Can you fill in this incident form please oh and this one

I am never Never NEVER going to stand with a group of boys again. They are boisterous twats that hurt girls. Today was the day that I came to this conclusion *leans back, puts feet up, daydream bubble appears above head*

"JORDAN seriously stay away from me! You're going to bump into me at any moment." Me and Kiera were standing with the boys at lunch like usual cos we were bored inside, chatting away with them having a laugh. But boys being idiotic boys decided they'd had enough of talking and laughing and proceeded to fight each other. As you do. Grabbing hold of each other in sumo wrestler fashion and pushing each other into walls, pulling other boys along to way. Because that's obviously fun. *stares*

Kiera backed away from the riot and I followed her to get out of their bashing path and continued to talk and laugh COS THAT'S WHAT YOU DO. After about 3 near misses of me being battered by the boys I said (shouted) quite clearly 'STAY AWAY FROM ME I'm scared you're gonna hit me!' Which obviously meant nothing to them, as what happened next was possibly the worst and most humiliating moment of my school life...

After a few minutes we were oblivious to the continuing rabble and had a good conversation going, when suddenly my eyes met a boy's...whose were coming rapidly closer to my face, accompanied by about 5 ratherly tall bodies. BAM! I was bashed onto the ground, a VERY MUDDY field to be exact, my head ever so close to the concrete. After a split second of silence, everyone realised what had happened. Most laughed, some screamed, some murmured in shock, I burst into tears. I sat up, my hands were grazed and my right thigh hurt a lot, but that didn't bother me at the time as I had fallen into the muddiest of places therefore my WHOLE uniform and bag was caked in wet sticky mud. It felt like ages me sitting there sobbing and looking at my now shit (literally) looking appearance, but I felt two hands on mine pulling me up and dragging me away fast to the toilets. Those hands belonged to Kiera obviously, who I now declare as one of the best best friends I've ever had. If it wasn't for her being there I would still be rocking in the mud in uncontrollable sobs. She grabbed my bag and instantly just said "Don't look down, just think, you can write an amazing blog on this!" Which I admit, through my sobs, made me go "Yeah..*sniff*...yeah that's right, good blog..." I was thrust into the toilets where girls gawped at me in shock and little Year 7s pegged it out not wanting to be involved. I daren't glance at myself in the mirror to see what I actually looked like, I could paint that picture myself from everyone's reaction. Kiera took control of getting as much mud off my bag and blazer as she could, while I shoved my stinging hands under a tap and feebly attempted to wipe myself down, which evidently failed.

By now I had stopped crying and the slow emotion of anger seeped through my body as I recalled what had happened. I was effing and blinding all the way to the Medical Room about how I am (apparently) going to "POUR ACID OVER HIS EFFING HEAD AND CUT HIS FUGLY FACE OFF!!!!!!" That's still on my mind, although could have some interesting consequences. Perhaps not.

The look on the lady in the Medical Room's face said it all really as I walked in, I was ushered to a chair where I was doused in wet tissues and asked a number of questions. My Mum was phoned and she rushed down to see the sorry sight for herself. Have to say she wasn't best pleased. She turned up just as I was filling out another incident form explaining what had happened and was being told that this was going to be taken VERY seriously and I would have to be taken out of class a number of times tomorrow to explain to the Head of Year and other important sounding teachers about what had happened. Fabulous. I quick changed into clean uniform Mum had brought down and took a chance to look at my phone, to the sight of 5 new messages. Oh people had found out then.


Now lunch was well and truly over and Mum made me go to Biology, even though there was only 45mins of school left, thanks Mum. I shuffled into class where all eyes snapped onto me, and even though I kept my head down and slid into the seat next to Nadia, I could feel eyes boring into my head, don't blame them, who doesn't like a bit of gossip? So rather than just tell Nadia what had happened, I ended up giving some sort of speech to the whole class...even the teacher...who now I'm sure realises that if she wants a class to listen, create a dramatic empathetic story about the subject, people WILL listen. Have to say I felt a lot better after people had said "They should pay for a new uniform!" "I'm gonna abuse his Facebook tonight saying what a dick he is" So yeah now I'm back at home, feeling sorry for myself and not making things easier for my hands while I'm typing. Ouch. *type* ouch *type* My uniform and bag is ruined and all that's on my mind are the meeting's I'm going to have to have tomorrow *sigh* plus I feel bad as some of the boys are my friends and I know for a fact they didn't do it intentionally. Woe me woe me.


