Study on BPD Sufferers & Cooperation (or lack of it)

[dandylife]

Borderline Personality Disorder Challenges Relationships
By RICK NAUERT, PH.D.
      Senior News Editor
      Reviewed by John M. Grohol, Psy.D. on August 19, 2008

Tuesday, Aug 19 (Psych Central) --  A new study finds different patterns of brain activity in people with borderline personality disorder were associated with disruptions in the ability to recognize social norms or modify behaviors — factors that may result in distrust and broken relationships.

Borderline personality disorder is a serious mental illness noted by unstable moods, behavior and relationships. Each year, 1.4 percent of adults in the United States have this disorder,1 which is widely viewed as being difficult to treat.

Using brain imaging and game theory, a mathematical approach to studying social interactions, the NIMH-funded researchers offer a potential new way to define and describe this mental illness.

They conclude that people with borderline personality disorder either have a distorted sense of generally accepted social norms, or that they may not sense these norms at all. This may lead them to behave in a way that disrupts trust and cooperation with others. By not responding in a way that would repair the relationship, people with borderline personality disorder also impair the ability of others to cooperate with them.

Brooks King-Casas, Ph.D., Baylor College of Medicine, and colleagues evaluated cooperation among pairs of participants playing an investment game. Each pair comprised a healthy “investor” and a “trustee,” who was either another healthy participant or a person with borderline personality disorder.

In total, 55 people with borderline personality disorder participated. An additional 38 healthy trustees paired with healthy investors served as a control group. The investors and trustees interacted through linked computers, but did not meet or speak with each other at any point.

In each 10-round game, the investor started every round with 20 “dollars” and could invest any amount between 0–20. Clicking a button to send the investment offer automatically tripled the amount, at which point the trustee decided how much to return. If the amount returned was less than the amount invested, the investor was likely to offer smaller amounts in future rounds, signaling a breakdown in trust and cooperation in the relationship.

Trustees could try to “coax” their investor partner by returning a large portion of the tripled investment, even when the offer was low—for example, returning all 15 dollars on a 5-dollar offer. Ultimately, coaxing resulted in generous payoffs in later rounds.

Compared with the control group, trust and cooperation faltered over time in pairs that included a person with borderline personality disorder. People with the illness tended to behave in ways that caused a breakdown in cooperation with their healthy partners. Moreover, they were half as likely as healthy trustees to try to repair the relationship through coaxing.

To determine whether a neural basis exists for this behavior, the researchers analyzed brain activity in the bilateral anterior insula. In addition to other functions, this region responds when we sense unfairness or violations of social norms.

In healthy participants, insula activity increased as offers or returned amounts decreased. For example, healthy trustees had high levels of activity if they received low offers from the investor or if they returned low amounts to the investor. If the offer or return was high, insula activity was relatively low.
By comparison, in participants with borderline personality disorder, insula activity increased only in response to low amounts they sent back to the investor; insula activity remained at an average level regardless of the amount offered to them by investors.

The findings suggest that either people with borderline personality disorder are not persuaded by rewards of money in the same ways as healthy people, or that they do not regard low investment offers as a violation of social norms.

The researchers also found that people with borderline personality disorder reported lower levels of trust in general, compared with healthy participants. In other words, untrustworthy behavior by the investors would not be seen as a violation of social norms because the participants with borderline personality disorder had less trust in their partners to begin with.

Using concepts from game theory, this study offers a new way of studying and understanding interpersonal relationships and mental illnesses that impair social interactions.
In addition to NIMH, the researchers also received funding from the Child and Family Program at the Menninger Clinic, National Institute of Neurological Disorders and Stroke (NINDS), and National Institute on Drug Abuse (NIDA).
Source: NIH/National Institute of Mental Health



Great to know this info - it's good to feel supported by science in what I'm going through. A person with BPD just seems to have a completely different way of viewing the world and of thinking. I see why it's so closely related to N-ism. The "Why is always about YOU"? thing fits so well. They can't seem to disassociate themselves from whatever/whoever it is you are talking about. They do NOT trust (paranoid), and their reactions to every little thing that goes wrong are catastrophic. So no wonder they have "unstable relationships". BUT they don't see themselves as the problem!!!!! And that is so frustrating. It took me YEARS to establish the fact in his brain that when I go to my book club (for 4 hours every 6 weeks), that I am not abandoning him.  Whew!

