Wednesday, May 6, 2009

DSM IV Axis II - The Church's Dirty Little Secret Part VI - Borderline Personality Cont.

As I continue this journey, I must add again (as a disclaimer) that I am not an expert on mental illness and I welcome corrections in the comments section from anyone who is. I have only a BS degree in psychology (and I work in neurology), which does not make me an expert any more than having a BS degree in biology makes someone a surgeon. I do have to know something about these disorders in my line of work because I face them (in my patients) on a daily basis.

The borderline personality disorder (BPD) is very stealthy. Most lay people are not familiar with it as a mental illness. This is why these people can ruin your life. You get tangled in their webs without even realizing it.

The good news, is that borderline personalities, while a disorder of the personality part of the brain, is treatable (as contrasted with the psychopath or sociopath), but I doubt curable. I have no doubt that these people can be real Christians (thus redeemable). However, in most of these Axis II disorders, the patient is the last to know that they are mentally ill.

While for most of us, if an authority in the matter (our doctor, wife etc) tells us that we are depressed, anxious, we are usually open to considering it. However, if you tell a borderline personality patient that they have the illness, they will become enraged. That is why it is hard to treat because the sufferer has very little insight. Maybe when their social life is in a constant state of disarray, and they have attempted suicide, they might humbly seek help.

As I said before, like most other mental illnesses, BPD is probably a function of brain structure (via genetics) and early childhood experiences. One theory is that the brain disorder is in the limbic system, which is the master manager of emotions.

The life experiences that can bring the disorder to “bloom” are usually early childhood abandonment or abuse. Relating back to my previous premise (many posts ago) the fundamental problem with all of us, the thing that really drives all our actions, is the desire to have value. This is a value before other people and God. Of course, the reality of the matter is that God has solved that problem once for all in Christ. But none of us fully grasp that . . . especially those Christians who claim that they do.

This early childhood experience can be things like mom leaving you in the crib for hours while she watches soaps, or drinks martinis. It could be dad walking away when you were five, never to be seen again. Or it could be, and in my patients this is one of the most common reasons, is that daddy (or mom’s boyfriend) started molesting you sexually. The anchor in your life suddenly becomes the devil and you never, ever feel safe again.

The borderline patient, something like the psychopath and sociopaths, try to create worlds where they coerce others to love them and never abandon them. But unlike the psychopaths or sociopaths . . . they don’t cut you up in pieces and throw your remains in random dumpsters if you don’t. They make you feel like you want to cut your own wrist at times.

So I think the root to all mental illness is about the same, but with different manifestations. I know that I suffer from social anxiety. I can get up to speak to a large crowd and feel a panic attack coming on. The issue is the same. I have an irrational fear of rejection (my value being low) of the crowd if I say the wrong thing . . . or if I accidently pee in my pants (which I’ve of course never done but it is part of the irrationality of the fear).

I’m going to next get into the details of how BPD plays out in our local church settings. I may pull from a couple of my own experiences. I don’t like to use my own experiences because it starts to sound like, “poor me.” However, I know my own experiences best. I guess I could make up fictional stories..

1 comment:

pennyyak said...

The question on the "fall" on the last post was very interesting. Do you have a book to recommend on this subject? I see from "Interesting Books" that you are a reader of N. T. Wright. I have read one of his books, and thought it delightful in its clarity and scholarship (which is something I don't often see together). Perhaps he has addressed this in one his books.