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What do professionals mean when they use the words, "brain disorder" when referring to Borderline Personality Disorder? I am not sure that I am clear about this at all. In fact, really, it is as clear as mud when you contrast and compare the various ways that different professionals employ this terminology.

Those who continue to forward this "BPD is a brain disorder" speak and speculation fly in the face of object relations theory which really is what I identify with and experienced to be true in my own experience with having BPD and in the work it took to recover – work by the way that did not include any psychiatric medication. Whatever might have been going on, in part in my brain, was addressed by Cognitive Behavioral therapy (CBT) and psychotherapy.

Odd too, that for some, likely not for those who have Borderline Personality Disorder, this "brain disorder" speak seems to be a welcome and embraced thing despite the fact that it is still not been clearly proven and despite its being as clear as mud presently.

I think it’s reasonable to assume that some professionals mean that they literally think BPD is a "brain disorder" in the sense that it is an actual physical or chemical anomaly in the brain of those with BPD. I don’t agree with this. It wasn’t my experience, personally.

To me this idea, this notion, this entire way of thinking is at best throwing a bunch of things, or theories, at a proverbial wall to see what, if anything will somehow stick. While some professionals and researchers do that, hey, what about you? You, the person with BPD now. The person in pain now. The person that really needs to find a way to tolerate the distress of the very real dysregulated pain of BPD until you can learn to resolve it and move beyond it? What about you?

Imagine what might be better accomplished if we all just said, hey, we don’t really know what causes it and rather than being wrapped up in that trying to find a way to make the treating of BPD "marketable" (read drug companies and more research money and round and round they go …) we will focus on funding DBT therapy and the other types of therapy that also can really help borderlines get better. What would happen then? Sounds maybe too simple for an overly-trained scientific mind perhaps? The nature versus nurture debate is one that I don’t think will ever be solved in any absolute way. In the meantime, people with BPD are in pain, some are taking their own lives. Can we really afford the luxury of all this speculative and costly drum-beating research that can’t possibly yield a better treatment than the psychotherapy that’s out there now?

It conjures up images of those who invent, create, market, and sell medications rubbing their hands together with exuberant expectation of hitting some proverbial financial jack-pot. A money-grab that I can’t see being of much benefit to those with BPD really. A money-grab, this search for the magical pill to fix the "brain disorder" that is as promising as all of us finding and moving to a perfect planet in space where all of humanity’s environment-destroying and self-destructive habits would magically be gone. Oh, on this new and perfect planet, yes, we would all be on some wonder drug, some perpetual happy pill and therefore we would never again have a problem.

Yeah, right sure eh?

Now, while I still disagree that BPD is a "brain disorder" my stance is somewhat dependent upon what is actually meant by the use of the words, "brain disorder". Why do I say this? Because I think there is some truth to a biological and/or neurological aspect (read that is just one piece of the entire picture of BPD etiology) to BPD. Having said that, however, it is not something that precludes recovery at all.

So, if a professional means that there is an element of something neurological in the brain in combination with all of the other pieces of what many consider to be the causation puzzle of BPD that, to me, makes sense and would be something that would be indicative of my own personal experience having had BPD and yes, having recovered from BPD.

I want to say to you today, if you have BPD, please don’t panic. Please don’t let the words, "brain disorder" leave you feeling hopeless. Please don’t think that just because a professional in whatever field says, "BPD is a brain disorder" that it makes it so. After all there are just as many professionals who disagree with this avenue of research and speculation – that’s right – it’s just speculation – as there are those who are for whatever reasons involved in thinking that spending their time chasing this no doubt ever-elusive definitive answer is going to be helpful to those who are in very real pain.

Now, I have included a video I just came across today of a doctor being interviewed. At first take as I began to watch and listen I thought, here we go, this should be good, as in I was very skeptical. But, then the doctor who rather sounds like he’s in the "it’s a brain disorder" camp suddenly seems to back off of that. Not only does he back off of that but he is rather refreshing to watch and listen to as he admits how much they really don’t know.

If you have BPD, what you really need to know is that you can know more about yourself than this doctor in the video can know about anything to do with you. Borderlines need to focus on finding hope and on having faith. Borderlines need to know that all of the formidable pain they are in really does make sense in their unresolved pasts. Borderlines need to know that there is every reason to hope that you can get on the road to recovery and that you can, at the very least, as Dr. Marsha Linehan, the creator of DBT therapy says, transform your suffering into manageable pain.

Borderline pain and suffering has its reason in the core wound of abandonment and its legacy. It is really not a huge mystery. It can certainly seem like a mystery to many with BPD who have not yet found a way to be consciously aware of the origin of their very profound pain. In the video below this doctor even agrees that DBT therapy is making in-roads into the improving of what he first describes as some "brain" reason why borderlines feel more emotional pain and why they aren’t able to regulate it.

After listening to this doctor, ask yourself, whose hands do you want to put your future in? Who do you want to entrust the resolving your abandonment trauma and its related pain to? Those who would theorize ad infinitum who really don’t have any answers or a combination of a skilled therapist and yourself who can work together to create the kind of emotion regulation and changes in thinking required to get on and stay on the road to recovery?

By the way, if you have BPD, you likely caught this too but did you notice the doctor wondering why borderlines don’t "feel" the cuts of self harm? How does he know that? Does he know that? I know that when I used to cut when I had BPD I sometimes felt it sometimes didn’t. The times when I physically felt it the reason that physical pain of feeling myself cut myself didn’t stop me wasn’t because I had some super-high pain tolerance (okay my pain tolerance wasn’t low either) it was a little thing called dissociation. It is that for many with BPD I suspect. And, for me, when I was borderline and cutting myself, self-harming my self, the transfer of unbearable dysregulated borderline emotion really made the physical pain totally insignificant in comparison.

I hope you will bet on you. I am betting on you. Take a leap of faith and begin, if you haven’t already to have faith in your own ability to face and heal your own pain in therapy with the help of a skilled therapist who believes that you can recover.

© A.J. Mahari, July 12, 2008 – All rights reserved.

“Brain Disorder” and Borderline Personality