Tag Archive | psychotherapy in berlin

OVERLOOKED SYMPTOMS OF ANXIETY

There is a lot written about anxiety and its symptoms. In my work, I notice few more indicators or symptoms that occurred often together with the anxiety. I decided to list them below. It doesn’t mean that you will have all the symptoms but it can help knowing that it’s not so uncommon to experience the following:

»I will die, go crazy or have heart attack« this is an obsessive thought that is common with anxiety. With time you will realize that nothing serious will happen while having panic attack but this thoughts will still pop up in your head. It is hard to get rid of them. It is very common that you have more than one intrusive thought. For example, »Will I have panic attack again?” or “How will I come through the day?” or “I am not strong enough«. Even if you proved yourself other vice time and time again you will still have this thoughts that comes to your mind.

»Pain«
Unusual or long persistent pain can cause fear that something is seriously wrong in people with anxiety.

“Unknown food or medication”
Thoughts that something bad will happened when we swallow unknown medication or eat new food are common.

“Sport”
Sensation when heart beads faster during sport can resemble panic attack. Which can begin real panic attack. Consequently many people with anxiety may avoid Sport.

“Swallowing”
In my work I have notice that ¼ of people with anxiety have fear of swallowing. Usually they have previous experiences with asthma or their throat becomes dry and tightens during panic attack.

“No escape”
Fear that you can’t escape form situation, feelings or place can cause enormous distress and anxiety.

“Smell, sight or sound sensitivity”
During panic attack many people have very sensitive sight, hearing or smell. It can even deepen their unpleasant feelings while experiencing the attack.

“Vivid imagination”
Persistent negative thoughts connected to us or significant other. For example, we are crossing the road and we imagine how we will get hit by the car. Imagination can get very detailed. I also notice that people with vivid imagination often report to me about fear of the dark.

HOW TO TRUST YOUR BODY AFTER (PSYCHOLOGICAL) ILLNESS

In this article I want to write what I experienced through my own personal story and as well through the stories of my clients. The loss of trust in your own body. I want to point out two ways that I notice this can happen. The first one is the loss of trust after psychological disorder, mainly anxiety, because anxiety usually hits our body first. Meaning, we all the sudden feel like we are going to die. I believe all individuals with panic attacks were at some point 100% convinced that there is something wrong with their body functions. After a while they learned that they suffer from anxiety. But also having depression or other mental illness for a longer period of time can easily makes you feel that your body (brain) is broken.
The second way is losing your trust after physical illness such as cancer or different chronic illnesses. I also notice that people with anxiety mostly weren’t in touch with their bodies before anxiety happened. They learned to feel their body through therapy. But in case of physical illness this is not always the case. Never the less in both cases it feels like a huge betrayal from our own body.

How much control do we really have?
I often get the feeling that society in which I am believes that if you suffer from mental or physical illness the reason for it lies in you. For example “because you smoked you got the lung cancer”-which can be true. But reasoning like “because you work too much you got a cancer, because you weren’t vegetarian you got a heart attack” are a little too farfetched. There is always some room for improvement considering our life style. Not just in eating healthy and exercising but also in connecting to our bodies, understanding them, give them space and time to relax and heal. A lot of pressure is put to our bodies from toxins, stress, and unhealthy life style. For sure. But this is not the only reason why some diseases occur.
“Personally I knew what my body was capable of. I was the picture of perfect health and fitness and the most severe illness I ever had was the flu. I had never broken a bone or had stitches and found myself proud of that. Then, on December 27th, 2004 everything changed. I was 24 years old and I was just told that I had a precancerous polyp in my colon and had to have surgery to remove it. What? Surgery? A colon polyp? My mind was a jumbled mess of confusion. But I did EVERYTHING right AND I was only 24 years old. Isn’t colon cancer something old people get? It shouldn’t have come as such a huge shock being that my older brother was just over a year in remission for colon cancer, diagnosed at the age of 26 but it was happening to me and it was. A shock that is. “
To conclude, sure we can do a lot for our health. And of course we can get sick because we are not taking care of ourselves. That is a positive thing, because we can actually do something about it. But to believe that everything what is happening to us is somehow our fault is to extreme. Maybe we would like to believe that we have so much control but unfortunately we don’t. And probably realization we don’t have total control awakes feelings of fear and distrust in our body after illness.

Where is my old body and old self?
Whenever you are faced with illness or an injury you are also faced with change and change is hard to accept and deal with. “I once felt so strong, so invisible and now I was left feeling like a stranger in my own body. My body was different. Now I barred a scar about 6 inches from my belly button to the top of my public bone, I had a bag connected to my stomach (that I had to go to the bathroom in) and I could barely walk a quarter of a mile without feeling tired.”
It is really hard not just to adjust to our new physical appearance but also to the feelings connected with the change. Sometimes we deal with it by forcing our body to behave the way it was before. “So, I got militant, mean, and aggressive to make sure that these crazy things didn’t happen again. I tried to shame, criticize, and force my body to be something different so I could finally be back to where I was before illness!”
It is completely normal to miss our old self and our old abilities. It is normal to envy other people that still have them. The illness changes your perspective on life and brings a lot of fear-fear of dying, fear of repetition, fear of not being able to live normally, fear to never feel good again, fear of how I am going to make it, fear of taking your own life. You can feel on your own skin what it means to be unhealthy. What a tremendous change it is. A lot of people need to redefine their lives on many areas and this is not easy at all and we can’t always be in peace with our new normal. That is the reality of the situation. Sometimes the lost is so big that we are never completely fine with it.    

The trust is lost
When we are surprised by illness or psychological condition the trust is broke. More so if we live a healthy life style. It feels like it caught us by surprised. Why me? I am doing everything right. “Your cancer was probably discovered when you thought you were healthy. It’s frightening to realize that you had a life-threatening disease without even feeling ill – and it is natural that you now notice every ache and pain and worry you won’t spot the signs of cancer coming back. And treatment has changed your body, so you are also experiencing a new set of strange and unfamiliar sensations.”
I’m a fitness instructor and had exercised all the way through – I don’t drink, I don’t smoke, I eat healthy. I felt angry and betrayed by my body. I thought: how dare you! I’ve looked after you so well and now you’ve done this to me again. First time round I had counselling, but strangely it’s easier this time because I know what to do and how to look after myself.’
“I don’t trust my body after my cancers. No way. First I was betrayed by breast cancer and then by melanoma on the opposite side of my body. We worry about cancer coming again, and we wait hopefully for solutions—sooner, rather than later. We all want to get along with our bodies, or at least call a truce.”

“With my experience of illness came a lack of trust in its ability to heal and stay healthy. I lost all trust that it was able to do its job.”
I choose this examples because you can literally feel it how deep the betray feels and how unsure we are after experiencing mental or physical illness.

