Borderline Personality Disorder

[Blackbird]

Curious as to other's thoughts about the BPD episode.

I'm a 34 yr old woman diagnosed with BPD. It manifests also in self-harm (in remission for 3+ years), and eating disorder, anxiety, depression, and alcoholism/drug addiction. I have received an "official" diagnosis from more than one clinician and I actually fit ALL the DSM critera for it, not just the 5 needed for the Dx. Fun times

Some of my initial thoughts of the episode-

-I'm SO grateful to Paul that this topic is being covered! It's not understood, not talked about enough, etc. So thank you.
-Call this my BPD rage if you will, but I want to reach through my headphones every time she giggles and strangle her. I don't mean to pick on a guest, I swear I don't, but I can't think of another guest who straight up annoyed me as much as Ginger. Kudos to her for doing what she does though. I also am in shock she is using the term "normal" in regards to the non-BPD brain. I also believe her opinion as to the majority of self-harmers have BPD. While yes, many of us with BPD self-harm, it is surely possible for a person to self-harm and NOT have BPD. I know this was said, and I appreciated how Paul even clarified the fact, but she still, in my opinion, seemed to hold that belief.

I've got about 20 minutes left to listen to so I'll go finish, but like I said I'm very curious as to other people's thoughts on this episode, especially other BPD sufferers.

[ladyluck]

I've been looking forward to an episode on BPD as I have someone close to me who I'm fairly sure suffers from this disorder, although it is untreated.

I also have to say that this is my first post to the forum but I really felt compelled to vent some frustration at this episode.

I have to say that I can't think of a single guest that's been less helpful and more annoying than Dr. Peterson. The single yes or no answer were terribly unhelpful and I really felt for you Paul as I could hear you struggling to get an interesting discussion going. And the GIGGLING! I'm sorry but I just can't take this woman seriously as a health care professional.

I think more discussion is needed on BPD. It IS a fascinating and underdiscussed dieorder, and I'd be really interested to hear from someone who is actually dealing with this disorder. But PLEASE no more of this woman!

[Herself]

I'm curious to hear if men find the cutesy voice & giggling as annoying as women or if we're just being catty. Because I even found myself looking at her photo and thinking, "Of COURSE she's blonde!"

[ngh65]

I am a woman and I did not find her voice or laughter annoying at all. I just chalked it up to being nervous and I was willing to cut her some slack. I found this podcast to be very informative and I really appreciated that the doctor noted the positive traits of those with BPD.

[AnArtist]

Add me to the chorus of disappointed listeners. I would have found any of the following issues forgivable alone, but when combined it added up to a frustrating and, yes, at times infuriating listening experience:

Dr. Peterson was one of the most passive interviewees you've had on the show. Since she seemed unable to initiate any discussion, Paul was left trying to solicit responses, which were often a monosyllabic "Yes" followed by giggles. I wonder if in the future it's a good idea to do a mock interview of 5-10 minutes to ensure that the guest is good at (and comfortable with) being interviewed.

Besides that, I did not get the sense that Dr. Peterson was particularly qualified to talk about BPD. She's a "life coach"? Seriously? It can't be that hard to find a licensed psychotherapist in the LA area who treats people with BPD. If it is, can you find someone who is at least articulate and mature? She seemed to have trouble expressing the wide spectrum of symptoms and behaviors that define the disorder and also reflects the variance among people who suffer from it. In other words: we're not all Glenn Close in "Fatal Attraction."

Here was what I objected to the most: BPD already has a lot of stigma surrounding it and I would go so far as to say that it is a pejorative diagnosis still. It is associated with violence/aggression toward the self and others, emotional manipulation, and the creation of chaos in other people's lives. Your guest did little to dispel that prevailing perception despite the fact that there are many, many people with BPD who engage in none of those behaviors. Yet she chose to focus on her patients (if I can use that term, since she's not actually a licensed practitioner) who have threatened her with death and torture, violated emotional boundaries, became vindictive, etc.

Finally, she was often very condescending toward people with BPD, which was revealed in statements like "You have to treat [patients] like five year olds" and "[Patients] want to figure out how to manipulate you" and "There are key functions in the brain that don't work right and when people get real close to them things get kind of crazy." These statements were actually bordering (no pun intended) on offensive. What kind of professional says things like this?

I could hear your frustration as an interviewer in this one. In the end, I wish you'd just cut your losses, chosen to not publish this interview and perhaps tried to cover BPD with another, better guest. I hope you'll still consider that, as it's a worthy topic and you could have a positive impact on public education and perception.

On a slightly different topic, I'd like to make people aware of an alternative to DBT, schema therapy. It is helping me with my (high functioning) BPD and I like it because it seems a bit less rigid (and more individualized) than DBT is, and there is a lot of emphasis on establishing trust between patient and therapist before moving on to more CBT-based work. Listeners who want to learn more about schema therapy in layman's terms can in a book by Jeffrey Young and Janet Klosko. Schema is not as widely practiced as DBT is, but it's well worth exploring if DBT is not working for a BPD sufferer.

[AnArtist]

Forgot to post the book's name: "Reinventing Your Life"
http://www.amazon.com/Reinventing-Your- ... +your+life

[grey_machine]

YES, this guest was incredibly annoying and came across as immature, unprofessional and under qualified. And yes, "Herself", as a guy, the cutesy voice, the giggling and her overall delivery were like nails on a chalkboard.

Sorry if I'm piling on, but this really was a tough one to get through. And I usually love every episode of TMIHH.

