AAPEL
BPD black & white thinking, "all good", "all bad"
splitting, brain functioning, reason and emotion

Introduction:

Connection between borderline personality, splitting, reason and emotion. On the face of it, there is no doubt that some BPD people are using splitting as a selfdefensive mechanism. Is it biological or psychological ? You will find on the last part of this document our vision which we hope comprehensive and listening to the suffering
Meme page en Francais / Same page in french
Glossary
Data, studies
What they say ?
Aapel view

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Glossary

Splitting: In simple words, we can say that splitting is a way to divide the world in "all good" "all bad". It is a black and white way to see the world without "grey". Splitting is one of the defense mechanism used to protect themselves

Defense mechanism.

It's a way to protect ourselves in some way. There is a lot, lot of defense mechanim possible.
Example
- Acting out: Allows a person to avoid thinking about a painful situation or experiencing a painful emotion Leads to acts that are often irresponsible, reckless, and foolish
- Avoidance: A defense mechanism consisting of refusal to encounter situations, objects, or activities
- Deflection: Also detected when the individual is in group therapy and consists of redirecting attention to another group member. The distortion campaign is a deflection ("HE is the sick one, not me !")
- Denial:Failing to recognize obvious implications or consequences of a thought, act, or situation (I'm ok)
- Dissociation: Dissociation is a split in the mind in which there can be two independent streams of consciousness occurring at the same time (multiple personalities)
- Humor: The individual deals with emotional conflict or external stressors by emphasizing the amusing or ironic aspects of the conflict or stressors
- Projection: Allows a person to attribute his own feelings or thoughts to others Leads to prejudice, suspiciousness, and excessive worrying about external dangers
- Somatization: Conflicts are represented by physical symptoms involving parts of the body
- Splitting See above
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Data, studies (statistics, prevalence, comorbidity, co-occurency)
* Shoda H. - Department of Psychiatry, School of Medicine, Shinshu University, Matsumoto, Japan
1993 Psychopathology - Splitting phenomena from a viewpoint of experiencing time: spectrum from multiple personality and hysteria to borderline personality disorder.
Results: The degree of splitting was most prominent in BPD

* Muller RJ. - Department of Psychiatry, University of Maryland School of Medicine, Baltimore.
1992 Compr Psychiatry - Is there a neural basis for borderline splitting?
The possibility that emotional trauma occurring later than separation-individuation, and involving other issues, may be the occasion for splitting is considered, as well as the possibility that a congenital abnormality in brain structure or function may be a primary factor in borderline pathology. Ways to test the hypothesis that borderline splitting has a neural basis are suggested.

* Herpertz SC, Dietrich TM, Wenning B, Krings T, ... - Medical Faculty of Aachen Technical University- Germany.
Biol Psychiatry 2OO1 - Evidence of abnormal amygdala functioning in borderline personality disorder
METHODS: BPD patients underwent functional magnetic resonance imaging (fMRI) to measure regional cerebral hemodynamic changes following brain activity when viewing 12 standardized emotionally aversive slides compared to 12 neutral slides, which were presented in random order.
RESULTS: Our main finding was that BPD subjects but not control subjects were characterized by an elevated blood oxygenation level dependent fMRI signal in the amygdala on both sides. In addition, activation of the medial and inferolateral prefrontal cortex was seen in BPD patients. BPD showed activation in the fusiform gyrus. CONCLUSIONS: Enhanced amygdala activation in BPD is suggested to reflect the intense and slowly subsiding emotions commonly observed in response to even low-level stressors.

* Schmahl CG, Vermetten E, Elzinga BM, ... - Dept of Psychiatry and Psychotherapy, University of Freiburg - Germany
2OO3 Psychiatry Res Apr 1 - Imaging of hippocampal and amygdala volume in women with childhood abuse and borderline personality disorder.
The purpose of this study was to measure hippocampal and amygdala volumes in BPD. 10 patients with BPD and 23 control subjects. Patients with BPD had a 21.9% smaller mean amygdala volume and a 13.1% smaller hippocampal volume, compared to controls. These findings are consistent with the hypothesis that alterations in the hippocampus and amygdala are associated with BPD.

