BPD

He told me i have BPD first time he saw me and still he didnt change his mind. If t is pdoc too he/she should tell us our diagnoses. If i have doubts i just ask about my diagnoses and i dont see any reason why cant they tell me what they truly think.

Naming something makes it appear manageable.
To just feel the 'craziness' is less manageable.

From a psychological and sociological perspective labeling usually has mostly negative connotations, rarely positive or neutral. Yet, if it is positive for an individual to have a label then they should get *it*labeled. Unfortunately, the BPD label has become a minefield. I've heard my teenager and his friends hurl it as insults against each other or to label an unacceptable behavior that one as committed. "That's so BPD man." It angers the heck out of me. My ex Therapist gets so angry at other therapist, and there are many that use it as a poison that they express to others as choking the life out of them. She always takes the time to school them, yet a lot of what she says goes unheard. She says, "One person at a time."

The OP sounds like she has an awesome therapist, and I hope she can find her answers in the therapy room to move her forward.

I think labelling can also have a certain appeal.

I had 2 main reasons why I sought an accurate diagnosis.

1. I was already labeled BPD w/o the diagnosis for 13 years. I had a break down in a board and care I lived at when I was ~19... one of the counselors stood over me yelling at me about how "BPD" I'm being, etc.

2. None of my symptoms fit the other conditions. I know I don't have bipolar, PTSD, Schizophrenia, or any other type of personality disorder. I felt like I was floating around the mental health field with no place to land. I knew my symptoms were real, but I kept worrying that maybe I was faking it, maybe I was simply being lazy.

I explained it to my doctors: it's like having a tumor, and your doctor knows the full diagnosis but doesn't want to tell you. But you go home worrying: what if it's cancer? What stage am I in? How much longer do I have left?

Yes, cancer vs BPD is a lot different. But for me, it wasn't about the label. For me, it was about understanding myself.

I'm very lucky. My Pdoc has had many clients with BPD. She also stays up to date on research in psychiatry. She knew that SSRI's are shown to have the greatest effect on BPD's depression symptoms. And that using a mood stabilizer helps reduce the extremes of reactivity.

My T has never had a long term BPD client (she does, however, have a ton of experience working with PTSD). She knew the stigma attached to BPD, but she didn't judge me for any of my mental health issues. She simply got to know me for who I am. She does admit to me that I'm challenging and can be frustrating, but that she also enjoys working with me and actually looks forward to our sessions.

DBT skills are life skills not just for borderlines.

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When I was a teen, my t at the time pinpointed this as the diagnosis I would have were I not a teen. Since I was a teen, he said that I had traits of BPD, and that I may always have some traits of it (BPD is not a diagnosis they typically give to teens, assuming they will outgrow some of the behaviors, and maybe it is just teenage angst and rebellion).

I read every book I could find on BPD. I tended to see myself a lot in the BPD diagnosis (but it's interesting, because a hallmark of BPD is feeling like you don't have a solid sense of an identity - like you are a "candle in the wind" or a chameleon taking on the emotions and identities of whoever you are around at the time, trying them on and seeing what fits... So in a way, the BPD diagnosis gave me an identity, if that makes sense. I kind of accepted it - even though it was not an official diagnosis).

Some good books I read about it:
Lost in the Mirror - Richard Moskovitz
Get Me Out of Here - Rachel Reiland
The Buddha and the Borderline - Kiera Van Gelder
Loud Inside the House of Myself - Stacy Pershall

I didn't get much out of the stop walking on eggshells books. Don't know why. Nor the I Hate You Don't Leave Me one - although the concept is quite familiar.

Here is a great blog about BPD that I stumbled upon last night:
Beyond the Borderline Personality - Beyond the Borderline Personality... There's some really great educational stuff on there, and I relate to a lot of it or at least learn from it.

