Q. You have stated that you feel BPD is a chemical problem within the brain. Is this always the case? Is this also the same with HPD (Histrionic) And in how many cases does HPD accompany BPD? Also, do you feel it is possible that psychological problems that involve mutation in the brain, can be caused by subconscious signals from outside sources? Forgive my lack of vocabulary. What I mean in is much the same way stress in documented by the mind, is it possible that the signals causing the disturbance are not delt with and therefore over time and accumulation cause a mutation? If this is plausible, would it be correct to think that if the signals were noticed at an early age, could the patient be made to face and understand them, therefore avoiding the mutation?

  A. Good thoughts on the topic. The idea of an external stressor causing the illness (be it BPD or HPD) have been the theoretical crux of where these behaviors originate. There is no way that I know of to reverse the past, nor to alter how or if an individual is exposed to a traumatic event giving rise to the illness. In short, even if the theory is true, nothing can be done. More importantly, the theory is illogical. We do not do painful things over and over. We look for ways to avoid them. Cutting over and over makes little to no sense if it were not biological. People get pleasure from it or relief.

Histrionic PD may and probably is chemical. It is maladaptive, and likely would be changed if it were under volitional control.