Oversensitivity and BPD
Rosalind, 26th October 2014
In my previous post I mentioned in brief that, for me, having an ‘oversensitive’ disposition has been the main ‘adjuvant’ for accruing my difficulties that have led me to meeting the criteria for a Borderline Personality Disorder diagnosis. Sensitivity has its place, of course, we all need to be able to tap into our sensitive selves, what would we be without the ability to be compassionate, thoughtful, generous, accepting? These are helpful tools that are actually very appealing to us for the most part, and serve on a wider scale as a means to improving ourselves, others, our communities, our countries and our world that we cohabit.
What happens if we are ‘overly’ sensitive to actions towards us and actions that we make towards others? Well, for some of us, if we are slighted in some way we may respond by feeling upset, hurt, disappointed, angry, confused; a host of unhelpful feelings can be triggered by our interactions or non-interactions with others. What about if we use our ‘over’ sensitive nature to completely guide our reactions to situations and others? Here are two examples:
Gossip within the workplace:
You overhear your work colleagues speaking ill of another colleague, this upsets you, you feel unable to keep this to yourself and feel that you need to challenge your co workers. You feel sad at what you are hearing, you feel upset for the recipient of the gossip as you see this as bullying and intimidating and this is not the way in which you feel you would behave. You personally feel threatened because you feel that if they are talking about your colleague in this way the chances are they talk about you too behind your back. You can not understand why they appear to be enjoying their unhelpful communication and what initially was born from a sensitive disposition, begins to feel unhelpful because you are starting to feel anger, judgement and negative and unhelpful feelings that are not managed well.
Poor Customer Service:
You walk into a store at your local shopping mall and see five staff just loitering around, chatting away and not acknowledging you or attending to your needs. You feel that you would not neglect a prospective customers needs and reflect on your own experiences of attending to others needs. What started out as a sensitive self that would use sensitivity to guide you toward being attentive, kind and aware may now become unhelpful as you find yourself sitting in judgement of those individuals and becoming more and more irritated by what you see to be neglect.
In both of these situations some of us will be quite flexible in our ways of thinking and adapting, opinions may be fairly liberal and gracious, for some of us however, we may feel that we just can not ‘let this go’, there may be an inflexible need to share your thoughts and opinions on how this is inappropriate and intolerable.
For me, on one hand, my ‘sensitive’ disposition enables me to tap into the ability to be caring, motherly, loyal.. On the other hand I can become quite disheartened by humanity, which means, aside my husband, I have two long term friends that I have kept under my friendship belt. I can also become angry, inpatient and judgemental of others at times, that is not helpful thinking and might demonstrate how sensitivity has its place but if we do not learn the skills to manage this sensitivity this is a fertile ground for deeper more pervasive issues surfacing over time.
What came first, the chicken or the egg?
This interests me because I believe I was born with an ‘oversensitive disposition’, there are many schools of thought about this online and from what I have researched there can be a fair body of ‘evidence’ to support either view point. Is sensitivity ‘acquired’ over time or are we born that way? I think only the recipient of the ‘inner being’, the individual themselves, can answer that. I suspect it will differ from person to person. It is my view that sensitivity whether predisposed or acquired can become a fertile breeding ground for mental health difficulties if we do not manage our sensitivity well or rather have not developed the skill set required to manage over sensitivity. In the future I will be creating a page on the concept of the HSP, ‘Highly Sensitive Person’, the term “highly sensitive person” (HSP) was coined by Dr. Elaine N. Aron in 1996, a doctor and author who has since written several books on HSP.
It appears upon brief consideration that a HSP, someone who is highly sensitive would not ‘cross over’ into the darkened realm of longstanding negative emotions bleeding into their lives, difficulty regulating emotions such as managing anger for one example. So, in effect the main difference appears to be that a Highly Sensitive Person, whilst affected by the HSP ‘traits’ that may impact upon their lives (shyness, fearfulness, rattled by complexities) remain relatively untroubled by external stressors, conflict or difficulties often associated with a Personality Disorder.
