Lamentations 3:33 MSG Bible; Philippians 1:6; Hebrews 13:20-21; James 1:3-4 NLT (God) takes no pleasure in making life hard, in throwing roadblocks in the way. God began doing a good work in you, and I am sure he will continue it until it is finished when Jesus Christ comes again. I pray that the God of peace will give you every good thing you need so you can do what he wants….I pray that God will do in us what pleases him, through Jesus Christ. For...when your faith is tested, your endurance has a chance to grow. So let it grow, for when your endurance is fully developed, you will be perfect and complete, needing nothing.
I took a whole bunch of scriptures and squeezed them together to try to make a point at the beginning of this Blog. If you are not a religious person, please bear with me, as the principles of what I want to talk about in this Blog I quoted above are in alignment. The fact is, that sometimes we don’t only get one or two triggers that come at us when we suffer from a mental disorder, we may get four or five or more...and all at once! We think we are okay handling the one or two, then comes another and another and you get the picture.
This happened to me personally just recently. I was okay with the one, then the second, then I felt my life was cascading with triggers coming at me. It took me by surprise, coming all at once like that and I have to admit, it was time to call out everything I had insofar as coping mechanisms, support from my “core team”, Dialectical Behavioral Training (DBT) techniques, you name it, I had to use it! Thank God, I have the background of therapy and knowledge I have acquired over the years, and people that love, care and support me, or I don’t know if I would have been able to handle it without a visit to the psych ward. I am not saying a visit to the psych ward is a bad thing, I am just thankful it didn’t end up being a necessity.
Let’s talk about some of the things those of us who live with Borderline Personality Disorder (BPD) are prone to do when triggers come at us. We have a brain that tends to see things as all “good/white” or all “bad/black”, so we will do what is called “splitting” and it usually tends to be on the “bad/black” side. We begin overreacting emotionally when things don’t seem to be going our way. We can become like a powder keg ready to explode with the slightest provocation. We may express ourselves in a rage episode or catastrophize the situation, making things even worse. When episodes lead us down this road, we can also enter into a state of wanting to self-harm. The self-harming is actually the way we disengage from our internal stress or emotional state. We just want the pain of the extreme emotion that Borderlines feel, to go away. As difficult as it is to understand, when a person with BPD self-harms, there is relief experienced by the physical pain from the intensity of the negative emotions we are experiencing. I won’t go into all the types or ways that Borderlines self-harm, the most typical being to cut with a blade on our skin, but the ways are many and going there only serves to ignite more stress into the situation from the shame and guilt felt after giving into a rage attack or self-harming.
Another way we may react in trying to deal with the symptoms we experience from the instability of a trigger or trying to regulate our emotions, is by dissociating ourselves from the situation. Because people see Borderlines as “overreacting”, others invalidate us because our intensified emotions causing us to shut down. We are told we are “blowing things out of proportion,” “it’s not the end of the world,” “stop making such a big thing out of this,” and we shut down. This is a common experience for a person with BPD on overload. In fact, research has found that 75% - 80% of those with BPD use dissociation in times of intense stress. Dissociation serves as a disconnect between the Borderline’s thoughts, emotions, behaviors, perception, and even memory and identity. It is actually a defense mechanism for someone with BPD when on overload. The person with BPD will feel as if they are detached from their body and/or the external world. Things may seem in slow motion, like in a movie, or unreal during dissociation. We may not act like our normal self, which is “identity alteration”. The Borderline’s short-term memory often shifts into disabled mode during this time and they may find it difficult to find words or remember how to do an everyday function. I have experienced this many times throughout my life. For me, it feels like an out of body experience as if I am incapable of performing or being “me” during this time. When we dissociate, it is because things seem totally out of our control. For the person with BPD, we as Borderlines, go there - to dissociation - purposely in our minds when we are incapable of keeping up with the stress overload. We zone out - literally. It is our brain’s way of coping in order to separate ourselves from what we perceive to be a traumatic or dangerous episode. It makes it more bearable for us. Dissociative episodes usually start in early childhood from living through traumatic experiences and continue in various degrees throughout our lives. I can feel an episode coming on and will usually announce to my husband or family that I am “starting to dissociate right now”. They know from thereafter that Alice is gone for the duration of the episode.
