Borderline Talks Back | Coral More | TEDxUBC

[Music] [Applause] they said she was made of fire and she said I am quick to anger but it is because all of the colors inside of me turned to rage when they are silenced they said emotional dysregulation and she said my mood is a temperamental ocean enormous and pulled in infinite directions they said marked impulsivity and inability to regulate responses to stimuli and she said when everything is an emergency it is impossible to prepare for disaster they said frequent suicide gestures gesture as in the physicality of speech just as the poem demonstrates that which has no words so do the injuries illustrate that which is unimaginable he said a pattern of violent relationships and she said my ocean loves just as deep as it hates my ocean buries its history and vomits it up on the shore the sea glass soft is my apologies they said difficult to treat she said how do you disentangle the roots from a tree how do you uncurl a bonsai from its contortions even when it knows it will not live long this way how do you learn to stop hurting yourself when it is the closest you've come to being quiet they call me borderline like an insult but I know how it feels to be limitless women who feel in extremes are taught to be quiet about our grief our top control contortion a bonsai bent into impossible positions the contortionist curls herself into a glass box look how small she can become watch how her bones turned to cartilage and when she disappears entirely all around the doctors gasp as if they did not intend to make her this way they call me borderline because I am the border between extremes my highs are helium my lows a skydive the borderlines the climb my skin speak of nights I did not know how to feel this much this inhibition of my own grief I curl myself into a glass box but I do not fit my ocean salt spills out around me in 1993 Marsha Linehan develops dialectical behavior therapy as the radical acceptance of two extreme opposites I am learning to be at once the storm and the lake sea glass and the broken bottle I am learning how to feel without forcing myself to drown so the poem I just read for you explores the symptoms of borderline personality disorder from a first-person perspective it's rare that any mental illness is discussed from lived experience but personality disorder is carry a unique stigma stigma a mark of disgrace or shame resulting from stereotypes prejudice and discrimination for me stigma was my teachers asking if I wanted to be treated differently when I disclosed my self-harm it was my mother begging dozens of doctors for help all of whom replied with not to worry I was tipped I was simply being a typical moody teenage girl it was silence constant and threatening a unique feature of the stigma associated with borderline personality disorder it is that it is usually perpetuated by the people we turn to in our time of need I want to tell you a story to illustrate how this clinician led stigma impacted me it was during one of my worst suicidal episodes when I took myself to the emergency room of the psychiatric hospital I waited by myself for an hour before a nurse came to take my blood pressure I waited for another two hours before a different nurse came to talk to me she told me it would be another couple of hours before I was seeing because they needed to triage you see even though a diagnosis of borderline personality disorder is an empirical predictor of suicide attempts we are often taken less seriously in crisis due to the frequency of our ideation I was angry so I stood up and I left the hospital no one tried to stop me I walked slowly hoping someone would follow me my phone rang I sent it to voicemail a nurse told me I could call back and make an appointment for the next week it is an acutely strange experience to be trained in suicide risk assessment and to experience a suicidal episode it is an acutely invalidating experience to be able to assess your own risk better than those who turn to you in your time of need in that moment I felt so completely alone suicidal episodes are very acute beings ideation especially for those of us with suicidal histories escalates to its maximum within hours for this reason timing is crucial to suicide prevention postponing crisis intervention by any number of days is essentially telling the suicidal patient we do not believe you I will never know of my experience was in fact due to my diagnosis my god my disorder often materializes in the form of identity disturbance I frequently believe everything I do and say is a lie I am often struck by the debilitating fear that my true identity will be discovered and everyone I turn to you for support will leave even now I catch myself believing I am fabricating this entire story the identity disturbance of BPD has a favorite food it's called self stigma and it happens when social stigma for example the commonly held belief that people with BPD are abusive and manipulative becomes internalized by the person with mental illness for me self stigma looks like believing I did not deserve care because I was falsifying my suicidal crisis for attention in this cycle self-stigma worsens the symptoms of illness I am an honors psychology student working in a clinical psychology lab and planning on pursuing a graduate degree in clinical psychology a professor once told my class that people with mental illness should not only keep this a secret but should never study the illness or its related characteristics I have been told by nearly every single person to keep my disorders a secret if I aspire to pursue a career in clinical psychology the stigma ascribed to BPD and other personality disorders stems largely from its name what do you think about when you hear the words personality and disorder in my introductory clinical psych course my classmates were shocked you can't say a person's inherent self is disordered they said this is simply a result of the pathologizing of undesirable characteristics they were suggesting abolishing the entire construct of personality disorders and here I was so many of my experiences shaped by the disorder of my personality were they saying none of what I had experienced was real it is harmful to assert that psychological dysfunction is due to appearance inherent self but it is harmful as well to ignore the unique and devastating consequences of chronic pervasive psychiatric distress how do we reconcile the two how do we acknowledge the difficulty of treating such distress while maintaining the essential humanity of the patient this is where the dimensional model of personality disorders enters the scene historically psychologists have placed people into personality disorder categories based on a conglomeration of clinical traits this is a breeding ground for stigma because it suggests we were born into this category and we will remain there forever however what we know about the humans is that we do not fit nicely into boxes we change over time we interact with our environment I was not born borderline I was born with a set of biological vulnerabilities that interacted with my experiences to shape my phenotype borderline personality disorder I want to tell you another story to illustrate what I mean by dimensional let's imagine emotional instability a common trait that accompanies borderline personality disorder has arranged from zero you're totally emotionally stable to a hundred you have absolutely no control over your emotions so all the humans will fall somewhere on this on this range in childhood I was about at 25 my emotions were intense and difficult to control I remember in the fifth grade I threw myself facedown on the snow because I got my first C+ because it is difficult to raise a child with these reactions my parents would frequently tell me to control my emotions I had never been taught emotion regulation strategies so I didn't know how to do this instead I would experience shame anger and guilts whenever my emotions were overwhelming these secondary emotions moved me up the scale of emotional instability to a 50 as I grew and my emotions grew alongside me I never learned how to effectively regulate my responses I began to self-harm because it did just that it was something I could do to be quiet when I was diagnosed with borderline personality disorder my placement on the scale had risen above the clinical thresholds an arbitrary number that reflects difficulty in day-to-day functioning or extreme distress I am part of the first generation of people with BPD who will achieve full symptom remission that is to say the skills taught in dialectical behavior therapy will help move us back down the scale to where we began well below the clinical thresholds as I begin to lose parts of my disorder I wonder who I am without it I am NOT neurotypical but I no longer fit into the category of borderline personality disorder I am living proof of the dimensional model if people like me who experience the pathological end of the continuum were viewed through a dimensional lens we would not be borderlines instead we would be people we would be people who do not have the resources to cope with our place on the continuum if people with personality disorders were viewed as humans first and pathological a second would not refuse to treat us the dimensional model existed people exhibiting traits of BPD would not be denied proper treatment due to their clinicians fear of marking their record with the stigma currently the dimensional model of personality disorders exists in the appendix of Diagnostic and Statistical Manual of Mental Disorders it's only there if you know where to look for it the categorical model is still the default and it is not until we change this that we will overcome the stigma of personality disorders it is not until we changed this that we will be able to prevent the factors that led to me walking out of that waiting room thank you [Applause]

Channel: TEDx Talks

Views: 62,125

Keywords: TEDxTalks, English, Health, Medicine, Mental health, Poetry, Psychology

Id: EqfrHy-pmVc

Length: 11min 50sec (710 seconds)

Published: Thu May 31 2018