Understanding Memory Issues in BPD

Understanding Memory Issues in BPD

The topic of apparent partial memory loss, total amnesia, or the cognitive memory glitches and distortions sometimes expressed by those suffering from Borderline Personality Disorder, is a vital one for anyone concerned with this disorder. Are Borderlines just “lying” when they claim they don’t remember certain of their own (often abusive) behaviours? Can they seriously expect others to rationally accept their sometimes massive revisions of events that were witnessed quite differently by other participants? Why do they seem almost self-destructively bent upon insisting on their version of history — and why does that history always write them as the ‘victim’?

There is a vast literature dealing with these questions, from pure biological research on brain function to theories of traumatic memory loss, to ethical speculations on the nature of such distortions of lived experience.

On this page we have attempted to group some of the leading literature and research on these phenomena — read all you can, and draw your own conclusions. Keep in mind that this is an area that’s much debated amongst the professionals themselves — and that every living person remembers their own life experiences in a unique way.

Above all, we provide these resources for non-Borderlines in order to achieve some insight into their loved ones’ often irrational memory behaviours. (“I’m not crazy: YOU are!” is a phrase well-known to non-Borderlines, and while technically neither partner is “crazy”, the following readings can be very validating when coping with an otherwise cognitively normal-seeming person with BPD.)

Generally speaking, it is impossible to separate these theoretical perspectives into genetic versus environmental camps, since most current research demonstrates the deeply intertwined interaction of both. The parts of the brain that govern memory are very plastic and respond sensitively to environmental conditions — most particularly during childhood, theorized as the most vulnerable period for the development of the cognitive peculiarities of what is currently labelled a Personality Disorder.

Understanding Memory Issues in BPD

Introduction to Memory Issues in Borderline Personality Disorder

Sigmund Freud’s original psychological model of memory involved the “repression” of negative experiences or uncomfortable desires in order to maintain the functionality of the person’s conscious identity, or ego, which could otherwise be seriously threatened. This repressed matter, however, does not entirely disappear, according to Freud: it inevitably expresses itself in the form of the psychological symptom.

Freud’s original psychoanalytic method was based on his premise that these memories could be retrieved to the patient’s conscious mind by engaging in stream-of-consciousness discussion with a trained analyst; thus Freud’s famous “talking cure.” It was postulated that the patient, via this process of memory retrieval in the presumably safe current environment of the analyst’s office — and with the aid of an analyst devoted to overcoming the patient’s repression — could subsequently learn to defuse the symptomatic re-occurrence of the original memories (Freud called the process abreaction).

The inability of some patients to achieve true healing abreaction was indeed what led to the first depictions of patients who might now be diagnosed with BPD or another dissociative or traumatic disorder (Freud’s circle viewed these patients as standardly neurotic except in specific triggering situations which called forth quasi-psychotic behaviours — thus they were seen to balance precariously on the psychical “borderline” between neurosis and psychosis. Other intriguing early labels included “hysterical neurotics” and “ambulatory schizophrenics”).

Later theories of memory have rejected Freud’s rather vaguely-defined notion of repression, and offer models of specific cognitive mechanisms, such as “minimization”, “re-labelling” and “directed forgetting” that all combine to create the active forgetting of trauma.

Current, more physiologically-based memory models look at the development of (and damage to) neural pathways that govern and store human experience. Check out the brain scans offered by Drs Bruce Perry, a leading researcher in the field, and Ronnie Pollard in their pathbreaking 1977 monograph, Altered Brain Development following Global Neglect in Early Childhood.

In addition, some very provocative recent DNA-based research (enabled in part by the Human Genome Project) has concentrated on locating a specific inheritable genotype and endophenotypes that make some folks more vulnerable to developing this mechanism than others. Some folks appear to be inherently more vulnerable to encoding experiences as traumatic than others, regardless of what the impact of the experience “objectively” should be. This latest research certainly goes a long way towards explaining why some children in a given family will develop BPD or PTSD, and others will not — a fundamental question that has puzzled researchers for many years.

Whether via repeated exposure or due to an inherited disposition towards traumatization, or both, some people dissociate when they are confronted with certain memories, that is, they psychologically turn off or mentally remove themself from the scene. Dissociation is, theorists speculate, the brain’s way of coping with traumas or memories of trauma that pose an actual yet inescapable danger to the individual’s safety. A repeated need to dissociate (as often observed in BPD) is now viewed by many researchers as a form of extended memory impairment that may reach beyond the specific traumatic memory itself.

Understanding Memory Issues in BPD

According to current leading trauma researchers such as Dr Bessel van der Kolk and Dr Judith Herman, repeated exposure to severe trauma overwhelms the brain systems responsible for integrating sensation, perception and emotion. As a result, memories for the various aspects of currently-experienced events become fragmented and inaccessible to one other, so that the memory is not stored as a retrievably complete whole. Dr Eric Kandel is one of the researchers currently studying this issue.

