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Re: more anger towards my therapist deerock deerock

Posted by Dinah on September 3, 2009, at 8:29:04

In reply to Re: more anger towards my therapist deerock emilyp, posted by deerock on September 3, 2009, at 7:40:06

Dee, for what it's worth, I interpreted your remarks less as dismissing the pain of depression or anxiety, and more as a reflection of so much of what is written about personality disorders.

Disorders of the self, they're called. Treatment prognosis is poor. It's difficult to work with these people. Etc.

But to me, that's old outdated thinking, and you oughtn't pay much mind to it. Linehan, for example, conceives borderline as having at its root an easy arousal and a slow return to baseline. Which is likely a biological issue. Schizoid and schizotypal are now seen as somehow related to thought disorders, tho to me they often seem like something a neurologist might categorize as being on the autism/asperger spectrum. Even antisocial personality disorder is linked to a problem with dopamine, or adrenaline or something.

I wish they'd change the name of Axis II from Personality Disorders to something less perjorative like "clusters of coping mechanisms".

And the current literature sees them as no more intractable or lifelong than depression or anxiety. Which really is intractable and lifelong. Medication doesn't always work, and medication that worked at one time can stop working. I can see where people who are dealing with that may be just as upset at the idea that it is treatable as people who are diagnosed with personality disorders are at the idea that it isn't treatable. All are significant, but not hopeless, issues to deal with.

Even the ubiquitous "neurosis" which had physical problems once considered totally in a patient's mind, now seems somewhat dated. Irritable bowel syndrome and migraines, once considered neurotic constructs, are found to have similar chemical backgrounds to the anxiety and depression shown by neurotics. Sure, the symptoms often come together. But no, they aren't all in a patient's mind.

Toss out what you've read, and listen to your therapist. She sounds like a sensible woman.




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