And that was the most humiliating day of my life. Sympathy welcome. *picks mud out of hair* X



What I would have looked like...if I was Asian...

You should not have told me I can put GIFs on here

Just spent the last hour looking at the Bangor uni videos. Standard September night really. UCAS -> English Language -> Same courses I always look at -> Oh look the same unis -> Funny, I recognise that bedroom I'VE LOOKED AT IT SO MANY TIMES.

I seemed to finish my Personal Statement this morning. That was, er, weird.

No doubt it will get ripped to shreds by a trillion people before I submit it, but writing the last line felt good. I'm not stressed about uni really. What? What do you mean you don't believe me? Verging on mental breakdowns constantly? You've received 5 emails of distress from me? Oh.

Honestly though, September's been ace. I'm 18. EIGHTEEN!

Did somebody say September? I'm sure I heard that. It's not July is it? S e p t e m b e r? The Autumn month? Yes I thought so. SO WHY IS IT 30C today??? No am I not happy about this. I have a new coat. It's burgundy. It has a very furry hood and I look like an eskimo. LET ME LOOK LIKE AN ESKIMO. I'm sure I heard my legs screaming in horror at being let out into the light today. Gorgeous red leaves, newly fallen on the ground, were shouting, "BUT IT WAS MY TIME. MY TIME TO SHINE IS NOW. WHY AM I NOT CRUNCHING? HELP ME UP, FFS. GET ME BACK ON THAT TREE." Even the slugs fell victim to the chaos. Thinking everything was dark, wet, and cold. Poor souls. They're the ones all crunched up on the ground, not the leaves. The only ones getting away with this are the daddylonglegs. Gliding around like they own the effing place. Spiders I can deal with. But daddylonglegs unleash emotions and actions I never knew I had. 

So yeah being 18's involved going out A LOT. Going to pubs, clubs, parties, buying cigar...*fades to black and silence. head pops into shot, and body shuffles in* Hahahahahaahaha...oh, you thought I was SERIOUS?

I've been fangirling the hell out of Doctor Who, geeking out over Stephen Fry's Planet Word, adding copious amounts of books to my Amazon wishlist, and voicing the tripod in War Of The Worlds in French with my friends, consequently crying with laughter and doubling over in stomach pain. 

The only remotely 18 year oldish thing I've done is click "I am over 18" boxes on websites with TRUTH. My 18yo life > your 18yo life.  

AND, EXIT

I Can Haz Insight

General dictionary definition of insight: the ability to perceive/understand things clearly and/or deeply

Psychological insight: awareness of one's own feelings, attitudes, symptoms, and the motives and reasons behind one's actions

Assessment of insight is a basic part of a standard mental status exam. People diagnosed with mental illnesses can have pretty good insight (for example, many of those with mood or anxiety disorders). They know they have a disorder, and they understand that some of their behaviors are unusual, harmful, or sabotaging. People who have schizophrenia or other psychotic disorders, as well as individuals with severe personality disorders, often have relatively poor insight. They don't necessarily recognize they have a problem at all. Often they believe the problem is other people.

Sometimes, as I sit by the sidelines and watch yet another drama unfold, I think about insight.

Insight isn't an all-or-nothing thing. Many treatments focus on helping a client develop some insight into his/her problems. You can't force insight on someone. It can't be done with logical explanations or rational argument or razor-edged criticism.

Like talking to a brick wall.

The interventions designed to cultivate insight don't focus on explanation or confrontation. They focus on creating a space in which the person has the appropriate information and the sense of safety that allows him/her to recognize what's really going on.

 Lack of insight causes a lot of frustration on all sides. It's difficult to comprehend how someone can't understand something that seems obvious to most other people.

Having insight doesn't necessarily make you feel better. Ever heard of depressive realism? Sometimes reality is kind of a downer. However, if you want to function well in this world, reality is often something you just have to deal with.

Anyway, lack of insight into one's own behavior isn't always the cause of the dramaz on the internets, but sometimes, especially in cases where one person is the clear aggressor/complainant and the rest of the avatars stand around shaking their heads at the outlandishness ... I think it has a lot to do with it.

Do you think lack of insight sometimes contributes to internet blow-ups? Can you think of an example from your electronic or real life?

