In psychiatric conferences, there are two topics that cause no end of excitement, and it is hard to find standing room when a lecture on any one of them is going on.
One of them is Borderline Personality Disorder. Why this diagnosis gets the mental health professionals to get so animated? Perhaps because the concept has no true existence. It is a pejorative rubric created to dump under its province all those irrational, erratic and difficult to understand behaviors that leave the therapist helpless. There is nothing like condemning a problem, especially on scientific grounds, to avoid dealing with it. By naming it as borderline, by which it is tacitly acknowledged that the patient is a jerk, one feels there is no more need to condemn oneself as incompetent. She is borderline and therefore it is her and not my problem. And it is this avoidance in real life that is overcompensated by talking endlessly over it in conferences.
And boy do they get profound in the lectures on this topic. Every one of it that I have attended on Borderline Personality Disorder starting from the great Otto Kernberg himself, to his wife - isn't it strange that both husband and wife are experts on the same illness - to lesser mortals, I have found their talk so erudite that in a matter of five minutes every member of the audience is grasping for straws. And therein lies the second reason for its appeal. If nobody can make head or tail of what the speaker is talking about then everyone in the audience becomes equal - obfuscation is a great leveler. And just like the supernatural does not exist and therefore human beings talk and write about it like no other issue the borderline disorder since it is a sham diagnosis it provokes the greatest attention.
The last but not the least important reason is the belief, which an astonishing number of mental health professionals harbor, that they themselves have a touch of Borderline Personality Disorder. We all have irrational aspects to ourselves which we don't understand and to varying degrees dread it's overpowering our rational front. These fans of borderline personality lectures are genuinely rushing to attend these lectures hoping to find some shortcut to heal themselves.
And what lies behind the cleverly annoying behaviors of the so-called Borderline patients that mental health professionals cannot scream enough as "splitting" - a concept that was introduced by Freud and never with any intention for it to be used as a pejorative epithet against the patients - which gets their goat? It is a negative transference towards authorities stemming from their rage at their parents for not doing enough for them. Making staff members on the hospital ward fight with each other - the so-called splitting - is at bottom nothing but making the parents fight with each other. And their self-destructiveness is also often a way to punish themselves, but, at the same time, a means to annoy and frustrate authorities (parents).
The lure of Lucid Dreaming is a little harder to figure. But it is guaranteed that a lecture on the topic will jam pack the lecture room with the fans overflowing into the corridor. And the psychology of its appeal, just like with the Borderline lectures, lies in the hope of finding some great pearl of wisdom that will enable them to start dreaming lucidly themselves and through this mastery over that mystical process, cure oneself. It is therefore driven by a desire for self-therapy. And this brings me to the unpleasant task of bursting the bubble of enthusiasm surrounding lucid dreaming. There is not much to its metapsychology. Lucid dreamers are people who are more awake while dreaming than others.
Dreaming is a state of semi-wakefulness to begin with - the failure of our ego to go to sleep completely (complete withdrawal of cathexis) - and not some special third state of consciousness which neither belongs to wakefulness nor sleep as the authors of that completely idiotic Activation-Synthesis hypothesis claim. While dreaming we are only partially asleep. Part of our brain gets activated and awake. This is why, if one fully wakes up a person out of intense dreaming, he can quickly get oriented to the real world. The neuronal networks responsible for wakefulness are already somewhat in gear.
Now individuals differ greatly in regards to the ratio of their wakefulness and sleepiness while dreaming. Some tolerate a high degree of partial wakefulness while dreaming, others do not, and get out of dreams/sleep altogether at quite low thresholds. Lucid dreamers appear to be individuals who can continue to dream while the centers responsible for wakefulness are quite active. They are individuals who can more easily ride the two horses of partial wakefulness and dreaming at the same time. They can divide their consciousness into taking cognizance of the dream world and the real world at the same time.
The psychological mechanism behind this appears to be similar to how hysterics can tolerate the co-existence of multiple personalities. People who are highly suggestible and enter into hypnosis easily - traits of hysterical disposition - appear to have a greater ability to dream lucidly. While dreaming their mind splits into two states of consciousness, one aligned to the real world and the other to the dream world with the ability of the former to influence the course of what is happening in the latter to varying degrees. And this is felt by them to be a special gift akin to some magical ability. It is the wish to go magical which underlies the fascination with this phenomenon and the great rush to hear lectures upon it. The lure of Lucid Dreaming is at bottom a lure of magic and a desire to become a magician with one's dreams and one's problems.
I recently came across a couple of lucid dreams in a patient who had never shown this gift previously. The analysis threw some light upon the nature of lucid dreaming and it is worth reporting it here.