Also there is always the danger of the cascade of triggers leading the Borderline straight into a Panic/Anxiety Attack. The reason being, again, that when a person with BPD feels a loss of control in a situation, they do not have the capability to display their emotions properly. The feeling with a Panic/Anxiety Attack can escalate to that of feeling as if they are having a full-blown heart attack! Your heart starts beating rapidly and your breathing becomes shallow, not taking enough oxygen in. This can lead to experiencing pins and needles, or a tingling sensation, throughout the body. A feeling as if you’re being smothered or suffocated ensues and you find yourself gasping for air. Many who experience their first panic attack find themselves at the emergency room (as I did) thinking they are smack dab in the middle of a full-blown heart attack. The person can even pass out from lack of oxygen and hyperventilating. I vividly remember my first panic attack. The doctor and nurses kept telling me to slow my breathing (seemingly impossible at the time) and then they gave me tranquilizers to calm me down. When all was said and done, the Doctor told me to go home, take a hot scented bath with candles and have sex with my husband! HA! I sincerely believed I was dying of a heart attack and this is what he tells me. True story - and I will never forget it as I went on to experience panic attacks as one of my symptoms of Borderline thereafter. It was strange, as I had never had one until then, and then after that first one, it was a regular occurrence. I have since trained myself in various methods and ways to combat a panic attack. I have also worked to educate my inner circle how to help and work with me through a panic attack so I do not end up in the emergency room. I will not say it is easy, but it can be done.
I have described a few of the many ways a person with BPD, Anxiety Disorder or PTSD will exhibit when cascading triggers ensue in their life. There are many other examples I could use, however, I want to talk about working through the situation(s) as they arise. The first thing to do, and I am speaking to your loved ones now and those who surround you in life, is to recognize that people with Borderline experience very intense negative emotions. Now is not the time to minimize or try to talk the Borderline out of those emotions. It may seem the Borderline is overreacting and catastrophizing, yet this is not a behavior that the individual with Borderline can easily control. We are not faking it when we become overly sensitized to a situation. (Please refer to my Blog on www.searchingforgrey.com on Minimization) for further information on this topic.
Go into it with the Borderline. I am not saying that you need to agree or disagree with what the BPD is feeling or exhibiting, but you need to GO THERE with them. Just repeat back to them what they are saying, perhaps holding their hand, have a gentle hand on their shoulder or back (the back is very good as it makes us feel safe) and talk in a soothing, non-confrontational voice. Speaking of having a hand on their back, see if you can get the Borderline to put their back up against something, a wall for instance. Just having that structure there feels like a safety net to a person experiencing a Panic/Anxiety Attack. Try to get them into a sitting position (not laying down). Say things such as “what I hear you saying is that what is happening right now is making you feel very upset, nervous, or angry”. Soft voice always! Try to get them to do some deep breathing with you.
It is important to help the Borderline “find the grey” area in the situation. Explain it to them specifically. Remember, we see Black/White in our brain. We benefit when those around us help us to see the grey and that disastrous consequences don’t have to follow from recognizing that we are currently feeling a loss of control, unhappy or anxious. My daughter and I have a code where she will say to me “What do you know to be the truth in this situation?”. Stay patient and keep repeating the GREY to us. We Borderlines have a general stance of vulnerability in unpredictable situations and we recognize that we overreact. We have been conditioned and have learned that others will tend to invalidate what we are feeling. By repeating the grey in the situation and helping us to find what DBT calls “Wise Mind Thinking”, we are eventually able to see what “normal” people see... being the grey. There are also methods of soothing for when a crisis hits someone with the disorder through DBT and Cognitive Skill training. The simple fact is that we with the disorder must invest ourselves in learning this training. It is up to us to learn what we need to do in managing our symptoms. I get very frustrated when I come across a person with a disorder like BPD who has NOT taken the time to learn skills or invest in educating themselves as to what we are up against during these times. I met such a person recently and was amazed at how, in her 50s, she was completely clueless as to what to do to take care of her symptoms. I could tell that she had not invested any time whatsoever in learning about her disorder and she totally depended on others to “fix” her. This is very sad to me, and why it is so important that we talk about these mental disorders and educate, educate, educate. It is also one of the main reasons people with mental disorders end up homeless, living a hopeless life, never finding their potential as a human being, because they refuse to do the WORK (and believe me when I say it is WORK) to learn how to take care of themselves and their symptoms. This is my opinion and I share it from years of observation and personal experience.
Back to our topic, one of the best things is to allow the Borderline talk through what they are feeling. No matter how off the wall it sounds to you, it is very real to us. Being able to verbalize our feelings in a safe way, with a safe person is very helpful to a Borderline. Just listen and keep reaffirming to the person with BPD what the “grey” is and that things will eventually work out.
In summation, triggers will always be a part of the life of someone with BPD or PTSD. It is important that the person living with the disorder, and their loved ones are educated as to what needs to be done when triggers hit, especially when multiple or cascading triggers hit. Sometimes, it might require a visit to the emergency room, if for instance the person with the disorder starts to self-harm or is having suicidal ideation. Each symptom displayed during the time of crisis by the person with the disorder should be approached on an individual basis. It is not helpful for the loved one to escalate the symptoms as they display. It is not helpful to conclude that a trip to the emergency room is the only solution. It is as important for you, our loved ones, to keep it together, as we are depending on you during that time of crisis to help walk us through.
By educating everyone concerned in the inner circle of the person with the disorder and realizing the root causes of these challenging disorders, much can be done to help the person suffering. It will help you, as a support person, as well as the person with the disorder, to make a more fulfilling and symptom-free life as much as possible an end result.
With you on the Journey, Alice