I've Been Close to Someone Who's Threatened Violence Publicly; Dangerous to Network With Her If She Isn't Getting Needed Help

Trigger warning:  This blog post discusses issues pertaining to child abuse, violent threats, rape, incest, suicidal gestures, and mental illness.


Stuart K. Hayashi




It wasn't easy for me to put this information right here. My concern about the danger -- including physical dangers -- outweighs such fears.  Some years ago I became very close to someone who, sadly, is dangerously mentally ill.  My friend has accused other people of being violent toward her, only later to act as if she does not remember the accusations she leveled. Moreover, in the years subsequent to placing a death threat against her mother on the World Wide Web for everyone to read, the archiving and documenting of this death threat remains.  Copies of the evidence are available.

I have contacted police about this on two continents.  On one continent, the police were unresponsive.  On the other, the police were responsive but said that jurisdictional issues prevent them from taking action.  Because my friend has given no indication that she has truly gotten past the obsession with violence, death, and child molesters, I judge that it is best for me to speak out here. What I know is that if I don't speak out about this, the danger is guaranteed to continue.  By contrast, if I speak out about this, there is at least a slim chance that someone might recognise my friend and give her the compassionate intervention she needs.




My Friend Publicly Threatened to Kill Her Mother -- The Evidence Is Archived, Documented, and Copied 
In 2004, in her home country of Norway, my friend put up this threat to kill her mother.  It is in English and it has been publicly available on the World Wide Web this entire time.  It is not one of those dumb, terse threats that people write on Twitter or YouTube, along the lines of, 'You disagree with me? Then I hope you die!'  Though the threat is grammatically inept in composition, it is nonetheless serious in tone and intent.  My friend does not say that she has some long-term plan to kill.  Rather, she envisions that one day she will become so incensed by her mother's nagging that she will take a knife and thrust the knife into her mother.  This is described vividly, as so:

Click on this to enlarge it and make it easier to read

The threat is documented and archived.  There are copies of it available.  This information is now irrepressible and un-erasable.

The very blog entry following it also has homicidal fantasies.  My friend and her on-again/off-again boyfriend at the time, whom she here calls “N,” were apparently on a break, and her boyfriend was pursuing someone else.  This is what my friend wrote about the other girl:

Click on this to enlarge and make it easier to read.

Direct Link | Archived Link

Some people in our respective circles have rationalised that these death threats are 'long past'.  After all, they say, these blog entries are more than ten years old.  Moreover, four months after my friend wrote her death threat about her mother, she wrote a follow-up post on that same thread where she claims to be all better:  '...im happy that i allowed myself to hate her [the mother]. otherwise nothing would have changed. I now love my mom to death like many other precious people in my surroundings'.

But it wasn't all better.  My friend made it all too obvious she is not recovered.




Years After Threatening Her Mother Publicly, My Friend Continues Exhibiting Publicly the Fixation on Violence and Death
When my friend was on Oahu from 2008 to 2012, she continued displaying morbid and even violent gestures, particularly in a public fashion.  Many of these morbid gestures remain on the Web, and have been documented and archived. There are also copies of this evidence available as well.

For example, in late 2010, my friend had another 'friend' (enabler, really) upload onto YouTube a video where she 'jokes' about being a neo-fascist 'of the Fourth Reich'.  My friend said privately it was a joke, but that is not obvious from the very strange video itself, which was listed as 'News and Politics'.  That my friend calling herself a neo-fascist 'of the Fourth Reich' is some joke is especially unclear for another reason: the enabler who uploaded the video is connected to an anti-immigration political group that advocates government force to curb Muslim immigration.  If you don't want people thinking you are a neo-Nazi, it's not wise to associate with that sort of group.  (Sadly, my friend actually first heard of that group from me, before it took on such a strident anti-immigration position.)

Around 2014, the enabler 'privated' the horrible video.  

Since you're probably not my friend's mother, you are probably wondering, 'Why the hell should I care?'  Until my friend confirms that she has returned to psychiatric care on a regular basis, I have strong evidence that she continues to pose a danger to colleagues with whom she networks. That could be you. Explaining this requires more context.




The Beginning of the Story Behind This
Before my friend showed me the murder threat and the disturbing 'Fourth Reich' video, she very slowly gave me clues indicating the danger.  First, she explained why she was born with her mother's last name instead of her father's, her father being an expatriate from the United States.  It was because her father himself had recently changed his last name.  The story behind that is itself bizarre and sad, and seems to have been because he felt betrayed by his own father back in the United States (we will call my friend's paternal grandfather WH here).  My friend laughed and said, 'My mum said to my father, "If we give our baby your last name, how do I know you won't change it again? We'll give her my last name; it's simpler." '  This father is a well-known photographer; his pictures have appeared frequently in the local newspaper and the website of his municipality/kommune, and his photos of the aurora borealis are celebrated throughout the world.

Then, for the first time, my friend sounded vulnerable. She said that she put on a front of bravado to hide her insecurities.  She admitted that she tries to make herself appear to other people that she is in a position of authority and responsibility, because she believes if people see her in such positions and seeming very confident and professional, they will not question her judgment or sanity.  No red flags went off for me; I reassured her that there was nothing unusual about nursing self-doubts.




The Accusation Against the Classmate 
In the weeks that followed, my friend increasingly showed an obsession with child molesters.  The first joke she ever told me happened to be what she identified as her favorite signature on online postings:  'The internet is where men are men, women are men, and small children are undercover FBI agents', alluding to online sting operations against child predators.  Then my friend would reminisce about an ex-boyfriend back in Norway.  She said that he was a deep, caring person who empathised with everyone, a man of upstanding good taste.  Then she stared at the ground and giggled, 'He always joked that he was a pedophile trying to lure kids into sex with him'.

Then in February of 2010, my friend came to a professor and me, and told us a troubling story.  She said that a classmate of hers in that professor's class had sexually propositioned her and, when she rejected him, he grew angry.  Based on his boasting about killing people in war and about his womanising, she was afraid he wanted to rape her.  They got into an argument and my friend had grown direly afraid of him.  A week later, my friend came to the professor and me and said that she was proven right to fear the classmate as violent, because he threatened her, 'If you tell anyone what happened that night, I kill you!'

My friend insisted that we not go to the police (in retrospect, I should have reported this to the police against her wishes) but that she wanted the professor to keep the classmate and her separate from one another.  She did not file any formal complaints with Hawaii Pacific University, but she did go around informally circulating this accusation among several other schoolmates.  I completely believed the accusation at the time.  Then my friend told the professor, several other schoolmates, and me a troubling story where she accused her writing instructor of invading her personal space as he flirted with her.  Again, she did not file a formal complaint and sternly insisted that none of us confidantes do so, either.  I completely believed this accusation as well.




The Obsession With Child Molesters
One night in April of 2010, when my friend and I were going out for an evening stroll, she said, out of nowhere, 'Why are people so bigoted when a convicted child molester moves into the neighborhood?'

My eyes shot wide open and I sputtered, 'Whah? . . . Wh-wh-wh-what do you mean?'

She explained, 'Whenever someone who, as an adult, had sex with a small child moves into the neighborhood, people immediately want to run him out.  They should consider that the child consented to the sex.'  She argued that a prepubescent child should be recognised as contractually competent to consent to sex with an adult caregiver.  She would not be swayed from this opinion, at least not this night.

Later, she also told me that when she was thirteen, she was groped by her then-best-friend, also thirteen years of age at the time.  She attributed her fear of men to the incidents of her friend groping her, though those incidents did not explain her obsession with child molesters in particular, nor her apparently fearing American-born men more than Norwegian-born men.