Learning to trust again
To heal your relationship with your body, you must reclaim body trust. Unfortunately for many the trust was lost way before illness. Or better said the connection was broken through well meaning parents, the medical establishment, a toxic culture, trauma, and dieting behaviors which make us less trusting of our bodies as we age. We end up turning away from our bodies. You can try to make better relationship with your body through different ways. Not all at once of course.

  • I cannot stress enough that it takes a lot of time for learning a new way of existing within your body. You really need time to heal and time to adjust. It is very common that you push your body too hard to soon. “I slowly gain my strength back. I rushed back to the gym only to find myself with a hernia and back in the hospital.” It is very hard not to rush back into your old ways of existing. On the other hand it is also very hard to accept if time doesn’t help and you are not able to go back to normal. “Fitness was my life. I opened a gym and was working out and teaching classes all the time. Then I got a heart condition. At first it looked that the operation will solve everything and I will be back to normal very soon. It didn’t turn out that way. I am struggling to find any meaning in life. What will I do if not fitness? I feel mad, betrayed and lost.”
  • We normally focus on what we aren’t able to do anymore. How many times I hear in my office: “Before panic attacks started, I was able to drive without a problem or I was active and running around the city all day long. Now I am afraid to go to the grocery store.” If the things doesn’t fall back to normal in decent amount of time we feel frustrated. And I agree, we need to grieve our old life as well as we can focus on what our body is able to do despite the difficulties. Something so “little” like we are able to walk or we are able to come to therapy despite anxiety counts.
  • Although I don’t believe everything is preventable with a healthy life style many of illnesses and psychological disorders get better with healthy, organic eating, moderate exercise and self-care (bath, good book). “Many of us, as cancer survivors, vow to take better care of our bodies after cancer treatment, and data does show that this helps lower the risk of recurrence. I work on healthier eating and physical movement. Fear was a great short-term motivator, and I was extremely fearful. After active cancer treatment ended, though, fear was not a good long-term motivator for me. My psychotherapist says fear is not a good long-term motivator for most people. It isn’t sustainable.” Fear shouldn’t be our only motivation we need to realize that it will be quite a bit of work to maintain healthy life style and falling off the rails is something that is expected.
  • Learning to listen to your body. Our body is sending us signs all the time. Mostly we ignore them because “we can’t rest now, we can’t eat now, we can’t bread now because there is stuff to do.” I love to give my clients one exercise that drill us to listen to your body more: Before you eat ask yourself how hungry you are from 0-10. After eating ask yourself again how hungry you are form 0-10. This is one example how we can start. With asking our body: “Hi, how are you, tell me what you are saying.” I suggest that you checking in regularly, acknowledging what is needed, and acting accordingly. “I was still disconnected from my body. Sure, I was eating at regular intervals throughout the day, but it still had very little to do with my actual appetite cues. It was more of a prescribed regimen for eating. Thus, I ate pretty much the same thing every day because I knew how it would make me feel, and I trusted that it was the “right” amount for my body to maintain its current weight. It was also hard when I had a food craving for something out of the norm.” The body sends us signals about its internal state. “All the discomfort and discombobulated symptoms I felt during my descent into depression and anxiety were by no means my fault but they did give me clues to what I needed in order to start healing”. This clues are not the same every day. We cannot put our body to regime-this is just another form of not listening to what it is saying. Our body will tell us what and how much of it is needed.
  • I believe there is nothing wrong to go to the doctor and check if your fears (something is wrong with my body) are real. It is ok to go and check for calming your mind. It is a part of healing process and trust me with time, work on yourself and positive experiences the checkups will be less frequent. “When I am afraid of my body, I try to get reacquainted with it. I hug myself and tell myself it will be OK. When something concerns me, I allow that it is OK and rational to go see the doctor right away, especially given my history as a cancer survivor. There is no point in letting worry eat away at me. On the days that I don’t like my body, I focus on something else or face up to everything that happened and honor my scars with massage and lotion. I try to make peace with my body. It is an ongoing process for me.”
  • Touch is very important. And a very good way to connect with your body. Your touch and touch of others. “I schedule regular massages and other self-care activities such as Epsom salt baths, facials and manicures.”
  • Sharing your experience has tremendous power in healing process. You can speak about your experience in therapy, with friends and family or take it the step further and speak in public or teach others about what you are going through.
  • Build trust by engaging your body in mental conversations about your desire for the two of you to cooperate and overcome the ailment. You can lay down comfortably and close your eyes. Imagine your body laying down. Start talking to your body in your mind and imagine what your body would answer. Listen to it and ask questions. Tell him how you are feeling and why you are hurt by it. Tell him also what you love about it. Mental conversation should be a regular thing between you two. It is like maintaining a friendship.
  • Find a balance between fighting for recovery and quality of Life. Managing your symptoms and working on your recovery can be a full-time job which leaves little room for anything else. Without joyful moments it’s harder to cope with hardship and to stay motivated during the long process of setbacks and recovery. Try to nourish your soul and take the “time off” from your recovery. I am not advising to go off the diet, exercise plan, medication etc. just a couple of hours or days to refresh yourself. Take a trip, go to sauna, have a tea with a friend, help in animal shelter, make art etc.
  • Practice self-compassion which involves being kind to yourself and recognizing that you’re not alone in your suffering can reduce self-blame. One way to cultivate self-compassion is to treat yourself the way you’d treat a friend going through a similar situation.
  • You decide what makes your body comfortable and give your body positive experiences again. It is like you re-teach your body through pleasant sensory information. This often involves being intentional about where you take your body and what you expose it to. “I often met up with a trusted girlfriend as I recovered from the hardest stretch of my twenties, and we’d just go get a cup of herbal tea at the local Coffee Bean. With the familiar ambiance, the soothing beverage, and my dear friend’s company, I felt safe and cared for while also technically being “out and about”.”

