Experiencing DBT: BPD therapy – Guest Post by Suzanne

This is a guest post by Suzanne that was originally posted as a comment on my post – ‘Which celebrities have Borderline Personality Disorder?’

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I had been in a weekly DBT group for TWO years & met with the DBT-certified Ph.D. therapist individually once a week (a few times when going through a particularly difficult time–that proverbial 2 steps forward, 1 step backwards thing–twice a week). I have been looking for another DBT group since she retired 1 year ago. It has been so crucial to my improvement & I think of it as “medicine” (best “medicine” I’ve ever had!) & hope to continue it for life (especially now that insurance companies here in the U.S. have “parity” so there is no limit of the number of mental health therapy visits per year as there was previously).

I had my 1st suicide attempt at 15 & last one 4 years ago & have the diagnoses of bipolar 1, PTSD, ADHD & acute anxiety & chronic insomnia.

I learned about DBT from my Depression & Bipolar Support Alliance support group. A fellow there said it was the only thing that helped him with his treatment-resistant depression. I called the therapist & told her my struggles & how I’ve been seeing therapists on & off since my 20′s & on so many medications (& tried so many different medications throughout my life; I am now 57-years-old so I’ve been at this a while!).

I told her about how I was still not doing well, especially since my suicide attempt 1 1/2 years earlier (that attempt was preceded by about 5 months of a hypo manic episode that I didn’t report to doc as I didn’t know it was dangerous & it felt so good as I usually spent most of my time depressed). I was diagnosed as being in a “mixed episode” during that time after the suicide attempt & was having my meds changed & trying new therapists–all to no avail.

After about 3 months of DBT & the individual therapy my suicidal ideation disappeared, my crying at the drop of a hat & extreme emotional reactions inappropriate to the situations started to decrease & I started to see a lot of improvement as I employed the techniques & skills I was learning. I was able to get off the anti-psychotic medication that I had been on for about 10 years (that was necessary to combat delusional thinking–mostly paranoid thoughts such as my husband wanted me to kill myself). Once I started to think more rationally with the DBT skills I could get off the anti-psychotic (though I believe I needed to be on the anti-psychotic at the start of DBT so I could even “think straight” during the “lessons” & put them into practice) & also was able to halve the dosage of my Lamictal (anti-seizure medication used to treat bipolar that I hope to get off completely eventually).

Even though I never had the official diagnosis of borderline (I told the therapist that I had quite enough diagnoses already when she put borderline down on the form as an “exploratory” diagnosis & asked her to remove it & also because I knew of the HUGE amount of stigma associated with borderline–even more so than with bipolar due to my being trained to teach classes in mental hospitals through National Alliance on Mental Illness (NAMI)–you wouldn’t believe how even THERAPISTS speak so disparagingly about “borderlines” & say how they try to avoid having them as clients. I also volunteered in the county jail co-leading a support group for the women there with a therapist & the jail personnel also threw around word “borderline” while describing many of the women in the jail as if “borderline” were a filthy word.

I figure diagnoses were useful only for insurance purposes as far as I was concerned; I had many of the symptoms of borderline & DBT was helping so that’s all I cared about. BUT in my manual for my DBT group it states:

**People with BPD are doing the best they can.
**People with BPD want to improve.
**People with BPD need to do better, to work harder, & be motivated to change.
**The lives of suicidal BPD individuals are unbearable as they are currently being lived.
**People withBPD must learn new behaviours for all aspects of their lives.
**People cannot fail in DBT.
**Therapists treating people whitBPD need support.
**Families coping with people with BPD need support.
**Stress related dissociative symptoms such as paranoia; feeling as though they are losing touch with reality; feeling victimized; unable to accept responsibility are common.
**BPD is extremely painful to the patients, to those who live with them & to society. People with BPD experience emotions intensely & are very vulnerable. They are among the most intensive & extensive utilizers of mental health services.

DBT-trained therapists are special therapists. They have to willingly be “on call” 24 hours a day to their clients, have compassion for those who suffer so much & make so little progress so slowly (I was a “fast progresser” in my group, but I was also the oldest {most were at least 25 years younger!} & had very strong motivation as I was so terribly miserable. I could hardly stand being awake as my thoughts were causing me so much pain & chaos & misery. I was afraid to leave the house as I thought people could tell I was “crazy” just by looking at me).