The patient suffers from obsessive-compulsive disorder and was in throes of deep depression because of separation from her husband and because she got fired from her job due to her obsessive perfectionist behavior which was affecting her productivity. She brought in to the sessions the following three dreams.
The first dream was not at all lucid, but it was its analysis that made possible the emergence of the phenomenon of lucidity in her subsequent dreams.
It was so real. I go into the garage where there was a pile of rope. [In real life my garage does not have any such rope]. I grab the rope, throw it over the beam, grab a step stool, and hang myself. All the while I am also watching myself doing it even after I die till I woke up in shock and extreme fear. It took a while before I realized that it is a dream and I am not dead.
The dream was subjected to analysis among other issues that emerged in the session. Some of the elements of the dream, like the garage symbolizing the mother's womb, where she wants to return to escape her current painful life; hanging as castration, with the head symbolizing penis that was being severed from the body by the rope [castrating the father by identifying with him while he was having sexual intercourse with the mother, during the time she was in the womb and thus robbing him of the penis and through that emerging in her next incarnation as a boy instead of girl was the full wish behind the dream] were suggested to the patient.
A week later when she came to the session she had had two dreams to report which she found quite strange because while dreaming them she was aware that they were dreams and she could influence their course. She is not familiar with the concept of lucid dreaming and did not use the term when reporting them The two dreams, though dreamt on two subsequent nights, were upon the same theme and quite similar in content and therefore she narrated them together.
Once again I am in the garage and the pile of rope is there but I am telling myself this is not how it is going to happen. I am telling myself that this is a dream. I see through the garage at a pond which is at the back of the house [in real life there is no such pond]. There is a sheet of ice upon the pond. I keep saying to myself I am not doing this but nevertheless I start jumping up and down upon that ice bent upon breaking it and then I see myself floating under that ice, dead. The same dream is repeated the next night with the only difference that I have complete control over what I am dreaming. I am aware what is happening and I keep telling to myself that I am not going to do it and when I break through the ice I do not go dead but shoot out like a rocket, flying up into the sky as a superhero. She made the gesture of a superhero, putting one arm over her chest and the other over her head to make the figure of a superhero.
The two dreams are of course the continuation of the theme of returning to the womb - the expanse of water replacing the garage - to escape the unpleasant present, and through death to be reborn and as the ideal male version of herself. But the wish to watch the parental intercourse while she was in intrauterine existence with the aim of robbing the father of his penis and emerging this time as a boy, and a boy who was a superhero (the very personification of phallus) was accompanied with less dread (fear of the father), a less fear of dying, with greater emphasis on rebirth than on death, and the whole fantasy played out in the dream was under greater control of the ego. The latter had not gone completely into sleep, but remaining partially awake was controlling the process going on it the dreamwork. Because of the analysis of the first dream, the fantasy of stealing the penis from the father was felt to be not as wrong and dreadful, and the wish to be born with it was more clearly shown in the third dream.
That the above analysis has validity was confirmed by the fact that the patient also reported that after the analysis of the first dream she had gone to the house of her estranged husband whom she had not seen for a year and since he lived in the same house where they had lived for 25 years - she was the one who had moved out - she had the key to it, and had taken out his 10-month-old dog which she had never seen before, in his absence and without informing him, and gone to a park to play and walk with it, doing it for hours, till she got a call from her son as to what was wrong with her that she stole that dog and to return it immediately to her estranged husband before the cops are called.
One of them is Borderline Personality Disorder. Why this diagnosis gets the mental health professionals to get so animated? Perhaps because the concept has no true existence. It is a pejorative rubric created to dump under its province all those irrational, erratic and difficult to understand behaviors that leave the therapist helpless. There is nothing like condemning a problem, especially on scientific grounds, to avoid dealing with it. By naming it as borderline, by which it is tacitly acknowledged that the patient is a jerk, one feels there is no more need to condemn oneself as incompetent. She is borderline and therefore it is her and not my problem. And it is this avoidance in real life that is overcompensated by talking endlessly over it in conferences.
And boy do they get profound in the lectures on this topic. Every one of it that I have attended on Borderline Personality Disorder starting from the great Otto Kernberg himself, to his wife - isn't it strange that both husband and wife are experts on the same illness - to lesser mortals, I have found their talk so erudite that in a matter of five minutes every member of the audience is grasping for straws. And therein lies the second reason for its appeal. If nobody can make head or tail of what the speaker is talking about then everyone in the audience becomes equal - obfuscation is a great leveler. And just like the supernatural does not exist and therefore human beings talk and write about it like no other issue the borderline disorder since it is a sham diagnosis it provokes the greatest attention.
