[crosstobear]

So I have a class (I'm in clinical social work school) where we talked about paraphilias. My professor is a bit of a dogmatic person and explained that people with BPD personalities are prone to paraphilias.

Then she went off an a completely unprofessional tirade warning us about "borderlines". Seemed she had an axe to grind. Asked what they are characterized by. I raised my hand.

"Fears of abandonment. Black and white thinking. Splitting. Intense relationships. Alternating self-esteem. Dissociation and brief psychosis" and she said "No."

She went on to say BPD is characterized by "lack of conscience. Extreme self-centeredness. No empathy. Lying, manipulation, conning. Projection and blaming others. Guilt tripping." Then she went on to say "These people are bad people. Untreatable. I'm warning you all, save yourself the headache and don't treat them. They are a lost cause."

So I raised my hand again and asked her if she thinks there's a connection between paraphilias and Antisocial Personality Disorder, since she has made the connection with BPD (see what I'm setting her up for, here?)...

She said "Good you asked. You see- Borderline Personality Disorder used to be called Psychopathy. Then Sociopathy. Then Antisocial Personality Disorder. Now it's called Borderline Personality Disorder."

I interjected- "Beg to differ. The DSM-V, DSM-IV, DSM-III, indicate that they are mutually exclusive. Yes, they are both Cluster B. But one is about attachment, abandonment, neglect and trauma, while the other is about a lack of conscience and lack of emotional depth. Borderline and Antisocial are different, have different etiologies, different prognoses, and are just, entirely different disorders. I can bring in mountains of evidence to illustrate that, and I urge you to also bring in evidence for your claim."

"I'm sorry I offended you by my opinion, but you see, Antisocial, Narcissistic, etc all are part of Borderline Personality Disorder"

"Professor, I think I'll agree to disagree. By the way- there's a mountain of research indicating very high recovery rates for people being treated for BPD. In fact, moreso than recovery from Major Depression. You know Linehan?"

"Yes, she's the expert on BPD"

"Exactly. She's a borderline herself. A recovered borderline. Her therapy has a 94% success rate. As social workers we believe firmly that the client knows his or her situation best. I think Linehan's ability to know herself led to her therapy being extremely effective in treating this disorder. Furthermore, schema therapy also has a success rate in the 90th percentile. Some even make a case for psychoanalysis, because BPD is more or less a vague umbrella term used by psychiatrists to label people who have too much trauma to be effective treated in a fast-paced, managed care health system. Believe me, I empathize with the frustration in dealing with clients who have BPD. I've treated them myself and can understand. However, it's one of the only treatable personality disorders and after 5 years, almost 80% are treated effectively to the point where they no longer display all criteria. Also, Borderline Personality Disorder comes along a spectrum and is often overdiagnosed. Many people with anxious attachments and mood disorders get mislabeled. Many people with traumatic pasts or complex PTSD get mislabeled. Psychiatry isn't exactly a science. As social workers we also fundamentally believe in the inevitable change of persons over time. There's research indicating that BPD can occur in "phases" and mellows out. I'll bring in some books next week."

BAM!

[crosstobear]

It's so funny because she saw me bring in the Linehan book this past week and her heart almost stopped thinking I'm gonna destroy her in front of the class. I instead offered to educate her and let her borrow my book, and gave her a list of resources and journals she can look at. I told her how we are all a class of clinicians that will go out there and help people. That BPD people are 30% of the clientele that seeks mental health treatment. That we cannot as social workers afford to dismiss these people and not afford them their due dignity. That we owe it to them to see them as humans and not labels. That they have no voice and are invalidated to the point that they invalidate themselves. Social work is about empowerment and we are their hope. We can't afford to be biased like this, especially in light of extensive research that shows that BPD is treatable and many recovered borderlines go on to live high-functioning, successful lives. I validated her and even gave her a few Robert Hare books on Antisocial Personality Disorder to educate her on that. She still clung to "do you have any books or studies that back up my claim that antisocial is a type of borderline?"

I told her I read and own a copy of Millon's "Personality Disorders in Modern Life" which explains the origins, etiologies, and symptomologies of each personality disorder using multiple theories. BPD and ASPD are indeed mutually exclusive, but some BPD behaviors, especially when triggered, may seem "conscienceless". I reminded her that as clinicians we must admit that we cannot enter the subjective reality of our clients or experience their conscious existence, so our guesses are conjecture, often with a sprinkling of projection, displacement, etc. We cannot indeed say whether a BPD's bad act is rooted in the same psychology of an ASPD's same bad act. But we can say that they have two different breeding grounds and different neural structures in the brain (for instance, lower amygdala functioning in the ASPD).

