Articles

How to Know If You Have Borderline Personality Disorder & How Treatment Helps

Posted on July 28th, 2017

“I feel like I’m always making new friends or falling in love with a new guy, but then something goes really wrong in the relationship and they push me away. The people in my life are always either getting mad at me, breaking up with me or letting me down and I don’t know what is going on, or what I’m doing wrong.”

These experiences can be common among people who have an underlying personality disorder. If you have sudden mood swings and experience lots of conflict in your personal relationships, with intense ups and downs that make your life seem unmanageable, these can be hallmark signs of borderline personality disorder, or BPD.

A complex and often misunderstood mental health disorder, BPD affects roughly 1.6% of people in the United States. Even the name “borderline personality disorder” is confusing and somewhat misleading, though experts have not yet agreed upon a more appropriate term for this personality disorder.

As with many mental health disorders, BPD occurs on a spectrum where there are “low-functioning” and “high-functioning” individuals. A diagnosis can be tricky because the signs and symptoms of BPD can overlap with other disorders. It is important to consult a licensed mental health professional to help determine if you have borderline personality disorder or another condition that presents with similar symptoms.

As a preliminary measure to seeking professional help, you can take a quick borderline personality quiz and also review this checklist of signs and symptoms that can indicate BPD.

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Saving Our Kids From Opioid Addiction One School at a Time

Posted on July 27th, 2017

If we are going to reach kids with effective messages about the dangers of abusing prescription drugs and alcohol, these messages probably need to be delivered at the local level. An anti-drug campaign in Southern California is doing just that.

Created in response to increased drug and alcohol use among teens in the South Bay beach cities area of Los Angeles, South Bay Families Connected (SBFC) is a nonprofit grassroots group that was founded to improve teen wellness and to warn young people and their parents about how to guard against drug and alcohol abuse.

Kicked off during #SBOpioidAwarenessWeek in May 2017 with its launch of The South Bay Opioid Awareness Project, the group partners with local schools and organizations to educate teens, parents, teachers and administrators about the dangers of prescription drug misuse and abuse. Through videos, presentations and discussion panels that are offered free to students and the community, the project aims to start a conversation that encourages safe use, storage, and disposal of prescription drugs to keep them out of the hands of kids.

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Narcotics on Dark Web Pose Immense Danger to Youths

Posted on July 26th, 2017

As the opioid crisis in this country grows, it is being aided by a culprit once believed to be vanquished from the scene — the internet.

The New York Times recently reported the resurgence of narcotics trafficking on what is known as the “dark web” and kids, sometimes younger than 18, are finding their way to these hidden websites. The Times reported the tragic deaths of two 13-year-old boys who accessed a synthetic opioid drug in this way.

“This has been an epidemic in recent years,” says Kenneth England, a primary therapist with Promises Malibu. “I have seen people as young as 18 getting drugs through the internet and/or dark web.”

“As people who are growing up in the “connectivity age,” they want privacy and to be doing “cool stuff,” so they are drawn to sneaky tactics such as this,” he says. “They find these sites by word of mouth, in conversations meant to impress others with their knowledge of the mysterious but deadly place to find drugs.”

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What Happens When You Give up Alcohol … and When You Can’t

Posted on July 25th, 2017

When an occasional glass of wine with dinner or a couple of beers over the weekend turn into a few drinks per day or the occasional drinking binge, it may be time to consider giving up alcohol … especially if you have been dealing with too many hangovers and your drinking is starting to affect various areas of your life, like your relationships, work performance, sleep patterns and overall health.

The recommended daily alcohol limit is one drink per day for women and two drinks per day for men, but even that rate of alcohol consumption can lead to problems for many people. If you are regularly consuming more alcohol than you think you should, giving up alcohol for even a short period is a good idea.

What happens to your body and mind when you give up alcohol? Let’s take a look at what happens if you stay sober for a month … and beyond.

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8 Early Signs You’re Developing an Alcohol Problem

Posted on July 21st, 2017

Having a drink with friends after work, a glass of wine with dinner or a few beers over the weekend is, for most people, part of “normal” life. Sometimes, though, casual or social drinking can develop into “problematic” drinking where life doesn’t feel right unless alcohol is involved. And, it can be tricky to know when drinking has crossed the line from normal to not-so-normal.

Problem drinking that becomes severe is diagnosed as alcohol use disorder (AUD) — a chronic relapsing disease where alcohol use is compulsive, and the drinker has lost control over their alcohol intake and feels bad when not drinking.

When you start drinking to avoid feeling bad, or to cope with stress, your drinking may be getting out of hand. It’s important to know the early signs of problematic drinking so that you can take steps to cut back. Recognizing an alcohol problem is the first step toward managing it.

