Borderline Personality Disorder Assessment
What to Expect from the Borderline Personality Disorder Assessment Process
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Updated July 27, 2008
Immigration Assessment
If you think you (or a loved one) may have borderline personality disorder (BPD), the first step toward recovery is getting an accurate diagnosis. But what happens during the assessment process?
Starting a Borderline Personality Disorder Assessment
The first step to getting an accurate diagnosis is finding a mental health professional who is trained to work with people with BPD and making an appointment. This alone can be a challenge. It can be very anxiety provoking to think of taking this first step; many people avoid it for months or even years. But, once you make the decision to move forward, finding a clinician is not always easy.
There are resources that can help guide your search. If you have health insurance, you may want to talk to the insurance company about clinicians who take your insurance and who have expertise in BPD (you should also ask how many sessions would be covered and how much the co-pay would be). If you do not have insurance, you may qualify for public assistance programs or services through your state or region's department of mental health or social services.
As you search, keep in mind that you are looking to contact a professional who will conduct an assessment, give you a diagnosis, and either provide treatment or refer you to people who are an appropriate match. There are a number of different kinds of clinicians who can do this, including psychiatrists, psychologists, social workers, licensed mental health counselors, and psychiatric nurses. Generally, psychologists have the most training in psychological assessment (although this is not always the case), so you may want to start there (most psychologists will have a Ph.D. or Psy.D. after their name, but you may need to ask them if they are a licensed psychologist).
Scheduling a Borderline Personality Disorder Assessment
When you have found a list of professionals who might work, it is time to call and schedule an appointment. Call the first person on your list, and let them know that you are interested in an assessment and treatment. Describe some of your symptoms. You can even mention that you think you may have BPD.
Talk to the potential provider a bit about their educational background and training, and what types of services they can provide. Also ask if they have experience with BPD, what and how they charge (and confirm that they will accept your insurance if you have it). Ask what to expect in terms of the assessment process. This process will usually take more than a few minutes; the provider should be devoting at least a session, if not more, to assessing your difficulties (unless you have had assessments previously and the diagnosis is already established).
Keep in mind that you should feel comfortable with the clinician. Try to get a sense of that over the phone. Does this sound like someone you could talk to? Unfortunately, depending on where you live, you may not have too many options to choose from. But, try to choose someone who has the right expertise and who you feel comfortable with.
The Borderline Personality Disorder Assessment Process
When you arrive for your first session, you may feel nervous and uncomfortable, particularly if you have never done this before. This is completely normal. It is not easy to meet a new person and share private details about your life. However, keep in mind that the more candid and honest you can be, the more you will get out of the assessment.
Different providers use different tools to conduct an assessment. Generally, you should expect that your clinician will interview you and ask questions about your current and past symptoms, your family and work history, and your current life situation. Some clinicians will also give you some short questionnaires to fill out. Some may also use psychological tests that are longer and cover many different questions.
The assessment may take one session, or, if it is a very complete assessment, may take several sessions. Your clinician will let you know what to expect in terms of how long the assessment will take, and what types of tests or interviews you will be completing (if any).
Getting a Diagnosis
In some cases, at the end of the assessment, you may need to be referred to other additional types of assessment before a diagnosis can be given. For example, if you have a history of one or more significant head injuries, your provider may want you to see a specialist to evaluate whether some of your symptoms could be related to that. Or, if you have not seen a primary care physician (PCP) in some time, your provider may ask you to visit your PCP to make sure that any symptoms are not related to underlying medical conditions.
However, in most cases, you will receive a diagnosis at the end of the assessment. Your provider will also talk to you more about why you may be experiencing these kinds of difficulties and will recommend treatment options that may work for you. It may be that the clinician you have chosen can provide some of the treatment, or they may need to refer you to someone with different expertise. The good news is that you will now be able to move forward with the treatment that will be best suited for you.
Source:
Groth-Marnat, G. Handbook of Psychological Assessment. New York: John Wiley and Sons, 2003.
Monday, March 22, 2010
Sunday, March 21, 2010
Anxiety Sufferers Process Emotions Differently: Study
Anxiety Sufferers Process Emotions Differently: Study
(HealthScout) UPDATED 2010-02-18
According to new research, the brains of people who have generalized anxiety disorder (GAD) process emotions in an abnormal way. For their study, scientists looked at MRI scans of the brains of GAD patients. They found that when exposed to different situations, the prefrontal cortex responded in an unusual way in these patients. The researchers say this finding could lead to better diagnosis and treatment of anxiety disorders. Read full story >
http://broadcaster.healthcentral.com/t?r=4&c=17659&l=427&ctl=17FAE7:323464311A7754CE7D504547630EFE78&
(HealthScout) UPDATED 2010-02-18
According to new research, the brains of people who have generalized anxiety disorder (GAD) process emotions in an abnormal way. For their study, scientists looked at MRI scans of the brains of GAD patients. They found that when exposed to different situations, the prefrontal cortex responded in an unusual way in these patients. The researchers say this finding could lead to better diagnosis and treatment of anxiety disorders. Read full story >
http://broadcaster.healthcentral.com/t?r=4&c=17659&l=427&ctl=17FAE7:323464311A7754CE7D504547630EFE78&
Book Review: Freedom from Self-Harm
Book Review: Freedom from Self-Harm
About.com Rating Article Feedback:
User Rating Be the first to write a review
By Matthew Tull, PhD, About.com Guide
Created: April 13, 2009
Adolescent DBT Treatment
Residential Treatment for females. Harvard affiliated McLean Hospital.
www.mclean.harvard.edu
Loved One w/ Borderline?