The Danger Posed to Colleagues (The Latest News Indicates This Danger Is Ongoing As This Is Posted)
Another night that same month, my friend was telling me about her day and then she said, very casually, that she bumped into the classmate.  I mean the same classmate she previously accused of threatening to kill her.  I was alarmed.  As calmly as I could, I asked her to go on.  What happened?  My friend said that she and the classmate had a nice talk, and he was just a nice, fun, friendly flirt.  Then she started into space, giggled, and said, 'Hee-hee! I . . . like [Classmate's name]'!

I was stunned.  I couldn't say anything in response.  My friend only responded to the awkward silence by changing the subject.

She also frequently talked about how she has had a long history of wanting to die.  At school, she threatened to kill herself several times.  Moreover, she mentioned hating her body and that this hatred for her body goes back to her early childhood, long before the boy groped her when they were both thirteen.  She mentioned that ever since she was little, she thought that female anatomy is disgusting because it makes her vulnerable to predatory males.  She did not elaborate on whether she felt threatened by one or two predatory males in particular.

The next day, I went to the professor to talk about her talking up that classmate as if she did not remember her allegation about him.  The professor brushed off my concerns.  Even as my friend made increasingly obvious and public morbid gestures, which he saw up close, the professor acted as if it was safe and acceptable.  For those reasons, I have lost a lot of respect for this man.

Throughout May of 2010, my friend switched back and forth in her memory of the classmate. First she switched back to saying he violently threatened her, and she went around telling other schoolmates about this.  The next day, she again talked about the classmate being just a nice, fun flirt. Two days later, she switched back to saying he was violent and dangerous.  Every time my friend changed her story, she sounded as if she did not remember what said the previous time, even if that previous time was no more than the day before.

By the autumn of 2010, my friend became very insistent on wearing the same garment to university class almost every day.  She took me to her apartment and she showed me all her clothes. It was not that she had lots of garments that looked alike.  This was the same black garment every day.  Then -- encouraged by the same enabler in Norway who uploaded the horrid 'Fourth Reich' video -- my friend uploaded photos of herself photoshopped to have a chalky white face like a corpse.  Two of the corpse photos even went on my friend's LinkedIn account, next to her résumé.  I think some people tried to assume my friend was 'just being a Goth or a Black Metal fan'.  However, my friend has a history of wanting to be dead literally.  For that reason, I could not dismiss this as my friend 'just being a Goth'; I had to take this seriously.

'A Lot of Abuse in My Family's Past[,] Including Sexual Abuse' 
By this time, I already didn't trust the judgment of my friend's American-born father. I did notice, though, that on Twitter he was following an eccentric woman from the same home state in the USA that he was from.  What got my attention was that the woman's website purported to be for a charity she set up, one for helping at-risk teens and twentysomethings (my friend's age range at the time).  All of the mental illness symptoms the woman's website described were the same as what my friend had either admitted to having or had exhibited to me directly. I thought, 'Who is this strange woman? Is she perhaps a psychologist with whom my friend's father consulted about my friend's problems in Norway?  About symptoms that are now becoming strong and publicly visible once again?'

I contacted this strange woman. I told her I was interested in her website, because I had a friend in her twenties who was exhibiting the symptoms the website described.  I mentioned to this strange woman, though, that I am worried that if she is a psychologist, she might consider it a conflict of interest for me to describe my friend's situation, as I think this strange woman knows my friend somehow.  The strange woman replied she is not a psychologist and it is OK for me to tell her what concerns me.   I told the woman about the morbid gestures but had not yet mentioned anything about the accusations about the classmate, the fear of men in general, or the obsession with child molesters.

It turned out that this strange woman is the paternal aunt to my friend.  The aunt remarked that my friend's situation was both familiar and unfamiliar.  The situation was unfamiliar in that, this entire time, the aunt was unaware that her Norwegian niece was going through all this. Yet, the aunt continued, what I described was indeed familiar in one respect:  when the aunt described mental illness symptoms on her own website, she was describing her own symptoms, and she was startled by how my friend's symptoms were similar to her own.  (I will not link to the woman's website, but rest assured that the website's URL is archived, its contents documented.)

Before I could say anything about the child-molester fixation or the accusation about the classmate, the aunt asked me whether my friend exhibited a prominent hang-up about sex.  I asked her what she meant.  The aunt replied, 'There is a lot of abuse in my family's past[,] including sexual abuse'.  Throughout the months, the aunt revealed that both a cousin and uncle of hers killed themselves, though in different ways. The cousin very deliberately committed suicide by throwing himself off a bridge. The uncle, named Delbert, sexually assaulted the aunt and later killed himself.  Later, the aunt mentioned that the father of both herself and my friend's father -- WH -- sexually abused the aunt and her sister.  As far as what the aunt said, though, my friend's father getting mad at WH and changing his own last name in protest -- to that of his mother's maiden name -- was unrelated to the sexual abuse.  Indeed, the aunt added that when she tried to talk to my friend's father about their own father sexually abusing her, my friend's father replied -- rather unconvincingly -- that he knew nothing of this when it was going on.

Later, it turned out that yet another brother, both to WH and that uncle Delbert, was also credibly accused of molesting a girl over whom he had authority.  The aunt said that this third brother 'drank himself to death'. That means there are credible accusations against three brothers on the paternal side of my friend's family.

The aunt went through the following pattern.  Every few weeks, she told me she would have a compassionate conversation with my friend about the public morbid gestures, and about their having so many symptoms and traumas in common.  But, last minute, the aunt would delay this.  Then she would start talking to me about something else, such as her co-workers irritating her.  Eventually she told me that she would have the compassionate conversation after she had her own confrontation with WH and her mother -- WH for sexually abusing her and with her mother for being an enabler who "looked the other way."  The aunt planned on confronting her parents with this through a snail mail.  She typed up a draft and e-mailed it to me.  I still have the entire draft in my possession.  It, too, is documented and archived, and copies of it have been made.

At the last minute, though, the aunt decided against mailing the letter. She rationalised that her mother was in poor health and the confrontation would worsen it.  Then she became uncommunicative and rude, and I do not think the compassionate conversation with my friend ever happened.  I suspect, at this point, it finally dawned on the aunt that if she looked further into the matter with my friend, she might uncover something incriminating not merely about WH, but about my friend's father himself, and that would undermine any remaining 'plausible deniability'.




Having to Go It Alone
It was up to me to have a compassionate conversation with my friend.  Most other people in our circles noticed the public morbid gestures but were too intimidated to say anything; they became perfect sycophants who helped my friend pretend that all of her public morbid gestures were safe and acceptable.

When I tried to talk to my friend about this, she feigned memory loss, pretending not to remember what she had told me about her obsession with child molesters and death and fear of men.  Then she added that by raising the topic, I had shown myself to be more evil and frightening than the classmate who threatened to kill her.  She added that my confronting her about this was more evil and hurtful than all of the misogynistic epithets her ex-boyfriends hurled toward her.  Soon after saying all this, she again feigned memory loss, this time pretending not to remember being angry just minutes earlier.  As if she didn't know how the conversation started, she began talking casually about her day and then put on a smile and asked me how my day was.  I reminded her of what our conversation was about -- her violent and morbid gestures.  She then grew enraged again and intoned ominously, 'This is not over!'

For the sake of my physical safety, I had to cut off ties to my friend. But I never stopped caring.




BiggerPockets.Com:  Where the Danger of Continued Violence Remains
Some months ago, when I looked at a real-estate investing website, my friend -- of all people -- popped up.  She talked about how she is a big shot real-estate investor who owns a parking garage in Norway and who is interested in New York.  She finally stopped using the horrid corpse pictures for her avatar.