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Books on Addiction: The 5 Best Books to Read Before Rehab

Posted on July 20th, 2017

Going to rehab is a vital step to entering recovery and it helps to be prepared with inspiration and information. There are so many books on addiction yet the classics in this field are the ones people always return to for inspiration and understanding.

Here are some of the drug addiction books that can help you on your path.

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5 Ways Being Around Nature and Water Can Improve Your Mood

Posted on July 19th, 2017

By Jody Trager, PhD, Program Director at Promises Malibu Vista

I’m lucky to live on the West Coast because every day I can drive to the ocean and watch the waves roll in before beginning my busy day. Studies show it’s healthy to be near the coast. It’s soothing and inspiring and I find it helps clear my mind and starts my day on a positive note.

I think this is true of any body of water — rivers, lakes, streams and waterfalls — and that’s why I recommend it so highly for clients suffering from stress and depression. Research shows that walking in nature and breathing fresh air can offer mental clarity and emotional healing and that being in or around bodies of water can improve mood.  Even a swimming pool can help.

This is why nature therapy, exercise therapy and utilizing the natural environment of Promises Malibu Vista are such an important part of recovery for women. It is important that clients discover their personal “happy place” in nature and which activity or experience makes them feel better, so we offer many options to try. They are also encouraged to enjoy that experience as frequently as possible.

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How Exercise Helps Treat Body Image Issues

Posted on July 18th, 2017

“You can never be too rich or too thin” said Wallis Simpson, Duchess of Windsor. “Nothing tastes as good as skinny feels,” said Kate Moss, international supermodel.

Such statements from iconic and famously slender women have become a kind of mantra for generations of women, who often develop low self-esteem and body image issues if their natural curves don’t fit within the super-slender silhouette so admired in Western culture. Many women, young and old, embark on starvation diets in an effort to lose weight and achieve the pencil-thin profile that continues to be fashionable.

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Professional Self-Regulation: 12 Signs That It Is Time to Address your Addiction

Posted on July 17th, 2017

By Gregory Skipper, MD, Director of Professional Health Services at Promises

As medical professionals, an important aspect of holding ourselves to ethical guidelines and standards of conduct is recognizing when we may be working while we are impaired by drugs or alcohol.

Although our line of work gives us a keen understanding of how impairment can put patients and others at risk, it is interesting how often physicians and others in the medical field overlook the signs indicating they themselves have a problem with addiction. There may be myriad reasons for this oversight, and many of them are understandable. Yet, a key responsibility of practicing medicine is professional self-evaluation and self-regulation.

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Alcoholism Facts: The Impact on Marriage and Relationships

Posted on July 11th, 2017

By Elizabeth Davies-Ulirsch, Primary Therapist at Promises Young Adult Program

Alcohol abuse can slowly destroy relationships. It can erode even the most committed love, scar children and impact families for generations. If you suspect a problem with your spouse, it is important to know these alcoholism facts.

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Cocaine and the Nervous System

Posted on July 10th, 2017

Commonly known as “coke,” “blow” and “snow,” cocaine is a drug made from the leaves of the coca plant. It can be used medically as a topical anesthetic, but is most widely used recreationally as a stimulant.

When used for recreational purposes, cocaine is typically sold in powdered form, which is snorted or burned and inhaled as smoke. Some coke users mix the powder into a solution and inject it into a vein.

Drug dealers often mix the powdered version of coke with other white, powdery substances like flour, cornstarch or other drugs — substances that are unknown to the user and can cause unexpected effects.

As an illicit drug, coke is also solidified into crystalline rock form, which is sold as “crack” cocaine. Crack users heat and smoke the rock crystals, a process that makes a crackling sound and leads to very rapid, short-acting effects. Considered 75% more potent than powdered cocaine, crack’s short-acting effects are more intense and can lead to addiction after one use.

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Is There a Genetic Predisposition for Alcoholism?

Posted on July 10th, 2017

Many people wonder if there is an alcoholism gene that automatically gets passed from generation to generation and determines whether people will drink in an unhealthy way.

It’s true that certain genes do make some people more vulnerable to excessive alcohol use but it’s also true that not everyone who is at risk for alcoholism will become an alcoholic.

Research clearly shows that there can be a genetic predisposition for alcoholism and that alcohol use disorder (AUD) can run in families, but there are many other factors at play.

Genetics play a role but so does early childhood experience.

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Trauma Reenactment Can Run (and Ruin) Our Lives

Posted on July 6th, 2017

By Natalia Balasundaram, Trauma Therapist, Promises, Young Adult Program

Amy grew up in a household that was dominated by her father’s cocaine addiction. She stayed away from drugs, but she always seemed to find partners with drug problems. A part of her hoped she could save them in a way that she could not save her dad.

