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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by workinprogress on March 26, 2010, at 1:30:58
My therapist doesn't "label" and doesn't really "diagnose", but I've looked up a couple of things I've struggled with on the internet and borderline personality disorder kept popping up. Fear of abandonment and black and white thinking are the big struggles, but emptiness and problems with self-esteem are there too. So, lots of the traits fit. I didn't know much about it, but I didn't think I wanted the label. I don't have intense rage/anger... figured that I was just worrying about it and my therapist would say it wasn't true. Well, it's been bugging me, so I finally brought it up. Instead of saying what I thought was more than likely what she'd say, she said the thing I'd feared (but thought was less likely)... that yes, you fit on the borderline spectrum. Yes, borderlines are challenging, but do I appear burnt out?
She also said that all people could find themselves in the personality disorders. Is that really true though? Why do they exist if that's the case? Why do I care? Intellectually, nothing has changed... I still have the same struggles and the same work to do. I'm still the same, she's still the same, but something is poking at me. I'm "disordered". Somethings "wrong with me".
At best I can see it as validation that yeah, there's a reason I'm in therapy and it's valid that I don't feel done and valid that I feel like I need to see her more than once a week. But, that validation doesn't work if all people have personality disorders. That probably doesn't make any sense... but anyway.
Anybody have any thoughts or answers? I don't really have a handle on what I'm feeling, but I know I'm struggling with this. I know it doesn't make any difference, but it does... you know?
Posted by Dinah on March 26, 2010, at 8:12:43
In reply to 'on the spectrum of borderline', posted by workinprogress on March 26, 2010, at 1:30:58
I do understand. I remember when the pdoc from h*ll blithely assured me that I had schizotypal personality disorder. Dr. "Just the Facts Ma'am" didn't agree, but my therapist is still sure I do.
Personally I identify myself with borderline personality disorder, and I've found Marsha Linehan's books very helpful in learning to understand myself and find ways to cope. In her descriptions of what it feels like to be borderline, I'd keep stopping and yelling "That's It!!!!"
Yet all my pdocs have ruled it out because some things just don't fit. My therapist, however, is quite struck with my borderline traits. He's seen me at my most borderline.
I do think most people have traits from one personality disorder or another. After all, they're all variants on normal human traits, and it's only the degree that makes it a disorder. And the amount of discomfort that it causes.
For myself, I've decided it's useful for me to think in terms of traits. Or being -ish. I'm borderlinish and schizotypalish. And I try to do it without judgment. The only possible reason any mental health diagnosis is valuable - especially in the mental health arena - are to help in understanding and treatment. I've found that in thinking of myself as borderlinish and reading everything Linehan writes, I've come to an acceptance of myself I might never have found when I thought of my own behaviors as bewildering.
I've got some printouts somewhere of some sensible ideas about the range from personality types to personality disorders. But I can't find them. I think it might be "ptypes" but the information I find on that isn't quite what I remember.
http://ptypes.com/correspondence.html
The thing I remember was more that people often fall into one or two types of personality traits, and that if it gets extreme enough, and causes enough distress, this moves from being a personality type into a personality disorder. I found that strangely reassuring. Where you fall on this spectrum is largely a matter of the art of clinical judgment, not science. Hence one pdoc believing that without question that I had schizotypal personality disorder, and the other pdoc being just as certain I had no such thing. That maybe I had schizoid traits, or possibly even schizotypal traits, but I did not have schizotypal personality disorder.
So don't let it bother you overmuch. Just use what is helpful to you and toss the rest.
Posted by Dinah on March 26, 2010, at 8:24:52
In reply to 'on the spectrum of borderline', posted by workinprogress on March 26, 2010, at 1:30:58
http://www.psychpage.com/learning/library/person/border.html
This might be a better link to illustrate what I was saying.
Posted by workinprogress on March 27, 2010, at 1:54:43
In reply to Re: 'on the spectrum of borderline', posted by Dinah on March 26, 2010, at 8:24:52
Thanks Dinah... for the reassurance, perspective, and the link.
Here's where I'm at:
I think I've been looking all along to figure out "what is wrong with me". Weirdly- this makes me feel like- here's why I struggle, somehow legitimizing and freed from beating myself up.
And... It comes with realization of... Rather than what is wrong, what just "is me" and my work. Not an excuse, but an understanding and compassion. I'm kind of really proud of myself. For all my hard work and growth and willingness to show up- in the face of my struggle- which is real in a way I haven't seen before. It allows me to give myself credit and understand why it has been hard/isn't easy.
Self awareness is hard (as my T would say) sometimes. But, it is also very very helpful. And Dinah, I think I've been able to do what you said- take what's useful and scrap the rest. Outside of the "borderlines are impossible, difficult, destructive, etc"- I find it a helpful lens to view my struggle and understand my pain. As my T said, it's a spectrum and I probably fall on the high functioning end, but understanding it allows me understanding/compassion for myself and empathy for others. We are all a product of the mix of wiring/environment- we all have our struggles... this one is mine.
a Work in Progress....
