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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by twinleaf on August 15, 2008, at 10:13:23
In this week's edition of Science (8 August 2008) there is an extremely interesting article by several psychoanalysts from Baylor, Menningers' and the University of London. In it, they describe using game theory to understand how people with BPD might differ from normal controls in how they deal with the social interaction involving investing small amounts of money ($20). They found that persons with BPD, described as having "unstable relationships, affective dysregulation and a broad incapacity to trust the actions and motives of others" had great difficulty in assessing the motives of investment partners. The control players were able to assess the motives of their partner-players correctly, and to respond in such away as to foster continued cooperation. For example, if one partner invested $10, the other would invest an equal or higher amount in return. This response allowed these players to progress through 12 rounds, with different amounts being invested, and with trust and cooperation being maintained. If these attitudes were temporarily lost, the player who had misread a cue would engage in "coaxing" behavior- bidding higher so as to regain the partner's trust. This was labelled "rupture and repair".The players with BPD consistently responded with lesser investments (investing only $5 in return for $10). These games ceased after 4-5 rounds, with both players feeling angry and taken advantage of. The BPD players were not able to correctly interpret the social meaning of the investments- i.e. that they indicated cooperation and trust, and needed to be responded to with equal or greater investments. And when rupture occurred, there was no attempt at repair.
Brain imaging studies done on the study participants showed that the anterior insular region of the cortex- a region known to be active in evaluating social behavior-lit up in the normal controls equally when investments were made and received. They were able to make accurate social evaluations of the situation while they were both giving and receiving. In contrast, the anterior insula lit up in the BPD subjects when they made an investment offer, but not when they received one. They had not developed an ability to properly evaluate the degree of cooperation and trust that they were receiving from another individual.
Although this study did not discuss any therapeutic implications, it seems clear that people who have BPD need a very interactive, interpersonal form of therapy, in which the motives and feelings of both the patient and the therapist are talked about at length. At first, studies like this do seem discouraging, because of the brain imaging information. But brains do have plasticity, and all of this increased knowledge is bound to help in terms of better therapy for more people.
Posted by Phillipa on August 15, 2008, at 12:39:08
In reply to a scientific study of borderline personality, posted by twinleaf on August 15, 2008, at 10:13:23
So for the BPD to trust and continue trust was manintained by the other being able to match or invest more this meant the BPD person felt like their investment was a good one. Or an I totally off target? Would like to understand. Phillipa
Posted by Stellabystarlight on August 15, 2008, at 14:37:13
In reply to a scientific study of borderline personality, posted by twinleaf on August 15, 2008, at 10:13:23
Phillipa,
I'll take a crack at explaining this study.
The study participants were playing a "trust game". Researchers found different patterns of brain activity in people with borderline personality disorder were associated with distortions in their ability to perceive social cues. This study suggests that people with BPD have problems accurately reading social cues. Which may lead them to respond and behave in a distrustful and uncooperative ways with others.
Hence, what Twinleaf says in his post; "Although this study did not discuss any therapeutic implications, it seems clear that people who have BPD need a very interactive, interpersonal form of therapy, in which the motives and feelings of both the patient and the therapist are talked about at length." makes so much sense for me.
Twinleaf,
Thanks for sharing this fascinating study and your astute assessment. Explains so much for me! I'm going to forward the article to my T.
Stellabystarlight
Posted by Phillipa on August 15, 2008, at 20:15:40
In reply to Fascinating study on BPD... » twinleaf, posted by Stellabystarlight on August 15, 2008, at 14:37:13
So since I trust and am not uncooperative I'm not BPD? Thanks Phillipa
Posted by Stellabystarlight on August 15, 2008, at 21:16:46
In reply to Re: Fascinating study on BPD... » Stellabystarlight, posted by Phillipa on August 15, 2008, at 20:15:40
> So since I trust and am not uncooperative I'm not BPD? Thanks Phillipa
Hi Phillipa,
I won't dare say, since I'm not your T...but, it's starting to look like I might be. I'm going to have a lot to talk about at my next session. Hope my interpretation of the study didn't confuse you more.