The last but not the least important reason is the belief, which an astonishing number of mental health professionals harbor, that they themselves have a touch of Borderline Personality Disorder. We all have irrational aspects to ourselves which we don't understand and to varying degrees dread it's overpowering our rational front. These fans of borderline personality lectures are genuinely rushing to attend these lectures hoping to find some shortcut to heal themselves.
And what lies behind the cleverly annoying behaviors of the so-called Borderline patients that mental health professionals cannot scream enough as "splitting" - a concept that was introduced by Freud and never with any intention for it to be used as a pejorative epithet against the patients - which gets their goat? It is a negative transference towards authorities stemming from their rage at their parents for not doing enough for them. Making staff members on the hospital ward fight with each other - the so-called splitting - is at bottom nothing but making the parents fight with each other. And their self-destructiveness is also often a way to punish themselves, but, at the same time, a means to annoy and frustrate authorities (parents).
The lure of Lucid Dreaming is a little harder to figure. But it is guaranteed that a lecture on the topic will jam pack the lecture room with the fans overflowing into the corridor. And the psychology of its appeal, just like with the Borderline lectures, lies in the hope of finding some great pearl of wisdom that will enable them to start dreaming lucidly themselves and through this mastery over that mystical process, cure oneself. It is therefore driven by a desire for self-therapy. And this brings me to the unpleasant task of bursting the bubble of enthusiasm surrounding lucid dreaming. There is not much to its metapsychology. Lucid dreamers are people who are more awake while dreaming than others.
Dreaming is a state of semi-wakefulness to begin with - the failure of our ego to go to sleep completely (complete withdrawal of cathexis) - and not some special third state of consciousness which neither belongs to wakefulness nor sleep as the authors of that completely idiotic Activation-Synthesis hypothesis claim. While dreaming we are only partially asleep. Part of our brain gets activated and awake. This is why, if one fully wakes up a person out of intense dreaming, he can quickly get oriented to the real world. The neuronal networks responsible for wakefulness are already somewhat in gear.
Now individuals differ greatly in regards to the ratio of their wakefulness and sleepiness while dreaming. Some tolerate a high degree of partial wakefulness while dreaming, others do not, and get out of dreams/sleep altogether at quite low thresholds. Lucid dreamers appear to be individuals who can continue to dream while the centers responsible for wakefulness are quite active. They are individuals who can more easily ride the two horses of partial wakefulness and dreaming at the same time. They can divide their consciousness into taking cognizance of the dream world and the real world at the same time.
The psychological mechanism behind this appears to be similar to how hysterics can tolerate the co-existence of multiple personalities. People who are highly suggestible and enter into hypnosis easily - traits of hysterical disposition - appear to have a greater ability to dream lucidly. While dreaming their mind splits into two states of consciousness, one aligned to the real world and the other to the dream world with the ability of the former to influence the course of what is happening in the latter to varying degrees. And this is felt by them to be a special gift akin to some magical ability. It is the wish to go magical which underlies the fascination with this phenomenon and the great rush to hear lectures upon it. The lure of Lucid Dreaming is at bottom a lure of magic and a desire to become a magician with one's dreams and one's problems.
I recently came across a couple of lucid dreams in a patient who had never shown this gift previously. The analysis threw some light upon the nature of lucid dreaming and it is worth reporting it here.
The patient suffers from obsessive-compulsive disorder and was in throes of deep depression because of separation from her husband and because she got fired from her job due to her obsessive perfectionist behavior which was affecting her productivity. She brought in to the sessions the following three dreams.
The first dream was not at all lucid, but it was its analysis that made possible the emergence of the phenomenon of lucidity in her subsequent dreams.
It was so real. I go into the garage where there was a pile of rope. [In real life my garage does not have any such rope]. I grab the rope, throw it over the beam, grab a step stool, and hang myself. All the while I am also watching myself doing it even after I die till I woke up in shock and extreme fear. It took a while before I realized that it is a dream and I am not dead.
The dream was subjected to analysis among other issues that emerged in the session. Some of the elements of the dream, like the garage symbolizing the mother's womb, where she wants to return to escape her current painful life; hanging as castration, with the head symbolizing penis that was being severed from the body by the rope [castrating the father by identifying with him while he was having sexual intercourse with the mother, during the time she was in the womb and thus robbing him of the penis and through that emerging in her next incarnation as a boy instead of girl was the full wish behind the dream] were suggested to the patient.
A week later when she came to the session she had had two dreams to report which she found quite strange because while dreaming them she was aware that they were dreams and she could influence their course. She is not familiar with the concept of lucid dreaming and did not use the term when reporting them The two dreams, though dreamt on two subsequent nights, were upon the same theme and quite similar in content and therefore she narrated them together.
