Last edited Thu May 21, 2015, 07:08 AM - Edit history (1)
1 ) It's been one of the most difficult of the personality disorders to treat. That has consequences for how clinics will deal with you.
Without the self-harming behavior, it is sometimes a diagnosis of last resort. Under the criteria of the DMS-iv, it was, and I think still is, quite variable from one person to another... at one point while a therapist was expressing frustration about 'trying lots of things that work for other people' I did a quick back of the envelope estimate on possible combinations of presence and different ratings of each symptom's (the dx used to require have some 5 of 7 or 8 symptoms) contributions to dysfunction DSM-iv...it works out to hundreds of combinations. So, your BPD an my BPD may not look anything alike in terms of the symptoms we are most plagued by... Similarly, as you might expect, therapeautic approaches can vary greatly in effectiveness.
2) As you read you'll find out that general psych clinics find BPDs difficult. BPDs feel much distress and want help...much of it isn't effective. That's frustrating for everyone. It's not uncommon to get a referral to another clinic that is supposedly 'better suited' to your problem. Truth is, you can't fix BPD in 10 visits. Even if you get to a clinic that does DBT which is intensive for months (and thereby expensive) many people must repeat the therapy and skills training to get close to managing.
3) BPD is more common in women, people trained and running DBT programs usually have many more women in their skills group...this can be problematic for men. Many people with BPD have histories of abuse (possibly associated with childhood behavioral precursors of BPD), and the impulsive expression of fear, anxiety, and frustration common in all people with BPD, is often interpreted as ANGER when it comes from men, and it is seen as dangerous and inappropriate among women who are abuse victims. Consequently some clinics don't want BPD men in groups with DBT women.
4a) The self-help industry produces lots of books about how a non-Dx can live with people with dramatic, serious mental disorders...and that's true of BPD. Much of the advice about dealing with BPD is to RUN AWAY! BPDs often have tremendous anxiety around issues of abandonment and reponses of others that threaten relationship. So this sort of cheap readily available advice is very painful.
4b) Many friends, co-workers, bosses etc only know BPD through the internet. And they are familiar with posts that innumerate reasons why you should run away from a friend, coworker or employee with BPD. So discretion about what you say to 'others' about your diagnosis is really important.
5. Some folks in the psychiatric industry think BPD is largely a developmental disorder acquired as a consequence of emotion difficulties following neglectful, uneven parenting/family relationships or traumatic losses in very early childhood. The lasting damage from such events may be called narcissistic wounds by some psychiatrists. About the only thing worse for a person with relationship issues and anxiety/fear about abandonment than being told you are an untreatable pain in the ass with BPD, is to be told you are Americans most hated sort of self-centered pain in the ass...a narcissist.
While not every psychologist or psychiatrist gets into the narcissistic wound thing with BPD patients ... if yours does you shouldn't equate being told you have a narcissistic wound with being told you are a narcissist.
It mostly means you have a deep emotional 'scar' that is not only exquisitely sensitive to re-hurt but which makes you constantly watch for clues in others' behavior that they are about to or have hurt it. Inappropriately dealing with the chronic aches and pains of that wound is how some psychiatrists interpret much of the dysfunction of BPD.
Good luck.
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