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#1
Mar 25, 2009, 07:29 AM
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In late 2008 I started seeing a new pdoc (the previous one was unprofessional in various ways and I was advised by my T and partner to see someone else).
After 3 sessions the new pdoc spoke with my T and said that, in his opinion, I am a borderline - he went on to say that I was 'untreatable' and should be partially hospitalised. This came as a surprise to me as my T had adamantly said in the past "no you do not have bpd" - his thoughts were AvPD and he finds me treatable and opposed the hospitalisation idea. When I saw the pdoc 2 weeks later he seemed to have lost interest in the idea of hospitalisation and he never mentioned to me personally about BPD. In any case, before this point I had the diagnosis of social anxiety and depression. In honesty, I'm not really sure which diagnosis fits - if any - but I'm curious to know whether I do (and to what extent) exhibit the symptoms of BPD. What I suspect was a factor in this diagnosis were my 2 suicide attempts (the second occurring a year and a half after the first) - the second time was very serious and I could have died. The second attempt I think perhaps could be described as 'impulsive' (I woke up in hospital and had difficulty remembering what I had done), the first certainly not. Other than this, I don't self-harm and I don't do any of the typical imuplsive behaviours (no addictions, no spending sprees, no promiscuity etc. - I can be impulsive on occasion but not in ways that are harmful, so perhaps this is just 'spontaneity'). My relationships are stable but I have great difficulty trusting people and daring to take initiative in contact with others. I tend to hold back and over analyse things, finding a reason to withdraw from contact. When I was very unwell a couple of years ago, I found it extremely hard to leave the house and would stay in a dark room for days on end - fortunately I'm a lot better now. I do want to be social but it brings tremendous anxiety and I'm very sensitive to rejection - I'd sooner run away from a relationship than risk confrontation and rejection/criticism. I have extremely low self-esteem and have a history of physical and emotional abuse as a child. I know that outbirsts of anger are characteristic of BPD. I seem to feel 'anger' more than I did in the past. I went for a whole year without once expressing any anger at all (other than a feeling of self-hatred) - and now sometimes feel very angry but this is infrequent (the last row I had with my partner was over a month ago). I can get 'stuck' on little details at times - for example my bf being messy around the house but I don't experience hate toward him. I don't recognise the extreme love/hate dichotomy that I read about - although maybe in the heat of the moment there is some of this. When I feel very stressed I do experience some dissociation. When I am very anxious I have started to have paranoid feelings - although I know that they are just that and don't 'believe' them. A while ago, for example, I imagined people were trying to poison me, but still knew this was a wild thought and could continue as normal. I've been seeing my T for 2 years and we have a good relationship but trust is very hard for me. I expect for him any moment to reject me or become hysterically angry with me (he has never done either of these things but they are my fears). One last thing, I have a huge fear of failure. I'm a perfectionist and often the risk of not succeeding prevents me from even trying. I finished school with the highest marks of any pupil, and some of the highest marks nationally (despite being a truant - I found it difficult to be around the other pupils so skipped school). I went to a top university but dropped out in my 3rd year - I couldn't deal with it socially - I felt so inadequate around the other students and was sure they disliked/hated me (I have a feeling I am intrinsically 'bad'). In the end I hid in my room and lost 10kg and took an overdose. I'm building my life up again. Hoping to go and study once more - this time a different study. I've been in a stable relationship with my boyfriend for 5+ years and have some friends now in my current life, although still feel very unsure of myself. Any feedback would be welcome. Onzi |
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#2
Mar 25, 2009, 12:28 PM
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Hi Onzich and welcome to PC....
