![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 27 to 51 of 51. Go back in thread:
Posted by Racer on March 8, 2004, at 2:47:15
In reply to Re: It does help, but /MAY TRIGGER***, posted by terrics on March 7, 2004, at 15:20:08
Have you talked to your therapist or pdoc about this? I hate to sound like a Mom here, especially since I'm not one, but that does sound pretty dangerous to me. Wound care, if nothing else. I hate to think of how bad that must feel for you, and how frightening that must be for you.
Have you told your T about the new aspects of it? The first rule in veterinary medicine is that, when confronted by new behaviors, rule out any physical cause for them before assuming it's behavioral. That sounds pretty reasonable for human care, too, as far as I'm concerned. Rule out something like hormonal changes, or a subclinical infection, or something weird like maybe an inflammatory syndrome starting up.
You don't have to give any details at all, but are you aware of anything new in your life that might have triggered this change? More stress than usual? I guess what I'm asking is this: are you aware of what changed, whether you are ready to talk to your T about it yet or not?
Last, and this is one of those personal questions I can ask and you have no reason to answer if you don't want to, does your T ever talk about this as a behavior, rather than a dx? You know, talking about finding other outlets for the pain? I'm really just curious about what the current treatment is like, not asking for any details about you that you might not want to get into.
Best good luck to you.
Posted by emmaley on March 8, 2004, at 3:08:44
In reply to ???s about Borderline dx, posted by Racer on March 7, 2004, at 13:10:24
Somehow, this thread brings back memories of watching the film, "The Hours," when Virginia Woolf (Nicole Kidman) said the following lines in a scene where her husband Leonard was so desperate for her to follow the doctors' prescriptions of staying in the countryside when she wished to return to London:
Leonard Woolf: If I didn't know you better I'd call this ingratitude.
Virginia Woolf: I am ungrateful? You call ME ungrateful? My life has been stolen from me. I'm living in a town I have no wish to live in... I'm living a life I have no wish to live... How did this happen? I'm dying in this town.
Leonard Woolf: If you were thinking clearly, Virginia, you would recall it was London that brought you low.
Virginia Woolf: If I were thinking clearly? If I were thinking clearly?
Leonard Woolf: We brought you to Richmond to give you peace.
Virginia Woolf: "If I were thinking clearly, Leonard, I would tell you that I wrestle alone in the dark, in the deep dark, and that only I can know. Only I can understand my condition. You live with the threat, you tell me you live with the threat of my extinction. Leonard, I live with it too. "
"This is my right; it is the right of every human being. I choose not the suffocating anesthetic of the suburbs, but the violent jolt of the Capital, that is my choice. The meanest patient, yes, even the very lowest is allowed some say in the matter of her own prescription. Thereby she defines her humanity."This scene at the train station always gets me. I always weep uncontrollably for it is so beautifully said, and with such courage. For some reason, it always pulls at my deepest core.
Should the client not have some say in the matter of their own prescription?
I am not great at diagnosing. I see the necessity for its existence and the potential benefits and harms. It's something that I struggle with still.
Posted by emmaley on March 8, 2004, at 3:28:12
In reply to Re: It does help, but /MAY TRIGGER***, posted by terrics on March 7, 2004, at 15:20:08
I want to really support what Racer, Dinah, and noa posted, terrics, and I want to support you. Like Racer asked, have you discussed this new development with your therapist? I so wish that you travel this path with loving companions that can support you, instead of feeling alone.
Take gentle care,
Posted by fallsfall on March 8, 2004, at 7:10:36
In reply to Re: ???s about Borderline dx, posted by emmaley on March 8, 2004, at 3:08:44
I just saw "The Hours" for the first time this week. Unfortunately, I couldn't watch it straight through as the phone kept ringing and I ended up needing to finish it the next day.
I also liked that scene. Mental Illness does not mean that we have no valid thoughts; it does not mean that we have no preferences.
Posted by gardenergirl on March 8, 2004, at 10:18:52
In reply to It does help, but brings up another ?? » gardenergirl, posted by Racer on March 7, 2004, at 14:03:00
>
> I guess I wonder what you believe about the validity of the diagnosis? If you think it's over or under reported? If it really is being used inappropriately by doctors as a way of avoiding difficult patients?I think there are some who use the term as a derogative name for people, like your pdoc threatened. I do think it's a valid diagnosis, although like Dinah, I think it seems to fit better under mood disorders than personality or characterological disorders. I'm not really sure if it is under or over reported. No data to go on in my head.
And can you tell me more about it in general? (I guess I'm looking for reassurance here, like "that doctor was not right, because a) you don't fit the dx, and/or b) BPD means [x], it does not mean that there's no hope for patients who fit the diagnostic criteria."
