BPD Is a Chronic Stress Disorder | LOIS CHOI-KAIN
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- Опубліковано 26 чер 2024
- Is BPD (Borderline Personality Disorder) actually a stress sensitivity disorder? Lois Choi-Kain discusses the relationship between BPD and stress, introducing us to a broader view of the disorder than either the interpersonal disturbance or emotion dysregulation model.
Dr. Choi-Kain is a powerhouse in the BPD treatment world. Her short bio:
"Dr. Choi-Kain is a leader in the Good or General Psychiatric Management (GPM) approach developed by her mentor John Gunderson, M.D. with his long-time collaborator Paul Links, M.D. GPM aims to be a generic form of BPD centered care that is more accessible and just plain good treatment.
Lois W. Choi-Kain, MEd, MD, is the director of the Gunderson Personality Disorders Institute. The institute provides training and supervision for numerous proven treatments, including mentalization-based treatment (MBT), dialectical behavioral therapy for post-traumatic stress disorder (DBT-PTSD), transference focused psychotherapy (TFP), and general psychiatric management (GPM). She works nationally and internationally to expand teaching efforts on borderline personality disorder and its evidence-based treatments and engages in research to study resources for training clinicians who need direction and patients who need access to informed care. With her mentor, John Gunderson, Dr. Choi-Kain developed a training program for GPM and has been expanding its applications.
In 2009, Dr. Choi-Kain developed the Gunderson Residence, a specialized residential program for adult women with severe personality disorders. In 2013, she founded the BPD Training Institute, a major center for proliferating awareness of and evidence-based care for severe personality disorders. Dr. Choi-Kain has also developed training clinics in McLean’s Adult Outpatient Services for treatment approaches such as MBT and DBT-PTSD."
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Nothing has been more debilitating than the shame I felt for years because I wasn’t able to function well in society, made bad choices and things so often overwhelmed me. I was diagnosed with a general personality disorder and might have been born somewhat “sensitive” but I had parents who were very emotionally illiterate, neglected my needs for comfort and protection on a serious level and than shamed me for being too sensitive and not disciplined enough. It’s a loop..... and that pattern is generational and has cultural roots too. The best thing I did was stop the relationship, get out of the role of the defective one and learn how to take better care of myself. It’s painful to hear this doctor talk about “missing out on life”. I did, big time. I’m giving myself a chance now, allowing myself a future. Scientific research is great, healthy love and emotional maturity are better.
I would not believe in this "born too sensitive", all humans are sensitive. We seek relationships, and if this relationship is not available, its absolute devastating to the child. Your whole personality is based on these relationships with the primary caregivers.
"... the greatest need of a child is to obtain conclusive assurance (a)
that he is genuinely loved as a person by his parents, and (b) that his
parents genuinely accept his love ... Frustration of his desire to be
loved as a person and to have his love accepted is the greatest trauma
that a child can experience ...
(Fairbairn, 1952, p.41).
"
Frustration is the key word here, how far is that from stress?
The stress is simply a result of this, not the cause. Its like an itch you don't know how to scratch, as you lack the ability to form these essential relationships. This is also the basis of all addictions. You seek ways to scratch that itch. People start to seek release through pleasure.
"And it is this trauma above all that creates fixations in the various forms of infantile sexuality to which a child is driven to resort to in an attempt to compensate by substitutive satisfactions for the failure of his emotional relationships with his outer objects. Fundamentally these substitutive satisfactions (e.g., masturbation and anal eroticism) all represent relationships with internalized objects, to which the individual is compelled to turn in default of a satisfactory relationship with objects in the outer world. (p. 40)"
When you mean “take care of your self” I am in the same boat. I am trying to take of myself and I take it as just working. I am distressed at my Job and sacrifice myself. How did you break free?
This comment expresses so much of what I feel as someone in recovery. You suggest that it's not some innate biology at the heart of BPD but chronic neglect and shame. I couldn't agree more. The "biology" and "abnormal" brain activity is produced as a result of chronic distress and lack of tools to cope with it. As a separate point, I wish mental health practitioners would stop trying to find answers using ultimately unhelpful distinctions like "emotional" vs. "interpersonal." At least with BPD, the experienced reality doesn't parse those two things. They are one and the same. Science always tries to separate, parse, break apart, and interrogate. We need concepts and vocabulary that better match with lived experience.
