[HelgaDE]

I just got done reading this article at http://brainblogger.com/2006/06/20/a...lity-disorder/ and thought that anybody could relate to this? I actually kinda relate to this because I've been trying to get a self harm support group going inside of a hospital for such a long time and with little or no sucess... It's like the hospital thinks were going to help each other with new ideas to self harm.

hey there. i find that p-docs (and psychologists and general practitioners and councellors and so on and so forth) vary in response to the dx.

it is true that people used to get a bad rap for it than they do now.

i think the article is a little one sided...

the reason why some clinicians won't take too many people with bpd dx is because of burnout. clinicians need to look after themselves too and people with bpd are often being regarded as high maintenence (compared to people receiving first time treatment for anxiety / depression and / or needing a new script for their medication).

good news is that there are pretty good treatment outcomes with dbt and dbt programs are designed to help prevent therapist burnout

there is a lot of hope for people with the dx
and that attitude is starting to filter through clinicians
(slowly slowly)

but yeah stigma is there...

thats why i typically think dx of personality disorder is best aboided unless you need the dx to get the treatment

[crackednfragile]

pdocs are beginning to understand more and more about BPD and it is becoming less stigmatized. There is a bio side to it and a social side. Many BPD's have been very abused. If pdoc doesn't want to treat, it is the wrong one. The hospital setting is probably not the right place for a group, since DBT is noted as the best treatment for BPD. It is better to have the group in the clinical setting since the goal is to stay away from the hospital, even with self harm. It is better to learn ways to stop the self harm. There is a cognitive way to figure out what starts the inner emotions that fuels the energy for self harm. In the end, the BPD has to try to work her way out of her own emotional mind without running to others to solve the problem. DBT group leaders do not suffer the burn out problems, as much, since they practice DBT (dialectical behavior therapy) with each other in a meeting each week. Hope this helps.

[JustBen]

It's getting better, but there's definitely still a bias out there. I think K is right about professionals trying to ward off burnout, but I think the problem is also fed by the misdiagnosis of BPD--in some hospitals and clinics, just about anyone who shows up exhibiting behavior that the staff doesn't like gets a BPD dx. It's really messed up people's idea of what exactly BPD is.

[Rapunzel]

One of my (past) therapists, when I told him I was interested in BPD, said that they can be a challenge. I was thinking about specializing in that dx, but I did tell him it could be exhausting if all of my clients had that, so I might have to limit how many BPD clients I had on my caseload at once. He said like one would be a good limit.

When I asked if he thought I had BPD, he avoided giving me a direct answer. I really think it fits me. I've looked at the criteria over and over and it describes me. The criteria don't mention "pestering therapists" and "being very demanding and difficult" or whatever else they are afraid of. I am difficult though. I just don't change very easily. But I have never telephoned any of my therapists, at all. I got permission to, if necessary, from my current one. I freak out mildly if she doesn't email me when she said she would, but I don't torture her about it. The previous one sometimes took 6 weeks to respond to email, and I really freaked sometimes about that, but kept it to myself. And when he did finally respond, then I was happy with him again, so that was what he got in my reply. I did obsess about him after he dropped me, and really had a hard time not hanging around where he was, hoping to get a chance to see him, but I tried hard to keep it under control and not bother him.

Nobody has been willing to dx me as BPD, probably in order to avoid stigma, but my current T is treating that. Wish people could call it what it is and work with it, and not insist on making it something else or assume that there is more (or less) to it than there is.

Rap