Monthly Archives: September 2015

Hard to Love – Nowinski

A good friend who has been fighting the good fight recommended Joseph Nowinski’s book on MBPD: Hard to Love: Understanding and Overcoming Male Borderline Personality Disorder. It was published by Central Recovery Press in 2014. The book is written for two audiences: friends and family seeking to understand what it is to suffer MBPD and those with MBPD seeking to overcome it. Here’s the cover illustration:

Cover Illustration, Hard to Love by Nowinski

Cover Illustration, Hard to Love by Nowinski

Hmmm, is that a picture of some brain process? I guess when you have a captive audience, cover illustration is not that important: people will read the book no matter what’s on the cover.

And the back blurb:

Renowned clinical psychologist Joseph Nowinski defines Male Borderline Personality Disorder, describes symptoms, and offers solutions that work. Borderline Personality Disorder (BPD) occurs commonly in both men and women, but is frequently misdiagnosed in men, resulting in either no treatment (or worse, jail time) or the wrong treatment. Dr. Nowinski lays out the origins of BPD in men and helps a man determine if BPD describes the problems in living he’s experienced, and if so, how to fix them. This book provides easy-to-implement solutions for BPD men and those who love them.

The following indicators are tell-tale signs of BPD: difficulty making relationships work, tendency to see things in black and white terms, starved for attention, emotionally instability, and drug/alcohol abuse. For some reason, the tell-tale signs of BPD reminded me of rock stars. According to Nowinski, BPD is the result of abandonment as a child. The way to overcome it is through building up psychological resilience: thinking thoughts along the lines of ‘my marriage is secure and my wife loves me’ instead of ‘I am not lovable or good enough for my wife’.

One of the reasons Nowinski wrote the book is to establish MBPD as a distinct disorder. Nowinski feels too often MBPD is misdiagnosed as depression or anxiety in men. This leads to the wrong treatment and the wrong medicines being prescribed. This was the hard part for me to understand: if the symptoms of BPD are difficulties staying in a relationship, a tendency to see things in black and white, being starved for attention, emotional instability, and drug/alcohol abuse, then how is it functionally different than depression? Here’s an easier example. Let’s say there are suitcases and backpacks. I say that suitcases are black, rectangular, have handles, and transport things. Then I say that backpacks are black, rectangular, have handles, and transport things. But then I say it’s critical not to confuse suitcases with backpacks. Would that be confusing?

Obviously backpacks aren’t suitcases. But to differentiate the two, distinctions must be made between the two: you can say, for example, that suitcases are hard and backpacks soft. I don’t feel that Nowinksi does this. He says MBPD is not depression but it’s not clear to me why they’re different. What the book needs is a chapter on the biological basis of MBPD. If not a chapter, at least a few paragraphs.

I understand the book is an introduction to MBPD. But even the short online blurb the National Institute of Mental Health reveals that there is a biological basis to MBPD:

Recent neuroimaging studies show differences in brain structure and function between people with borderline personality disorder and people who do not have this illness. Some research suggests that brain areas involved in emotional responses become overactive in people with borderline personality disorder when they perform tasks that they perceive as negative. People with the disorder also show less activity in areas of the brain that help control emotions and aggressive impulses and allow people to understand the context of a situation. These findings may help explain the unstable and sometimes explosive moods characteristic of borderline personality disorder.

Another study showed that, when looking at emotionally negative pictures, people with borderline personality disorder used different areas of the brain than people without the disorder. Those with the illness tended to use brain areas related to reflexive actions and alertness, which may explain the tendency to act impulsively on emotional cues.

These findings could inform efforts to develop more specific tests to diagnose borderline personality disorder.

Nowinski argues that MBPD goes back to childhood abandonment. But then the National Institute of Mental Health suggests that the disorder is genetic and inherited:

Studies on twins with borderline personality disorder suggest that the illness is strongly inherited. Another study shows that a person can inherit his or her temperament and specific personality traits, particularly impulsiveness and aggression. Scientists are studying genes that help regulate emotions and impulse control for possible links to the disorder.

