[dancinglady]

I have been in this forum for 2 years now and every time I am here I read the posts of suffering people over and over from the same people. Almost every person is seeing a pDoc, therapist, case manager, or mental health worker. I am curious if therapy is effective why is the suffering still here. I know what the mental health workers say "this patient is at fault". This gets rid of their guilt of doing an ineffective job or they are just not suited for this type of work. An example I have a church member who wants to be a counselor. God help her clients. She is not able to do this work. I wonder if DocJohn is doing a study to evaluate therapy effectiveness by utilizing everyone's posts and publishes the results.
People like me have been in therapy for years. Am I just a long range paycheck. Do these professionals have the ability to help us really? I know I have busted my butt all these years and it is not my fault because I can say I have worked extremely hard.

If you think your current therapy is not effective, another one I have heard about that is effective for BPD is DBT. I do not know much about it. Hopefully someone else can elaborate on therapies that are good for BPD.

[kamikazebaby]

Therapist I saw on Monday said if they couldn't help me or provide a good plan of action for me, they'd tell me that and send me to someone who could help me (in their opinion). HALLELUJAH. Too many therapists sit there taking your money when they are incapable of helping you.

[kamikazebaby]

Originally Posted by ChaoticInsanity

If you think your current therapy is not effective, another one I have heard about that is effective for BPD is DBT. I do not know much about it. Hopefully someone else can elaborate on therapies that are good for BPD.

I was just talking about this last night. DBT is helpful, certainly, but it is by no means a magic bullet. Just a corner of the puzzle. They always like to make it sound like it's all any person with BPD would ever need. NOPE.

[sabby]

I wonder if DocJohn is doing a study to evaluate therapy effectiveness by utilizing everyone's posts and publishes the results.

Unfortunately, I cannot give any response to the rest of your post, but for the quoted part I can tell you that DocJohn does not do any research on anyone's posts here at PC.

Our guidelines do not allow any research by anyone and DocJohn follows that guideline as well.

These forums are primarily for mutual emotional support and information sharing. Advertisements, announcements, research requests or any type of research on the content of these forums are strictly prohibited. Unless otherwise noted, copyrights of individual messages are owned and retained by their original poster. Unauthorized use or reproduction of any material found on these forums is strictly prohibited without prior authorization of the copyright holder.

[Crazy Hitch]

Hi Dancinglady,

This is a fascinating post.

It's made me think.

Thank you for sharing.

[Phew, I'm a little relieved that my random posts aren't used for research purposes because my posts are so random ]

[Trippin2.0]

I would never want to be observed by anyone, let alone a therapist.

I'd feel like a zoo animal!


I've only had one year of therapy, but already I feel as if its helping, it feels as if I'll be able to reach my goals eventually.


I could never do therapy that wasn't goal orientated. I have specific outcomes I seek from therapy. The therapist is there to help me plan and also guide me through it.


Yes I obviously spew my guts if I'm upset during session, but I don't schedule sessions for a pair of ears, that would be a waste of time for me as I have many ears willing to listen to me rant and rave and cry.


My point, sorry I was getting to it...


Maybe its not so much that either of you are doing it wrong, but that the mode of therapy is not best suited to your needs. I would strongly suggest discussing therapeutic options with your T and see if the two of you can find a solution to your dilemma.

[BlueWhisky]

Oh to be in therapy. Sadly right now my BPD doesn't seem to let me earn enough money to get the chance to see if DBT would work.

I will tell you that I've been in therapy on and off for 20+ years and I decided over a year ago to quit indefinitely. For me (I stress that this is my situation and my opinion only), I didn't feel that it was getting to the root of the problem which are the core beliefs I have about myself and life. How could it? You'd have to go back and completely rewrite the fundamental things I learned from my mother (and subsequently the rest of the world, given her template) about who I am, my value, and my worth. And you can't do that. When I initially quit I was at a point where I was depressed, nothing was helping, I was frustrated, my T was frustrated, I could tell she dreaded seeing me, and I was like, "I am wasting money here. I'm done." And I do believe I am better for it. Honestly...I feel like most of my T's dreaded working with me once the BPD diagnosis was in effect. I literally had three T's either fire me or hand me off to another T once they determined I was borderline. Awesome. Great for the trust issues.

I don't believe it was all a waste of time. Over 20+ years, I'm sure I learned things that are so ingrained that I don't even know I got them from therapy, and there are other things that I consciously took from my interactions with various T's (or from my time(s) inpatient). Of course, now that I'm thinking about it, I can't name a one of those things. But they're there .