My mother had committed suicide when I was 15 after being in & out of mental institutions since I was 3 (1st indication of her illness according to medical records I’ve gotten was her threatening to kill us children & then herself when I was 3); she was diagnosed as schizo affective & was about to be involuntarily committed when she died. My father was a “functioning” alcoholic & not much of a father as he didn’t protect us from her abusive behavior when she was delusional (he was off with his “lady friends”).

My mother was raised (from the age of 5) in a Catholic convent in New Zealand (where she was from) & it sounded like a horror. I’m sure it is much different now, but that with lack of loving parental contact probably contributed to her mental problems. After reading only about 10 pages of her records from the mental hospitals (I’m waiting until I find a new therapist to go through them–2 “bankers boxes” of them), I realize how disturbed & tortured she was. It was really a life of hell for her. I feel so sorry for what she lived with in her mind.

Dad dumped us kids into a boarding school when our mother died which he should have done sooner as it at least was a stable environment. I also met my future husband there when I was 15 & he was 16 (lucky guy!) & he has stuck with me & supported me through all my drama & dysfunction & distress & chaos & illness. We have been married for 37 years now! He saw such an incredible improvement wth DBT that he asked whether my retired therapist might come out of retirement for me! I wish she would!

There are now many books–some workbooks specifically designed for certain issues such as eating disorders, bipolar disorder, etc.–& there are also several “manuals” & instructional books about DBT for the layperson, family members, & professionals. There are also web sites with skill exercises for people to download that are useful as well as how to find a properly trained DBT therapists & groups.

Even though I am not a trained therapist (I am a “consumer”–the word used for the “mental patient”, I guess because we “consume” mental health services & possibly psych meds!), I have received a lot of training from NAMI in order to teach their classes & to speak to community groups & university classes & mental hospital patients, etc. & training from seminars paid through government grants the therapist I volunteered in the jail with got for me, & I have–with permission from the presenters–attended several conferences on mental health issues for professionals such as one just last month on using DBT to treat eating disorders that was attended by therapists who also received credits to keep their licenses updated.

A funny aside–at one of these conferences for the therapists at break time, a therapist recognized me & approached me to say, “Hello” & she apologized that she couldn’t remember what facility I worked at! (We had name tags on.) She just knew that she recognized my face & assumed I was a therapist & I had even asked a question of the panel so I hadn’t given away my “consumer” status by asking a dumb question. I laughed & told her I was a “consumer” & she recognized my face as she had been a sub for my DBT group a couple times & I told her the name of the facility. So I guess I “passed.” I’d come a long way from my pre-DBT time when I thought the grocery store clerk could tell just by looking at me that I was “crazy.”

If no DBT group is available, Recovery, Inc. is another avenue that Dr. Linehan recommends (I have attended Recovery, Inc. meetings; they are free & teach many of the same skills though is not as thorough, of course, as DBT).

I wonder if my mother could have been helped with DBT (& a loving, faithful husband, of course!). My husband even mentions that part of the equation which is huge, but being married to me has been no picnic. He has experienced the “walking on egg shells” around me for years on end as he never knew what would “set me off”–usually things that made no sense! I was VERY unpredictable–could go into crying for seemingly no reason.

I was not one of the angry, abusive (overtly, at least) dysregulated ones; I was more of the deeply depressed & then go into some kind of passive-aggressive, immature behavior like “run away from home” when I’m 42-years-old or do things to make him worry about me like go out drinking alone in bars & not telling him where I am (sort of like the little kid thinking “He’ll be sorry when I’m gone.” Yes, I truly was that immature & have apologized for my years of abusing him now that I recognized what I was doing, but as Dr. Linehan states I was doing the best I could with the skills I had–which were not very effective ones).

He is really a saint &, thank goodness, has his own life & accomplishments & has not allowed my problems to be the focus of his life & take away his joy. When I speak to family members I stress that they shouldn’t allow their loved one’s mental illness to destroy their lives, too. It would be a double tragedy if that were to occur. Some people cannot be helped. That is just a reality.

Some people cannot be returned to their previous state (especially sad to see parents grieving when their teenagers or young adult children have sudden psychotic episodes such as can happen with the development of bipolar disorder & many times despite “successful” treatment this means a new reality–the child is not returned to exactly as the child was before & it is so sad for the parents to see the loss of perhaps the direction of the educational capabilities, career, etc. due to medication side effects or shaky self confidence when something so scary & dramatic suddenly occurs).