Parents of Patients With Schizophrenia Can Stop Feeling Guilty Now

Schizophrenia is not something I really wanted to focus on much in this blog.  Certainly, family dysfunction (and a variety of other stresses including someone just leaving home for the first time to go to college or join the military - an extremely common scenario) may trigger or exacerbate a first psychotic episode in a vulnerable patient, leading to the hallmark delusions and hallucinations. 

However, the vast majority of neuroscientists, physicians, and psychologists no longer believe schizophrenia to be primarily a "functional" (psychological or behavioral) disorder.

As I have mentioned several times, given the current state of our knowledge about neural networks in the brain (100 billion nerve cells with over a thousand separate connections each), the idea that schizophrenia is a brain disease is extremely difficult to "prove" beyond a shadow of a doubt, as some mental illness deniers insist we must. 

It would be hard to believe that the brain is the only organ in the body that is immune from any chronic developmental disease that would cause microscopic deterioration to its parts - in this case its neural network connections.

The fact that our current treatments for psychosis suck big time, while an important issue in itself, is not really relevant to the argument about the nature of the illness. 

Still, because some of my readers keep bringing schizophrenia up, I would like to describe a new study that I think should finally lay at least one argument to rest.  The study is brilliantly designed and the results very clear.

In my post Antipsychotics Are for Psychosis, Not Insomnia, I discussed an earlier study that looked at the role of antipsychotic medications in the development of severe brain shrinkage (cerebral atrophy) that is seen in many severe cases of chronic schizophrenia.  That study concluded that both the underlying disease and the medication both contributed to this phenomenon.  The study was not conclusive, however, because there was no actual control group.

At last, we now have the very first prospective study about this issue by Andrew M. McIntosh, David C. Owens, William J. Moorhead, Heather C. Whalley, Andrew C. Stanfield, Jeremy Hall, Eve C. Johnstone, and Stephen M. Lawrie.  It has been published on line in the journal Biological Psychiatry. 

A prospective study is one that follows over time a group of similar individuals (cohort) who differ with respect to certain factors under study, in order to determine how these factors affect rates of a certain outcome.  In this case, 162 individuals at high genetic risk of schizophrenia and 36 healthy control subjects were followed over 10 years. 

The high risk subjects had at least two first- or second degree relatives affected with schizophrenia.  None of the subjects in the study had any psychotic symptoms or other evidence of schizophrenia at the beginning of the study.

Participants received detailed clinical and up to five MRI scan assessements at 2-year intervals. The results?  17 of the 146 high-risk subjects who were scanned developed schizophrenia over the 8 years of the study. People at high genetic risk of schizophrenia had significantly greater reductions over time than the control group for whole brain volume and left and right prefrontal and temporal lobes.

Greater prefrontal reductions were shown in high-risk subjects who subsequently became unwell compared with those who did not. These changes were significantly associated with increasing severity of psychotic symptoms.

In other words, cerebral atrophy was developing in these patients before they had been treated with any antipsychotic medication.  In fact, it started to develop before they even had any symptoms!  So the atrophy is clearly present in the absense of any treatment at all.

Oh, and guess what?  The study was not funded by the drug companies, nor do any of the authors declare any drug company connections.

So, if you are the unfortunate parent of a person with schizophrenia who is dead set on blaming yourself for the condition of your child, I would ask two questions.  These are rhetorical questions, since I have no way of evaluating the accuracy of your anwers:

First, were you an abusive or neglectful parent or the spouse of an abusive or neglectful parent?  If not, what on earth are you feeling so guilty about?



Can a website help you better manage your anxiety and panic

Maybe sometimes you get so scared you think you're going to die. Or maybe your head jitters with anxiety, or wondering whether life is worth living makes it hard to get out of bed.

What do you do? Steps taken by people with panic, anxiety, and/or depression include psychotherapy, cognitive-behavioral therapy, SSRIs, benzodiazepenes, exercise, meditation, and biofeedback -- and that's just the start of the list.

But do any of them actually work?

Typically, at PANIC!, we've addressed questions of treatment efficacy via discussion of information from "official" sources -- published research studies, for instance.

Sites like CureTogether and patientslikeme offer a new and exciting source of information about what ails you, from the type and severity of the symptoms that others report, to the popularity and perceived efficacy and side effects of a wide range of treatments.

By submitting information about yourself (anonymously), you can help strengthen the database of knowledge about health problems -- and maybe learn about a treatment that could work for you.

If nothing else, these sites remind us that we're not alone. (On one of the sites, I actually found an example of someone who's also panicked while meditating!)