In all of that reading, I have heard it described by Marsha Linehan (the pioneer and founder of the therapy specifically designed to treat BPD, which is DBT - Dialectical Behavioral Therapy - which you probably already know all this, just in case someone else hasn't heard of it though, who also came out as having BPD herself) as feeling like an emotional third degree burn victim. This makes sense to me. As such, a person with BPD will be extremely sensitive to the emotions of others around them. There was even a study where they took 20 people with BPD, 20 people with no mental illness, showed them each videos of faces where the faces changed from neutral to showing an emotion, and those with BPD identified the change quicker on the whole, than those who did not have BPD. One reason for this might be that a person with BPD is always scanning the emotions of those around them and looking for signs that a person is going to abandon them (another hallmark of BPD - the fear of being abandoned, rational or not). So you take a person with heightened emotional processing and they will read into a facial expression, or even a comment a loved one makes - and read into it negatively - thinking, oh this person is surely going to leave me now. Then because of the fear and helplessness, they will have a reaction. Maybe some of the classic acting out behaviors - risky behaviors - or maybe even fight, and go into a rage due to the extreme feelings of helplessness and feelings like the person is going to abandon them anyways, and there isn't anything they can do about it, so to have some feelings of control, they might help this happen and push a lover out the door, or a relationship over the edge, to where this manifests itself and the person with BPD really does become abandoned. Then sets in the negative emotions towards self - suicidal feelings, or the chronic feelings of emptiness (another hallmark of BPD).

And then on top of all of that - the stress related paranoia, or at an extreme, stress related psychosis (or dissociation) even... probably related to early trauma(s).

Linehan and others say that a person with BPD, or some the BPD symptoms, grew up in an environment that was somehow invalidating to them and their existence. A large part of treatment- (along with learning basic emotional regulation and distress tolerance skills that for one reason or another, a person with BPD just never learned - maybe because the parent had a mental illness, or had substance use, or was absent - and they did not have these skills either so they could not teach them) is learning how to self-validate - one's self and one's experience and one's existence. This self validation is important, because a person with BPD has been looking outside themselves for this all the time, and hence always living in fear of abandonment. Because abandonment basically feels like death to the person with BPD - if the person they have been relying on for validation or even at the extreme, proof of their own existence.

Just some thoughts, take them or leave them..

This is a great description Sweepy. I've also heard it describes as having a radio switched on and stuck on high volume and the only way to turn the high volume down is to turn the radio off. So it's a radio that is either dialed to extremely loud, or off. The whole black or white thing, and the emotional rollercoaster.. And the emotion swing is more out of control than say for a person without BPD. So yeah hard to turn on or off (or volume down, say) at will.

Angelic Goldfish, I didn't want to quote the whole thing because it was really long, but I also relate to that being able to read the emotions in a room. And yes, I tend to "disappear" into them, like I tend to either start feeling the same way, or I react to them. So if I feel like someone might be bored with me, I feel rejected and go away. Or if I feel like someone isn't as happy to talk to me as they are trying to fake, I react in the same way. But if someone is genuine, I either become really suspicious or I end up feeling really happy and connected to them. And I can have a positive encounter with someone one day, and then have a negative (in my mind) encounter the next day, and all of the positive stuff stops existing. It's like it doesn't matter, and I am overwhelmed by all of the negative. It becomes a black hole or a vortex, sucking me down into the worst thoughts.

In a way it is like being stuck in the continuous present tense. You can't relax and just enjoy a situation, you are always on guard and reading others for cues of either harm or rejection, and ultimately abandonment. It is emotionally and mentally exhausting, and also to feel like you have to take on others' emotions, as you say - like how you start feeling the same way. (For me, this isn't even a conscious choice). Then you lose touch with your own emotions, because you are feeling what the other person is feeling so its destabilizing at times, and probably confusing. I don't know if you struggle with boundaries at all, but I do. I feel they are non-existant at times, and like I'm not even allowed a boundary. I grew up in an enmeshment type situation though.

And I can relate to having a positive encounter with someone one day, then a negative one the next - and all you can remember is the negative one then. The positive feelings don't sustain or carry over. It's like the last encounter is frozen or burned into the emotional memory bank and it becomes the factual one. Makes relationships very challenging because you don't know if you are going to be in a hurtful situation with the person. It makes everything unsure because you can't sustain the loving and positive interactions over time to add up to a secure attachment with a person.

I've also heard how those with BPD (or perhaps it was depression or something similar) read negative connotations or meanings into neutral faces or expressions. It's like you expect others to be hostile at some point, or at least negative and hurtful and rejecting towards you. So then it is very difficult to be in relationships because it is very difficult to trust the other person.

I did have a very enmeshed mother (she is codependent), so I am sure that contributes.

