On Treatment and Recovery from Borderline.

[Penny Century]

I wanted to say something about how I view borderline and the recovery process around it.

I used to, according to the DSM, be borderline. I had 9/9 of the listed criteria for diagnosis. I was pretty much on a first-name basis with the staff at my local ER. I was "circling the drain" when I finally talked to my psychiatrist about borderline, and he reluctantly dx'd me (he didn't want me to have the stigma on my record) and referred me to a therapist who did a combination of DBT and Transference Focused Psychotherapy.

Going through that year of therapy was INCREDIBLY hard. Not only was it a lot of "work" in terms of the diary cards, etc., but I had to REALLY look at myself and my life and accept that there was a LOT wrong.

"Radical Acceptance" is a HUGE part of DBT. To radically accept, you fully acknowledge that something is. That doesn't mean you say it's good or bad, just that it is. For me, I was someone who wanted more than anything to be perfect. Honors grad from an Ivy in law school. Hard worker. I did everything I could to not be crazy, to not look crazy.

To say to myself, and REALLY accept that I HAD A REAL PROBLEM and WAS NOT "NORMAL" was FUCKING HARD. Hated it. Sobbed for hours over it. But I did accept it... and then I was able to start changing my behaviors. (With a lot of help from my therapist and a lot of work on learning mindfulness and what my emotional triggers were, and HELL what my emotions were even called, because I didn't know the names for them I'd spent so many years shoving them in a corner.)

The thing is... to get through DBT and away from a lot of that self destruction, to find a stable sense of self (which, let me tell you, when that happens, feels amazing)... I had to do accept a lot of harsh realities. I didn't know who I was. I was in a cycle of relationships with men who thought they could "save" me. I was angry at everyone for my childhood, and at the same time didn't want to admit that it was a remarkably fucked up childhood. I didn't know what my emotions were. I wasn't in control a lot of the time. I was abusing drugs and cutting. I was lying to myself about a LOT of things.

I had to accept that I needed to change.

I had to accept that my childhood sucked, and then just let it be what it was.

I had to take responsibility for my own actions. No blame, just accept it, and move on, change.

I had to learn how to meditate!

I had to, basically, look at my life and tell myself the truth, and then not hate myself for it. Just acknowledge what my life REALLY was like, accept that, and work on learning to be healthy.

If I am sometimes harsh when I talk about borderline, it is NOT because I am callous.

One of the first things my DBT therapist said to me was "No one, not me, not anyone but another borderline, will EVER understand how much emotional pain you are in. It is staggering, and I won't even pretend that I understand it."

He was right. It is REALLY PAINFUL to be borderline. Curl up on your bathroom floor and sob painful. Clawing out your brain painful.

If I am harsh... it is because the only way to STOP that pain is to be honest with yourself.

Honesty isn't about judgment. It's about seeing what is really happening. No blame, no shame. But accepting that I had real problems and needed to change so many areas of my life that I was scared shitless I wouldn't be "me" when I finished DBT.

In some ways, I'm not who I was... and I like those ways.

I didn't have a real "me" before DBT... I have a stable sense of self now.

Facing the harsh truths of life is necessary for change.

And it is worth it.

I have a stable sense of self, I don't dx, I don't feel that pain daily. Yes, I still identify as borderline because a lot of that is still in me, and because I need to keep DBT skills as a part of my everyday life. But my life totally changed. If DBT was a church, I'd proselytize.

So, if I am seemingly harsh, it's because I know that to get better, borderlines have to accept a lot of harsh things. Soft words only go so far.

I validate your pain, being borderline hurts.

And I want other borderlines to get better. Lying and saying it will all work out isn't helpful.

Treatment means work.

But, the treatment DOES WORK.

Isn't that a better thing to say?

To say that yes, DBT is painful... but it works, this pain can end. Isn't that better than to offer sympathy and not acknowledge the real reality of borderline?

Ok, so that's a bit of my story and an explanation of how I see things.

My best to all the borderlines,

Penny

[Registered Nut]

Hi Penny,

Thank you for this post. I am so glad for you that you are recovered. Do you have times that the bpd comes back to haunt you?