I just can't believe a very, very reputable state university (globally known) has professors this biased. There are enough psych nurses and psychiatrists shitting on borderlines. We don't need social workers doing it, too.

[Lonlin3zz]

Ego. The word is "Ego"

Ego has destroyed many people.

[here today]

Kudos and congratulations!! Awesome that you could both confront and validate. Can you say some more about how you were able to hold those opposites in mind at the same time?

[Blue_Bird]

Good for you! her attitude is one that creates and encourages stigma. It's nice that there are people out there like you who have a better understanding of the disorder and are willing to work with someone who has it.

[DBTDiva]

Originally Posted by crosstobear

So I have a class (I'm in clinical social work school) where we talked about paraphilias. My professor is a bit of a dogmatic person and explained that people with BPD personalities are prone to paraphilias.

OMFG. What is her degree in? I have a master's in social work and I found that sometimes the social worker professors who did not have much mental health experience would be really old fashioned in some of their views. I would complain to the administration about that professor, I really would. People think professors are experts and take everything they say at face value without questioning. That kind of ignorance is damaging! Once I spoke up in a presentation and said "you're assuming no one with a personality disorder is sitting in this room." I would be livid, I'm nearly livid just reading about this! Good for you for standing up to her.

[Onward2wards]

You hear that distant rumbling sound? That's my enthusiastic applause.

[vonmoxie]

Wow. Her muddied perceptions about how cluster B disorders intersect sound like they are many decades old. Scary to think how many people she's led astray in the meantime, and honestly pretty shocking that no one has set her straight before. Good on you for speaking up.

[Atypical_Disaster]

You have successfully made my week. As someone who's been called a psychopath so often because of having BPD and having mirrored ASPD to get revenge, thank you for speaking up. Way too much ******** about BPD these days. I have had my fun getting back at professionals who stigmatized me over this, but of course the person I hurt the most was myself.

On behalf of someone who suffers from this disorder, thank you for what you said. You nailed it all perfectly.

[Fuzzybear]

Originally Posted by Blue_Bird

Good for you! her attitude is one that creates and encourages stigma. It's nice that there are people out there like you who have a better understanding of the disorder and are willing to work with someone who has it.

[dancinglady]

Originally Posted by crosstobear

So I have a class (I'm in clinical social work school) where we talked about paraphilias. My professor is a bit of a dogmatic person and explained that people with BPD personalities are prone to paraphilias.

Then she went off an a completely unprofessional tirade warning us about "borderlines". Seemed she had an axe to grind. Asked what they are characterized by. I raised my hand.

"Fears of abandonment. Black and white thinking. Splitting. Intense relationships. Alternating self-esteem. Dissociation and brief psychosis" and she said "No."

She went on to say BPD is characterized by "lack of conscience. Extreme self-centeredness. No empathy. Lying, manipulation, conning. Projection and blaming others. Guilt tripping." Then she went on to say "These people are bad people. Untreatable. I'm warning you all, save yourself the headache and don't treat them. They are a lost cause."

So I raised my hand again and asked her if she thinks there's a connection between paraphilias and Antisocial Personality Disorder, since she has made the connection with BPD (see what I'm setting her up for, here?)...

She said "Good you asked. You see- Borderline Personality Disorder used to be called Psychopathy. Then Sociopathy. Then Antisocial Personality Disorder. Now it's called Borderline Personality Disorder."

I interjected- "Beg to differ. The DSM-V, DSM-IV, DSM-III, indicate that they are mutually exclusive. Yes, they are both Cluster B. But one is about attachment, abandonment, neglect and trauma, while the other is about a lack of conscience and lack of emotional depth. Borderline and Antisocial are different, have different etiologies, different prognoses, and are just, entirely different disorders. I can bring in mountains of evidence to illustrate that, and I urge you to also bring in evidence for your claim."

"I'm sorry I offended you by my opinion, but you see, Antisocial, Narcissistic, etc all are part of Borderline Personality Disorder"

"Professor, I think I'll agree to disagree. By the way- there's a mountain of research indicating very high recovery rates for people being treated for BPD. In fact, moreso than recovery from Major Depression. You know Linehan?"

"Yes, she's the expert on BPD"

"Exactly. She's a borderline herself. A recovered borderline. Her therapy has a 94% success rate. As social workers we believe firmly that the client knows his or her situation best. I think Linehan's ability to know herself led to her therapy being extremely effective in treating this disorder. Furthermore, schema therapy also has a success rate in the 90th percentile. Some even make a case for psychoanalysis, because BPD is more or less a vague umbrella term used by psychiatrists to label people who have too much trauma to be effective treated in a fast-paced, managed care health system. Believe me, I empathize with the frustration in dealing with clients who have BPD. I've treated them myself and can understand. However, it's one of the only treatable personality disorders and after 5 years, almost 80% are treated effectively to the point where they no longer display all criteria. Also, Borderline Personality Disorder comes along a spectrum and is often overdiagnosed. Many people with anxious attachments and mood disorders get mislabeled. Many people with traumatic pasts or complex PTSD get mislabeled. Psychiatry isn't exactly a science. As social workers we also fundamentally believe in the inevitable change of persons over time. There's research indicating that BPD can occur in "phases" and mellows out. I'll bring in some books next week."

