It’s a cruel irony that people who have borderline personality disorder (BPD) will often have the most difficulty finding and getting proper treatment from mental health professionals. Because, unlike virtually every other mental disorder in the book, borderline personality disorder is seen as one of the worst of all disorders to try and treat. People with BPD are the most stigmatized amongst a population already burdened with heavy stigma, people with mental health concerns.
Borderline personality disorder is characterized by a long-standing pattern of instability in interpersonal relationships, the person’s own self-image and their emotions. People with borderline personality disorder can also tend to be impulsive. Borderline personality disorder is a fairly rare concern in the general population.
It’s the ever-changing and very intense emotions that set someone with BPD apart from others. Their relationships are fast, furious and fleeting. Whether it be a friendship or a professional therapeutic relationship, people with BPD often find it difficult to hold on to it. Their thoughts are often characterized by what cognitive-behaviorists term “black-or-white” or “all-or-nothing” thinking. You are either 100% on their side, or you are actively against them. There is little in-between.
Given this manner of looking at the world, it’s no wonder people with borderline personality disorder can be challenging to work with. They will often “test” the therapist who works with them, by either engaging in impulsive, dangerous behavior (needing to be “rescued” by the therapist, such as committing an act of self-harm), or by pushing the professional boundaries of the therapeutic relationship into forbidden areas, such as offering a romantic or sexual encounter.
Most therapists throw up their hands when it comes to treating people with BPD. They take up a lot of the therapists’ time and energy (often much more than the typical patient), and very few of the traditional therapeutic techniques in a therapist’s arsenal are effective with someone who suffers from borderline personality disorder.
Dozens of people with borderline personality disorder have shared their stories with us over the years, expressing the pure frustration they experience in trying to find a therapist willing (and able) to work with them (see, for example). They often recount stories of having to go through therapists in their local geographic vicinity like others might go through a box of tissues at a funeral. It’s distressing to hear these stories time and time again.
But that’s not the way it should be.
Borderline personality disorder is a legitimate, recognized mental disorder that involves long-standing and negative patterns of behavior that cause a person great distress. People with BPD need help as much as the person with depression, bipolar disorder or anxiety. But they’re not getting it because they are being discriminated against by therapists who simply don’t want to deal with the time and hassle of someone with BPD.
Therapists can legitimately turn away someone seeking their help if they don’t have the skills, experience or education necessary to treat a specific concern. Borderline personality disorder is best treated with a specific type of cognitive-behavioral therapy called Dialectical Behavior Therapy (DBT). This specific type of psychotherapy requires specialized training and education in order to use it productively and ethically.
Few therapists bother to learn this technique, however, because of the trouble that is commonly associated with people with BPD. Plus, they think, they may not even get reimbursed for treatment of this concern because generally most insurance companies do not cover payment for treatment of personality disorders (no matter how much pain the person is in). This is a bit of a red herring argument, however, as professionals know many reasonable and ethical ways to obtain such payment by adding additional, reimbursable diagnoses on the patient’s chart.
The stigmatization and discrimination of people with borderline personality disorder needs to stop within the mental health profession. This bad behavior reflects poorly upon therapists who repeat the same inaccurate and unfair generalizations about people with BPD as others did about depression three decades ago. Professionals should know the local therapists within their community who are experienced and well-trained to treat borderline personality disorder. And if they find such numbers lacking, they should seriously consider it as a specialization of their own.
But if a therapist does nothing else, they should stop talking about people with borderline personality disorder as second class mental health citizens, and start treating them with the same respect and dignity all people deserve.
89 comments
As a therapist, I want to ensure that not all therapist can be painted by this broad brush. Some of very favorite clients have been BPD clients. Why? Because they often have the ability to grow and improve, and leave their symptoms far behind. Not all clients can do that. With the right supports, and a LOT of effort, clients with BPD can really excel. And when that happens, I cry big ole tears of joy.
If a therapist does not carry hope within themselves for their clients, they may want to find a new vocation.
True, and all generalizations are, by their very nature, not very specific nor always accurate.
The key for someone with this concern is to find an experienced and honest therapist who embraces and enjoys working with them.
I am a therapist in training, who grew up with a severely borderline sister. I also work a suicide hotline and hear the frustration of my fellow counselors when they talk to clients who are suicidal and also have borderline traits. These clients are often hostile and help-rejecting, and yet they are coming to us in crisis and need our assistance. I know there are therapists out there committed to helping these clients, but the stigma is real.
Only omission in the article is that DBT seems to have been developed to work most effectively with co-therapists in an in-patient environment. While I agree that everyone who works with this population ought to know DBT techniques, they may not be as effective for clients who are being treated by sole practitioners.
Sorry but I have had NO success with CBT training
Its if u feeling normal but if u are gngbthru a real bad crisis the ONLY things that help are quick acting tranquilizers
While I believe it’s true that patients who have borderline personality disorder have difficulty finding help, I find it limiting to suggest that therapists have a stigma against this disorder. Just by the classification of personality disorder, therapists who take insurance will not treat this type of patient unless they can pay out of pocket. This is because insurance companies do not and will not cover treatment for any personality disorder be it borderline, antisocial, schizoid, or schizotypal to name a few. That being the case, this article being centered on borderline is such a small snapshot of what is really going on as to be insignificant, misleading, and highly insulting to therapists everywhere who live in a society where insurance dictates what can and cannot be treated.
I am a graet believer in the “cure thyself” phylososphy. Each of us is ultimatley responsible for our own wellness. much like the patient who believes that he will never get well, a therapist that starts out believing that BPD is harder to treat than other illnesses handicaps himself and does a diservice to his patient. Self awareness is the first step. learning to recognize the symptoms of the illness and differentiate them from who you really are is next. and finnaly, learning to redirect those thoughts and behaviors in a positive way.
Saying someone with BPD should “heal thyself” is incredibly simplistic and will never happen in that population.
Sorry, but people with BPD need to know that with help (big emphasis on help)they can heal themselves. If you’re not willing to heal then it won’t work.
I tend to understand what you’re saying. At age 69 I’ve only just self diagnosed to realize
that I fit the BPD traits like a glove and I’m relieved to at last be able to put my finger
on the lifelong problem. I will endeavour to do more reading for a clearer perspective and would be absolutely grateful if anyone can point me in the right direction the ‘cure’.
Even worse to me are my collegues who don’t believe in borderline PD. They think they’re doing the patient a favor by calling it bipolar or depression. The problem is that the patient is then treated with numerous drugs that don’t work when they need life skills teaching. If we accepted the diagnosis and the work involved, there wouldn’t be a stigma to avoid.
Rebecca,
You need to get over yourself. As a mental health professional myself I think that this article barely begins to address the abuse that people with the borderline personality diagnosis undergo on a daily basis by mental health professionals.
Individual therapists may be wonderful—I’ve known many, but the field as a whole and I include therapists of all stripes as well as psychiatrists need to start looking at the disdain with which they so often approach their clients—borderlines have it the worst but in most public mental health systems and hospitals disrespect is rampant for anyone with a label.
It’s really scary that these professions can’t take an honest look at themselves.
Hi, I’m Robert King and I live in Canada. Right now I’m desperate for support and answers. So I’m taking the step of reaching out in the wild blue yonder of Internet land to try and access something that even remotely resembles them. I have been banned from the public mental health clinic in the area where I live for supposedly uttering threats to my clinician. Last year I was finally diagnosed with BPD which at the first was empowering and validating. Let me say that on the day and clinical session I became quite upset when my clinician began to paraphrase from her computer screen some of what I had said a month or so prior during a visit to the ER for an acute crisis. At that time I had expressed dissatisfaction with this particular clinician. I really lost trust in her after an incident in a DBT group session a few months after being diagnosed with BPD. Truth is I felt all this stuff was basically forced on me with the notion that if I did not take part in this group, I would not be treated individually. Everything seemed to be happening at a speed that I felt was overwhelming. Also I felt like I had absolutely no say in this process of treatment and the approach seemed, rightly or wrongly, authoritarian. You get the sense that you are being stigmatized, judged, etc. even though they would certainly deny it if asked. Once again you begin to feel fearful, anxious, untrusting, and voiceless. How can anyone begin to heal and move forward toward healing and a life worth living with this kind of so called treatment. You also begin to feel helpless, yet again and hopeless, yet again. To me this sort of cold treatment by mental health professionals borders on criminal negligence and malpractice. I did not threaten anyone at the clinic the day I was told by my clinician in those exact words, you are banned. After the incident I contacted a university law school legal aid service and explained what happened. They told me that what I had said to my clinician did not meet the legal definition of a threat. I know I did not threaten her. In fact at the level of upset at was at I showed a whole lot of restraint and that doesn’t mean I would have hurt anyone either. Basically from the get go that day I felt like I was on trial in her office while she reiterated what I had told the psychiatric staff at the ER the night I was seen there. Now maybe I’m crazy but even a criminal caught red handed has a right to a vigorous defence and due process. Yet when dealing with the mental health system there is no such thing. This is simply unjust even from a human rights point of view. I mean how far have we really progressed as a society in the treatment of the mentally ill from the days when they were kept in shackles and locked in dismal barred cells and hosed down with cold water if they got out of hand. I may have a mental illness but I still feel I know what it is to be treated with compassion, empathy and human dignity. Also at present I’m trying to see if I can find legal help to fight this shabby treatment and possibly sue for damages. The state of the public mental health system where I live is really bad and I also feel like a fight for my own rights is also a fight for others’. Please if you can offer your thoughts or suggestions I would be grateful, thanks.
