Transcription
When I was in treatment, despite all the varying manifestations of our symptom sets, the one core thing that we all shared was this pain, this internal pain. And I remember that that was a pain that I felt from the time I was very young. It isn't as present now, like it's kind of gone, that thing that I walked with.
I was curious to hear you talk about that and to talk about that in relationship to this symptom that the DSM talks about which is emptiness, which is something I actually have never as much related to. And I don't know if those two things are actually related or if one, the emptiness, is a description from the outside looking in versus the experience from the inside looking out.
I think that's a really important question because while we have DSM diagnostic criteria, I think there are a lot of experiences that people have with various syndromes that aren't as well described. But what's interesting about this pain that you're explaining, people have called it things like dysphoria or anguish, toxicity, a feeling of being broken beyond repair. And I think there is a combination of forces that lead to that feeling.
I believe that one of those forces has to do with the problems of emotional intensity and sensitivity. People with BPD have greater degrees of negative emotions. They also are sensitive to positive emotions and tend to shut those down very quickly as well. And they have a lot of intense reactions to emotions so that they lose control in the face of intense negative or positive emotions. So the things that make us human, that is our interior reaction to things, when you feel like that's a runaway freight train and you have that going off in you all the time and you can't understand it or do anything about it. Why wouldn't you feel pain and anguish and being broken beyond repair?
I think the things that cause people to lose hope for themselves and not try to do things that are self-enhancing has to do with their beliefs about themselves. And I think it's really common for people who struggle in those ways to explain that by saying, "Well, I must just not deserve it or maybe it's never going to happen for me or there's no way out of this." And of course, all those thoughts too only compound the painful feeling.
Now, the emptiness, when you ask people about it, while you may not relate to that criteria, there are a lot of patients who describe it very specifically that they have a feeling in their gut that they describe in terms of emptiness. And whether that has to do with a lack of a sense of self that's coherent and stable or a kind of a vacuum of emotions and experience on the inside because people are too avoidant of those things or too um overwhelmed to really put those things in their place. Nobody really knows what is the source of that emptiness, but it's something that I think is very much part of the syndrome for some people.
And as people age and establish themselves in life through various developments, whether you get a job and you have a role in that job and you see yourself as capable in that job or you have a family or a partner or a friend and you see yourself in that role, all these sources of self start to come together like puzzle pieces and then give you a bigger picture of who you are. And I think that building sense of stability and identity does do something to these feelings of dysphoria and pain and emptiness.
So I often times talk about personality functioning in terms of being a mental envelope around our psychologies that help us manage ourselves, that is cope, know who we are, that is identity, feel good about ourselves, that is self-esteem, and also is our kind of passport to other people and relationships. So if you're in like a round small container, people kind of see you from the outside as that continuous stable entity and they recognize you. And these kind of envelopes of ourselves help us navigate different um routes that we're on with some continuity, predictability, and recognizability.
And what's interesting about personality is that these things interact, right? So, if you're one of these stable containers and people recognize you as you're Rebby and you make borderliner notes and you have a certain aesthetic in your filming and you care about educating the public, that kind of reinforces a sense of your own identity and provides all those self capacities that I talked about because it's in making the schedule for these things, doing the research, planning the sequence of events that then regulate how you're managing yourself rather than your emotions or your fears or your rage attacks. And so I think anyone who doesn't have a stable, steady way of managing and isn't understood well by those around them will have problems doing things that help them understand how they work and feel good about who they are.