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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 47 to 71 of 71. Go back in thread:
Posted by fallsfall on December 13, 2004, at 12:55:12
In reply to Re: I don't get it » fallsfall, posted by fires on December 13, 2004, at 10:54:24
OK... I am easily confused these days.
I did also answer your original question, however, if you would be interested in discussing that...
Posted by littleone on December 13, 2004, at 14:20:40
In reply to Re: That's ok. There's no need for you to get it. » littleone, posted by fires on December 12, 2004, at 22:52:26
> Are you aware of the current prognosis for those with moderate to severe BPD? Yes they deserve treatment, but don't expect a great outcome.
Fires, you made me laugh with this. You've fallen into your own trap of believing everything you read on the internet :)You can have a prognosis in relation to a liver transplant. You can have a prognosis in relation to open heart surgery. It denotes the chances of success or failure.
I think you will find that the website you quoted uses a standard template of symptoms, treatment, prognosis, etc for a very wide range of conditions.
But with psychological problems, there are no successes or failures. There is a continum of growth that continues throughout the individual's lifetime. Therapy is not a cure. It is a tool that can be utilised to assist in this growth journey.
I would hazard a guess that the website was referring to the fact that due to the traits of impulsiveness and vilification that some people with BPD exhibit, there is a high drop out rate from treatment by these people.
However it would be grossly inaccurate to say there is a poor prognosis. In my opinion, with a strong committment from the individual and the assistance of a skilled T, I believe there is an excellent "prognosis" for growth.
Also, you need to remember that even if a person drops out of treatment, it could still be argued that it was successful to a degree. In all likelihood, the person has walked away with an awareness of some of their issues. Even just an awareness can sometimes assist in everyday life.
Posted by fires on December 13, 2004, at 16:15:48
In reply to Re: I think you DO get it, posted by Joslynn on December 13, 2004, at 12:52:05
I don't recall ever using the word transference in a post. Please define what you mean by transference.
I think we might want to concentrate on what is known, rather than what things seem or sound like.
You stated: "Unless you really do just want to hurt sensitive people who come on here for support?"
What? Where did that come from?
Posted by 10derheart on December 13, 2004, at 16:16:01
In reply to Prognosis » fires, posted by littleone on December 13, 2004, at 14:20:40
Posted by fires on December 13, 2004, at 16:52:47
In reply to Prognosis » fires, posted by littleone on December 13, 2004, at 14:20:40
No. Many sites made the same prognostic statement.
If psychotherapy can't offer any more than "growth", I'd sugggest the BPDs take a look at pharmacologic treatments. Here's just one:
Posted by pegasus on December 13, 2004, at 17:04:50
In reply to Re: Prognosis » littleone, posted by fires on December 13, 2004, at 16:52:47
You don't value growth? That would explain a lot.
This is sounding like a false dichotomy to me. A person could surely use pharmacotherapy for relief of symptoms as well as psychotherapy for growth. In fact, that's what I'm doing, and both parts of my treatment are doing wonders. It would be sad to me to miss the growth part of the equation, but of course, everyone gets to choose what their own goals are.
pegasus
Posted by fires on December 13, 2004, at 19:26:21
In reply to Re: Prognosis » fires, posted by pegasus on December 13, 2004, at 17:04:50
> You don't value growth? That would explain a lot.
>
> This is sounding like a false dichotomy to me. A person could surely use pharmacotherapy for relief of symptoms as well as psychotherapy for growth. In fact, that's what I'm doing, and both parts of my treatment are doing wonders. It would be sad to me to miss the growth part of the equation, but of course, everyone gets to choose what their own goals are.
>
> pegasus
>
>
First, I feel that your rhetorical question is quite offensive. I feel that it is a thinly veiled sarcastic putdown.I tried the growth part of the equation and found it akin to malpractice. For a patient to have to endure psychotherapy for physical problems due to a Ts lack of medical knowledge is inexcusable. I'm sure that you are aware that T is continually having to psychologize problems of living because meds have made such a signicant inroad into "emotional" disorders.
In my state, CA, it got so bad a few years back that Ts (non MD types) lobbied to try to get laws to allow them to prescribe!! Wanting for patients? You bet.
Then came Oprah, Dr. Phil, and other pop psych personalities to save the day.
They even have succeeded in getting people to believe that they primarily over-eat for "emotional" reasons - imagine that-- and they are both over weight!
Posted by gardenergirl on December 13, 2004, at 19:43:19
In reply to Re: Prognosis » pegasus, posted by fires on December 13, 2004, at 19:26:21
> First, I feel that your rhetorical question is quite offensive. I feel that it is a thinly veiled sarcastic putdown.
Fires,
In the spirit of equal time, I just wanted to let you know you might want to consider rephrasing this. Merely adding "I feel" to what you are saying does not an "I" statement make. If you wish to consult the FAQ for more information you can find it at http://www.dr-bob.org/babble/faq.html#civilregards,
gg
Posted by Gabbix2 on December 13, 2004, at 19:51:18
In reply to Re: Prognosis » littleone, posted by fires on December 13, 2004, at 16:52:47
> No. Many sites made the same prognostic statement.