I also had the advantage of being aware that I was ill (from witnessing my mother’s illness growing up) & I wanted to get help which is a big hurdle a lot of the time. My mother didn’t think she was ill; it was everyone else’s fault. She even told us children that my father had “Satan’s blood in him”; therefore, we children were tainted with Satan’s blood–thus, her idea that we were evil & she sometimes had homicidal impulses towards us children.

Usually, people w/BPD have had some kind of trauma or lack of appropriate nurturing (parental care) in their lives. That was certainly the case in every individual in my DBT group. Even one young woman had an interesting kind of lack of proper parental care in a way I wouldn’t have thought of–it was “OVER-CARE”–in that she was the baby of the family & her parents & siblings refused to allow her to do anything on her own (like they didn’t want her to grow up & be independent), didn’t let her make any of her own decisions, go anywhere without a family member (which made her very fearful of the world), practically cutting her food for her & she was still living at home at the age of 30 & looked & acted like she was 13 & couldn’t do anything without checking w/”Mommy” & she also had anorexia & cutting symptoms (cutting was a symptom almost 100% present in the participants in the group–all women).

The others asked me if I “cut”, but I said it hadn’t “been invented yet” when I became ill! I had never heard of self harm in that way until rather recently. I did the old fashioned way of drinking too much & a period of anorexia in college & suicide attempts & then now some binge eating.

The therapist did ask us if we minded having a male join the group at one point & I did have a negative reaction to that due to some sexual issues I had so he did not join the group & then hours after she asked that question I felt INTENSE guilt about my voicing not wanting a male & keeping him from benefiting from DBT so I called the therapist in almost hysterics & left a voice mail as I didn’t feel I was WORTHY of benefiting myself & denying him the benefit of the DBT group. I wanted to drop out of the group so he could join the group.

The therapist called me back right away & told me that the reason WHY she asked was that it was important for the existing group to not be disturbed or feel any sort of discomfort that would detract from our feeling of safety & security & she asked the question specifically to make sure she didn’t do anything to impair the progress of anyone in the group & it was GOOD for me to speak up for myself & my needs & that she had already found another DBT group for him & placed him & that I was WORTHY of receiving help & voicing my concerns & needs.

I heard an interview on National Public Radio (NPR) a few years ago w/Jason Blair (I believe that is his correct name; he is the New York Times–pretty sure it was NY Times–journalist who lied & wrote false stories but received awards for his articles & it was discovered that he falsified most of his articles & was fired & disgraced & later said he was diagnosed bipolar disorder & now is some kind of “counselor” in a mental health facility after receiving treatment & leading a DBSA support group).

Anyway, during the interview he stated that many times a “consumer” such as himself & DR. MARSHA LINEHAN (& he identified her as being known as having borderline personality disorder) can be more effective as a provider of mental health services as they personally know what the symptoms, thoughts, behaviors, etc. experienced by the patients are like! I asked my DBT therapist if she had heard Dr. Linehan was borderline! She said she had not heard that before. I had Googled it & could not find any other citation of that info. & comments from that interview voiced my same question of: “Where did you find out that Dr. Linehan had borderline personality disorder?” There was never any answer given, but from the NY Times article here someone said it was “known” in the “inner circle” of therapists, I guess.

As far as “celebrities” identifying themselves with mental illnesses I know many writers & some television & movie people have. Off the top of my head I can think of: David (think that is his 1st name; the interviewer) Frost; Robin Williams (comedienne & actor); Linda Hamilton (“Terminator” movie); Carrie Fisher (“Star Wars” movie); Patty Duke (“Patty Duke” TV show & numerous movies–most notably “Helen Keller”; several books, also); Mary Karr (poet & prof of literature at Harvard, I believe, & author of memoirs “Liar’s Club”–excellent, as well as “Cherry” & “Lit”; the actress who just “came out” with bipolar 2 who is married to Michael Douglass (not sure if she came out by choice or if she was going to be “outed” by a tabloid–that’s what I read so she decided to do it on her terms to preempt the “rag” newspaper making it scandalous or something)…

So sorry to ramble so long. You can tell I am a total DBT fanatic!

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