[littleblackdog]

Recently I had an 8-week course of distress tolerance therapy. It turned out to spectacularly badly timed as, during the course my Grandmother and Dad were both diagnosed with cancer and both died.
Nonetheless I went along to every session, did what I was asked to do between sessions and worked really hard

Possible trigger:

sadly it failed to have any impact on stopping or reducing my SH

Towards the end I had an assessment by my psychologists supervisor. This lasted 30 minutes and I don't remember much as it was only a couple of days after my Dad died. At the end she said I wouldn't be offered any more therapy. She said because I had a lot going on and she didn't think I would cope well with being asked to do more work.

Since then I have been feeling rubbish - like it was my fault for being bad at therapy, like I don't deserve to be helped or like I am being punished for my Dad dying.

Then, this week I found out from my doc that the real reason was that the woman who did my assessment was concerned that I have an emotionally unstable personality disorder. Pdoc disagrees and assessed me again and is going to talk to the psychology people as she thinks I need more therapy.

I am just feeling really ambivalent about going back. I don't know how many people knew about the 'diagnosis' and lied to me. I really struggled in therapy but I was painfully honest with my therapist even about things I am deeply ashamed of and to think that she may not have been honest in return really hurts.

Plus I have been walking round for weeks thinking that it is all my fault and that I don't deserve help...

I am sorry for your parents' death. My deepest condolences.

I feel bad that you were lied to, you deserve to be told the truth. This cannot be changed, as the psychologist has her own psyche and way of treating clients.

There are several things to consider.

- You did not fail anyone. It's not like the psychologist came to your home and asked, "Will you be my client? I infer you have disorders that need therapy. Please respond." So STOP feeling guilty. The psychologist has legal issues to dwell upon (unfortunately rather than psychological ones) and she probably thought it was best at that time. But it is NOT your fault. Heck, my psychiatrist believes I am too stupid for therapy.

- It's not like that you don't deserve to be helped. Are you a cannibalistic serial killer like Hannibal Lecter? Nope. You are a person that has guilt that he was wronged and believes it's his fault. If we believe everyone who is ill and is victimized for it (think about old psychiatric hospitals) didn't deserve to be helped, we have a misunderstanding there.

- It's not like you're being punished for your Dad dying. We all are after all organisms and death, like every organisms, is inevitable. Is it okay that you feel guilty for your parents' death? Of course not. You should tell your psychiatrist, and turn down his authority for treatment if you do not like it. It's not the doctors or therapists that are to be blamed for patient's suffering, but it's just how the legal system works.

My best wishes to you.

(Remember, it's not possible to study psychology objectively because we all are humans. You cannot carry your degree or lawsuits with you once you die. Why all the guilt for something she did? She thought it was best to not tell you you may have BPD, and later told your psychiatrist that you have BPD, and both disagreed each other. Ask your psychiatrist to be on meds only to avoid further confusions. That'll save you money and pain and time too.)

[ChickenNoodleSoup]

I am a bit confused... she doesn't want to offer more therapy because she thinks you have a personality disorder? In that case you'd need even more therapy, you'd totally deserve it too.

It's not at all your fault that the therapy didn't work for you. It might be the wrong kind of therapy, or it might be that it happened at the wrong time. You were honest and in return you weren't told the truth. I think that's a mistake on their end, not yours!

I hope your Pdoc finds a way that you can try therapy again, either the same thing or a different kind. You absolutely do deserve to be helped by honest and caring people!

Originally Posted by ChickenNoodleSoup

In that case you'd need even more therapy, you'd totally deserve it too.

It's not at all your fault that the therapy didn't work for you. It might be the wrong kind of therapy, or it might be that it happened at the wrong time. You were honest and in return you weren't told the truth. I think that's a mistake on their end, not yours!

I feel very unfortunate to share with you that there are no treatments available for personality disorder. Meds do not work and therapy is trial-and-error.

But that doesn't mean anyone in the world should feel guilty for having mental illness, any kind of it. It's not their fault. This is coming from someone who has schizophrenia.

I just wanted to share this and I whole-heartily agree with the rest of your post.

[littleblackdog]

Originally Posted by TheLonelyChemist

She thought it was best to not tell you you may have BPD, and later told your psychiatrist that you have BPD, and both disagreed each other. Ask your psychiatrist to be on meds only to avoid further confusions. That'll save you money and pain and time too.)