I think that it's just more work for some of us. And of course you have to be willing to change and to do work yourself, and maybe that's where my problem lies; maybe there's a part of me that is resistant and closed off. In fact, I know there is. I think that, for those of us with serious mental illnesses/personality disorders, if you're able to do so, therapy is a necessity. Just like insulin is for a diabetic. I know that I will try again. But I believe that I need to be ready to do so and in a good, healthy place when I start therapy instead of in crisis mode like I usually am when I start to see a new therapist.

[freespirit37]

Personality disorders are very hard to treat. There is no effective medication for BPD. It's not like Bipolar disorder where you can take your meds and be normal.

I asked my doctor once, "Will this ever go away?" He replied that I would always have interpersonal problems because of my borderline personality traits but that by learning the skills, I can manage it.

Just going to therapy doesn't necessarily help. We have to take an active role in our recovery, by doing homework, practicing the skills, etc.

[freespirit37]

Originally Posted by kamikazebaby

I was just talking about this last night. DBT is helpful, certainly, but it is by no means a magic bullet. Just a corner of the puzzle. They always like to make it sound like it's all any person with BPD would ever need. NOPE.

There is no magic bullet. DBT works if you practice the skills regularly. It takes a lot of work.

[freespirit37]

Originally Posted by misskeena

Honestly...I feel like most of my T's dreaded working with me once the BPD diagnosis was in effect. I literally had three T's either fire me or hand me off to another T once they determined I was borderline. Awesome. Great for the trust issues.

Unfortunately, there is some stigma among some mental health professionals that BPD is untreatable and that borderlines are manipulative. Not all therapists believe that. I am very happy with the one that I have and we are dealing with core issues relating to trauma. It is opening a lot of wounds and causing me pain, but I am ready to face it now.

Originally Posted by freespirit37

I asked my doctor once, "Will this ever go away?" He replied that I would always have interpersonal problems because of my borderline personality traits but that by learning the skills, I can manage it.

That's disheartening. I knew that already but...*sigh* I was trying to pretend that it wasn't true, heh.

I honestly don't think the skills will work for me. I think there is too much damage. I know that sounds really negative (I'm sorry) but the issue I have is that I will do okay for a while, then something will happen to undermine my confidence and it's like kicking my legs right out from under me--I just get totally knocked over. I don't have a lot of offline support, honestly. That's kind of a big factor.

[freespirit37]

Maybe you could find a support group? I am in AA and also a therapy group for substance abuse and PTSD. Without these things I would be totally isolated and even worse.

[Dobby67]

Originally Posted by BlueWhisky

Oh to be in therapy. Sadly right now my BPD doesn't seem to let me earn enough money to get the chance to see if DBT would work.

Our BPD doesn't make us money, it causes us to lose our money making ability. My anger got me fired from a job I had for 12 years. I still haven't gotten a new job and it's been 3 years. I can't go to just any therapist, I have to deal with the one that is assigned to me. Which I don't know how that will go. But I have heard about a therapy call STEPPS. I read it on one of the post here.

Originally Posted by freespirit37

Maybe you could find a support group? I am in AA and also a therapy group for substance abuse and PTSD. Without these things I would be totally isolated and even worse.

Between full-time school and part-time work I don't have time in my life right now, unfortunately. Maybe after I graduate in October. I plan on getting back to therapy or doing something once life slows down a little (though honestly, I have to go back for my bachelor's to keep a job so idk when that will happen). I'm not opposed to it, just don't have time.

[kamikazebaby]

Originally Posted by freespirit37

There is no magic bullet. DBT works if you practice the skills regularly. It takes a lot of work.

Yeah, that's pretty much what I said. But DBT isn't the only thing you need. I know it takes a lot of work.

[bpdtransformation]

Yes, my experience is that psychotherapy for BPD can be very effective. I was fortunate to be able to do twice a week therapy for several years, and I've recovered to the point where I function and feel well most of the time; I don't have BPD anymore.

My favorite type of therapy is psychodynamic / psychoanalytically-informed therapy. Transference Focused Therapy would be one example of that.

Another good intensive therapy for BPD is schema therapy.

There's some data here on how effective they can be. It's pretty encouraging if you read through it closely and understand the charts.