However, she changed her name; she now goes by her father's last name.  To someone unaware of the context, that must seem a touching tribute to a man of obviously large meaning in my friend's life. But based on what my friend kept saying, and also based on what her aunt said, I am afraid that the name change appears to be yet another morbid gesture.  :'-(
 

If you network with her as a colleague, it would be prudent to remember her behaviour with respect to her classmate and the writing instructor.  As long as my friend refuses to take responsibility publicly for her public morbid gestures -- including, but far from exclusively, the still-online murder threats and photoshop-corpse photos -- there is probable cause in concluding that the danger remains. Indeed, if you work at a particular IKEA Service and Pick-Up Point, you should be very concerned.

I have to bring this up publicly.

First off, falsely accusing someone of a violent crime is itself an initiation of the use of force.  The reason is this.  If X goes to Z and accuses Y of having committed violence against X, then Z may easily respond with violence toward Y, either doing the violence himself as retribution or going to the police (remember that government action is backed by the threat of violence).

Furthermore, every impassioned public threat of violence -- such as the one my friend put on the Web publicly for her mother -- must be taken seriously.  Serious public threats of violence count as an initiation of the use of force.  The reason is that, although not all violent threats are acted upon, there is probable cause to judge that the person who issued the threat might still act upon it one day.

Even if my friend never does violence to her mother, she has given enough reason for people to suspect she might do something equally dangerous or retributive to someone else to whom she feels emotionally attached. You cannot justly hide behind the phrase 'This is my privacy and none of your business!' when the matter involves violent threats you have issued publicly against your own mother. That is particularly when you have continued, throughout the years, issuing public gestures indicating a continued obsession with death and violence.

If you have come into contact with my friend and truly care about her well-being and the safety of those around her, please, please, please confront her compassionately and firmly -- pardon that redundancy -- about how her happiness, her being able to accept herself and her past, without all these evasions, is most important, and that the courage to return to regular psychiatric care is worth it.  It is the part of me that retains confidence in my friend -- that part of me that holds onto the hope that she finds inner peace, authentic happiness, and the hope that she is capable of gaining it -- that asks this both of her and of you.




On May 17, 2020, I added the paragraph about that other brother to WH also being credibly accused of child sexual abuse. On August 15, 2020, I added the information about my friend posting her violent fantasies about her romantic rival.

A Right to Privacy Doesn't Extend to Violent Acts, Including Threats of Violence

Any act of violence -- even in self-defense -- has ramifications for everyone in the community. If X threatens violence against Y, there is probable cause to believe X might also be a violent threat to Z as well -- a violent threat to everyone else.   Violence is inherently a public matter, inherently an externality; it cannot properly be privatized and, to use an economics term, the costs of it cannot be fully "internalized."  By that I mean that if X hits Y,and then Y hits X back, it doesn't mean that Y's retaliation has made them both even.  Y's "private" retaliation does not render this a private matter that can be dropped.  No, this remains a public matter because the violence can still escalate.

Anyone who uses violence -- even in self-defense -- is a possible threat to everyone else, and that is why, even when someone uses violence in self-defense, it is right for police and courts to look into the matter and ascertain whether it was indeed self-defense.

And serious threats of violence -- even if not yet acted upon -- are worthy of police attention, as they create probable cause for members of the community to ascertain that the violent threat might be acted upon.  Moreover, if Q goes around falsely accusing R of making a violent threat toward Q, that counts as an initiation of the use of force, as third parties, mistakenly believing they are exercising retaliatory force in defense of Q, may end up being violent toward R, and this would end up being an initiation of the use of force.

Violence and the threat of it are the greatest threat to anyone's liberty; violent threats are what deny someone the freedom of peaceful action.  Moreover, a right to privacy does not extend to someone threatening violence.  That is, if L seriously threatens violence against her own mother, that is something the public has a right to know about, even if L's mother herself tries to dismiss that as something not to be taken seriously.  Even if L's mother dismisses it, other people around L remain potential victims of L if L does not receive proper treatment from mental health professionals or the law.

If you have been threatened with violence, or if it has already been inflicted upon you, you may be justified in fearing that if you come forward to authorities with this information, it may put you at risk of being subjected to violent reprisals from the assailant.  For that reason, in the short term it may be rational that you tell but a few people about this circumstance and ask them to keep it secret in the foreseeable future.  However, that can only go so far. There is probable cause for the law to inquire as to whether this alleged assailant may pose a violent threat to parties besides you and therefore, in the long run, the protection of every peaceful person's rights requires that this information ultimately be publicly available.  On that basis, a right to privacy does not extend to any credible accusation that you can level about someone either threatening violence or having committed it.

There Is No Right to Use Government to Suppress the Truth

"There is no 'right to be forgotten.'  But there is a 'right to  remember.'  History is important.  Speaking the truth is a human right."

--Jimmy Wales, Monday, August 4, 2014


When legislation says you have a "right to be forgotten," what it really means is that it will use the force of law to shield people from facing the peaceable consequences of their own choices.

In the Long Run, You're Not Fooling Anyone

If I tried to deceive you, it would not merely be a matter of me trying to outsmart you. It would also be a matter of me trying to outsmart empirical evidence and the laws of nature themselves. In the long run, that isn't sustainable. Reality is absolute, which means that empirical facts are absolute. I can outsmart people in the short run, but I cannot outsmart reality in the long run.

A lie can persist for thousands of years. Since that is beyond my lifetime, it seems that a lie can persist indefinitely. But thousands of years is not the same as eternity. Even though you cannot observe everything for an eternal amount of time, it is still to logical to conclude that the long-term result for a deception is for it to be exposed eventually. Here is why I say that.

Suppose that you have a website. First I leave a post on your website as myself. My post shows my IP number, and you can see from my IP number that I'm in Hawaii. Now suppose that I create a sock puppet account and post while posing as someone in Croatia. And suppose that you see that the IP number is exactly the same -- it's the same Hawaii IP number. And you know that Stuart Hayashi is not sharing his ISP account with some Croatian. By noticing the evidence, you have busted me.

Every human action has consequences. This includes consequences that are byproducts of the action -- meaning that these consequences can be anticipated but that having these consequences occur was not the main end sought by the action. For example, if I walk through snow and leave footprints behind, leaving those footprints was not my main goal, and yet my action nevertheless caused the footprints to appear. These byproduct consequences surely leave behind evidence. My footprints in the snow are evidence of my having walked through the snow. Insofar as I am truthful with you, there is evidence to support that I have been truthful. Likewise, insofar as I am deceptive with you, there is evidence to support the conclusion that I have been deceptive. Consistent observation of the facts themselves, and consistency in understanding the context, will ultimately support true claims and undermine false claims. Therefore, insofar as people observe empirical evidence, the facts will always give true claims the advantage over deceptive ones.

When I tell you the truth, I am not trying to outsmart you; I have the facts to support me. Likewise, if I lie to you, I am not merely trying to outsmart you; I am trying to outsmart empirical evidence. And as reality is absolute, empirical evidence cannot be outsmarted.

Yes, it is true that if someone consistently practices deception, he can learn from past mistakes and learn to be more thorough in covering his tracks. If you have caught me using a socket puppet account, based on IP evidence, then maybe next time I might try to switching to a different IP number before I post on your page using a fake account. But no matter how thorough a con man may attempt to be in covering up every trace of his deception, it is not plausible to expect that he can cover up every trace at the noumenal level; reality is too complex for that. Therefore, no matter how sophisticated the deception, there will always be evidence of what really went down.

A deception might take thousands of years to undo. Someone might die before his lies catch up with him. But insofar as anyone observes the evidence and follows up on it, the deception is vulnerable in the short run and doomed in the long run. And insofar as a charlatan is able to get away with his deceptions, this is not so much on account of the charlatan being the cleverest man in the world, but more so on account of the people around him either (a) failing to observe evidence or (b) having observed the evidence of deception, failing to call the charlatan on it.

