Posted by grrrilla on May 5, 2000, at 19:25:43
In reply to Re: treatment for Borderline Personality Disorder, posted by Noa on May 5, 2000, at 15:51:07
> There are approaches out there for treating people with this dx that focus primarily on current coping skills, and take the emphasis off the past. Skills such as identifying, building and maintaining healthy boundaries, building structure in your life, becoming aware of negative thought patterns (this is the cognitive component), skills for expressing, diverting, managing emotions, etc. There is one therapist that wrote a book about a group approach, using these cognitive behavioral approaches. It includes structured contracts for safety, etc. I' sorry, I don't remember the author or title.
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> Focusing on skills implies hopefulness, I think.
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> I think it is important to remember, too, that any diagnosis is simply an man-made construct meant to help think about the problems the person has and how to help them. There exists in nature no such entity as a borderline personality. Heck, we can barely agree as to what personality is anyway. BPD has become a dumping ground dx in many cases. Often it is the people presenting with difficult to treat problems, which can be frustrating for the doctors, especially with frequent regressions in progress made. Also, having a shared label often seems to imply more similarity than difference, when in fact, there is usually more that is different and unique about each person given such a diagnosis than what they share in common. In the end, although a label might help to organize a way to think about problems, the individuals involved have unique sets of difficulties.
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> The other aspect to BPD that is bothersome is that having a problem with one's personality does seem to imply that their problems won't change unless the persons themselves are made to be different at the core than who they are. Well, gee, there is nothing like creating a sense of safety for good treatment than to start off implying that the person's true self IS the problem, rather than seeing as the person EXPERIENCING or SUFFERING problems. While you can make a good argument that a certain group of symptoms and problems can be clustered in a shared dx, I think a CHANGE in language, and in conceptualization, is in order. The words and concepts in the label, BPD, are inherited from decades ago, when a very narrow view of personality development was widespread. While those ideas about personality development can still be useful and valid, we know a whole lot more now about how complex personlity development is, and that trying to understand personality development requires looking at it from a number of perspectives, not just from ego psychology. So I would like to see a new label for this dx, one which better describes a cluster of symptoms, rather than suggests a theoretical, unproved, origin of the problems.Thanks for writing all this. It's exactly what I think. I hope your days of feeling better didn't end when you went back to work.
poster:grrrilla
thread:31921
URL: http://www.dr-bob.org/babble/20000429/msgs/32471.html