I was dx in 11-05. I already knew I had severe MDD. A meltdown, suicide attempt got me in a hospital finally and I was then finally diagnosed. I was shocked to see me in 8 out of 9 of the characteristics of borderline. I had some DBT treatment at the hospital and on an outpt basis. That was when I had insurance.

When I lost insurance, I have not had access to real DBT tx. I want it, but now that I have been through therapy consistently since then, I have come a long ways. I would still like to go to DBT classes, but it is not affordable and I am now applying for disability much to my dismay, but I am accepting that. I am still an RN, but no longer able to function in a full time job. I am wondering if I can ever get back to it, I think I burned out after 22 years of working.

I still have a lot of sensitivity to things, roller coaster emotions and some sexual confusion. I am wondering how improved I am exactly. I have not done as much as I could to progress I think, I don't know, maybe I have.

I would not say I have a strong sense of self at all yet. I love my counselor, but she is not tough on me. She is more soothing to me. However with limited funds, I cannot go to a therapist unless they charged a nominal fee. The ones at the mental health center are a joke to me.

I just wanted to get your thoughts on my situation and any advice you might have to give me. I want so bad to get my life back, and at 54 years old it is easy for me to just want to give up. I had a close call with a suicide plan just this past week. Due to stressing over my son. I finally decided I just have to completely detach from his situation, or I will die.

I know you can't be my therapist, but I feel like I am floundering and need some better direction.

Thanks, RN

[Penny Century]

Since I'm in a blunt and honest mood...

Read my post again.

Look at your life and ask the hard questions, answer them truthfully, accept that truth, and move from there.

[Inspired_Neurosis]

Thank you very much for your heartfelt post. I hope you don't mind if I don't elaborate as extensively as you have, but it is possibly relevant to me, and I will ruminate upon it.

Edited October 18, 2009 by Inspired_Neurosis

[Registered Nut]

Since I'm in a blunt and honest mood...

Read my post again.

Look at your life and ask the hard questions, answer them truthfully, accept that truth, and move from there.

I appreciate the response, and I have done the above. Unfortunately that still does not answer a lot of my questions I had for you.

I understand if you do not have the time or patience to go through each of the questions.

My sister is very blunt, and most people call her very direct or rude. I don't think you were rude, but you could have just said to seek help elsewhere and that is what I will do.

Thanks, RN

[Penny Century]

Thank you very much for your heartfelt post. I hope you don't mind if I don't elaborate as extensively as you have, but it is possibly relevant to me, and I will ruminate upon it.

Thank you for the thanks.

I didn't set out to write an emotional purge/life story, just happened by accident, yanno? It wasn't meant as a confessional, I was just letting something out that's been brewing for a while.

Food for thought, yes, I did want it to be that, I think.

Be well,

Penny

[Penny Century]

I appreciate the response, and I have done the above. Unfortunately that still does not answer a lot of my questions I had for you.

I understand if you do not have the time or patience to go through each of the questions.

My sister is very blunt, and most people call her very direct or rude. I don't think you were rude, but you could have just said to seek help elsewhere and that is what I will do.

Thanks, RN

Your questions are a bit too vague for me to really address. I understand that you're in a jam and life is a bit messy, but I have no advice on that, really. If that makes sense? Maybe if you narrowed down what you're asking a bit more I could try to answer?

[vanderk]

An excellent post, Penny, one that probably ought to be pinned. You lay it out in good detail. Characterological change is possible but changing behaviors that have become reflexive is a huge challenge. I refer to it as 'the hard work miracle.' Readiness to change is maybe the greatest challenge, mostly because it hinges on the honesty you describe. Good job!

[toplessviggen]

Hey Penny,

Thanks for the post,, your up front id ness was just what I needed,,

Ya see I have been diagnosed with bipolar2 for over 30 years and have been through all the meds , over 100 ects , but just in the last couple of months have cycled into something where I sense the hope is all gone.. not the first time, but different now..

But I have always looked into the primary diagn , that of bp,, though usually in the black, with several suicide attempts, lots of hospitalizations.. the manias were mildish but there every now and then..