Right and Wrong Ways to Achieve a Sense of 'Control'

I have developed a simple theory on the cause of most dysfunctional human behavior. Perhaps it is too simple. But this is it:

Everyone wants to exercise some level of control in their lives, and there's nothing bad about that. All choice is an exercise of control. Dysfunctional human behavior results when people lack an adequate sense of control and they therefore resort to unhealthy methods of regaining a feeling of control: a manner damaging to self or others. I think all forms of tyranny result from someone feeling that he does not have enough control (even if he's a nation's dictator, he feels inadequate about control) and therefore trying to control others through the threat of violence.

In response to this, many people say, "Stop trying to control stuff! Just be satisfied with how you don't have control."

That is an entirely losing proposition. If someone feels that he doesn't have enough control over his life, you won't persuade him against the dysfunction by telling him that it's good to cede control.

I think this is a better approach: acknowledge that the desire for control is actually very healthy; the real problem is the manner in which one is trying to maintain or obtain control. The search for control in a dysfunctional manner has damaging results and, in the long run, the person who wants to have control will up end with less of it. Therefore, it is best to show that person how there are much healthier, more humane, more peaceable methods of finding control in one's life.

If You Notice Someone Obsessed With Self-Disfigurement, Gently Speak Up About It (Here's How)

Body Dysmorphic Disorder (BDD) is a mental condition in which someone feels alienated and disturbed by his or her own natural physical features -- so much so that this person holds a debilitating hostility toward his or her own body.  The person feels that his or her natural form is "disfigured," and, ironically, it is in the process of trying to "correct" the believed disfigurement that the person can actually end up disfiguring him- or herself.

Anorexics have a form of BDD. They suffer from the delusion that they are grotesquely obese and must "correct" that imperfection by starving themselves.  Another example of people with BDD are certain extremely rich Hollywood people who are so insecure about their appearance that they keep getting cosmetic surgery, and they end getting so much "corrective" plastic surgery that they stop looking human. 

Of course, in the long run, the issue isn't ultimately about one's looks; that's a red herring.  What is actually going on is that the person with BDD, no matter how much he or she boasts of professional success or being a big-shot real-estate investor, feels as if he or she doesn't have a sufficient amount of control in life.  The person with BDD tries to regain a sense of control by imposing control over matters that are quite petty and even self-harming.  When an anorexic starves herself, that's horrible, but she feels that she is solving the problem because the practice of self-starvation includes "control" and "discipline."  The same principle is at work when someone routinely gets a knife and cuts her wrists.  Another way one can try to impose control is to dress exactly the same every day and to try to cover up the "natural deformity" by trying to look like a pallid corpse.

I know from personal experience in the Hawaii Pacific University that to care deeply about someone who has BDD is very painful and traumatic.  And if just knowing and caring about someone who has that condition is traumatic, you can imagine how much worse it is for the person who actually has that condition.

If you notice a friend very conspicuously shoving self-disfiguring gestures in your face -- dressing the same every day and uploading photos onto LinkedIn where one is photoshopped to look like a corpse -- please don't write this off as a harmless quirk or eccentricity.  It can mask something far deeper and worse.  If you notice someone engaging in repeated self-disfiguring gestures and pretend not to notice, that continued pretense actually tacitly reinforces the self-harming gestures.   If you know someone who repeatedly makes self-disfiguring gestures, there is a compassionate way to address it that is not harshly disapproving or bossy. 

I recommend that you say to this person:

"I value you; you bring a lot of value to my life.  And I cannot help but notice certain things -- certain gestures [i.e., the cuts on the wrists; the insistence on wearing the exact same clothes to class almost every day, the photos on LinkedIn where one is photoshopped to look corpse-like].  And when I see them, I can't help but notice that you have a lot going on in your life.  If you don't want to talk about it, you don't have to.  But I want you to know that if you ever do want to talk about it, I am here for you."

Addressing the person that way is good because it lets that person know that he or she is not fooling anybody; of course the self-disfiguring gestures are noticed.  Simultaneously, the approach is not bossy or harshly disapproving (what most people judgmentally call "judgmental").  It is gentle and lets the person know that you raise the issue precisely because you care and accept that person.

Self-Acceptance and Having a Firm Sense of Identity

From my friend Esha, I learned about this quotation:

"Face it, kid:  unless you can be yourself, you won't stay with anyone for long."

--Sylvia Plath

Sylvia Plath had personal experiences with inner pain.  The idea here is true: being able to accept and trust others, to be loyal to them in the long run, is largely incumbent upon first being able to accept oneself, to have a firm sense of one's own identity -- a coherent, integrated narrative identity. 

March 1 Is Self-Harm Awareness Day

Remember that March 1 is Self-Harm Awareness Day.

You don't have to face this alone.  Receiving the help that you need, you can triumph over these obstacles and truly embrace life.  :'-)

Alexi-- Alexi-- Alexithymia? -- Such a Mouthful! -- in BPD?

The Journal of Personality Disorders published a study suggesting that persons with BPD can often experience a condition known as alexithymia.  It refers one having extreme difficulty understanding emotional responses -- those of oneself and those of others.  The study suggests that those with BPD have a harder time understanding their own emotions -- particularly when it comes to difficult negative emotions like fear of relationship commitment -- than they do those of others.

As an article in Psychology Today put it,

The findings showed that people with BPD (compared to healthy controls) were less able to identify feelings, but it was the feelings within themselves that gave them the most challenge. Their difficulty was in putting themselves into the situations, especially when the feelings depicted were negative. Unlike people with antisocial personality disorder, individuals with BPD can feel compassion toward others and even empathy. It’s their own inability to tolerate (and therefore think about) negative emotions that seems particularly disturbed.

This has given me a lot to think about. I have read that many persons with BPD pride themselves on being able to "read" people well, but that, in controlled experiments, they often mistake neutral expressions for disapproval. I think that to have a consistently ability to interpret emotions from other people's body language accurately, one has to understand one's own emotions first.

My Criteria for Judging Whether a Pattern of Behavior Should Be Judged as Potentially Indicative of 'Mental Illness'

I can understand that some people believe that to call a mental illness an "illness" is misleading, as they believe that there is not evidence of a physiological cause.  However, I think it is important to acknowledge that certain people fall into certain psychological patterns that are self-damaging.  And it is noticeable that:

1. The pattern consists of unusual behavior

2. The behavior is harmful to self, others, or both self and others

3. The behavior has a lot to do with some deeply-ingrained belief or propensity to believe

4. Even though only a minority of the population engages in such behavior, it is conducted by enough people for psychiatrists to notice a pattern.  That is, it's not confined to one person; there are multiple cases of it.

I think this raises the issue of what should or should not be considered an indication of mental illness.  First off, a behavior should not be considered a sign of mental illness just because it is unusual.  For instance, Albert Einstein wearing his hair the way that he did, was strange.  But I don't see how his having strange hair inflicted long-term damage on his life or happiness.  Therefore, Einstein having strange hair is not enough to be taken as a sign of mental illness.

Rather, I think that what makes a pattern a behavior a sign of mental illness is that it is severely damaging to others or at least to oneself.   However, I think a certain qualifier is in order.  If someone engages in a certain behavior, and this leads to his unhappiness primarily on account of other people disapproving of it, that is not sufficient for the behavior to be classified as a mental illness.

For instance, one might argue that Galileo invited great misery upon himself for publicly stating that the Earth revolves around the sun.  One might also say that, in terms of his social standing, he might have been better off if he never shared his knowledge.  Galileo speaking the scientific truth arguably did cause him great unhappiness, but the unhappiness was caused less by the behavior itself than by the social establishment's disapproval of it.  For instance, we can ask ourselves what effect Galileo's actions would have had in a society where everyone approved of him saying that the Earth revolved around the sun.  If everyone approved of Galileo's behavior, would it hurt him?  No.