So which is it–does it have a biological basis or is it from abandonment? If it has a biological basis, are drugs effective? If Nowinski argues that MBPD has environmental roots (this is my impression), he should at least mention the other viewpoints. After all, I think it must be safe for me to assume that Hard to Love and the National Institute of Mental Health are talking about the same disorder?

What Nowinski is good at is telling stories of the difficulties people with MBPD go through in their day to day lives. People with MBPD find it difficult in relationships to give the other person the benefit of the doubt: they automatically assume the worse about themselves and others. The book opened my eyes to how it would be difficult to live like this. So, to my friend and all the others out there suffering from MBPD, keep fighting the good fight!

Until next time, I’m Edwin Wong, and I’m Doing Melpomene’s Work.

Preface Released to Beta Readers

After a flurry of last minute activity, the preface has gone out to the eight brave beta readers last Friday. It’s a bit of a milestone as now, for the first time *drum roll* Paying Melpomene’s Price has GONE PUBLIC! If you haven’t received it yet, the spam filter might have put it into junk mail. Well…it might be junk but I’d rather the beta readers tell me than the spam filter!

Here’s the little blurb that went out with it. Thanks to MR and MA for ideas and suggestions on putting the blurb together:

Brave Beta Readers,
This is it! The preface of Paying Melpomene’s Price is attached. Two identical versions: a Microsoft Word document and a PDF. You can either comment right on the Word document (use a big font or colour) or markup the PDF with Adobe Acrobat. Alternately, you can comment in return email by citing page and paragraph (e.g. page 2, the paragraph that starts with ‘Two and a half…’). I can also deliver hard copies to those wanting to go that route! All sorts of options, use the easiest!
This is what I’m looking for: 1) parts you like (I should do more of this), 2) parts you don’t like (I should do less of it), 3) parts you understand (I should do more of this), and 4) parts that are difficult to understand (I should rewrite). Here’s a set of symbols:
Parts you like, put a checkmark
Parts you don’t like, put a frown
Parts you understand, write a capital U
Parts that are hard to understand, write a ?
Don’t worry about grammar and spelling. Those things will be caught down the line. Go with initial reactions. Right now, I’m most concerned with people’s reactions: what they like and what they don’t like. Don’t worry about offending me! Now’s the time that honesty is appreciated. Better to fix things now than later! There’s eight beta readers, so it’ll be interesting to see if some kind of consensus forms. I’m betting it will.
No rush. If things get busy, wait for the next instalment to come out (one per month, eight more sections). BIG thanks to everyone for participating!
Enjoy!
Edwin Wong
Writer – Doing Melpomene’s Work

It’ll be interesting to see if a consensus forms between the eight beta readers. Will they like/dislike the same things? It’s a diverse crowd of beta readers: artists, graphic designers, a doctor, a restauranteur, an academic coordinator, and some self-employed business people. No one (as far as I can tell) with a professional theatre background. That might be a good thing. One person moonlights as a bona fide editor (has edited articles for Science and Nature). Ages range from thirties to sixties. Three women and a five men. A good mix.

The preface is eight pages long. Before rewriting, it was ten pages long. Another page or two can probably get deleted somewhere down the line. But it’s as good as I can get it right now. After sending it out, I was curious: how long would it take to read eight pages? I timed myself reading it in 17 minutes. But that’s sort of cheating as I’m reading my own thoughts. For other people to read it maybe it would take 25-30 minutes? If you’re making notes on the page as you go along, that might add another fifteen minutes. So maybe 45 minutes or so?

Another things: Microsoft Word pages (and PDFs made from Word) are longer than book pages. I counted up how many words there are in several softcover academic type works and compared them with the word count in the preface. Word counts in books vary according to spacing, font, and page size. But it seems like you can convert Microsoft Word pages into average book pages by dividing by 0.6. So, eight pages of the preface in Word = 13.33 book pages (8 / 0.6 = 13.33).

Until next time, I’m Edwin Wong and I’m glad there are brave beta readers out there Doing Melpomene’s Work.