Discover the Secrets to Helping and Supporting Your Loved One with BPD
BorderlinePersonalityDisorder.us
PTSD Treatment
Treatment Center for Women's Psych. Issues. Operated By Women. Call Now
www.HollywoodPavilion.com
PTSD Ads
PTSD
PTSD and Veterans
DBT Therapy
Combat Stress
Posttraumatic Stress
Publisher's Site
Post-traumatic stress disorder and deliberate self-harm (also called non-suicidal self-injury) are often linked.
"Deliberate self-harm" means doing something to cause immediate physical harm to yourself but not for the purpose of ending your life. Self-harm behaviors include cutting, burning, scratching, punching, or carving words or pictures on oneself.
Self-harm behavior can be difficult to stop and many people are reluctant to seek out treatment for self-harm due to the shame they feel about the behavior. Fortunately, there is a new self-help book available for people who deliberately self-harm.
A New Resource for Coping with Deliberate Self-Harm Behavior
Freedom from Self-Harm: Overcoming Self-Injury with Skills from DBT and Other Treatments (published by New Harbinger Publications) by Doctors Kim L. Gratz and Alexander L. Chapman may help those struggling with self-harm behavior.
Freedom from Self-Harm is an easy-to-read and accessible book that provides a wealth of information on:
•Why people often engage in self-harm
•Myths about self-harm
•Causes of self-harm behavior
•Mental health disorders that often co-occur with self-harm, such as PTSD and borderline personality disorder
•The consequences of self-harm
•Psychological treatments and medication that may be helpful for self-harm
•Coping skills for self-harm
The information provided in the book is up-to-date and presented in a validating and respectful manner. The authors also provide case examples throughout the book to help illustrate more complicated points.
Probably one of the greatest advantages of the book is its presentation of coping skills that someone struggling with self-harm could implement right away. For example, the book provides information on healthy ways of managing emotions (given that self-harm is often thought of as a way, albeit unhealthy, of regulating emotions), as well as worksheets to help people use these skills.
If you struggle from deliberate self-harm and are looking for a way to stop this behavior, you may benefit from checking out this great resource.
About.com Rating Article Feedback:
User Rating Be the first to write a review
By Matthew Tull, PhD, About.com Guide
Created: April 13, 2009
Adolescent DBT Treatment
Residential Treatment for females. Harvard affiliated McLean Hospital.
www.mclean.harvard.edu
Loved One w/ Borderline?
Discover the Secrets to Helping and Supporting Your Loved One with BPD
BorderlinePersonalityDisorder.us
PTSD Treatment
Treatment Center for Women's Psych. Issues. Operated By Women. Call Now
www.HollywoodPavilion.com
PTSD Ads
PTSD
PTSD and Veterans
DBT Therapy
Combat Stress
Posttraumatic Stress
Publisher's Site
Post-traumatic stress disorder and deliberate self-harm (also called non-suicidal self-injury) are often linked.
"Deliberate self-harm" means doing something to cause immediate physical harm to yourself but not for the purpose of ending your life. Self-harm behaviors include cutting, burning, scratching, punching, or carving words or pictures on oneself.
Self-harm behavior can be difficult to stop and many people are reluctant to seek out treatment for self-harm due to the shame they feel about the behavior. Fortunately, there is a new self-help book available for people who deliberately self-harm.
A New Resource for Coping with Deliberate Self-Harm Behavior
Freedom from Self-Harm: Overcoming Self-Injury with Skills from DBT and Other Treatments (published by New Harbinger Publications) by Doctors Kim L. Gratz and Alexander L. Chapman may help those struggling with self-harm behavior.
Freedom from Self-Harm is an easy-to-read and accessible book that provides a wealth of information on:
•Why people often engage in self-harm
•Myths about self-harm
•Causes of self-harm behavior
•Mental health disorders that often co-occur with self-harm, such as PTSD and borderline personality disorder
•The consequences of self-harm
•Psychological treatments and medication that may be helpful for self-harm
•Coping skills for self-harm
The information provided in the book is up-to-date and presented in a validating and respectful manner. The authors also provide case examples throughout the book to help illustrate more complicated points.
Probably one of the greatest advantages of the book is its presentation of coping skills that someone struggling with self-harm could implement right away. For example, the book provides information on healthy ways of managing emotions (given that self-harm is often thought of as a way, albeit unhealthy, of regulating emotions), as well as worksheets to help people use these skills.
If you struggle from deliberate self-harm and are looking for a way to stop this behavior, you may benefit from checking out this great resource.
Childhood Abuse, PTSD, and Deliberate Self-Injury in Adolescents
Childhood Abuse, PTSD, and Deliberate Self-Injury in Adolescents
By Matthew Tull, PhD, About.com Guide
Updated: April 10, 2009
About.com Health's Disease and Condition content is reviewed by the Medical Review Board
Adolescent DBT Treatment
Residential Treatment for females. Harvard affiliated McLean Hospital.
www.mclean.harvard.edu
PTSD and Veterans
Deliberate self-injury (also referred to as deliberate self-harm) basically means doing something to cause immediate physical harm to yourself but not for the purpose of ending your life. Self-injurious behaviors may include:
•Cutting
•Burning
•Needle-sticking
•Banging your head
•Carving on your skin
•Severe scratching
•Punching yourself
•Biting yourself
Cutting is often considered to be the most common method of self-injury.
How Common is Self-Injury
Self-injury is more common than you may think. Although high rates of self-injury have been found in some groups of people with certain psychiatric disorders (for example, borderline personality disorder and PTSD), high rates of self-injury have also been found in young adults. Specifically, it has been shown that anywhere between 17% to 37% of college students have engaged in self-injury.
There is also some evidence that adolescents may be at high risk for engaging in self-injurious behaviors. Specifically, approximately 14% to 21% of adolescents indicate that they have engaged in some form of self-injury at some point in their lifetime.