JAMA Network | JAMA Psychiatry | Outpatient Psychotherapy for Borderline Personality Disorder: Randomized Trial of Schema-Focused Therapy vs Transference-Focused Psychotherapy

[dancinglady]

I have been in both and it was ineffective in fact damaging to me. Every BPD is somewhat different and so what works for one does not work for others. I was traumatized when my therapist FIRED me on the spot one day.

I am happy that it worked for you. You must be young, these therapies are very effective if you are young when you start. I was an old lady when I started. I had been in therapy for over 25 years before I started.

[dancinglady]

Originally Posted by bpdtransformation

Yes, my experience is that psychotherapy for BPD can be very effective. I was fortunate to be able to do twice a week therapy for several years, and I've recovered to the point where I function and feel well most of the time; I don't have BPD anymore.

My favorite type of therapy is psychodynamic / psychoanalytically-informed therapy. Transference Focused Therapy would be one example of that.

Another good intensive therapy for BPD is schema therapy.

There's some data here on how effective they can be. It's pretty encouraging if you read through it closely and understand the charts.

JAMA Network | JAMA Psychiatry | Outpatient Psychotherapy for Borderline Personality Disorder: *Randomized Trial of Schema-Focused Therapy vs Transference-Focused Psychotherapy

You are so lucky. They caught your disease early so you had a much better chance of the therapy being effective. You must have had a really good trained therapist (cream of the crop) who did not run away from a person with BPD. I think BPD is milder in men because of the limited use of the emotions.

[bpdtransformation]

Thanks dancinglady... sorry to hear your therapist "fired" you. That doesn't sound at all fair! I hope you have been able to find someone better since then.

Your response makes me think of a few things associated with the medical model of mental illness. I have a couple of critiques; don't take these the wrong way:

1) I wouldn't say BPD is milder in men; it depends on the person. One could just as easily argue that men are less verbal, so have less ability to talk out their problems or form a therapeutic relationship. But I don't think that would be a valid argument either.
2) I've read about older borderlines who've done very well in therapy. Just because you're "old" when you start, it doesn't mean you can't do well. It's a matter of getting the right quality and quantity of emotional support that a person needs. People can start moving in the right direction at any age. I'm not trying to be unrealistically optimistic ; getting better is hard work, but it's possible at any age.
3) As for BPD being a "disease", I wouldn't say it has the validity or reliability necessary to be considered a medical illness. For me it's more helpful to think of BPD as representing a vague spectrum of severe problems in handling relationships and adaptation to the world. That's different from thinking of it as "a disease," less concrete and pessimistic, although I understand you may not have intended it negatively. I hope that makes sense.

[dancinglady]

1) well taken. I had read there are fewer men with BPD.
2) what publications show this in a clinical supervised research study
3) I have never had emotional, physical or spiritual support. I have no friends not that I have not tried. But people stay away from me even with all the changes I had to make. I was a tormented teased and bullied for 13 years.
4) The issue with older and not getting proper treatment (in therapy for 34 years with ineffective, unprofessional therapists) unlike a younger person I have 40 years of flashbacks, nightmares, regrets and memories that involuntarily come into my brain every hour. I could go on but I think I have stated my opinion. I hope you don't take it the wrong way.
5) this is more for the insurance companies. If you don't do it their way you don't get paid as a doctor. Insurance companies RULE the medical world. I worked in healthcare for 12 years.

[bpdtransformation]

Hi Dancing Lady,

Thanks for your response; I think I understand your points. Of course I don't take your opinion the wrong way.
Sorry things are still very difficult - I know from my own experience it can be so difficult to stay positive and hope you will not give up!

About older "borderline" people doing well, there is not going to be much scientific data on this, mainly because it is not an issue that's going to get much funding (i.e. not that many people want to know "can older borderlines do as well as younger borderlines?"... most people with BPD are young when first treated, anyway.)

My opinion came from what I consider common sense; I don't mean that the wrong way. For one thing I've seen my mother, who had severe borderline traits (never diagnosed, but she probably could have been) and was married to a physically abusive man for 30 years, go to therapy, decide to leave my father, get her Master's, work a full time job for the first time after age 50, and find a new better relationship with a much better man. For another thing I've read long treatment accounts of older "borderlines" recovering, in books by the writer Lawrence Hedges (In Search of the Lost Mother of Infancy), Jeffrey Seinfeld (The Bad Object), and a couple of others. Common sense tells me that if with sufficient help they can recover, why can't any old borderline? :-)

But the bigger reason is, why couldn't older "borderlines" do as well as younger ones? All other things being equal, it might be "less likely" on a group level, but that is really meaningless and not how the world works IMO. What matters is whether a person can get good enough help, frequently enough, for long enough, to do what they want. If the sufficient conditions of support are present, anyone can do well. It doesn't make sense to me to say "older borderlines are less likely to get better", because any one of them could do well to different degrees.