Here is a site that gives info about BPD. http://www.bpd.net.nz/dsm.html
It lists the DSM-IV criteria among other things. I would not presume to try to affirm or deny such a difficult to make dx for someone here, but you might be able to do that for yourself when you read the criteria.The reassuring thing is that even if you do fit the criteria, that does not mean there is no hope for you. Haven't you made progress already in therapy? Besides DBT and psychodynamic therapies have shown to be effective with people with BPD.
Someone earlier posted about feeling like DBT only went so far, and that psychodynamic is better now. I wonder if the program she was in takes DBT through all four stages? The first stage is very crisis and problem solving oriented. This is usually when skills training happens. Once the person is stronger and is utilizing skills effectively to prevent the more troubling symptoms, stage two then focuses on trauma and emotional processing. I'm guessing a lot of programs just provide stage one stuff. Three and four move towards actual happiness and self-esteem. A lot of therapies do not go that far.
> Thanks GG! Them's part of my initials, did you know that? My husband's initials, too! Must be why we 'click', huh? Just the initials, nothing else needed...Cool!
gg
Posted by Crooked Heart on March 8, 2004, at 11:12:33
In reply to Re: It does help, but /MAY TRIGGER***, posted by terrics on March 7, 2004, at 15:20:08
Hi terrics
When you start DBT at the end of March, will you be stopping seeing your present therapist? I know from what you've said in other threads that she has crossed boundaries, she has dumped her stuff on you, but also last week she gave you some very practical and helpful advice. I just wonder whether the prospect of finishing with a therapist, even one who has forgotten that it's her job 'to mind the store', not the patient's, well I wonder if that has something to do with the desire to cut deeper?
Would it help to see a pdoc or even a family doctor if it feels as though things are getting out of control?
Just suggestions, I don't know if they're any help.
Please take care and keep posting. Thinking of you. ((((terrics))))
Posted by fallsfall on March 8, 2004, at 15:38:38
In reply to Re: It does help, but brings up another ?? » Racer, posted by gardenergirl on March 8, 2004, at 10:18:52
I'm the one who switched from DBT/CBT to Psychodynamic therapy.
I was in CBT for a year before I went into one 6 month DBT skills training class. My CBT therapist went to the therapist's meetings during those 6 months, but she is not trained in DBT (she bought and read Linehan's books). I am atypically borderline, so during the class I was able to attend to most of the sessions and complete most of the homework. So, I would say that I was mostly out of the crisis phase during skills training.
I stayed with the same CBT therapist for an additional 7 years. I had neglect, but not trauma, in my childhood. So the work I have to do is more related to general views and feelings, rather than processing specific traumatic events. I became frustrated with CBT because it felt like we were skimming the surface - learning how to deal with symptoms and collecting more coping skills, but that those things only covered up the pain. I asked my therapist at least twice to help me go deeper. The first time she said that she really wasn't trained to do that, nor did she "believe" in it. The second time she did try - but it was very clear that she was completely uncomfortable with the whole thing. So I dropped it quickly.
I guess that my assessment of the 4 stages in DBT is that I couldn't get past stage 2. I was able to return to work for 2 years (after a 5 year disability), but I still considered myself to be depressed, and after the two years I crashed again and have been disabled for an additional 2 years.
I did agree with the diagnosis when I received it (8 years ago). Since then I have made some progress and there are times when I think that I don't quite meet the requirements any more (but there are also times when I do...).
Posted by terrics on March 8, 2004, at 21:10:44
In reply to Re: It does help, but /MAY TRIGGER*** » terrics, posted by Racer on March 8, 2004, at 2:47:15
T completely ignores anything to do with SI. I think she thinks ignoring it will diminish the behavior. She does not think I am a true borderline, that was someone else who dxd bpd, a very cruel human being. My current T. did ask if SI was esculating. I will talk to her about it Wed.
Yes there is a big stress in my life. I will tell it soon. It is nothing horrible, just difficult for me. Thanks for your concern. terrics
Posted by terrics on March 8, 2004, at 21:13:45
In reply to Re: It does help, but /MAY TRIGGER*** » terrics, posted by Crooked Heart on March 8, 2004, at 11:12:33
Posted by terrics on March 8, 2004, at 21:15:02
In reply to Re: It does help, but /MAY TRIGGER*** » terrics, posted by emmaley on March 8, 2004, at 3:28:12
Posted by gardenergirl on March 9, 2004, at 15:34:38
In reply to Re: It does help, but brings up another ?? » gardenergirl, posted by fallsfall on March 8, 2004, at 15:38:38
Thanks for sharing more of your experience. Actually, my experiences with DBT also come from reading the book and my Behavior Therapy class. I am not formally trained in DBT. But I use many of the principles with a number of clients as I really like the approach. I agree with how CBT only seems to skim the surface. Very helpful for developing skills, but not at getting at pain. Glad you are working with someone who is trained in this and obviously more comfortable with it.