@@Nobody-Nowhere just commented more or less the same thing. i don't know why this fundamental element was overlooked. i think it is the root of all things bpd and many other disorders.
@@Nobody-Nowhere ok so maybe some of us are hyper sensitive? i was always more emotionally sensitive than my sisters but also couldnt sit through my hair getting brushed because my scalp was too sensitive so i was physically sensitive too
As child of a bdp mother, I think it is critical for kids showing emo dysregulation at school age to get therapy so they can better navigate in life. In my exp with my Mom, bdp isn't just about stress but also mind blindness & dissociation. Sufferers need tools/guidance to manage their emotions & understand other peoples' povs as young as possible, the younger they incorporate better mental/behavioral habits, the better.
I really think looking into stress is key to BPD. How does stress cause the emptiness feeling one feels with BPD. I feel like just an empty shell, no idea who I am. I grew up in a very stressful family situation and have never been able to deal with stress. I am 59 years old and because of stress I isolate, and have no friends except my husband and sister. I hide out in my house and don't venture out, only when I have to. This is not a life.
💜You're not alone. I completely get it💜
Same
I can totally relate with you!
I am 57 and live the same way. Life was scary as kid growing up- lots of loud fights, then the silence of complete neglect, the shouts and screams of mom and dad fighting. She finally left for good, but my dad was so depressed and shut down for several years. It was so lonely. And we were poor. Things eventually improved but I am stuck in those trauma years, despite years of therapy and medications. That fear and sadness and anxiety is the core of who I am unfortunately. Although I have bot been diagnosed Borderline, I am very good at faking normal, but that's exhausting.
She's absolutely right about that last assertion; I'm doing the best in life I ever have, and it is not what I expected. This feels wretched and endless, having to wade through every interaction that left a mark, learn how process it, and claw out meaning and purpose very slowly. I keep reminding myself this is all stuff most people were to learn in childhood, this will take some time but the things I'm working on are improving.
Dr Choi-Kain is the first doctor I heard speaking about BPD with compassion and so much understanding. It felt like being given a hug. Thank you so much! I am in need of life rehabilitation and I wonder how to "re travel the road that didn't go so well", without being able to afford therapy.
i'm not sure how she started off saying some people are born more sensitive to stress, and find things stressful that others don't, and then immediately follow that by saying that the person manages stressful situations poorly which generates more stress. how about environmental factors? like growing up in abusive households? poor attachments due to neglect and abandonment? etc etc why the jump lol this definitely contributes to a child's ability to manage stress if they have grown up in a chaotic and/or abusive environment.
Imagine living in a world where no one liked you much, or took much interest in you, where no one found your jokes funny, where no one wanted to be you, or when you turned up people would say, oh, not you again, etc. Well, even the strongest person would get very upset after a while.
Now imagine that happening to a baby. A baby relies almost entirely on one person, the mother, for a positive interaction, if she gets it wrong, because she's tired, depressed, unhappy, whatever, she could produce a borderline.
Not every sibling will develop the disorder because it takes a unique sequence of events which psychologists are still studying. Forget genes, which at most contribute only a tiny amount to the disorder, if anything at all.
UA-cam - How Unloving Parents Create Self-Hating Children. The School Of Life
Biopsychiatrists are in the business of selling you medicines and so they like to believe in reductionistic genetic theories because this means, they believe, you have a physical illness, and therefore can be treated by drugs. But their medicines either barely work, make things worse, or stop working eventually - and no one has studied what has happened to the brain when they have stop working. The ADs never seem to work again either either, which is scary! These drugs could also leave you sex-less for life. Post SSRI Sexual Dysfunction is real - no libido. Sometimes, when a person is in terrible pain, the medicine risk profile may change and it might be worth taking some medication for a short while. But always aim to get off if it you can. Google Professor David Healy - PSSD. Post SSRI Sexual Dysfunction. Other side effects can become permanent too, like dry mouth.
This happened to me for 40 years.
Im trying to pick up the pieces. It will take a long time.
Story of my life. I hate normal people tbh
I get blind when I fear someone is cheating on me...feel so powerless that I can create a much bigger problem to the situation!
it´s never just one thing....even the explanation of BPD needs to embrace that.