Brian had a mom with a severe mental illness who needed constant caretaking. As he grew, he dated women who were emotionally frail and who needed to be taken care of. Being with people he could intensively care for was familiar and comfortable.

Yolanda’s father hit her when she was a child and her mother called her names like “fat” and “pudgy face.” Both parents dished out enough abuse to help shape Yolanda’s life into one filled with fear of ridicule, shame and low self-esteem. For most of her life she drifted toward partners who abused her physically and verbally.

Although Amy, Brian and Yolanda grew up in different circumstances, they shared something that studies show is very common:  Trauma reenactment. It is the often subconscious compulsion to recreate the traumatic circumstances of youth. Because of this undercurrent and need to continue what began in childhood, they select certain opportunities and draw certain kinds of people to them ― as adolescents and into adulthood ― who set the stage to reenact the kinds of behaviors and experiences of childhood.

Three Things You Need to Know

People who experience trauma may have a wide range of symptoms and experiences related to their childhoods. Trauma reenactment can manifest in different ways in different individuals until they become aware of the patterns they are recreating.

It’s a chronic condition.  People with trauma may suffer from PTSD or live in a constant state of anxiety. Having experiences that recreate the original trauma can be terrifying or exhilarating. They may literally “get high” from the drama.

It’s often driven by the subconscious. Some people go from one life experience to another based on the original trauma and never know what causes their behavior. They constantly find themselves in similar situations, with the same kinds of people. This could include always surrounding themselves with people similar to their family of origin ― the names change but the types of people do not ― or constantly getting involved in high-risk activities.

Even if aware, they may try to suppress it. Some people realize they are constantly choosing unhealthy friends and partners, and getting involved in negative experiences. Unable to cope, they try to drown out the feelings in substances and process addictions such as overeating, sex, gambling, shopping and other experiences that activate adrenaline and excitement.

Seeking High-Risk Behaviors

Trauma impacts the parasympathetic nervous system and can keep people in a state of hypervigilance or flight, fight, or freeze. Trauma reenactment can perpetuate the physical experience of trauma, which is an underlying driving force of thrill-seeking and risky behaviors.

For example, if someone has kleptomania, they will go out and steal or seek out high-risk activities because of the high that it releases.  Someone with childhood sexual abuse trauma may find themselves in the grips of a sex and love addiction, domestic abuse or in a consistent pattern of self-harm.

Other trauma reenactment might lead people to seek out heightened feeling states that closely resemble those habits common to people we might think of as “adrenaline junkies.”  This may not be the precise activity that caused their childhood trauma, but it is somewhat familiar and provides an “extreme” experience. It escalates over time, with the need to have even more extreme experiences in order to feel anything.

The nervous system becomes so used to being high on adrenaline that it is hard to bring it down. So they’ll go out and seek even more advanced, high-risk activities. Some will turn to substances for this extreme and, because of the need for the state of physical arousal, addiction can be the end result.

Trauma Reenactment Is Not Always a Bad Thing

In recovery, the first thing to do, always, is to identify the problem. When people begin to see the trauma that has driven the recreation of certain patterns and experiences, they can begin to heal.

Trauma reenactment can also be used consciously as a way to reset the internal experience of trauma that drives the external behaviors.

Some people relive their worst trauma and go back to the scene of the trauma as a way to heal themselves. For example, Kara witnessed the shooting death of a friend when she was young and for years she suppressed her grief and pain with high-risk sexual activities like one-night stands and maxing out her credit cards with comfort purchases and food. She avoided the scene of the crime for many years, sometimes driving by and wanting to stop but going to a bar instead of spending a moment at the scene expressing her grief.

While in recovery for sex and spending addictions, she was able to return to the place where her friend was shot with a supportive person by her side and allow herself to mourn as she remembered that awful, traumatic moment that set her on a path of self-destruction.  There was still an old bloodstain on the concrete in front of the store where the shooting occurred. She was able to leave a rose where the body had been.

Instead of heading to a bar for a drink and a pick-up, she went home and allowed herself to cry.  It was a huge step toward healthy recovery.

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3 Brain and Body Based Therapies That Can Help Heal Preverbal Trauma

Posted on July 6th, 2017

By Natalia Balsundaram, Trauma Therapist, Promises, Young Adult Program

Lily was so excited about becoming a mother. She lovingly collected baby items and built a nursery for her first child. She couldn’t wait to meet him.

In her sixth month of pregnancy, she discovered her husband was gambling — heavily.  He told her it was to “make money for the baby.”