* Bazanis E, Rogers RD, Dowson JH, Taylor P,... - Department of Psychiatry, University of Cambridge.
2OO2 Psychol Med - Neurocognitive deficits in decision-making and planning of patients with DSM-III-R borderline personality disorder.
METHOD: BPD patients were clinically assessed before completing computerized tasks of decision-making and planning previously shown to be sensitive to frontal lobe dysfunction, and tests of spatial and pattern visual recognition memory previously shown to be sensitive to frontal lobe damage and temporal lobe damage respectively. The performance of the BPD patient was compared with that of a non-clinical control group.
RESULTS: The performance of the BPD patients on the decision-making task was characterized by a pattern of delayed and maladaptive choices when choosing between competing actions, and by impulsive, disinhibited responding when gambling on the outcome of their decisions. BPD patients also showed impairments on the planning task.
CONCLUSIONS: These findings suggest that BPD is associated with complex impairments in dissociable cognitive processes mediated by circuitry encompassing the frontal lobes. Further work is needed to examine the specificity of these findings.


B&W thinking, "all good", "all bad", splitting, brain functioning, reason, emotion and BPD, what they say
"A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. This is called splitting." (dsm4)

'Patients with BPD internalize early pathologic object relations. The use of primitive defense mechanisms (which individuals without BPD outgrow during normal development) maintains these early pathologic object relations. In the early stages of development, the infant experiences the maternal figure in 2 contradictory ways: The first is the good mother who provides for, loves, and remains close. The second is the hateful, depriving mother who unpredictably punishes and abandons the child. The result is intense anxiety, which leads to the borderline defense of splitting ("Personality Disorder: Borderline", kernberg)

"Splitting, like other behaviors common in BPD, is viewed not as an intentional act of aggression, but as an automatic response to the emotional intensity and dysregulation that the client can learn to anticipate and replace with more effective behavior" (Don St. John, P.A, "The STEPPS Group Treatment Program
for Borderline Personality Disorder", University of Iowa Department of Psychiatry)

"I consider splitting and dissociation to be synonyms, and I consider borderline personality disorder, which is based on splitting, to be an Axis I dissociative disorder" (Patricia D. McClendon - Ross, "Definitions: Splitting vs. Dissociation", 1994). AAPEL: why not ? But in that way it would be necessary to redefine dissociation including "light dissociation"

"At any given moment, you as the Non are viewed by your borderline significant other as either all good, or all bad. They don't usually spend much time thinking, "Hey, you do bad things sometimes,but mostly you are a good person." This is beyond the ability of most people with borderline traits. If you disagree with something they say, then merely by disagreeing you become a bad person. The splitting behavior is what makes borderlines so addictive to Nons.
Sometimes a split can become permanent. If you are permanently split bad, then they can no longer see any good coming out of you. This is why it's so easy for them to engage in tactics such as the distortion campaign. After all, you are Hitler, Stalin and Satan rolled into one, and you get what you deserve. " ("Splitting - An Introduction ", bpd411)

"What we refer to as black and white thinking is a primitive pattern that dates back to early childhood. When a two year old looks at the world, they see things as going entirely their way, or as a disaster. Mom is here, and feeding me, so she must be good. Mom is in the other room, she therefore doesn't exist (object constancy) so she has abandoned me, and is bad." (bpd411)

"Splitting: Small children see everything in life as being all good or all bad. This immature psychological defense persists in borderlines, resulting in "black and white thinking." When life events are perceived as bad, dysphoria usually results. When things are good, the borderline frequently feels vulnerable, and fears the black returning - often leading again to dysphoria." (leland heller,"THE BORDERLINE PERSONALITY DISORDER NEW MANAGEMENT CONCEPTS")