I am on men's but they don't work for me - I have been trying for 2 years to find a combination I can tolerate and that will work with no success. That's why Pdoc referred me for therapy in the hope that the combination of media and therapy would help.

Originally Posted by ChickenNoodleSoup

I am a bit confused... she doesn't want to offer more therapy because she thinks you have a personality disorder? In that case you'd need even more therapy, you'd totally deserve it too.

It's not at all your fault that the therapy didn't work for you. It might be the wrong kind of therapy, or it might be that it happened at the wrong time. You were honest and in return you weren't told the truth. I think that's a mistake on their end, not yours

The joys of the NHS mean that I would have to go to a different service for therapy for bpd

I think it feels worse because they know that I tried cbt before but that didn't work and I was just left feeling worse and with no further help. This time was the same, only worse because now I don't even have any hope that medication will work

Originally Posted by TheLonelyChemist

I feel very unfortunate to share with you that there are no treatments available for personality disorder. Meds do not work and therapy is trial-and-error.

But that doesn't mean anyone in the world should feel guilty for having mental illness, any kind of it. It's not their fault. This is coming from someone who has schizophrenia.

I just wanted to share this and I whole-heartily agree with the rest of your post.

Um, there are now therapies formulated FOR personality disorders in recent years: Dialectical Behaviourial Therapy, Transference Focused Therapy, Schema Therapy.

https://www.sciencedaily.com/release...0210101955.htm

https://bpded.biomedcentral.com/arti...2051-6673-1-20

https://jamanetwork.com/journals/jam...article/209673

LittleBlackDog, you DO deserve support, care and effective help!

Standard CBT doesn't work for a lot of people. There's modifications like Trauma Focused CBT and CBT for eating disorders etc.

There's Acceptance and Commitment Therapy too, there's formulations of it for trauma.

There's Compassion Focused therapy, Mentalistion based Therapy, Transference Focused Therapy, Dialectical Behavioural Therapy, Schema Therapy etc.

[littleblackdog]

Originally Posted by QuietMind

LittleBlackDog, you DO deserve support, care and effective help!

Standard CBT doesn't work for a lot of people. There's modifications like Trauma Focused CBT and CBT for eating disorders etc.

There's Acceptance and Commitment Therapy too, there's formulations of it for trauma.

There's Compassion Focused therapy, Mentalistion based Therapy, Transference Focused Therapy, Dialectical Behavioural Therapy, Schema Therapy etc.

Thank you. Unfortunately in this country cbt is pretty easy to access but anything else is ridiculously hard.

I hope I haven't offended anyone here. I know there is nothing wrong with or to be ashamed of for having a personality disorder, it's just that that I was confused as to how someone came up with that diagnosis for me, and why I wasn't even told.

My experience of the NHS was rather upsetting like yours.
I was dx with BPD. I remember sitting in aftercare from the detox I'd been in and crying, feeling hopeless. I mean who wants a dx like that!!

The psychiatrist assessed me. Said medication would be of no benefit to me and said come back in 6 months.

Fast forward. I crashed. The treatment centre gave me a card of a private therapist.
15yrs later in still with her. She said I didn't have BPD and even if I had, it wasn't untreatable. Though she knew a lot of people prefer not to work with with that dx. Not her by the way.
So. Find a private therapist who has a sliding scale.
I look back at my NHS experience and think I could teach them a thing or 2. But hey. Life goes on.

Originally Posted by littleblackdog

Thank you. Unfortunately in this country cbt is pretty easy to access but anything else is ridiculously hard.

I hope I haven't offended anyone here. I know there is nothing wrong with or to be ashamed of for having a personality disorder, it's just that that I was confused as to how someone came up with that diagnosis for me, and why I wasn't even told.

In my country CBT and SFBT (solution focused brief therapy which is even more bleh than CBT) is also pushed heavily and other therapys often are only found in secondary or tertiary services.

I've a friend in a rural part of the UK and she and others have shared quite a lot about the funding cuts to the NHS and the poor, woefully inadequate services.

There's a lack of funding for treatments formulated to treat chronic Axis 1 issues like recurrent, chronic depression and anxiety.

No, I know you weren't being disparaging of folks with personality disorders. They shouldn't have slapped such a diagnosis without extensive, thorough and detailed assessment. And not telling you is so incredibly unprofessional.