How many is many? Do they all agree on the definition of borderline personality disorder? Could you provide the links to the many sites please?
Posted by gardenergirl on December 13, 2004, at 19:54:26
In reply to Re: Prognosis » pegasus, posted by fires on December 13, 2004, at 19:26:21
> I tried the growth part of the equation and found it akin to malpractice. For a patient to have to endure psychotherapy for physical problems due to a Ts lack of medical knowledge is inexcusable.
Just curious, but wouldn't an MD be a better professional to consult for physical problems? I'm not sure how a T's medical knowledge could supercede the diagnosing physician.
And your use of the word "endure" is interesting. Why couldn't you get out of it?
>
> In my state, CA, it got so bad a few years back that Ts (non MD types) lobbied to try to get laws to allow them to prescribe!! Wanting for patients? You bet.I'm not sure how much you have read about this new trend, but wanting for patients is not a driving force behind it. Increased access to care, particularly in more rural or underserved areas and a better ability to monitor the effects of the medication, as clients are usually seen weekly for therapy, are the primary reasons for the push. Thus, the two states to enact such laws to date: New Mexico and Louisiana are two states that acted in order to provide their residents with improved access to mental health prescribing providers, as they both have significant rural and underserved populations.
> They even have succeeded in getting people to believe that they primarily over-eat for "emotional" reasons - imagine that-- and they are both over weight!
Hmmm, anyone care to lay odds on what the topic du jour of the next public service announcement might be?
gg
Posted by TofuEmmy on December 13, 2004, at 20:25:04
In reply to Re: Prognosis » fires, posted by gardenergirl on December 13, 2004, at 19:54:26
>Hmmm, anyone care to lay odds on what the topic du jour of the next public service announcement might be?
gg
Dang it all gg.... I just polished off those chips. And I was all comfy cozy and happy, and then .....poof....it all vanished!!
Emsky hanging her head in anticipatory shame
Posted by littleone on December 13, 2004, at 20:46:25
In reply to Re: Prognosis » littleone, posted by fires on December 13, 2004, at 16:52:47
> No. Many sites made the same prognostic statement.
Of course they have. Many of these sites are medical based sites with the same symptoms/treatment/prognosis format.There are some excellent mental health sites out there and generally speaking you will find that they give a more thorough description of how treatment can or can't assist. One such site is at the below link (although I never seem to be able to make those rotten links work).
http://mentalhelp.net/poc/view_doc.php?type=doc&id=476&cn=8
> If psychotherapy can't offer any more than "growth", I'd sugggest the BPDs take a look at pharmacologic treatments.
Quoted from the above site. I think it says it all:
"Like with all personality disorders, psychotherapy is the treatment of choice in helping people overcome this problem. While medications can usually help some symptoms of the disorder, they cannot help the patient learn new coping skills, emotion regulation, or any of the other important changes in a person's life."
Don't underestimate the value of growth Fires.
Posted by Gabbix2 on December 13, 2004, at 21:26:36
In reply to Re: Prognosis » fires, posted by littleone on December 13, 2004, at 20:46:25
New Knowledge & New Conceptions.(Borderline personality disorder)
Psychiatric Times, July, 2004 by Gunderson, JohnByline: John Gunderson, M.D.
Our evolving understanding of borderline personality disorder (BPD) and its treatment is reflected in each of the contributions to this Special Report of Psychiatric Times. This evolution includes the surprising evidence that this disorder has more significant genetic determinants and many patients have a far better prognosis than had previously been thought.
<snip>
John M. Oldham, M.D.
article for Primary Care Physicians)THE BORDERLINE PERSONALITY DISORDER
NEW MANAGEMENT CONCEPTS
The Borderline Personality Disorder (BPD), a psychoneurological disorder affecting tens of millions [1,2] is now treatable with a combination of medication and other therapies. Fortunately fluoxetine (Prozac) [3] and low dose intermittent neuroleptics [4] can stop most of the mood swings, and many of the irrational behaviors.
Treatments: Medications:
<snip>
Psychological Counseling: Borderlines need a multidisciplinary approach. A good therapist is necessary, and borderlines should be strongly encouraged to get into counseling. For some, a psychologist/family physician team is very effective. Referral to a psychiatrist may be necessary. Psychiatric hospitalization is occasionally required, especially for strong suicidal ideation.
<snip>
Posted by fires on December 13, 2004, at 22:16:39
In reply to Re: Prognosis » fires, posted by gardenergirl on December 13, 2004, at 19:54:26
God help the patients whom are getting meds from Ts!
Posted by fires on December 13, 2004, at 22:19:38
In reply to Re: Prognosis » fires, posted by littleone on December 13, 2004, at 20:46:25
Don't underestimate the power of normal physiology.
