Posted by Quintal on August 9, 2008, at 19:22:54
We spent most of yesterday's session covering this area. She doesn't think I have any sort of autistic spectrum disorder either, but I disagree on both counts. Most of this centers on why I feel so detached from people and disorientated in social situations. I feel there's an underlying problem besides the avoidance because whenever the avoidance is no longer a problem other factors have come into play. This seems to me to be mostly down to poor social skills (lack of reciprocity in particular) and unstable/stormy relationships with others and wildly fluctuating changes in self perception.
I have been diagnosed with BPD by my former psychiatrist, who I had a lot of conflict with. T agrees that this might have been a punishment and a warning to other doctors that I am a difficult patient, but nevertheless there is a great deal of truth in it which she refuses to see. If she really believes this was a misdiagnosis I hope she will write to my GP and ask for that to be removed from the list of current diagnoses. Anyway, we had a bit of a debate about this so she went next door and got a book on personality disorders so we could look at the diagnostic criteria together. I thought I met most of the them, and where I didn't I think it's because I've learnt skills to control certain behaviours, yet still had the urges (for example suicidal gestures and self injury).
The only thing I felt didn't apply to me was the fear and frantic efforts to avoid real or perceived abandonment. This is becuase I don't seem to be bothered about being left alone, indeed I prefer it, and this is something she's been trying to tackle. You can see from this post a few weeks ago that this isn't true - I do have problems with abandonment, but the difference betwen me and most borderlines (maybe the female borderlines who make up most of the population) is that I would rather be competely alone than face the constant risk of abandonment. http://www.dr-bob.org/babble/social/20080721/msgs/842788.html
I told her I'd ordered Marsha Lineham's DBT manual and it came today. I've read the introduction and the first few pages, and the thing that bothered me was that the therapy is primarily aimed at reducing suicidal and parasuicidal behaviour, and only in women. Lineham makes it clear that DBT has not been studied and proven effective for the needs of borderline men in the same way it has done for women. Despite the fact that women make up over 80% of the borderline population I felt this was a bit sexist and was left feeling rejected.
T didn't think DBT was what I needed, but said she would be interested in what I thought of the DBT manual. She thinks I need to work on my avoidance behaviours, whch I am, but we seem to be going round in circles because this borderline/autistic stuff keeps getting in the way. She thinks this is just a way for me to avoid tackling my avoidance behaviours, so I feel trapped, a bit like I did with my pdoc who didn't believe I had bipolar disorder or social anxiety. It took a psychotic episode to prove him wrong, and I don't want to end up having to prove my borderline traits by having a similar outburst. With the autistic/Asperger's thing I think I've developed such good coping skills that it's not obvious to anyone I meet in a professional, structured setting, but it is painfully obvious to myself and others in open-ended social settings.
Q
poster:Quintal
thread:845220
URL: http://www.dr-bob.org/babble/psycho/20080727/msgs/845220.html