The following caught my eye today. Although writtern by someone with BPD, I think it can apply to everyone who is emotionally sensitive.
I can certainly relate to needing to train my pre-frontal cortex in the art of emotional regulation.
http://farewelltodaylight.com/2014/08/25/sink-or-swim/
I can certainly relate to needing to train my pre-frontal cortex in the art of emotional regulation.
http://farewelltodaylight.com/2014/08/25/sink-or-swim/
I'm drowning,
and you're standing three feet away
screaming "learn how to swim." (c.j.)
Sink or Swim
This blurb speaks to the plight of all those who suffer from mental illness. It is evocative of the misunderstanding that many of those in the neurotypical population have towards our burdens. I am saddened thinking about the number of times in my life I have been told to “snap out of it”, “grow up”, or “get it together”. If I could, I most certainly would but this is my reality: I have borderline personality disorder. The physical parts of my brain required to do such a thing as spontaneously and expeditiously “grow up” are incapable of performing such a function as they are. In the case of BPD, the issue is not merely chemical imbalance. The problem is the functional connectivity and activation levels in certain regions of the brain.
There are two emotional systems in the brain. There is a lower level system that generates our basic and more primal emotion (the limbic system) and then there is a higher level system that regulates and details emotion (the cingulate gyrus and the prefrontal cortex). This is the current understanding, anyways. Our brain is unique from most other organs in that its physical development is highly affected by the environment. Sure, the environment affects all of our body’s organs, but not so much as the brain. In the brain, everything that we do, every decision that we make, every thing that we learn and forget changes the topography and physical connectivity. In this sense, the brain can be thought of as one of those interactive story books. The decisions you make for the characters at critical parts of the book influence the story’s outcome.
There is also something else, which I have brought up before, and that is biosocial theory. This theory postulates that the brain is so interactive that the way we interact with our environments and they way they interact back with us affects the brain’s physical development. This is key to understanding the etiology of borderline personality disorder. Numerous studies have shown that those with BPD have deficits in PFC activation during activities requiring emotional regulation. The functions of the frontal cortex include: planning complex cognitive behavior, personality expression, decision-making, and moderating social behavior. Collectively, these are called a person’s executive function. Also, along these lines, it is thought that the frontal lobe is key to emotional regulation. Remember those two emotional systems mentioned earlier? Well, unless we get the proper input as children (a nurturing and emotionally validating environment) certain areas in the frontal cortex never get activated. The brains is and its function is very much like most skills in life, you don’t use it you lose it. Or in this case, you never develop it.
Without that key input, the frontal circuits never develop properly. They need to be activated to develop because “neurons that fire together wire together”. Because of this, when those developing BPD reach their teenage years and adulthood their PFCs cannot control the lower level primordial emotional system because it never got exercised when they were children. One of the roles of an attachment figure or a parent is to teach is, inadvertently, the way to properly express emotion. We learn this by observing their own emotional expression as well as receiving feedback about our own. We may be jumping for joy and knocking things over and we are then told that this is inappropriate. Or we may be sad and cry and we are taught that its ok to be sad but its not ok to neglect our responsibilities. This is emotional validation and learning. Without this critical input from our environments, the lower level system is allowed to run rampant. If we grow up in abusive or emotionally invalidating environments, as we get older our emotions become more intense because the brain WANTS them to be validated because it WANTS to develop the way that our natural genetic code says that it should. Thus, as invalidation continues the emotional experience and expression strengthens to a pathological level to compensate.
Having an intelligent and working explanation for the way BPD, and perhaps other mental illnesses, develop is all well and good but the picture is still pretty grim until we learn another fact about the beautiful organ that is the human brain. This is a concept called neuroplasticity. By willfully engaging in certain activities instead of others we activate specific areas of the brain over other. It follows that if one does things to activate the prefrontal cortex, the PFC circuits will start to develop themselves. In this way, one can literally rewire ones own brain. It turns out, practicing exercises of mindfulness like the ones taught in Dialectical Behavioral Therapy activate and strengthen the PFC circuits. Remember that “neurons that fire together wire together”. As time goes by and the techniques are practiced the PFC becomes more easily activated as the neural circuits are developed. This is exactly why we see the emotional regulatory abilities of those who go through intensive DBT programs improve so drastically, often to the point of remission if persistent. The key is, it takes time and it take practice.
Unfortunately, it is very difficult for those with BPD to engage in the activities required to do this neural rewiring. Certainly not impossible, otherwise people would never recover from BPD and they do. Just difficult. That is why it is not as easy as “getting it together” or “growing up”. There is no switch that we can flip to suddenly be different than we are. We did not choose to be this way, if we could have most of us would have chosen otherwise. Yet, not only must we live with our own suffering as well as the suffering we create around us, we must also live with the stigma against us and chronic misunderstanding of what our illness really is. We are a product of our genes and our environment. It’s not nature vs. nurture it is nature AND nurture. BPD is a disorder in which its development is set into motion long before we have reliable conscious control of our actions by factors which we have NO control over. So, why should we be judged as harshly as we are? It is beyond me and it needs to change.