Once again I am in the garage and the pile of rope is there but I am telling myself this is not how it is going to happen. I am telling myself that this is a dream. I see through the garage at a pond which is at the back of the house [in real life there is no such pond]. There is a sheet of ice upon the pond. I keep saying to myself I am not doing this but nevertheless I start jumping up and down upon that ice bent upon breaking it and then I see myself floating under that ice, dead. The same dream is repeated the next night with the only difference that I have complete control over what I am dreaming. I am aware what is happening and I keep telling to myself that I am not going to do it and when I break through the ice I do not go dead but shoot out like a rocket, flying up into the sky as a superhero. She made the gesture of a superhero, putting one arm over her chest and the other over her head to make the figure of a superhero.
The two dreams are of course the continuation of the theme of returning to the womb - the expanse of water replacing the garage - to escape the unpleasant present, and through death to be reborn and as the ideal male version of herself. But the wish to watch the parental intercourse while she was in intrauterine existence with the aim of robbing the father of his penis and emerging this time as a boy, and a boy who was a superhero (the very personification of phallus) was accompanied with less dread (fear of the father), a less fear of dying, with greater emphasis on rebirth than on death, and the whole fantasy played out in the dream was under greater control of the ego. The latter had not gone completely into sleep, but remaining partially awake was controlling the process going on it the dreamwork. Because of the analysis of the first dream, the fantasy of stealing the penis from the father was felt to be not as wrong and dreadful, and the wish to be born with it was more clearly shown in the third dream.
That the above analysis has validity was confirmed by the fact that the patient also reported that after the analysis of the first dream she had gone to the house of her estranged husband whom she had not seen for a year and since he lived in the same house where they had lived for 25 years - she was the one who had moved out - she had the key to it, and had taken out his 10-month-old dog which she had never seen before, in his absence and without informing him, and gone to a park to play and walk with it, doing it for hours, till she got a call from her son as to what was wrong with her that she stole that dog and to return it immediately to her estranged husband before the cops are called.
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I was wondering, could the emphasis on behavioural therapy treatment, that is, socialisation to a societally determined way of being, of the symptoms commonly referred to as borderline personality disorder be attributed, at least in part, to the counter-transference reactions elicited in health processionals?
ReplyDeleteI mean, if the Borderline patient gets under the skin of the health professional, the health professional may be at pains to promote an idea of a "bad" patient needing to be be bought into line rather than a suffering individual needing to be understood and helped to heal. A view seemingly often adopted by patients with a "nothing to see here" attitude.
Thus psychoanalytical treatment is promoted as counter-indicated for these symptoms because health professionals, as a collective, collude to punish the patient, with societal consent, because their ego ideal as helping, kind, altruistic, successful professional has been severely undermined by these patients.
It is well known that the creator of DBT, Dr. Marsha Linehan, was herself diagnosed with BPD, not that this precludes success in the field of suffering, but adaptation is not healing, and adaptation via behavioural therapies tends, to my mind, to reinforce damaged structures rather than to heal the damage. Thus by inventing DBT, a harsher extension of CBT, which had limited "success" in this area, it could be interpreted the former patient has identified with the aggressor, and defensively sought to further alienate people from the possibility of reconnecting with their own souls.
Anyway. I guess I have over emphasized the point.
As a side note,I have has success in becoming lucid in dreams,and did indeed,before embarking on my own psychoanalytic voyage,entertain magical fantasises of healing through lucidity. As an extension of that, I felt, misguidedly, that hallucinogenics might offer the same magical solution. To be honest, as I discover how murderous I am towards my own libidinal expressions, I wish there was such a magical cure. How magnificent, and devoid of learning from experience, that would be!
Hi iv been diagnosed bpd, if you say bpd has no true exsistence at all what would you say is happening? Besides the moods themselves i empathize alot to the point i would cry for them if they could not, my emotions are so intense i feel like i would explode unless i self harmed or screamed etc.. Maybe theres more to bod and its not on the border or neurosis or psychosis as im neitger feeling any of those.i have difficulty with sleep and do lucid dream which causes sleep paralysis alot when i actually want to wake up. I dont feel 'magical' or anyother special gifts or whatever. All i know is this pain inside along with intensity of my emotions has taken a role of self destruct on because if i dont harm myself it would come out at others. I also get regular migraines with aura and tend to get one before i have an episode - do you think migraines & bpd are related? Or that research could be done into it? Sorry for going on or if its diffcult to understand what i have written. Thanks. -
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