[girlonthe3rdfloor]

Hi every one. Just want to say that I feel the same. I almost didn't want to finish listening- but to my relief - other listener felt the same. Just remember she was not the best choice- and she was not very engaging. I think Paul tried very hard - but it wasn't going anywhere. BPD is such a complex issue in the mental health field both in diagnose & treatment. Sadly many insurance will not cover treatment if the person is only diagnosed with BPD, so alot of time we as clinician (I am only a psych nurse!) have to give them other Dx. such as depression in order to get compensated. So that alone should say how under-served this population is. Another problem is that alot of the professional don't show interest working with PBD. My theory is that people who are struggling with this are also incredibly intuitive, and smart. They can smell bull-shit from miles away - and if any one as a professional in the mental health think "they are better then the rest" the borderline pt. going to "let them have it". But yes working in our broken mental health system and not being fully available to offer help to our Borderline client, really make them fill neglected- rejected by our health care system. That outrage is really not a "symptom"- I think is an accurate respond to how we treat our vulnerable people. My own best policy with any one who come to psych emergency specially if they are diagnosed with PBD is HONESTY .. that seem to work better then meds.
I feel so bad that this episode was a disappointment. But we should thank Paul to put this very important topic on the map in this web site. We need all the education we can get and some times the pt. are the best educators. So I hope we hear alot more from others to share their own experiences and to have ongoing dialogue ..
BTW go easy on our guest lady ok ?!!

[Jamous]

Hey everyone! This is my first visit to this site, first post, and 2nd podcast I've listened to. I've been dx with a number of things including BPD. Prior to the dx I read "I HATE YOU, DON'T LEAVE ME" and absolutely felt I could relate to the symptoms of BPD. In any case, here's my thoughts on the podcast:

I'm incredibly relieved to read that so many ppl seem to be on the same page as me when in comes to the interviewee- and this episode as a whole! Phew! I kept thinking "Man, I'm so irritated right now. She's not taking this seriously. She sounds condescending at times. Her portrayal of this dx isn't all that accurate (my opinion of course), she's being incredibly vague in her explanation of things, my skin is crawling just listening to her voice- but I'll continue to listen anyway, hoping she'll say something valuable..." You get the point. So I immediately start questioning my own thoughts "Uh oh, is that JUST my BPD mind coming up with that? Oh sh*t. I must be awful. Everyone else is probably loving this podcast and thinks this lady is fabulous. OMG I'm too sensitive.. or am I? I better give this lady more of a chance bc she IS the 'NORMAL' one, right?" HAHA I realize I still sound like a Borderline basket-case, but it was nice to hear someone else questioning whether it was their own 'Borderline Rage' or not.

On a positive note, I do appreciate the fact that she discussed some of the better qualities of those with BPD. I personally find it extremely difficult to see any positives with this disorder bc it has been incredibly painful to 'deal' with.

I'd like to hear some future podcasts where BPD pts are interviewed. I had several other opinions I wanted to express, but for whatever reason they have left my mind at the moment, so I'll have to follow up with another post once I remember.

Oh, and "Reinventing Your Life..." is a great book I find it very informative and easy to relate to. Many of the therapists I've seen are using the schema therapy.

[in_media_res]

The interview was uneven, but doesn't seem to merit the harsh criticism it seems to be getting - IMHO.

On the point that Dr. Peterson further stigmatizes individuals with BPD, I'd just note at one point she went to some length to describe many positive traits she's found among her patients. Given the outright hatred some professionals seem to show towards individuals suffering from the disorder, I was greatly appreciative of the comments. That said, some of her comments were unfortunate -- treating people like five year olds being a case in point. As someone with BPD, I can appreciate what she was trying to say, but it does come across as offensive.

I don't think the complaints about simplistic yes/no answers have much merit. I didn't hear a lot of that, and in those cases where she did give a brief answer it was in response to some lengthy exposition from Paul. If you want the guest to talk more, perhaps the interviewer should talk less and ask more open ended questions. Just saying.

The discussion around medications was distressing. Paul mischaracterized Lamictal as an anti-psychotic. Happily, the mistake -- it's actually an anti-convulsant prescribed as a mood stabilizer for bipolar patients -- was corrected quickly. I was disappointed with Dr. Peterson's response that there isn't a medication for BPD "yet." It seems unlikely there ever will be such a medication -- for which I think I'm glad. I'd hate to think it's possible to alter someone's personality through medication. That's mostly a reflection of my own experiences with medications -- YMMV. For those interested, there is a quite helpful article that describes the efficacy of various medications in treating co-morbid conditions and targeting releif of specific symptoms. It's located here: http://www.currentpsychiatry.com/articl ... p?AID=9751 You may have to register to gain access, and it's meant for practitioners, but I think it's approachable and understandable.

The extended descriptions of BPD patients as manipulative was distressing. She's seen far more individuals with BPD than have I, so she probably has a better insight into the matter. I'm often desperately afraid of being abandoned, and feel as though navigating relationships is akin to making your way through a mine field. Those fears drive a lot of behavior that's almost certainly dysfunctional, but seemingly unavoidable. The discussion makes it sound as though such behavior is intentionally malevolent and volitional. I think in many cases it's not that way at all -- it's just people doing the best they can in a situation that feels absolutely impossible.

I also have some issues with the suggestion that psychodynamic therapy is inappropriate -- I've found it helpful (and DBT to be particularly unhelpful), but I suspect that's a consequence of my own particular personality and probably not applicable to the larger population. People might also consider EMDR as a means of addressing trauma.

As I say, I found the interview to be a bit uneven -- but I was happy to have some attention on the disorder. I've struggled with this my entire life, and was only recently diagnosed in middle age. It's incredibly helpful and reassuring to know there are reasons I behave the way I do, and that there is hope of recovery.