Category: Life worth living

Everyone has a unique sense of self that is shaped by our thoughts, feelings, memories and relationships. This self creates our individuality and sets us apart from everyone else. It is also the foundation upon which self-esteem is built. But what if our Self seems vague, elusive?

For some people (such as those with borderline personality disorder), finding a stable Self can be particularly challenging. But understanding how our brains work, and using specific strategies, can help us on this journey.

What is the Self? 

Here’s the boring scientific answer: the sum of all the physical and psychological (thinking, emotional, motivational, social) characteristics that make a person unique. 

To turn this phrase around, Self is about ….

• How do I see my body and what does it say about me? 
• How do I interpret the facts of my biography? What does my story say about the kind of person I am?
• How do I routinely react to external events? 
• What kinds of thoughts are typical of me? 
• What triggers my emotions and which ones?
• What drives me? What is important to me? What do I aspire to?
• How do I relate to others? 

And on and on.

If you have rushed to answer the above questions in the hope of finally understanding yourself, I have bad news for you. Having separate, scattered answers is not the same as having a firm inner certainty about who I am.

For random facts to be transformed into a coherent and beautiful self-image, they need to be sprinkled with “magic dust” (as in Peter Pan!). And the magic dust in this case is the process of self-awareness.

What does self-awareness consist of?

Self-awareness is a complex cognitive process in which we turn our attention inward, analyse, integrate and store information about ourselves, and identify with this ‘Self. 

If we try to break self-awareness down into the individual Lego pieces that make it up, we get:

• Consciousness. Simply put, awareness of what is going on inside and outside of us. Always present to some degree while we are awake, it usually comes with the package. 
• Metacognitive thinking.  This is the process of observing what you are thinking.The ability to notice and critically examine one’s own thoughts is no longer innate, but is specifically developed. 
• Autobiographical memory. This involves not only remembering past experiences, but also building relationships between different memories and how we manifested ourselves in them. Remembering your past experiences, as you might guess, is essential to having a stable view of your identity. 
• Self-reflection and mindfulness. This includes the ability to notice your emotions, physical sensations, behavioural responses, thought processes and how they all relate to each other.

A dash of neuroscience

The brain is conceptually divided into three parts: the reptilian (or lizard) brain, the limbic brain and the neocortex (i.e. the cerebral cortex). The reptilian brain is responsible for instinctive behaviour. The limbic system controls emotions. The neocortex is responsible for reasoning, introspection and awareness.

If we match the building blocks of our self-awareness to these parts, it’s clear that it’s the cortex – and its robust connections with other departments – that we need to understand ourselves.

The neocortex lags developmentally behind other parts of the brain, becoming a fully functional tool only between the ages of twenty and thirty. What does that mean? Well, it’s a relief if you’re under twenty: some of your difficulties in understanding yourself can easily (and rightly) be attributed to age and the rate of cortical development.

Let’s focus for a moment on autobiographical memory, which is seen as a proxy for identity integration. The posterior cingulate cortex and the left medial prefrontal cortex play a crucial role in its operation. Indeed, there are numerous articles on how these are the areas that may be underdeveloped or have developmental abnormalities in borderline personality disorder (BPD). The hippocampus and its surrounding areas are also important – and there are problems here too: in BPD, the connection between the cortex and the hippocampus are also affected. All in all, this means that people with borderline personality disorder have biologically based reasons for struggling to find themselves. 

But it’s not just people with BPD who can have problems. And it is possible to help yourself find your identity in any condition, including BPD.

Ideas: How to build your own Self

• Practice mindfulness. 

Meditation and informal mindfulness practices (being in the moment, being open and paying attention to sensations, thoughts and emotions) can help you develop an observant attitude and become more aware of what’s going on inside you. And the better and more often you notice what’s going on inside you, the more material you have for identity construction. 

• Develop metacognitive thinking. 

Noticing your own thoughts is taught in cognitive behavioural therapy, but you can do it to yourself. Analysing your own thought processes through observation and self-reflection can help you better understand how you arrive at decisions and reactions and, if you generalise, what drives you in general. 

• Improve autobiographical memory. 

Recording and reflecting on significant life events can strengthen your connection with these memories. This gives you the material to generalise and gradually integrate the many individual episodes into the self.

If something causes us worry and anxiety, we tend to avoid it. Afraid of public speaking? You may never agree to them for various reasons. Worried about going out with a friend? You could say you’re ill and not go. The more we avoid, the scarier it becomes the next time we do the same thing. So gradually, by giving in to the urge to avoid again and again, we reinforce our belief that the danger is serious. So, little by little, avoidance steals our space to live. This is what happens with PTSD, social anxiety, obsessive-compulsive disorder, panic disorder, phobias – and more.

What is the treatment in such cases? Exposure. 

Exposure therapy is a type of cognitive behavioural therapy (CBT). It helps people overcome anxiety by gradually exposing them to the things that make them anxious. This can be done in different ways:

• Imaginal Exposure. This is where we describe in detail and visualise what is terrifying (e.g. contracting a deadly virus in the case of OCD or a history of trauma in the case of PTSD). 
• In vivo exposure. It involves encountering a frightening object or situation in real life (this could be a trip to a doctor’s office or a small-talk with a colleague).
• Exposure using virtual reality. Using a VR helmet helps you to encounter frightening things in a safe and controlled environment (for example, being in the company of snakes or spiders).

Here is a simple example of exposure therapy in CBT:

A person with a fear of spiders (arachnophobia) might start by looking at pictures of spiders. Once he can do this without feeling too anxious, he might move on to watching videos of spiders. Finally, he may try to hold a spider in his hands.

The therapist provides support and guidance throughout the exposure process. 

Another example:

A person with a fear of public speaking might start by speaking in front of a mirror. If he can do this without too much anxiety, he may move on to speaking in front of one person. Eventually he may try speaking in front of a small group of people.

There are two types of exposure:

• Formal – when the therapist and client make a step-by-step plan of work.
• Informal – when we approach the frightening thing as the opportunity arises, without a plan made in advance. 

How can you use the exposure method on your own? 

There’s a cool term exposure lifestyle that means you: 

• The first thing you do is learn to notice how your fear and anxiety manifest. What do you usually feel in your body when you feel anxious? What do you usually start to do in those moments? Some make a phone call, some amuse the people around them, some go to the fridge and so on. What thoughts do you have when you’re anxious? 
• Practice noticing when some everyday things make you feel anxious or fearful.
• If the object or situation is safe, catch yourself wanting to avoid it – instead, approach it. 
• Repeat this at random moments, anywhere, anytime, as if your whole life is your training ground. 

For example, walking past the coffee shop and thinking, “It would be awkward to go there alone. And you catch yourself in that thought – you turn towards the cafe and go in for a latte. 

Exposure therapy is challenging and scary, but it’s very effective. And an exposure lifestyle can bring adventure, new stories and joy to your everyday life – from its courage.