Now, what of being gay?  Someone might argue that if someone publicly comes out as gay, that might cause him great unhappiness.  But that has more to do with widespread social disapproval of homosexuality than with homosexuality itself.  If someone came out as gay in a society where nobody disapproved of that, I don't think it would harm him.  Therefore, even though psychologists did classify homosexuality as a mental illness for most of the twentieth century, they were wrong to do so.

Therefore, I have this generalization:  a behavior does not indicate mental illness solely because it is unusual or because doing it openly would bring widespread social disapproval.  Rather, the behavior can properly be seen as an indication of mental illness if it is unusual and would bring harm to self or others even if everyone in society approved of it.

For example, what if, to relieve stress, I always got a blade and made cuts on my wrist?  Imagine, if you will, that nobody in society disapproves of this.  The fact of the matter is that even if everyone in society condoned it, my cutting myself would still pose a physical danger to me.  Therefore, self-cutting does deserve to be considered a psychologically disturbed behavior.

What if I purposely starved myself to become skeletally thin?   Even if everyone in society condoned it, the behavior would still be a physical danger to me.  Therefore, this, too, merits classification as a disturbed behavior.

Thus, I think these are the correct criteria for judging whether someone's actions might be indicative of mental illness:

1. The behavior is extremely dangerous to one's life or long-term well-being, or dangerous to the lives of others, and would be such even if everyone in society approved of it.

2. The behavior is unusual and practiced by a minority of the society's members, but still happens frequently enough for multiple cases of it to be documented.

Is it possible for an entire society to be mentally ill?  For instance, it was normal for Aztecs to believe that if they did not sacrifice someone -- ripping out his heart -- to appease supernatural forces, then the world would end.  That is a very harmful belief, and it caused much tragedy.  But as this belief was normal in that society, I do not think it was a sign of what is usually called mental illness; what I think it shows is that even very normal people are in danger of engaging in self-destructive actions when such actions become the social norms.

I think an entire society can become corrupted in a form of self-destruction; that is what happened to Germany under Hitler.  However, I think that is a phenomenon different from mental illnesses like self-cutting and self-starvation, which are difficult to make into social norms.

Patients With BPD Can Get Better ='-)

A study in Denmark shows that patients with Borderline Personality Disorder can indeed get better with additional treatment.  :'-)

More About 'Identity Disturbances'

Narcissistic Personality Disorder (NPD) is not the same as BPD.  A person can have one condition but not the other.  However, the conditions are not mutually exclusive either; someone can simultaneously suffer from both self-destructive maladies.

NPD, by the way, is often misunderstood.  People assume that narcissism refers to extreme self-love.  Actually, clinical narcissists don't really love themselves as they really are; nor does their pathology assist them in rationally achieving long-term happiness.  Rather, narcissism refers to fixating on maintaining a certain image of one's character -- such as having a certain type of reputation -- and of prioritizing this mere image above the actual long-term well-being of the real self.  Recall that, far from doing what was necessary to achieve his long-term happiness -- what was in his actual self-interest -- Narcissus let himself perish as he gazed at a mere surface image of himself.

Anyhow, here is a man who makes many vlogs about NPD.  Having been diagnosed with the condition, he considers himself an expert on it.  Many of his vlogs are interesting, but this one caught my especial attention.  Although all of the traits discussed in this video are traits he attributes to NPD, it sounds to me like he is describing the phenomenon of "Identity Disturbance" -- one of the nine main diagnostic criteria for BPD.  If someone suffers from "identity disturbances," it means that she does not have a healthy, consistent sense of her own identity, and thus periodically goes through what she deems abrupt and dislocating "changes" of personality, though what is consistent is that one attempts to appear successful, in some cases bragging that one is some big-shot real-estate investor.  No matter how much this is called "change," however, what sadly remains consistent is the continued lack of an authentic, independent sense of identity.  Even though the term "Identity Disturbance" is not used in this video, I think the video is very accurate in describing this phenomenon.

When you go through the vlogger's videos, you can see that he has a pretty bleak outlook on this sort of condition. He believes that professional help can assist one in mitigating the symptoms, but that full recovery is impossible. :'-(

I want to contradict that particular assessment. I think that when one finally decides to commit to life and long-term happiness, one really can heal for the long term. A return to psychiatric care is worth it. You owe it to yourself -- to your long-term happiness -- to try. :'-)

Scary Black-and-White Pic ='(

Actually, pics are not the most important thing.  What's important is the information.  I hope by now it is clear that pictures are less important on this blog than the essays, which provide insight.  All of the essay posts are worth reading.

I Will Always Care

Wishing a happy birthday to someone I care about.  Whether this is understood or not, your lasting happiness is of paramount importance.  I meant -- and mean -- everything that I have said.  :'-)

If You Know Someone Who Exhibits Suicidal Gestures, Are You a Real Friend to That Person . . . or a Sycophant?

 

As I've blogged before, someone having suicidal ideation does not always lead to that person attempting suicide, but it remains very dangerous.  It is dangerous both for that person who has the suicidal ideation, and those who care about him or her. That is why I have absolutely no tolerance for it. None. When I say that, I don't mean that I cast moral disapproval on those who experience suicidal ideation. What it does mean is that if someone I care about happens to display very prominent suicidal ideation, the ethical course is to intervene.


Michael Jackson Syndrome?
There is a common story about many self-sabotaging celebrities that goes something like this. The celebrity is on a very self-destructive path, which causes visible harm to him or her, as well as trauma for those who care about the celebrity's well-being. The self-destructiveness can be manifested in substance abuse, eating disorders, self-cutting, criminal behavior (or falsely accusing others of criminal behavior), or symptoms of morbid mental illness.

Even though such self-destructive behaviors do not necessarily mean that the celebrity consciously desires to commit suicide, in this particular post I will place all such self-destructive behaviors under the category of "suicidal ideation," "suicidal gestures," and "suicidal imagery." (A psychologist might dispute that as being too broad on my part.)

Because of the celebrity's socially prominent status and because the celebrity acts outwardly confident in public, most people around him or her are reluctant to address this issue. Often, these people keep silent and pretend not to notice the disturbing suicidal gestures.  Some members of the celebrity's entourage go even farther, complimenting or at least explicitly approving of the suicidal gestures. Such a person who refrains from confronting the celebrity is not a real friend but a sycophant. By playing along with the celebrity's self-imposed illusion that the celebrity's suicidal gestures are safe and acceptable, the suicidal gestures are normalized and tacitly encouraged. Far from being conducive to the celebrity's long-term happiness and well-being, this "accepting friend" amounts to a passive "enabler." Think of Hans Christian Andersen's famous story "The Emperor's New Clothes."

Once in a while, someone close (or who was once close) to the celebrity does try to confront the celebrity about such dangers, or urges other people in the celebrity's circle to compassionately address the issue. When this happens, the whistleblower is often marginalized, ridiculed, and devalued. That's terribly tragic, because the whistleblower has shown himself to be a real friend -- exactly what those hangers-on, who have failed to address the issue, have not been. Those real friends -- the concerned whistleblowers -- are sidelined, and the self-defeating celebrity surrounds him- or herself with "yes" men and sycophants who play along with the illusion that everything is fine and normal.They then ostracize the whistleblower as the maladjusted troublemaker.  (Again, it's like "The Emperor's New Clothes.")


A Problem for Non-Celebrities as Well
As I do not know the celebrities personally, I cannot claim omniscience about them; my interpretation of them can be mistaken. However, from what I've read of their biographies, I think the scenario I just verbalized can be largely attributed to Michael Jackson, Charlie Sheen, and Lindsay Lohan. But it doesn't just apply to famous entertainers.