So I have considered investigating the rest of my diagn.. which includes big anxiety, social phobia, and borderline personality disorder.. ran through some tests and maxed out in the personality disorder one.. so , duh, I started to read up on it and it fit me to a tee.. and explained behaviors that were associated with my mania parts of the bp2 diagn.. But it could all be fit in the per dis. . All the running around , excessive spending, etc.

so to read what you have written convinces me that I am going to have to look at attacking it with more than drugs,, I have been through groups, pretty good at manipulating them in the old days, but see I need a readjustment, and get down to doing some cognitive work,, time to accept , after all these years of focusing on the bp2,

Do you have any books in particular that you found really good? ,, Years back I read Burns' dbt..

Good luck to you, I hope to have the guts and determination that you have.

David

[etkearne]

That therapy regimen sounds right up my alley! I do not have BPD, but I do have NPD, which is in the same cluster of disorders. It is coupled with bipolar disorder. The meds situation is about as good as it can gets-- I need to find the right therapist. I can never accept things for what they are. I always try to just keep putting thin covers over them. I'll discuss some of this with my therapist next time. I'll mention that I would like to explore therapies used in borderline PD.

[EtchesShelly]

Thank you Penny, you gave me hope. I know I have alot of work ahead of me, for I was only recently diagnosed. It's nice to know that if I put the work in there will be rewards through out the journey.

[breezy]

An excellent, heartfelt, honest, and hopeful post. Thank you.

[sinisteria]

Hey Registered Nut,

I see and feel your problems.

Everybody has different situations with BPD, and with their lives.

Getting proper help isn't easy for all.

I wish I could answer something wise to you, but Im also just seeking for help.

But the thruth is that you can recover, it is possible, even if the circumstances are difficult.

Myself, I can't start therapy, cause I dont have money for it. But something will be arranged

sooner of later. Im sure it's good for you to talk about this with your current therapist too,

and also keep in mind what Penny said about meditation, you could try and go for it too.

I'm sure it is not a waste of time. There is hope, and just try and talk to your therapist or other

sources, who can help to bring you good treatment and care!

My situation is quite different also. I've recognized that there's something wrong with me since

I don't even remember...

And I always had the feeling of sickness, or wrongness... and realised it's not all going like it should be.

Also I know my childhood wasnt all ok, I've been dealing with it,

or dealing with the parts I can remember..

So, ofcourse, accepting and realising is important, but especially if depressed,

one needs good treatment.

Yes, I'ts a rough road, but I have the feeling, that if I'll survive this, it's a huge strength and will bring also wisdom

and happiness.

Respect your broken mind (body, soul), accept it, and heal it. Or let it heal in the process.

edited for some typo's

Edited March 14, 2012 by sinisteria

[someday...]

To Penny

(don't have time to read the other comments right now...)

Wow. I'm in soooo much emotional pain right now, and your top (original?) post was and is me. I have not done any work yet- haven't found a therapist yet... but know I'm going to have to go through hell to get well, a little daunting, but all that stuff- alcoholism, child abuse, whatever- (not that it's 'just' like borderline)- there is alot of suffering before healing. (I remember when I first looked it up, I fit all the criteria, it freaked me out. My memory is bad from all the stress, anyone else like that?)

But it was good to hear all you said- good to know that other people know what hell it is, I was in terror and have felt suicidal since realizing that I likely do have Borderline- terrified that I cannot get well or cannot get help....

I hope I can find it all- mostly get rid of guilt (which eats at my guts), shame, forgiving myself, looking at my childhood and realizing it just 'is', and to stop suffering from it, looking at alot of past and present garbage in my life... It's basically like learning how to stop torturing myself, wouldn't it be? And torture myself, I do.

I need FREEDOM, and I guess I'll have to brace myself for the 'ride' towards wellness. Of course- I wish it was easier. I've been through so much (many deaths and stuff), and alot of REALLY tough things for YEARS (nervous breakdown after trauma 6 years ago) I feel like I'm so tired of fighting, I just want to lie down and stop fighting my way through things.... so weary.

But it sounds like DBT is the ticket. (Although I haven't yet found a therapist or ANYONE in my city that does it, very discouraged about that.) But hopefully it's work out. DBT sounds like a dirty word to me- because I know I'm going to be ripped apart emotionally from the sounds of it, but it sounds like the ticket to freedom in the end.