I love her voice and the way she talks.
My mind is blown. Yes! This is exactly what’s been missing. This is the pathway between misery and possibility.
I cannot handle stress I get psychosis when under stress it's awful it's ruined my life
I suggest that the sufferer from BPD is still awaiting the intervention of a primary carer to enter their internal world and provide confirmation, containment and understanding of their emotional state, while at the same time the adult is desperate to keep the 'other' outside the bounds of their psyche. So there is terrible tension between the immature and demanding needs of the infant and the mature independent requirements of the adult. This, anyway, is my experience.
So well put! This has been my dilemma too.
@@coraly6821 Thank you for your comment, I find that reassuring.
Wow. Your comment took my breath away. Very well put!!!
@@jc9084 Thank you.
Ooof. What an astute comment. Thank you for sharing this!
Brain plasticity is a blessing and a curse. Dr Lois' discussing the amygdala is intriguing just as Dr Alan Schore's research on the impact of early stress on the infant right brain growth spurt is telling. My other thought relates to the huge number of somatic problems associated with mental disorders. I have long felt that the HPA axis is key. Keep these videos coming
Gabor Mate goes into great detail with regard to this arena as well. His writing is great.
Wow!….What I would give for this amazing Dr. To be mine!….Super stressed all the time. I am so sensitive & had a abusive, traumatic childhood. Destroyed me. No social support so nobody to de-stress with . I can’t keep a job down as what she just explained happens to me. Memory goes, can’t think straight. Awful feel so unsupported & alone. I’m 42 now & just feel can’t cope. Where I live there is no programmes to help. I have it all, depression, anxiety, eating issues, substance abuse. :( Don’t know what to do. What an amazing doctor.
I feel ya, to the extent that I can within my own experiences with BPD & PTSD. It has been challenging to find support, to say the least.
I recently ordered a book titled “The Dialectical Behavior Therapy Skills Workbook” (2nd edition) by MxKay, Wood, & Brantley. I am finding it helpful.
Working through this book, slowly I might add, utilizing this channel, along with working with a new and very compassionate therapist, I am finding some relief from overwhelming emotions.
This is by no means easy. Also, it is a slow process and if I look too far ahead, I will give up. Interestingly enough, becoming more mindful of the present moment and the emotions I feel which lead to self destructive coping skills, is the beginning of the road ahead.
My journey with bpd has really just begun. I’ve lived with this “secret” for 12 years because the first counselor to mention bpd warned me that I would never be “cured” & shouldn’t ever tell people about this because “therapists wouldn’t want to work with me”. Yet, since having children, I find it absolutely necessary to do everything I can now for our future…all while remaining mindful of the present.
Seemingly impossible! Yet, entirely doable!
Are there any legit online DBT groups or platforms used for people who need support?
@@bethanynelson4254 sounds great what you are doing. I also have PTSD. I stayed sober for 6 years but recently relapsed due to lockdown.
I have done DBT found it ok. For me it is my anxiety that really messes me up & constant brain fog. Just can’t think clearly & I have serious issues with food. It just feels too much you know, like just too old to keep battling.
I seem to have bad luck too. Things never work out for me. Lots of people left me over my mental health. Yeah I mean it is called Emotional Unstable Personality Disorder now not BPD but people won’t stop using the term BPD.
I think today therapists are more understanding but all depends on how you are. I have quiet BPD, never self harmed, never been to hospital etc. It’s the mix of symptoms that kills me & I am always sick due to trauma. I sometimes think really C-PTSD I have.
Wish you all the best, glad you found a therapist to work with. I have tried everything so kinda in limbo at the mo in what to do. Xx
@@Lilynite10 fact check me on this but I was told by a professional that bpd may possibly be removed as a personality disorder when the DSM is revised or whatever. Instead, it would be moved to a trauma related disorder.
Again, I have only indirect assumptions of this possibility based on a conversation with a therapist. Of course, my history with therapists of all kinds is a bumpy one full of mistrust.
Also, I know and have heard of people being diagnosed with bpd without any traumatic pasts really, however, I do believe trauma itself can be passed down. I have no degree. All that pours out of me is based on my experiences, feelings, & the only ways of coping that I’ve known.
