My day and the new therapist

The day went well. I left the house twice. I did everything I needed to do.

The appointment was great. I really like my new therapist. She’s empathetic, knowledgeable and optimistic. She is willing to do some DBT exercises in the last 10 minutes of the session. I’m going to order one or two books online. I told her about the stigma BPD patients face but I don’t think she is prejudiced or biased. I’m hopeful about this. We instantly created a bond and I’m happy that she’s older than me which means she has more life experience.

I had this CBT therapist. Once I told her that I felt embarrassed about my lack of accomplishments and she said she would also feel like that if she was me. I left that appointment crushed. I left like I entered. That’s not helpful at all.

I feel lighter. I cried a bit while telling my story, I hate doing that. Nor crying but the act of telling my story again. I have told my story numerous times. It gets so tiring. Reliving my past is not a good experience. But I’ll do it as long as it is needed, how many times it is needed for me to get better. If I have to feel uncomfortable to get better, so be it.

I hope you had a good day, too.

Image by tsukiko-kiyomidzu, courtesy of Pixabay.

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What is DBT and how it can help BPD patients

DBT is a type of cognitive behavioral therapy. It was developed in the 70’s by Marsha Linehan Ph.D., in the University of Washington. It was originally designed for people with chronic suicidal thoughts as a symptom of BPD. Linehan started by using CBT (cognitive behavioral therapy) but she found that it wasn’t very suited for BPD patients. Marsha Linehan then analyzed the issues and made adaptations that proved to be suitable for BPD patients. Techniques based on acceptance were added to make sure patients felt validated and supported before they start focusing on change. DBT is based on the idea that opposites can exist side-by-side (dialectics), which means accepting situations as they are while analyzing various points of view in any situation and working on balancing an effort to change.This helps to stop the patterns of black and white thinking.

The goal of DBT is to help the patient build a life that they find worth living.

DBT includes individual psychotherapy and group therapy. Patients learn skills to deal with problematic behaviors. Problematic behaviors are a way of coping or an attempt to solve a problem. These behaviors offer temporary relief and they often don’t have a long-term effect. DBT assumes that patients are doing their best and that they need to learn new behaviors to deal with difficult situations. There are 4 modules of skills:

ºMindfulness

ºDistress tolerance

ºEmotional regulation

ºInterpersonal effectiveness

Useful links:

Behavioral Tech- What is DBT?

Dialectical Behavior Therapy

DBT Self-Help

/r/DBTSelfHelp

Image by diego_torres, courtesy of Pixabay.

BPD is treatable

I see a lot of misinformation out there so I wanted to make one thing clear: BPD is treatable, it can remit.
I have found this article about it and also, this article.

The first one is a post from 2004 but still relevant today. It says that clinical trials show promise in treating BPD. It talks about how many people with BPD don’t seek out treatment and the ones who do are likely to drop out of treatment. One of the reasons is the black and white thinking. We start by idealizing our therapist and sometimes, for minor reasons, we start seeing them as bad. I’m guilty as charged, I have dropped out of therapy many times. I’m trying to stick to therapy now, I know it’s very important.

“the therapist needs to appreciate the reality of the client’s emotions. BPD patients require emotional acceptance–a DBT staple–because they often lacked it as children, says Linehan. In an invalidating environment, for example, a child might express anger and be told by a parent that she is jealous. “They never gain a sense that their needs, wants and desires are reasonable,” says Lynch, adding that such circumstances can lead to emotional difficulties and a problematic sense of self. DBT helps these people restore their sense of self, and legitimizes their emotional experience.”

The second article covers the evolution of effective BPD treatment and the prognosis of the condition.

“According to a longitudinal study by Dr. Mary Zanarini, over 90% of patients treated for BPD setting reported remission of symptoms for two years following treatment and 86% reported remission for at least four years. These findings are in line with previous studies that have shown similar results and paint a significantly more hopeful picture of borderline personality disorder prognosis than that typically advanced in popular culture. According to Dr. Jerold J. Kreisman, an associate clinical professor at St. Louis University,”

“It is now becoming clear that most [people with BPD] get better. Indeed, the long-term prognosis of remission of many symptoms is better in BPD than in major depression and bipolar disorder … As we develop better ways to define, treat, and, especially, understand patients with BPD, we will improve the ability to relieve the suffering inherent in this illness.”

So the prognosis is good for us. There is hope.

A combination of psychotherapy (DBT) and medication can help improve symptoms. In my case, DBT (dialectical behavioral therapy) and proper medication (including antipsychotics, two anti-depressants, a mood stabilizer and an anxiolytic for sleeping). I stopped being so moody, anger disappeared. I feel more serene and in control. Mental health apps like Wysa have helped me deal with the negative thoughts. They have decreased. Mindfulness meditation (which is the basis of DBT) is now a part of my life and it’s very helpful.

Medication by itself isn’t enough. It’s not going to teach you positive coping skills and strategies for dealing with BPD.

You and I can overcome this, I know it.

Image by ShonEjai, courtesy of Pixabay.