I need the emotional ups and downs and internal hell to stop (which seems to have really escalated, why?), but you have survived and will. Very good stuff, it gives me hope. (Wish I could hire someone to do the suffering part of therapy for me and give me brief updates from time to time. What a dream that would be!)

If you or others are believers, please pray for (or at least root for me) to continue the fight- really, I'm in bad shape. And also to find a therapist.

Thanks for your story Penny.

[b@shitcrazy]

Dear Penny

 

It has been a year since I began the hard work of healing. A year since I read your post at the top of this thread and it ding ding dinged the ring of truth for me. And I have worked my way through the DBT programme here in Auckland and have happily been discharged free of any of the 9 characteristics I started off with. 

 

What an incredible wonderful process it has been! It has been the absolute best year of my life and so very worth every inch of struggle. 

 

I am very happy to have also found that stable sense of self. I would like to share my thanks and support for everyone else who has also discovered themselves in the best way possible. Reading your post made the hard work something I really looked forward to.

 

Strength and happiness to us all. 

 

And to everyone who is still in the process of struggling... please keep on with it.. the results are so very wonderful. ;D And you're not alone. and AND... you have SO much to contribute!!! Please don't take too long to figure that one out.

 

 

Ani   

[sakurasun]

I've been in recovery for quite a while..I feel like my issues won't ever leave me.  I've been told the issues won't ever leave me but the therapy and meds will help lessen the impact.  Is this true?

 

Sam

[in_media_res]

I've been told the issues won't ever leave me but the therapy and meds will help lessen the impact.  Is this true?

Depends on how you look at it, but the data is actually hopeful. From my own experience, meds are useless, at least with respect to BPD. Your mileage may vary. I can post a link to an interesting article that talks about the efficacy of meds for treating co-morbid conditions and symptoms (for example, if you're depressed and borderline). Results vary. For treating borderline personality, therapy is the best option. That, and as Penny points out, learning to accept a hell of a lot -- which can be exceptionally painful and difficult. I haven't done it yet, although there are days when I think I'm making progress.

I mentioned data...here are some numbers from a couple of different studies:

In the first, "the study [of 111 individuals with BPD] found 85% of the people with BPD experienced remission and only 12% of those patients relapsed. The relapse rate was lower than for either major depression or other personality disorders." More info, and a link to the study itself, here: http://articles.latimes.com/2011/apr/06/news/la-heb-borderline-personality-20110406

A second is less optimistic, but still encouraging. That research -- covering 290 inpatients over 10 years -- showed about half of the people recovered. "Over the study period, 50% of participants achieved recovery from borderline personality disorder, which was defined as remission of symptoms and having good social and vocational functioning during the previous 2 years. Overall, 93% of participants attained a remission of symptoms lasting at least 2 years, and 86% attained a sustained remission lasting at least 4 years. Of those who achieved recovery, 34% lost their recovery. Of those who achieved a 2-year remission of symptoms, 30% had a symptomatic recurrence, and of those who achieved a sustained remission, only 15% experienced a recurrence." Link to the abstract is: http://www.ncbi.nlm.nih.gov/pubmed/20395399

So yes...it's hard, but there is hope.

Good luck, and strength, to all.

[marcie]

Hi

 

It was good to read these posts. It made me cry, Penny Centtury, when I read this part of your post:

 

One of the first things my DBT therapist said to me was "No one, not me, not anyone but another borderline, will EVER understand how much emotional pain you are in. It is staggering, and I won't even pretend that I understand it."

He was right. It is REALLY PAINFUL to be borderline. Curl up on your bathroom floor and sob painful. Clawing out your brain painful.

 

Because nobody has ever acknowledged the pain I have experienced, the pain that seems to pull away the whole foundation of what is a fragile 'me' and makes me tumble down in small pieces. Again and again and again, every few days, it's like my life ends.  

It helps that someone else knows that the pain is real, even on an anonymous forum, it really helps so much to hear that someone else knows too that it is real. Because my family members and boyfriends have never understood that, nor have they tried to understand. I can see how confusing it must have been for them, but the way I am, dependent on other people telling me what is a 'normal way of feeling', it would have helped me if someone had realised how much I was hurting, and supported me, then. But other people aren't your caregivers, they have their own lives to manage, and as you say, they have never experienced such emotions over what to them seem trivial matters.