For more than a year, I corresponded online with a very intelligent person whom I will call "Lucy." Lucy expressed interest in looking beautiful, and, of course, in the beginning that sounded perfectly safe. Increasingly, though, Lucy would post pictures of bony anorexic women (this is not humorous hyperbole; they were literally anorexic-looking) and labeling them as the sort of people she wanted to emulate. She posted disturbing photos of herself looking ever-thinner and frailer. She then wrote status updates complaining about really odd physical ailments, like temporary blindness. Such physical ailments are rare in someone of such a young age . . . but common among people who experience starvation and malnutrition. Frighteningly, a large number of "loyal friends" (translation: sycophants) clicked "like" on the disturbing pictures and announcements and encouraged it.

Eventually, a minority of Lucy's online friends -- people much wiser and ballsier than myself -- wrote to Lucy that they were concerned about her health. Not once did they morally criticize her or express full-blown rejection of her as a person . . . though she reacted as if she interpreted it that way. Lucy pointedly told these people that her self-starvation was none of their business.

If Your Suicidal Gestures Are Nobody Else's Business, Why Do You Post Them on Facebook, LinkedIn, or Wordpress?
The whistleblower friends thought that Lucy's response was rather inexplicable. Their thought was, "If you think that your suicidal imagery is none of my business, then why are you putting it on display in front of me and other people?"

Of course I can be wrong, but I think I know the reason. I suspect that on some level the suicidal gestures did disturb Lucy, and that is exactly why she shared images of it on Facebook. She did not want other people, however, to confirm her fear that she was placing herself in a dangerous situation. Insofar as a "cry for help" refers to the crier wanting other people to acknowledge the problem, this was not a traditional "cry for help." Rather, it was like some kind of game of "chicken" in which Lucy implicitly dared other people to comment on the dramatic and alarming change in appearance.

Insofar as people refrained from negative comment, or even complimented the disturbing images, Lucy felt vindicated that her suicidal gestures were actually safe and acceptable, and that her painful health problems were completely unrelated to her self-imposed starvation. The sycophants granted Lucy this short-term gratification, giving her "social proof" that the starvation wasn't a form of self-harm. As for the whistleblower friends who raised the issue, the sycophants reprimanded them and piously told them that they were the assholes.

I blocked Lucy on Facebook because I did not want to lend tacit support to that self-destructive tendency. I envy those who wrote to her about the issue, though, as they were the ones most helpful toward her, even though such positive effects are not obvious in the present.

I have known someone who is similarly self-destructive and who similarly exhibits "hints" of the inner pain. This person has informed me that this person has a long history of self-injury and of contemplating suicide. Almost two years ago, this person started posting a lot of suicidal imagery on Facebook, LinkedIn, and Wordpress. In this case, I did confront the person.


How to Compassionately Address a Self-Destructive Person Without Forcing an Argument
If you are in a similar situation, and you strongly care about that person -- the "Lucy" in your own life -- I urge you to address the issue. If you notice something is going on, and you say nothing, that helps normalize the suicidal ideation and self-defeating behavior. It implies that the self-destructiveness is normal and acceptable.

If someone has routinely displayed suicidal gestures to you in person or online (like on LinkedIn or Facebook), then it doesn't really fly for that person to say, "This is none of your business!" When someone has, on more than one occasion, shoved his or her suicidal imagery in your face, he or she has made it your business. If he or she fully believed that the suicidal imagery was not your business, he or she would not have put it on display in such a conspicuous fashion.

Often people are reluctant to confront their "Lucy" because they have this rationale: "My friend can be very scary and temperamental sometimes; even my friend's great height is physically intimidating. If I mention that I notice the suicidal imagery, it will just start a big argument. She will hold a grudge and not seek help, and nothing good will result from the confrontation. It will only make our relationship awkward."

In the past two years, I have become very familiar with that feeling -- that fear, that feeling too intimidated to say something. Quite frankly, though, if someone is exhibiting suicidal ideation and expects you not to address that, then the relationship is already awkward. More importantly, I think there is a way to compassionately address the issue without forcing an argument. I suggest that to your own "Lucy," you say something like this:

I strongly value your friendship; you mean a lot to me. When I see the [here, make a brief list of the disturbing gestures you've witnessed, such as the dead-body imagery or the defensive insistence on wearing the exact same clothes every day --S.H.], I can't help but think that you must have a lot going on. You don't have to talk about it if you don't want to. But I want to let you know that if you ever do want to talk about it, I am here for you. :'-)

I think that gesture is even more powerful when it comes from a close relative, like an uncle or aunt.

If the person you care about -- your "Lucy" -- happens to respond to you in an abusive/bossy/devaluing fashion, I recommend that you ignore it and reaffirm, "I know what I know.  If you ever want to talk about it, I am here for you.  :'-) " And if that person provides no response, or responds dismissively, that's OK; at least you showed where you stand.

Note that that approach does not force an argument, demand that the person change, or cast moral disapproval. It does, however, let the person know that you are aware of the suicidal gestures and that that is not something you condone. It conveys, through action, that you reject the suicidal gestures but still value the person qua person. Hence, it shows the person that you accept him or her while you refuse to play along with the ruse of normalcy -- that you refuse to help normalize the pathology.  I concede that the person who needs help might resent it as patronizing if you take this approach.  But all in all, it's the best available alternative.

I think that everyone has a right to their own harmless eccentricity. That is not the same as being an idle bystander when noticing a friend's suicidal gestures. This cannot be emphasized enough:  Suicidal gestures are not a lifestyle choice.

Narcissus Didn't Love Himself: The Echo

If you remember Ovid's rendition of the Greek myth, there was someone else who cared about Narcissus:  Echo.  And, like Echo, I repeat myself.

Someone can place so much emphasis on maintaining an outward image -- a public persona of strength and confidence -- while the true self inside is hurting and goes neglected.  But rather than maintaining this image, it is far better to tend to the happiness of the true self, and to resume getting the help one needs.  The tragedy was that Narcissus did not realize this.  But it did not, and does not, have to be that way. 

Narcissus Didn't Love Himself

Narcissism -- in both the clinical and colloquial sense -- is commonly considered malignant self-love.  But today it occurred to me that the Narcissus of Greek myth doesn't really love himself; he loves his reflection, which is merely a surface image.  The image has visual traits derived from the real Narcissus, but it is far from encapsulating the whole person. 

Narcissus focuses on maintaining the image -- just as some people maintain their outward persona -- while the needs of his true self go neglected.  Narcissus was therefore self-sacrificial; he sacrificed the life and fulfillment of the true self for a much lower priority, an image.

Look Alive, Mate

This should be obvious, but you're at your strongest when you present yourself to the world as what you really are: alive. :'-)

Dissociative Identity Disorder (formerly known as Multiple Personality Disorder)

When you look at the Wikipedia entry for Dissociative Identity Disorder (DID) -- formerly known as Multiple Personality Disorder -- you find that it has a number of possible symptoms that are also symptoms named in the nine main diagnostic criteria for BPD.  Some overlapping symptoms include:

• Depersonalization
• Depression
• Derealization
• Disruption of identity characterized by two or more distinct personality states
• Distortion or loss of subjective time
• Flashbacks of abuse/trauma
• [...] panic/anxiety attacks
• Identity confusion
• Mood swings
• Paranoia
• Pseudoseizures or other conversion symptoms [looks like epileptic seizures --S.H.]
• Self-alteration (feeling as if one's body belongs to someone else)
• Sudden anger without a justified cause
• Spontaneous trance states
• Suicidal and para-suicidal behaviors (such as self injury)
• Unexplainable phobias

March 1 Is Self-Injury Awareness Day

"Self-injury" refers to repeated, deliberate acts of physically harming oneself as a way to distract oneself from painful emotions. An example of self-harm is using a blade to make cuts on one's own wrists.

