Posted by fallsfall on March 7, 2004, at 16:21:08
In reply to ???s about Borderline dx, posted by Racer on March 7, 2004, at 13:10:24
I have been diagnosed Borderline, but I don't fit the typical model - I'm not impulsive, and I don't get angry (maybe NOT getting angry is my problem...). Terrics, I disagree that SI is the hallmark of Borderlines - I think that splitting is - black and white thinking. I do a lot of splitting.
When I was interviewing new therapists, I would walk into their office and say "I have depression and BPD - but I'm not really a typical BPD...". One reason I did this was because if a therapist was going to have problems dealing with someone who was "BPD", then I knew they couldn't handle me. I wanted to know right off the bat.
Racer, if you ever read Psych books that are written for therapists, I would highly recommend Linehan's book "Cognitive-Behavioral Treatment of Borderline Personality Disorder". There is also a skills training manual, "Skills Training Manual for Treating Borderline Personality Disorder". The skills training manual has a few chapters at the beginning that summarize what is in the book - so if you only want to read a little, you could start there. These books describe how Linehan believes BPD is often triggered by the environment, and really capture (at least for me) what it feels like to be borderline.
Like Dinah, I had an "ah-ha" moment reading Linehan's books. The therapy that she describes is called DBT - it is a variant of CBT. I think that DBT could be helpful to lots of people who aren't Borderline (though many DBT programs are limited to patients with BPD). I did 6 months of DBT skills training, and my CBT therapist was very interested in reading Linehan's books.
For me, however, DBT and CBT did not go far enough. They were helpful in getting me to a place where I had enough coping skills to stay out of the hospital most of the time (I've been in twice, once before the DBT, once five years after). But they left me frustrated that the *cause* of my anguish wasn't being addressed - I was just learning to live better in spite of it. I'm now in Psychodynamic therapy, which does seem more able to get to the causes. I don't know if I could have survived my current therapy if I didn't have the DBT/CBT stuff first.
I have heard that with patients who have similar behaviors, that women are diagnosed with BPD, while men are given Anti-Social Personality Disorder diagnoses. My understanding is that Anti-Social PD is as rare amoung women as BPD is among men.
My take is that a diagnosis is helpful only if it helps you or your therapist understand you better, and create a more effective treatment plan. I think that there are a significant number of experienced therapists who aren't scared by the BPD diagnosis, and those of us who have even some tendencies in that direction will do ourselves and the therapists of the world a favor if we find out who they are, and stay away from the "unenlightened".
poster:fallsfall
thread:321635
URL: http://www.dr-bob.org/babble/psycho/20040303/msgs/321685.html