Also, thanks for clarifying about trauma. My post seems to suggest that all people with BPD have had trauma, and I know that's not true. I guess I was being sloppy. Certainly many have inner pain, as do those without the dx. Again, glad that your T is a good fit for you.
Take care!
gg
Posted by noa on March 9, 2004, at 17:56:40
In reply to Re: ???s about Borderline dx » noa, posted by Apperceptor on March 7, 2004, at 21:05:28
Why, thank you, m'dear! That means a lot to me, especially coming from you--a doc in training.
See---maybe it's true what my previous therapist told me once about having learned most of what he knows about being a therapist from his patients!
I learned this philosophy from two very caring (consecutive) therapists who never made me feel like a diagnosis, only like a person needing understanding and dignity.
Posted by noa on March 9, 2004, at 18:05:32
In reply to Re: It does help, but /MAY TRIGGER*** » Racer, posted by terrics on March 8, 2004, at 21:10:44
I hope you'll be able to discuss the SI directly with the therapist. It is definitely an issue especially right now. You're right--ignoring it isn't going to make it go away. And you are describing urges that do sound dangerous to me, as other people have mentioned. If there is something going on right now in your life that is adding stress to stir up the SI urges, I hope you can address this with your therapist. Maybe you need some extra supports in place right now?
And I have found that for me, it isn't necessary for a stressor to be proportional to my reaction to it. There are ways that little stressors can trigger for me deep and old feelings way beyond what I would expect.
Posted by noa on March 9, 2004, at 18:11:32
In reply to Re: It does help, but /MAY TRIGGER*** » Racer, posted by terrics on March 8, 2004, at 21:10:44
I forgot to say--
I think the reason sometimes I have strong reactions to stresses that seem proportionally smaller than my reaction has something to do with the meaning of the stressor, which I am not usually aware of immediately until I can dissect it with my therapist. Sometimes some thing will trigger a reaction because it connects somewhere below the surface to some memory or experience I've had that I either haven't thought about in a long while or don't think of as particularly difficult until this kind of little moment in time triggers feelings about it.
Anyway, the first important thing is that you be safe, OK?
Posted by terrics on March 9, 2004, at 20:26:45
In reply to Re: It does help, but /MAY TRIGGER*** » terrics, posted by noa on March 9, 2004, at 18:05:32
Posted by gardenergirl on March 9, 2004, at 23:34:53
In reply to Re: It does help, but /MAY TRIGGER*thanks** (nm) » noa, posted by terrics on March 9, 2004, at 20:26:45
Terrics,
Let me add my support, belatedly to the other posts. I'm concerned about you. I hope this is something you can talk about in therapy. It sounds like you must be feeling pretty low. Babblers are all here for you, and we all care about you. Please take some support and ease in that.You are in my thoughts and prayers,
gg
Posted by terrics on March 10, 2004, at 19:08:48
In reply to Re: It does help, but /MAY TRIGGER*thanks** » terrics, posted by gardenergirl on March 9, 2004, at 23:34:53
Thank you too. I am not really horribly low, but I am very angry about something that I cannot fix right now.
T. does not like to talk about the cutting, but she will let me talk about the anger and what is causing it. Although I did not tell her today.
She has changed her method and instead of psychoanalytical she is now doing cognitive-behavioral. For years we did the psychoanalysis and I got worse. This is a good switch, I think.
I really appreciate the support here. terrics
Posted by pegasus on March 11, 2004, at 10:56:58
In reply to Re: It does help, but /MAY TRIGGER*thanks** » gardenergirl, posted by terrics on March 10, 2004, at 19:08:48
Hi terrics,
I'm a little confused about how your T can be doing CBT without letting you talk about your SI. My understanding of the cognitive side of CBT is that you would examine the thoughts behind the feelings. So, using a cognitive-behavioral approach to treating SI would - I thought - require examining the thoughts that you have that are related to the SI. And I'm not sure how you can discuss those without discussing the SI itself. Because, if you're like me, you probably have some thoughts going on while you are injuring yourself. I talk about those thoughts, as much as I can, with my T, and that seems like a critical part of my therapy. I mean, there's a lot of shame and self hatred, and anger, and feeling abandoned, etc., and it comes out as SI. Figuring that out has been super helpful for me. I feel bad for you that your T won't let you talk about that big big part of your experience. Maybe I'm misunderstanding?
I just wanted to let you know that other Ts handle this differently. My T is thrilled whenever I talk about SI, because I have a lot of shame, and tend to keep it very secret in my life, and avoid talking about it during therapy. Maybe you are different, and your T has a theory about why *not* talking about it in your case is a better approach. Maybe you could ask her what that theory is, so you can feel less neglected and denied about this in therapy. If she does explain it, I'd like to hear what she says.