Originally Posted by QuietMind

Um, there are now therapies formulated FOR personality disorders in recent years: Dialectical Behaviourial Therapy, Transference Focused Therapy, Schema Therapy.

https://www.sciencedaily.com/release...0210101955.htm

https://bpded.biomedcentral.com/arti...2051-6673-1-20

https://jamanetwork.com/journals/jam...article/209673

LittleBlackDog, you DO deserve support, care and effective help!

Standard CBT doesn't work for a lot of people. There's modifications like Trauma Focused CBT and CBT for eating disorders etc.

There's Acceptance and Commitment Therapy too, there's formulations of it for trauma.

There's Compassion Focused therapy, Mentalistion based Therapy, Transference Focused Therapy, Dialectical Behavioural Therapy, Schema Therapy etc.

I understand that. But I doubt the therapies are effective for everyone.

Agreed, they don't work for everyone. Schema therapy has a pretty good success rate (you can google the studies saying BPD folks can no longer meet criteria after 2 years treatment) but won't work for everyone, for example.

Huge and important difference from your comment that "there are no treatments available for personality disorder."

Well this is my personal opinion. Look at schizoid personality disorder, do you think there are effective treatments available for it? Of course not. But it might be my own black-and-white thinking.

[Lemoncake]

I have a personality disorder my T didn't disclose it to me for 9 months until after I saw another psychiatrist who diagnosed me with major depressive disorder. I said in passing that I thought I was borderline,and he agreed with me but said he wanted to treat me as an individual so didn't think it was useful to tell me. The main difference between my T and the psychiatrist was the amount of time I'd spent with each- but by then it was already 70 hours with T in comparison to 1.30 with the pdoc. So that's where the disagreement can stem from.

Treatment for personality disorders is possible- but most likely you are going to need long term treatment rather than just 8 sessions and it requires working with the right kind of T. When I first started around 18 months it was 3 months after I decided that I was going to kill myself. I didn't even know what I felt but it was so deep. It was the just constant cycling between the highest of highs and frequent suicidal lows mixed in with pure rages and constant self harm. The anger came out in sessions and was aimed directly at him T through acting out and hostility. Some days I told him that I loved him, the next that even his face irritated me. I tested and I pushed him. Two other T's told me directly that I was too high a risk to work with. Not everyone has the training to handle that so that's why I think she said she couldn't see you as it wouldn't be ethical of her to do so. But there are T's out there .

I would recommend the documentary : "Back from the edge" and "Having A Life Worth Living - Dr Aguirre's Insights", both of which are available on youtube.

[Fuzzybear]

They shouldn’t have slapped any diagnosis on you without extensive and detailed assessment. I’m not making any comment about the system over here ....

[maybeblue]

Originally Posted by TheLonelyChemist

Well this is my personal opinion. Look at schizoid personality disorder, do you think there are effective treatments available for it? Of course not. But it might be my own black-and-white thinking.

There haven't been many studies on treatments for people with schizoid personality disorder, mostly because they don't tend to think anything is wrong. They just don't like being around other people. They also don't cause many problems for society like people with antisocial personality do. So while they may seem weird to people around them, they aren't too likely to come in for treatment at all.

Borderline personality disorder is entirely different. People with borderline personality disorder absolutely know that something is wrong. They feel great distress and so they go in for treatment. Some of the symptoms are very dangerous too, so it's very beneficial for society in general for us to find effective treatments. And there are some. It's not hopeless. It's complicated and difficult, but people can recover from it or at least manage it.

Also, not all people with personality disorders are the same. Some will have better success than others. There's a whole host of other variables such as income and ability to pay for treatment, intelligence, motivation, and support systems that all influence treatment success or failure. It's not unlike diabetes. A person with a relatively high income and health insurance will be able to afford the cutting edge drugs and healthy food needed to manage it. If she has family and friends that support her and motivate her to take care of herself she'll have better success too. If she lacks those things, she's likely not to do as well.

And probably like diabetes, a personality disorder is something that a person will have to be aware of and manage for the rest of her life, but just because something isn't completely curable, it doesn't mean that there isn't hope to have a much improved existence.

[littleblackdog]

Originally Posted by Fuzzybear

They shouldn’t have slapped any diagnosis on you without extensive and detailed assessment. I’m not making any comment about the system over here ....