Someone can be a self-injurer without having Borderline Personality Disorder (BPD).  Moreover, someone can have BPD without being a self-injurer.  However, it should be noted that having a history of self-injury and self-harm is one of the nine main criteria for diagnosing BPD: "Recurrent suicidal behavior, gestures, threats or self-injuring behavior such as cutting..."  Of course, it is important to remember that even if one's self-injuring has gone into remission, that, by itself, is not proof of recovery from BPD if other self-sabotaging symptoms remain present.

March 1 is Self-Injury Awareness Day. Its symbol is the orange ribbon, as shown here:

A reminder to those who have a history of self-injury: you don't have to face this alone.  There are people who -- even if they have not self-injured themselves -- understand what you have gone through, and will always care about you:

More Dialectical Behavior Therapy Clinics on Oahu

I have previously blogged about websites providing contact information for mental health professionals on the island of O'ahu who treat Borderline Personality Disorder (BPD).  That is here and here. On those same posts, I provided links to a clinic on Oahu that provides Dialectical Behavior Therapy (DBT) for BPD.

Just now I found a website providing contact information for other clinics and therapists in Honolulu who provide DBT. Among those professionals, though, only one mentions having a strong focus on providing DBT.

I know that, deep down, you know that it's a good idea to return to getting the help you need. Have courage. The long-range happiness that you deserve is within your grasp. You only need to commit courageously to making it a reality. :'-)


UPDATE from Sunday, June 7, 2015:  Oh, wow; now this blog post is really outdated.  A good resource is the University Hospital of Northern Norway, also called Universitetssykehuset Nord-Norge in Tromsø, particularly the psychiatric center. What is not outdated is the importance of your long-range well-being. Regular psychiatric care is worth it for your happiness. :'-)

More About Possible Epilepsy-BPD Link

I have previously posted about whether there might be some hereditary connection between epilepsy and Borderline Personality Disorder (see here and here). Well, I have more findings on that.

I previously mentioned that Bipolar Disorder symptoms and BPD symptoms are often confused with each other. About one-fifth of those diagnosed with BPD are also diagnosed with Bipolar Disorder.

Well, it turns out there is strong evidence of a correlative link between the occurrences of epilepsy in one's family and of someone in the family exhibiting bipolar symptoms. Accordingly,

After thoroughly examining the data, the researchers discovered that 12 percent of the epilepsy patients showed signs of bipolar symptoms – approximately twice the amount of all the other disorders, and six times the amount of those with no illnesses at all.

You can see a PDF on that study here.

There is also the matter of psychogenic non-epileptic seizures (PNES). These seizures outwardly resemble epileptic seizures, but the sort of electrical activity in the brain that occurs in epileptic seizures are not detected in psychogenic non-epileptic seizures. However, there is a statistical correlation between someone having psychogenic non-epileptic seizures and exhibiting strong symptoms of diagnosable personality disorders, including BPD.

The drug carbamazepine (which has the brand name Tegretol) is used to treat epilepsy, bipolar disorder, and BPD alike.

More About Epilepsy and BPD

I previously posted about some theories that there may be a link between having epilepsy in one's family and having borderline personality disorder (BPD).

Recently a very wise person who has been diagnosed with BPD and is recovering from it brought up the possible BPD-epilepsy connection with me.  This person pointed me to the website of Dr. Leland M. Heller.

According to Dr. Heller, "The most severe BPD symptoms are likely a form of epilepsy and include 'dissociation' (unreality, body parts going numb, deja vu, etc.)..."

Of interest to me was the page where Dr. Heller stated,

Epilepsy means nerve cells firing inappropriately and out of control. Some individuals have a genetically unstable neurological system that can cause epilepsy in different areas.  This instability in the instinctual "trapped, cornered, wounded animal" response causes the BPD. Some other common disorders are likely epileptic in origin including bipolar disorder...

Dr. Heller also addresses the possible BPD-epilepsy connection here.

I Will Always Care

I told someone, "The only way I will ever again feel safe in your presence is if you return to seeing a mental health professional on a regular basis." Should this person ever visit this blog, I want something to be understood.

I said that not because I do not care about you, but exactly because I do.  You can go on looking very confident and outwardly successful to everyone else and, as you well know, I have never had any objections to that.  But it's simply not enough; you are due for so much more and so much better.  What you deserve is that lasting happiness that Aristotle called eudaemonia -- Greek for "good spirits."  It refers to an ability to feel at peace within the confines of your own psyche, to be comfortable in your own skin and in the body that Nature gave you, to accept yourself and see in yourself the charm and beauty and compassion that others have seen in you on those occasions when you let them.  To know that there is nothing unnatural or uncomfortable about one day having children and starting a family of your own.  No, starting a family is not any kind of duty or moral obligation; it is simply something very rewarding, an enterprise grander and more challenging than any business scheme I could cook up. So much happiness is possible to you, and just begging to be allowed entry into your life.  And, as you are cognizant, that happiness reaching you is incumbent upon the hard and disciplined choice to accept it.

Contrary to your fears, no one sees you as some specimen to be put in a laboratory, poked or prodded.  You are never on some stage to be judged harshly by anyone.  And no matter how strangely you may look or dress, no one is staring at you; people are much too consumed by their own worries or insecurities to project negative thoughts upon you.  No one plots against you, no one conspires against you, no one is trying to outsmart you, no one wants to use you. On the contrary, everyone believes in your greatness as a person and is rooting for you to win at life. 

A return to psychiatric care does not have to be a prison sentence.  Nor must it feel like one.  In Hawaii, it would be you -- and no one else -- who would ultimately be in control.  You could fire any mental health professional who did not meet your standards of competence and care.  As far as American mental health professionals are concerned, it is the patient who is the boss.  Getting the care that you need is a form of self-determination and self-empowerment.  Far from submitting to the dictates of anyone else, receiving quality care is a form of psychological liberation, no less important than political and economic freedom.  I want you to be happy.  But far more important than that is that I want you to want you to be happy.

You told me that I cannot force any of this upon you, and of course that is true.  I was the one who first told you, "I cannot persuade anyone to do anything.  I can only encourage you to persuade yourself to do something."  That applies here.  I force no one's hand.  I wish happiness for you.  And I unabashedly plea that you put at least as much priority as I do upon the joys and sense of serenity just waiting to be experienced. 

Whatever you do, I will always give a damn, irrepressibly.   I have no regrets about knowing you; I only have gratitude for it and I face no qualms in expressing that.  Just as you have every right to your own choices, I have a right to mine.  Of course I can move on and put the emphasis on my writing projects.  My doing so will never mean that I have forgotten anything.  I will continue to remember and to care.  That is my own prerogative.  :'-)

Identity Disturbances

Among the nine criteria for diagnosing Borderline Personality Disorder, another is the presence of "identity disturbances."  As Psych Central phrases it,

There are sudden and dramatic shifts in self-image, characterized by shifting goals, values and vocational aspirations. There may be sudden changes in opinions and plans about career, sexual identity, values and types of friends. These individuals may suddenly change from the role of a needy supplicant for help to a righteous avenger of past mistreatment. Although they usually have a self-image that is based on being bad or evil, individuals with borderline personality disorder may at times have feelings that they do not exist at all. Such experiences usually occur in situations in which the individual feels a lack of a meaningful relationship, nurturing and support.