Dandylife

[James]

Dandylife....BPD is really complex PTSD and it's always caused by severe child abuse. This study that you present here mentions none of this. A person suffering form this disorder is most unlikely to ever recover unless the causes are addressed. There is a fairly new therapy that appears successful in treating BPD. It is called Schema Therapy, perhaps the biggest reason for it's success is the abuse/the memories and associated emotions are felt by the patient as encouraged by the therapist rather than the old conventional therapy which denies this. The other factor leading to it's success is the intimacy and close relationship that is experienced between therapist and client which is a for of re parenting. I am not surprised at all about this studies findings. It appears to suggest BPD is caused by something wrong with the brain. Abuse does affect the way the brain works in order to hold in repression, very traumatic memories of earliest childhood, and this is what these studies show. trauma will change Brain chemicals/structure but this is largely reversible by feeling and reclaiming repressed emotions. This is why Schema works so well but it is not the only therapy available.  These good therapies are few and far between b/c most therapists and researchers are afraid of their own feelings and haven't the courage to face them therefore they are incapable of dealing with the truth of their clients..........James

[gjazz]

I cannot disagree more that BPD is always caused by severe childhood abuse.  I believe it can be.  But I have spent more than two decades working with writers and other artists, and statistically BPD is so much more common in these people than in the general population--and they are not hiding their pasts, in fact they examine memories in depth, using them in their work, trying to figure themselves out.  Some come from disastrous backgrounds.  Some come from stable, loving homes, the salient common experience is there is almost always at least one aunt, uncle, cousin, parent, grandparent, sibling etc. who suffers from the same condition.  In addition, my aunt is bipolar, as is a very close friend from childhood.  My aunt (who married my mother's brother) certainly had an abusive childhood, but my friend did not.  He is, however, considered an artistic genius as a writer. Tormented and witty.  Medicated.  Confused.  Baffling and exasperating and unpredictable.  But we've known each other since second grade, and talked long into many, many nights, and the one thing I can assure is, he's not from an abusive background.  As he readily admits: he was the abuser growing up.

[James]

Gjazz....As he readily admits: he was the abuser growing up. It is very common knowledge that children who torment others were tormented themselves usually by their parents which is often times repressed.
 

[Ami]

Gjazz....As he readily admits: he was the abuser growing up. It is very common knowledge that children who torment others were tormented themselves usually by their parents which is often times repressed.
 

 I agree with James.                 Ami

[gjazz]

I agree with James as well.  It is very common for abused people to deny the abuse.  I just happen to know of people diagnosed with PBD who were not abused as children, but who do have genetic ties with others who also suffered from the same disorder.  We shall have to agree to disagree.

[gjazz]

And because I didn't really respond to the case I cited: my friend has never tormented ANYONE as an adult.  He is a brilliant and very gentle and insightful man, who is somewhat tormented himself by the fact that as a child he had so little ability to stop himself from lashing out at those who tried to love him.  He has spent years baffled by this,  especially now that both his parents are dead and he cannot try to make amends.  My argument is not that childhood abuse does not exist, or that it does not cause trauma, including triggering BPD, at times lifelong.  My argument is simply that it is not the only cause of BPD.

[dandylife]

James,

I've read, also, about the origins of BPD. What IS known (alot is not known) is that MOST BPD sufferers had an ABANDONMENT or severe traumatic experience that took them away from a caregiver between the ages of 1 and 3. There is a dramatic amount of evidence of a correlation here. Not necessarily ABUSE. In fact I don't recall having heard or read that term in relation to BPD (childhood abuse). Not to say it couldn't be so...I just don't remember reading that!

Thanks for the info on Schema Therapy. I've actually read and have the book here in my bookcase "Schema Therapy, A Practitioner's Guide" by Jeffrey E. Young, and Assoc. The re-parenting part of the therapy is fascinating and makes sense. Most therapists run as fast as they can away from these patients, though, as you well know, they are famously difficult to deal with.

Dandylife

[gjazz]

It's a very interesting subject.  My uncle (mom's brother) married a woman who was diagnosed in her late twenties, after having four kids in rapid succession.  She was told that stress was a factor, but we all knew her own mother had mental health issues, and chalked at least some up to that.  Now, my cousins--those four kids--had a very different life than hers.  She was given both extensive talk therapy and medication from the get-go, and my uncle was an incredible father.  All that said, two of my cousins, both women now in their thirties, show every sign of having the condition.  And their brother, who is fine, has a son, aged 17, who was diagnosed several years ago.

I think one of the interesting things about this thread is the link to N-ism.  It got me started comparing my bipolar aunt with my incredibly N father.  Their self-absorption is similar in degree, but my aunt lacks the manipulation factor.  She MUST be right, at all times, and will argue a point to hell and back, no matter how minor, no matter how wrong she might be, until everyone just gives up, but she lacks my father's guile and his desire for something beyond just "being right."  She desperately needs to feel in control of herself, and needs lots of reassurance that she is (by being right) but my father wants control over others.  She makes statements that require forgiveness constantly, but they are overt, tactless comments that unless one is feeling especially sick of it, it's best to attribute to someone who's just doing the best she can with the hand she was dealt.  Not always easy.  But in the end I think she lacks my NF's ulterior motives. 