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When and How Can a Parent Stop Parenting

In her column of 9/13/09, a letter writer asked Dear Abby:  “At what point does a parent stop giving unsolicited advice? It is painful to watch my "child" repeatedly make choices that aren't in her best interest.”  The writer's daughter was 43. 

After describing some self-destructive behavior by her daughter, the writer added, “Although I am trying to keep my mouth shut, she tells me she "feels" my disapproval… Must I duct tape my mouth shut?

The relationship between parents and adult children is by its very nature a bit of a mine field. In order to rear their children properly, parents have to discipline them. Parents have to tell children what to do, what not to do, and how to behave in various social situations. Parents have to find ways to make their children follow these parental directives. Good parents continually set limits with their children.

The difficulty is, when is this supposed to stop?

Does the child suddenly become capable of making his own enlightened choices by virtue of having lived eighteen years? Should parents ignore the wisdom of their added years and never advise their adult children about anything? If the parents do persist in giving counsel, how upset are they going to be if the child chooses not to follow their sage advice? If a parent suggests a course of action over a particular issue, will the adult children feel infantilized?

Even with peers who are not relatives, the issue of when and when not to give advice can get to be problematic.  In Eric Berne’s psychotherapy model, transactional analysis, he shows how asking for and giving advice can become a “game.”  On the surface, two people may seem to be engaged in an “adult to adult” conversation, but the subtext may be entirely different.  One member of the dyad may be acting like, say, a helpless yet petulant child trying to frustrate the other member, who may be acting out the role of an exasperated parent who thinks he or she knows what is best for the other person.

A game people play

When the two parties actually are parent and child, the question of whether or not there is a hidden agenda being acted out becomes that much more complicated.  The parents may claim that they are “just expressing their opinion,” while the adult children feel like they are being told what to do as if they had no valid opinions on the subject themselves.  Is the parent’s advice merely an opinion, or is it a directive (a commandtelling the child how to behave)?

 

Unless parents and adult children are adept at metacommunicating about this issue (talking about the way they talk to one another), tension is bound to develop.

This situation becomes compounded exponentially in those situations where the parents themselves are highly conflicted about the advice they give.  They may be unsure of and unhappy with their own choices in life, but cannot admit that even to themselves - let alone to their adult children.

In such a case, two events frequently transpire: the parents bring up the issue involved rather often — because they are themselves preoccupied with it — and they give out a double message.  The offspring often interpret the advice to mean “Do it because I did,” but almost simultaneously, the way the advice is given may also have elements suggestive of “I hope you don’t have to do what I did and become miserable like me.” Whenever this chain of events takes place, a question about the motivation behind the parental advice giving is invariably created for the child.

The child must choose between two possible presuppositions. As mentioned, either the advice is meant as a directive or is merely the parent's opinion about a controversial issue. The frequency of the advice giving will most usually indicate to the child that how he or she behaves is a matter of grave concern to the parent. Therefore, the younger family member will presuppose that the parent's statements about the issue are directives or instructions.

But which part of the double message should the children heed? In situations where the advice is given ambivalently or is part of a double message, they will then make an effort to determine, using principles of ordering environmental cues that I describe in my book, Deciphering Motivation in Psychotherapy, which side of the double message to follow.

  

Consider the example from that book of a woman I will call Trudy and her mother. Trudy was having all kinds of anxiety symptoms over making a decision to really commit to her boyfriend.  Her mother had said on numerous occasions that "marriage is a mixed blessing: one has to take the bitter with the sweet."

One could interpret this as sage advice on the wisdom of not expecting perfection and retaining one's equanimity in the face of unavoidable adversity. Nothing in the lexical content of the statement indicates that Trudy's mother was commanding her to behave in any particular fashion or make any particular choices regarding marriage or spouse selection. The statement can be viewed as an expression of the mother's opinions about life and as good advice - nothing more.

  

On the other hand, the fact that the mother seemed compelled to drive this point home by repeating it over and over again suggested otherwise. The statement began to sound like a warning: "You'd better watch out! If you get married, you'd better be prepared for all the bitter you're going to get along with any sweet!" Every time the mother would talk about the good points of relationships, she seemed to be throwing in a warning about it.

Not only that, but her frequent repetitions indicated to the daughter that the mother was very concerned about whether the message had been heard loud and clear by Trudy. Perhaps she was worried that Trudy had not understood it the first twenty times it was said.