I don't thinks Psych Central means that a BPD sufferer's entire outward persona will completely shift from minute to minute or day to day (although some mood swings can be like that).  Rather, it's more along the lines of someone "searching for identity" the way a high-schooler would.  One would can have certain career goals in mind and have a certain type of fashion for some months or some years.  Then some stressful triggering event can cause this person to immediately switch all of this around so that the clothing choices and career goal will be completely different.  Those who do not have BPD can also sometimes make sudden changes.  However, those with BPD often make sudden changes in manner that those around them finding more jarring and confusing.  

A helpful article on this subject is found here.

As recovered Borderline Rachel Reiland has pointed out, sometimes this identity confusion can manifest in the BPD sufferer wearing a sort of mask, trying to always appear confident and friendly to mask a gnawing self-doubt and extreme predisposition to being bothered by what other people say.

Someone suffering from BPD identity disturbances will not have an integrated, consistent personality, but instead have a highly fragmented personality, switching back and forth. The true self will emerge when one feels safe. However, once one feels threatened in some way, the impervious false self emerges as a form of "protection." Sadly, this "confident" false self happens to wall off the person from true emotional bonds, thus becoming a maladaptive obstacle to finding true lasting happiness. :'-(

Some psychologists can mistake this phenomenon for Multiple Personality Disorder. However, there is an important difference. When someone with Multiple Personalities switches from one personality to another, the switch is unconscious; the person doesn't know it is happening. By contrast, the Borderline with a disturbed, "fragmented" personality does have some conscious awareness of when she or he is changing personalities as the result of some emotional trigger. Again, Rachel Reiland explains that.

The identity confusion can even come in the form of changes in perceived sexual orientation.

But you are not cursed to permanently suffer with this. A return to psychiatric care can be of enormous help with the proper diagnosis and committed mental health professionals. Please take your happiness very seriously. :'-)

Wearing a Mask of Confidence on the Outside, Feeling the Opposite on the Inside

The blog Beyond the Borderline Personality presents this interesting excerpt from an article in Scientific American Mind (the article itself is not fully Web-accessible):

BPD is also characterized by a disturbing, but fascinating, dual nature: when people with the disorder are not experiencing flagrant symptoms, they often appear highly functional. “You could meet a patient with BPD in a social setting and not have an inkling that the patient had a major psychiatric disorder,” says psychiatrist Glen O. Gabbard of the Baylor College of Medicine. 

On the bottom of that page, there are many insightful comments from sufferers of BPD and/or Bipolar Disorder who  discuss how they appear very confident and composed in public -- such as, say, boasting about being some great real-estate investor -- but are tormented by insecurity on the inside:

*"in many ways I appear 100% [fine in public] but it's just an act..I can only keep up the appearance for so long before I snap..even when I snap I can usually manage to contain it somewhat.."

* " I understand the facade all too well, but it's only a facade. So many times I feel I could fall apart at any moment. I try not to let people on to that little tid bit, but I certainly know what you're talking about."

* From the blog writer herself:  "This is actually one of the reasons my Roommate was not convinced I'm Borderline because when she first moved in with me she'd never seen me dissolve from one minute to the next. I'm so good at portraying a fairy tale version of myself that no one quite catches on"

Also, there is a sad follow-up to my previous post mentioning Amy Winehouse's tragic death. The Daily Star reports that a family member of Amy Winehouse has made the educated guess that Ms. Winehouse suffered from BPD symptoms. Unfortunately for Ms. Winehouse, this would not and cannot be corroborated by a mental health professional. As one article elaborates,

According to the [Daily] Star, a family member said that the Grammy award-winning singer may have suffered from Borderline Personality Disorder. "It was never diagnosed, because unfortunately she would never agree to a proper diagnosis," the Daily Star quoted a family member as saying. "I'm not an expert, but from what I've read on Borderline Personality Disorder it kind of fitted with her."

Meanwhile, Winehouse’s father, 61-year-old Mitch Winehouse, told the Star he wished Amy would have sought counseling. 

If you are experiencing inner pain like that described in the quotations above, then -- even if your symptoms are not as severe as Ms. Winehouse's -- it would be prudent to make sure that you are currently receiving professional help on a regular basis. No one should have to experience such consistent pain. Your true, inner happiness -- not your outward public success -- is what is most important, and there are people in your life who care about you. :'-)

Paranoid Delusions

Suppose I repeatedly insisted to you that all of the men who walked past me in Waikiki leered at me and wanted to sexually assault me.  Then suppose that, when we walk in Waikiki side-by-side, you notice that the men who walk past me simply mind their own business; you catch no leering.  If I repeatedly make this distrustful insistence to you about men -- that they're all ogling me -- it might be the case that my claim amounts to a paranoid delusion.

Paranoia is often associated with Paranoid Personality Disorder (naturally) and schizophrenia.  However, there are cases where it is also found in Borderline Personality Disorder (BPD).  In fact, the presence of paranoia is one of BPD's nine main diagnostic criteria.

What Is 'Suicidal Ideation' (Warning: Post Has Disturbing Contents)

This blog discusses what are already difficult subjects (BPD and Body Dysmorphia), but this post is about something I find particularly uncomfortable.  However, I find it necessary to clarify the distinction between suicide and "suicidal ideation."  The topic of Borderline Personality Disorder is difficult to begin with, and I already had to tread carefully to begin with.  However, I have to be even more careful with this one.

One of the nine criteria for diagnosing Borderline Personality Disorder (BPD) is the presence of "suicidal ideation." Now, most of us know what suicide is, but ideation is not a very familiar term.  What is suicidal ideation?

About.com explains, "Strictly speaking, suicidal ideation means wanting to take one's own life or thinking about suicide without actually making plans to commit suicide. . . . Suicidal ideation is one of the symptoms of both major depression and bipolar depression."

About.Com gives this example:  "Alice often imagined ending her own life in some dramatic way, like jumping off the highest bridge she could find - but it was only suicidal ideation because she really had no intention of actually doing any of the things she imagined."

Thus, to consider the possibility that someone possesses suicidal ideation, it is not necessary that this person actually sincerely plans to commit suicide.  If this person repeatedly contemplates how much sadness or pain would be ended by death or suicide, that is enough grounds to consider the possibility that this person suffers from suicidal ideation.  That applies even if you have a hard time imagining that this person actually would go through with killing her- or himself.

Now suppose that you know someone who has repeatedly and seriously mentioned, "I have a strong feeling that I am not willing to exist."  Suppose this person has made very visible self-destructive gestures, such as having a past of cutting her or his own wrists with a blade.  Suppose this person envelopes her- or himself in morbid imagery and -- absent of giving you any sort of coherent context for the behavior -- puts up self-disfiguring self-portraits in which this person is made to look like a pallid, gray-skinned dead body.  Now imagine that, when you talk with this person and people who know this person, it seems very hard to imagine this person would actually go through with suicide.  That last factor -- that it's hard to imagine the person going through with suicide -- does not preclude the possibility that the person in question is experiencing suicidal ideation.

In short, if someone continually fixates on morbid, self-destructive, self-disfiguring, or suicidal imagery, there is a chance that this person fits the "suicidal gestures" criterion of the BPD diagnosis, even if everyone in this person's circle finds it unlikely that this person would actually commit suicide.  (Of course, only a trained mental health professional can offer an official diagnosis.)  Should someone have suicidal ideation, that might fit one of the nine diagnostic criteria for BPD.

Now I will explain why this blog post requires even more caution than usual:  I must emphasize that I do not want to downplay the suicide risk of those who have BPD.  Out of those diagnosed with BPD, 1 in 10 actually do commit suicide. I neither want to overstate nor understate such dangers.  That rate is significantly larger than that of the general population. 

Even if you find it unlikely that you would ever commit suicide, I have the strong conviction that if you experience suicidal ideation -- or have experienced suicidal ideation over the past nine years -- it could be very important to return to psychiatric care.  Your life and long-term happiness are of profound significance.