What May Place Adolescents at Risk for Self-Injury?
The experience of childhood physical or sexual abuse, as well as the development of PTSD symptoms, have been found to be connected to self-injury.
For example, one study by researchers at the Veterans Affairs Boston Healthcare System, Boston University School of Medicine, and Harvard University looked at the role of childhood sexual abuse, PTSD symptoms, and self-injury among a group of adolescents around the ages of 12 to 19.
They found that having re-experiencing, avoidance, and emotional numbing symptoms of PTSD as a result of childhood sexual abuse may lead to self-injury.
How Might PTSD Symptoms Lead to Self-Injury?
People may use self-injury as a way of attempting to express and manage uncomfortable and upsetting emotional experiences, such as anxiety, sadness, shame, and/or anger. Self-injury may also provide a temporary escape from or be a way of avoiding emotional pain. These emotional experiences commonly stem from experiencing PTSD symptoms, such as intrusive thoughts or memories about a past traumatic event.
Self-injury may also be a way of expressing pain. People struggling with the emotional numbing symptoms of PTSD (where there are difficulties in having certain emotions, especially positive emotions), may use self-injury as a way to feel something or create feelings.
What Can Be Done About Self-Injury?
Self-injury is a serious behavior. Although some people report that it causes relief from painful emotions, this relief is temporary. Afterward, people may feel more painful emotions, such as shame, guilt, sadness, and/or anger. The behavior may also leave scars which people may feel shame about and attempt to hide, and the behavior may become more severe over time.
If you engage in self-injury or you know someone who does, it is important that you seek out help. The S.A.F.E. Alternatives website provides information on their nationally recognized treatment program for self-injury, as well as resources on and referrals for people struggling with self-injurious behaviors. The Borderline Personality Disorder Survival Guide also provides excellent tips on how to address and cope with self-injurious behaviors.
Sources:
Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006). Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behaviour Research and Therapy, 44, 371-394.
Gratz, K. L. (2003). Risk factors for and functions of deliberate self-harm: An empirical and conceptual review. Clinical Psychology: Science and Practice, 10, 192-205.
Gratz, K. L. (2001). Measurement of deliberate self-harm: Preliminary data on the Deliberate Self-Harm Inventory. Journal of Psychopathology and Behavioral Assessment, 23, 253-263.
Greenspan, G.S., & Samuel, S.E. (1989). Self-cutting after rape. The American Journal of Psychiatry, 146, 789-790.
Harned, M.S., Najavits, L.M., & Weiss, R.D. (2006). Self-harm and suicidal behavior in women with comorbid PTSD and substance dependence. The American Journal on Addictions, 15, 392-295.
Lyons, J.A. (1991). Self-mutilation by a man with posttraumatic stress disorder. Journal of Nervous and Mental Disease, 179, 505-507.
Nock, M.K., & Prinstein, M.J. (2004). A functional approach to the assessment of self-mutilative behavior. Journal of Consulting and Clinical Psychology, 72, 885-890.
Pattison, E.M., & Kahan, J. (1983). The deliberate self-harm syndrome. American Journal of Psychiatry, 140, 867-872.
Pitman, R.K. (1990). Self-mutilation in combat-related PTSD. American Journal of Psychiatry, 147, 123-124.
Ross, S., & Heath, N.(2002). A study of the frequency of self-mutilation in a community sample of adolescents.American Journal of Psychiatry, 152, 1336-1342.
Weierich, M.R., & Nock, M.K. (2008). Posttraumatic stress symptoms mediate the relation between childhood sexual abuse and nonsuicidal self-injury. Journal of Consulting and Clinical Psychology, 76, 39-44.
Whitlock, J., & Knox, K.L. (2007). The relationship betwen self-injurious behavior and suicide in a young adult population. Archives of Pediatrics and Adolescent Medicine, 161, 634-640.
By Matthew Tull, PhD, About.com Guide
Updated: April 10, 2009
About.com Health's Disease and Condition content is reviewed by the Medical Review Board
Adolescent DBT Treatment
Residential Treatment for females. Harvard affiliated McLean Hospital.
www.mclean.harvard.edu
PTSD and Veterans
Deliberate self-injury (also referred to as deliberate self-harm) basically means doing something to cause immediate physical harm to yourself but not for the purpose of ending your life. Self-injurious behaviors may include:
•Cutting
•Burning
•Needle-sticking
•Banging your head
•Carving on your skin
•Severe scratching
•Punching yourself
•Biting yourself
Cutting is often considered to be the most common method of self-injury.
How Common is Self-Injury
Self-injury is more common than you may think. Although high rates of self-injury have been found in some groups of people with certain psychiatric disorders (for example, borderline personality disorder and PTSD), high rates of self-injury have also been found in young adults. Specifically, it has been shown that anywhere between 17% to 37% of college students have engaged in self-injury.
There is also some evidence that adolescents may be at high risk for engaging in self-injurious behaviors. Specifically, approximately 14% to 21% of adolescents indicate that they have engaged in some form of self-injury at some point in their lifetime.
What May Place Adolescents at Risk for Self-Injury?
The experience of childhood physical or sexual abuse, as well as the development of PTSD symptoms, have been found to be connected to self-injury.
For example, one study by researchers at the Veterans Affairs Boston Healthcare System, Boston University School of Medicine, and Harvard University looked at the role of childhood sexual abuse, PTSD symptoms, and self-injury among a group of adolescents around the ages of 12 to 19.
They found that having re-experiencing, avoidance, and emotional numbing symptoms of PTSD as a result of childhood sexual abuse may lead to self-injury.
How Might PTSD Symptoms Lead to Self-Injury?