Healing
Healing is a process, not an event. Regaining trust when it has been lost takes time and is not all that different from how we rebuild trust in any other relationship.
One thing that is very important is to realize that it is normal to feel anxious when you are not 100% if illness, cancer, asthma or anxiety will resurface. It is normal to fear the unknown. Most people get uncomfortable when they don’t know what to expect. To make your fear of unknown milder you can “prepare” yourself for it. I don’t have doomsday preppers in mind but just gathering valid information, write down in diary what you will do in case certain event happens again. Also there is a good visualization exercise that you can practice. Visualize your body in the unknown, fearful circumstances and imagine how your body is getting more and more relax.
It is important to realize that fear will come back. Yes, you can move forward and heal from the experience but that doesn’t mean that this didn’t happened. Especially in the first few years you will be triggered by news, similar stories around you and your body sensations. “Anticipating a check-up, or the news that someone you know has been diagnosed, had a recurrence or died, can bring it all back. As time passes, there are days when it goes out of your mind, but the milestones are hard.” “Fran was approaching her five-year anniversary when she found another lump. It took me straight back to a really dark place. Thankfully it was fine, but it made me realize how vulnerable I feel.”
In my practice I notice that when our outlook to circumstances starts to change two “parts of us” emerge. One is “old part”-the anxious one, the one with intrusive thoughts, have a lot of fear and distrust, doubt that things will ever change. And the “new part”-encouraging one, one that sees change and is more optimistic, the one who believes that there is a light in the end of the tunnel. With therapy, persistence or regular practice the “old part” becomes weaker. Consequently even when the fall back occurs the new part helps you to go out of anxious feelings much quicker which makes your trust in you and your body even stronger. “I’ve done a lot of soul searching, had a lot of therapy, and done a lot of work on myself over the years and I’ve made immense progress. But I have come to realize that the roots of self-doubt and insecurity are planted deep and they don’t die easily. I don’t always know what wakes those sleeping roots up, but inevitably, every now and then, they awaken. And I struggle again. I start to feel unsafe again. The ground begins to feel unsteady and I lose trust in myself again.
When people talk about recovery from illness, they usually refer to being fully healed and getting back to normal life. But in reality, regaining your former health and resuming your activities isn’t always possible. Some suffer from health problems that cannot be cured. Recovery is not all or nothing deal. You decide what recovery means to you in a sense of realistic expectations. One thing I am sure of: working on your trust will make things better even if the trust will never be fully regained.

 

 

PART IV: INTERACTION BETWEEN BPD MOTHER AND CHILD

In this article (Part IV) I want to take a deeper look at some of the research that was done regarding relationship between Borderline parent and children in comparison to mothers that don’t suffer from BPD.

Infants

Studies have found that interactions between mothers with BPD and their baby are characterized by insensitivity, high levels of intrusion, and low levels of positive response to infant distress. Mothers with BPD smile less, touch and imitate their infants less, and play fewer games with their babies. They often have difficulty identifying and appropriately responding to their children’s emotional state. These unmet psychosocial needs at critical moments of development increase risk of disorganized attachment and rob children of security, comfort, and safety from the very beginning of their lives. Newman and colleagues found that infants of BPD mothers aged 3 to 36 months were less attentive and less interested in interactions with their mother during a free-play interaction compared to infants of healthy control mothers.

Pre-school
Macfie and Swann examined mother-child attachment in 30 preschoolers (4-7years) in comparison to 30 children with healthy mother-child bond. They discovered that role reversal was significantly more likely to be present in the narratives of children with a BPD mother. More negative parent-child relationship expectations, such as the relationships characterized by danger and/or unpredictability were also found in the preschooler’s narratives. The children also exhibited greater fears of abandonment. Lastly, the children of BPD mothers also showed more incongruent (e.g. the child cleans his/her room then ruins it) and shameful self- representations (e.g. the child says he/she is bad) in the narratives.

School-age children
Different studies showed that children of mothers with BPD have more psychiatric diagnoses, such as ADHD and higher rates of BPD symptoms in childhood. These children also reported more cognitive and interpersonal vulnerability, such as a negative attributional style, ruminative response style, dysfunctional attitudes, self–criticism, insecure attachment style, and excessive reassurance seeking. Adolescents
Adolescents whose mothers had BPD exhibited more attention problems, delinquency, aggression, more anxiety, depression, and low self-esteem. In general BDP mothers reported that they feel less satisfied, less competent and more distressed with their parenting abilities.

DSM IV criteria for Borderline Personality Disorder

  1. Frantic efforts to avoid real or imagined abandonment.
  2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
  3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
  4. Impulsivity in at least two areas that are potentially self-damaging (e.g., promiscuous sex, eating disorders, binge eating, substance abuse, reckless driving).
  5. Recurrent suicidal behavior, gestures, threats, or self-mutilating behavior such as cutting, interfering with the healing scars (excoriation) or picking at oneself.
  6. Affective instability due to 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).
  7. Chronic feelings of emptiness and worthlessness.
  8. Inappropriate anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
  9. Transient, stress related paranoid ideation, delusions or sever dissociative symptoms. (APA, 2000, pp. 292-293)
BPD can often occurs together with other psychiatric problems, particularly bipolar disorder, depression, anxiety disorders, substance abuse, and other personality disorders.

My movie recommendation for understanding BPD dynamic: 
Mommie Dearest

In case you want to deepen your understanding of your relationship with your parents, please take a look at my online workshop “Mending our childhood wounds and patterns” HERE.

This workshop will help you with understanding the patterns, roles and attachment you are having in your family dynamic and will shine the light on your behaviors and wounds you are carrying with you. It will also teach you how to deal with your emotions that will evoke through this self-discovery.

PART III: TYPES OF BORDERLINE PARENT

Experts wonders whether there are actually distinct types of borderline personalities. The minds are divided but experts still try to distinguish between the different types of BPD in academic literature as well as in popular one. In Part III we will take a look at both of them. Please note that this list of types serves as a guidelines and person who suffers from BPD can have a mix of everything.

Popular Literature
Dr. Christine Lawson in a book Understanding the Borderline Mother introduces 4 types of borderline mothers that fall into high functioning or low functioning category:

High-Functioning BPD Mothers

The Witch
The Witch is someone who acts out viciously when they feel threatened, rejected and criticized. This type of mother seeks power and control over others, and reacts with unpredictable rage. Family members live in fear of triggering her. Unconsciously she is consumed by self-hatred and tends to be extremely hostile and cruel towards their children. She tends to be self-obsessed and has little or no concern for others. The Witch has no remorse and will not apologize for hateful acts she has done to her child. At the base of their need for power and control is their intense desire to prevent abandonment. This particular sub-group of BPD is very resistant to treatment. It is not uncommon for their children to develop depression, shame, insecurity, Post-traumatic Stress Disorder.

  • “There was a problem with my report card, showing I had a 0, even though I knew for a fact I had done the assignment. I didn’t have enough time to tell the teacher about it, so I would do so the next day, in order to fix my grade. I showed my Mother, trying to explain it to her, and even though I had a simple solution to fix it the next day, she proceeded to slap me across the face and scream at me for getting a 0, as well as proceed to call me lazy and not caring about my education. Yeah, I had the proof to show her I had done the assignment, could easily get my grade changed, and even then, I was still getting yelled at, grounded, and getting my things taken away. And slapped across the face.”

The Queen
The children of a Queen Mother are supposed to be her loyal subject. Queen needs to be the center of attention and uses her children to fulfill her own needs. “Pay attention to me! Love me, love me, prove to me you love me and do everything as I say!” If you disagree with her, don’t do as she says or you have your own needs, you don’t love her. Children are not permitted to have their own needs or opinions, and are not encouraged to become individuals in their own right.
She pretends to be a perfect woman who has it all together, independent, powerful, and in control of everything. They can be manipulative and vindictive and have a strong sense of self entitlement. They cross boundaries without recognition or regret. Inside they experience chronic feelings of emptiness and inability to self-soothe when distressed.

