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A Theory for the root Cause of BPD

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IndigoCorkscrew

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I have to agree with the abandonment theme. I rarely dare to put any effort into opening up to people or daring to trust them. Only my wife I guess, and even that's risky. I opened up to another person recently who has similar mental health issues. Now I feel foolish and frightened. I'm scared they will ridicule me and stop talking to me. So irrational but it hurts badly. It's almost as if I can not dare talk to anyone unless they are like me.
 
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SJS

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Firstly I would say, it is quite nice of you to take an interest in BPD not having it, most people wouldn't care.

However I have trouble with "investing too much agreement into an idea". You could say that people with BPD can be very invested in ideas, but that doesn't go very far into explaining 'the root cause' of BPD. That is more just an observation on the symptoms/ manifestation of BPD.

The root causes are complex, including:
  • being born much more sensitive and prone to BPD
  • having an invalidating environment
  • relation to primary care-givers/ experiences in childhood
a combination of these factors, result in a different brain function. Now we are getting closer to 'root cause'.
People with BPD quite literally have different brains that are structured differently. See the brain scans:
Its All In Your Head: Borderline Personality Disorder and the Brain

To cut a long story short, the way people with BPD react to things, results from heightened responses in the amygdala, which in turn lead to distress/ over-emotional responses. Treatment for BPD Is mainly about getting people away from "emotion brain" i.e. limbic system/ amygdala response, and getting them into using their pre-frontal cortex which is used for processing things more rationally/ seeing things from multiple perspectives.

You are certainly right with the inability to
" take everything with a pinch of salt. They don't go all in on a belief, and reserve some doubt",
though once again this is a symptom more than root cause.
The most effective treatments for BPD encourages this ability to not "go all in one belief", to see something from more perspective than one.
Hence the word "dialectical" in "dialectical behavioural therapy": dialectical in this context meaning "concerned with or acting through opposing forces." i.e. being able to see the two opposing sides to something rather than holding on to one firmly.

You could describe "dialectical behavioural therapy" as the therapeutic form of "taking everything with a pinch of salt". I like to remember that the "dia" means two. See one thing in two ways.

As you rightly say, the typical BPD responses are more often automatic, and not conscious. This is because the brain becomes comfortable taking certain routes. i.e. neural pathways. It is quite hard to re-wire those pathways though it is possible.
Interesting.. So it is tied to something more biological than mental.

I had another idea about it the other day, perhaps you can tell me what you think of this. I asked "Why go all in on a belief?". What is a person feeling to do such a thing. I thought perhaps it was something to do with comfort. That maybe committing to an idea more wholeheartedly provided a deeper feeling of comfort and security, than the potentially insecure feeling that comes with taking things with a "pinch of salt".

Like, perhaps at an early stage they felt more pain and fear from that lack of security than the pain of having something swept out from under them? Like on some level, what they actually deeply fear is the potential of the unknown.
 
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dewey

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Interesting.. So it is tied to something more biological than mental.
I mean yes, the brain works in a different way, biologically, to the average brain, as the scans show. But the contributing factors can be life experiences. And the only way they really know, at the moment, to remedy it is through changing behaviours and thought processes through ongoing practice.


I had another idea about it the other day, perhaps you can tell me what you think of this. I asked "Why go all in on a belief?". What is a person feeling to do such a thing. I thought perhaps it was something to do with comfort. That maybe committing to an idea more wholeheartedly provided a deeper feeling of comfort and security, than the potentially insecure feeling that comes with taking things with a "pinch of salt".

Like, perhaps at an early stage they felt more pain and fear from that lack of security than the pain of having something swept out from under them? Like on some level, what they actually deeply fear is the potential of the unknown.
I suppose it could be seen as more comforting to see things as all good/all bad without the pinch of salt, but I think it once again goes back to over-emotional responses clouding rational response.
I don't know much about that area, but I'd be tempted to think that seeing something as 'all bad' goes back to extreme versions of primal fear responses (as in the over-active amygdala), protecting oneself from the "all bad" thing.
 
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WhySoSerious

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This is my take on it which is backed up by a HUGE amount of research from Linehan and many other BPD researchers over the years...

The individual is born with a huge propensity to emotional intensity - they did brain scans and parts of the brain either over activate or under activate which leads to us with a higher than average likelihood of emotional turmoil.