[James]

Hi Dandylife.....You bring up something that's very important and thats the question of what is ABUSE. Abuse to a small child , infant or even the fetus is very different from what most adults consider abuse. The reason why is B/C underlying the predicament of the small child is his profound helplessness to meet his own needs. Most adults can't fathom that their lives were threatened to the point that much of their childhood memories and possibly all of infancy are now blocked b/c of terrifying memories. There are cases where children have been raised in true love and as adults these people consider it normal to very easily recall  much of their infancy. This is not true for adults who've been abused.

Much of adult emotional problems are abt this repressed pain, abt being unconscious.It's essential to find this pain in order to truly change , we need the real insight as to why we feel like we do. This is why most psychotherapy doesn't in the end really work b/c therapist as a rule won't go that deep.  Over and over again I see people deny or claim they haven't been abused, but have loads of disturbing symptoms. They are highly repressed, and their symptoms are abt their child's emotional life. The symptoms are abt what happened, but the adult has no conscious memory, so he remains in terror and possibly delusion without access to his child's reality. A cross look at a infant by a parent can spark unimaginable terror. But how many adults would consider this abuse? Maybe the adult is angry and consciously knows that he is not going to kill the child but the infant doesn't understand it. This sort of terror is repressed and then its triggered sometimes as an adult without any memory. But unfortunanety these repressed emotions are still active and cause most of the symptoms we see in adults. Most adults are repressed and can't understand the sensitivity and helplessness of the child they were. Without this,  their lives may not make much sense.

Most people probably define abuse as the most obvious stuff like hitting yelling etc. Repression does one thing, you will not remember. When it comes to abuse few really consciously know what this means to a child. Can you imagine how a tiny child feels when it's spanked or hit by someone 10x it's size. Terrified!!! However many adults find this acceptable to do. Shame on them. Most adults avoid their own pain, researchers look to genes to explain symptoms and many  therapists refuse to let patients go to deep feeling areas b/c they hold in check their own terror by holding down the patients feelings. Talking abt feelings is hardly the same as feeling To think one was unloved is hardly the same as allowing yourself to FEEL the lack of love. This is extremely difficult and painful, few will do it. Most people refuse to go here so they stay sick or caught forever misunderstanding what their feelings are really about and then symptoms don't leave or just change form. The symptoms of adults are nothing more than the body with these memories, constantly warning of old danger, triggered by present day stimuli. All BPD are children who have been severely abused in their own childs mind. The adult continues to act out childhood trauma without being aware. This is why the BPD will interpret so many situations as about being abandoned and then he feels terrified or expresses anger. It is about abandonment from childhood ( this was ABUSE to the child, terrifying life threatening abuse) The terror is not necessarily from hitting etc it can be a parent who uses the child for their own needs and the child feels this and is terrified, but how many adults can recognize this danger? It can actually appear to the unaware that the parent loves them. BPD reactions may not appear to make sense but it does in context with the past. Blind researchers will not understand this and will fail to recognize abuse b/c they are so terrified of their own , now repressed  I'm convinced that few people or even therapists really understand and personally know what the unconscious is.  I can't make anyone understand this but encourage you to find it in your own past. Here lies the real answers and once you see it for real you can understand for yourself. Only a few will want to go here, the rest will live in fear and denial and may continue to act out trauma unconsciously and always will be involved in struggles, hurt others or themselves without knowing the truth.  This way is about becoming truly conscious. Drugs will hinder this process b/c they will shut down access to very deep feelings and you will never be able to go there and permanently resolve these old fears and symptoms.

For people who do not understand or believe this, one primal, as in primal therapy possibly might help you understand. Not recommended without expert help. Primalists and people who have used holotrophic breath work, among other therapies, have been able to go back to conception. I have read where some BPD patients realized that at the time of conception the now fertilized egg could not attach to the uterine wall and this created a feeling of terror b/c this now living organism felt it would die. This is just one scenario. These feelings just don't go away. This is easy to intellectually understand but the real understanding only occurs when you discover this inside your ownself. I had to think twice whether I would post this. I won't struggle with anyone trying to convince them of these facts I know to be true. I do encourage you to find your history and take all your feelings seriously. I think it's much better to find our own answers in ourselves rather than willy nilly believing the so called "experts". I think a lot of these "experts", even if they know intellectually this stuff ,are full of BS until they experience and know the truth for themselves.....James

[Ami]

Dear Dandy,
 I can say ,for me, that I have struggled for my whole life to heal. I struggled on the board for two years to try to unearth what this pain was and how to heal it. It was to little avail, other than learning how to fight,which I did.
 I have found that I must mine the unconscious or I will never truly heal, other than cosmetically.
 I agree with James.     Ami

[miss piggy]

Hello to you all,

I am returning to this board after a long absence.  I will reintroduce myself on a new thread, but this one was so interesting, I just had to jump in.  First the cliff notes: my SIL is BPD and I've known for a long time that my dad is N, but I'm suspecting that he is also BPD. 