Low-Functioning BPD Mothers

The Waif

The Waif portrays the helpless victim, exhibiting how everyone is treating them and how they need protection. They can suffer from depression, anxiety, irrational fears, and feelings of vulnerability, helplessness, hopelessness and are prone to deep despair. But they are rejecting attempts by family members to help them. In this way, they passively control others and are generally unable to nurture anyone. 
They expect from the children to “save her” and believe that people are out there to get them and do not trust others. Children may feel that they can help if only they do more, learn more, and give more. Unfortunately the Waif continues to stay helpless as a means to control and avoid abandonment. She neglects her children, often they feel angry and alone and may develop codependency issues as adults.

The Hermit
Hermits may have a tough exterior and a superficial image of being confident, determined and independent. Except, they’re actually terrified of the world, and distrust everyone and are prone to rage and paranoia. They feel constantly betrayed by others and take criticism as a condemnation of who they are. Perfectionism is a hallmark of the Hermit, and they can rage or criticize (which they often do) when others fail to meet their expectations. They have no desire to go out in the world and have close friends outside of their family, especially their children. They gain their self-esteem from work or hobbies.

  • “My mother often said that as she got older, she became afraid of everything. We could never get her to try and go out with friends unless we took her out for coffee or shopping. We were the only real “friends” she had. And honestly, we were because we had to, or else, who else would she have?”

BPD types in academic literature

There were quite a few attempts to find different subtypes of BPD in academic research.

In The Essential Family Guide to Borderline Personality Disorder, Randi Kreger grouped BPD into:

  • Lower-functioning/conventional types is described as engaging in a lot of self-destructive behavior that requires frequent hospitalization. They are very low-functioning, meaning they may not be able to work or go to school. The author calls this self-destructive behavior “acting in,” an idea that correlates with the concept of internalizing symptoms.
  • Higher-functioning/invisible type is described as functioning well in most contexts, but engaging in a great deal of “acting out” behavior, such as verbal abuse, criticizing others or becoming violent. This description correlates well with the concept of externalizing symptoms.

One study examined types of borderline personalities based on a personality disorders that co-occur often with BPD. They categorized person in one of the 3 clusters:

  • Cluster A tended to engage in more paranoid thinking and eccentric behavior.
  • Cluster B tended to have more dramatic or arrogant personalities.
  • Cluster C tended to be more fearful.

Another study examined BPD subtypes in adolescent boys and girls. Interestingly enough study found reliable BPD subtypes in girls, but not boys. Girls with BPD tended to fall into one of the following categories:

  • high-functioning internalizing
  • depressive internalizing
  • histrionic and angry externalizing

Another study found three BPD subtypes:

  • withdrawn–internalizing
  • severely disturbed–internalizing
  • anxious–externalizing

Individuals with different presentations of BPD may respond differently to the treatment. In this study, individuals from the severely disturbed-internalizing subtype did not see symptom improvement with treatment, where those in the anxious-externalizing and withdrawn-internalizing subtypes did.

The last subtypes of BPD I want to write about is from T. Millon. He lists 4 subtypes of BPD:

  • The Discouraged Borderline looks like individual with Dependent Personality Disorder (codependent). They tend to be clingy, go along with the crowd, and walk around feeling somber and somewhat dejected. Deep inside however, there are often angry and disappointed with the actions of those around them. Scratch the surface, and that anger could explode, but they are much more likely to do harm to themselves by self-harming or even suicide. 
Some of the symptoms common to this subtype are: excessive dependence upon others, cycles of withdrawal and aloneness, passive, permissive, recurrent depression including tearful episodes (more common than rage episodes), anger can feel sudden and surprising to others, paranoia and self-persecution, more likely to deprive rather than indulge oneself, victimized, tendency to evoke sympathy, feelings of abandonment can invoke psychotic episodes, trigger desperation and suicidality, irresponsible behavior, uses drugs, alcohol, food, money, or sex for self-soothing, tendency to use fantasy to escape reality, gives away or destroys belongings, suffers from chronic or recurring illness or somatic complaints.
  • Impulsive Borderline seems to be a first cousin to the Histrionic Personality Disorder. These individuals tend to be flirtatious, captivating, elusive and superficial. They are highly energetic and seek out thrill after thrill. They are easily bored and seem to have it never ending appetite for attention and excitement. As their name implies, they will often act without thinking, getting themselves into all sorts of trouble. Such individuals can often be very charismatic and it’s easy to get caught in their spell. This type of person is in constant conflict with society. Bouts of violence are not uncommon. This person may have antisocial personality disorder as a co-occurring diagnosis. This person is operating in an Abandoned Child mode–a plea for attention, any attention–as well as an Angry Child mode. The Angry Child believes that other people deserve to be punished for his/her pain, and behaves accordingly. This type of person with BPD may have poor impulse control, abuse substances, or self-harm. On the other extreme he or she may not care about himself/herself, it’s all about what the other person thinks. This often results in extreme efforts to avoid disapproval and abandonment.
  • Petulant Borderline is unpredictable, irritable, impatient, and complaining as well as defiant, disgruntled, stubborn, pessimistic and resentful. They are torn between relying upon people and at the same time keeping their distance for fear of disappointment. They vacillate between feelings of unworthiness and anger. This anger can be quite explosive. This is a passive-aggressive person. He or she will injure himself or herself, either physically or emotionally, in an attempt to get needs met. This person has an unstable sense of self, a frantic fear of abandonment. They operate in an Angry Child mode. He or she is angry and will hurt friends and family as a result. They often doesn’t recognize the anger-the world is the problem, not them. They don’t know how to express their needs in a healthy way, so relationships seem to be a game of “If you really loved me” or “You should know what I want”.
  • Self-Destructive Borderline is marked by his constant sense of bitterness which they turn inward. They will often engage in self-destructive behaviors whether it is conscious or unconscious. Their levels of self-hatred can often reach monumental proportions leading them into all types of self-destructive behaviors, ranging from poor healthcare to reckless driving to performing humiliating sexual acts. This person often suffers from depression as a co-occurring diagnosis and is a self-injurer. This is a person who feels that no one cares, and reacts by not caring about himself or herself. They operates in an Abandoned Child mode. Since they don’t feel loved, they reacts in self-destructive ways in an attempt to feel something instead of nothing. They lives in terror of abandonment, is self-loathing, and has no idea who they are inside. Thoughts of self-injury or actions are a given in this type.

In case you want to deepen your understanding of your relationship with your parents, please take a look at my online workshop “Mending our childhood wounds and patterns” HERE.

This workshop will help you with understanding the patterns, roles and attachment you are having in your family dynamic and will shine the light on your behaviors and wounds you are carrying with you. It will also teach you how to deal with your emotions that will evoke through this self-discovery.

PART II: DAMAGES OF GROWING UP IN BORDERLINE FAMILY

In the title of this article I used the word “damage”. This word is a good description of how children that grew up in Borderline Families feel inside – damaged. Let’s go into details, what kind of emotions, feelings and actions are hidden behind this word. Many people in counseling who were raised by a borderline parent end up struggling with anxiety, low self-esteem, issues with trust and intimacy and difficulties being vulnerable with others.