Its funny about labels and definitions especially about souls as dynamic as people,,,they seem to follow the old adage,,"beauty is in the eye of the beholder"....  Somehow we need to call things something...and in the inverse,,be called something..but often in the impulsiveness of this need we define things wrongly. I don't know if you suffer with BPD but I did note one aspect of your description. No one mentioned adandonment. Without the pervasive all consuming fear of abandonment which is the cortex of all exhibited fears in the disorder, BPD would seem an unlikely diagnosis... Please make yourself a spectacular day,,,because you are spectacular person....  Lenny
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I have only one conclusion,,and that is things change too quickly for me to draw them.... Sobriety date...Halloween 1989. I was plucked from hell...and treat this gift as if it is the only one... |
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#3
Mar 25, 2009, 06:26 PM
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Thanks Lenny,
Abandonment is a difficult thing for me really to grasp. I certainly fear rejection, and although it's related to abandonment I'm sure, it's not quite one and the same thing. I would say my greatest fear is failure, not abandonment. At the moment my bf is away (on the other side of the globe) - he has had to stay away a week longer than expected and I'm finding it hard without him (not feeling 'abandoned' as such but a bit lonely) - I suppose I'm just so used to living with him now that it's harder to function without him - it's human to miss someone. Growing up, I was very much alone - I sought safety in my isolation I think - and I am very good at getting 100% absorbed into a task. It's easy to grow accustomed to company though - I'm happy I share my life with someone. He's good at giving me a reality check - distracting me from going too deep into my own thoughts - I hope I am something like that for him too.Anyway, I wanted to thank you for your kind words - it felt good reading them. Onzi Quote:
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#4
Mar 25, 2009, 06:41 PM
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Hi Paddy,
I read your other thread and replied. It's nice to see other posters from the same country. In my case, this pdoc is the first person to have mentioned BPD (and I only heard that via my T) but I do know that more and more people seem to be 'earning' this label. Due to the negative associations (the stigma) attached to this disorder, it can feel like name-calling and there is the risk that professionals will abuse their power by dishing out this label to all patients they find difficult to treat. It's awful that people should feel ashamed to share about a serious and real illness that they have because of the stigma attached. It seems that the borderline has become the new 'neurotic' (a label that is rarely used now because of the negative connotations associated). I don't think my pdoc is a 'bad guy' - he seems to be far more professional and competent than the first one I saw and I suppose their job is to see a lot of patients and make a lot of relatively quick decisions/judgments. Onzi Quote:
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#5
Mar 26, 2009, 06:15 AM
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I'm sorry you are feeling unwell. This weather doesn't help.
I also have the idea that 'bipolar' is more acceptable (even trendy?!) than BPD. There has been quite a bit of coverage of bipolar in the media in recent years, with various notable celebrities 'coming out' about their illness. It's not something shameful, unlike BPD (or at least that's my feeling about it). My T isn't interested in diagnoses. He only said about AvPD because I pressed him on "what is wrong with me?" but I think in his view diagnoses are limited - he is an analyst. Fitting people into neat boxes, categories doesn't tend to help. Of course it is human to want to identify ourselves with a certain group - but if the identity we come up with is something that makes us worse, then that isn't a help. Could it be in your case a situation of a self-fulfilling prophecy? Someone gives you a label and they expect certain behaviours and you feel angry and end up living up to that label all the more? I'm so frighteneed of my pdoc now that I'm sure he sees someone with far more pathology than my T does, and indeed than I really have. When I have my appointments with him, it feels like I am sitting with my dreaded mother opposite me! Maybe I will tell him this next time I see him, lol! I've been in the Netherlands for a couple of years now - originally from the UK. It's been hard - it's difficult adjusting to a different culture. The people seem more direct. My T is quite 'distant' I suppose - he doesn't flood me with empathy or validation - but that's probably to do with the therapeutic approach he uses (and this suits me quite well). The pdoc, on the other hand, is overly warm and that stirs up the full force of my distrust - while he probably is just trying to be nice! If nothing has really changed and you managed quite well for many years with whatever problem you do have (bipolar), then is it really necessary to view the problem differently than you have been doing? Besides, there is a difference between having bpd features and satisfying enough characteristics to earn a full-blown diagnosis. I think many people have features of this condition from time-to-time. Probably there is even some overlap between bpd and bipolar symptomology. I hope in time the condition will become better understood, better treatment plans will be available and that its image among professionals will change. That said, AvPD has a similarly bleak outlook, just doesn't seem to draw the same negative attention as BPD. Like you, I feel 'happier' being an AvPD than a BPD! Onzi Quote:
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#6
Mar 27, 2009, 06:27 PM
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Is the GGZ a bit like the RIAGG? I don't get treatment from an institution or hospital. I see a private psychotherapist (I pay) and I see a pdoc at his own practice, although this is fully covered by my insurance. I started by going to the local RIAGG - a kind of mental health organisation/clinic but they were not very helpful and the therapist I saw there (once or twice for an initial consult) didn't speak English. They were going to offer me EMDR/CBT once in 2 weeks, which wasn't what I really felt would help me (especially because we couldn't communicate!). I then looked for a psychoanalytic therapist and came up with my current T. He isn't covered by health insurance but gives me a reduced fee - he is very good though. I know I could have gotten free psychotherapy - even free analysis - had I gone to an institute but at the time I wasn't in a stable enough state to spend several months on a waiting list - I needed to get help urgently.