Thank you. That's what confused me - how she reached the diagnosis in the course of a 30 minute assessment. I don't remember much about it because I was still in shock about my Dad, plus talking to someone new like that just makes me really anxious but I don't know what I could have said to make her think that
I still don't think I will be offered any additional therapy because during this course the psychologist talked about other types of therapy but said many times that they don't accept people who SH.

[Fuzzybear]

Originally Posted by littleblackdog

Thank you. That's what confused me - how she reached the diagnosis in the course of a 30 minute assessment. I don't remember much about it because I was still in shock about my Dad, plus talking to someone new like that just makes me really anxious but I don't know what I could have said to make her think that
I still don't think I will be offered any additional therapy because during this course the psychologist talked about other types of therapy but said many times that they don't accept people who SH.

They always have their reasons why they say NO - it stinks

Originally Posted by littleblackdog

Thank you. That's what confused me - how she reached the diagnosis in the course of a 30 minute assessment. I don't remember much about it because I was still in shock about my Dad, plus talking to someone new like that just makes me really anxious but I don't know what I could have said to make her think that
I still don't think I will be offered any additional therapy because during this course the psychologist talked about other types of therapy but said many times that they don't accept people who SH.

Can your psychiatrist help you in any way with his authority?

[Fuzzybear]

Originally Posted by TheLonelyChemist

Can your psychiatrist help you in any way with his authority?

Why would a psychologist even say that? I find it very odd.

That doesn’t for a minute mean I don’t believe they said that.. I do believe it

[maybeblue]

Originally Posted by littleblackdog

Thank you. That's what confused me - how she reached the diagnosis in the course of a 30 minute assessment. I don't remember much about it because I was still in shock about my Dad, plus talking to someone new like that just makes me really anxious but I don't know what I could have said to make her think that
I still don't think I will be offered any additional therapy because during this course the psychologist talked about other types of therapy but said many times that they don't accept people who SH.

Can you request a second opinion or is there an appeals process? It seems to me that SH would be a reason for treatment, not a reason to deny it. I wonder if you just ended up with a jerk evaluator. I have to admit that I don't really understand your medical system. But I wouldn't just take "no" for an answer. Most bureaucracies have some second layer that you can go to if the bottom rung people are idiots. I think getting your doctor to advocate for you might help.

[Fuzzybear]

Originally Posted by littleblackdog

Thank you. That's what confused me - how she reached the diagnosis in the course of a 30 minute assessment. I don't remember much about it because I was still in shock about my Dad, plus talking to someone new like that just makes me really anxious but I don't know what I could have said to make her think that
I still don't think I will be offered any additional therapy because during this course the psychologist talked about other types of therapy but said many times that they don't accept people who SH.

PS what do I know.. I think the official line may be that DBT does “accept” people who SH.. and why would anyone who SH be denied therapy, it makes no sense..... One thing I do know, it isn’t personal about you

[Fuzzybear]

Originally Posted by maybeblue

Can you request a second opinion or is there an appeals process? It seems to me that SH would be a reason for treatment, not a reason to deny it. I wonder if you just ended up with a jerk evaluator. I have to admit that I don't really understand your medical system. But I wouldn't just take "no" for an answer. Most bureaucracies have some second layer that you can go to if the bottom rung people are idiots. I think getting your doctor to advocate for you might help.

It would be nice if this works.... my paws are crossed ....

[littleblackdog]

Pdoc, now she has reassessed me still thinks I need therapy so is going to speak to psychology and 'argue her case' but I don't know how rigid the rules are. If that doesn't work there may be another service I can access (the MH system in my part of the country is fragmented and impossible to work out) but I have no idea what is available or how long the waiting lists are.

[Fuzzybear]

Originally Posted by littleblackdog

Pdoc, now she has reassessed me still thinks I need therapy so is going to speak to psychology and 'argue her case' but I don't know how rigid the rules are. If that doesn't work there may be another service I can access (the MH system in my part of the country is fragmented and impossible to work out) but I have no idea what is available or how long the waiting lists are.

what a mess (I too have experienced the mess in this part of the country )

I hope this works out for you .. keep “us” posted

[littleblackdog]

Originally Posted by Fuzzybear

PS what do I know.. I think the official line may be that DBT does “accept” people who SH.. and why would anyone who SH be denied therapy, it makes no sense..... One thing I do know, it isn’t personal about you

I think because they only offer brief courses of therapy and they know that once you start doing the work people often feel worse they are concerned that they won't have time to work through to 'the other side' and don't want to leave people worse off after their course of therapy...