The question of what is abuse, how do we define it? is an interesting one to me.  As far as I know, my father is/was tormented by the fact that he was born second.  That's it.  I'm being facetious, but sometimes that's where the ultra competitiveness comes from.  But the joke in our house is that anyone born second is in for a life that's "tougher" than the rest of us.   

[dandylife]

Hi,
I checked the book, Schema Therapy to see what it had to say about the origins of BPD.

VERY interesting. It did say that 3/4 of all BPD sufferers are women. And that it is very likely that a woman with BPD has suffered from sexual abuse as a child. (don't remember reading that as my BPD person is Male!)

Anyway,
it also says that BPD is likely set off by 4 instances from Family of Origin:

1) If family of origin is unsafe and unstable.

2) If family of origin is depriving.

3) If family environment is harshly punitive and rejecting.

4) Family is subjugating. (supresses the needs and feelings of the child)

All these things constitute abuse, I believe. It offers the absence of that which is good, support, love, caring, acceptance, validation, safety.

James - I understand what you are saying, and I agree. I'm glad this is being discussed - I find it fascinating and very helpful.

Thanks!

Dandylife

[James]

Dandylife......I'm glad you read up on Schema therapy. BPD and most mental illness is a result of abuse. This is also true of many physical illnesses and physical symptoms in both adults and children. I reread the "scientific" study you posted at the top of this thread and wanted to take it apart line by line and expose the absurdity of it. I'm too tired right now to post it b/c of the length, maybe later. These so called researchers have illuminated nothing as to the etiology of BPD but do expose their own denial and stupidity. What a waste of time and money on their part but it does keep their own repression intact while pretending to be looking for a better way to understand and define BPD without having to come face to face with their own reality.  I have known 3 people with BPD and all three were abused but in the case of a 15 yr old girl few would know it. I knew her parents and they appeared perfect and were looked on highly by society, they appeared so loving to almost everyone but underneath this facade they were as cold as ice and very confusing to this girl and so she is confused later in life. She wasn't loved. Her parents don't understand they weren't loving and she's now confused b/c her body knows the truth but her adult mind can't b/c of the repression of early trauma which set the stage for her to be deceptively led into a world where she was forced to believe, by her own mind, as a child their "love" was real. It wasn't. Her parents acted the part, but it wasn't real, it was nothing but a huge lie and these huge lies leave adults in a state of confusion unable to see the truth. This is horribly confusing when it happens, it is brainwashing and these lies will make us sick. I bet if I asked her now she would even say she was loved. It's all about the repression of abuse and the child's intense and vital need to believe it's loved even if it isn't. It's a rare child that sees the truth of abuse and doesn't out of survival believe then that their loved. It's also very rare for a child (or even an adult) to see thru the lies of a society who is blind to abuse and unknowingly supports it. The body in it stores memories including the lack of love which is life threatening to the small child. Our earliest and possibly the most terrifying experiences of trauma are stored in the body and without a voice it has no other way to signal what has happened other than thru symptoms. The brain will repress these memories and then a connection to whats actually happened is consciously lost. Abuse does damage the brains in small children. It is very possible to recover these memories/emotions and then the mind will interpret what the body knows in a way that anyone can understand thru language. Then symptoms, after their real cause is felt, they do go away once we finally know the truth at least to the extent that the brain isn't damaged too severely.  Make sense? Alice Miller defines real parental love like this "I love my children if I can respect them with their feelings and their needs and try to fulfill these needs as well as I can. I don't love my children if I see them not as persons equal to me but as objects that I have to correct.......James

[dandylife]

James,

I'm sorry that the study struck a negative chord for you. For me, it was a positive thing in that their conclusions support my experience - which is that BPD causes irrational thinking and makes a relationship with a BPD sufferer almost impossible. The cooperation angle I thought was brilliant. These studies have been done in the past with "normal" subjects and I thought this was great - as BPD is usually shelved as far as research - as these people are considered "too far gone" to help usually.

The study said:
"They conclude that people with borderline personality disorder either have a distorted sense of generally accepted social norms, or that they may not sense these norms at all. This may lead them to behave in a way that disrupts trust and cooperation with others. By not responding in a way that would repair the relationship, people with borderline personality disorder also impair the ability of others to cooperate with them."

I'd still be interested in your evaluation.

TT,
Hi!
I admire your thinking about moving on and enjoying the peace you now enjoy (I hope that's the case!) Sometimes the analysis process is what brings about peace. You can finally, then, let it rest! I continue to deal with this behavior daily, so I think my true peace is down the line....somewhere....

Love,
Dandylife