It has been proposed that these gaps in memory storage and later recall may compel a person to confabulate, or make up conjectural memories to fill in the blanks of experiences they cannot remember clearly. Unfortunately, this is one of the least-researched areas of modern psychological research, and what research there is tends to concentrate on the role of confabulation in the areas of crime-witnessing or schizophrenic disorders, but it is very relevant to the study of BPD in particular. Whereas psychologists believe that everyone confabulates at one time or another, more severe distortions in memory — the blatant “rewriting” of personal history — are extremely common in Borderline pathology.

Dissociation and Memory Loss/Distortion

Dissociation and depersonalization are descriptive terms for a subjective experience, rather than a technical analysis of the biophysiology involved. As researcher Dr Joan Turkis describes it, dissociation is “the disconnection from full awareness of self, time, and/or external circumstances. The essential feature of dissociative disorders is a disturbance or alteration in the normally integrative functions of identity, memory, or consciousness.”

Theorists since Freud have speculated that this “out of body” experience is related to an innate cognitive coping mechanism for surviving early, intense abuse and/or neglect. However, despite persistent popular (and some cases even clinical) mythology, this abuse does not apparently always have to be sexual to provoke dissociation. Whatever its nature, the early trauma is presumed to have been damaging enough to the emotional stability of the young baby or child to instigate the unconscious dissociation process as an emergency survival technique.

Everyone experiences occasional dissociation to some degree (driving home from work for the thousandth time on the same route: when you arrive, you realize your brain was on “autopilot”, thinking of something else the whole time; although you know the route exactly from memory, you can’t recall specific details from this one journey. Another example is the sudden blinking awareness of the “real world” that startles you upon emerging from an engrossing film in the movie theatre).

For those with BPD and related disorders, dissociation can take a more intense form, seemingly erasing entire episodes or even years of experience. [note: this phenomenon is distinct from the ego defence mechanism of “splitting”, in which a loved one might be completely demonized at the drop of a hat.] Many folks with BPD report a pervasive sense of merely participating physically in interactions while their mind is elsewhere, most particularly when recalling or being reminded of traumatic past events. This reminder or “trigger” for the memories may well be an unconscious association known neither to the person with BPD nor to their loved ones. Seemingly innocuous comments, sights, smells or references can set off a period of dissociative absence (or rage) which is as frustrating as it is painful to all parties involved.

[The impulsive anger or rage so closely connected with BPD appears to stem from this sort of “memory triggering” — possibly limited in his/her early emotional development by the same traumatic abuse (and/or neurological malfunction) that originally caused the dissociative response, a person with BPD often possesses only a very restricted repertoire of expressions, most notably relying on depression and anger to express more subtle effects such as nervousness, reserve, a sense of inadequacy or ambivalence.]

Certainly, most people associate this ‘With Dr. Jeckyl/Mr. Hyde’ phenomenon with Multiple Personality Disorder (now called Dissociative Identity Disorder), as depicted in many Hollywood films from Sybil to Fight Club, but we are less aware that the same mechanism plays a role in other personality disorders, too. Many researchers believe that BPD is a dissociative disorder lying somewhere on a spectrum between PTSD and Dissociative Identity Disorder.

In fact, some researchers have questioned the actual existence of DID (Multiple Personality), speculating on “the possibility that both the history of abuse and PTSD symptoms may be seized upon as evidence of potential DID by therapists who seek to explain many of the puzzling features of BPD.” Be that as it may, if one has lived intimately with someone suffering from BPD, it’s not hard to understand this confusion among clinicians.

The results of a recent study of dissociative symtomatology in BPD patients, by Dr Mary Zanarini, a BPD expert at McLean Hospital in Massachusetts, found that:

“Thirty-two percent of borderline patients had a low level of dissociation, 42% a moderate level, and 26% a high level similar to that reported by patients meeting criteria for posttraumatic stress disorder (PTSD) or dissociative disorders. The results of this study suggest that the severity of dissociation experienced by borderline patients is more heterogeneous than previously reported. They also suggest that borderline patients have a wider range of dissociative experiences than are commonly recognized, including experiences of absorption and amnesia, as well as experiences of depersonalization.”
During a dissociative episode, the brain is thought to switch into a biochemically-induced “high defence mode”, during which the storage of new memories is effectively blocked. Yet not all memory is erased, which is quite confusing to those interacting with the individual during these times. Researchers propose that “these early encoding deficits […] have a deleterious effect on the short-term memory system; they manifest as deficits in the ability to take in new information but not in the ability to conceptualize and manipulate previously encoded information”.

In summary: According to current traumatic theories of memory, any peripheral environmental cue to the original trauma itself (no matter how remote) sets off a biochemical resonance, triggering the dissociative effect, which in turn prompts the creation of confabulations. Whether the original trauma was objectively traumatic or not is irrelevant — the sufferer’s brain perceived it as such. The process is lightning-quick and may not be perceived by the individual as a cognitive chain reaction to a biochemical unbalance, but as an automatic and natural response to a perceived threat — as appears to be the case for many sufferers of BPD.

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