Thank you for posting this story. There needs to be much more awareness of Borderline Personality Disorder, and the incompetence of so many mental health professionals in treating it.
I believe I have BPD. I am not sure, because after going to dozens of therapists, I was never able to last longer than 5 or 6 weeks. No one ever mentioned Borderline to me. Not a single therapist or doctor even told me the word. I was given antidepressants that only made me worse, and then told that my impulsive behavior was because I was a bad person doing bad things and I knew better.
The first time I read the book “I Hate You Don’t Leave Me”…I just knew. That was me.
But now I am stuck in a small town, and the closest place that offers Dialectic Behavior Therapy is about a 6 hour drive away. So….I guess I’ll just have to “fix myself” as someone said…
I am fifty one years old. I had bpd and was in unsuccessful therapy from third grade through twelfth. After high school, kicked out of my house, I bounced from one group house or boyfriend to another, and have had more jobs than I can recall, usually waitressing positions. Having no health insurance, but earning too much to qualify for public assistance, I was only able to get involved in therapy by signing on to various short-term studies, which were of no use to me, and a waste of time for the therapists. I did not receive the diagnosis of bpd until I was in my mid-twenties when I attempted suicide, which caused me to be hospitalized, and because I lost my job, I qualified for medicaid. After that pointless hospitalization at Saint Elizabeths – were I saw a therapist once a week, and carried a razor blade in my jeans pocket because no one thought to check, and where I spent the bulk of my time shooting pool with another young woman who had bpd and an old alcoholic guy, I realized I would have to heal myself. I got involved in Aikido, which was a great training program, and which I found extremely helpful. In fact, I highly recommend it to anyone who needs help getting away from their destructive thinking. And I highly recommend NOT becoming too involved in the inner personal relationships within the group – it can ruin the training. I practiced religiously for several years and my impulse control got better, plus my overall feelings were more manageable and I felt less volatile. When I began getting migraines, a neurologist put me on a beta blocker, which had a rare side affect of causing psychosis, which it caused in me. All that I had gained in the way of controlling my mood swings, and most particularly NOT self-mutilating, went down the tubes. I sliced myself to shreds and wound up in a good psych hospital, where I was admitted to the service of a therapist who was familiar with bpd, but who specialized in working with patients who had drug abuse issues. We hit it off – there was definitely mutual attraction and both transference and counter-transference. This therapist, a highly ethical man, was able to use the attraction to keep me in therapy long enough for us to establish a trusting relationship, and he was able to keep tabs on his own feelings well enough to maintain reasonable boundaries. I was in therapy with him for six years. I asked him at one point why he was willing to work with me, since during the first two years I was very demanding – calling him every day for reassurance that he would not abandon me, and cutting myself in spite of making agreements not to, among other things. He told me that he worked with me because he believed that I could get well, and as far as the demands I made on his time, he said that he only worked with one borderline at a time, which enabled him to give more than he might otherwise be able to do. Another time I asked him if he’d successfully treated any other borderlines, and he told me that one woman in particular had done quite well. When I asked him why he thought she’d done so well, he said, rather uncomfortably, that he thought it was because she knew that he really cared about her. I asked him if he loved her and he said he had. I asked him if he loved me, and although the question made him extremely uncomfortable, he said that he did. He said this while maintaining all the appropriate boundaries, and I never harbored the belief that he loved me in an inappropriate/sexual way. In fact, if he had, it would have been extremely destructive, since what I needed from him, more than anything else, was for him to NOT want me sexually. And he didn’t. He genuinely cared about me and about my welfare. I also knew that he had a very happy home life, which made me feel more secure since although I was attracted to him, I knew that if we every actually responded to the attraction, he would have tumbled off of his pedestal and I would have not been able to continue to get the help I needed to become well. He made a commitment to work with me, and then he stuck by me until I was able to straighten my life out. Before I left therapy, I asked him what the most difficult thing had been about working with me, and he said it had been the constant redefining of the boundaries of our relationship. He really wanted to give his all, and he also wanted to be sure that what he gave was truly in my best interests. His love for me and his guidance, coupled with his compassionate, intuitive listening skills enabled me to feel some semblance of what it should have felt like to have a consistent, loving and supportive parent – something I missed in childhood. I have been out of therapy since the mid 1990s, I’m happily married, and have two lovely children. I know how demanding I was during the first two years of therapy with this wonderful doctor. I can easily understand why doctors would not want to work with borderlines. We can be unbelievably demanding, unfair, and ungrateful, we lie, we connive, we steal, we manipulate, we are unreliable, we self-mutilate, and when all else fails, sometimes we kill ourselves. We are also bright, attractive, funny, charming, warm, loving, empathetic and kind. It’s a difficult balance, working with a borderline. Any doctor who can successfully treat a borderline is one hell of a talented person. I have a neighbor and close friend who is a therapist. His specialty is bpd, and he is very good at what he does. Like my doctor, it is his love and respect, coupled with his ability to maintain boundaries, that enables him to help his patients as well as he does.
Thanks for sharing your story, Judy. My sister, who has a BPD diagnosis and has been with the same therapist for going on 10 years now, has been improving, albeit slowly. She is also funny, charming, bright, and a phenomenal mother. I am very grateful that she found the right therapist.
And for Sarah, who lives in a small town, I just want to add that Dialectical Behavior Therapy is not the be-all, end-all for this disorder. My sister is being helped by someone who comes from a more psychodynamic orientation, but he has helped her tremendously. In other words, you might be able to find a compassionate and patient therapist, from a different therapeutic orientation, who would be able to work well with you.
I was hospitalized last May of 07 for an overdose that should have taken my life. I researched this for over a month. So I was then transferred to a psych hospital for 15 days to. There I was diagnosed with borderline
personality disorder (axis 2) Axis 1 was major
depressive disorder. I believe though that the Bpd has over-ruled the major depression. I
never seem to know my boundaries, I’m very Impulsive, and I’ve always had to have some kind of medication or alcohol to feel normal.
I’ve been through 4 psychiatrists, many therapists. For many years I was very demanding, no real thought structure to my thinking, almost like I live in a fantasy world. I’m very kind to others though, and I feel for others who are having trouble or have
Bpd themselves. My self esteem is really low so I tend to get embarrassed very easily or just Isolate. I’ve been in many many relationships in my 46 years of life. Most of the time I usually used anti-anxiety medications or alcohol. I’ve been told I am an alcoholic which from what I read goes along with the Bpd. I never had the proper upbringing or the proper attention at home.
For me it started in 2nd grade when I used to
seek attention by doing my school work incorrectly on purpose. I was brought to a psychiatrist even back then and the psychiatrist said it was my parents who needed to change in order to bring me up properly. But that never happened so around 21 my life really started going down hill.
My mom always told me these horrific stories about me getting lost when I was way to young,
my dad left me in the car while he went for cocktails and I would get out, then picked up
by the police but nothing was never done. That was back in the 60’s though, where was DSS back then? My mom ran around with her sisters husband and my dad could never really be bothered and was very critical and didn’t really care much at all. So I never had the core foundation upbringing that I needed back then. The therapist I’m seeing now seems to think I’m not borderline, but the medical records from the psychward has it down as a 2nd diagnosis. I’m wondering if I’m wasting my time with her. I have stopped drinking which I think has helped. But I’m still very demanding, explosive, very unreliable, my mood swings are from one extreme to another.
I’ve always tended to take things for granted
too not really having any real conception of life. Just sliding by sort of speaking. I start projects but never finish them. I know I’m smart because I have been to college, and
I am a funny person at times, Love people of all walks of life. I still have a huge issue with trust so I don’t let very many people in
which seems to be long standing with me even to this day. It takes a very long time to feel relaxed around anyone that I don’t know very well. The Interpersonal relationship issue tends to stand out the most, which makes me believe I do have Borderline personality disorder. Sometimes I even think
I am stuck in my teenage years why I don’t know. As in that peterpan syndrome. I definetly know right from wrong but sometimes it takes a few bad mistakes for me to conceptualize it. Well I hope my story helps out others. Thanks for reading.
Hi Liz,
I wish your sister the best. She’s fortunate to have a sister who cares about her.
Regarding Dialectical Behavior Therapy, my therapist didn’t use behavior modification or a cognitive therapy approach, he was into psychoanalytical therapy, but what really mattered, as I mentioned before, was the fact that he sincerely and consistently cared about me.
In fact, one day, after about a year of my calling him virtually every day with some fear or other, based on my belief that he was going to get tired of me and leave, he wrote me a note. It said, “I am not going to leave you. I am always with you, even when I am not with you. I will always be here for you.” He signed his name to it, and I had the gall to give it back to him and ask him to write the word “love” before his name. Although he was clearly uncomfortable, he wrote it.
I kept that note, folded, inside a plastic baggie, and I put it under my pillow every night for about four years. What I needed more than anything was for someone who was never going to hurt me or take advantage of me to basically mother me. And he did.
My friend who is a therapist, who I mentioned likes working with borderlines also does not use Dialectic Behavior Therapy. He uses consistent boundaries, love, and gives his patients the sense that he is always available to them. Neither of these doctors have turned their lives into knots doing this, either. They use safety measures so that they aren’t constantly having their private lives torn apart by interruptions. They use an answering service, and, like I said, they create and sustain boundaries.
