Dr. Gautham's

Neuro Centre

(Established in 1988)

A Neuro-Behavioral Medicine Clinic

Dr. Gautham's Neuro Centre
4/68 P C Hostel Road
Chetpet
Chennai, Tamilnadu 600031
India

ph: +91 98410 10197
alt: +91 44 4285 9822

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Below is a sample question with Dr. Gautham's reply to it. Make your question as detailed as possible to enable an appropriate suggestion / direction that is specific to you. Include details of problem / symptoms, duration, details of associated persons / situations, aggravating factors if any, and relevant personal details

 

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Friday Holiday

    Question:

    We are a love married couples, married 5 years back without parents acceptance. Till then we are living in abroad, visiting India once in a year. Immediately after marriage a year in my house they accepted us. During that initial period and before that, my mother and my wife quarreled lot many times, due to this, still their relation is not good.

    During the first year as her parents did not allowed her in the house, that time it was so worst, daily she will give suicide warning and running out of house, breaking everything incase if I talk with my house. But after she gave birth, their parents allowed her. After that this behaviors reduced a little. Still, she will threaten that she will go home back or threaten with something.

    Please note that, almost a similar case happened when she was in her childhood, that time her mother and her grandmother had a fight, ended with her mother to live in their parents' house for 3 years. After that, my wife parents joined, there after her mother made her father not to have much relation with his parents and brothers. Still it is continuing. In depth I do not know whose mistake was that.

    Due to this, my wife is restricting me not to talk with anyone in my house. Even for the last 5 years, this is the case. I should only talk in front of her, with loud speaker ON. She always thinks that, if I talk with my house, my mother may tell anything about her, so it might give problem to my family life. Incase if I go out of her words, then she will fight with me, going out of house, gets angry in very very worst condition. During that time, her face changes much, talk everything out of control.

    How can I compromise her? Due to her behavior, we are not running a good family life.....
    Whether my wife has to go any counseling or Psychiatric treatment? I wanted to change her behaviour.
    (Could you please suggest me what is the difference between them, which I should take first or how )

    Anticipating your kind reply.

    Regards

    Dr. Gautham's Reply:

    You are not alone. A large number of couple are in a similar plight to yours. It is said that love is blind. What that means is that, when you are in love you are blind to family and social requirements which have a large role to play in your life after marriage. It also means that you turn a blind eye to your mate's negative attributes. Also that you fail to see the problems that you could get into post marriage. As you can see from your own experience. This blindness of the minds eye leads you into a number of erroneous assumptions. One such, is the assumption that all undesirable behaviour of your lover is caused by others and that all undesirable personality attributes in your lover are only temporary reactions to pressure or oppression by parents, family, or society. You fail to realise that you may be dealing with a personality disorder and take on the role of a "knight in white armour" rescuing the damsel in distress assuming that you can shield her from her oppressors and provide succor thereby correcting her behaviour. Only after marriage do you begin to realise how wrong your suumptions were. Suicidal threats, running away following a conflict, destructive behaviour when denied are all hall marks of a borderline personality disorder.

    Borderline personality disorder (BPD) is an emotional disorder that causes emotional instability, leading to stress and other problems. The self image persons with BPD is distorted, making them feel worthless and fundamentally flawed. Their anger, impulsivity and frequent mood swings may push others away, even though they desire loving relationships.They have an insecure sense of who they are. They often experience a love-hate relationship with others including their spouses. They may idealize someone one moment and then abruptly and dramatically shift to fury and hate over perceived slights or even minor misunderstandings. This is because people with the disorder often have difficulty accepting gray areas � things seem to be either black or white. All this leads to turmoil in relationships, frequent changes in jobs, friendships, goals and values.

    People with borderline personality disorder often feel misunderstood, alone, empty and hopeless. They're typically full of self-hate and self-loathing. They are highly unstable emotionally, and develop wide mood swings in response to even mildly stressful events. Interpersonal relationships in BPD are particularly unstable.

     

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Dr. Gautham's Reply Contd...

Typically, people with BPD have serious problems with boundaries. They become quickly involved with people, and quickly disappointed with them. They make great demands on other people, and easily become frightened of being abandoned by them. Their emotional life is a kind of rollercoaster.They indulge in impulsive and risky behavior, such as alcohol and drug abuse, risky driving, unsafe sex, gambling sprees or illegal drug use. Strong emotions that wax and wane frequently are common with intense but short episodes of anxiety or depression. There may be inappropriate anger, sometimes escalating into physical confrontations, and suicidal behaviour. There may be difficulty controlling emotions or impulses with destructive outbursts. Poor impulse control may lead to problems with gambling, driving or even the law. They may be fully aware that their behavior is destructive, but feel unable to change it. All this leads to many areas of their lives beingaffected, including marriage, social relationships, and work. People with BPD may also lose touch with reality for short periods of time during which their imagination takes over from reality. During such periods they may suspect everyone of trying to harm them and may even hear imaginary voices talking badly about them or plotting to harm them.

Personality is shaped by both inherited tendencies and environmental factors, or experiences during childhood. Some factors related to personality development can increase risk of developing borderline personality disorder. These include a hereditary predisposition (a close family member � a mother, father or sibling � has the disorder), childhood abuse (physical, verbal, and others), and neglect. Persons with BPD have inborn temperamental abnormalities. Impulsivity and emotional instability are unusually intense in these patients, and these traits are known to be heritable. Similar characteristics can also be found in the close relatives of patients with BPD. The impulsivity that characterizes borderline personality might be associated with decreased serotonin activity in the brain. Some borderline patients describe highly traumatic experiences in their childhood, such as physical or sexual abuse. Others describe severe emotional neglect. Many borderline patients have parents with impulsive or depressive personality traits. However, some patients report a fairly normal childhood. Most likely, any of these scenarios is possible. Borderline pathology can arise from many different pathways.

The social factors in BPD reflect many of the problems of modern society. We live in a fragmented world, in which extended families and communities no longer provide the support they once did. In contemporary urban society, children have more difficulty meeting their needs for attachment and identity. Those who are vulnerable to BPD may have a particularly strong need for an environment providing consistent expectations and emotional security.

Earlier, it used to be believed that there is no specific or universal method of treatment for BPD. However, today we have medicines that can stabilise the swinging emotions, alter the perceptoion of the environment, and take the edge off impulsive symptoms. Once the emotional swings and impulsivity have been controlled the way they perceive life and relationships can be modified using cognitive behaviour therapy. Cognitive behaviour therapy help you to change how you think ("Cognitive") and what you do ("Behaviour)" by challenging the way you think about and react to your environment.

As you have described, your wife appears to be suffering from Borderline Personality Disorder and her mother also seems to have had the disorder. Your wife also seems to have gone through a traumatic childhood. She requires to be treated with a combination of medicines and cognitive behaviour therapy.