stellabystarlight
Posted by Phillipa on August 15, 2008, at 23:46:17
In reply to Re: Fascinating study on BPD... » Phillipa, posted by Stellabystarlight on August 15, 2008, at 21:16:46
No not at all as I was under the impression that cutting and splitting of people were also symptoms as that is what they taught in nursing. A different perspective is very much appreciated. Love Phillipa
Posted by twinleaf on August 19, 2008, at 19:40:00
In reply to Fascinating study on BPD... » twinleaf, posted by Stellabystarlight on August 15, 2008, at 14:37:13
It seemed to me like a real milestone that this article was published in Science rather than in a less widely read psychiatric journal. Scientists in diverse fields tend to at least browse through all of the articles, and I think they were probably as pleased and surprised as I was to see it there.The article had beautiful graphs and elegant brain images with the insular cortex lit up in yellow and red- just like all the other articles! But I think it must be close to a first for psychoanalytic authors.
I don't exactly have BPD, but I do have at least one of the criteria- a fear of abandonment. The analyst I am going to now spends a great deal of time searching for miniscule misunderstandings on my part. If, for example, he needs to change the time of an appointment, he won't be satisfied with me being polite and co-operative about it; he wants to know about even the tiniest feelings of fear or abandonment. We often go through entire sessions working on little things like this. I find them tremendously helpful. It's wonderful to know that you can go over and over tiny aspects of the relationship, noting small ruptures and making small repairs- that you can revisit something as often as you need to.
twinleaf ("she")
Posted by susan47 on August 23, 2008, at 19:04:00
In reply to Fascinating study on BPD... » twinleaf, posted by Stellabystarlight on August 15, 2008, at 14:37:13
This also makes total sense to me, especially when I look at my recent diagnosis and the way I went completely off the rails with my last male therapist. Having just started CBT with a female therapist (I am so LUCKY FINALLY to have a Dx and treatment) I am so clear about this being on the correct track, if the train goes somewhere hallelujah .. I am so sick and tired of mental illness, (unhappiness and severe ways of acting it out?) being misunderstood.
We need to understand ourselves. This helps in my self-understanding.
Posted by susan47 on August 24, 2008, at 15:45:14
In reply to Re: Fascinating study on BPD... » Stellabystarlight, posted by susan47 on August 23, 2008, at 19:04:00
Posted by twinleaf on August 24, 2008, at 19:24:03
In reply to DBT, not CBT. (Above) (nm), posted by susan47 on August 24, 2008, at 15:45:14
I'm so glad you have found a new therapist! I assume you are doing DBT with her, but I think you also mentioned a "he". Do you have another male therapist for more psychodynamic issues?
Posted by susan47 on August 25, 2008, at 16:54:17
In reply to some really good help, finally!, posted by twinleaf on August 24, 2008, at 19:24:03
No. Should I? I think perhaps I should, but I'm so leery of finding myself in transference. Although it felt wonderful. I would love to feel transference again, but not have it be transference :().
Posted by susan47 on August 25, 2008, at 16:58:23
In reply to some really good help, finally!, posted by twinleaf on August 24, 2008, at 19:24:03
What I put myself through, what I put my therapist through, what he put me through, still is so painful and I am suffering severe depression YET (meaning as in today, here, now, this moment, God damn me I just want to FEEL GOOD, feel better even than this, please God let me feel better than this SOON before I die, before I kill myself with my own hand, let all my Writing be not for naught hahahaha). F*ck it.
Please forgive me, I seem to be overwrought with feeling, emotion, and also I am under the Influence at the moment, because Not being under the influence of mj, which is where I was at Constantly when I was seeing my D.O.C., my doc, doctor heal me please ... when I was going through transference I developed a highly toxic marihuana habit.
Love ya.
Tragic.
A tragic life. A tragicomic death. There have been.
This is the end of the thread.
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