When she lashed out at him in dismay over his behavior, he packed a bag and left her for two weeks to go off on a gambling spree, putting their family life in disarray. Abandoned and filled with despair, she cried herself to sleep at night, patting her stomach, and promising her baby she’d find a way to take care of him. But she did not feel very hopeful.

When her husband returned, broke and broken, their marriage was never the same and their finances were drained. Every day was filled with stress, worry and arguments. When she went into labor, she had a friend take her to the hospital instead of the father of her child.

As much as she tried to protect her unborn baby from her stress, there was no way she could totally shield him. The seeds of ​preverbal trauma​ had been planted.

Womb With a View

Just as small children can be impacted by stressors in the home, unborn babies can be affected by what goes on in their mother’s mind and body during pregnancy. The first signs of trauma can occur before they even enter the world.

The unborn baby’s only environment is the uterus and if the mother is having chronic aggravation, or the mother has mental health issues or uses drugs, it all impacts the baby’s environment. For example, if the mother is stressed or has PTSD, she is constantly on high alert. Or if she is in an abusive relationship, and is constantly having exposure to those stress chemicals, that’s going to impact the child.

In Lily’s case, the devastation of her marriage while pregnant took a toll on her. Once she gave birth, she researched how her own traumatic experience may have impacted her son and learned that, ultimately, it may come down to nature vs. nurture. Some people are exposed to trauma while still in the womb and will not develop trauma. Others can go on to develop PTSD, anxiety and other disorders, or addictions. Some of the factors that exacerbate preverbal trauma are these more commonly known traumas.

  • Childhood trauma​. A disturbing life experience, or a series of experiences, that deeply wound people in their early years between ages 0 to 6. This may include: Physical, sexual, or emotional abuse, exposure to domestic abuse, addiction or violence between parents, siblings or within the community, and experiences in natural disasters or in war zones. It also encompasses devastating accidents or injuries, pediatric medical issues and loss.
  • Complex trauma​. Repetitive exposure, usually within the home, sets children up for chronic problems that can include PTSD.  It could be repeated sexual abuse or physical abuse at the hands of a relative, or witnessing a mother or sibling regularly beaten by a family member. It might also occur from seeing a caregiver continually drunk or on drugs or neglect by one or more parents. It happens when an environment is unsafe, there is not enough food or basic needs being met and a child has no one to turn to for help.
  • Attachment disorder​. Infants cannot fend for themselves and when they do not receive the care they need from primary caregivers, it disrupts normal child development. Secure attachment occurs when comforts are offered and basic human needs are fulfilled. But if parents are unable to bond with babies, are non-attuned, or if there is neglect or abuse, the lack of stability produces disruptions in the child’s neurophysiological systems. The more secure and stable the earlier attachment, the more success we have later in life at regulating emotions. Conversely, the more disruptions experienced can lead to issues later in childhood and in adulthood.

Treating Preverbal Trauma

Mothers have lives, human emotions and pain and cannot shield their children from every exposure to negative experience or from every one of life’s slings and arrows.

Fortunately for Lily’s son, she went into therapy and in the process of healing her own wounds learned more about how to bond with her baby to counteract some of his preverbal trauma. This gave him at least one healthy parent who did her best to be attuned to him. Ultimately she may have reduced or preempted the risk factor for preverbal trauma.

Not every mother can be expected to know how their stress has impacted their children, so many people grow up with symptoms of preverbal trauma.  Some of the following therapies have been found to be effective.

  1. EMDR​ (eye movement desensitization and reprocessing). This exposure therapy helps people “reprocess” negative life experiences and psychological trauma in order to desensitize the experience. The person begins by identifying the worst part of the trauma, naming it, and through a series of steps desensitizing its intensity.
  2. Brainspotting​. This is a psychotherapy​ that recognizes there is activation in the body when describing trauma and it correlates with a particular part of the brain. A therapist observes the physical reaction and uses the visual field to assess the part of the brain connected to the trauma.
  3. Somatic Experiencing Therapy​. This therapy allows someone to re-experience the trauma in small doses and to recognize where in the body shame, fear and pervasive thoughts may be stuck. This helps them get “unstuck” physically and move on from the trauma emotionally.

The reason these “Brain Body Based” therapies and others help with preverbal trauma is that they work on the nervous system, on both the body and the brain.

People use their frontal lobes to think. That’s where the executive functioning part of the brain resides. But in targeting PTSD and preverbal trauma, the attempt is to reach the older part of the brain, the reptilian brain. That is where the fight-or-flight response, the survival mechanism, is out of whack.

When the deepest traumas cannot be accessed through talk therapy, these three trauma therapies are a helpful addition to the healing toolbox.

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