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Marsha, Marsha, MARSHA

At last, someone who is giving Borderline Personality Disorder a new image, a new spin, a positive focus and dispelling all of the myths surrounding this socially constructed disorder.  Thank you, Marsha Linehan, for coming out of the closet.  What a breath of fresh air you are!

I have read Marsha’s book on Dialectical Behavioural Therapy and since then I have been recommending this type of one on one therapy, based on Cognitive Behavioural Therapy, radical acceptance, Buddhist meditative practice and mindfulness with the adjunct of group therapy and inter-session therapist phone-calls, to many people.  It proves beyond a shadow of a doubt that there is life beyond this subjective, patronizing, ineffective, degrading and destructive diagnosis, generally given out by the psychiatric industry. 

So it takes someone very brave (or naïve) to come out of the Borderline closet.  There must have been something in the atmosphere that week because I also outed myself as a diagnosed Borderline.  Perhaps Marsha and I are channeling each other through the Universal Unconscious Carl Yung talked about where some people are so in tune with the current global zeitgeist of evolutionary mental thoughts and images that they unblock some old ideas and lock some new ones into the merging and emerging brains of like-minded people in a telepathic manner.

In Freud’s day BPD’s were called “hysterics” and their trauma was dismissed as unconscious fantasy.  Imagine being told your childhood rape, incest, or sexual assault was the product of your over-active and reactive imagination?  Would that not do your head in?  While Freud has a lot to answer for with the abandonment of his “seduction theory,” he did do his best to convince the medical/psychiatric/neurological population at the time that this was the cause for hysteria.  Seeing as no-one publicly believed him he felt he had no choice but to abandon it and find a more acceptable reason for women’s distressful circumstances and situations.  Since then evidence based research has led to a rather large correlation between sexual abuse, whether repressed or not, and BPD signs and symptoms.

Latest research into Borderline Personality Disorder (BPD) is also starting to show this diagnosis to be part of the Post Traumatic Stress Disorder spectrum.  Currently, in order to receive a diagnosis of BPD you have to fulfill five of the following nine symptoms which include efforts to avoid real or imagined abandonment, unstable, intense interpersonal relationships, identity disturbance, impulsivity, recurrent suicidal behavior, emotional instability, chronic feelings of emptiness, inappropriate, intense anger and transient, stress-related paranoid thoughts or severe dissociative symptoms.

Many of these symptoms are experienced by most of the population to a lesser degree.  For Borderline Personality Disorder to be diagnosed these symptoms have to be rigid and inflexible, interfere with your every day living and impair your life and relationships to a greater degree.  This diagnosis can be very subjective and sometimes based upon the psychiatrist’s own personal preferences, biases and prejudices.  Sometimes difficult patients who ask lots of unwanted questions in psychiatric units can be labelled with Borderline Personality Disorder, when all they are trying to do is find out more about what works for them, how it works for them, why what is happening is simply not working and that the treatment being foisted upon them is ineffective and disrespectful.

People with Borderline Personality Disorder need to have their stories acknowledged with understanding, compassion, empathy and validation.  Their behaviour was adaptive and geared up towards survival.  Those survival skills honed as a child are no longer needed in the adult world but when stress and distress becomes overwhelming, old coping mechanisms come to the fore.  If Vietnam Vets have flackbacks due to Post Traumatic Stress Disorder then BPD sufferers are still fighting a personal war that ended many years ago.

Borderline Personality Disorder sufferers are over-represented at hospital emergency departments and psychiatric units.  Staff, both doctors and nurses can be critical, judgemental and scathing towards these people presenting with self-harm and suicide ideation.  Individuals with BPD frequently possess good interpersonal skills, empathy and compassion in abundance but the problems arise when emotional triggers are pulled and the person starts to decompensate and regress.

Rather than castigating and abandoning a person when this happens the mental health professional needs to realise that the person with BPD is doing the very best they can with their limited abilities focussed purely on surviving the hostile and overwhelming experience.  Their adult coping skills have been overwhelmed by a biological response that starts in the amygdala (the emotional centre of the brain) and that results in the person simply unable to hear and respond to what the other person is saying because the anger, pain and darkness have taken their brain and world view hostage.

Interpersonal response patterns taught in DBT skills training are very similar to those taught in many assertiveness and interpersonal problem-solving classes.  They include effective strategies for asking for what one needs, saying no, and coping with interpersonal conflict.

There are many famous internet-diagnosed BPD sufferers in the world who have managed to live meaningful and fulfilling lives.  People with BPD are not all like Glenn Close’s character in Fatal Attraction.  Princess Diana was posthumously diagnosed with BPD as was Marilyn Monroe.  According to some websites Britney Spears, Lindsay Lohan and Amy Whitehouse also appear to fulfill some of the criteria.

Suffering is not a foregone conclusion.  The best antidote to the pain and suffering of BPD is to find a good Dialectical Behavioural Therapist and live in the solution, not the problem.  Yoga, meditation, self-reflection, healthy eating choices, learning to let go and move on and put history behind is what DBT is all about.  Medication in the form of mood stabilisers can be an advantage, but mindfulness therapy can change the brain for the better.

DBT is like non-invasive brain surgery and within twelve months it is possible that some people can be living a fuller, happier, more mindful and meaningful life.

Pictures:  http://lisboncpc.blogspot.com/2010/05/relationship-with-borderline.html and http://thinkingmansyoga.blogspot.com/2010/12/why-do-you-call-it-yoga-and-meditation.html

Marsha, Marsha, MARSHA


Sonia Neale

Sonia Neale was recently awarded the Inaugural Barbara Hocking SANE Australia Fellowship to study and research Borderline Personality Disorder overseas in the USA, Canada, UK and Ireland. Her previous Psych Central blog was called Therapy Unplugged. She is the author of two books, The Bad Mother’s Revenge and Death by Teenager, both published by ABC Books/Harper Collins. She lives in Western Australia, is married with three adult children, has studied psychoanalytic psychotherapy, has a Certificate IV in Mental Health and is studying for a Psychology/Counselling degree. She currently works as a peer support worker in the mental health field. Please email her on davson at iinet.net.au


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APA Reference
Neale, S. (2019). Marsha, Marsha, MARSHA. Psych Central. Retrieved on March 29, 2020, from https://blogs.psychcentral.com/unplugged/2011/07/marsha-marsha-marsha/

 

Last updated: 30 Mar 2019
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