Therefore, let us as “patients” come together as “community” because with support and compassion we can live without so much suffering.
Now….,where to get started? It is mostly helpful when conversing with others “like me” but I can see how it has had a negative impact as well. A safe environment, without an open bar 🤣, where people can ask, answer, collaborate, set intentions, take actions & raise awareness….
That’s something I wish I could implement into my life and perhaps I soon will.
One on one therapy is great, I like to study and learn so I’m willing to put in the “homework”, application of new coping skills is the most difficult, because like you, anxiety often keeps me manic-ish, and perhaps I’ve been misdiagnosed with adhd because stimulants make it worse, yet so often seem to save me from myself by keeping me focused and busy and can act as a distraction from reality.
Ramble as I may, this is therapeutic for me. I want to to apologize, but I won’t because I do ALL.THE.TIME. & I don’t really think I am sorry for the long rant. It’s almost more of a proactive apology, worried what others will say or think or if they even will…cause I care but I don’t wanna care but I can’t help but care🙄
Just letting people know, I completely reversed my chronic-stress and mood disorder with ashwagandha. It also helps a lot if you take it with b vitamins, magnesium, high-dose omega-3s.
I started taking that over a month ago. When I forget to take it I feel more depressed and off. I originally got it for my hubby’s testosterone because he’s sleepy. What brand do you use if you don’t mind me asking. I didn’t look into the best one yet just used Amazon
That seems like a wonderful advice. I began taking omega 3s and B vitamins and I thought I had felt a bit different, but I will definitely try this out! Thank you!!
I was diagnosed early (in my 20s), but treated the wrong way and for the wrong thing (dissociative issues.. crazy type of therapy.. made me much worse...an entire book can be written on that.. and there have been some!) for a decades, then by well-meaning therapists who did not understand the problem and did not harm but stagnation set in. Remission without recovery for many years. It was just grueling internally. Finally I "broke down" again several years ago in my late forties. I missed out on so much life in those nearly thirty years. I wonder, where does one and how does one obtain this "life rehabilitation/ resuscitation" if it is not in the form of psychotherapy? Is such a thing available, or does the patient simply have to grope around to see what they can grab hold of in the time that remains? I absolutely get the part about "it may not be what they wanted it to be" as far as a life... I get that so well.. the grief is just enormous when one runs headlong into the fact that much of life was lost to this.. unnecessarily to boot...
😢😢😢😢this is my situation also I will never get those years back ! all the precious time lost that I would and should be living a very different life right now instead of in my forties and lost without a decent support system.. I need money to gain my independence back and go no contact with my narcissist family.
emdr therapy
I think what is worse is that you only get to see how much life you missed out on only when you've hit absolute rock bottom. The internal guidance system just wasn't working, there were no warning bells ringing and exit signs visible... it's traumatizing
Your explanation makes a lot of sense. Chronic stress causes a lot of ills, both mentally and physically. Great presentation.
This is the kind of "outside the box" thinking we need more of, for all cluster B disorders
I wish I could work with Lois, she seems to understand more than anyone I’ve listened to. I’m glad I found this channel. Lois is very open minded talking about BPD, which tells me she is intelligent and understands this disorder.
This Dr. is speaking my language. I totally understand myself with this stress sensitivity and generating more stress type situation. I don't have any formal diagnosis. I was given an informal diagnosis of BPD at age 20 by a therapist but the psychiatrist used it as a diagnosis. When I found that out my to-be husband told me not to trust them and I completely stopped all treatment. I have been trying to do it all on my own for 15 years and have had my runs with 12 step programs, mindfulness communities, naturopathic doctors for chronic pain etc. After this stressful year and a half I am completely burnt out. I've finally come back to mental health and I agree with this video because the inability to manage stress causes the physical emotional and mental aspects all to stop working well and feed off of or starve each other. I also like the transdiagnostic approach discussed because I relate both to BPD and to autism spectrum conditions. Thanks!
This is great. For me, Doc often present perspectives of this disorder that is truly multidimensional regarding its genesis, presentation, and best treatments. Hopefully, this results in subsequent clinician interests and the development of specialized treatment availability throughout the world.
Wow! This was point-on! I wish lay people understood (or even cared) about all of this.