BAM!

Well this could not have better stated what my treatment was like for 40 years. This is what everyone believed back in the day when my children were removed and I was deemed unfixable which meant I was an unfit mother. The therapists just continually re traumatized us on top of my already years of trauma. I could go on but you get the picture. We were seen as the worst patients in the mental health world. No one wanted us as patients why most of us are already dead.

[bpdtransformation]

CrosstoBear,

Check out the interviews #28 and 29 (with Lewis Madrona and Lloyd Ross) that I recently put on my site, bpdtransformation (Dot) wordpress (Dot) com

I wonder what you would think of them. Your teacher sounds like her mind is totally infected by the disease model, and even then, her conceptualizations of antisocial and borderline states don't fit what most psychiatrists think about them.

I think if you emailed her those interviews with Madrona / Ross it would really drive her crazy!

One point of contention - I would argue that BPD and ASPD are not actually cleanly separable discrete conditions, nor illnesses period. They fade into each other along a continuum. Read the Ross interview and you'll get a sense of what I mean.

[random_emotion]

awesome thank you for standing up to her!

[roboanxia]

Originally Posted by bpdtransformation

One point of contention - I would argue that BPD and ASPD are not actually cleanly separable discrete conditions, nor illnesses period. They fade into each other along a continuum. Read the Ross interview and you'll get a sense of what I mean.

Symptoms overlap. Do their etiologies overlap too? I read free paper on types of abuse and personality disorders.

Possible trigger:

Sexual abuse linked with BPD and ASPD, but only BPD when the sexual abuse wasn't physically abusive as well.

Only borderline men tend strongly toward ASPD too, so it's really odd that she tried to conflate the two.

[Kat4212]

When the psychiatrist I was seeing labeled me with BPD I thought finally someone was going to help me and see me as a person. That was the biggest mistake that I had ever made which was to believe that this Dr. Was going to help me. When I read what BPD was I thought this is not me. Eventually I somewhat agreed but this Dr. Was mean and hateful toward me because of the BPD. He told me I was not worth **** and I knew he was telling the truth because my whole life I felt like nothing, a piece of worthless crap! Still feel that way right now. Dr.'s, social workers, etc., do not want to help people with BPD. This Dr. Thought thought since I was a piece of crap, it was ok to have sex with me. This was all in his office, he would close the doors and I knew he was going to hurt me, he was sadist. He kept me in the hospital for 4 months and I never thought I would ever be able to leave. I was put in the hospital for trying to kill myself but 4 months for having BPD? Never again have I told anyone about BPD or what went on in the hospital. Never told anyone this until now, who would have believed me anyways? The Dr. Was the head of the inpatient program.

[crosstobear]

Originally Posted by here today

Kudos and congratulations!! Awesome that you could both confront and validate. Can you say some more about how you were able to hold those opposites in mind at the same time?

Yes. I saw her as human and empathized. People enter our professions because they are very loving and caring and want to nurture. It is hard trying to heal someone with extensive, horrific trauma that predisposes them to self destructive behavior and projection. As someone whose both had BPD traits and treated people with it, its very draining and difficult.

At the same time, I knew her tirade came from a place of deep powerlessness and disappointment. The ignorance was only human. Life happened to me very early on and years of therapy and understanding from amazing people helped me out of my symptoms and enabled me to be understanding. I am capable of profound ignorance and nastiness at times and I only hope to be shown mercy.

A homeless guy once taught me "you catch more bees with honey than vinegar". I'll never forget that man.

[crosstobear]

Originally Posted by Kat4212

When the psychiatrist I was seeing labeled me with BPD I thought finally someone was going to help me and see me as a person. That was the biggest mistake that I had ever made which was to believe that this Dr. Was going to help me. When I read what BPD was I thought this is not me. Eventually I somewhat agreed but this Dr. Was mean and hateful toward me because of the BPD. He told me I was not worth **** and I knew he was telling the truth because my whole life I felt like nothing, a piece of worthless crap! Still feel that way right now. Dr.'s, social workers, etc., do not want to help people with BPD. This Dr. Thought thought since I was a piece of crap, it was ok to have sex with me. This was all in his office, he would close the doors and I knew he was going to hurt me, he was sadist. He kept me in the hospital for 4 months and I never thought I would ever be able to leave. I was put in the hospital for trying to kill myself but 4 months for having BPD? Never again have I told anyone about BPD or what went on in the hospital. Never told anyone this until now, who would have believed me anyways? The Dr. Was the head of the inpatient program.