People may use self-injury as a way of attempting to express and manage uncomfortable and upsetting emotional experiences, such as anxiety, sadness, shame, and/or anger. Self-injury may also provide a temporary escape from or be a way of avoiding emotional pain. These emotional experiences commonly stem from experiencing PTSD symptoms, such as intrusive thoughts or memories about a past traumatic event.
Self-injury may also be a way of expressing pain. People struggling with the emotional numbing symptoms of PTSD (where there are difficulties in having certain emotions, especially positive emotions), may use self-injury as a way to feel something or create feelings.
What Can Be Done About Self-Injury?
Self-injury is a serious behavior. Although some people report that it causes relief from painful emotions, this relief is temporary. Afterward, people may feel more painful emotions, such as shame, guilt, sadness, and/or anger. The behavior may also leave scars which people may feel shame about and attempt to hide, and the behavior may become more severe over time.
If you engage in self-injury or you know someone who does, it is important that you seek out help. The S.A.F.E. Alternatives website provides information on their nationally recognized treatment program for self-injury, as well as resources on and referrals for people struggling with self-injurious behaviors. The Borderline Personality Disorder Survival Guide also provides excellent tips on how to address and cope with self-injurious behaviors.
Sources:
Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006). Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behaviour Research and Therapy, 44, 371-394.
Gratz, K. L. (2003). Risk factors for and functions of deliberate self-harm: An empirical and conceptual review. Clinical Psychology: Science and Practice, 10, 192-205.
Gratz, K. L. (2001). Measurement of deliberate self-harm: Preliminary data on the Deliberate Self-Harm Inventory. Journal of Psychopathology and Behavioral Assessment, 23, 253-263.
Greenspan, G.S., & Samuel, S.E. (1989). Self-cutting after rape. The American Journal of Psychiatry, 146, 789-790.
Harned, M.S., Najavits, L.M., & Weiss, R.D. (2006). Self-harm and suicidal behavior in women with comorbid PTSD and substance dependence. The American Journal on Addictions, 15, 392-295.
Lyons, J.A. (1991). Self-mutilation by a man with posttraumatic stress disorder. Journal of Nervous and Mental Disease, 179, 505-507.
Nock, M.K., & Prinstein, M.J. (2004). A functional approach to the assessment of self-mutilative behavior. Journal of Consulting and Clinical Psychology, 72, 885-890.
Pattison, E.M., & Kahan, J. (1983). The deliberate self-harm syndrome. American Journal of Psychiatry, 140, 867-872.
Pitman, R.K. (1990). Self-mutilation in combat-related PTSD. American Journal of Psychiatry, 147, 123-124.
Ross, S., & Heath, N.(2002). A study of the frequency of self-mutilation in a community sample of adolescents.American Journal of Psychiatry, 152, 1336-1342.
Weierich, M.R., & Nock, M.K. (2008). Posttraumatic stress symptoms mediate the relation between childhood sexual abuse and nonsuicidal self-injury. Journal of Consulting and Clinical Psychology, 76, 39-44.
Whitlock, J., & Knox, K.L. (2007). The relationship betwen self-injurious behavior and suicide in a young adult population. Archives of Pediatrics and Adolescent Medicine, 161, 634-640.
"Where are the best intensive Dialectical Behavior Therapy programs for people with Borderline Personality Disorder?"
Adolescent DBT Treatment
www.mclean.harvard.edu Residential Treatment for females. Harvard affiliated McLean Hospital.
"McLean Hospital"
by littlebear on Jul 25 2008 (20 months ago)
McLean Hospital in Belmont Mass. right outside boston has a well known borderline program (I think residential and outpaitnet, PHP.. They also have an adolescent DBT residential treatment program where the stay is at least 1 month
BPD Treatment for Women
www.GundersonResidence.org Superb Residential BPD treatment. Harvard affiliated McLean Hospital.
http://askville.amazon.com/intensive-Dialectical-Behavior-Therapy-programs-people-Borderline-Personality-Disorder/AnswerViewer.do?requestId=1472008
www.mclean.harvard.edu Residential Treatment for females. Harvard affiliated McLean Hospital.
"McLean Hospital"
by littlebear on Jul 25 2008 (20 months ago)
McLean Hospital in Belmont Mass. right outside boston has a well known borderline program (I think residential and outpaitnet, PHP.. They also have an adolescent DBT residential treatment program where the stay is at least 1 month
BPD Treatment for Women
www.GundersonResidence.org Superb Residential BPD treatment. Harvard affiliated McLean Hospital.
http://askville.amazon.com/intensive-Dialectical-Behavior-Therapy-programs-people-Borderline-Personality-Disorder/AnswerViewer.do?requestId=1472008
Where I am getting my treatment for my BPD
Dialectical Behavior Therapy program to open
at McLean
(June 2007 Issue)
By Jennifer Chase Esposito
This month, McLean Hospital in Belmont, Mass., will open what's believed to be one of the first residential treatment facilities in the country for treating adolescent girls in need of intense psychiatric care using Dialectical Behavior Therapy (DBT).
Originally developed to treat adult suicidality resulting from Borderline Personality Disorder, researchers have found positive effects using DBT treatments with adolescents. The patient population will be females aged 13-19 suffering from consistent emotional dysregulation who have not responded to previous treatments.
"Dialectical Behavior Therapy first looks at emerging Borderline Personality Disorder as a diagnosis [that] is restricted to adults, so no such therapy is [typically] done on children," says Philip Levendusky, Ph.D., vice president of network development at McLean.
Levendusky says there is "clear evidence that kids have the same profile as adults," but because the symptoms are seen so early in their lives and can often be confused with the normal maladies of adolescence, the symptoms may seem less apparent.