This is then compounded by the "invalidating" environment as they call it. Abuse, trauma, being told we are wrong, over-reacting, attention seeking, manipulative, thinking wrong, feeling wrong emotions etc. We really rely on our environment to confirm what we are thinking/feeling is "right" and much of the time we don't get that. Sometimes we have to over-respond to get needs met because out family/friends don't hear how much pain we are in. At other times we get punished for feeling crap, so we shut down and don't express it.

1) This leads to emotional difficulties - we go from 1-100 and people (and we often) don't know why we are feeling like it.

This leads to problems with:

2) Sense of self - if we constantly rely on others to validate we are feeling/thinking "right" and they don't, we often change our views depending on who we are

3) Thinking problems - judgments of self-others, black and white thinking, musts and shoulds, beliefs people are judging us, distrusting others

4) Relationship problems - ups and downs, we idolise people (FP, ergh!), then we demonise them if they screw up. We are intense and people back off. We are passive or get into conflicts. We demand things forcefully or we avoid asking for things at all. We always say no or never do.

These issues lead to:

Behaviour problems - self-harm, alcohol or drugs, getting into fights, escaping/withdrawing when depressed, avoiding painful emotions, getting into harmful relationships etc

People think that the behaviours are the problem but they aren't. From what Linehan says, the behaviour is our solution to the problems of numbers 1-4! The problem is it doesn't work in the long term. Short term we take drugs, self-harm (for example) and we feel better temporarily. But in the long term we just feel shame, guilt, sad, angry at ourselves or others and frustrated.

I hope this makes sense. I had a therapist explain it to me once and send me info on it (though I have since moved and lost it!)

Let me know if you need clarification! That is the theory as Linehan puts it and is widely used in the literature about BPD.

PS: The OP is right in principle re: thinking styles. DBT suggests that people with BPD can't (or have limited capacity to) think about multiple perspectives and move into black and white, good/bad, right/wrong ways of thinking. It tries to remedy this by using dialectics which is a whole subject in itself. Asking ourselves "what information haven't I got here?"
 
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dewey

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The individual is born with a huge propensity to emotional intensity - they did brain scans and parts of the brain either over activate or under activate which leads to us with a higher than average likelihood of emotional turmoil.
I have seen brain scans from adulthood that show different brain structure (e.g.over-active amygdala) in adults with borderline patients,
but then I haven't seen any evidence that shows that from birth the brain is structured that way.

The way you phrase it makes it sound like the individual is born with their brain structured that way, but it doesn't seem accurate. Though I would agree I have read that BPD indivudals are born more sensitive,/prone to the disorder, I haven't seen evidence of this in brain scans from the age of birth.
So if you have this evidence please cite it.


This leads to problems with:
I think you're incorrect in the way that you use the word "leads to" because it's more the case that poor sense of self, thinking problems and relationship problems are part of the emotional difficulties that someone with BPD faces. As in, I don't think you can say those collection of issues that a BPD person faces necessairly leads to or stems from the emotional difficulties, it's more that those are a collection of issues that a person with BPD faces.

I agree with most of the rest of what you said though.
 
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WhySoSerious

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I have seen brain scans from adulthood that show different brain structure (e.g.over-active amygdala) in adults with borderline patients,
but then I haven't seen any evidence that shows that from birth the brain is structured that way.

The way you phrase it makes it sound like the individual is born with their brain structured that way, but it doesn't seem accurate. Though I would agree I have read that BPD indivudals are born more sensitive,/prone to the disorder, I haven't seen evidence of this in brain scans from the age of birth.
So if you have this evidence please cite it.



I think you're incorrect in the way that you use the word "leads to" because it's more the case that poor sense of self, thinking problems and relationship problems are part of the emotional difficulties that someone with BPD faces. As in, I don't think you can say those collection of issues that a BPD person faces necessarily leads to or stems from the emotional difficulties, it's more that those are a collection of issues that a person with BPD faces.


I agree with most of the rest of what you said though.
When I say leads to its just a short way to explain the model. I wouldn't take singular words all to literally with me, I say it as easily as possible.

They haven't done much studies on "at birth" though you are right in the sense that the amygdala and limbic system fires off too much and the prefrontal part doesn't dampen down the limbic responses as much as it should. I suspect (baring in mind that this is just a theory based on Linehan's research, and as with many things in psychology isn't concrete fact) that these brain changes may develop as a result of neglect, trauma and other things.

I am only going by what a Linehan student told me directly - they trained under her in 1995.
My citation is: The Oxford Handbook of Dialectical Behaviour Therapy - Swales, M.A. (2020).

