Timothy Rogers, MA, LMFT
Licensed Marriage & Family Therapist mfc101500
- Let me be the last therapist you see -
Cult of Personality
Every person has a personality: longstanding ways of perceiving, relating to, and thinking about the environment and oneself. However, when these trains are inflexible, maladaptive (unable to adapt), and cause significant functional impairment or subjective distress, they constitute a personality "disorder."
There are 10 classified personality disorders and of those, Borderline Personality Disorder is the most common, most complex, most studied, and certainly one of the most devastating, with up to 10% of those diagnosed committing suicide. BPD exists in approximately 2-4% of the general population; up to 20% of all psychiatric inpatients and 15% of all outpatients. Females predominate (about 75%) within psychotic settings while males are more common in substance abuse or forensic settings.
As a result of clinical observations since the 1930's and scientific studies done in the 1970's psychiatrists determined that people characterized by intense emotions, self-destructive acts, and stormy interpersonal relationships constituted a type of "personality disorder." The term "Borderline" was used because these patients were originally though to exists as atypical (Borderline") variants of other diagnoses and also becasue this patients tested the borders of whatever lists were set upon them.
The diagnosis became "official" in 1980. While there has been much progress in the past 25 years in understanding and treating BPD, the diagnosis is underused. This owes mainly to the fact that BPD patients is difficult to treat and often evoke feelings of anger and frustration in the people trying to help them. Such negative associates have caused many professionals to be unwilling to make the diagnosis. Many give precedence to co-occurring conditions such as depression, bipolar disorder, substance abuse, anxiety disorders and eating disorders. This problem has been aggravated by the lack of appropriate insurance coverage for the extended psychosocial treatments that BPD usually requires.
* From A BDP Brief: An introduction to Borderline Personality Disorder Diagnosis, Origins, Course, and Treatment by John G. Gunderson, MD 2011
Information is a good thing. Just remember it's one perspective.
Consider that it's less about diagnosis
& more about a view of the world from a traumatized place.
No-one is to blame. However taking adult responsibility is key to healing...for everyone.
Less excuses More reason.
-----------> The Dogma of a BPD diagnosis <--------
This is the criteria for Borderline Personality Disorder. Before you scroll down to diagnose yourself, know that this criteria is listed in the manual (DSM) used by mental health professionals to provide diagnosis and conceptualize client behaviors, thinking and emotional state. Before any insurance company will consider paying for treatment, they require a diagnosis (with corresponding code) from this manual. For some, the manual is bible-like. For others, it's a guide. A way into what a client could be suffering from. However, not unlike any journey up the mountain, there are many guides with many paths to help us reach the top. Finding one that is a good fit for you is the strongest indicator of your potential for success.
----------> Prognosis <---------
Research has shown that outcomes can be quite good for people with BPD, particularly if they are engaged in treatment. With specialized therapy, most people with borderline personality disorder find their symptoms are reduced and their lives are improved. Although not all the symptoms may ease, there is often a major decrease in problem behaviors and suffering. Under stress, some symptoms may come back. When this happens, people with BPD should return to therapy and other kinds of support. Many individuals with BPD experience a decrease in their impulsive behavior in their 40’s.
A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked by impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
*Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association