Helping Borderline

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Helping Borderline

– some people diagnosed with Borderline Personality Disorder do not accept that they can change
– symptoms of BPD can decline with age & become more manageable in adulthood
– it is quite common for BPD sufferers to talk casually about suicide
– sufferers criticise others often, including carers
– therapists can feel as if they are walking on egg shells around such sufferers
– any hint of criticism will trigger the BPD sufferer’s relationship trauma, causing the brain to go into “panic mode”, which will cause them to seek solutions to their anxiety including shutting down any suggestion that there is phonetically a problem with themselves, which will cause the person to reject your advice & attack you verbally or emotionally
– they have likely been abandoned, abused, neglected, mistreated in some significant way when younger
– when a child they were criticised by their parents – & the abandonment is interpreted as occurring because “they are a bad person” or not being good enough, or never being good enough
– when young, what often followed criticism was the black pit of abandonment (like being annihilated through your lack of attachment)
– when they were young, they were made to feel they not only had no self-worth, but they didn’t even have a self – that they don’t even exist / black pit of hopelessness
– they are extremely sensitive to rejection & implications of rejection
– never able to develop a sense of who they are – therefore, thinking about the future is extremely challenging & can feel incredibly distressing
– they do not know how they feel, & therefore find it incredibly difficult to put themselves in the shoes of another person
– they are in crisis mode every day of their life, & have distress tolerance problems
– therapy takes time – short-term results are rare – avoid directive therapy, & avoid CBT usually
– DBT
– therapist support is necessary, like Drs working in an emergency award
– notice counter-transference
– stay close to the client, but do not be vulnerable to them
– typical reports: we were just talking & all of a sudden he was so hostile to me & yelled at me
– sufferers can be very explosive & their mood can shift quickly because they have been traumatised
– he recommends not being vulnerable with a BPD client so you are not hurt as the therapist & you will get burned out
– focus – less on skills, but establishing a relationship so that they feel worth it – then they may take to the corrective emotional experience & develop themselves
– the therapist is a secure base & that for the first time in their life, a human being can be trusted
– developing answer to the question: who am I? & what do these emotions I am having mean?
– aim: to make the sufferer feel more secure in the world.

Source: Psychology in Seattle | Podcast date – 17 December 2016

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