Mind reader
Children of BPD parents routinely become overly sensitive to the moods and needs of others. They needed to adjust to their mothers mood and predict how she would react. Many grew up being afraid of their mother. They are constantly doing “risk assessment” monitoring their mother’s moods so they can manage the situations and protect themselves from anger and drama.
In adult relationships they are responding to these invisible demands from other people. The problem is many times they are adjusting to something that other (healthy) person doesn’t expect them to. The “secret” demand is not really there like it was in their childhood. It is really difficult for them to go out of this mode and trust that nothing bad will happen if they don’t please the other. The realization that we are all adults, responsible for ourselves doesn’t come “naturally” to them.

Are my emotions real?
It is extremely hard not to doubt their perception for the children of BPD parent. Their perception was always questioned and their emotions were invalidated. This may lead to children who deny or question their emotions and emotional responses. If you are constantly told that what you are experiencing is not real you star doubting your feelings and your views of reality.
Children have a very difficult time expressing their feelings because they can rarely distinguish between their feelings and their mother’s feelings.
This doubt is also shown in the perception of their childhood. Did it really happen? A part of them doesn’t believe it fully because it was always denied by their Mothers who never took the responsibility. Furthermore in calm periods, when the parent is behaving better they begin doubting whether the bad things actually happened. 
In adulthood this can be triggered every time someone is disagreeing with you. If you are not a 100% sure into what you wish to say you rather pull back and doubt your truth. More over even if you are a 100% convinced that what you are seeing is a red picture, you can become convince you may be seeing it wrongly, perhaps it is orange after all. You need a constant reassurance from others that what you are feeling and thinking is valid and right.

  • “I’d been so entrenched in that fog throughout my childhood and early adult life that I was unable to see clearly the reality around me.”
  • “When I found out, in 2006, that she’d drained my trust fund, I was horrified. But on some level, I was also relieved: so much of the nightmare of my relationship with my mother had happened in secret that I struggled to know if it was even real. But now I knew it was. Now, I had proof, and I could finally leave her, with a clean conscience.”

Hard to leave
Children of BPD parents have a really difficult time to physically or/and emotionally move away from their parents. Because they were hearing how bad of a child they were when they wanted to be independent they have trouble moving away or cutting their mothers off. This guilt is binding them to their mothers and it is really hard to cut it off for good. In my practice I mostly see emotional bond that is the hardest to let go. They feel obligation to visit their Mom, speak to her, make sure that she is O.K. Although it is apparent that they are not doing this because they want to but because it is expected from them.

Overly critical

They act and feel like they are never good enough. Lack of self-esteem is very common with them. They are really hard on themselves and at times even brutal. It’s like they internalized their Mothers criticism and now they are treating themselves the same way.

  • “I grew up hating myself and relying on my mother for all of my self-worth.”

Illusion of love
The adult children of borderlines struggle with the illusion that they were loved when they weren’t. They feel lack of love towards their parent but they blame them selves for that. This loop is created because a Borderline parent gave them the constant feeling that they are not loving towards them because they are a bad, ungrateful children. They often ask “I must be crazy if I feel like this about my mother right” or “maybe I’m not a good enough child, if only I try harder, she will love me” not realizing they will never measure up in their mother’s eyes.

  • “I feel like a horrible daughter for having bad feelings towards my mother. Sometimes I even think it would be easier if she was just dead. I try to explain my feelings to my boyfriend or a friend and everyone seems to think she is the nicest person ever. She manipulates everyone. They all think I am just being dramatic.”

Fantasy World
Many escape to fantasy world during the childhood and if they don’t resolve what was happening to them while growing up also in adulthood. It is very common that they fantasize the death of a parent. Only children who were severely physically or/and emotionally abused have these types of fantasies. The fantasy is the only way to get out of the toxic environment.

  • “I escaped my childhood like most traumatized children do, by disassociating from reality and fleeing into fantasy. There were window ledges and shade trees that called to me, closets and woods—places I could get away to dream.”
  • “I remember playing Tom and Jerry cartoon nonstop in my head before going to bad. This way the only way I could calm down and fall asleep.”

Anger

Unadorned the guilt, doubt, feelings of unworthiness bring to a lot of anger towards Borderline Parent and their Childhood. They find it unfair (and it is) that they had childhood like that and all the problems that are coming from it. They feel angry that they need to go through the therapy while their Mother is not taking the responsibility. They feel angry that they need to face the pain while somebody else was the one who FUCKED UP.

  • “I’m angry that I didn’t have a childhood, that I witnessed horrible things, was abused in many ways, and that my relationship with my siblings took a toll. I’m just pissed. But more than anything, I’m angry that my mother will never really “get it.” She’ll never see or understand the pain she has inflicted. Really all I want is an acknowledgment of what she has done and the amount of work I’ve had to do to dig myself out of this bottomless pit she dug for me. I want an apology. And then I want to be left alone. I’ve had to try to come to terms with the fact that I will probably not get that from her. Which just fuels my anger. Ugh. ”

Fear of becoming like Mother
The fear of becoming just like your parent can increase with age. Some even deny their wish to become a parent because this fear is running so high. They are trying to prevent the pain that they were feeling when growing up. Maybe comparison to you parent is not that obvious at first but it can occur in small everyday stuff like “I am not drinking coffee like my Mom did.” To overcome comparison and realize that same or similar features don’t make you your parent is really challenging.

  • “I resigned to spend my life proving that I was not her. I’d place a mental check mark in the “not-my-mom box” when I hit a milestone. Attain a college degree. Check that box! Still speaking to my dad after age 21. Check! Not addicted to alcohol or painkillers. Check. In retrospect, being on constant red alert for mom-like tendencies was concerning.”

Relationships
Children of BPD parents have trouble with interpersonal relationships. It is very often that they develop codependent tendencies. They can also use manipulation to maintain relationships or over pleasing behavior. It is not uncommon that they find themselves in destructive relationships which bring them pain. They are being unable to create a true intimacy. They are preventing it through constant fighting, distance (emotional or physical), manipulation, codependency etc.
 Because they were often told that the World is a bad place and they have trouble to trust people. Also to trust that they are worthy of love.

  • “I just realized why all my relationships (platonic and romantic) are superficial and hence not long-lasting. I have constructed an invisible armor around me for protection. If they don’t get too close, they won’t hurt me.”
  • “I have a hard time voicing my opinion and saying when I think I’m right. I’ve been in a relationship for 4 years and I’ve changed a lot during therapy. At the beginning of this relationship, I was pretty submissive and didn’t want to cause any conflict. I am now becoming more confident in myself and feel okay with a little bit of conflict.”