Lois has been a powerhouse in her role in the treatment of BPD. Gunderson made a good choice in passing the baton to Lois. And she is right in linking many conditions like functional neurological disorders, chronic pain disorders, eating disorders, atypical depression, and other psychiatric phenomena with borderline personality disorder. To say that BPD is a stress sensitivity disorder is certainly not wrong nor is the relationship of BPD with the attachment system. But the framework for all these related issues must be appreciated from the perspective of the CNS as a computer for problems of adaptation. Stress is best understood not from the common vernacular of something excessive, but any issue which places a demand on an organism to expend resources at any level. Then one can recognize that adaptive issues are hierarchical, in a way similar to Maslow's model or appreciating the differences between classical conditioning versus operant conditioning in terms of the neural hardware necessary to perform them. In parallel, the CNS is hierarchical simultaneously along a number of axes. As the CNS progressively develops models of how the world works with ourselves as a central feature of the models, our capability to create effective models of our complex engagement with the world often requires secure attachments with role models who help us integrate the necessary features of our bodies with the features of the objects to achieve increasingly complex operations effectively. We mimic much of how one successfully achieves certain operations in the world and therefore the attachment system serves a vital role in influencing our trust and therefore who we allow ourselves to be influenced by and therefore the stress we experience when engaging some novel task. For now, what I will say is that borderline personality disorder is the lack of sufficiently complex strategies for engaging many critical tasks due to a lack of integration of essential parts of the process often for lack of a healthy attachment with competent role models. Just reason that you do not need anyone to teach you that chocolate tastes good and is desirable. You do need someone to teach you at what point some bean needs to be sufficiently ripened to be picked from the tree and processed in certain ways while being mixed with other ingredients. You do need someone to teach you that a diet of chocolate alone would likely kill you from the lack of other essential nutrients. You do need someone to hold you back from persistently consuming chocolate to protect your teeth or to avoid becoming obese. Some things the hierarchical nervous system will immediately recognize and make a simple connection, while other tasks require a long period with extensive observations in order to recognize the essential connections and encode these. So when Lois talks about stress being rewarding, she is talking about a kind of relationship to an adaptive challenge which is doable/achievable because there is a sufficient model to approach the problem and the previous experience of one's cognition that would allow one the confidence to undertake a problem with a level of excitement about a chance to expand one's internal model and increase one's adaptive functioning. The transdiagnostic comorbidities arise because there are more than one way to moderate stress. The optimal way is to solve the adaptive challenge most directly. However, other strategies that lower stress involve distraction or avoidance as in reward substitution.... BPDx individuals often engage in instant gratification strategies because they mainly have oversimplified models that they have learned through their own experiences. You don't need anyone to teach you that heroin feels good or sex feels good or skipping classes feels good if one has not developed the discipline and confidence to solve intellectual problems. Enough said.
This was an eye-opener! Thank you !
Wow. I have PTSD and what she describes sounds so much like me and what I’m doing in recovery.
This is very interesting. It gives me a lot of insight as to what I'm going through right now and the benefits that can be achieved by this. Thanks for sharing
This is completely on point. Well done.
So insightful and intelligent, devoted and knowledgeable. She’s also very beautiful
This was incredibly insightful, thank you~
... I'm recuperating today from a complete meltdown after too much rubbing in my REJECTION SENSITIVITY area. I've sincerely tuned into this this year. Up till 3:30 am and this morning even my face is altered, for hours still, I'm starting to worry my sagging right eyelid won't ever go back up! Anyway, good timing.
Thanks. For the effort.
I believe you are onto something! I’ve been diagnosed with both.
I’m a Korean adoptee and recently diagnosed with BPD. Curious about the relation between adoption and BPD. All my adoptee friends keep telling me I most likely have cptsd. But I feel I could definitely have both
Unlikely have both but they have very similar symptoms. Key difference is that BPD is characterized by a constant fear of abandonment which doesn’t exist with cPTSD. PTSD has similar explosive episodes, but drug and alcohol addiction is common.
Another BPD (propably CPTSD too) here. Check out Dr.Fox here on youtube :) he is specialized on BPD and talks also about CPTSD. Much love
Odog i love her. What she says gives me hope and i feel.. relief?! Thanks for this wonderful channel.
