Speak Your Mind - Borderline Personality Disorder

people with borderline personality disorder often face a higher degree of stigma than people with other mental illness and since this is a show about reducing the stigma associated with mental illness tonight on our first episode of the season my expert guests will shed some light on borderline personality disorder that's next on speak your mind you welcome to speak your mind I'm dr. Carolyn Phelps licensed psychologist with the Human Development Center we begin our 7th season with a discussion about borderline personality disorder people living with this mental health condition often feel misunderstood and are often maligned sadly even by other mental health professionals tonight I have two guests who will share their knowledge so we can have a better more compassionate understanding of borderline personality disorder but first if you're a regular viewer you know we depend on your questions to help explore this issue so call the numbers on your screen right now locally dial two one eight seven eight eight twenty eight forty four or call toll free at it can include chronic and intense suicidal thinking which may sometimes lead to repeat suicide attempts may not can also include self-injurious behaviors where people will harm themselves it also is impulsivity and trouble struggling struggles with controlling anger managing intense anger it can be about intense feelings on fear of being abandoned a really unstable sense of who you are it's we it but no one symptom alone is going to give you that diagnosis it's there have to be at least five from the ones that are written up in the DSM but it's a tough diagnosis for a lot of people because it carries a stigma there are agencies who when they see that diagnosis will say that they will not see the person or they have a set notion about what they're going to have to deal with before they've even met the client I want to talk a little bit about the stigma later but I want you first patty to sort of just expound on what the the person living with borderline personality disorder what it's like to be in their skin with some of the symptoms that Joann was describing emotional life becomes excruciating I mean one way to kind of encapsulate that those diagnostic criteria is that this is a disorder of severe emotion dysregulation and the misunderstanding I think comes from the idea that I mean many of us well-intentioned can fall into the idea that or forget or not understand that people are doing the best that they can and that when they're having a hard time regulating or processing emotions they really they just don't have the skills or the capacity in that moment so I think we're related to that what you mentioned is this notion of people doing the best that they can and how sometimes the behavior comes across to other people as that's not the first thought that somebody has in relation to that is that this person is doing the best that they can true and I think that part of the deal with that is that people tend to in the general run of things think that we're in charge of our emotions and they don't like to think of our emotions feeling like they're in charge of us but if you have borderline personality disorder your emotions are so intense and that's biological it's not something people choose they are born with that temperament we don't know exactly all the biological pieces of it but we know that it is a doubt but definitely a biological component and so they're not choosing to be super sensitive I mean I had it once described to me really well is that that exquisite sensitivity to emotions is almost like your will have one layer less of skin that you not only are sensitive to your own emotions but you're sensitive to the emotions of others around you and then that ability to be able to then interpret becomes difficult because our emotions are so revved it's just incredibly difficult place to be and so people exist then almost as if they're they're emotionally their emotional capacity is always turned on high and high alert and we all have we all have periods of time in our life where we are overstressed and where where we're on high alert but for many of us that that doesn't exist sort of chronically in our life but when it does the one the next little thing that comes down the road is the thing that that that tips us over and I think what both of you are describing then is the notion that if that's the way you're the way your insides are biologically you're wired that way chronically then every little thing that comes down the road is a big thing then is that fair for me to say absolutely absolutely I'm smiling because I'm thinking of the metaphors I use with my clients and explaining this and there's a there is a smoke detector in my house that's in conveniently located near the kitchen and it'll go off if I'm boiling water and I don't shut the door you know so it's it got this device that that has a function and it works really well but it works so well that the alarm will go off when there is no danger anything that it's that's not unlike how the brain of someone with the store disorder functions and which then can get into a cycle it just exacerbates itself because if your environment doesn't understand that often the reaction is you're too sensitive just calm down why does everything have to be a big deal which creates more of a sense of invalidation and certainly doesn't help the person regulate themselves and and calm down you talked about that whole notion of invalidation and what that is like for the person who is living with borderline personality disorder well I just want to pick up where you where you left off so somebody is reacting intensely emotionally to something and the other person this is the if you like the social bitter third thing that keeps things going is that they don't quite know how to respond frequently they don't understand what's going on that person is also doing their best more often than not but they're going why is this such a big deal what that's received as by the person with the diagnosis is that's received as like nobody understands me this I can't cope and it actually escalates the emotion intensity for them they may appear sometimes to shut down on the outside but inside everything's imploding and they have the sense that there's something always wrong with them that they are somehow other broken not working right and we call that invalidation and that that invalidation is not always deliberate but it comes out of people's either not understanding not recognizing or not knowing how to respond and when we talk about our clients they know what they're experiencing but they don't necessarily know why and they certainly don't