My point is an agreement with Liz to Sarah, that you don’t have to have a therapist who uses this particular technique to get well. You need a therapist with whom you and the therapist feel a sense of camaraderie – and then it is incumbent upon you – the patient – to guard against that ugly problem of putting the therapist on a pedestal. You can put them up there, but you have to be aware that you’ve done that, and you have to remember to be fair, so that when the day comes that the therapist does something that you think is not pedestal quality behavior, you don’t let all the work you’ve done go to waste as you make a snap decision that the therapist was no good after all. (Don’t succumb to the philosophy that if someone really cares about you than there must be something wrong with them!) What I mean is you have to be prepared for the crash, it will happen. And you should summon as much grace as you possibly can, and let your therapist glide gently to the ground, hopefully allowing him or her to land on their feet without bruises. They have ego’s too, and although they don’t want to be affected by the good feeling they get from being put on a pedestal, they can’t help it. It feels good to be seen as wonderful, and patients do that for their therapists for a while.
Regarding Dialectical Behavior Therapy – and I’m sure it’s a great way to approach helping borderlines, I’m not knocking it, I’m just saying what Liz is saying, that borderlines can be helped with other forms of therapy.
Anyway, as a borderline patient, whatever type of therapy you get into, it is not a bad idea to get involved in some sort of martial art, Aikido, Tai Chi, or some other type where meditation and awareness of body and surroundings take precedent over knocking the stuffings out of someone else. It’s a great way to make a commitment to do something, it offers slow but detectable progress, it helps with controlling emotions, it helps with being able to see the big picture and to stop seeing the world in terms of ones own oft-changing perceptions, and there is also the belief that one can heal the mind by healing the body.
Unfortunately, borderlines often have trouble holding jobs, so many borderlines don’t have extra income for martial arts classes, but many dojo’s (martial arts training gyms – it actually means “the house of the way”) offer training in exchange for cleaning or other services.
If that’s not possible, walking is a great way to clear the mind. I used to walk four to six miles most days. It is really helpful and I highly recommend it.
Okay, that was as long-winded as my first post. Sorry to take up so much space – I’ve just given this a lot of thought, and even though I’ve felt healthy for years, I remember how horribly painful having bpd is, how you can feel like Major Tom out in space, with no one within thousands of miles, and no way to get home. It’s a horribly lonely feeling, and as a borderline, you can feel that aloneness in the midst of a group of good friends. It can be excruciating to have bpd, so I feel unbelievably fortunate to have had the experiences I had which led me out of that hell hole, and I hope that I might say something that might be of some help someone else.
Hi Dave,
I just read your post. I’m glad your overdose did not take your life. I am sorry you feel so awful, and I wish you the best in figuring out how to help yourself. Your family history sounds about right for a lot of borderlines – inconsistent and/or indifferent parenting. I read a great book, which I highly recommend to you. It’s pricey because it’s a professional book, but if you can’t afford it, you may be able to get your local library to order it for you. It’s called: “The Narcissitic Family, Diagnosis and Treatment” by Stephanie Donaldson-Pressman and Robert Pressman, ISBN 0-7879-0870-3.
Two other books come to mind which I also found tremendously helpful, “People of the Lie: The Hope for Healing Human Evil” by M.Scott Peck, ISBN 0-684-84859-7, and “The Verbally Abusive Relationship: How to Recognize it and How to Respond” by Patricia Evans ISBN 1-55850-582-2.
The first two books deal directly with the issues of having parents who hurt their children, and I recommend the Narcissistic Family very, very highly. The basic point is that there are parents out there who create an environment where the children live in service to the parents needs, rather than the other way around. As a parent, I know that I have to give myself to my children. I don’t mean in a slave-like way, but they are the ones who need to be parented. The Narcissistic Family really gets into the dynamics of dysfunctional parenting, and it’s an empowering eye-opener for anyone who was raised by indifferent, immature or cruel parents.
The second book specifically deals with people who are evil. My mother was evil. But only to me. To my sister, my mother was oblivious. So I grew up with abuse, and my sister, living under the same roof, grew up with neglect. People Of The Lie was very helpful to me.
The third book is really written more for women, and as a man you will have to transpose the author’s language, but I put it in my list because it’s tremendously insightful in terms of helping to identify what is happening in conversations when you feel someone is being unkind, or cruel, but you can’t quite put your finger on what they are doing. Since you mentioned you have low self esteem, plus relationships are hard for you, I thought you might find this third book useful.
The other thing I did as far as reading goes, was I read a lot of books on good parenting, so that I was able to figure out what I didn’t get that I should have gotten. That helped me to understand that a lot of the things I thought were “wrong” with me – that low self esteem thing – were created by the environment I lived in – so, although I was left with the problem, I was not the cause of the problem.
Viewing a problem you have as being intrinsically “your fault” only makes things worse. But not taking responsibility for fixing the problem doesn’t do any good. If a person is blind, that’s a problem they have to deal with. But it’s not their fault that they are blind, it’s just something they have to deal with. And they do. It’s the same with emotional problems. It’s not your fault, but it is yours to deal with.
Okay, I’m off my soap box, getting back to work. Dave, I wish you the best. I know how hard it is to live with so much pain and uncertainty, but I believe that one can find a way to heal, and I sincerely hope that you find that path soon. It sounds like you’re already on it, actually. Best to you!
The saying, “Physician – Heal thyself!” refers specifically to doctors! How can a person with a brain disorder heal their own brain using a tool (the brain) that is flawed? Obviously, we need professional caregivers to heal us. The saying, “Physician – Heal Thyself!” I believe is from Shakesphere. Back in his time a doctor would “heal” a patient with blood letting or applying leaches, amongst other great ideas. The patient protests these crazy methods and pleads that the doctor, himself, take the same treatment, if it is so great! A modern example might be shock-therapy. There are measurable results and measurable side-effects. BUT – How many Psychiatrists or Psychologist have you heard of who have signed-up for that magical treatment? I’ve heard of none.
The cruel ironies of this story about patients with Borderline Personality Disorder being mistreated are many. I have Major depressive disorder, BPD, and PTSD and I’m the grand-daughter of a diagnosed BPD. Number one irony for me is the repetition of rejection, discrimination and cruelty through our lives.
First we get to grow-up with parents that are lacking, molesters and bullies who are many, siblings who are only out for themselves and who pile-on the verbal, emotional, physical and sexual abuse. After all, who’s stopping them? No one. Then we “grow-up” when we get to be frequent victims of sexual- harassment, crime, get to be battered wives, hookers, homeless or hoarders. Usually, due to our under-diagnosed, under-treated, under-medicated and even under-hospitalized positions we tend to make a mistake or two. People call the police – who hate us. Judges don’t understand. After all, aren’t we educated? Employed? Parents? We end up in jail. (Someone – please find some data on the percentage of jail and prison inmates who have BDP). Then we get to have our children taken away – because we are “criminals”. Or just because we are “crazy”.
Say we finally do get suicidal and enter the mental health system. THANK GOD! FINALLY – PEOPLE WHO WON’T HURT ME. FINALLY, PEOPLE WHO KNOW WHY I’M LIKE THIS (ie. all the child abuse, rapes, incarceration, banishment, lost familes and lack of treatment,). FINALLY – I CAN RELAX FOR A MOMENT. FINALLY – I’LL BE LISTENED TO, UNDERSTOOD AND HELPED!
Lord help us! Now the truth comes out about what happens when we enter the mental health system – WE ARE DISCRIMINATED AGAINST, REFUSED CARE, ABANDONED, TREATED WITH DISTAIN, AND MORAL DISCUST! Why? Because we’re too difficult to treat?! For the love of God – We are lucky to be alive!! We are blessed to be kind and not repeat the evil we suffered under. Thank God we aren’t sociopaths!! PLEASE GIVE US A BREAK! FOR ONE HOUR. FOR TEN MINUTES. PLEASE, GIVE US A BREAK FROM THE HELL THAT IS OUR EXISTENCE!! Wow. And people wonder why we are suicidal.
A lot of people who survived the cruelty and physical abuse and neglect that we did don’t do as well as us. A lot of those survivors become murderers, child molesters, rapists, dictators, etc. and end up in prison or hung from a rope. Or if they are never caught for their crimes, they certainly never go into the mental health system for help!
A lot of people who survived the cruelty and physical abuse and neglect that we did end up as prostitutes and drug addicts. Some don’t survive at all. Some survive only to later take their own lives to stop the emotional pain and social ostrisization and poverty.
MAYBE – THE GOOD PEOPLE OF THE MENTAL HEALTH SYSTEM COULD THINK ABOUT THAT FOR A YEAR OR TWO AND START BEING KINDER TO BPDs AND GIVE THEM THE CREDIT WE DESERVE FOR RISING ABOVE THE SESS POOL WE WERE REARED IN.
My greatest therapists are Jesus Christ and Lao Tzu (Taoism). I recommend reading THEIR WORDS, not other people’s words about them. When I hurt about how my Mom, my only living parent, allowed my older brother to abuse me DAILY IN OUR HOME, I think about God/Jesus who is not flawed or lacking like she was. God/Jesus loves me and are proud of me even when I fail, even when I fall, even when I’m selfish and wrong, even when I’m terrified and paralysed. Knowing or convincing myself of that gives me the best therapist around, the best parent ever, THE ONLY THING that won’t leave me or hurt me or ignore me is God/The Tao.
God blessed me with the strength to survive, blessed me with three amazing, beautiful children, blessed me with education and the fight to get treatment in an hostile environment. I’ve lived through hell, been showered with gifts from God, and I’m NOT going to give up now, no matter how suicidal I feel! I WILL KEEP ON SURVIVING!
Don’t hate me because I haven’t let the bad of the world make me a bad person. Don’t hate me because I follow peace, kindness, equality, no matter how much I lose to do so. Don’t hate me because I’m difficult or different. Please, be happy you aren’t me and maybe give me a smile. I will appreciate it! I promise!