I was once taken advantage of when I was hospitalized at 13 years old. I'm sorry this happened to you and it's very common. Predators in the system know how invalidated and stigmatized BPD's are and think no one will believe them because they are so "manipulative". Its disgusting and evil. I'm sorry for your experience, sister.

[dancinglady]

Way too triggering. Need to get off this site.

[dancinglady]

Originally Posted by crosstobear

Yes. I saw her as human and empathized. People enter our professions because they are very loving and caring and want to nurture. It is hard trying to heal someone with extensive, horrific trauma that predisposes them to self destructive behavior and projection. As someone whose both had BPD traits and treated people with it, its very draining and difficult.

At the same time, I knew her tirade came from a place of deep powerlessness and disappointment. The ignorance was only human. Life happened to me very early on and years of therapy and understanding from amazing people helped me out of my symptoms and enabled me to be understanding. I am capable of profound ignorance and nastiness at times and I only hope to be shown mercy.

A homeless guy once taught me "you catch more bees with honey than vinegar". I'll never forget that man.

We have to agree to disagree. I also was a professional in the field. Professionals in this field are sick or sicker than the patients they treat. You have pointed out several examples just in this one topic. They are not loving caring that is just a trained act so that we pay them.

[crosstobear]

Originally Posted by dancinglady

We have to agree to disagree. I also was a professional in the field. Professionals in this field are sick or sicker than the patients they treat. You have pointed out several examples just in this one topic. They are not loving caring that is just a trained act so that we pay them.

I'm sorry you feel that way. I acknowledge that this is the case with some, but things aren't so black and white. I'm guessing you've had bad experiences with clinicians?

[Fuzzybear]

I think some "professionals" are loving and caring, some are sick, indifferent, and sometimes predators Far too many of the latter kind

Originally Posted by dancinglady

We have to agree to disagree. I also was a professional in the field. Professionals in this field are sick or sicker than the patients they treat. You have pointed out several examples just in this one topic. They are not loving caring that is just a trained act so that we pay them.

[Fuzzybear]

I like that you learnt from and respect the homeless man. Sometimes wisdom comes from the most "unexpected" places.

I too have had appalling experiences with clinicians. . But I acknowledge there are some who care. Without the ability to care, they are, naturally, worse than useless.

Originally Posted by crosstobear

Yes. I saw her as human and empathized. People enter our professions because they are very loving and caring and want to nurture. It is hard trying to heal someone with extensive, horrific trauma that predisposes them to self destructive behavior and projection. As someone whose both had BPD traits and treated people with it, its very draining and difficult.

At the same time, I knew her tirade came from a place of deep powerlessness and disappointment. The ignorance was only human. Life happened to me very early on and years of therapy and understanding from amazing people helped me out of my symptoms and enabled me to be understanding. I am capable of profound ignorance and nastiness at times and I only hope to be shown mercy.

A homeless guy once taught me "you catch more bees with honey than vinegar". I'll never forget that man.

[Chuva]

Crosstobear, a big THANK YOU.

I was once fired by my pdoc because he told me I was untreatable and unfixable and might only get some relief from ECT. Needless to say, I haven't had any ECT's done to me. I'm now being rightfully treated for BPD and my therapists are very caring. Luckily. This is not true of all the therapists out there, sadly.

[dancinglady]

Originally Posted by crosstobear

I'm sorry you feel that way. I acknowledge that this is the case with some, but things aren't so black and white. I'm guessing you've had bad experiences with clinicians?

I think my previous post explained my experience. You seem in one of your posts to pain them all white with the loving caring and nurturing. I am just letting others know my experience. Every time I come on here I am criticized about my opinion. I thought u stated u were loving caring and nurturing not confronting. Oh that is right you confronted your teacher my bad.

[Fuzzybear]

Hi dancinglady, I appreciate your posts and opinions, as I do everyone here.

I'm not sure that being loving and caring, and at times confronting ignorant cruelty are mutually exclusive?

(meaning the teacher as "ignorant and cruel", not you )

Originally Posted by dancinglady

I think my previous post explained my experience. You seem in one of your posts to pain them all white with the loving caring and nurturing. I am just letting others know my experience. Every time I come on here I am criticized about my opinion. I thought u stated u were loving caring and nurturing not confronting. Oh that is right you confronted your teacher my bad.