 

So you are alone with the painful feelings, but you can get support when you want to find a way out of it. I have seen three or four different therapists in the past and been hospitalised in psychiatric wards and have also been taken to hospital once for an almost-successful suicide attempt, after which I was in a coma for a month, but I have never been diagonsed. Now, I have to march to the GP and tell him what I think is wrong with me. Well, I know how to talk to them, I will tell him what symptoms I have and when he hears the list then he surely has no choice but to tell me he thinks I 'may' have borderline personality disorder.

The thought of having to start seeing a therapist and talking to people and finding medication is already making me quite weary, I don't like talking to people much and I am not looking forward to starting this journey. But I have to do something, or I might as well just give up completely, because it is the pain I cannot take anymore, the hurt and the rage and the despair, I need to find a way to stop that pain. And if I can slowly find my personality somewhere, that will be really good too, although I am 40 now and I remember when I started losing myself, I was 12 and I developed rituals for 'creating' the perfect me, words I would say to myself to make myself the person I wanted to be, certain places I would sit in, in certain positions, hands on my knees or legs crossed, hair in a certain way and certain clothing on, and when I would get up, I would be that perfect person. Sometimes it lasted for a minute, sometimes for hours but I don't think I was ever the perfect person for an entire day. But those rituals were part of me developing this disorder, I am sure ot it. I stopped repeating them at the age of 21 or so so have been without them for a long time. but I am still without a personality, and I need to find something, even little bits of a real me, find more things that I like (not just think that I like), as well as my own boundaries and limits, and personal space, which also have always been missing.

 

Apologies, I didn't mean to write so much but this is a crisis point in my life, my partner and I have gone through a period of time when we almost broke up and I don't know which of my reactions are justified and which are not, because I simply don't know the code, and so I need help.

Edited October 3, 2013 by marcie

[cipher]

marcie,

i just wanted to let you know that i can relate to a lot in your posts - i just recently turned 40. i spent today with 2 male therapists talking about my relationship issues, and just turned into a crying mess because it all feels so hopeless. i've been suicidal, and have constantly cried, called various suicide helplines on a daily basis for months, not worked for 5 years, and just generally been feeling like the cause of malcontent in the world. it's great also that you feel for sure that you have BPD due to that "i tick ALL the boxes i need to!" type feeling - it's reassuring to have that, i think. (i do with depression, but not with BPD)

 

if you check out the threads and do a bit of a search - a pattern that i've noticed is that a lot of people with BPD are on (and rather fond of) Seroquel. one of the side effects is increased appetite - that is, a rise in blood sugar levels due to craving sugars - be that sugar itself, or simple carbs like bread, pasta, corn, potatoes etc in massive amounts. one of my tricks is cutting down on sugar (in dried fruit, fructose in bread, onions, etc) and upping good fats like avocado, coconut oil, nuts, seeds.

 

the wondrous upside of seroquel is calm, and blessed sleep. after taking antidepressants for years - seroquel was more what i was after - and it works within a hour or so, instead of waiting weeks for antidepressants to kick in. if you aren't on an antipsychotic or any other meds, it could be a good start - so i'd suggest chatting with your doctor - or getting a referral to someone who specialises in bpd for their take.

 

good luck on your journey to wellness.

[marcie]

Hi cipher

 

Thanks...Sounds good to me. I had a brief look on the Internet for Seroquel. I hope they will either get me referred quickly or prescribe something right away.

I am a vegetarian, and I am quite active so I probably won't be putting on LOADS of weight, but last time I was on Fluoxetine I never noticed I was eating any more, but obviously I was as I did put on weight, slowly. Now I've finally managed to lose most of the excess but I'm still a size bigger than I was two years ago.

 

I have quite a lot of baggage (APOLOGIES for the pun!!) from sexual abuse and from a few years of being a sex worker (it's all coming out now, this shite) and a lot of my feeling accepted is about feeling attractive and sexually wanted, hence the concern. I can see that I'm concentrating on the wrong things right now, I realise feeling happy in your mind is about a million times more important than feeling sexually attractive, it's just one of those weird things I have conditioned myself into. Oh, it's so complicated. But yes, I will definitely talk to them, and I will listen to their advice.

 

Thanks again for your post.

Edited October 3, 2013 by marcie