It’s been a long time since my last blog because I felt I had run out of things to say about BPD. However, since working in peer support work for the past year with a caseload that comprises of 75% women with BPD, I thought it prudent to resurrect my blog because I now have lots more to say both now and in subsequent blogs and I also need your valuable input for something I feel is incredibly exciting.
In Western Australia, we have no non-clinical psychologist run Dialectical Behaviour Therapy (DBT) services for BPD sufferers. We do have three teams in the metropolitan area of Perth run by fantastic, dedicated clinical psychologists who are the only MH professionals able to deliver this service. This is not nearly enough though. Only a small percentage of people can get help in this public sector which means they don’t have to pay. Medicare-refunded therapy (mostly with a considerable gap payment) is six sessions per year, an extra four if there are exceptional circumstances. Seeing as many people with BPD are on disability pensions, unemployed or under-employed, self-payment is not an option.
The new Clinical Practice Guidelines for the Management of People with BPD by the National Health and Medical Research Council states that “Health professionals at all levels of the healthcare system and within each type of health service, including general practices and emergency departments, should recognise that BPD treatment is a legitimate use of healthcare services. Having BPD should never be used as a reason to refuse health care to a person.”
It is great that this is finally recognised but the reality is that long term clinical and non-clinical treatment options are simply not widely available in Western Australia. Through my role as a peer support worker I am hoping to start up a non-clinical self-help support and friendship group under the existing umbrella of government and non-government services. My long-term vision is to be trained and train others in DBT skills to set up other groups all over the …
I was recently at a social function and eagerly went up to this woman I work with, touched her shoulder and said, “Hi, how are you?” She stared at me, looked very uncomfortable and frantically searched around for either someone more interesting to talk to or someone to rescue her from me.
This is a woman I have found curt, abrupt, dismissive, snappy and abrasive in the past. I have never had an interaction with her where I have left feeling as though a warm breeze has blown through me, but rather a cold, icy wind that has left my whole being feeling fractured and discombobulated.
I knew this and yet I still went up to talk to her because, as a chronic masochistic people-pleaser, I unfailingly seek approval and acceptance from totally wrong and inappropriate graceless women. I cannot bear the pain of rejection and abandonment from anyone even though I did not like her and essentially had split her into the “bad” part of the good and bad. I always had an intense negative emotional reaction to her, felt deflated, empty and questioned who I thought was, and after an interaction with her I wanted to throw myself off a cliff.
Sometimes, the smallest things in life can cause the greatest pain and physical reaction. A bee’s sting is almost invisible to the naked eye and yet can easily kill someone when they have an allergic reaction. A mere critical stinging comment can just as easily send a person suffering Borderline Personality Disorder into “emotional anaphylactic shock.”
When a person has a life-threatening reaction to the poison from a bee sting, an ambulance is called and the person is taken to hospital where they receive treatment for their illness as well as respect and dignity but when someone suffering an emotional reaction to life circumstances presents at emergency, they are sometimes treated with rejection, intolerance and disdain. People can die from a bee sting and Borderlines can “die” from their own personal rage and self-hatred. If you present at emergency with a swollen face and throat unable to breathe with all your body organs shutting down, is some doctor or nurse going to say, “OMG, it’s a tiny bee sting, how bad can that be, look at you, get over yourself,” like they sometimes do when Borderlines present at hospital with similar symptoms.
Yet both types of people are in much pain and danger.
PLEASE TWITTER AND FACEBOOK THIS TO OTHER AUSTRALIANS
In Perth, Western Australia this week, Psychologist Ben Mullings and myself talked about the Medicare Better Access Initiative mental health issues on ABC720 Perth radio on Monday 30th May, 2011. It was about our campaign to get the government to reverse its decision to cut the number of Medicare rebated sessions from 12-18 sessions to 6-10 sessions. Here is the link:
Please see below for our Australian GetUp Action campaign you can vote on (these are the people responsible for the above picture), the petition you can sign, the facebook page you can join, the media release and our first (but not last) piece of publicity. I have added links if you wish to send emails to Federal and State politicians to protest against these cuts which come into effect 1st November, 2011.
Psychologist Ben Mullings and myself will be talking about mental health issues on ABC720 radio, Perth Western Australia, on Monday 30th May at 1pm. It’s about our campaign to get the Australian Labor government to reverse its decision to cut the number of Medicare rebated sessions from 12-18 sessions to 6-10 sessions starting from 1st November, 2011.
Read about us in the ABC news online: http://www.abc.net.au/news/stories/2011/05/27/3229499.htm
Please join our GetUp Action Group campaign and vote: http://suggest.getup.org.au/forums/60819-campaign-ideas/suggestions/1833821-better-access-to-psychologists?ref=title
Please sign our petition: http://www.gopetition.com/petitions/better-access-to-psychologists.html
Please contact Ben Mullings (see below) for further details.
Here is our media release.
There was both bitter and sweet news in this month’s Federal Budget for all Australians suffering mental health issues. While it is most prudent that the Labor Government is placing much needed funding for people suffering severe mental health issues in low socio-economic, rural and indigenous areas with their early intervention programmes, Headspace Centres for youths and Early Psychosis Prevention and Intervention Centres, this comes at a cost of cutting back the number of sessions available to patients under the Medicare Better Access Initiative with psychologists, both clinical and registered.
These have been sharply reduced from 12 sessions with an additional 6 for exceptional circumstances to 6 sessions with an additional 4 for exceptional circumstances, the Government rationale being, that people who see clinical psychologists suffer from a mild to moderate form of mental illness rather than a severe one. Here is a section taken from the Federal Budget 2011.
Nancy McWilliams admits in her book Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process that she can sometimes be a masochist with a depressive personality, which can gear itself up towards rescuing her clients from themselves.
In her section “Therapeutic Implications of the Diagnosis of Obsessive or Compulsive Personality,” she says “… by accepting compulsively self-harming people into analytic treatment unconditionally, the therapist may unwittingly contribute to their fantasies that therapy will operate magically, without their having at some point to exert self-control …”
This is known universally in Therapy World as “rescue fantasies.” Sometimes there is a repeat pattern of trauma in therapy where the obsessive, compulsive self-harming client with abandonment issues regresses and imploringly begs the therapist for extracurricular activities, and the therapist panics and enables the client to regress further by trying to pull them out of their regression with a magical cure, trying to rescue the client by crawling into their fantasies and merging with them. This can cause the client to withdraw and disintegrate or verbally attack the therapist in a sadistic manner due to feelings of overwhelming engulfment. This is where the cure can be worse than the disease.