"Splitting is an idea that comes from Kernberg. If you read Damasio you will learn about where in the brain reason is located and how reason is processed versus emotion.  Splitting as Kernberg describes it is probably due to cognitive dysregulation in the brain or misplacement. People with BPD vary enormously. Any combination is possible. " (Valery Porr,”BPD and Splitting”, TARA APD)

"The brain has two systems for evaluating situations. One is evolutionarily ancient, emotionally driven. They immediately constrain the hypothesis space considered by the second system, which is conscious (driven by central executive), uses logical reasoning and inference to plan strategies for goal achievement. Emotions are the source of our "common sense" — the immediate knowledge that there are certain things we never have to consider as possibilities. This is possibly why we can succeed where computers fail.
The error is in thinking that the mind can be separated from the body, they are fundamentally intertwined. How essential emotions are to our ability to reason and make decisions. Man with prefrontal damage felt no emotions, unable to judge consequence of his actions, disapproval or reward had no effects on his actions. Elliot after surgery (removed frontal lobe and connecting structures), was unable to hold down job or function normally in real life, but performed above-average on IQ tests" (Damasio Antonio R,"Descartes' Error : Emotion, Reason, and the Human Brain", Avon 1995)
Aapel: This could explain why borderline have problems to act "normally" the emotions being essential to make a right decision, now, bpd peoples are "over-emotional"


Aapel view of Splitting and Borderline Personality Disorder
Here is our feeling
"Bullshit" !
It is also possible to think that the borderline disorder does not exist but that is not any more a denial but some blindness !
Spitting is the second dsm's criteria, we can thus suppose that it is a significant point, no ?
The psychoanalytical vision of kernberg assumption a philosophy which "holds the water" when we known that the majority of borderline lived trauma experiments during childhood (see ptsd).
Suggest that they would have remained at an early emotional stage seems completely logical.
Then, the neurologists "add a layer" by affirming that the brain functioning of a borderline person reveals notable differences, confirming as well as the disorder would have some biological and genetic parts. Damasio drives the point home showing that emotions are essential to the reasoning and an adapted decision-making.

If moreover, we take in account to the fact that a majority of borderline recognize itself or are recognized like having black and white thinking (see for example testimonys), that begins to make a lot
... And all this would be denied !
That is to say and well according to our last assumptions the earth is punt and non spheric (2nd degree - As long as with saying anything)!

Is splitting (black and white thinking) common with BPD ?
Yes, even if we don't have statistics (if you have someones, don't hesitate to give them us), but it seems, that more than 75% is close to reality

All BPD peoples have black and white thinking  ?
Difficile de savoir exactement car cela peut etre conscient ou inconscient. Cette pensée N&B est-elle réelle ou une perception ?
Disons que la présence de pensée noir et blanc chez un individu est un fort indice pour soupconner un trouble borderline
Mais à l'inverse que l'absence de pensée noir et blanc ne suffit pas à prouver que la personne n'est pas borderline (dans tous les cas d'autres investigations sont necessaires)

Is BPD people "bad" ? Why I'm now a "monster" for him/her  ?
Si l'on en croit certains "spécialistes", la réponse pourrait être "oui". Ils les décrivent comme antisociaux, violents, dangereux, bagarreurs, méchants, sans état d'âme, sans consciences, narcissiques, etc...
Si vous-mêmes les croyez alors vous devez considérer comme délirant le contenu de ce site !
Bon, assez rigolé.
Affirmer cela est démontrer que l'on a strictement rien compris au trouble borderline
Le jour où tous ces (auto censure) auront compris que tous les comportements "méchants" d'une personne borderline ne sont que des mécanismes de défense, la justice aura franchi un pas supplémentaire