"What we've had here [at McLean] are generic programs. But with the evolution of the field, there is incredible interest in applying [DBT] to adolescents," says Levendusky, adding that the new facility will "creatively try to put together a state-of-the-art treatment program."
"Parents have called us and say there is nothing of its kind," says Blaise Aguirre, M.D., medical director of the new Adolescent Dialectical Behavior Therapy Center, as it will be named. Aguirre has been a child and adolescent staff psychiatrist for seven years at McLean and is a psychiatry instructor at the Harvard Medical School where he provides child adolescent training for residents. He says he "doesn't know of any other short-term residential unit in the country that's using a strict DBT model of treatment, where all of the clinicians are trained in DBT treatment." Aguirre does say, however, there are clinicians practicing DBT on young people in San Francisco, Los Angeles, Seattle, and New York.
Although the program will be primarily for New Englanders, Aguirre doesn't rule out fielding inquiries from other parts of the United States. Current McLean patients come from all over this country and as far as Mongolia and Spain.
The average inpatient stay will be about four to six weeks. "Anecdotally, 70-80 percent [of patients] have really good outcomes when the DBT treatment is very intensive," says Aguirre. "It's the idea of really 'packing it in,' and immersing" patients in the program.
The other upshot of an intense stay at the center is that it will decrease the opportunity for relapse once the patient gets back into his/her normal routine. "The downside of DBT treatment [in adolescents] is that it's very difficult to have continuum of care when we discharge kids who can't get DBT in their home environment."
Aguirre says that almost all studies show that up to two percent of the general population suffers from BPD. "In adults, I've never seen - and I've asked very senior colleagues about this - a BPD person who didn't suffer in adolescence.
"If two percent of the population is suffering, that means a lot of adults are suffering," he says.
By developing programs that can quickly halt early symptoms of BPD from becoming full-blown BPD, Aguirre believes that McLean's new center will help.
This self-pay program will cost approximately $1,400 per day. For more information about the program call 877-967-7233.
It truly is one of the best hospitals in the entire country for this issue and I will always continue to work to get better.
at McLean
(June 2007 Issue)
By Jennifer Chase Esposito
This month, McLean Hospital in Belmont, Mass., will open what's believed to be one of the first residential treatment facilities in the country for treating adolescent girls in need of intense psychiatric care using Dialectical Behavior Therapy (DBT).
Originally developed to treat adult suicidality resulting from Borderline Personality Disorder, researchers have found positive effects using DBT treatments with adolescents. The patient population will be females aged 13-19 suffering from consistent emotional dysregulation who have not responded to previous treatments.
"Dialectical Behavior Therapy first looks at emerging Borderline Personality Disorder as a diagnosis [that] is restricted to adults, so no such therapy is [typically] done on children," says Philip Levendusky, Ph.D., vice president of network development at McLean.
Levendusky says there is "clear evidence that kids have the same profile as adults," but because the symptoms are seen so early in their lives and can often be confused with the normal maladies of adolescence, the symptoms may seem less apparent.
"What we've had here [at McLean] are generic programs. But with the evolution of the field, there is incredible interest in applying [DBT] to adolescents," says Levendusky, adding that the new facility will "creatively try to put together a state-of-the-art treatment program."
"Parents have called us and say there is nothing of its kind," says Blaise Aguirre, M.D., medical director of the new Adolescent Dialectical Behavior Therapy Center, as it will be named. Aguirre has been a child and adolescent staff psychiatrist for seven years at McLean and is a psychiatry instructor at the Harvard Medical School where he provides child adolescent training for residents. He says he "doesn't know of any other short-term residential unit in the country that's using a strict DBT model of treatment, where all of the clinicians are trained in DBT treatment." Aguirre does say, however, there are clinicians practicing DBT on young people in San Francisco, Los Angeles, Seattle, and New York.
Although the program will be primarily for New Englanders, Aguirre doesn't rule out fielding inquiries from other parts of the United States. Current McLean patients come from all over this country and as far as Mongolia and Spain.
The average inpatient stay will be about four to six weeks. "Anecdotally, 70-80 percent [of patients] have really good outcomes when the DBT treatment is very intensive," says Aguirre. "It's the idea of really 'packing it in,' and immersing" patients in the program.
The other upshot of an intense stay at the center is that it will decrease the opportunity for relapse once the patient gets back into his/her normal routine. "The downside of DBT treatment [in adolescents] is that it's very difficult to have continuum of care when we discharge kids who can't get DBT in their home environment."
Aguirre says that almost all studies show that up to two percent of the general population suffers from BPD. "In adults, I've never seen - and I've asked very senior colleagues about this - a BPD person who didn't suffer in adolescence.
"If two percent of the population is suffering, that means a lot of adults are suffering," he says.
By developing programs that can quickly halt early symptoms of BPD from becoming full-blown BPD, Aguirre believes that McLean's new center will help.
This self-pay program will cost approximately $1,400 per day. For more information about the program call 877-967-7233.
It truly is one of the best hospitals in the entire country for this issue and I will always continue to work to get better.
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PTSD, Cutting, and Other Forms of Self-Injury
By Matthew Tull, PhD, About.com Guide
Updated: May 27, 2009
Carbide Cutting Tool
PTSD and self-injury (also called deliberate self-harm), such as cutting and burning, frequently co-occur. Deliberate self-harm has been defined as the deliberate and direct destruction or alteration of body tissue without conscious suicidal intent, but resulting in injury severe enough for tissue damage to occur. Basically, deliberate self-harm means doing something to cause immediate physical harm to yourself but not for the purpose of ending your life. Self-harm behaviors may include:
•Cutting
•Burning
•Needle-sticking
•Banging your head
•Carving on your skin
•Severe scratching
•Punching yourself
•Biting yourself
Cutting, skin carving, severe scratching, head banging, and punching oneself have been found to be some of the most common methods of self-harm.