The Ingredients of People who come out okay is likey secure attachment
Thank you I have bpd and this helped.
I would be able to manage my stress more if this beautiful genius would sit down!! Lol
And put the coffee cup/spoon down. The noise is distracting me. 😂
This information was extremely enlightening. In view of your findings, i have nit seen this strategy used anywhere. Just a vicious circle of hospital visits and more drugs that make matters worse😢
fascinating.
It is misery acting out.
I liked your comment.
I like your empathy
and ADhd..rejection sensitivity..
BPD is simple;
*The world we live in !!!!*
@@carolinehall11
@Caroline Hall Joke for self satisfaction: Business associate is clinical BPD and I have discussions 5+ years with what I thought was MPD but turns out to be multiple brothers ~ myself very mild for … I have engaged institutionalized cases which display extended hyper perception then when they attain their Penultimate Declaration it goes flat but I have to live with it · Lois Choi-Kain describes the natural narcissistic growing-up process that allows humans to develop their own identity so this can be really funny to me if person wants to joke: I claim 11 Personalities !!! Meet the challenge ! → For 'Narcissist' we find accuse others of that of which you are guilty *>>* Distract attention away from yourself; Clarice was not my best student so I passed her to my Hannibal my assistant
@@ChiDraconis Have you been drinking?
I agree the world is a very scary place, constant stress...so you aren't alone. I don't like even going out of my house because a car ride to the store and dealing with
dumb@zz drivers is enough, let alone the rude people everywhere you go.
Thank You The videos have been so helpful. I agree that your on the right track with this one. A person can be scared of a Horror movie. They are well aware it’s just a movie. May even say to themselves stop being scared it’s just a movie. Their brain tells their ANS it’s real. Some people are so sleepy after a movie. Is it from setting, boredom, or being in fight and flight mode along with the movie? So if simply watching a scary movie can make a person sleepy and maybe even scared of the dark for a few nights. They still know it was just a movie but their ANS does not know that. Meanwhile they may feel silly for being scared of the dark. Eventually they adjust back to normal ANS and their fight and flight responses calm down. Take that same concept and pretend your body never gets over that movie. Will your ANS system adjust or stay on high alert for life. That is the response to trauma. Can hacking my HRV bring down the ANS response? Can awareness and meditation retrain the brain and ANS response? Can exercise calm the ANS or trick it to believe you have run from your danger? 🤷♀️ Is the added depression a way for your body to get you to go to sleep or pretend your dead. Is the depression just physical weakness from over worked ANS? And that in turn cause self hate and helplessness? Or so it feels that way for me. I ordered the Apollo and going’s hack my HRV as much as possible. Let’s see what happens. 🤷♀️ I know exercise and a strict diet helps but still not balanced.
Now that I know what I got I don’t want to socialize I’m 😟 scared 😱 I recently been diagnosed
I agree with her theory re stress
Where do you get social support?
how do you get the rehabilitation? any sources
What about psychedelics?
Why all the tape on the laptop?
what do you mean that the result may not be what you want it to be? do you mean that often the result is not as large as what the patient hopes?
Yep that's me ,my life is destroyed and others .
0:25 - 0:32 my entire life story in 7 seconds!
I wish you could help me overcome my diagnoses..
GAD, Panic disorder, severe depression, PTSD, BPD, OCD...
Ive been struggling to find therapy and someone like you since 2011..
I wish you were in my area... :(
Cigarettes were the universal anxiety reducer. Cigarettes were, unfortunately addictive, God is the perfect parent! He hears each person who speaks to Him 24/7.
I was interested to hear her explanation to where the stress then comes, well.. apparently you are born too weak and sensitive :)
Well, that's the only answer if you intend on claiming that stress is the cause of personality disorders and not the outcome.
I think these are simplistic disease models. Repeat amygdala few times, and it sounds all scientific.
its a cluster B personality disorder
🤦
Thanks, Sherlock!
Give this man a Nobel Prize!
🙄
Okay dad
GO CARNIVORE... and most of your stress will go away. stable mind. stable soul.
i really wish i could get back the nine minutes that was wasted here LMFAO
Rounds up to ten though. Microdosing will fix you right up.