LASTLY, I HIGHLY RECOMMEND THAT IF YOU ARE SUFFERING FROM ANY DISEASE, EMOTIONAL OR PHYSICAL OR BOTH – BUY YOURSELF SOME LOVE, LOYALTY, PROTECTION, COMPANIONSHIP, ENTERTAINMENT, PERSONAL TRAINING – A DOG, OR TWO. YOU WILL BE HAPPIER! AND YOU WILL BE LESS LONELY.
One book I read about BPD said that the patients often have stronger bonds to their dogs than to people in their lives. This is perfectly LOGICAL. As I told my last two phychologists, “I have never woken from a deep sleep to find my dogs paws around my neck, choking me. A person did that to me. No pet has ever sexually harrassed, assaulted, or molested me. People did that to me. So, it makes PERFECT SENSE that I’m more bonded to my Shi-Tzu than any grown-up I know. My kids, however, have my heart and soul – 100%!!
Love, love, JuJu
Julia, I whole heartedly agree with 90% of what you said. We have come directly out of the most vile, evil, destructive environments available. Just becasue some of that vileness wants to follow us is no reason for the people who have never lived in it to distain us, but they do. I think the problem is that they are mamal too. All mamals are hard wired to take from those weaker than themselves. (Just watch a herd of horses, a pack of wolves, even a warren of rabbits, they all do exactly the same thing.) Therapists see BPD patients as perfect vicitms…we learned early and well that being srtong in any way was an invitation to be broken even more. Therapists know this, and BPD patients are custom made victims…so we are the ones that therapists can also use to exercise their dark sides. It is a normal, boilogical thing to do…it’s just a little tougher on BPD patients, not like we haven’t been THERE before!
Oh heavens above!!!
Leave borderlines alone they are precious loveable people i should know i suffered with the illness for 9 years of my life they can be helped so for god sake dont treat them like they are insignificant because they are just normal people like everyone else
DONT EVER THINK MENTAL ILLNESS CANT HAPPEN TO YOU when i was 5 i wanted to be a police officor NOT A MENTAL PATIENT and you should pray that if something were to happen to you that society wont turn their backs on you like so many did for me
I’ve posted this on another entry, yet it’s appropriate to share on this one with adjustments.
I am a consumer and am in the fight against this stigmatization and criminalization coming towards us from all angles especially those whom are suppose to assist in our advancement towards understanding our illness.
The media plays a crucial role in maintaining many of us in such oppressed state that many never gain their hope back and believe they are not normal with a treatable illness that’s triggered like high blood pressure and the likes.
Together with the Criminal Justice System, these tools are not being utilized for the benefit of the people’s well state of mind but to further shock and awe many into a more frantic and irrational state of mind.
The DSM is okay only in the fact that it allows others to understand if open minded that these conditions are treatable, though it’s not geared in the promotion of alternative treatment which in many cases may be more effective than medication.
Just thought I’ll share this thought.
The only way to ensure that fellow peers in the struggle with their syptoms have a fair enough opportunity of maintaining a sense of wellness, is to allow others who have been through that road and obtained real life experience (not text book experiences), to be a part of one’s recovery.
So, the question lays, Are you truly here to assist the many of us in getting a better understanding that it is ok to be overwhelmed mentally and that it doesn’t always have to be like that (even after taking the conditions in society as a whole into account), and in concluding I wonder how many peer specialists are employed if any by your colleagues.
I’m an intern currently and I can tell you that there is a HUGE stigma at least where I’ve done all of my training. There is not one week that goes by where I don’t hear from another intern “how awful those borderlines are” and the jokes and negative statements I hear constantly irk me, as a result.
In fact, at one point I shared my feelings about it and some of the interns started to change their attitudes, but take it from me, there is still a huge stigma and it’s a shame because really under it all Borderline is simply an attachment disorder and if therapists would realize that it isn’t the fault of the person and the person needs to be reparented, maybe the stigma would end.
“borderlines are people with attachment issues who need reparenting”
You’ve summed it up.
As a recovered borderline, I’ll tell u that all my symptoms are under control. But it does not stop the floods of anxiety, despair, emptiness, meaninglessness that plagues me not forgetting the rage if I am betrayed.
A lot of us were physically/sexually abused in our childhood and then suffered a traumatic event which we couldn’t handle which lead us to snap.
Interpersonal Neurobiology by Daniel Siegel was what helped me the most. I realised it was so much circuitry and miswiring.
The day I was given the diagnosis was the day I began my speedy recovery – I could recognise why I was the way I was, felt what I did and reacted the way I did…when I realised it was due to attachment issues, I strove to overcome it.
To clinicians, I have to say, be patient – we are just like children we don’t mean to be difficult it hurts as hell inside we don’t blame others as much as we blame and hate ourselves more than anyone hence we cut cos we are clueless how to cope.
When a bpd patient recovers, often thru secure attachment, they are the most loving empathetic ppl u will meet because they know the hell that is anxiety and abandonment and will not want others to feel inadequate or unloved.
My doctor did not treat bpds until he met me.
And I worked very hard to recover. He now treats BPD patients after having worked with me and I worked very hard – journalling, reading voraciously, feedbacking and doing everything he suggested. He was encouraged by my desperation to get better.
Thing is, I only was able to when I realised what happened to me – that my feelings were a result of attachment not pathological disease of the brain.
With the advancement of neuroscience – there’s a lot of hope for BPDs. Don’t give up on us. We will grow up. Meanwhile, see the love and innocence in BPDs.
The rage and anger stems from disappointment and rebelling.
And not knowing how to deal with the painful emotions we suffer in more amounts than average ppl – it’s no fun to be reactive all the time and definitely not cool. We know that that’s why we often don’t give a shit…we want to not care, cos caring hurts so much.
Hence the shifts in mood.
It is all about fear of loving another, not being worthy of love and a constant need to do things to gain approval because we don’t know how to love and parent ourselves.
Give BPD patients a chance. We are just children, broken children who are trying to grow up and to give a shit about the world,
Despite our incredible anxiety and emptiness.
Thanks for reading.
20 years of BPD, I haven’t self-harmed in 5 years, no suicide attempts in 2.
I fear for the future still but I just try to keep on going.
Mindfulness Meditation helps greatly.
B.
P.S… John, I also should thank you for your great blog. I read it daily through bloglines and have used many of your articles to teach others. I appreciate your work. Thank you so much!
I’ve actually had to deal with this since I apparently have BPD “tendencies,” depending on which pdoc I’m seeing. It seems to be a license for absolute rudeness and disdain on their part.
But the consensus is that BPD is a dumping ground for difficult to treat and just generally disagreeable patients, and as a code to future workers in the psychiatric field who may have to deal with them. This article is pretty much spot on.
This is driven by my personal experience. You’d have to be a fly on the wall at some of my appointments to believe the shit attitude that comes from the psych workers when they think I’ve been pegged as BPD.
But with time and they get to know me it’s been pretty consistent the diagnosis of the “tendencies” is probably wrong or completely marginal compared to the bipolar disorder. And the sea change in attitude as that realization comes about is stunning.
I am a patient who was severely emotionally abused by a therapist who, after five years of treatment, a number of other diagnoses (from her) and even being one of her favorite patients, suddenly decided that I was borderline. She abruptly ended my therapy while shaking her fist at me after I had attempted suicide because of a crisis at my work (and was still hospitialized and very, very shaky). After she ended my therapy she continued to interfer with my treatment both in the hospital and in aftercare. After that she wrote some absolutely horrible and very untrue things about me to my employer, effectively ending my employment. Even my psychiatrist at the time was taken aback by the things the therapist wrote. The irony is that while I probably did had some borderline tendencies at the time, I have never really “been borderline”. I was in deep crisis at the time and was probably suffering from PTSD brought on by a childhood sexual abuse trigger. I am also bipolar type II. There is much more to it but I can certainly testify that her attitude took a 180* shift once she decided I was borderline. It has taken me many years and several other therapists to get over the damage, self-hatred and self-doubt she caused me. Fortunately for me they have told me that they see no trace of borderline in me.
Thanks for letting me vent about my firsthand knowledge of the horrible prejudice about borderline personality disorder among therapists. I certainly hope there will be MAJOR changes. My old therapist is very fortunate that I did not file a formal complaint. I seriously considered it but decided I was just happy to get away from her. I hope I haven’t put anyone else at risk by not doing so.
THERAPIST, KNOW THYSELF. This should be the second rule, after ‘do no harm.’ Knowing your own boundaries and the limits of your abilities as a therapist, your willingness to take on challenges and knowledge of when you’re in too deep – I don’t think a therapist/physician/nurse should walk away from the profession because he/she does not work therapeutically with persons diagnosed with BPD. This can’t be the acid test of when to hang up your hat and give up your license.
There are plenty of other individuals who need our help. Just be aware of your built-in detectors. As with anyone who has regular contact with someone who thinks and behaves in certain familiar patterns, you must able to say ‘no,’ I cannot, should not, I will not treat this patient.
ES
Hi Judy,
Thanks for your reading recommendations. Yes it has been the other way around for me. I’ve
always had to lie to keep the family together.
And I swear my mom wanted a child so I could
be of service to her. She had an affair with
her sisters husband for 25 years and everyone
knew about it including my mothers sister and her children to. So I was always stuck making
up excuses for my mother to my father who was
an Isolated and very moody guy. When I was growing up I was always lost here and there.
