Thursday, June 7, 2012

Dysregulation and Borderline Personality Disorder: What is it?

For those of us with Borderline Personality Disorder it’s all about emotional dysregulation. There are even people that would like to change the name of this disorder to Emotional Dysregulation Disorder. So what is emotional dysregulation? According to the Wiki:
Emotional dysregulation (ED) is a term used in the mental health community to refer to an emotional response that is poorly modulated, and does not fall within the conventionally accepted range of emotive response. ED may be referred to as labile mood (marked fluctuation of mood) or mood swings.
Possible manifestations of emotional dysregulation include angry outbursts or behavior outbursts such as destroying or throwing objects, aggression towards self or others, and threats to kill oneself. These variations usually occur in seconds to minutes or hours. Emotional dysregulation can lead to behavioral problems and can interfere with a person's social interactions and relationships at home, in school, or at place of employment.
Emotional dysregulation can be associated with an experience of early psychological trauma, brain injury, or chronic maltreatment (such as child abuse, child neglect, or institutional neglect/abuse), and associated disorders such as reactive attachment disorder. In such cases as borderline personality disorder, hypersensitivity to emotional stimuli causes a slower return to a normal emotional state. This is manifested biologically by deficits in the frontal cortices of the brain.
Thanks for that clinical look. In short: it’s the inability to have appropriate emotional responses and maladaptive coping mechanisms. That doesn’t mean all the time. We’re not always running around in a perpetual state of trauma, but when something does trigger an emotional response it is often more severe than you would normally expect. Mood swings aren’t just happy to neutral to frustrated. Mood swings are euphoria, to aggravation, to rage. It’s a response of magnitudes.
The obvious example is that classic Borderline rage. When something goes wrong most people might experience frustration and a quick flash of temper, but for someone with BPD it might spark a complete melt down of temper and wrath. When I was in high school I recall having frustration getting my hair proper (I was seriously OCD about some stuff) and raged in a fantastic display of tears and smashing my fist through the bathroom wall. Not a normal response.  It was instantaneous and unexpected. All of a sudden I couldn’t hold back the tears, my whole body got hot, and I need to direct that feeling somewhere, anywhere. I felt like a failure, not perfect, worthless, a terrible person, not worth living. Anger, temper, self-harm, suicidal ideation, threats of suicide, panic attacks, anxiety, crushing depression…. These are the things people think of when they think of emotional dysregulation in Borderline Personality Disorder. But they’re not the only things, and not even the majority of feelings.

It’s the sense of things being so overwhelming to us. To anyone else the thing that triggers the maladaptive emotions could be inconsequential or not very important, but to me it would become the only thing I could think about. Something small and seemingly unimportant, becomes an irrevocable fixation; like a brutal car wreck you know you want nothing to do with but can’t seem to look away. Everything is directly related to my self-esteem. Little things going wrong can tie directly into our self-worth. If I don’t anticipate everything my boss might ask, I feel like a failure and fear that I’ll be fired. My heart starts to pound, I obsess over every little “mistake”, and my anxiety spirals out of control. When in reality all he says is, okay get back to me.
When these overwhelming emotions become too much to handle it could result in our brains defense mechanisms kicking in to help us cope. For me this often occurs in the form of severe dissociation. Something will be so excruciatingly taxing, I’ll be so emotionally worn out, that I’ll suddenly notice that I no longer feel much at all. I don’t even feel connected to my own body. Like a fog settling down over my mind and my consciousness taking a step back outside of my body. Not only am I disconnected from my emotions, but I’m disconnected from my physical self. It’s like walking through a lucid dream where nothing feels real but you are still aware that you control the direction and movement of events. Sometimes I wouldn’t be sure if I was awake, or a whole person. When I depersonalize or derealize it’s like being a puppet master for a Me shaped marionette. There’s no knowing when it will kick in or end. There’s no controlling it. All there is to do is wait it out and hope things calm down enough where the defense mechanism subsides and you no longer feel the trauma that set it off in the first place.

This can also have to do with emotional memory and the inability to maintain consistent and accurate perceptions of those around us. That lack of object constancy/permanency that I like to mention.
And then there are the positive emotions. But not just positive. Ecstatically positive emotions. When things are bad with BPD they are very bad. But when they are good, they’re euphoric. Love isn’t just moon eyes and warm cuddles, it’s an all-consuming cocoon of joy and safety; warmth and ecstasy. It’s often quickly followed by fear of loss and abandonment mixed up with all the other emotions that bombard us and become an overwhelming tidal wave of inescapable feeling, but in those moments and hours when it’s good, it’s like a tangible blanket of happiness. It’s what made leaving my Evil-Ex or The One so damn hard. For all the trauma and terror they’d inspire, they could also create moments of absolute desire and love. I would live for those moments. I knew they could be there, and I would hold onto the hope that they would keep coming back, despite the fact that 95% of the time things were terrible. The high of the good was powerful enough to wait out the lows of the abuse.
Emotional dysregulation is the concept that embodies all the things that make our behavior seem so wildly out of proportion to what you would normally expect. It’s the high sensitivity to emotional stimuli. They hypersensitive emotional skin people with BPD often wear. It’s the emotional vulnerability to triggering events. It’s internal and external experience that trip emotional responses real or imaginary. It’s the reactions, responses, headaches, nausea, ruminating or racing thoughts, need to lash out or crawl into a corner and die. It’s the hypersensitivity to what people say or small facial expressions or attitudes. And the secondary emotions that are created by the aftermath of our initial reactions: often guilt, worthlessness, rejection or relief. Emotional dysregulation is one long term for an even longer idea of what goes on in the emotional mechanisms of people dealing with disorders of emotion.   

3 comments:

  1. Thanks for this article. My soon to be ex, I suspect is BPD and we go through cycles of euphoria but mostly emotional dysregulation. Its good to hear what's going on in the mind of someone who has this type of mental illness...honestly I was starting to believe that I was the cause...but too many damnes if you do respond this way or damned if you respond that way prevented me from excepting this untruth.

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  2. I've been there so many times with my ex/friend--both after things she's said, and I've said--that I can barely bring myself to be the emotionally responsible one anymore.

    It used to be that I'd apologise or validate her feelings, and she'd eventually come right back to me. But it's worsened over a ten year period. Letters, calls, notes, talks, these all used to soothe her burns. Now, she's split me so many times, I'm never sure how she'll take them.

    I hesitate to even text-to-make-peace her now. The more years that pass, the more virulent her rage, and the sweeter her idealization have become. I don't know where her truth ends and her blind rage begins.

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  3. Incredible article . . . right on spot. Thank you.

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Leave me a comment! It makes me feel good and less paranoid about talking to myself =)

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