I am curious as to your qualification/background though
 
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dewey

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When I say leads to its just a short way to explain the model. I wouldn't take singular words all to literally with me, I say it as easily as possible.

They haven't done much studies on "at birth" though you are right in the sense that the amygdala and limbic system fires off too much and the prefrontal part doesn't dampen down the limbic responses as much as it should. I suspect (baring in mind that this is just a theory based on Linehan's research, and as with many things in psychology isn't concrete fact) that these brain changes may develop as a result of neglect, trauma and other things.

I am only going by what a Linehan student told me directly - they trained under her in 1995.
My citation is: The Oxford Handbook of Dialectical Behaviour Therapy - Swales, M.A. (2020).

I am curious as to your qualification/background though
Yes my understanding was that the brain changes occured over time, not at birth, so I was wondering if you had a link for that.

Sorry I just realise that the way I said "please cite the evidence" sounded super strict and professional, I just wondered if you had a link to brain scans from birth. Thanks for letting me know what the book was though.

I don't have qualifications, I'm just someone living with BPD that's done a lot of research.
 
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WhySoSerious

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Yes my understanding was that the brain changes occured over time, not at birth, so I was wondering if you had a link for that.

Sorry I just realise that the way I said "please cite the evidence" sounded super strict and professional, I just wondered if you had a link to brain scans from birth. Thanks for letting me know what the book was though.

I don't have qualifications, I'm just someone living with BPD that's done a lot of research.
No problem, the response came off a tad prickly which is why I wasn't sure.

Its difficult to say as I don't think they have really done any from birth studies. I suspect it is because you would then have to break things down and controlling for traumas, invalidation, life events etc is near impossible. I will have a look at the data and let you know though :)
 
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WhySoSerious

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Crowell, S. E., Beauchaine, T. P., & Linehan, M. M. (2009). A biosocial developmental model of borderline personality: Elaborating and extending linehan’s theory. Psychological Bulletin, 135(3), 495-510. doi:10.1037/a0015616

"According to the developmental model presented here, a taxed caregiving environment perpetuates emotional and behavioral dysregulation in the biologically vulnerable child. Theorists have proposed that early neurocognitive impairment may be one such vulnerability that moderates the relationship between an insecure/disorganized attachment and a later BPD diagnosis (e.g., Judd, 2005). Thus, traits and behaviors may manifest as early as birth and likely shape the developmental context within which BPD emerges. This process is dynamic and continues into adolescence and adulthood."

The other articles are a tad jargon heavy but there doesn't seem to be any "from birth" scans presented. At least not when looking through PubMed, PsychInfo, CINHAL etc.
 
Until

Until

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I preface this by saying i'm not a professional, and i do this just as a passion and a hobby..

I don't suffer from BPD myself, but i've been thinking of the potential causes. What makes someone borderline compared to another person, and you'll have to let me know if this resonates with any of you who do suffer from it.. However, i have to explain a couple of relevant things first for this to fully make sense.

When believing something it involves investing agreement into an idea. A belief when broken down into it's parts is simply an idea + agreement. An idea you've agreed is true. However, what i have discovered is there are degrees to which people invest agreement into ideas.

Some people will invest a LOT of agreement, and this makes a belief feel very solid and secure. Some people however, take everything with a pinch of salt. They don't go all in on a belief, and reserve some doubt.

So my theory is this :

The black and white thinking, which is a key symptom of borderline personality, could be due to investing too much agreement into an idea.

So say you put all your trust in someone very easily, this belief feels extremely secure, you're feeling very happy.. Suddenly you find out this person has betrayed you in some huge way. What happens? What once felt so secure now emotionally swings completely to the opposite side. Like having the rug pulled out from under you.

Could BPD be a result of simply not having enough doubt when committing to a belief? If so, taking everything with a pinch of salt might negate the symptoms of borderline personality disorder completely.

This is easier said than done of course, because the brain actually automatically forms beliefs without you consciously having to do anything. But perhaps if it were ingrained as a practice to throw in a little doubt with everything, it might form a habit that could resolve this issue of emotional instability.

Let me know what you think of this, and if it sounds accurate.
No that's not how it works. BPD is from nature and nurture. You have simplified it into just a belief. Anyone can have beliefs, so a person without BPD can go into something trusting a person then they do something that shows they can't trust a person. That throws them off and doubts the other person, doesnt trust them anymore, anyone can feel like that at some point with or without BPD.
 

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