  

Naturally, Trudy began to worry about the consequences of getting involved with men. She became concerned not only that she might be in for a rough time, but also, for some reason, that her mother might become very upset about it. What Trudy did not realize was that the mother's repetitions indicated that she was trying to convince herself, not Trudy. In any event, the motivation presupposed by the mother's statement was in question, and the patient had been forced to guess what was correct. A good therapist would be alert to the possibility that Trudy may have guessed wrong.

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Mixed Messages in Your Family A Quiz You Can Take

I have been studying the families-of-origin of patients with borderline personality disorder (BPD) since the the late 1970’s. As readers of this blog already know, I discovered that the biggest and most common emotional conflict in the parents who produce offspring with the disorder is a conflict over the very act of becoming and being a parent.  As I described in a previous post, the parents think being great parents and taking care of children is the end all and be all of human existence, but secretly they wish, for a variety of different reasons, that they could be spending most of their time doing something else entirely.

Since they are conflicted about their parental roles, they constantly give off mixed messages to their children about what is expected from them. This leaves the children to try to figure out how to meet their parents’ contradictory needs to be both needed by their children and, simultaneously, for their children to just go away. The children solve this dilemma by adopting various versions of the spoiler role.

Children growing up with mixed messages from parents is, in fact, a hallmark of families producing children with any personality disorder.  The problematic mixed messages are often in regard to only certain behaviors or role functions – usually just one or two – while the parents respond to other roles and behaviors in a coherent, non-contradictory manner.

For those readers who are now adults, how does your family stack up in the continuing double messages department? My colleague Hillel Abramson and I designed an instrument to try to measure the amount and type of double messages adults perceived as receiving from their primary attachment figures, called the Family Interaction Scale or FIS.  While designed with only borderline personality disorder (BPD) in mind, it can be used more generally, and you can administer it to yourself to see what areas are problematic for your families.

But first, just a little background.

In order to see what is going on in families, one has to appreciate that conversations between family members have subtexts. A subtext is an underlying, implicit and often distinct theme in a conversation that is not perceivable if someone is only paying attention to the literal meanings of the sentences spoken. In order to understand a subtext, one also has to listen to an entire conversation before hidden meanings might become evident. Just a few sentences will not do. 

Furthermore, an understanding of the entire history of the relationship between the people having the conversation, not just the current interactions, is also required to tease out important latent themes.

Therefore, appreciating the subtexts of conversations between intimates involves thousands of variables that will be completely different for each dyad or group being evaluated. To think that subtexts of this complexity can be “measured” by standardized questions and answers on a psychological test is ludicrous. For this reasons, truly “empirical” studies are impossible.

But in today's world, one must try. Some people insist that observations of subtexts are just “anecdotal.”  They can therefore just dismiss it as an object of scientific study. To get around this just a wee bit, we chose 9 of the most common themes in the families of those with BPD that I had observed over the years, and asked four different groups to rate their parents’ ongoing, current communication in these 9 “domains.”

The four groups were patients with the disorder, those who were subthreshold for the disorder (that is, who met 3 or 4 of the criteria for BPD rather than the required 5), non-psychotic patients being treated in our clinic who did not have BPD, and normal controls who exibited no psychiatric disorders at all.

The domains are:

1.  Praise and criticism

2.  Comments to friends and relatives about the subject

3.  Reactions to advice given by the parents

4.  Blame for the parents’ problems

5.  Frequency of advice giving by the parents

6.  Degree of parent’s preoccupation with the subject

7.  Relationship of a parent’s mood to the subject’s mood

8.  Parental reactions to the subject’s work failures and successes

9.  Parental reactions to the subject’s romantic failures and successes

For each domain, we provided 6 to 7 options. Since no human relationships are completely consistent all the time, we wanted to avoid saying anything that implied that the parents were “always” one way or another.  So we asked subjects to please check only the one item in each domain rating that "came the closest to describing the parent's current behavior towards you most of the time."

For each domain, there was one response pattern that we deemed appropriate. Another response pattern we originally deemed “neglectful.”  However, in thinking about it as the results came in, it seemed to us that it would be more accurate to say that these items reflected the fact that the issue in the domain did not seem to matter at all to the parents.

There were two response patterns that we deemed polarized – the parent acted most of the time at one extreme or the other without much in between.  There were also two response patterns that were indicative of  the pattern in which we were most interested: double messages. The parents either were perceived as blatantly contradictory in their behavior, or they said one thing but seemed to mean something that was contradictory to what they said. 