have the skills always tonight to deal with it well I think that's true for folks in the environment as well they don't know how and so the one starts to feed the other and that's why you'll see a lot of really intense relationships and broken relationships in the person who has brought nine personality disorder you often hear other people refer to people with borderline personality disorder as manipulative which is about as invalidating it yeah yeah yeah number one but talk a little bit about I guess I would like you to talk about both sides of that why the behavior may be perceived as manipulative and then what that does to the person who's hearing you know you're being manipulative I want you I want to start with with something that I heard that really helped me remember how absurd that really is it despite how it looks that way there's a there's a really nice documentary called back from the edge and it's it's on YouTube if anyone is interested in learning more in in that video they feature not just experts on the disorder but also three people who are recovering from this and living with borderline and one of the the people in the films I was commented on this idea of manipulation and said to manipulate you need to be able to be planning and and choosing but when someone is in that highly reactive emotional state none of us when we're that emotional can make good decisions you know we can't we're not able to sequence and plan and think about outcomes so when you think about it that way that when someone is highly emotional and behaving in a way that might appear to be manipulative might bring our own logic into it say well they're not in a state where they can be that planful and intentional about Thanks the I was reading doing some reading before I came here tonight and the psychiatrist had written about the notion that what is being labeled as manipulative is in fact part of the illness and and so there there is that that judgmental sense with the word manipulative that it is behavior that is completely within your control that is not ill that is not a part of an illness that if you say it's part of an illness that's just excuse making for the behavior when in fact this is what what we're saying is that this is part of the illness behavior absolutely I mean when you think about it one of the things that people will often seem to do is folks with this diagnosis school often engage in self um like I said at the beginning or engage in suicidal threat so thinking and sometimes because it happens again and again that's actually the person's attempt to regulate themselves to to express in the only way that they've got left how in that moment about how they are completely lost and it's not about I'm trying to get attention in this manipulative sense of that but yes do they need attention you bet but where they need is validating attention you need somebody to say I get it this is really hard right now this is really really hard you can validate how somebody feels but you don't have to go along with the behavior the two are separate they one influences the other but if you can validate the feelings that behavior I guarantee you will start to dissipate so it is about understanding that the behavior can be sort of a communication about this is how I am feeling right now I am feeling the only way I know how to express how I am feeling or to regulate how I am feeling is by engaging in this behavior and then if that is dismissed either by friends or by family members or by other mental health professionals it sends the message that oh I didn't understand you I didn't understand what were you saying and if the only way that the only language that you have is to maybe engage in self-injury then it's like oh well I'll tell you again then I'm not even I want to be careful also about this idea of communicating and things being that that intentional in my work with people have in what we refer to as target behaviors the real intense emotion ality self-injury overdosing suicide attempts maybe it's gambling or substance abuse or having sex with someone you barely know or you know other things that when you're in your wise mind you wouldn't ordinarily do those behaviors really they're very effective at regulating emotion in the short-term but they have very serious consequences in the long-term and they don't they don't they're not a long-term solution to regulating when when I meet with someone that's one of the first things that we talk about is well how does this work for you you know particularly with self-injury how what is the function because that is validating is to say I know you want to change this and I know you're doing it because in the short term it does work for you and it's not very often that people are consciously aware or say well I'm doing this to communicate to other people they just stress on feeling I I don't know if that's you know a matter of not having that insight but for many people it's certainly not always the or the main intention the intention is just to not feel so awful to shut it down to shoot it to shut it down or at least to bring the intensity down unfortunately though that becomes then up potentially a part of the cycle because then so you get the immediate relief from whatever it was that you did to get the relief and then you get the wash back backlash backlash thank you the backlash of one other people's reaction to what you did and to your own sense of helplessness because it may have given you some relief but here I am again and now I've done this and now people are going to think that or shame and shame and guilt kicks like crazy and then the intensity starts again and I still don't have another way of handling it or and shame and self-loathing can often be a part of borderline personality disorder as well not knowing who you are or what is of value that I mean what the other symptom I forgot to mention is is that a chronic feeling of emptiness inside one one person I worked with talked about feeling like it was just like a clanging Bell in there it was just mmm empty that's a beautiful metaphor of describing that that that experience in a way especially for people who wouldn't know what that would mean of what does it mean to feel and to feel empty inside here's a question from a viewer patty is borderline personality disorder the same as multiple personality disorder heavens no I'm not explaining this for the viewing audience because that's kind of what I said at the beginning is that the viewing audience doesn't necessarily understand what borderline person and we you know you hear they hear these terms sort of loosely in the media and often in context in a movie where it's even more loose inaccurate yeah yeah well and I'm