2012年8月29日 星期三

Early Signs of Borderline Personality Disorder Before it Becomes Full Blown


What would happen if children at risk to develop Borderline Personality Disorder were able to get help in a early stage of its development? Most people do not know the characteristics of BPD and would be hard pressed to identify it in young children. Most people are helped when the mental health problem is full blown. In early adulthood, the symptoms scream for attention and become full blown.

There is the context out of which the BPD develops. Children from abusive families, emotionally, not just physically, are prone to develop the disorder. What is happening at home?

*emotionally cold parenting.

*not able to express feelings

*black and white thinking: this is good; this is bad.

*crying episodes, seemingly without reason.

*daydreaming to excess. Starring

* observer rather than a participant to the extreme.

* sadness.

* facial expression that seems wooden, lack of smiling, even when happy.

*alcoholism in one or both of parents.

*siblings that are distant to each other.

* over achieving together with the other attributes.

* no rewards seem to change their poor self image. The self image is poor

regardless of grades or achievements.

*older parents.

*parents that are overachievers

*reading and rereading questions to make sure they are "correct". Fear of failure.

* emotional numbness. Little emotional expression or self awareness. Face is like a mask.

* excessively "good", well mannered or the opposite.

* Unable to verbalize much about their family. Difficulty talking about their family specifically.

*small outbursts of opinion to galvanize a crowd. Easy prey for religious convention and cultism

People suffering from BPD have trouble moderating their emotions. Emotions come boiling to the surface in extremes. Moderating the emotional reactions seems beyond control. When a child comes from an emotionally abusive family, this child might not be able to express anger at home without fear of punishment. The anger becomes rage and goes underground. After stuffing the feelings so much, the child tries to turn off the feelings entirely so as not to be overwhelmed by these foreign and inconvenient feelings. Eventually, it becomes self numbing. The other side is hysteria or emotional discharge to extremes, such as verbal explosions, or sobbing without seeming reason. The child is probably not aware of the reasons for the repression of ongoing family trauma. To survive in the family, the child represses the memories to make it through.

In one case the child was caught between the parents on most every issue. Would you choose mother's side or father's side? Instead they were ground up in the middle of endless battles between parents. There is no way to find an answer that does not upset one or the other parent? The personal interactions with primary caretakers becomes intensely painful. Later it is harder to choose side in an argument and to defend it without a feeling you will be annihilated or demolished. One teacher observed the child seemed to not like small talk. The child does not know what he/she thinks so small talk is painful. The child ego or center is trying to survive the daily barrage of attacks of parents and possibly siblings. If other children observe the parent's attacks, what is to prevents the siblings from being aggressive or hurtful. In there families, none of the children are getting their needs met. Among siblings, it is natural to have rivalries and competition that reflect underlying deprivation that all the children are feeling. The children can feel jealousy toward the youngest, for example, but be unaware of why they are jealous. This type of dysfunctional family is very difficult to repair. Family group psychiatric intervention is possible if the members are willing to work to improve their family. It is difficult to enrich these families where the parents are so invested in the dysfunction.

To try to give emotional support to the children is desirable to modify the damage of the family setting. There has to a place to go such as camp, Boys and Girls Club, or YWCA or other activities. The more the child spend time outside of the family, the more experiences they will have to compare to the original family situation. The experiences with normalcy whether dinners at friends homes, sleep overs, and other activities, the greater the chance that the child will be able to refer back to these places for reference rather than the traumatic events of the home. BPD is a distorted reaction to living. Therefore, to readjust the child needs to experience normalcy whether in the classroom, the school, the church, or whatever.

BPD persons frequently spend time alone. If the verbal interactions at home stimulate pain, why seek further conversations. Being quiet is a safe place. Eventually, the position of being stuck between to parents is a no win place to be. Anxiety arises as the child anticipates future interactions. The child may develop a desire to please others. Trying to duck and stay out of the range of fire whether it be debates or conversations where you put your views on the line. The BPD child will learn to hide their feelings. Being so afraid of attack on their very identity, why not invent some personalities or personna that are safe from attack. One personna might be the "good girl" or the funny kid or the empathetic observer. Within these destructive homes, a BPD can read the atmosphere of their parents even before words are spoken. The antenna are out all the time. The only problem arises is that in the outside world not every one acts like your parents. It is difficult to differentiate from an attack and a benign approach. These children need friends who have healthy households that they visit and get some healthy parenting. These friends homes are life saving.

The context of the family might show up in parent conferences and are one of the best indicators of potential BPD development. It occurs in some of the "nicest" families. The rigidity of their views might show something of the underlying events.

If the parents seem to need the child to be a trophy for their egos, that could be an indicator. These parents treat their children as objects to satisfy their own ego needs, so the achievement of the kids are bragged about by these parents. They are unable to see their children as rounded or with strengths and shortcomings. The kids are charicatures, or projections, not real.

The parents may come to parents' night but not the sports or drama production. When the father appears at the father-daughter dance, he spends time offering the math teacher a job with his company where he does the hiring. This is a specific example but gives the situation very clearly. Most abuse is about power. This example illustrates how it works in this a family context where BPD developed.

Class activities that practice "gray" thinking, away from black and white differentiation is very helpful. Class activities that practice identifying emotions, such as writing about an historical event as if present would help identify emotions. Exercises that help develop values, self-esteem and self awareness help the child to come out in a safe environment. School debates are excellent ways for children to defend and identify a point of view. Class work that promotes teamwork is helpful, as well. Art, music, gym, and other extracurricular activities allow children to define themselves.

We all want our children to live to their potential but why not create schools where healthy egos can develop and mental illness is identified and repaired.

We want our children to learn the 3 rs but why offer schools where our children learn emotional health.




Janet Kirkpatrick
Janet_Kirkpatrick@msn.com





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