I got out of my crib twice when I was like 3
years old. The neighbors used to pick me up. I got out of the car and the police picked me up. Today I say to myself
“where in the hell were my parents and what parents leave there 3 year old alone in the
house” Even if its for 5 minutes? My mother is very narcissistic and I think I have a tad of it myself. I was out all hours at the age of 14
drinking with a lonely divorced woman and her daughter. The thing is that nothing really seemed all that wrong back then. But in my early twenties it started having a horrendous
affect on me. The irony of it all is now I am
back still taking care of my mother who is now
83 and has had cancer 3 times and now she has
a scarred longue with a large mass, so her breathing is really bad. Her memory is very poor too. When I tried to take my life others
in the neighborhood said, “Oh your poor mother.” I was like HAAAA! If you only knew what I have been through in the past 27 years!
My mother was always a very beautiful woman and my dad very handsome. So I have both of there good looks (not being conceded) and have
been through many many relationships. Even though my self-esteem sucked.
I will look into those books, thanks again and good luck in your therapist training.
Great article.
I just wrote a first-hand account of my own experience with the BPD diagnosis called Let’s Talk About Borderline on my own blog. (http://depressionmarathon.blogspot.com/2008/03/blog-post.html)
This is so clearly the most stigmatizing diagnosis a person can carry! The open disdain and unprofessionalism I have experienced due to these three letters on my chart has been astounding, and sometimes shockingly unbelievable.
Despite reinventing myself through DBT, I still face discrimination from MD’s who refuse to remove the BPD diagnosis from my chart. Another example of how mental illnesses are treated differently from other illnesses–if I had worked hard, followed treatment recommendations, and recovered from hepatitis, diabetes, or cancer, they would not be listed as CURRENT diagnoses needing attention! But, with this label, rather than being rewarded and recognized for my hard work, it is instead stamped there like a threat–reminding me that as a “mental” patient, my treatment is largely based on the pre-conceived notions and whims of the professional who happens to pick up my chart.
I second Peer in spirit and criticism, and will lament the horrifying abuse histories that correlate with BPD which are always glossed over in both discussion and treatment. That includes the infantilizing CBT/DBT corrective applications, which do more harm than good, do not address the trauma, and that more of us are willing to challenge and spit back in disdain, thanks largely to the support and solidarity of grassroots peer specialists paid and unpaid.
The worst of the stigma that I’ve encountered about this diagnosis is that perpeptuated by clinicians. Not ALL clinicians to be sure, but I think it is fair to say MOST. For example, clinicians often characterise borderline behaviours as: ‘attention seeking’, ‘manipulative’, ‘agressive’, ‘hostile’, ‘rejecting of help / advice etc. Intent seems to be ASSUMED rather than ASSESSED. The generalizations from the diagnosis to assumptions about a particular person seem to be made more frequently and often harmfully about individuals with this disorder.
I think that it takes a therapist with special talents and skills to do good work with people who have borderline issues. The therapist patient fit is really very important and might well be harder to find for people who have borderline issues. Therapists also need to be very secure in themself because people often need to learn how to sit with intense distress and really… If the therapist is unable to sit with intense distress then how is the client going to learn? Often people need to convey their distress and harmful interactions by SHOWING rather than TELLING. Takes a clinician with a great deal of emotional stability and ego strength to see borderline communications as communications and thus to respond rather than react.
I found myself laughing when I read your post. How many times have I asked a therapist, how do I change myself? Only to get the reply, well, you have to WANT to change. They actually didn’t HEAR me ask how to do exactly what they just advised me to do!!! It was like I didn’t say a single word, especially not one that would get in the way of their preconcieved notions about those letters on my chart. With an atmosphere like that, I wonder why BPD patients have trust issues?
I think the stigma is mostly because clinicians feel powerless. Which is often… How the borderline person has felt for much of their life. Clinicians seem to have trouble coping with that feeling – as do clients. Clinicians seem to blame the borderline person for their feeling – and the clients seem to blame the clinicians. I think that often interacting with borderline people brings out the borderline person in us. That is scary for some clinicians. Especially clinicians who became clinicians in order to feel some sense of successfully controlling others and altering the world for better. Clinicians who have felt powerless and deal with over-control. They thus judge the borderline person for ‘not being able to control themself’. Which just adds to the severe judgement that the borderline person has encountered in their life… So easy to be part of the escalating and so hard to reduce the emotion… So much nicer to treat that other person who is consistently grateful and appreciative and compliant and obedient and who proclaims to be much much better in virtue of that little pill and / or chat…
Clinicians wouldn’t feel so powerless if they would adopt another way of describing their patients that would be less blaming, less punitive and less damaging to the already fragile “self” of this clinical population. People who suffer from what has been obnoxiously termed “borderline personality disorder” by a health care industry that seems to blissfully ignore the incredibly painful subjective experience of people who suffer in establishing their medical (DSM) criteria in such abusive terms. With no gray areas to most descriptions of BPD for the general public, there is total ignorance of just how differently this disorder plays out in every individual. It is time to stress that there are mild, moderate and severe forms of BPD, it is time to take a close look at what the disorder is, to realize that these are all behaviors we only see under certain kinds of stress, i.e. no one is “borderline” all the time, and to separate the illness from the personal biography of the person. The greatest injustice has been to term this illness a “personality disorder” as if the DSM criteria described one kind of person – a total fallacy that drives most people who have to read this criteria knowing it is their DX, people “with BPD” who search the net to know more and confront all the hate that is being nurtured against them with the complicity of the DSM-IV-TR, into heretofore unknown depths of shame and loathing.
If one in all – society, parents, peers, hot line helpers – would target the SHAME that has poisoned the wellspring of these people’s very being they could well find that what they were taking for hostility was in fact a last ditch defense against a seemingly hostile world.
Hi Dave,
Two other possibly helpful thoughts – There may be an ACOA (Adult Children of Alcoholics) meeting near you, or Al-Anon meeting. If you live in a heavily populated area there will probably be several different groups to try out to see which one feels right. Although my mother was NOT an alcoholic, my experience was that her inconsistent behavior was so akin to alcoholic behavior that she might as well have been, and even though I felt awkward going to these meetings at first, I gradually became very comfortable. You don’t have to volunteer anything, except “Hi my name is” at some of them – some, you don’t even have to do that. I listened to others speak for several months before I said anything, and then, when I did, I said that my mother wasn’t an alcoholic but that a therapist had recommended the meetings to me because she was as inconsistent as one, and I gave an example and was accepted unquestioningly into the group.
I found that hearing what others had to say about vicious, destructive parenting, and how they coped, didn’t cope, hurt and healed – everyone’s at a different stage – was tremendously helpful to me. Additionally, at an ACOA or Al-Anon meeting, no one is labeling anyone with various diagnosis – BPD, etc. Though one can tell eventually who many of the BPD people are because of their anger and volitile explosions! (No put down, borderlines have much to be angry about!!)
The other suggestion is getting involved in a martial art, Aikido, Ti Che, or some other not particularly violent killer martial art. The act of moving your body is helpful, practiced silence is helpful, learning to be still is helpful, interacting with others in a guided, streamlined, focused and specific way that has clear boundaries is helpful. Commitment to doing something and making it a priority is helpful, too.
With both ACOA/Al-Anon meetings and a martial art, I highly recommend that you do NOT forge close friendships or date any of the people in either group. Even if someone seeks you out. You can gently say that you are not available at the moment.
(If you saw the movie “28 Days” – NOT TO BE CONFUSED WITH “28 Days Later!” with regard to healing and dating, they recommend getting a plant. After a year they recommend getting a pet. If, they say, after two years, both the plant and the pet are still alive, then it might be time to think about dating. Not bad advice!)
Lastly, Dave, I’m not sure what I did to make you think I’m in training as a therapist. I’m not. I was a MAJOR borderline and I had the very good fortune to connect with a therapist with whom I “clicked” – after many therapists, a lot of self-mutilating, a string of dead-end jobs, a host of unsuccessful relationships, including some abusive ones, a very serious suicide attempt and numerous self-help projects that did not help. I was in serious therapy with the therapist I worked well with for six years, (the first two unbelievably intense). After that I spent another four years checking in periodically. At this point, we exchange birthday cards each year and I give him a call about once every three years.
I do not have BPD anymore. I can feel when BPD symptoms start forming – fear, unaccountable and devastating “alone in the universe” feelings, a rapidly rising boiling rage, etc. But I manage them by identifying them early on, knowing that they won’t last, and then doing something to stop them from developing, rather than embracing and nurturing them – unlike what I used to do which was to embrace and nurture those horrible feelings.
I’ve developed friends in a community of people who have no idea of my histrionic, perpetually suicidal, dramatic, and thoroughly, agonizingly painful and terrifying past life. If I let myself go, I will destroy these friendships, and I’ve worked so hard to get where I am that I don’t want to let that slip away simply because it would provide me with immediate gratification – especially since I know I’ll be feeling better in a matter of hours, or a day, and life will be back on track. It’s not worth ruining friendships or job relationships for the luxury of acting out when I feel stomping mad. I just retreat and regroup – find a good book, watch a funny movie, find funny bits on Utube, etc. – call in sick if I must – I’m not saying that these distractions work when you have BPD, they don’t; BPD is a much stronger force than funny movies. But, as I said, after a lot of work, I don’t have it anymore, just the residual potential responses. And I can keep them at bay until they dissipate.