trying to kind of get my mind around where that that misconception might be and I suppose because this I mean if we were to just kind of back up and talk about what it means to be highly emotionally sensitive there are three characteristics of that one is a very sudden reaction to an emotional stimulus the other is that it's a very intense reaction and then the third is what we refer to as a slow return to baseline so you know many of us might get any and emotional something that triggers us and we might have a very strong feeling but then we settle down right away the person with this disorder has a hard time getting back to whatever their baseline is which might is already a higher sensitivity than the average person and I suppose that might be where that that misconception could come from is if if you suddenly are behaving in a very different way than you were five seconds ago you know that someone might be like well who is this what's this all about and in you know and then the behavior flips again or the identity issues that Joanne was talking about if you can't regulate your emotion you can't have solid relationships and if you don't have relationships it's hard to kind of bounce around and figure out who you are and so I suppose that could contribute to that idea of different personalities because I think when you don't know who you are that you can almost come off like a chameleon yes you're trying to people please presenting so you'll possess different personas in an attempt to please to cover and be able to smooth the way through when you're feeling really raw or to fit in and connect yes yeah and and we all do that I mean I'm a different person if I'm visiting my my in-laws you know I'm gonna have certain different traits in that situation than if I'm going to the bank and asking for a loan um I can still remember as a small child the shock of seeing what my father looked like at work yeah the answer he had the different voices you know he he responded to things differently he didn't have a multiple personality even have had that word but I certainly was aware that he was presenting very differently in different settings but with borderline personality disorder that effort to fit in to try and make the very disparate pieces work can perhaps maybe that's why people think oh they have multiple personality as well as not that that avoidance of that feeling of rejection and fear of abandonment that goes is that I need to figure out what you want from me so that you don't leave me or you don't reject me or you think poorly of me which in turn makes it really difficult to form the relationship because if I'm pretending to be everything that you want me to be in the back of that is because you wouldn't like me if you knew what I was really like so even if you say you really like me I can dismiss that because you don't know me and that becomes a pipette self-perpetuating piece and it's for protection it's nothing more than really intense need to protect oneself Patti a caller asks the question that they heard that borderline personality disorder can start with childhood abuse is that true it's see it's certainly not a universal as Joann said there's there's very clearly a biological component to this and we don't we don't know all the reasons why some people come into the world with us how emotional sensitivity but certainly those adverse experiences that can be childhood abuse it can be for some you know people they describe bullying in school or in early ages a really profound experience that leads to that sense of disconnection of not fitting in you know abuse is a is one of the most awful ways of being invalidated not you know just not being recognized as so often but not always then is the answer and I can't believe that we're getting a bit short of time already I want to talk just a little bit about the the notion of is borderline personality disorder treatable okay so I'm old school and I was raised personality disorders de facto are not going to be treatable in the sense of cured what they are is learning how to live with who you are and have a life that's truly worth living as you are it's not that you're going to change your exquisite sensitivity to mush which is actually a strength as well as a weakness if you have the skills to live with it but how can you live a really life that you can enjoy that is satisfying and fulfilling that we can do that's what the therapy can be based on giving people the skills to learn how to do that and move into relationship and what would you say is the message of hope that you would like to leave our viewing audience with petty yep this is a very treatable condition the you've mentioned your old school that was that was what we were taught as this was not treatable and research now shows that many people after treatment no longer meet criteria for BPD I can't rattle off the statistics but we do know that and you may continue to be an emotionally sensitive person but living with that with the skills to be able to recognize and understand your own emotions to be able to work effectively with them so that you can build those relationships that we all need to thrive and to have a life worth living I think that's a wonderful message of hope to leave the audience with and so here's what we know and what Patti just said was that borderline personality disorder is now a very treatable condition thanks to dr. Marsha Linehan who really was the founder of one of the most effective treatments which you are going to hear more about from the same two guests on October 20th we're going to have them back and we're going to hear about the treatment for borderline personality disorder I think the other message of hope really needs to be directed towards us and that called to be a gentler kind ler community where we see everyone including ourselves as doing the best that we can in the moment and while we all may need a little work and a little improvement all in our hearts want to do the best that we can and that includes the people who we may not have a great understanding of I think if we find that as the compassion point that would be the place for all of us to start so thanks so much for joining the discussion on this our very first show of our seventh season and don't forget to visit us on the web at speak your mind online org where you can find a schedule of our topics which reminds me Carlo we need to do that tomorrow and our resource links join us next week when we'll be talking about living with Asperger's I'm dr. Carolyn Phelps thanks for watching and good night you you you

Channel: PBS North

Views: 318,282

Keywords: Speak Your Mind, speak

Id: CAnpZph0Sxc

Length: 26min 8sec (1568 seconds)

Published: Sun Oct 02 2016