It also appears that there is a more complicated ‘formula’ that will eventually lead to one meeting the criteria for Borderline Personality Disorder, so being ‘highly sensitive’ alone would not qualify a BPD diagnosis. For me, I know I was ‘highly sensitive’, and I still am, very much so. My difficulties have come about in part because I did not have the ‘framework’ around me that would teach me the skills to manage that sensitivity. I learnt my own ‘coping’ skills and whilst they got me through, they have, over time become very unhelpful.
Below is a letter that I wrote to a lead clinician at a local specialist Personality Disorder Hospital, I had an assessment quite recently to ascertain what ‘talking therapy’ would be offered to me, this was an overview of some of my experiences and difficulties. I have included this to demonstrate that my unhelpful thinking patterns and behaviours have been present from a very early age, with no major events or trauma that have triggered the way that I started out my journey of ‘life experiences’ and interpreting myself and others.
Letter content sent to specialist PD Hospital:
Dear Dr Name Changed,
For as far back as I can remember, I have experienced debilitating ‘symptoms’ of what has now been diagnosed to be Borderline Personality Disorder. The symptoms of course ‘ease’ marginally at times however the ‘symptoms’ are cruel and relentless for the most part.
To give you some examples of ‘symptoms’ showing themselves from as early on as nursery age:
- 3-4yr: ‘Shy’ and ‘awkward’, continually comparing myself to the other children as an indicator for behaviour, thinking and responses. A desperate separation anxiety developed upon introduction to primary school followed by the feeling of ‘being alone’ and ’empty’. That feeling of ’emptiness’ has remained throughout.
- 5-6yr: ‘Awkward’ and ‘confused’. Being in a constant state of confusion was what I can remember as a debilitating factor throughout primary school years, confidence did not improve throughout. This instability was carried right the way through to adolescence through to adulthood. Learning was impaired, I could not ‘grasp’ basic instructions that were given even in an environment like ‘playing games’. I remember ‘over thinking’ everything, I would often ponder on how much life I had left before death, even at that young age, this has remained.
- 7-9yr: The issues above carried through and became compounded by the lack of ability to ‘learn’ from other children and adults. I was particularly awkward and my unusual pattern of ‘socialising’ was becoming more apparent. I could not ‘settle’ in a small group, I flitted around from group to group not ‘stopping’ for long enough, my fear, in part was that I would be ‘turned upon’, that I would be judged, not liked, life would be ‘over’. At such an early age it literally ‘felt’ as though my existence would end if I was attacked or disliked in some way. Learning ‘difficulties’ started to become more of a problem at this stage, reading was a problem, not so much because of the ability to read, it was the ability to ‘absorb’ information that was close to impossible. I would have to reread several times just to pick up ‘some’ of the content, this remains to date. Because there was a constant ‘confusion’ and inability to absorb information I struggled more and more. At one stage one of my teachers put me at the front of my class and put a pointed hat on my head that had the word ‘Dunce’ written on it, the floor space around the chair I sat on was circled, I was not allowed to move off of the chair.
The years between nursery schooling to pre high school were much the same, awkward, confused and continually comparing myself to the other children. The ‘voices’ and thoughts were relentless and unkind and always present.
At around this age I was more ‘aware’ of my mother’s ‘ill health’ and found myself becoming ‘consumed’ with fear and upset, worrying about that. I remember developing a particular difficulty with getting to sleep, reawakening throughout the night, although getting to sleep had always been a problem for me.
- 10-11yrs: At around 10 years of age following some events that may have triggered a particular difficulty ‘coping’ with my usual thinking patterns, I ‘spiralled’ into a very dark and isolated place emotionally, a deep depression, this lasted for around a year or so. I had completely withdrawn and isolated myself, suffering with anxiety and panic attacks, used to forget to breath when falling to sleep and awake gasping for air. I developed strange habits and was unable to walk alone or unaided in some way, if alone I would need to hold onto walls, readjust my routes and times to facilitate as easy a journey as possible, that would sometimes mean I would need to walk double the distance or setting out at ridiculous times to avoid people. I also suffered with Hypochondria, I thought I was ‘dying’ with all sorts of ailments.