In reading the items below, you should be able to easily figure out which item corresponds to which response pattern.

Subjects in the original research were asked to choose and rate up to three attachment figures from their childhoods who were still alive, still interacting with the subject in the present, and not senile.  “Still in contact" could mean in person, by phone, by letter, or even by word of mouth.

These figures had to have served in the parental role when the subjects were between the ages of 5 and 15.  We provided the following list:

1.  Natural Mother

2.  Natural Father

3.  Adoptive Father

4.  Adoptive Mother

5.  First Stepfather

6.  Second Stepfather

7.  First Stepmother

8.  Second Stepmother

9.  Father's Father (only if he lived with you)

10.  Father's Mother (only if she lived with you)

11.  Mother's Father (only if he lived with you)

12.  Mother's Mother (only if she lived with you)

13.  Brother at least 5 years older than you

14.  Sister at least 5 years older than you

15.  Other (Specify)

Here were the test items:

DOMAIN 1

1.  This person consistently praises me no matter what I decide about how I run my life

2.  This person consistently criticizes me no matter what I decide about how I run my life.

3.  This person consistently goes back and forth between praising and criticizing me for the same decisions.

4.  This  person is consistently fair in praising and criticizing me for my decisions.

5.  This person rarely  praises or criticizes my decisions about how I run my life.

6.  Regarding my decisions, this person consistently says one thing but really                  means another.

________________

DOMAIN 2

1.  This person consistently brags about me to their friends and relatives.

2.  This person consistently bad mouths me to their friends and relatives.

3.  This person says contradictory things about me to friends and relatives.

3.  This person is consistently fair in making remarks about me to friends and relatives.

5.  This person consistently does not talk about me with their friends and relatives.

6.  This person consistently says one thing about me to friends and relatives but really means another.

________________ 

DOMAIN 3

1.  This person acts happy only if I follow their advice.

2.  This person acts happy only if I ignore their advice.

3.  This person consistently acts unhappy with my reaction to their advice no matter if I follow or ignore it.

4.  This person accepts my reaction to their advice even if I disagree with it.

5.  This person consistently does not react to how I respond to their advice.

6.  Regarding my reactions to their advice, this person consistently acts one way but really feels another.

________________ 

DOMAIN 4

1.  This person consistently blames themself for their own problems even when they are not at fault.

2.  This person consistently blames me for their own problems even when I'm not at fault.

3.  This person consistently goes back and forth between blaming me and themself for their problems.

4.   This person is fair in assigning blame for their problems.

5.   This person consistently blames others rather than me or themselves for their problems.

6.    This person rarely blames anyone for their own problems.

7.     In assigning blame for their problems, this person consistently says one thing but means another.

_______________ 

DOMAIN 5

1.  This person almost never tells me what to do, even if I ask for their advice.

2.   This person almost always tells me what to do.

3.  This person consistently goes back and forth between telling me to make my own  decisions and telling me what to do.

4.    This person usually tells me to make my own independent decisions but will offer advice if asked.

5.   This person is unconcerned with who makes the decisions in my life.

6.    Regarding telling me what to do, this person consistently says one thing but really means another.

________________

DOMAIN 6

1.   This person  consistently expresses worries  about how I am doing even when they know I'm doing well.

2.    This person never expresses worries about me even when they know I'm in trouble.

3.     In expressing worries about how I'm doing, this person goes back and forth between expressing worries and saying nothing.

4.    This person is consistently reasonable when expressing concerns about how I'm doing.

5.    This person doesn't even bother to find out how I am doing.

6.    In regards to worrying about how I'm doing, this person consistently says one thing but really means another.

________________

DOMAIN 7

1.    This person only acts happy when I am happy.

2.     This person only acts happy when I am miserable.

3.     This person goes back and forth between acting happy when I'm happy and acting happy when I'm miserable.

4.     This  person shows sympathy with how I feel but their mood does not depend on how I am feeling.

5.     This person almost never reacts to how I am feeling.

6.      When I'm happy or unhappy, this person  consistently acts one way  but really feels another.

_________________ 

DOMAIN 8

1.     This  person does not act happy unless I am succeeding in my career.

2.     This person usually acts unhappy about my career accomplishments and relishes in my failures.

3.       This person goes back and forth between acting happy about my career successes and relishing in my failures.

4.      This person expresses satisfaction with my career successes and sympathizes with my career failures.

5.      This person almost never reacts to my career successes and failures.

6.      When reacting to my career successes and failures, this person consistently acts one way but really feels another.