Realistic expectations
Perhaps the most difficult thing to accept is that Borderline mother is not capable of insight and will never truly understand why her child avoids her or sets boundaries with her. She is not taking responsibilities for her actions and is making you feel like you are overreacting or she was doing you a favor. It is really hard to accept that your mother will never acknowledge your feelings or agree with you when she is in the wrong. Yet alone apologize .

  • “Why do you act guarded around me?” Child “Because you have hurt me in the past and I don’t want to be hurt again” “I hurt you! I don’t remember that. When?” Child “You used to hit me with a belt when I was a child”
  • “I don’t remember that. You are making it up. You lousy shit”.
  • “My mother could not apologize. She could not take criticism. When it came to discipline and power struggles, she had to win.”

What the future holds?
Unfortunately being raised in BPD Family makes you prone to the development of psychological disorders like depression, anxiety, Post Traumatic Stress Disorder (PTSD), Narcissistic Personality Disorder and also Borderline Personality Disorder. Recovery from being raised by a borderline parent is often a lifelong process. Although it really gets better with time if you work on yourself. Being psycho-educated about what is going on is important first step towards understanding. You can only work on what you’re aware of.
I would recommend working with the therapies to help you deal with all the emotions, pain and feelings and give you the corrective experience. With time and many positive experiences you will be able to move away from the toxic dynamic. On that note it is also important to say that Borderline parents suffer as well. They have their own past traumas. That being said, parents are not off the hook for abusing their children. As an adult it is your responsibility that you take care of your own wounds before you become a parent. And it is very important that you start to take care of your childhood wounds, to stop the destructive cycle.

In case you want to deepen your understanding of your relationship with your parents, please take a look at my online workshop “Mending our childhood wounds and patterns” HERE.

This workshop will help you with understanding the patterns, roles and attachment you are having in your family dynamic and will shine the light on your behaviors and wounds you are carrying with you. It will also teach you how to deal with your emotions that will evoke through this self-discovery.

PART I: MY PARENT HAS A BORDERLINE PERSONALITY DISORDER (BPD)

In this series of articles I won’t talk about BPD but I will focus on the dynamic that is created when you are raised by someone who is struggling with BPD. Until now there was a belief that more women than man suffer from BPD. That’s why I will talk about mothers in this articles. But lately there have been studies that have shown misdiagnosis in male population. It is now believed that percentage between man and women with BPD is close to equal.
From the birth on, the connection between you and your child is very important. It is crucial for physical survival but equally important for psychological well-being of the child. Unfortunately not everyone is having luck with their parents which can lead to serious mental disorder.
Most people would not believe what goes on in Borderline families. The dynamics are intense, destructive, subtle and not readily apparent to the casual observer. BPD is fragile and unpredictable personality. They can be very successful but they struggle with interpersonal relationships. These may be associated with episodes of impulsive aggression, self-injury, and drug or alcohol abuse.
People with BPD are often described as a child in an adult’s body. These individuals can be incredibly immature and seem to be stuck at an early age of psychological and emotional development. Consequently BPD parents frequently parentify their children-meaning they make them responsible for their emotional and physical needs which is a form of a child abuse. While a person with depression or bipolar disorder typically endures the same mood for weeks, a person with BPD may experience intense bouts of anger, depression and anxiety that may last only hours, or a day at most.
A mother with personality disorder often lacks empathy, feels entitled, rejects personal responsibility for her behavior, engages in bullying and intimidation, is dishonest, has the relative morality of a small child, has chaotic and extremely dysfunctional relationships, has no sense of fair play and is completely self-obsessed. The borderline parent lacks insight and believes that she is the fine parent of an ungrateful child and goes to any length to prove that this is the case. But how is it to be on the other side? On the side of a child?

What dynamic is in BPD Family?

No space for you
Children of BPD learn to sacrifice their true selves because they need to be focused on her BPD parent in order to survive. They are emotionally or physically abused if they feel differently as their mothers. If they reject her offering (advice, suggestion, emotion) they are portrayed as a bad, ungrateful, disloyal children. Because of the attachment issues borderline mothers tend to smother their children and treat them as small extensions of themselves. Child learns quickly that it is best to get along otherwise there will be a conflict or the emotional cut-off. For a child who is dependent on their mother there is no other way then to sacrifice his identity and go along with her. The child interacts out of obligation. Autonomy, the freedom of self-direction and self-expression, is not welcome. The following examples shows how every situation turns out to be about her:

  • Teenager child is telling her Mom that he feels depressed. Her response: “What do you have to feel depressed about? You know what I was going through when I was your age”. The feelings and potentially serious condition of a adolescent are ignored and denied. “Mom, I cannot make it to dinner tonight, I don’t feel well.” Mother: “You don’t feel well? I am still suffering from the Cesarean Section they gave me so that you could be born.”
  • “Even when trying to confront the issue, any issue, it gets made all about her pain.”

Splitting

Common defense mechanism of BPD is splitting. Which means that a person splits off the good and the bad in themselves and projects bad onto others. This can also be a reason why your mom is denying all the bad she has done and has chosen to see only the good in her. 
In families splitting often occurs by having a good and a bad child. Borderline mother forced teams with the good child whom is required to behave like her. The all good child often feels guilty that they survived the abuse especially relative to a no-good child. This dynamic causes a toxic, estranged relationship between siblings. The lack of closeness is creating isolation, every member of the family is on it’s own. 
The splitting also occurs by being good one moment (idealized) and being completely bad the next.

  • “In our family my brother was always priced by my mum. He could get away with everything. Everything that was wrong felt on me and my sister. We were taking her emotional abuse. But to think about his relationship with our mom. He needed to be there for her in every moment, listening to her, defending her and sleeping in her bed till early teens.”
  • “My Mom always priced me when I brought home the good note. She couldn’t stop giving me the compliments. How smart I am, how she admires my determination and motivation for school. The moment I brought home a bad note, well it wasn’t really bad, but it was not the best, I needed to sit and listen how lazy I am, how I will never become anything.”
  • “I sometimes wonder if she will ever be able to have a conversation with me without saying something along the lines of, “You’ve hated me since you were a little girl.” And then she just calls up one day and all is well, as though she hadn’t just threatened to end our relationship a day before. Usually, I get split back to the light side (as I call it) when she needs something that she knows I can provide. Then I’m back to being a good person.”

She loves to help
With borderline dynamic there are three kinds of things connected to help.

1. She is often a valid member of a community. Willing to help everyone and give all she has to them. Sometimes she can literally give your things to somebody else in a name of help.

2. When it comes to helping you it often comes with a high price. The problem is the help is not being offered for truly altruistic reasons, but rather it is being offered to support the mother’s desired image of being a good mother. In case you reject her help it can be taken as an offense. Once you ask for help they can control you with that and try to win a fight with throwing it at you even years after. “oh, you can’t do this for me but I could help you get a job during collage.” The child quickly learns not to ask for help and tries to avoid his/her mom helping them because they know they will have to pay for it at some point or they will be paying for it forever.