- 12- 16 yrs: At this stage the year long ‘breakdown’ lifted, it seems without any intervention. I had no support however, somehow, the transition into senior school seemed to adjust this experience. What followed was a dense ‘fog’- a ‘block’ that has remained to date affecting my ability to think clearly and progress. All other symptoms have remained, black and white thinking became more prevalent. I loathed school, learning was very challenging. It was more apparent by now that I had no self identity or awareness, I had not developed my own personality and that has also remained to date. By the age of 16 I was using drinking alcohol as a coping mechanism- I would often attend school and sat most of my GCSE’s intoxicated. I went straight into employment upon leaving school and would also drink on the job to get through the day.
Life or the way I experience and interpret life has not ‘eased’ at any point, I am completely exhausted. I spent many years trying to push through the fog and understand what has been ‘going on’, why I was so ‘depressed’ and unhappy. I never ‘admitted’ to myself that I suffered with mental health problems- I say that but this ‘opportunity’ to diagnose was missed by my GP. Upon visiting the family GP when I was experiencing the ‘breakdown’ my mother was advised that ‘it is all in her mind’- of course, it was. I needed help, presented the symptoms at an early age and was not supported. My ‘survival’ technique was cast at that point, I ‘learnt’ that ‘I’ was the problem and spent the rest of my life (to date) struggling to get support.
I engaged in all sorts of attempts to improve my situation and alleviate symptoms from self help books, NLP seminars, religion (not that I was religious for that reason), Healthy eating, counselling, medication. Self loathing and sabotage is also a huge factor in my inability to experience a reasonable quality of life.
More recent overview that was communicated with Dr Name Removed via email, May 28th:
- Self harm
I have self harmed infrequently over the years, when I have used this ‘coping mechanism’ it has been banging my head against the wall or floor. What I will say is that I have ‘internalised’ much of my experiences and mental health difficulties and this has manifested in the following physical disorders:
1.Irritable Bowel Syndrome Investigations: Colonoscopy, Barium Meal
2.Cardiac Arrhythmia Investigations: ECG, Holter monitor 24hour and seven day reading, Echogram. No ‘structural’ issues were noted, it was identified that ‘electrical instability’ was present due to stress
3.Tinnitus I had two hearing tests and an MRI scan, this was clear, it was suggested that the hearing issues and ongoing tinnitus were related to ‘Psychological issues’
4.Insomnia I have had sleep problems since childhood
5.Infertility This has come about in my twenties, this is not specifically attributed to ‘stress’ although investigations concluded that ‘there were no physical issues leading to infertility’.
All of these issues can be substantiated in my clinical records.
- Suicidal thoughts and behaviours
In the past three years I have found ‘living’ progressively difficult culminating in suicidal thoughts in the past two years or so.
- Severe dissociation
This is a huge debilitating factor for me, I mentioned to you within our meeting that I have constantly ‘lived’ through a third person, ‘acting’ my way though each day. I am completely ‘identity less’. Another way to explain this would be to say that it feels like being ‘a dead person walking’ or someone else is ‘living’ my life and I am a useless spectator.
One example of disassociation is the act of writing this letter and the many I have written in the past ‘campaigning’ for a more suited (helpful) support, I have learnt to disassociate as a survival mechanism and whilst I know it, I am unable to change on my own. It takes me days to put together an email and when I write I am writing for someone else, not me.
In my meeting with you I was more ‘academic’ than emotional as every thought previously I had engaged in about our appointment I imagined myself fainting onto my knees out of complete desperation or just being completely emotional. I was completely overwhelmed and relieved by your offer of a referral and in any other circumstance would have shown it, I was numb and in ‘survival’ mode.
- Depression and mood disorders
Another debilitating element of my experience day to day, depression (deep unhappiness), alongside a ‘paralysing’ ‘block’ that hinders what would be considered to be normal day to day activities. I spent the last three months or so engaging in no housework at all. I have issues with anger and anger management. I cannot drive because of my underlying potential to erupt.
I was always referred to as having ‘mood problems’ or ‘hormonal problems’ by my mother and late grandmother, they identified my ‘mood swings’ early on in my life, as early as around five or six years of age, this carried on through childhood, adolescence through to adulthood.
