteria 3 – Identity disturbance, unstable sense of self and identity, combined with Criteria 9 – transient, stress-related  paranoid ideation and dissociation =blocking emotions, reading, writing, socialising.
  • Criteria 1 – fear of abandonment = recurrent theme throughout the crisis
  • Criteria 7 – chronic feelings of emptiness = recurrent throughout the crisis
  • Boundary setting occurs…
  • Criteria 4 – Impulsivity and recklessness = bad sharon acting out against boundary setting
  • Criteria 2 – unstable interpersonal relationships = splitting, devaluation, making others out to be the villain.
  • Criteria 5 – NSSI (Non Suicidal self-injury) = slicing arm with car key.

The only criteria which is not glaringly obvious in this crisis cycle is criteria 8 – display of intense anger, however I suspect that (as is usually the case for me) the fact that my anger is almost always self-directed rather than outwardly expressed against others that it was also present – maybe you can see it in what I have written? If so, can you point it out to me please?

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17 comments on “Real life experience of a BPD crisis – and the application of the DSM IV criteria

  1. Sharon, I find it so helpful reading ppls experiences and I must try and get hubby to read cos seeing it b&w makes so much sense of the crazy that feels so all encompassing at the time.
    Hope things are looking up for u now! Xxxx

    • Thanks Nicci, yeah I think I’m coming out the other side again now, but who knows for sure… I agree about reading about others experiences, theres so many books about BPD/mental health but they rarely give the inside perspective so clear cut and honest as those of us who put it out there in this form do xxx

  2. Sharon: Thank you so much for this post. As you said, reading about your experience from your inside perspective is truly rare and so insightful. You help me understand our 22yo daughter with BPD; now I may be able to help her cope. Certainly I will understand more of what she is thinking/feeling and will feel better helping her and not internalize the things her bad side says. You have made a significant difference and I can’t thank you enough.

  3. You have a way of breaking the huge things down and trying to talk about them, I like how your mind knows that writing helps, and I feel you, people dont really understand BPD lot of the times they think you’re just being “moody” but theres more to it, I gotta say I love how you flat out describe your feelings to that, I really love this (:
    -Good luck, with everything.

    • Thank you. I find it really weird how I just seem to disconnect from the feelings completely so I can write about them. If I write ‘whilst’ I’m feeling I’m not nearly so good at capturing it – it becomes too filled with crappy words that spill out from the feelings rather than the actual feelings – if you know what I mean? 🙂

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  8. One difference I have (maybe just an opinion about how to approach all these intense emotions/reactions w/partner or spouse; I have been married for 38 years & we were high school sweet hearts in boarding school since I was 15 & he was 16)–but I do communicate skills I am learning through DBT & talk about “homework” which basically is all about him, of course! The one I love & fear I will lose even after all these years. He knows the basics about my family history (really fu**ed up), but I don’t want to reveal all that sh*t & taint his mind w/that. No point to that, except if I’m trying to have a “poor me” party. It is what it is/was so I just need to deal w/it so it doesn’t impact me to such a great degree today. Which for me means lots of individual therapy, DBT, support groups, studying on my own, & medications as prescribed.

    He doesn’t need all the gory details. He came from a wholesome family & I am benefitting from his stability, for sure.

    But I try to be a wife & mother first & have the “dirty” details (suicidal ideation–he’s already had to haul me off to the ER twice for acting on those; my extreme emotional reactions which for me are usually being HURT by just his raised eyebrow) are for me to talk about w/my therapist & meds provider. I don’t want to burden him anymore than he has to be w/all my mental illness symptoms & crap.

    That is for me to deal w/on an on-going basis w/individual therapy, DBT & my meds provider (who is a psychiatric nurse practitioner so she spends a lot of time getting to know me–no 10 or 15 minute appts. when dealing w/heavy duty psych meds {have bipolar 1 as as dx, too}).

    For me, I let my husband in to a certain degree but I don’t want his life to revolve around my illness & thankfully it hasn’t. He’s successful in his career, has & continues to be a wonderful father to our 2 grown children, & enjoys his male friends & hobbies, such as tennis, fishing & skiing.

    We enjoy our dinners out, our companionship & I don’t want to muck it up by bringing him too much into my mental health issues. I don’t want him to be my caretaker, but my loving partner. I have tremendous issues to work on & take responsibility for them.

    He married me–not my mental illness symptoms, for sure, as they are pretty unattractive. He understands some of my triggers (had to tell him) & areas I’m struggling with, but I don’t put the burden on him to have to “get it”–all the nuances of my problems. That’s what my therapist & support group are for!

    Kind of like I don’t want him in there when I’m getting a colonoscopy (family history so have to have them frequently), but he knows the basics of why I need them & drives me back & forth–but he needs to stay far away while I go through the “prep”, please! Let me as a woman have some “mystery” even in regards to my mental illness symptoms! –Suzanne

    • Thanks for sharing Suzanne, you are very lucky to have such a stable and supportive relationship with your husband. It just goes to show that Borderlines can do it! It gives hope to the rest of us 🙂

  9. Reading this has helped me to understand better what happened to my wife and I. We were married in 97, she filed for divorce in 2010. The divorce is not final. I have struggled to understand how no matter helpful, supportive, loving or forgiving I was, nothing seemed to work right when she was in the throws of her disrgrulation. And, I seemed to become her enemy, no matter what I did or did not do. And, I couldn’t understand how her impulsive choices were supposed to be helping her or anyone. Now, I have aglimps into how I became not the nurtuer I was trying to be, but in her mind I became her abusive father. And, how since everything thing seemed “broken” to her, why not give into impulse to sooth the hurt.

    I still wish my wife, whom I still love, could find peace. I miss her dearly. She was my angel. Now I know she was an angel chased by demons, and there still seems to be nothing I can do.

    But, thank you for a post that gave me a window into what things were like for her.

    Compsed on my phone, and subject to errors.

    • Thanks Stephen, I’m glad my post helped you understand what your wife is living with. Yes, I think an ‘angel chased by demons’ sums up the curse of BPD pretty well! There is probably very little you could or can do, she needs to find help ( and want help) to learn to overcome the horrific emotional vulnerability and turmoil that BPD causes. I hope you can get some peace in knowing that it wasn’t your fault and that she was not fully in control of herself either. Best Wishes
      Sharon x

  10. wow all makes sense. i feel same way its what ruined my relationships and during the break up period where its possible to get them back i keep pushing them away and in horrible ways by putting them down.

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