  • “Besides the fact that she’s done this so many times it’s turned into crying wolf at this point, her method of asking for help “with a knife to my throat” also takes away any of the warm feeling that I might get from helping her.”

3. She expects of her children to help her or better said save her from every emotional or physical problem she is having. They often play “I am your mother” card. “oh, you don’t want to do this for me but I am your mother. You should take care of your parents.”

Neglect
Physical and emotional neglect is very often in Borderline families. People with BPD can be so absorbed in their own pain that they are incapable of taking care of their child. They can also escape to substance abuse or other addictions while leaving the child to take care of him/herself.

  • “My mom locked herself in her room for days. I was very afraid that she will do something to herself. I was forced to take care of myself and younger siblings and also spending my energy to convince her to come out of the room.”
  • “She rarely showed affection. She would also get onto my brother and me if we said, “I love you”, as she would scold us and say to only say that phrase if you REALLY mean it. She would never come to you and show affection. We would go to her for hugs and kisses. I remember trying to hold her hand in the movie theater and her pulling her hand away, looking at me funny.”

Rage
Rage outbursts are very common in BPD families.

  • “Once my father moved out and I became a preteen, something changed. My mother and I started fighting. We fought the way I remembered my parents fighting: brutal, out-of-control arguments that would last for hours. I couldn’t tell if this was normal or not.
  • “My mother would fly into rages, telling me how awful I was for hours, and then, moments later, would coolly ask me what I wanted for dinner, appearing to not even remember that it had happened. She acted like I was crazy, and so I assumed that I was. She took me to a child psychologist to deal with whatever supposed defects I had that led to us fighting so often. Then she pulled me out of therapy after a few sessions, when she got into a screaming fight with the receptionist.”
  • “My mother could turn her rages and sadistic behavior on and off like a light switch. She would instantly become “normal” the moment another person entered the room. My mother could be nasty as a snake to my brother and me and then turn it off and be sticky sweet to whoever is at the door or on the phone. Even at a young age, this behavior made me sick.”

Criticism
Mothers with Borderline Personality Disorder often put-downs, insults and criticize their children.

  • “This is a woman who criticizes everything about me. From my “boring, plain, unadventurous” taste in clothes (not boring, just not enough like her), to my “annoying, inconvenient” pescetarian diet, to my need for a spiritual life (“religion is for weak, stupid people who need a crutch to get through life”). Although I am gifted with artistic talents that have won awards and put me on famous stages, nothing I do is ever done without a touch of criticism on my performance.”
  • “I became keenly observant of her methods, never questioned her authority, and strived to be the best at everything, because anything less was a massive disappointment in her eyes.”

But on the other hand they are unable to accept the criticism. They can even go against the law of physics if necessary.

  • “She didn’t see reason to change course if her direction conflicted with the instruction manual, or, say, the natural laws of physics.”
  • “In college, I finally grew brave enough to tell her she had a drinking problem, but after three pointless attempts at an intervention, my efforts seemed futile. Her reality, no matter how factually incorrect or emotionally unjust, was all she could see.”

Blame and guilt
BPD parent can use guilt tripping for many different occasions to achieve what they want. Often they use it because they are afraid of the separation and are making their child feel bad every time s/he wants to do or go somewhere on their own. They of course don’t forget to mention “how alone they feel and how bad of a child you are because you are not spending more time with her”. Although the time that is spend with her is mostly in conflict.
Consequently you grow up blaming yourself for everything-for your mothers mood, for unsuccessful relationships that you are having, for wanting to have time for yourself, for eating too much, for eating too little, for not being “more” successful, for…

  • “I proceeded to ask her why she always has to twist things to make me feel bad, and she proceeded to tell me that I should be ashamed of the way I treat her, and blamed me for making her feel bad. The meeting ended with her throwing her Christmas present, a check for the wedding (which she initially refused to contribute to in any way, and wanted me to invite about 5 of her personal friends) and some of my stuff through the window of my car, and tell me that she’s done.”
  • “Out of the blue my mom asks me what I think about my new Mother in Law. I tell her that I’m very happy with her, and that she is a kind, patient, gentle woman, who listens and gives good advice, and always roots for me. Well, I might as well have crashed the car at that point, because my mother’s reaction was horrific, and completely manipulative. She said, “Oh good. You must be so happy to finally have a mother that cares for you.”

Abandonment
Abandonment issues are at the core of borderline personality disorder. They view separation as betrayal. They can use many forms of manipulation to try to prevent it. One of the most common manipulations is playing a victim, making you feel guilty, threatening with suicide and having an angry outburst. Abandonment doesn’t have to be real it can be something completely normal for child’s development. Like having a sleep over at a friend.
There are also other ways that BPD mother tries to prevent abandonment. One of them is to make the child her best friend. They develop a relationship with a child that is preventing him/her to become an individual. She may look to this child for comfort and validation rather than the other way around. It’s difficult to tell where the boundaries are between the mother and the child. Both tend to cling to each other in fear that the other one will leave.
It can also take the form of infantilizing their children. The mother is unable to tolerate her child’s developmental growth toward healthy independence. They find it difficult to adjust their parenting strategies to match the developmental needs of their children. Oftentimes, children who are being infantilized may develop depression, anxiety, developmental delays and may even be misdiagnosed with an autism spectrum disorder. In the extreme form infantilization can lead to Munchausen by Proxy.

  • “My mother always had a problem with either my Dad leaving (business trips, trips to see his family, extracurricular athletics) or her present husband (my step-father) going away. She stays home all the time, and presently has little to no friends.”
  • “There will usually be some kind of message or voicemail that doesn’t leave you the option of ignoring her, sometimes over-dramatizing what is going on to the point where it will make me panic, or at the very least, make it clear that I’m a horrible child if I don’t respond right away.”

Parental alienation
A mother with BPD may not be able to tolerate a loving relationship between her kids and their father. It is not uncommon for these mothers to speak poorly about their dads in an attempt to turn their children against them. The child can be used as a weapon to carry out her push/pull relationship with the father.

  • “Throughout my life, she looks for signs that I am “betraying” her with my Dad. She asks leading questions or comment about how I should or shouldn’t do something that might involve my Dad, testing me to see where I stand.”
  • “When my Dad showed me attention or gave me money to buy something nice for myself. She always punished me for it by silence for days or not giving me lunch money: “because your father already give you some.”

Jealousy
Mother with BDP is often jealous of her own children and sees them as a competition for attention, love, admiration and resources. The possibility that her child may be smarter, more attractive or popular can be very threatening to her.

  • “Even before that I could never bring anyone around my mom because she’d always find a way to make it seem like she was the perfect mom. The sickest part is that people would think she was this wonderful Christian women that could be the mom they never had. These people would confide in her and tell their deepest secrets and she’d share them with me. Trying to hurt me by showing me how much everyone loved her and wanted her.”
  • “I understand jealousy all too well. My mother actually slept with my first boyfriend to break us up. And she had a hand in my marriage crumbling as well.”

