Posted by fallsfall on December 4, 2003, at 8:16:20
In reply to Re: psychological theoriesmof Self » fallsfall, posted by ramsea on December 3, 2003, at 14:54:30
Ramsea,
I am 46 years old (female). I have always been an "achiever". When I was 38 I had it all - 3 kids and a house husband (and a house), and a career managing Software Engineers (42 of them) for a fast paced company. But all that responsibility (since my husband let me make all the decisions for the family, too) was too much. I started depending heavily (read that: in love, almost stalking) on my best friend. Eventually I was too much for her to take and she told me to get some help (in a very compassionate way). My GP diagnosed depression (it was SO hard for me to be brave enough to hear that) and sent me to a CBT therapist (a very good one). She said "No, problem, we'll have you out of here in 6 - 8 sessions". That was almost 9 years ago. She pried me away from my friend and I latched on to her. I started wanting to hurt myself and went into the hospital. That's when she diagnosed me as Borderline. I did go back to work for 2 years in the middle of the 9 years, but I wouldn't say that I stopped being depressed.
Until I was 38 I thought I had no limits - I could do anything. I think that I have been depressed a bit for my whole life (and I did see a psychiatrist in 5th grade for 1 1/2 years for constipation [usually control issues]) but I never knew that anything was wrong (remember, I could do anything). My pediatrician (who was T. Berry Brazelton!) remembers my mother as being depressed, and me as being a "sad child". So that's my history.
My library has "The Flight of the Mind" (and it is available...) I'll check it out.
My (humble) opinion is that some people are more sensitive to their environments, and that if these "sensitive" people have bad environments that they will become Borderline. Thinking about it, perhaps a BiPolar child would tend to act on his environment in a way that might increase the environment's tendency to go in a bad direction. In other words, a BiPolar child would tend to be stressful to his parents, which might exacerbate their tendency to provide a "bad" environment for the child.
I also think that there are kids who are constitutionally strong enough that it doesn't matter how bad the environment is, they are going to be OK. And there are kids who are super sensitive and will become borderline in fairly reasonable environments.
I had a group therapist (Psychodynamic) who asked my diagnosis. I told her Major Depression and Borderline. She said "Oh, I don't care about the Borderline" - sort of like she either didn't believe in it, or at least it wasn't relevant for her. Maybe she just wanted to put the right thing down in the "diagnosis" box on the insurance form. You might ask your pdoc if he specifically thinks that YOU are not borderline or ADHD, or if he just doesn't think that those are useful categorizations in general.
You are not badgering me! We are talking about my favorite subject - and it is obvious that you have done some research, which makes for an interesting discussion.
Unexcused absences for being in the hospital. I think that Linehan's theory here is that when a Borderline patient goes into the hospital, that it is a way of coping with ... something. She wants them to learn coping skills that will allow them to remain in their "outside lives". Borderlines CAN learn coping skills and learn to live in ways that are less traumatic and that generate fewer crises. She is making a statement that getting to the state where hospitalization is the best choice is not a good thing - so she wants to make sure that it is not rewarded (and is punished a little). Her other point, though, (which I think makes even more sense) is that if a patient is in the hospital, then they are NOT in Skills Training. Skills Training therapy cannot occur if the patient doesn't show up. When they are in the hospital, they can't show up. So being in the hospital is a "therapy-interfering behavior". There are Borderline patients who are not READY for Skills Training, and this is one of the signs of that. By making it an unexcused absence, patients who are in the hospital all the time (these are the people who aren't ready for Skills training) use up their absences and have to drop out. This is actually a good thing for both the patient and the group. It gives the patient (and his therapist...) a wake up call. Skills training is really like a class, if members of the class miss too much of the material they disrupt the progress of the class as a whole.
Thanks for the great thread.
poster:fallsfall
thread:286142
URL: http://www.dr-bob.org/babble/psycho/20031202/msgs/286463.html