What Everyone Can Learn From Personality Disorder Treatments | Dr Lois Choi-Kain

one of the things that i'm doing with my research lab is that we're trying to convert a lot of the good stuff or the potent mechanisms of the treatments that we use here into online formats and formats that require very little therapist exchange with individual patients so that it's more accessible affordable and sustainable for our field i've been talking to a lot of clinicians because i supervise a lot of people in administering these treatments these psychotherapies and what i say is that there's a process of translating this knowledge the facts about this treatment and the patients that you're treating into wisdom and i think it's really wisdom that gets conveyed between people that helps people grow and you know i'll tell you that all the things i really most learned from my mentors like salman akhtar skip pope john gunderson were not the facts i could learn those on my own but what really mattered to me was their wisdom those things they said more spontaneously for example john would tell me when patients got really angry at him and i was a bit taken aback by it he said oh they just are angry because they care about what i have to say which i thought was a very interesting twist on the situation and my interpretation or he would say they're angry because you didn't give them what they wanted and it really detoxifies the reed we have on things so these pieces of wisdom whether they're packaged in people like john gunderson or in treatment strategies i think they even out our view of some sort of situation we're in so that we feel like it's less like a fire that we can't touch or a threat that we have to attack and so i do think that all the treatments work in different ways but there's no proof that the reason they work is specific to what they're doing because we know there's many many treatment approaches that now have been proven for borderline personality disorder and in my efforts to de-brand it it's not to try to tear down these treatments because i think they've made massive contributions to the field and to society but i want to figure out what are the bare bones so that most people can at least do that and john really did a lot of thinking in terms of boiling down all his knowledge into wisdom he was really good at that and conveyed it in a way that most people could understand instead of using really technical terms because as i've always said i think the basic limitation of some of these treatments is that they use like really highly intellectual and scientific terms to describe human problems so that it becomes very difficult to understand how it actually translates into life outside the therapy or the group therapy but i do think that there are common pearls of wisdom that run through all of them and what john said is that the operative ingredients had to do with thinking first that is think before you do things have goals and organize your activities around those goals rather than whether or not you're good or bad or whether or not someone's there for you or not really think about what you want and then do the things that you need to do them so if you want someone to be there for you in a relationship don't yell at them all the time or maybe you should do things for them sometime or maybe you should show them you appreciate it and collaborate with them those are goal driven behaviors rather than emotionally driven behaviors and lastly he talked about these corrective experiences try to take two you know like as a director's cut like try that again and see if you can have a different experience of it that allows you to have a different concept of it when someone's yelling at you it's because they care about the thing you're talking about rather than that's a bad sign and that's what we have to do all the time is correct our ways of doing things so that they work better and that's universal for all of us that's what i think personality disorder treatments have to to teach the world about how we all grow up as human beings so none of the things that are taught in these psychotherapies are bad for people most humans could benefit from using them but people with bpd really need them because they've missed out on life a lot and they've been really confused about their life experiences and what to do with the experiences that they've had it's the conversion of knowledge to wisdom i guess that they're really struggling with in terms of this wisdom exchange which is like almost like an oral tradition don't we need this like human sort of wheel to make the change in other words in the digital space is it possible to i mean i don't think i've personally had change without this sort of wisdom wheel that's yeah fed my heart well i think people do well with different combinations of these things and some people do well enough without the human contract in fact if you think about bpd as a problem of interpersonal hypersensitivity which i do some people are so overwhelmed by the other person in the room that they actually do better if some of the work is done without that other person there and that's actually the concept behind dbt for ptsd martin beau has his treatment is a lot of it is homework driven and self-study because the patient has been traumatized by people so that actually empowers the person to do more thinking in their own time and space in a way that works for them not just in the 45 minutes they have with their therapist at a time that works for the therapist so i actually have really changed my mind about how much the therapist matters i was struck by how much people really gained by watching the session i did with charlotte and feeling like it conveyed something that they also related to and you know whether it's that you see something in a movie or in a book or hear it in a song that feels like it captures something that you've been through you feel like less alone and more grounded that that's a reality that exists in the world and it verifies it for you and clarifies it so that you can kind of locate it and affirm it within yourself and that gives you a more solid sense of yourself so i think that people can be transformed by humans even without contact or individualized interaction and every person needs to find it for themselves one thing i'll go back to is that i think all healing interventions work through something that bruce wampold wrote about in common factors that are operative in psychotherapy he called it the healing myth that everybody is walking around with a folk psychology that means just like a layperson's understanding of themselves in the world like one person might say oh the world's an okay place some bad things happen but i'll just amble along and mostly things will work out that may be their folk psychology but another person may think everything that i do is horrible and never works out and only hurts people or everybody in the world is horrible and they're going to hurt me somehow so i have to minimize how much i do that exposes me to that danger so you take these folk psychologies that are built from combinations of biological factors and human experience and then you get involved with someone whether it's a clergy person or a healthcare professional or a shaman or even like a psychic and they give you a healing myth that generates a change in the way that you see the world and you see yourself and that healing myth only works if it creates a more constructive understanding of what that person is to do with themselves and the world and so a lot of these treatments for borderline personality disorder construct a healing myth like for dbt that bpd is a problem of emotional dysregulation you get skills you're more effective and then you'll live a life of normal happiness and unhappiness or mentalization-based treatment you don't mentalize stably you that is you don't understand yourself and others and social interactions in a consistent way so you need to improve that so that you no longer have borderline so these are ideas that we use as healing myths to replace the existing maladaptive understanding a person has that they're carrying around like baggage you know so that everything is repeating it's history is repeating itself over and over again right and i think the goal is to make that myth about ourselves constructive so that we can lead satisfying lives and do things that are good for other people around us i mean that's a life goal not everyone achieves it and i find that a struggle every day

Channel: BorderlinerNotes

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Length: 10min 29sec (629 seconds)

Published: Tue Jul 27 2021