Deliberate Self-Harm, Trauma, and PTSD
The experience of a traumatic event has been linked to deliberate self-harm behavior. In particular, people who have a history of sexual abuse and/or physical abuse have been found to be more likely to engage in deliberate self-harm. Women who have been raped may also be more likely to begin engaging in deliberate self-harm behavior. People with PTSD have also been found to be more likely to engage in this behavior.
Why Do People Use This Behavior?
There is evidence that people engage in deliberate self-harm as a way of attempting to express and manage their emotions, such as anxiety, sadness, shame, and/or anger. Deliberate self-harm may also provide a temporary escape from or be a way of avoiding emotional pain.
People with PTSD in particular may use deliberate self-harm as a way of getting back in touch with the present moment (also called "grounding"). Some people with PTSD may experience dissociation or flashbacks. Hurting oneself such as through cutting or burning may "shock" the body back into the present moment, ending the flashback or dissociation, much like the way smelling salts work.
Consequences
Deliberate self-harm is a serious behavior. Although some people report that it causes relief from painful emotions, this relief is temporary. Afterwards, people may feel more painful emotions, such as shame, guilt, sadness, and/or anger. The behavior may also leave scars which people may feel shame about and attempt to hide, and the behavior may become more severe over time.
Resources
If you engage in deliberate self-harm or you know someone who does, it is important that you seek out help. The S.A.F.E. Alternatives website provides resources on and referrals for people struggling with deliberate self-harm behavior.
Source:
Chapman, A. L., & Dixon-Gordon, K. L. (in press). Emotional antecedents and consequences of deliberate self-harm and suicide attempts. Suicide & Life Threatening Behavior.
Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006). Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behaviour Research and Therapy, 44, 371-394.
Gratz, K. L. (2003). Risk factors for and functions of deliberate self-harm: An empirical and conceptual review. Clinical Psychology: Science and Practice, 10, 192-205.
Gratz, K. L. (2001). Measurement of deliberate self-harm: Preliminary data on the Deliberate Self-Harm Inventory. Journal of Psychopathology and Behavioral Assessment, 23, 253-263.
Greenspan, G.S., & Samuel, S.E. (1989). Self-cutting after rape. The American Journal of Psychiatry, 146, 789-790.
Harned, M.S., Najavits, L.M., & Weiss, R.D. (2006). Self-harm and suicidal behavior in women with comorbid PTSD and substance dependence. The American Journal on Addictions, 15, 392-295.
Lyons, J.A. (1991). Self-mutilation by a man with posttraumatic stress disorder. Journal of Nervous and Mental Disease, 179, 505-507.
Pattison, E.M., & Kahan, J. (1983). The deliberate self-harm syndrome. American Journal of Psychiatry, 140, 867-872.
Pitman, R.K. (1990). Self-mutilation in combat-related PTSD. American Journal of Psychiatry, 147, 123-124.
Whitlock, J., & Knox, K.L. (2007). The relationship betwen self-injurious behavior and suicide in a young adult population. Archives of Pediatrics and Adolescent Medicine, 161, 634-640.
PTSD, Cutting, and Other Forms of Self-Injury
By Matthew Tull, PhD, About.com Guide
Updated: May 27, 2009
Carbide Cutting Tool
PTSD and self-injury (also called deliberate self-harm), such as cutting and burning, frequently co-occur. Deliberate self-harm has been defined as the deliberate and direct destruction or alteration of body tissue without conscious suicidal intent, but resulting in injury severe enough for tissue damage to occur. Basically, deliberate self-harm means doing something to cause immediate physical harm to yourself but not for the purpose of ending your life. Self-harm behaviors may include:
•Cutting
•Burning
•Needle-sticking
•Banging your head
•Carving on your skin
•Severe scratching
•Punching yourself
•Biting yourself
Cutting, skin carving, severe scratching, head banging, and punching oneself have been found to be some of the most common methods of self-harm.
Deliberate Self-Harm, Trauma, and PTSD
The experience of a traumatic event has been linked to deliberate self-harm behavior. In particular, people who have a history of sexual abuse and/or physical abuse have been found to be more likely to engage in deliberate self-harm. Women who have been raped may also be more likely to begin engaging in deliberate self-harm behavior. People with PTSD have also been found to be more likely to engage in this behavior.
Why Do People Use This Behavior?
There is evidence that people engage in deliberate self-harm as a way of attempting to express and manage their emotions, such as anxiety, sadness, shame, and/or anger. Deliberate self-harm may also provide a temporary escape from or be a way of avoiding emotional pain.
People with PTSD in particular may use deliberate self-harm as a way of getting back in touch with the present moment (also called "grounding"). Some people with PTSD may experience dissociation or flashbacks. Hurting oneself such as through cutting or burning may "shock" the body back into the present moment, ending the flashback or dissociation, much like the way smelling salts work.
Consequences
Deliberate self-harm is a serious behavior. Although some people report that it causes relief from painful emotions, this relief is temporary. Afterwards, people may feel more painful emotions, such as shame, guilt, sadness, and/or anger. The behavior may also leave scars which people may feel shame about and attempt to hide, and the behavior may become more severe over time.
Resources
If you engage in deliberate self-harm or you know someone who does, it is important that you seek out help. The S.A.F.E. Alternatives website provides resources on and referrals for people struggling with deliberate self-harm behavior.
Source:
Chapman, A. L., & Dixon-Gordon, K. L. (in press). Emotional antecedents and consequences of deliberate self-harm and suicide attempts. Suicide & Life Threatening Behavior.
Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006). Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behaviour Research and Therapy, 44, 371-394.