That is true. I actually wrote to Dr. Anthony C. Ruocco who published a recent study about that for BPD. BPD people tend to read expressions more negatively than what they are. It's very similar to Prosopagnosia (face blindness). It isn't face blindness which is common in autism and Schizophrenia, but it's like a blindness to expressions.

Yeah my mom was the enmeshed/codependent one as well as also abusive, so it was very confusing! Have you heard of Dr Dan Siegel? He explains the attachment stuff pretty well - as far as why a person may be fragmenting or dissociating and how reading a caregiver's face as a child has impacted attachment (especially if a caregiver had the intent to harm you as a child).

(two different videos on disorganized attachement, even though they both are titled the same they are different videos.. Short ones about 2-5 minutes each)..

Another interesting thing I learned about BPD, from the book Lost in the Mirror, is that it is not common for the person with BPD to have had a comfort object (blanket, stuffed animal, etc) as a child. I don't know where they got his research from, but I know that I didn't have a comfort object until I went to the hospital as a teen and my best friend gave me this stuffed animal bear. I kept that as a comfort object all through out college. Again, I'm not sure where they got that from, or how common it is to anyone else, but I found it interesting, and could relate.

One thing I do have is a comfort object. I always did and still do.

True. It's not only for people with parasuicidal behaviors. It can also help people with anxiety disorders, autism, and bipolar disorder.

HazelGirl, I think this could really help you. Our thinking patterns can really interfere with relationships, influence our outlook on life and the treatment of mental illness. I just realized this on Wednesday, when my psychiatrist explained how my pessimistic thinking and my catastrophizing tendencies contributed to the nasty psychotic depression I just went through.

I'd like to take a DBT class even though I don't have BPD.

Facial expressions are confusing for people with autism and schizophrenia, because they cannot interpret what they mean. BPDers can interpret facial expressions, but misinterpret them, because they expect people to treat them badly. This is also true for anyone who has been chronically mistreated in life.

Prosopagnosia can cause interpersonal problems. Imagine not being able to recognize your own mother or partner. It is humiliating.

So do I

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AngelicGoldfish, thanks for the videos. Very insightful.

The_Little_Didgee, I would like to take a DBT class, too. But group therapy or classes sound really scary and intimidating.

Somewhere on Psychotherapynetworker there is an ~ one hour video. You only need to watch less than five minutes of it to get how those diagnosis so many of you covet was build on a house of cards, a poker game, and a throw of the dice. And, by a show of hands on who wants the diagnosis in or out of the DSM. No scientific evidence needed, Bipolar ll in, and Aspergers out...The people on the committees were even abhorred by this behavior

If the label comforts one, gives you (plural) purpose, and moves you from point A to point B...then it is the right thing to seek. And, specially for you, Hazelgirl, if it can pull you out of the quagmires you continuously find yourself.

Hazelgirl, I do not see you as 'coveting' that diagnosis, nor do I see you as finding yourself continuously in quagmires. I think characterizing it that way is demeaning and dismissive. You are working really hard and struggling through some difficult things. I think it is admirable that you are at least considering all possibilities in your effort to heal.

I don't want this. I want to understand what is going on. Regardless of whether that means I have a diagnosis or just a series of symptoms, I would like to freaking understand myself. That's what I am trying to do. It's making me frustrated that some people think I "want" this diagnosis. No! I want to understand myself. Sometimes a diagnosis opens your eyes to better understanding and a more clear direction towards healing. That's how it was for my PTSD and my ADHD. They were eye-opening because I finally understood. I wasn't just "weird" or "different" or "weak". I had something I could point to that helped me understand. This is the same way.

Hazelgirl, you might be interested in reading about Kernberg's Borderline Personality Organization (BPO). Both my current therapist and former therapist don't go by the DSM descriptions; instead, they only recognize the 3 levels of personality organization:

Neurotic
Borderline
Psychotic

Depends on:

1. ego strength
2. emotional defenses
3. internalized object relations/attachment
4. reality testing ?
5. sense of self
6. superego integration
7. impulse control

This is because hardly anyone matches the set of symptoms listed the DSM categories. All the cluster Bs and some others usually fall under BPO because it's pretty broad like CPTSD. What you describe in your posts consistently sounds like BPO. Just my opinion.

I saw at least a dozen therapists and psychiatrists, but no one told me I could be Borderline. It makes me angry today because I could have gotten the proper treatment when I was younger had I known. You are so young-this is good that you are looking into this now.

