18 Comments

Great article!

The reverse causality idea is compelling to me because I have a family member with borderline personality disorder who tried to convince me that I had been abused, both as a child and as an adult. For example she told me that Child Protective Services had been called to check on me as a toddler (not true) and tried to recast a couple of experiences where a boyfriend was just being a bit neglectful as abusive. In another instance, I had a good friend with BPD who hadn't spoken to her father in over a year and consistently told me it was too painful to talk about. Finally, when pressed, she described the incident and it was just her father refusing to pay for her to get her car door fixed. Unsurprisingly, when I told her this didn't seem like a good reason for years of silent treatment, I got silent treatment for a week. Borderline Personality has such a strong impact on the culture, especially leftist culture, and it doesn't get talked about enough.

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Nice piece. Your readers may be interested in my, similarly titled, piece, from a month ago: https://triangulation.substack.com/p/the-myth-of-trauma

"The notion of trauma is another powerful tool our culture provides. It gives people meaning but also creates an alibi with the end result of a sense of entitlement."

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Great article!

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Jun 15, 2023·edited Jun 15, 2023Liked by Aporia

A provocative thesis that aligns to my priors but i want to poke at a methodology question. It seems like the argument rests, pardon lay speak, on trauma self report being strongly predictive of BPD as among a pool of random people but weakly and then not at all predictive as among DZ and MZ twins (i.e. within a twin set an MZ twin who self reports trauma is not especially more likely to have BPD than a twin who doesn't). Do i have that basically right?

If so how do we weigh the reliability of the self report? Always thorny but self reports as among strangers seem somewhat reliable. Twin X reports trauma but twin Y doesnt on the other hand sounds much more likely to reflect different narratives, perceptions etc since the environment and risks are shared. I wonder if the argument turns on over reliance on self reported different experiences between cohabitational twins on a subject that people are not especially predictable interlocutors on. Curious how you think I should think about that concern.

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This was really great! Fantastic

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Really great article, thank you

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Imagine living 200 years ago. Almost everyone had experienced traumas that make modern traumas look like child's play. Go further back in time. A child's earliest memory might be their father saying "yes, your brother was just eaten by a sabre tooth tiger".

Why hasn't evolution given us coping mechanisms? Perhaps it has but they are anti-social.

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The other thing I can't rightly reckon with is who this article is even for. I doubt any serious mental health professional believes personality disorders are wholly rooted in trauma, and I certainly haven't seen anything that would suggest mental health professionals see PDs as fully curable as much as manageable. Moreover, if early attachment trauma is in fact a major contributor to BPD -- which admittedly is partially unknowable but has been pretty extensively studied -- then the article linked about recategorizing BPD as a trauma-spectrum disorder is not really that far off the mark.

Also, I think it's fairly uncontroversial that trauma has an effect on the physiology of the brain and that through therapy one can learn new thinking patterns and coping mechanisms that can also alter the physiology of the brain. Even if no trauma is present and psychotherapy is not pursued, behavioral therapies like CBT and DBT are used for that very purpose, and behavioral therapy is kind of all the rage right now anyway.

So, again, I'm not exactly sure who this article is directed toward except maybe a NYT bestselling author that you may or may not be envious of?

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Jul 31, 2023·edited Jul 31, 2023

This article takes a decidedly (and I'm assuming purposefully) narrow approach to the idea of trauma.

Specifically, with borderline personality disorder, as many studies or causal links may or may not exist with regards to "traditional" trauma, the etiology of BPD is often frequently and strongly linked to DEVELOPMENTAL trauma.

https://pubmed.ncbi.nlm.nih.gov/33055291/

"Recent research suggests that in addition to neurobiological and psychosocial factors, genetic vulnerability may be responsible for the development of BPD. Psychosocial background includes childhood trauma, maternal mental illness, maladaptive parenting styles and dysfunctional parent-child relationship, all of which are recognized as contributing factors to the development of insecure or disorganized attachment styles in the infant. Regarding the neurobiological background, changes in the hypothalamic-pituitary-adrenal axis, neurotransmission, endogenous opioid system, and neuroplasticity play a prominent role, the development of which is also affected by childhood traumatic events. Brain imaging studies reveal differences in the limbic system (hippocampus, amygdala) and frontal cortex, which are also involved in stress response, cognition, memory function, and emotion regulation. Early developmental processes may also play an important role in the development of the disorder, as depression during pregnancy or increased stress affects the quality of maternal care and may also affect gene expression through epigenetic mechanisms. With respect to the gene-environment interaction, the interaction of the child's impulsive traits and the invalidating family environment can be highlighted, which can lead to disruption of emotion regulation. The persistence of BPD symptoms is supported by the evolutionary approach concerning several aspects. Fear of abandonment can be explained by the anticipation of exclusion and maladaptive attempts to avoid it."

Developmental trauma related to BPD is linked to object-relations attachment trauma during infancy and pre-verbal periods (before the age of 2) which means the subject will likely have no memory of these events since memory doesn't begin forming until around the age of 2 and a half. Furthermore, these memories are not even likely to be remembered as traumatic at all being that there is no other basis for comparison.

Additionally, this article doesn't mention anything about "childhood adversity" -- so I don't know if you're intentionally trying to wrap this all around a semantic axel.

https://www.cambridge.org/core/journals/european-psychiatry/article/abs/childhood-adversity-in-association-with-personality-disorder-dimensions-new-findings-in-an-old-debate/1CDB14D2C4D96203303E19FA2E7CA1E4

https://onlinelibrary.wiley.com/doi/abs/10.1111/acps.13118

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Some things are traumatic - like being shot at for instance - but of course the word gets trotted out now in the media in the most absurd contexts. I'm reminded of a wonderful radio play (many years ago). Two young men talking in a bar; one of them is telling his tale of woe and the other is innocently trying to counsel his friend - "have you ever thought of bottling it up" he says.

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I would like the writers' opinion on the work of Dr. Alexander Lowen -a student of Wilhelm Reich. I suspect there is some connection between the matters discussed here and his central theses.

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Please define "trauma."

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Jun 16, 2023·edited Jun 16, 2023

Ditto on Freud, who told his patients their memories of child abuse were only dreams.

As for causality, an 80 lb woman is more likely to suffer broken bones from an impact than a 200 lb man. However, her genes did not cause the break. The impact caused the break.

Neither are her genes defective, although they "dispose" her toward broken bones relative to the genes of a 200 lb man.

Some people are genetically more susceptible to trauma from an adverse experience, but the susceptibility is not the cause. The adverse experience is the cause.

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