Gratz, K. L. (2003). Risk factors for and functions of deliberate self-harm: An empirical and conceptual review. Clinical Psychology: Science and Practice, 10, 192-205.
Gratz, K. L. (2001). Measurement of deliberate self-harm: Preliminary data on the Deliberate Self-Harm Inventory. Journal of Psychopathology and Behavioral Assessment, 23, 253-263.
Greenspan, G.S., & Samuel, S.E. (1989). Self-cutting after rape. The American Journal of Psychiatry, 146, 789-790.
Harned, M.S., Najavits, L.M., & Weiss, R.D. (2006). Self-harm and suicidal behavior in women with comorbid PTSD and substance dependence. The American Journal on Addictions, 15, 392-295.
Lyons, J.A. (1991). Self-mutilation by a man with posttraumatic stress disorder. Journal of Nervous and Mental Disease, 179, 505-507.
Pattison, E.M., & Kahan, J. (1983). The deliberate self-harm syndrome. American Journal of Psychiatry, 140, 867-872.
Pitman, R.K. (1990). Self-mutilation in combat-related PTSD. American Journal of Psychiatry, 147, 123-124.
Whitlock, J., & Knox, K.L. (2007). The relationship betwen self-injurious behavior and suicide in a young adult population. Archives of Pediatrics and Adolescent Medicine, 161, 634-640.
Monday, March 15, 2010
.Understanding Borderline Personality Disorder
Understanding Borderline Personality Disorder
Learn more about the symptoms and associated features of borderline personality disorder, including emotional and relationship instability, impulsivity, suicidality, self-harm, and more.
..Coping with Symptoms - Challenges in Coping with Symptoms
All the symptoms of borderline personality disorder are difficult to deal with, but most people with BPD have one or two symptoms that they can identify as the most disruptive to their lives. For some, the chronic feelings of emptiness can seem unbearable. For others, the constant struggle with self-harm is the hardest burden to bear. What symptom is most difficult for you to manage?
Impulsive Behavior - How to Tame Impulsive Behavior
Many people with borderline personality disorder struggle with impulsive behavior, including acts like reckless driving, unsafe or promiscuous sex, going on spending sprees, and others. Do you struggle with impulsive behavior? What things do you do that get you in trouble? How have you been able to tame your impulsive behavior?
What Does Dissociation Feel Like - What Does Dissociation Fee…
Dissociation is difficult to define, and many people experience dissociation differently. What does dissociation feel like for you? How do you know if you are dissociating?
Do You Tell Lies - Why and When Do You Tell Lies
Do you tell lies? While there is no good research on the connection between BPD and lying, lots of people with BPD will tell you that they find themselves telling lies even when they don't mean to. What do you lie about? What triggers your lying? Do think there is a connection between BPD symptoms and lying?
Is It Time for a Borderline Personality Disorder Name Change - Border…
Many experts are now calling for a borderline personality disorder name change, because the term "borderline" is outdated and because, unfortunately, the name has been used in a stigmatizing way in the past. What do you think? Should BPD be renamed? What are the advantages of renaming the disorder? Do you see any potential drawbacks of renaming BPD?
Borderline Personality Disorder Axis II - Should We Keep Borderline P…
Borderline personality disorder and other personality disorders are on a separate axis, axis II, in the Diagnostic and Statistical Manual of Mental Disorders multi-axial diagnostic system. But, does BPD belong on Axis II? Or is it actually better captured if it is recognized as an Axis I clinical disorder? What do you think - is BPD a "personality disorder" or is it a disorder that deserves recog…
Suicide Risk Factors
Is there a way to predict who is at greatest risk for attempting or committing suicide? This article covers two different kinds of suicide risk factors: distal and proximal risk factors.
Suicide Risk Factors - When Are You Most at Risk
Many people with BPD have suicidal ideation from time to time. But there are some critical periods when you are at the greatest risk of a suicide attempt. Have you learned what risk factors signal that you might make an attempt? How do you know that you are becoming unsafe? What do you do when you realize you may make an attempt to keep yourself safe?
Who Am I? Borderline Personality Disorder and Identity Problems
Do you ever find yourself asking, who am I? What do I believe in? What is my place in this world? If you do, you are not alone. Many people with borderline personality disorder (BPD) struggle with identity issues – it is one of the core symptoms of the disorder.
Who Am I - Struggling with Identity Problems
Do you often ask yourself "who am i?" What is my place in the world? Do I even exist? If you do, you are not alone. Many people with borderline personality disorder (BPD) struggle with identity problems.
Borderline Personality Symptoms - Describing Your Borderline Personal…
The symptoms of BPD can be very hard to understand for someone who has not experienced them. How do you let other people know what it feels like to have BPD? Do you have a particular way of explaining your symptoms to let others know what it is like to have the disorder?
Understanding Borderline Anger
Anger is a key feature of borderline personality disorder. Learn more about borderline anger and how to get help.
Deliberate Self-Harm
What is deliberate self harm and why does it occur? Learn more about self harming behaviors, why self harm happens, and how self harm is treated.
What is Borderline Personality Disorder?
What is BPD? What are the symptoms? How is it treated? Learn more about the basics of BPD.
Understand Dissociation
What is dissociation? Is dissociation a disorder? How is dissociation treated? Learn more about dissociation in BPD.
Suicidality in Borderline Personality Disorder
Suicidality is an unfortunately common occurrence in borderline personality disorder. Learn more about the link between suicide and BPD, and what you can do to keep yourself or your loved one safe.
Impulsive Behavior and BPD
Are you someone who tends to take action without thinking through the consequences? Do hasty decisions often get you into trouble? Do you often act based on your feelings in the moment rather than on a long-term plan? You may be struggling with impulsive behavior, one of the symptoms of BPD.