Le clivage est un mode de défense. Chez le borderline l'émotion prend le pas sur la raison.
Que dire de plus ? rien
Si vous êtes passés intantanément de l'état de "perfection" à l'état de "monstre", cela prouve une chose, c'est que vous n'êtes pas indiférent à cette personne borderline. Mais c'est trop "compliqué" pour cette personne de gérer des situations conflictuelles, de stress. L'émotion prend le pas sur la raison
Face à un état émotionnel incontrolable, il a le "choix" entre le déni, la campagne de dénigrement, les larmes, la colère, la fuite physique, l'agression physique, l'humour, la dissociation et la pensée noir et blanc, ...
Il faut bien comprendre que c'est une question de survie pour lui, tout simplement
...
He's Bad ?
No he's sick and suffering, et le drame pour lui c'est qu'il est, à divers degrés, conscient de cela

C'est bon, il est malade mais je ne comprends plus rien. C'est génétique, biologique ou psychique cette "chose" ?
Vous dites qu'il a été démontré qu'une personne borderline a un cerveau qui n'est pas comme celui de tout le monde ! Que faire alors ?
Si le trouble borderline n'était "que" génétique alors le seul moyen de les aider serait la thérapie-génie. (modifier les gênes).
Non la génétique ne semble être qu'un élément qui permet de prédisposer à la maladie. Partons donc de l'hypothèse probable que ceci est vrai.
- Si vous n'avez pas de prédisposition génétique alors vous ne pouvez pas devenir borderline
- Si vous avez une prédisposition génétique alors vous pouvez devenir borderline.

Bon soit mais quand certains borderline pensent "c'est ma nature", il ont raison, leur cerveau a un fonctionnement différent !
Oui et non. Ils ne sont pas nés avec CE fonctionnement de leur cerveau. Des études ont démontrés un lien avec le niveau de sérotonine. Rappelons que cette sérotonine est un neurotransmetteur. Donc en donnant des médicaments qui permettent de rétablir un niveau normal de sérétonine, on modifie le fonctionnement de leur cerveau qui, de fait, va "mieux" fonctionner

Ok, en lui rendant sa sérotonine, vous re-rendez le cerveau plus "fonctionnel" mais ce qui est cassé est cassé. Un paraplégique à qui l'on rend l'usage de ses jambes ne peut pas marcher !
Oui, absolument c'est pour cela que la thérapie est indispensable.

Attendez, un cerveau, ce n'est pas une jambe, il ne suffit pas de le remuscler pour pouvoir à nouveau marcher, c'est donc foutu, on ne peut rien faire !
La preuve en est qu'un aveugle de naissance à qui l'on rendrait le nerf optique resterait aveugle !
Détrompez-vous, des études ont prouvé que des personnes qui avaient une lésion d'une certaine partie du cerveau étaient capables de reprogrammer une autre partie pour pouvoir lui faire faire cette tâche.
Une personne borderline a vraisemblablement à la fois une prédisposition génétique, des différences biologiques et a subit un environnement favorisant le développement de la maladie.
Ce qui a été fait peut être défait(même si c'est pas toujours facile).
Le cerveau d'un individu évolu physiquement (via par exemple le nombre de connexions neuronales) tout au long de la vie d'une personne et c'est d'ailleurs grace à cela que l'on ne pourra jamais avoir un clone car nous sommes aussi le fruit de notre expérience.
Avec l'aide des médicaments adaptés qui permettent un fonctionnement "libre" du cerveau, la thérapie permet de "réparer" le fonctionnement cérébral en "reprogrammant" des processus "sains" par dessus des processus inadéquates principalement d'autodéfense.

Please read the page BPD and dissociation
La page trauma and BPD
La page memory, vision impairment and BPD

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AAPEL - Back to BPD summary page
 

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Warning:
All the information in this site is aimed at helping people understand a "rather particular" and puzzling kind of disease
But more especially, to support everyone affected by it, sick or not.  In any case, it is ESSENTIAL to see a therapist who specialises in this field they can confirm or give an alternative diagnosis
The name of what you’ve got doesn’t matter so much, getting the right treatment for the right patient does
 

last update  2008
Copyright AAPELTM federation - All rights reserved
Author, Alain Tortosa, psychotherapist, founder president of the Aapel
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