The deeper problem with all of this is that BPD is simply not a valid or reliable syndrome (i.e. its traits are subjective, descriptive, based on researchers subjectively assessing when various observed traits reach a supposed "borderline" threshold of intensity or severity... this is impossible to do consistently/scientifically). So all research associated with BPD could be considered suspect on this basis alone. A lot of people don't appreciate how little actual science lies behind our current "mental illnesses". But to me that is a positive thing because it helped me to stop identifying with the label BPD.

[dancinglady]

You seem to be very knowledgeable. Are you now studying to be a therapist? Don't take this the wrong way - so if you don't ID what is with yiur name and y r u here? If you don't ID I would think you would go back to a normal existence and leave this all behind.

I think what I heard from your posts is everyone is different. Everyone has different parts of this. An example I do not do drugs, I don't self harm and except during really bad times I don't drink too a drunken state. I have recently but with my history it is a phase not an addiction. I have had it checked out by many people. I have not attempted suicide. I don't have random acts of sex with many lovers.
I had 13 straight years of bullying. I had a narcissist mother and an absent uncaring and unloving father. That is years of bad stuff. That takes time and $$$$$$$$$ to get over. I was a single widow with two disabled children that I still support. I could go on. I get you are young and have not lived a very long life so that limits your wisdom. When I was young there were onily two dx - bipolar and schizophrenia so when I was young there was no DSM anything and no treatment so yes NOW people are diagnosed and treated when they are young not then.
I hope I am not being too blunt and harsh with what I am saying. If you see that in the post I apologize.
You are right there is no interest in finding out if older BPDs get better we were the BAD patients for years. Do yourself a favor call your local psych ward as an experiment and act like you are trying to admit a suicidal 50 year old BPD and you will really get told how therapists SEE us. It is not pretty.

[bpdtransformation]

No I'm not a therapist; I work in a field far removed from psychology. I come here sometimes b/c I want to spread the message that BPD is "curable", medically inappropriate as that term is, and that one doesn't have to identify with BPD if one doesn't want to, because there really is no scientific backing behind the term. (Of course, if people want to label themselves as "borderline", I won't tell them not to do that, it's their choice). I was borderline for many years, so can readily relate to people that are dealing with different degrees of "borderline" symptoms now.

But, my opinion is that it's sad and harmful for many people when they're told that BPD is a mental "illness" they will inevitably have for life; that is simply not supported by evidence, and a stronger argument can be made that BPD (the "disorder", not the symptoms) is "curable" on the one hand, and "nonexistent" on the other.

That sounds paradoxical. When I say "noexistent", it doesn't at all mean that "borderline symptoms don't exist - of course they do, in innumerable degrees and varieties - it means, rather, that there is little evidence that BPD represents a syndrome, i.e. a grouping/pattern of symptoms occurring in people more frequently than would be expected by chance. It can be very difficult to see this, given how everyone is told by psychiatrists that "BPD" is a real medical illness. But the evidence for its validity and reliability, and thus its existence as an "illness", is shockingly weak. If it is used at all, BPD might be understood better as a symbolic, vague descriptive term resulting from the faulty medical model of psychiatry, rather than as a valid diagnosis or illness.

Another way of thinking about this is that there is no reliable/scientific way that "borderline" conditions can be separated reliably from less severe or more severe emotional problems. If you understand this lack of clear boundaries, a lot of the supposed science and theory behind BPD falls apart, again in my opinion.

Having said all this, the misinformation, stigma and confusion surrounding the BPD label will not get better, until there is a better alternative way of thinking about severe emotional problems. I'm interested therefore in discussing how so-called "borderline" conditions can be reconceptualized in a way that is optimistic, empathic, and hopeful... and also in a way that doesn't always use a "diagnosis" or label to explain suffering if people don't want it. In my opinion that might be best achieved by abandoning the notion of a "borderline disorder". But that would be a much longer discussion on a different topic. You can probably figure out by now why I have the name bpdtransformation.

I wrote more about these ideas here - https://bpdtransformation.wordpress....-bpd-debunked/