Control
There is a high need of control with BPD parents. They believe that they are entitled to unilateral control over the children. It is common that BPD mother sees the children as her property. She feels that everything that is going on in the family needs to go through her. In BPD families there are times with over-involvement, intrusive behavior and periods of withdrawn, avoidant behaviors. These behaviors may also manifest as oscillations between hostile control and coldness. It is quite common for parents with BPD to attempt to control their children’s behaviors, feelings, and actions to a degree that inhibits their child’s ability to develop independently.

  • “I always thought I had a great and loving mother who only wanted the best for me until I recently went to college. I realized it was more about controlling my life than actually wanting to help me. She was practically living through me. Every time I tried to tell her that she needed help, she became the victim and talked about how horrible of a daughter I was and all the lies I create.”
  • “I can’t make my own decisions because she always made them for me.”
  • “She always told me what to do and how to do it. How I should dress, who I should visit, with whom should I be friends, how should I prepared the food. She always corrected me in every way possible.”

Distraction
It is very common for BPD personality to find a way to distract themselves from reality of life. They turn to any kind of substance abuse and addictions, overspending, workaholism. Basically they can make every item their current obsession until they move on to a new one. They distract themselves from being left alone with their thoughts. It is very common that they struggle at nights when everything calms down.

  • “My mother is a shopaholic, and buys incredible amounts of stuff. She has purchased hundreds of hat boxes but she doesn’t wear hats. She purchased hundreds of shoes but she rarely leaves the house. As far as the eating, she is very, very overweight and binges on food through the night. She stays up all night and sleeps all day.”
  • “She also tends to really focus in on things that can distract her. When she was working, she obsessed with her work and left no time for any social life, and when she retired, she found new ways to stay constantly distracted”.

Center of attention
BPD personality demands attention at all times. They often creates high drama in order to get and keep the attention.

  • “On my wedding day my mother make it all about her. How her daughter is leaving her. She wept so loudly that we needed to stop the ceremony in order to calm her down.”

In Part I we saw what kinds of dynamics can occur in Borderline Families. In the second article (Part II) we will take a look at what kind of psychological burden a child who was growing up in Borderline Family takes with him/her.

In case you want to deepen your understanding of your relationship with your parents, please take a look at my online workshop “Mending our childhood wounds and patterns” HERE.

This workshop will help you with understanding the patterns, roles and attachment you are having in your family dynamic and will shine the light on your behaviors and wounds you are carrying with you. It will also teach you how to deal with your emotions that will evoke through this self-discovery.

TWO LAYERS OF ANXIETY*

*the article is based on my private practice observations

Anxiety is often a reason why people knock on my door. It is also the subject that I am most drawn to. That’s why I would like to write a short article based on my work experiences about dealing with anxiety.

In short, I approached anxiety in two levels:

  1. Dealing with symptoms: In the Internet era, people educate themselves about panic attacks and how to ease symptoms. Consequently this level is the most accessible for self-help. Cognitive-behavioral psychotherapy is mainly focused on this level. Many people come to psychotherapy equipped with the knowledge and exercises how to help themselves with panic attacks. But why do those people still come to therapy? I believe focus in this level is not enough for the long term anxiety relief. In my practice, I focus 80% of my time on second level:
  2. Deeper approach: Psychotherapeutic relationship offers safe, understanding, trusting environment which is especially important for people with anxiety. For them, knowing that they have safe place, whit expert who they can trust, play enormous role. I notice that people with anxiety often keep their fears and worries to them self, they are overly consider with other people’s emotions and are on the mission not to hurt others, their true content is locked inside them which one day explode into panic.
    In time, the therapeutic relationship is safe enough for all the hidden content to come to light, having somebody to talk about it, relieves the burden that is kept inside and coses stress. Often we are so used to carrying a burden that we don’t realize how anxious our mind and body are feeling.

What (not) to expect in therapy

A lot of people believe that there is some kind of recipe for panic attacks solution. And they expect to get it from therapist. There is not just one anxiety, I see different kinds of it, some overwhelming others »just« as symptom form some other mental disorder. Therapy needs to get to its core and there is no recipe for that.

I don’t believe that you can cure anxiety response 100%. Let’s not forget that no matter how unpleasant it is, it is still a normal human response. The only difference it is that by people with anxiety, the centers for danger are triggered where there is no actual life threatening situation. The difference after therapy is that less things are causing us stress. Before it was stressful to go to the grocery store, now it would be stressful when having an accident. That’s a normal body/mind response.

HIGHLY SENSITIVE PERSON (*HSP)

In this article I will summarized the work of Elaine N. Aron, Ph.D. book, The Highly Sensitive Person. In her psychotherapy practice she worked with HSP for decays and come to an interesting conclusions.

In connection to anxiety: HSP often treats his high arousal as anxiety. He got false messages form the environment that unpleasantness he is experiencing (due to high arousal) is actually fear. Consequently when they get aroused (annoyed, tired…) that automatically triggers fear.

Twenty percent of the population is born with HSP, 30% of them are extrovert and it effects women and men equally. The author distinguish between two subtypes:

First one is calm, quiet and satisfied quickly the other is slightly contradictory, for example he is curious but careful, cheeky but scared, he gets bored very quickly but at the same time, he is quickly overstimulated.

Hypersensitive nervous system
HSP have a hypersensitive nervous system. Exposed to the same amount of stimulus, they tend to absorb more and consequently they get aroused faster. Also they process everything very deeply and get easily overwhelmed.

They pick up the stimulus form the environment that many others would normally overlook. Some people call that good intuition. Their delicate sense make them a good writers, historians, philosophers, judges, artists, researchers, theologians, therapist, teachers, conscious parents and citizens.

Main characteristic of HSP Person:

  • Creative (unusual imagination), very empathic people.
  • They tend to have more vivid dreams and nightmares then others. Even if they didn’t have any traumatic experience it is not unusual for them to fear the dark. No wonder many of them have trouble sleeping.
  • They feel hunger very strongly.
  • They have hart time making decisions, especially because they are being more aware of consequences, wanting to make right by everyone and paying great attention to details.
  • If they had many negative experiences in life, they are more prone to anxiety or depression. HSP children can get criticized for their sensitivity, often the environment doesn’t know how to react to it. That’s why many of them feel like there is something wrong with them. In the environment that is in tune in with their sensitivity, they flourish to a confident person, viewing their sensitivity as a gift.
  • They react to criticism more intense than others which can result in avoiding criticism all together, by trying to please other people and putting others first.
  • They have lower pain tolerance. They feel changes in their body more profoundly, that’s why they are having trouble to brush the painful sensation off their mind.
  • They tend to be more sensitive to violence in the movies and real life. Due to their great imagination, they can vividly imagine what it would be like. The images can linger with them for weeks or even years.

Are you a HSP? Find out in these questioner: http://hsperson.com/