- p
Posted by terrics on March 11, 2004, at 20:30:52
In reply to Re: It does help, but /MAY TRIGGER*thanks** » terrics, posted by pegasus on March 11, 2004, at 10:56:58
Hi, if you want to scroll down Racer asked me about SI. I think it explains where my therapist stands. I am aware of why I do it. I guess the trick is finding a way to stop. My personal opinion is that for me talking about it will not help. terrics
Posted by pegasus on March 11, 2004, at 23:02:03
In reply to Re: It does help, but /MAY TRIGGER*thanks** » pegasus, posted by terrics on March 11, 2004, at 20:30:52
OK, sorry, I got the impression that you didn't like your T's strategy of not letting you talk about the SI. Sounds like you are agreeing that talking about it wouldn't be helpful to you, so I was wrong. Maybe that was me projecting.
Can I point out, though, that if your T's idea is that you are doing it to seek attention (which, by the way, is what I always dread people would think about my SI, and it would freak me out if my T thought that - but that's me), it sounds like she's maybe off base a little there. You did say that you are doing it more and more seriously now, and you aren't getting any attention for that in therapy, right? Because you can't even talk about it. Plus, you said you keep the secret very well, so I assume you aren't getting attention from anyone else about this either. So, then how could it be an attention getting thing? Maybe I'm still not getting it. Sorry.
The other thing that is still niggle at me about this is that your SI is obviously a big deal to you, and a concern. Just based on the fact that you've brought it up here on babble. So, I'm always a little confused when a T wouldn't want someone to talk about something that's a big deal in their life. I don't mean to be slamming your T. Maybe it's just a theoretical orientation that I'm not familiar with. You don't have to explain if you don't want to. I just wanted to share with you that it's confusing to me when I look at it on the surface anyway. And please feel free to do whatever you want with my opinion. I just mean to offer you another point of view, in case that's valuable to you.
- p
Posted by terrics on March 12, 2004, at 14:51:03
In reply to Re: It does help, but /MAY TRIGGER*thanks** » terrics, posted by pegasus on March 11, 2004, at 23:02:03
Hi Pegasus, I posted it that day because it IS getting worse. Why bother discussing it? I still do not think it will make a difference. The Babblers are anonymous so I feel free to say how things really are. SI makes me feel real at least,so I do not want to give it up until I am better. Maybe by then I'll be able to do surgery. LOL terrics
Posted by pegasus on March 12, 2004, at 18:13:34
In reply to Re: It does help, but /MAY TRIGGER*thanks** » pegasus, posted by terrics on March 12, 2004, at 14:51:03
Oh, terrics, it makes me so sad to hear you say that. I don't want to give my SI up either, so I definitely am not saying that I think you should give up yours. I guess I am just trying to articulate that talking about my SI has been part of my healing process. I don't do it as much as I used to, and I think it's because someone is finally listening to me try to sorth through what it means to me, and to care about that part of my pain. I'm sad to hear about you not having that type of support.
But again, maybe you don't want that, and I'm just projecting. Maybe it's all different for you. I know a lot of people SI for really different reasons. And if it's helping you cope with stuff that otherwise might lead to into even more serious trouble, then it's working for you on at least some level, right? It's just such a sad and hurtful way to cope, and I hope that one day you and I and all the babblers who SI will find a more self-supportive way.
- p
Posted by terrics on March 13, 2004, at 10:37:08
In reply to Re: It does help, but /MAY TRIGGER*thanks** » terrics, posted by pegasus on March 12, 2004, at 18:13:34
It surprises me how many SI. I think the underlying reasons for doing it are probably similar, but are expressed differently. Either way it is sad. I really think DBT will help me and I am hoping that I will stop without forcing the issue.
I am tired of being me and I am tired of the difficulty I have in LIVING. I hope I can change with help cause I haven't been able to without help. It is good you are decreasing the SI. Keep it up. terrics
Posted by Crooked Heart on March 14, 2004, at 4:48:23
In reply to Re: It does help, but /MAY TRIGGER*thanks** » pegasus, posted by terrics on March 13, 2004, at 10:37:08
Hi terrics
You said you were surprised how many SI. It's surprising me at the moment in 'off-internet' life. Maybe it's becoming more OK to talk about it, thank goodness, at least that's something.
I hope the DBT does help.
Thinking of you. ((((terrics))))
ch
Posted by terrics on March 14, 2004, at 9:56:17
In reply to Re: It does help, but /MAY TRIGGER*thanks** » terrics, posted by Crooked Heart on March 14, 2004, at 4:48:23
I will let babble know if I think DBT is worth it. Thank you for the encouragement. terrics
This is the end of the thread.
Psycho-Babble Psychology | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.