Now the other, the stuff I mentioned above, about ACOA meetings and martial arts – those are REALLY helpful while one had BPD! Therapy, I think, is really important, with a good therapist, but some people either can’t find one, or can’t afford one, so the meetings and the martial arts are TREMENDOUSLY helpful! They are helpful in conjunction with therapy, too – although be forewarned, some therapists don’t want their patients going to ACOA meetings while they are in therapy; they are afraid the patient will do the therapeutic work at the meetings, rather than in the office, and the therapist will be out of the loop – missing vital information they may want to have. Many therapists also rely on the transference process to help in the work – if I hadn’t had my therapist on a pedestal, believe me, I wouldn’t have stuck with therapy with him long enough for the therapy to be effective – so therapists benefit – if they can maintain their boundaries in a caring way – by transference. When a patient both sees a therapist and attends ACOA meetings that the therapist has nothing to do with, the risk exists for the patient to focus their transference on someone at the meeting rather than on the therapist. This does not bode well for the therapeutic relationship if the therapist relies on transference. So you need to find out about that if you are in therapy. But I personally think both are very, very helpful.
Borderlines feel a level of aloneness that is akin to the terror an infant feels when it isn’t getting it’s needs met. This is no slight to borderlines. The aloneness can’t be minimized. It is excruciating. I know, I spent thirty some years feeling that agonizing aloneness. It is an ugly place to live and many borderlines will do anything to not feel alone – including destructive things like sleeping around, staying in dangerous environments and relationships, etc.
Going to ACOA meetings, and training in a martial art, offer a feeling of being a part of a group. And while not giving that one-on-one attention, they still provide a place where there are others around, united by common purpose. So, again, I highly recommend them – along with the caution to not get into an romantic entanglements with other members.
One other thought – there are foods and drinks that it’s better to stay away from. Nutrition is not something most people thing about, but it’s been proven that a vegetarian diet reduces aggressive feelings and tendencies. Also, caffeine is not so good; apart from not being good for you, it keeps you awake and borderlines tend to do most of their mental anguish suffering in the wee hours of the morning when the rest of the world is asleep, so doing things to make yourself more likely to be up late at night aren’t helpful. Alcohol and drugs generally exacerbate the problems of pain and rage, and used excessively, they stop people from maturing (i.e. if at age twenty you begin drinking and smoking pot every day, and at age thirty, you quit, you will have spent ten years NOT doing any maturing, you will be like a twenty-year-old mentally, in a thirty-year-old body). But everyone knows how they personally fare with both, and some people do find relief from a glass of wine or whatever, so I’m not saying absolutely not, but in general it’s better to stay away from alcohol and drugs. Further, there are no guidelines for the impact that preservatives, bovine growth hormone (in almost all dairy), massive antibiotics, etc. have on our systems, but I can guarantee you that I and many friends of mine have had a noticeable reduction in unpleasant emotions, and a greater calm and more ease with focusing by only eating fresh produce, organic foods, little or no sugar – except fruit sugars – and staying away from the above mentioned “bad” stuff. Any day when all I eat are fresh fruits and vegetables, it is AMAZING how much better I feel physically, and how much brighter my outlook is!
Anyway, I am not in therapist training, so I’m sorry if I said something that led you to believe that I was. I have analyzed my own experience extensively because I’ve written a novel whose main character has BPD, and the story is about her recovery. I had to be honest in the story, so I’ve really had to think about what made me sick and what happened that made me well. That’s all – no therapist training.
Again, Dave, I wish you the very best. I know how awful it feels to be in that self-doubting, alone place. It is clear from the above posts that there are many, many people who know just what kind of a nightmare having BPD is.
While I’m on my soapbox, in addition to the fact that there is a lot of prejudice among therapists and clinicians against borderlines, the state is against them too, and trying to get social security disability when you have a BPD diagnosis is nearly impossible, unlike some other diagnoses. We borderlines are often so bright and high functioning that it’s hard to understand the level of oft hidden dysfunctionality and the intense aloneness and fear that can distort our thinking and ruin our lives. The fact that we crash and burn over and over, doesn’t fit the paradigm for public assistance. It’s maddening to say the least!!
Okay, soapbox is being put away.
Again, all the best to you!
-Judy
I really like this article Dr. John and thanks so much for showing such emotion for BPD and all that it entails for patients.
It angers me to hear that interns, therapists, or any medical professional for that matter would complain and make jokes about something so serious. I tried suicide once at 16 but not a day goes by that it doesn’t cross my mind still.
I don’t find anything funny about that. Perhaps those individuals did not go into the profession to help people and should reconsider their career choice.
I’ve been with my therapist for over two years and it is still hard to trust and let him in 100%. There are things he and I should be talking about but I can’t yet.
It isn’t anything he has or hasn’t done, it is my fear of having someone know all of me and still accept me. It hurts me way more than it will ever hurt him or anyone else.
I’m still working on it and I’m glad he hasn’t given up on me yet.
According to several therapists my borderline husband has worked with the reason there are so few therapists who know DBT techniques is because the only way to learn them is to go to classes that cost many thousands of dollars, not because therapists don’t want to work with borderline patients. These therapists do work with borderline patients and generally seem to see DBT as a positive thing. His current therapist has said that she would love to learn DBT techniques because it would increase her income, but she can’t afford to take the classes.
It seems to me that a significant part of the stigmatization of borderline patients by therapists is an inability on the part of most therapists to successfully treat borderline patients, even in those circumstances where the borderline patient wishes to be helped. This is understandably frustrating for both the therapist and patient. DBT addresses this issue, but apparently needs to be more accessible to practitioners.
Thank you Doctor for taking the time to write what you have written above.
Once I walked out slamming a door on a therapist whose response to a moment of severe trauma in my life was to put the brake on and try to terminate a therapy that he had started (I had originally consulted only for relaxation techniques, he was the one who opened “Pandora’s box”). I recognize that he was afraid and that the situation was out of hand.
That was my only ever “cry” for help and it probably was enough to earn me the dx of BPD, which arrived a short time later. It doesn’t matter that I’ve never called any therapist after hours. Or that I am too introverted and shy to be dramatic, to call attention to myself. Or that I have never gotten upset with anyone for postponing or for being late. Or although I suffer terribly from feelings of abandonment, friends, family and partners will never see any “frantic attempts” on my part to avoid their “abandoning” me. Like Dave I took on full care of my mother. Rarely impulsive, dysthymic I am without a doubt.
I was horrified at being dx BPD and the only way I could understand it was by looking into subtypes so that I could say, okay I use mostly “internalizing dysregulated strategies”, once in a blue moon “externalizing dysregulated” but never “histrionic impulsive” (the latter is apparently the least pessimistic by nature) to process my (overwhelming) negative emotions; okay my “attachment behavior” is “avoidant” and not “ambivalent”, etc. Other studies other subtypes – unbelievable how many have been coined up to now in attempts to describe this disorder more accurately.
Subtypes seem to me to be a far cry from stereotypes. The latter are far more popular. But why is it so hard to talk about real individuals? It even seems hard for those with “BPD” (who should know better) to avoid stereotyping themselves – never mind others. I can always tell when someone with “BPD” has swallowed all the “official” descriptions.
I admit it can be awfully hard to distinguish “subtypes” from “stereotypes”. But it really bothers me how we toss around certain adjectives these days as if just one adjective says everything there is to say about someone.
Take the widespread – and spreading – use of words like “good” and “evil”. It can hardly be attributed to “borderline splitting” as its way too common. But calling someone “evil” totally blocks us from ever understanding that person, their motivations and their suffering. It is counterproductive to breaking the heavy chains of intergenerational maladaptive parenting – which is the essential issue here. When I could see my parents as survivors of poverty, of war, and of their own parents, people who did what they could, I found peace and an infinite, but beneficial sadness.
In my humble opinion the adjectives exploited by the DSM with it’s “Axis II” BPD, NPD, HPD,ASPD, etc. are not the most useful to describe real people, not even oneself. They might be useful to therapists in guiding their treatment plans. That’s it and it should stop there, unless we are able to put these words in an informed, well nuanced and empathic description complete with someone’s subjective experience. We need to nurture our capabilities to see behind the behaviors to the personal biography, accept that what works for one might not work for another and start to see ourselves as well as others as the unique human beings that they are. A society in which moral judgments run rampant is finally oppressive and unjust to all.
You have hit the nail on the head when it comes to the discrimination practiced int the Mental Health arena reguarding BPD patients. We are call “evil, demanding, attention seeking, histronic…ect” We are also expected to automatically KNOW what we were never given the opprotunity to learn. To understand by osmosis what has never been explained to us, and to find logic in I don’t know. Somehow, these are the ways the “good” people in Mental Health Care are helping us.
If a therapist had issues with treating a client with BPD they need to be honest and upfront about it and not treat the client in such a way that the client will decide to end treatment that breaks trust with the profession as a whole. And as for disclosure it is ok to confirm a BPD diagnosis i’ve heard from many people that they would have liked to know earlier the treating professional had the answer that the patient has been waiting probably years for but refuse to offer the relief the patient desperately wants. As for diverting from the issue of diagnosis “you don’t need a label to see a therapist” goodness get more training.
even without intense treatment such as DBT the borderline individual can have a properly functional fulfilling life
normal psychotherapy can be quite useful knowledge of simple things like issues with unreality are reversible, mood can be theoretically controlled and you control your own thoughts can have massive impacts on the individuals functioning.
It’s time psychiatry was taken to the next level with clinician’s attitudes being equal amongst all disorders. it is possible
“As for diverting from the issue of diagnosis “you don’t need a label to see a therapist†goodness get more training.”
If that was in response to what I wrote, there is a misunderstanding. I have no “training” at all and never meant to give the impression that I did. I was just trying to describe how difficult it was to be in therapy for my first therapist and myself, and how hard and bewildering it was at first for me to deal with the “shame of being borderline”. I’m still dealing with this feeling, which is why I found this post.
