The Pain Paradox: BPD and Health
Borderline Personality Disorder has created a medical mystery, not only for psychologists, but for doctors & physicians as well.
The mystery is this: Individuals with a diagnosis of BPD often report high levels of physical pain as a result of long term health problems. However, when it comes to short-term visceral pain, such as from acts of self-harm, it is not felt at all. This is the pain paradox of BPD: I feel too much, I feel nothing at all.
Visceral Pain Unexperienced
Recent studies have shown, when patients suffering from BPD, were put under the glare of EEG, and subjected to intense short-term pain, scientists discovered something remarkable. BPD brains quickly star producing Theta currents - the brainwaves of sleep, trance, and deep relaxation.
It is also now an established fact, that visceral pain releases endorphins and other natural opioids which create a state of lingering tranquility and peace.
Finally dissociation, either through intense stress or numbing-out, on a neurological level, appears to show the brain temporarily shutting down, in all but the most rudimentary functions. Dissociation creates detachment, which does a very good job of masking pain completely.
As such, for those of us with BPD, pain on a subjective level is often under-experienced. It also explains why cutting, burning or attacking one’s own body, often doesn’t hurt — and why self-harm is dangerously addictive. On a biological level, such wounds cause the brain and body to fight back with calm and relaxation, which lasts quite a long time.
‘Many patients claim to “feel nothing,” seemingly immune to the body’s experience and acknowledgement of tissue destruction’ Randy A. Samson, MD
Scars That Run Deep
Studies have also shown for people with BPD, endogenous pain located within the body, is often experienced as debilitating. One of the reasons for this is because. Traumatic stress experienced early in life leads to long term health problems.
Neuropeptides are molecules associated with learning, memory, and emotion. They are released by the brain, but then travel through the bloodstream to receptors all over the body. If a person has experienced childhood trauma, neuropeptides will be encoded with such data. This leaves a lasting imprint on the mind, but the body as well. For lack of a better word, this imprint is experienced as “pain.”
Finally chemicals such as adrenaline and cortisol set the body on edge. They can cause high-blood pressure, cardiovascular disease, aching joints, chronic fatigue, and low immunity. Unfortunately, they also impair some of the key components of the mind. For example, when the amygdala is saturated in stress hormones, it is unable to process events, and will continually overestimate threat. This creates a loop which further weakens the body’s health and resilence.
BPD sufferers are often beset with physical health conditions from IBS to fibromyalgia. This is not because we are frail, derelict malingerers; its because stress effects us — both mind and body.
‘Emotional memory is stored throughout the body […] The connection between emotions and health is more than folklore’ Professor Gordon Turnbull
Of course, all this scientific talk of pain is rather cold-blooded for those of us who suffer it everyday. Anyone with BPD will tell you, we’d gladly accept physical pain if we could get rid of emotional hurt — unfortunately we often have to deal with both.
Perhaps then we may like to think of borderline personality disorder, as an illness that revolves continually around pain — both emotional and physical.
We need support not only from psychiatrists and psychologists but also doctors and physicians as well. This is not a morbid preoccupation with suffering, but only an acknowledgment of how emotions impact on the body. Hopefully by helping one we can help the other, and bring about healing all round.
‘How many mental health problems, from drug addiction to self-injurious behaviour, start as attempts to cope with the unbearable physical pain of our emotions?’ Bessel Van Der Kolk MD