I've never thought about group therapy - or DBT. I wonder whether there are any English groups in Amsterdam - there's definitely a big English-speaking community there. I'm not sure what exactly the pdoc thought when he mentioned BPD - if I recall, my T's words were "Dr. X thinks you have something of BPD" - the pdoc never said anything about it to me directly, and he hasn't asked me the questions he would need to in order to know whether or not I fulfilled the criteria. I think he was mostly going on the fact that I'd made a second suicide attempt. He's never asked if I have any addictions, for example, or if my relationships are unstable. At the time I think their discussion was mostly as to whether I was well enough to continue under ambulant care or should better be admitted to a hospital programme of some sort - it's not been brought up since. Are you seeing a DBT/CBT therapist or do you do psychodynamic therapy? Fijn weekend Onzi Quote:
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#7
Mar 28, 2009, 07:46 PM
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Just a quick reply - I'll write more tomorrow. There are many options besides through the GGZ/RIAGG for therapy and whatever your pdoc says about you, you shouldn't encounter problems getting therapy elsewhere. Personally, therapy once in two weeks is insufficient. I'll post some links and suggestions tomorrow which you might like to research. It should all be for free but you might have to wait a few weeks to get an intake/start seeing someone in private practice (most people in private practice are also covered by insurance).
My first pdoc was a TA - he did talk a little about this with me - in the end I moved on to my current pdoc because he wouldn't reconsider the AD I was taking and seemed confused at times about which meds/dosages he'd prescribed (which didn't fill me with confidence!) - other than that, he wasn't unkind in anyway. If I recall, his practice was affiliated with a special retreat centre in Switzerland. I'm sure there are more TA therapists and pdocs in the Netherlands. I'll try and track down that website and see if there is a link to a general directory of TA therapists. I was disappointed with my experience with the RIAGG, so I simply told them I would no longer continue under their care and made my own arrangements. I remember writing them a sort of complaint letter. I phoned my current therapist (found him through the NVPP) and in the first or second session explained why I hadn't been happy with the RIAGG. He wasn't surprised and was shocked by the approach of the therapist I saw for an intake there. As far as finding a pdoc - I'm surprised they have turned you down. I think you have a right to see someone new and refuse to have notes sent on from your previous pdoc - i.e. ask for a fresh start. I'm sure there will be a pdoc out there, especially in Amsterdam, who will continue your care - or else look further afield. Again, there are directories listing all pdocs in your area and there might be some specialising in bi-polar and/or personality disorders. There will also be pdocs working at clinics specifically for patients with more complex problems and so would likely be more sympathetic. If you decide to find a therapist outside of the GGZ, then this might be a good step on the way to finding a pdoc also in private practice, because a sympathetic T can then correspond with the new pdoc regarding your background. You just need an understanding T in the Netherlands on your side. I'm glad you received some respite and care in Spain. I don't know what I would have done had I stuck with the RIAGG. I now see a T twice a week and he is flexible - so if I need an extra appointment he can almost always accommodate. Likewise, he is available by e-mail and phone if needed. I'm guessing someone in a big centre wouldn't be so readily available. It sounds like you have a good spot in Amsterdam. I live in regio Utrecht. Anyway, I'll post tomorrow with some links and a translation - hopefully something will be helpful. Groetjes, Onzi Quote:
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