_________________

DOMAIN 9

1.     This person does not act happy unless I am having a successful romantic relationship.

2.     This person usually acts unhappy about my successes in romantic relationships and relishes in my failures.

3.     This person goes back and forth between happy about my romantic successes and relishing in my failures.

4.     This person expresses satisfaction with my romantic successes and sympathizes with my romantic failures.

5.     This person consistently does not react to how I am doing in romantic relationships.

6.     When reacting to my love life, this person consistently acts one way but                   really feels another.

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The results of the study were published in 2005 in the psychiatric journal Comprehensive Psychiatry, volume 46, pages 340-352, and were highly significant and in line with most of our predictions. The fact that they were so significant was even more impressive considering the fact that the number of subjects in each subgroup was relatively small. Discovering small differences usually requires larger samples, so this means that the differences were probably quite large.

We found there were significant differences between groups in regard to appropriate and contradictoryresponses for the first attachment figure rated. BPD patients endorsed fewer appropriate responses than did the patient controls (p=.001) and than did the normal controls (P=.011). There were no other significant differences among groups regarding appropriate responses for the first rated individual.

BPD patients reported significantly more contradictory responses than did patient controls (p=.004) and normal controls (p=.003). In addition, Subthreshold subjects reported more contradictory responses than did patient controls (p=.009) and normal controls (p=.005).

Contrary to prediction, there were no significant differences in the mean number of polarized responses among any of the groups. The polarized responses were indicative of something called splitting: the tendency of people to think of others as all good or all bad.  BPD patients are thought to be unable to see shades of grey, but they were no more likely to endorse polarized response patterns than anyone else. In other words, this was evidence that patients with BPD do not split, at least when thinking about these issues. This was also shown in another way described below.

There were also no significant differences in what we first called neglect responses among any of the groups. This was a bit of surprise since neglect is often present in the parenting styles of those with BPD.  However, even when prominent, it tends to oscillate with overinvolvement.  But if these items measured lack of interest rather than neglect per se as described earlier, the fact that the parents of subjects with BPD were not characterized as uninterested should have been no surprise. That is because-  clinically - even when parents of future BPD patients are neglectful, they tend to blame it on the child!

When chronic unhappiness (dysthymia) was controlled for in comparisons of subject groups, the pattern of significant effects remained the same.

The number of subjects rating two parental figures (N=59) was considerably smaller than the number of subjects who rated at least one (N=93). No significant overall effect between the groups on the way they responded to the FIS regarding person B was found – possibly because of the much smaller sample size. However, the trends were the same.

Normal controls reported significantly more appropriate responses than did BPDs (p=.002), Subthresholds (p=.004), and patient controls (p=.024). BPD patients reported significantly more contradictory responses than did normal controls (p=.002) and trending toward reporting more than did patient controls (p=.064), while subthreshold subjects reported significantly more than did normal controls (p=.038). There were no significant between group differences in polarized or neglect responses.

Every contradictory item on the questionnaire was endorsed for person A by at least two of the BPDs (5%) with a range of 5% to 32.5%. The most commonly endorsed contradictory item was, “This person consistently goes back and forth between praising and criticizing me for the same decisions.” 

When we examined the FIS by domains, the most commonly endorsed domain in which either contradictory response was endorsed by BPDs for person A was domain 1, with 40%. The corresponding percentages were domain 2, 27.5%; domain 3, 25%; domain 4, 20%; domain 5, 32.5%; domain 6, 22.5%; domain 7, 20%; domain 8, 27.5%; and domain 9, 20%.

The fact that the pattern in the various domains was all over the place within the BPD sample also indicates that each item was considered separately and there was no pattern of items being  rated globally in one consistent way. Such global ratings might be expected in "splitting" subjects who were unable to look simultaneously at both good and bad characteristics in an individual.

Furthermore, although the mean number of contradictory responses of BPD subjects within the varius domains was considerably higher than the mean for patient controls for person A, it was still quite small—only 2.24 (range 0 – 8 out of a possible 9). The mean for the normal controls, however, was only 0.46.  In other words, the normal controls perceived almost NO double messages from their parents. 

So readers, go ahead and use the FIS to rate your own families on how often they drive you to distraction with double messages. You don't have to share the results with anyone unless you want to. But please feel free to share your general reactions to the FIS items in the comments section.