Posted by Dinah on March 27, 2010, at 10:19:57
In reply to Re: 'on the spectrum of borderline', posted by workinprogress on March 27, 2010, at 1:54:43
I definitely understand. I used to be obsessed with figuring out *why* I did the things I did. To the point where I went through psychological testing and everything.
A big part of that understanding was understanding parts of borderline personality disorder. Not only do I have the traits, but I have even more of the underlying issues. I underlined a good many passages of "Cognitive-Behavioral Treatment of Borderline Personality Disorder" and marked the books with flags and brought it in to read to my therapist.
Yes, I've found it very helpful to have the framework.
Posted by obsidian on March 28, 2010, at 0:29:02
In reply to 'on the spectrum of borderline', posted by workinprogress on March 26, 2010, at 1:30:58
I think that diagnosis has become so stigmatized that it has become useless or worse harmful. There are so many personality characteristics, each on their own continuums.
hey, I get it, a cluster of symptoms, dysfunctional ways of coping, but shouldn't we focus on those things instead.I'm not responding to anyone here, my frustration relates to my overall experience and impression of that term. I see the term over-used to the point that it is nothing more than a sophisticated insult with little sophisticated understanding to back it up.
Sure, there are people whose symptoms are glaring examples of what is put forth in DSM-IV, but most aren't.
my two cents,
sid
Posted by floatingbridge on March 28, 2010, at 2:23:27
In reply to 'on the spectrum of borderline', posted by workinprogress on March 26, 2010, at 1:30:58
What a great discussion here.
I've worked (am working?) through the morass and dread of 'the' dx. Seems any diagnosis can be used as a weapon against one's self or another.
And then, recognizing myself in print, or in a comparative case, and having my doc and others (like myself) with compassion gives a dx real utility.
Accurate diagnosis, correct diagnosis, helpful diagnosis?
Posted by workinprogress on March 28, 2010, at 11:27:00
In reply to Re: 'on the spectrum of borderline' » workinprogress, posted by floatingbridge on March 28, 2010, at 2:23:27
It's true. I think you can use it either way, or some combination. I think initially I did a "very borderline" thing- I saw all the bad things about the label, decided it confirmed that I was bad- unlovable (in fact, that's what it feels like so much of what people say about borderlines comes down to, "these people are too difficult and destructive to deal with"). But then, I realized I was feeling some relief and understanding from it as well. And I was able to have some compassion for myself. "Oh, there's a reason I do these things, struggle in this way, have this pain..." whereas before, I wondered why the heck can't I figure this out- my friends aren't like this.
So- it's self-awareness I guess. Acceptance and understanding for all of ourselves. I am a lot more than:
- intensely afraid of abandonment
- highly emotionaly reactive (without an emotional vocabulary... though I'm learning)
- a black and white thinker
- impulsive
- lacking a sense of self
- have unstable interpersonal relationships
- empty feelingI am also:
- passionate
- bright
- empathetic/caring
- spontaneous and fun loving/playful
- insightful
- loving
- sensitiveAnd... nothing's changed. The challenges I had before we had the talk about borderline are still the same. T and I even went down the list... things I want to work on:
- black and white thinking
- not manipulating to get what I want
- continued work on thinking/feeling together
- staying present
- "the weather" (recognizing that feelings change)
- differentiating in times of stress
(there's more, but I can't remember them now)Anyway, she said.. yep, all doable- nothing here we can't figure out. (of course she has much more patience than I on the timeline ;) ).
So, nothing at all has changed. Except that I have more information and that information is helpful to me. I knew all those things (symptoms) about me before- now there's an arbitrary label, but also an explanation for how I ended up with all those symptoms. And, that people with those symptoms really struggle sometimes, because it's really hard. That gives me understanding and compassion for myself that I didn't have before. THAT is VERY useful. B/c I turn inward in my anger/hatred, not outward. I don't hurt myself physically, but I do a bit of damage emotionally. That's interesting... that's the way I was raised too, nothing physical, all emotional (neglect mostly, but lots of dismissive, you're bad for your feelings stuff).
Those are my thoughts for today. Thanks everyone for chatting through this with me.
WIP
Posted by floatingbridge on March 28, 2010, at 19:28:28
In reply to Re: 'on the spectrum of borderline'- fb and sid, posted by workinprogress on March 28, 2010, at 11:27:00
Thanks WIP for sharing your thoughts about your process--I really appreciate it.
I received a massage yesterday, the first in 20 years. This was a big step for me with my issues. The experience was very positive--and I've found a fit--a massage therapist whom I can trust. Anyways, my point is that, during the session, I heard this in my head--true patience requires courage. Thought it fits many situations, the healing process, child-rearing(!).
Usually I get overwhelmed, panicky, fearful of what seems to be enormous rather than look at the task at hand, step by step.
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