Posted by fires on December 13, 2004, at 22:26:23
In reply to Re: Prognosis, posted by Gabbix2 on December 13, 2004, at 21:26:36
Thanks for the info. "More genetic determinants" --why is this not surprising?
Posted by Gabbix2 on December 13, 2004, at 22:39:14
In reply to Re: Prognosis, posted by fires on December 13, 2004, at 22:19:38
You know fires, I have noticed that you seem to do a lot of "Black and White" thinking, either or, all good, all bad. Therapy - bad, Physiology - good. That can be one of the symptoms actually of Borderline Personality Disorder There is no reason that treatments can't complement each other, or different people with different beliefs can't complement each other.
I'm sure you've heard this before though, yet you keep coming back to say similar things about different topics.
It appears to me that you are terribly afraid of not getting noticed, not getting attention that you'll pay any price. Otherwise you'd be posting on a board where your ideas would be more in sync with the other posters. That can be another symptom of BPD. It's a good thing that the prognosis isn't really as bad as it was made out to be.
Posted by Gabbix2 on December 13, 2004, at 22:43:44
In reply to Re: Prognosis » Gabbix2, posted by fires on December 13, 2004, at 22:26:23
> Thanks for the info. "More genetic determinants" --why is this not surprising?
That's not really news, it's been pretty commonly known at least since the early 70's that there are genetic components to BPD.
With mental illness it's rarely one OR the other. And supposing it were soley genetic, that doesn't mean therapy would be useless our thoughts affect our bodies profoundly. If they didn't there would be no market for porn.
Posted by Gabbix2 on December 13, 2004, at 23:12:20
In reply to Re: Prognosis » fires, posted by Gabbix2 on December 13, 2004, at 22:39:14
This was unnecessary
> It appears to me that you are terribly afraid
of not getting noticed, not getting attention that you'll pay any price. Otherwise you'd be posting on a board where your ideas would be more in sync with the other posters. That can be another symptom of BPD. It's a good thing that the prognosis isn't really as bad as it was made out to be.
Posted by Dr. Bob on December 13, 2004, at 23:22:58
In reply to Re: Prognosis » fires, posted by pegasus on December 13, 2004, at 17:04:50
> I consider your post to be completely unsupportive of people with this diagnosis.
> And completely judgemental.
>
> alexandra_k> You don't value growth? That would explain a lot.
>
> pegasusPlease don't be sarcastic or post anything that could lead others to feel accused or put down.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
Follow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above posts, should of course themselves be civil.
--
> Hard to communicate with, or trust someone with such severe symptoms -- in my opinion.
>
> firesFor the record, I've already blocked him above:
http://www.dr-bob.org/babble/psycho/20041210/msgs/429218.html
Thanks,
Bob
Posted by pegasus on December 14, 2004, at 10:20:32
In reply to Re: Prognosis » pegasus, posted by fires on December 13, 2004, at 19:26:21
I disagree with everything that you say in this post.
Posted by pegasus on December 14, 2004, at 12:14:11
In reply to Re: please be civil » alexandra_k » pegasus, posted by Dr. Bob on December 13, 2004, at 23:22:58
Actually, I wasn't being sarcastic, although I could see how one might read it that way. I really did think that fires was saying he didn't value growth much, and that if that were true, it would explain a lot of his apparent attitude about therapy. Really, sincerely. But I'll try to make those comments more clear in the future.
pegasus
Posted by crushedout on December 14, 2004, at 13:24:07
In reply to Re: That's ok. There's no need for you to get it. » littleone, posted by fires on December 12, 2004, at 22:52:26
Since most of the BPDs on this site are highly invested in their treatment, I don't even think this link is terribly relevant to us.I know fires is blocked. I'm just continuing this conversation with the others.
Posted by littleone on December 14, 2004, at 14:49:19
In reply to Re: That's ok. There's no need for you to get it. » fires, posted by crushedout on December 14, 2004, at 13:24:07
Hi crushedout,
I get very discouraged reading some of the literature on pd's. They really are very difficult to treat as the problems really do infiltrate every aspect of your life. I have AvPD myself and find therapy very disheartening at times. I certainly don't want to be told I have a poor prognosis.
The timing of fires' posts was funny for me because I had been discussing BPD with my T during the last couple of sessions. I certainly idealise/vilify everyone and I also have a problem with feeling very up and down (although mood swings are related to a large number of problems, not just BPD).
I meant everything I said in my prognosis post about if the individual is determined enough and has a good T to help them, they can beat it.
Despite the fact that pd's are so pervasive and so ingrained, my T was adamant that they aren't set in stone. You *can* change these aspects of yourself.
Posted by verne on December 17, 2004, at 1:13:28
In reply to I don't get it, posted by fires on December 12, 2004, at 15:39:01
I did all those things you mentioned: called my therapist after hours, left long messages with pre-recordered music that included Foreigner's song, "I want to Know What Love Is?"What's to get? I sought therapy because I was in constant emotional pain.
"What's to get?" is for high school bullies.
verne
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