I was just trying to address how hurtful the inappropriate use of “personality disorders” can be by people like myself. But precisely because I have no training I do my best to refrain from all judgment on a “professional use” of the term. It does seem that many professional people are questioning the placement of “BPD” as a “personality disorder” on an “Axis II” with “objective” criteria as opposed to “subjective” in the DSM at this time, especially as the DSM-V is on the horizon. I am not one of them however, I follow the debate from the sidelines if at all.
I respect greatly and stayed in therapy for 5 years with the professional who diagnosed me as having BPD. I am certainly most grateful that he was honest and forthcoming about what he thought.
The other side of the picture is the high proportion of frivolous lawsuits and ethics complaints filed against therapists treating borderlines. Too often the borderline personality disorder has to prove they are right and putting a professional through the ringer gives one the impression of great personal power. Go to any mental health malpractice workshop for continuing education and the attorneys all say refer borderlines as they cause more trouble than they are worth. What is, is.
It’s even worse when someone gets diagnosed with Borderline and is actually depressed! They teach you this in basic psychology: You can’t diagnose a personality disorder when all of the symptoms also fit an established Axis I diagnosis. Yet people get diagnosed with personality disorders while they are in the middle of a depressive or hypomanic episode, based on symptoms that go away when their moods stabilize! Naturally that results in improper treatment in addition to the therapist’s bias. You would think that such a simple mistake in differential diagnosis would be avoided the majority of the time; but it’s still happening. Personality disorders are life-long patterns, and when you don’t establish that long-term nature, you run the risk of diagnosing a personality disorder when a mood disorder is the real problem.
Please help me…I have a severe case of Borderline Personality Disorder and have been turned down by numerous Doctors because I’m simply ” too complicated of a case” for them …..I can’t take this anymore
– Jen
phoenix,
i was referring to a quote directly from a therapist which was “there’s not a sign on my door saying you need a diagnosis to see me” avoiding the issue of disclosing a diagnosis. he has since following an angry letter
I was diagnosed with BPD a few years ago. I have been involved in DBT and ACT ever since.
I find it hard to explain BPD to others, especially in Australia and particuarlly to fundamentalist Christians! When you say you have BPD to Mental Health Professionals thats when you get the worst reaction. They seem to instantly transfer their past experiences onto you and interprate everything you do in a negative way.
Most people think I’m selfish and self centered. They are probably right. A person in pain is usually consumed in that pain.
Many people tell me my pain, anxiety, rapid thoughts, constant need for validation (fragile sense of self) etc. is ‘all in my mind’. Maybe they are correct and maybe thats the whole problem! Its a disorder of the mind and emotions.
At times regulating what I feel is almost impossible. The anxiety from being around others (especially in the absence of validation) can become so overwhelming that I act in ways that others may not understand. Then a snowball effect takes place, their reactions to my reactive behavior can further add to the anxiety produced from such an invalidating environment.
So I have a tendency to avoid everything and everyone by isolating for weeks and months. Then the ruminating begins, then the need for any anesthetic to numb (alcohol, substances etc.) the memories and feelings.
I no longer think of suicided but the times I have have been either a cry for help or the real deal.
Thanks for reading.
I was married to a woman who may have been a sufferer of BPD. I of coarse am not an expert but several experts that I have spoken with agreed with my assessment. My ex wife herself suggested that she had BPD. It fit her exactly, she said. The therapist that she met with on her first visit suggested it as well but obviously needed more time to make sure. We split up after her second session (I attended both). I don’t know if she still goes. I hope so.
Our marriage ended on a very bad note and I do not regret the decision. My kids were suffering from my wifes constant need to check up on me (stalking at work). The constant need for reassurance was a huge battle. Just when I climbed that wall and changed myself to accommodate her needs another wall was built 2 times as high. It was a constant rush to patch all of the holes, but for every hole that we plugged three more opened.
Watching somebody go through this is heart wrenching, but to know that you have no idea what they are feeling is devastating. You see it and you think you can fix it. She asks you to say something or do something to help her yet, nothing helps. There are no magic words! If there are please post them here.
Everyone seems to think that BPD is a curse. In my case I was married to the most intelligent, loving, caring, and beautiful woman in the whole world. She was so creative and could have ended wars with her ability to help others. This disorder, in no way defined her as a whole. One of the hardest things for me was trying to determine where her personality ended and the disorder began. I obsessed about trying to heal her with my words and actions. Her family and I tried playing doctor when we had no business doing so. All I knew was that I wanted to help her.
I miss her a lot and I guess the only real regret I do have is not being equipped with the knowledge I now have. That is not to say that we would succeed now, because I know a little more about her battle. I am sure that we would still fall into some of those same pits that split us apart again. I still pray for her and others with this disorder.
As a society we need to stop considering mental illness as some sort of black mark on a person. Mental Illness should be equal to any physical illness.
My request to the experts is that they do not sweep this disorder under the rug. I have seen it with my own eyes. The fact that there are some “experts” that steer clear from BPD patients is disgusting. What if you needed immediate surgery to keep you alive, but because the doctor thought it was to complicated he sent you away? That doesn’t happen, nor should it in this arena. For the ones that do treat and truly care, you are amazing people and deserve all the respect in the world.
Because they are unpleasant to treat. They worry people that they will commit suicdie, which they often do. They do not adhere to the sick role. They are angry and lie. They are very distressed, which makes them distressing to be around. They make the therapist feel inadequate.
If you adopt the mirror neurone/self psychology way of looking at things, to empathise with someone with BPD you have to feel and think a little bit like them, in other words, to lose your own mind a little bit.
Here are really important reasons: They burn out the system that the therapist is part of, thereby making the therapist’s collegues dislike them. They make even good therapists look stupid or unethical, which is very damaging for the therapist.
In other words, for lots of good reasons. Therapists: be kind to yourself. Those with BPD: you need to be aware that you will take up each position in the victim, rescuer, persecutor triangle and that if you persecute your therapist, they will either have to stop you or sack you.
Hence our collective obsession with finding a way to heal ourselves without the very unhelpful help of another betrayer
Who are they? Are you just one more person out there using throwing this dx onto people defensively or making a real effort to understand someone’s defense system and the traumatic cause and effect behind it?
Mirroring is a technique used for narcissistic defenses – not to be confused with what a true “borderline” defense needs.
I can assure you, someone who has BPD does not want his therapist to join him in his insanity, but rather to consistently and firmly counter his almost delirious negativity with a positive and sane outlook – for weeks and months if necessary.
If you can not talk about being plagued by suicidal thoughts with your therapist, who can you talk to?
Telling people who have struggled to carry on in the real world in spite of an infinite number of reasons to have checked out long ago, to submit themselves to therapists in a continuing struggle to stay connected to the world, that their personality is rotten from way back, i.e. “borderline” is to insure that the straw that finally broke the camel’s back will have an afterlife that will outdo plutonium. The news just might not give them cause for rejoicing as they struggle to stay in a therapy that is probably their last ditch effort to glue together the shattered fragments of their SELF.
Would you rather treat those that are paranoid, schizophrenic, writhing in dysphoric manias? Can you really tell me there’s no burnout there? At least those with BPD still retain enough faith in the “system” to approach it – perhaps THEY can no longer feel the pain of getting burned. They even get better (if still fragile)under good enough therapists… so I guess wonders never cease…
I’m pretty sure I have BPD and have watched it develop since i was about 16. Im now 23 and have still not been able to bring myself to see anyone about it. As a child I remember feeling very distant and like i didnt belong. Although i was not neglected, we are a very cold family in that we never talk about how we feel…even when i was very very young i woulnt let them see me cry. My brother has some kind of personality disorder however again has never been diagnosed because these things were never talked about and were ignored. Whereas I was distant and extremely introvert, he was the opposite, loud, hyperactive and demanded every bit of attention from my mum. My brother (4 years older) is still the same, and gets jealous whenever i speak to my mum and will cause an argument with her just so the attention is on him. I dont know what it is that he has but it isnt helped because he takes drugs as far as i know.
As for myself,I dont think my family has any idea about what im going through as i cant speak to them about it, im scared they will tell me to shut up because ive always been the “together” one and im at uni and i have to be the perfect one. I have never been together!Only my romantic partners ever really see the all the different sides to me. I cant even talk about it to friends so i dont understand why people see it as attention seeking. Its weird though because deep down im craving attention in a way…usually from boyfriends because i have a “need” to feel loved in a romantic way. Unfortunately Ive been in a very abusive relationship when i was 17-18 and I feel it was just after this that i started to feel especially unstable.
I was also raped twice when i was 15 but i never dealt with it…in fact it just lead me to allow myself to be used by men because at that moment in time it makes me feel loved but then only makes me feel even more worthless in the longrun.
Ive been with 2 lovely men since those times though but this time it was my behaviour that was the problem. They stuck by me for a long time but eventually it got out of control. My moods are forever changing every minute, Im either in love or full of hatred…never in between. My current boyfriend has not told me he loves me and it makes me feel awful…sad and angry. Sometimes Ill leave him because I dont think he likes me even if being alone is what scares me most…i think i do it in the hope that he will say he will reassure me in order to get me back….but it never gets to that stage because i will have overcome my rage after a few hours and call him and carry on like it was never a big deal. I hate it because i know how difficult it must be to be in a relationship with me. When i get into one of those deep depressions or bouts of anger people will often walk out and leave me until its over because they know there is nothing they can say or do that will make it right. I dont understand it myself and i dont think other people realise, i confuse myself just as much as i confuse other people. Sometimes i cant even remember things i say when im that angry even though i may have really hurt someones feelings.