My first ‘encounter’ of more severe mental health difficulties were at the age of around eleven, I had a breakdown that lasted around nine months. I was in a constant state of complete and overwhelming unhappiness, confusion and anxiety. I would ‘forget’ to breath when eventually falling asleep, I used to have to hold a person or a wall when walking to school, even walking took intense thought and planning. I completely isolated myself from friends both in school and outside. I had a permanent
headache and a ‘closing of the throat’. I also developed some bizarre habits, nervous twitches and Hypochondria. The GP responded to visits to him by saying ‘it was all in my mind’. No support or intervention was offered.
- Eating disorders
Over eating as a short term ‘comfort’, I am three stone overweight although I know this may not constitute a disorder.
- Alcohol and substance misuse
Alcohol misuse in my mid to late teens, alcohol was a way of ‘blocking’ life out. I have often ‘considered’ using alcohol as a ‘blocking out’ tool but know this will not work long term.
- Effects of trauma and abuse
I believe that PTSD is the reason that I have been ‘distracted’ over the years from ‘admitting’ that I had personality disorder (BPD). I knew something was ‘not right’ and spent a lot of time analysing my past and trying to work out why I felt so disjointed and fragmented all of my life.
I encountered physical and mental abuse from my first ‘serious’ boyfriend. In my marriage I have had multiple miscarriages, two ectopic pregnancies resulting in surgery each time, two IVF cycles that have been unsuccessful. Caring for my mother whilst working within a stressful environment. Financial difficulty associated with unemployment, we have a mortgage and the only substantial income has been that of my husband’s for approaching four years. These are some of the ‘events’ that have ‘compacted’ the already present mental health difficulties.
- Severe problems in relationships
I have severe issues that have developed over the years with all of my loved ones. The relationships with my husband, daughter, mother, brother are all affected resulting in difficulties through communication and expectation. I can only ‘manage’ seeing my mum once every three weeks or so and that too for short periods of time.
I have ‘cut out’ many dozens of friends that I have had over the years, retaining just three friends that I speak to around three or four times a year. I have almost completely isolated myself, I keep a ‘safe’ number of people ‘in’ my life so I can ‘retreat’ and isolate completely whenever I need to, this can last for weeks or months.
- Breakdown of everyday functioning
In the past three to four years my ‘functioning’ has been hugely impaired, I have gone into ‘shut down’ mode and found it close to impossible to engage in normal daily activities much of the time. I have been unemployed and unable to return to work for four years. I worked in a ‘high functioning’ environment, ‘acting’ my way through each day in order to maintain a management role, ‘winging it’ for most of the time. I used to experience ‘cycles’ that would be around three weeks of depression and lethargy and around a week or so of intense energy and ‘opportunity’, I over estimated my ability but usually this would result in ‘impressive’ results that would ‘carry’ me through the following ‘depressive’ weeks.
I have been Agoraphobic for over three years, only leaving the home with my husband and very infrequently. Recently I have started to go out on and off alone or with assistance other than my husband, but this is very much intermittent, not consistent or ‘pre-determined’.
- Transient psychotic states
I have been experiencing intermittent (transient) ‘psychosis’ for around one year or so, this is usually brought on by an upsetting argument or particularly stressful period and lasts anything from several hours to several days.
- Extensive use of other health and social care services
I have had three periods of counselling, two of which were lengthy terms, the latest being with the Open Door Project (GP referral). These just ‘took the edge’ off of the ‘circumstantial issues’ that had gone on over the years, the underlying mental health issues were left completely untouched.
I had a three week ‘stay’ in Lakeside mental health unit, admitted on November 18th. I have since gone through one year of assessment services and since November 4th 2013 have been under the Recovery West Services with Community Care Nurse’s that have been allocated throughout my discharge from hospital.
In spite of my desperate efforts over the years I have not had a reasonable quality of life, the quality of life I have experienced has been poor. The outward achievements of marriage, motherhood and so on have been achieved through ‘acting’ my way through, I have been completely disassociated from these experiences and as such my life has been ‘wasted’. The ‘life’ I have lived, has been as a spectator. I am completely exhausted and would very much appreciate it if I would be considered for assessment.