The Three Levels of Personality Organization - Personality Disorders

This link doesn't say much, but if you google the terms, you can read more about it through online books. Take care.

I apologize for offending you , my kiddo pointed out I used poor of word choice. My Aspergers - self diagnosis. In using coveted I meant search or seek a diagnosis. Not the word I used. The response was meant to show as we look for a label the research is not scientific. And, also if we believe something will help us then it usually will, positive thinking. As someone ones said to me it can be self soothing to help us heal. Also by quagmire all was meant is the issues we find ourself withe you are going through many of the same ones that I and everyone else are in or went through. So again, no disrespect was meant, and I apologize again.

I've been following this thread and everything you say rings so true for me as well. Like you I don't have a BPD diagnosis but have been told I have traits of BPD. The difference with us is that I have self harmed- as a teen briefly until I was hospitalized and put on meds, and now as a woman in my 40's - after a particularly stressful time and a change of meds.

Once the self harm started again my pdoc got me a T who specializes in DBT right away and she's been great. I was so afraid to admit to both her and my pdoc the true nature of my symptoms too because I was also aware of the stigma surrounding BPD traits, and I finally got the nerve up to talk to them both about this. Both told me not to buy into what you read online. They both also were adamant that I didn't have a real BPD diagnosis, but do have traits. So I think it is so important that you tell your T everything you are telling us here. That is what she is there for and would be more upset that you're afraid to tell her than by your symptoms.

One thing that is important to know is that many other mental health diagnoses share symptoms with personality disorders. People with ADHD (and Aspergers) for example tends to have problems regulating emotions, difficulty with identity (due to lack of focus and follow through). People with trauma also can have the traits you describe, but they are not all Bordeline. I think so many people (especially women) who seek mental health services have some traits consistent with BPD. But Ts can't possibly diagnosis everyone with some traits as borderline, and save the label for the most severe of cases - and those cases can be very severe.

But whether you do have the diagnosis or not doesn't diminish the significance of what you're experiencing or make it any less troublesome for you. If your T is experienced with DBT then she is the ideal person to share all of this information with. She sounds great and I bet she will know how to help you. You just have to let her help you by taking a risk and being completely honest with her. I don't know if you'd need a DBT group it could be too intense (my T thought it wouldn't be a fit for me because I was less extreme than some people in the groups. Maybe a class on the skills or just sessions with your T focusing on it. She probably has handouts and could give you homework. She can give you all this with out a formal diagnosis. Honestly, the diagnosis won't add much in terms of insurance purposes - you just need relief from your symptoms. If you present all of what you are saying here to your T, she may diagnose you with BPD or might not. Regardless I think she will still discuss it with you and help you as best she can.

I haven't read the entire thread but there's a lot of excellent information in it. I was diagnosed with BPD but I never understood why for a long time. I never cut, I had stable relationships, never acted like the descriptions of the disorder. Yet 4 different kinds of Ts said I met the criteria. They based it on my poor sense of Self and my attachment problems. My current T doesn't label people but I know she agrees with my diagnosis.

My experience in a DBT group was very positive, and not scary at all. Yes, the skills are valuable and can be useful for anyone, I think. We didn't have to say what our diagnosis was, but I know at least one member had bipolar, not BPD.

HazelGirl, if you want to know if you have BPD, by all means ask your T. But even if you do have it, it's not going to change who you are or how your T is treating you.

I am learning so much from all of you. Speaking of comforting behavior or things.... I rocked on my hand and knees when I was a child and head banged to get to sleep. Then it progressed to rocking in a rocking chair and to this day, I am constantly rocking in a rocking chair. I know this is self soothing behavior. This tells me I was neglected as a child. I was also invalidated as a person by both my mother and brother. Fathers were absent. So I am ok if I get diagnosed with BPD. I do have emotional trauma so I am in need of therapy for sure. It is never too late to work on issues no matter how long ago they happened.

Getting older has had it's positives for me as time tended to mature me a bit. I know I am not the same person I was at 20 or 30. In fact, I think my symptoms of BPD were more severe. No self harm or suicidal stuff but I was very clingy with friends and this was a real problem. Now I just handle things differently. I still have many issues with avoidance of relationships but without acting out. I am still a sick puppy in my opinion, but if it is any consolation, at least with me, age has toned me down in some respects.