I have a tendency to make important decisions when im in these moods such as breaking up a relationship as i mentioned, or quitting a job/uni and really honestly feel at the time that its what i need to do even when i question it. Then Ill deely regret it very soon after.
Im in my 6th year at uni because i have yet to complete a full year without any of these issues…im literally doing something like 2 out of 6 modules a year because when i get depressed or angry etc. these things just dont matter to me at all. I dont care about anything, especially not myself or my career (Im normally very ambitious but i never bother to get involved in anything or get a good job now because i know ill mess it up again in a few moments of whatever it is that happens to me.) I think about dieing every day, i think about me dieing and whether people would care but this doesnt upset me that much…what upsets me the most is that i think about other people dieing alot of the time and the its the thought of losing someone that scares me….i hate being alone, but sometimes when im not alone i still feel alone and lonely, i often feel like im in another world that nobody understands. Its funny because so many people say to me that I always look like im in another world. Itll take people a while to get my attention, i sometimes dont notice people i know when they are right in front of me and most people put it down to the fact im blonde! haha but i cant concentrate on anything other than people i care about. I worry about them all the time and worry that theyre gona leave me. I try n plan how i will deal with it because i know i wouldnt be able to otherwise.
Im blabbering now but im sat here at 6.47am (omg) because i havnt been able to sleep and just writing is making me feel a bit better.Id like to speak to someone about it but its hard because sometimes i feel fine and then dont like to talk about it cos i think im just being crazy. Ive tried to ask other people if they feel some of the things i do, liek very briefly, but they kind of just go along with it to make me feel better, but that the last thing i want them to do! I dont want this to be normal because then i cant deal with normal and this is no life to look forward to. I cant progress unless i know there is something wrong with the way i am but i dont want to be the first to go to the doctor and say it. I want someone to tell me to go. If they send me away thinking im just attention seeking or overreacting ill feel awful…i cant deal with people thinking i make this up. my boyfriend thinks i do, to manipulate him and to get my own way but manipulative and attention seeking are far from what “i” am. Im a good person and i want people to see it.
I know that was a bit long but can someone tell me if it sounds like BPD? And if so, what would be the best way to approach the doctor about these issues? Theres so much more i could say but my heads getting jumbled now!
Thanks guys. It was god to just write xxxx
I’m a psych student, and 2 of my Counseling professors this semester have already jokingly recommended turning down patients with Borderline PD based on the fact that we are “deceptive” “manipulative” and “drama queens.”
I was treated with DBT therapy a few years back and it saved my life. I am fortunate to live within a half hour of a hospital with a GREAT outpatient program for adolescents, but I know many people are not so fortunate. This article confirms what I suspected, and its disgusting.
I was diagnosed with BPD while
hospitalized to prevent me from ending my life. The name BPD is really awful. I am now leaving a
happy, functional life. My husband left me. He couldn’t deal with it. I was treated for bi-polar, PTSD, panic and anxiety. I used a lot of cognitive distortions in my thinking patterns. I learned about these and how to correct that problem through using a book by David Burns. I had the help of a very skilled pastor/therapist. He
had a better approach to counceling
and helped me work through a lot of
the horrible things that had happened. When he left, I tried another therapist who made my life much worse through group “therapy”.
I am still in counceling and probably will be the rest of my life, but I don’t want to deal with the pain of distorted thinking or addiction or anxiety, panic, depression, and manic episodes with out getting the help to overcome. I
want to be a victor, not victum. For the most part I think spouses who leave are cowards! The exception would be those who have to because the wife isn’t getting help and cooperating to make life better for the whole family.
Another point about DBT. It was the
worst treatment tried on me. In fact one therapist told me, no one else agrees with you, so be quiet. The DBT program did much to try to destroy my faith in God.
I know that alot of Christians will
reject someone with BPD, but not all. I found that trying to educate those willing to learn, helped.
According to my therapist I have a mild form of BPD. I am currently doing a group research project on BPD, and the disorder truly scares my classmates. I find it apprehensible that they may go into the field. I know I have been challenging and my BPD behaviors were only mild, but it is a mental health disorder that can be successful treated with the proper training.
A couple notes here, to add to what others have so eloquently described.
1] The label “borderline personality disorder” is an outdated phrase, based upon the earliest theories of what the actual disorder was. There’s hints it may be changed in the DSM V.
2] Current prevailing theories suggest that BPD may actually be a form of PTSD, and that trauma-based counseling may actually be of benefit.
3] DBT is supposed to be the first, best approach to successful treatment of BPD. What to do when DBT fails is uncertain.
4] Therapists : as I’ve been lectured so often in my own education, people with BPD are people. Remember not to identify people with their disorders – it’s a trait, not an entirety. You will need outstanding boundaries of your own to work with clients who have been diagnosed BPD.
5] Clients diagnosed as BPD : you have been wounded, most likely by your parents. It will take real commitment, work, and discipline to overcome your affliction. But it can be done. You are also a handful to handle in therapy – be patient with your therapist.
6] Therapists have had their careers and lives ruined by clients with BPD, perhaps more so than any other single diagnosis. It is little wonder that many are gun-shy to treat the disorder.
7] That said, making fun of anyone with the disorder simply because of it is cruel and heartless.
I think your point #6 reinforces the stigma with little to no evidence to support it. I don’t think it helps either therapists or clients who have this disorder to again suggest — with no research support — that people with this disorder ruins therapist “careers and lives.” Really?
While BPD may sometimes be challenging to treat, in the hands of an experienced clinician, there’s no more reason to demonize this disorder than any other.
Hmm, I’m afraid I have to disagree. I think there is actually a lot of evidence to support the statement that people with BPD can ruin careers. It is all over the place. All you have to do is really look for it. While I don’t think any official academic research studies have been conducted on “People with BPD Ruining Therapists’ Careers” there are entire professional continuing education courses regularly offered in many different highly reputable places such as the NASW, which are designed specifically to teach clinicians how to deal with “high conflict” clients who have BPD and/or NPD and avoid getting sued and having their licenses revoked. I have not, however, seen any courses on how to avoid being sued by clients with Social Phobia. So I believe if therapists were not regularly experiencing such issues with these particular clients, there would be no need for anyone to offer such courses. It’s more than just stigma.
Again, no sources. Just anecdotes, and the problem with anecdotes on these things is like reviews with Yelp, the only one’s giving input are usually the ones who’ve had bad experiences. The ones who have good experiences don’t even think to dive into this.
I know it’s been 8 years, but I’d love for you to post sources on that rather than a lengthy and frankly meaningless comment.
Can you or anyone recommend a way for someone with BPD (myself), who’s first experience with the mental health profession (1991-1994) was such a nightmare (unethical MSW’s licenses revoked, etc)? I have, I think 2 major barriers that have stopped me from getting help since then that I’m now 45 and in the worst condition of my life. First, after the first experience, the handful of times where I thought I would seek treatment again ended in my quitting within the first 2-3 sessions because I would do one of 2 things. I would first expect a new Dx based on a fresh evaluation. This always involved the questions of childhood abuse, and I understand why, because I know the occurance is prevalant. It is not true with me, and I am 100% certain of the fact. I was NOT an abused child by any degree, and it hurts me when I can’t get my tdoc or pdoc to get off the subject. I feel put in a position to defend my parents, because they don’t deserve it, but am treated as though I’m in denial instead, so it never goes anywhere after that. I end up quitting because it’s too distressing to know the other person is sitting there insisting there are factors behind my condition that just aren’t. Of course I leave and never go back, and “hate” that person “for life”.
If the above isn’t the problem, it’s because of something I cause, and know I do this deliberately, but don’t know how to NOT do it so I can help myself. In my need for the new tdoc to assess me, somewhere in the very beginning, I decide I really don’t do any of the things that make me BPD, and on the level I operate on at the surface at this time, I somehow am able to put on a face that makes it seem as though I’m not that bad off, just maybe a little depressed with a few minor “quirks”. I minimize or fail to disclose true symptoms/actions, because I can convince myelf they aren’t there, or just not there anymore. I may even be both so fooled by my own act that I decide I’m really NOT BPD, that I take the denial and run with it, so proud of myself for just “fixing it” by my own will. Obviously, this is never really the case. Then, when I sink into my worst place, I’m too ashamed to go back and look like I’d been a phoney liar. So I quit again.
Am I hopeless? The handful of people I know will tell me what I already know – that I have to be able to be completely up front about everything having to do with my symptoms and actions, etc so I CAN be helped. I know this, at the moment, but then I’m too embarassed again, afraid of being humiliated and stigmatized, fear that my BPD alone causes others to make assumptions regarding both my intelligence and my credibility, and am never able to let myself do what I need to. How do I get help with these behaviors, when one of the behaviors itself always gets in the way? I know what I need, I know what I have to do to get it. I just don’t know what to do about the ways I get in my own way that keep me failing every time. Over and over I read about how patients at my age are often symptom free, or have only few, milder episodes, and that makes me fear I’ve screwed it up too much for too long.
thank you.
I not only have BPD but also Anxiety, Panic disorder, PTSD, Agoraphobia….My case manager told me on Thursday that the way i live and they way i think is stupid. In return I cut for the first time in 8 months.
I think if people dont know what they are doing or how to deal with someone like me they should just find me someone else instead of insulting me and taking away everything i have worked on so hard..with only a few words.
I called to report her today and they told me that they just could not believe that she would ever say something like that…This small town mental health is just that….SMALL MINDED…