NIMH: National Survey Tracks Prevalence of Personality Disorders
A study by researchers at the State University of New York Binghamton and Harvard University explores the prevalence of personality disorders in the U.S.
Research Report: Self-Harm is Prevalent in Children
This BBC report on research performed by Britain's National Health Service shows that self-harm is very prevalent (and on the rise) in children.
NIMH: Evidence of Emotional Reactivity in BPD
Research has demonstrated that the strong emotional reactivity described by people with BPD is evident in laboratory tests.
Learn more about the symptoms and associated features of borderline personality disorder, including emotional and relationship instability, impulsivity, suicidality, self-harm, and more.
..Coping with Symptoms - Challenges in Coping with Symptoms
All the symptoms of borderline personality disorder are difficult to deal with, but most people with BPD have one or two symptoms that they can identify as the most disruptive to their lives. For some, the chronic feelings of emptiness can seem unbearable. For others, the constant struggle with self-harm is the hardest burden to bear. What symptom is most difficult for you to manage?
Impulsive Behavior - How to Tame Impulsive Behavior
Many people with borderline personality disorder struggle with impulsive behavior, including acts like reckless driving, unsafe or promiscuous sex, going on spending sprees, and others. Do you struggle with impulsive behavior? What things do you do that get you in trouble? How have you been able to tame your impulsive behavior?
What Does Dissociation Feel Like - What Does Dissociation Fee…
Dissociation is difficult to define, and many people experience dissociation differently. What does dissociation feel like for you? How do you know if you are dissociating?
Do You Tell Lies - Why and When Do You Tell Lies
Do you tell lies? While there is no good research on the connection between BPD and lying, lots of people with BPD will tell you that they find themselves telling lies even when they don't mean to. What do you lie about? What triggers your lying? Do think there is a connection between BPD symptoms and lying?
Is It Time for a Borderline Personality Disorder Name Change - Border…
Many experts are now calling for a borderline personality disorder name change, because the term "borderline" is outdated and because, unfortunately, the name has been used in a stigmatizing way in the past. What do you think? Should BPD be renamed? What are the advantages of renaming the disorder? Do you see any potential drawbacks of renaming BPD?
Borderline Personality Disorder Axis II - Should We Keep Borderline P…
Borderline personality disorder and other personality disorders are on a separate axis, axis II, in the Diagnostic and Statistical Manual of Mental Disorders multi-axial diagnostic system. But, does BPD belong on Axis II? Or is it actually better captured if it is recognized as an Axis I clinical disorder? What do you think - is BPD a "personality disorder" or is it a disorder that deserves recog…
Suicide Risk Factors
Is there a way to predict who is at greatest risk for attempting or committing suicide? This article covers two different kinds of suicide risk factors: distal and proximal risk factors.
Suicide Risk Factors - When Are You Most at Risk
Many people with BPD have suicidal ideation from time to time. But there are some critical periods when you are at the greatest risk of a suicide attempt. Have you learned what risk factors signal that you might make an attempt? How do you know that you are becoming unsafe? What do you do when you realize you may make an attempt to keep yourself safe?
Who Am I? Borderline Personality Disorder and Identity Problems
Do you ever find yourself asking, who am I? What do I believe in? What is my place in this world? If you do, you are not alone. Many people with borderline personality disorder (BPD) struggle with identity issues – it is one of the core symptoms of the disorder.
Who Am I - Struggling with Identity Problems
Do you often ask yourself "who am i?" What is my place in the world? Do I even exist? If you do, you are not alone. Many people with borderline personality disorder (BPD) struggle with identity problems.
Borderline Personality Symptoms - Describing Your Borderline Personal…
The symptoms of BPD can be very hard to understand for someone who has not experienced them. How do you let other people know what it feels like to have BPD? Do you have a particular way of explaining your symptoms to let others know what it is like to have the disorder?
Understanding Borderline Anger
Anger is a key feature of borderline personality disorder. Learn more about borderline anger and how to get help.
Deliberate Self-Harm
What is deliberate self harm and why does it occur? Learn more about self harming behaviors, why self harm happens, and how self harm is treated.
What is Borderline Personality Disorder?
What is BPD? What are the symptoms? How is it treated? Learn more about the basics of BPD.
Understand Dissociation
What is dissociation? Is dissociation a disorder? How is dissociation treated? Learn more about dissociation in BPD.
Suicidality in Borderline Personality Disorder
Suicidality is an unfortunately common occurrence in borderline personality disorder. Learn more about the link between suicide and BPD, and what you can do to keep yourself or your loved one safe.
Impulsive Behavior and BPD
Are you someone who tends to take action without thinking through the consequences? Do hasty decisions often get you into trouble? Do you often act based on your feelings in the moment rather than on a long-term plan? You may be struggling with impulsive behavior, one of the symptoms of BPD.
NIMH: National Survey Tracks Prevalence of Personality Disorders
A study by researchers at the State University of New York Binghamton and Harvard University explores the prevalence of personality disorders in the U.S.
Research Report: Self-Harm is Prevalent in Children
This BBC report on research performed by Britain's National Health Service shows that self-harm is very prevalent (and on the rise) in children.
NIMH: Evidence of Emotional Reactivity in BPD
Research has demonstrated that the strong emotional reactivity described by people with BPD is evident in laboratory tests.
What is Phone Coaching and How Can It Help You?
What is Phone Coaching and How Can It Help You?
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Created March 02, 2010
Question: What is Phone Coaching and How Can It Help You?
One important aspect of dialectical behavior therapy (DBT) for borderline personality disorder is phone coaching. What is phone coaching, and how can it help you cope with symptoms?
Answer:
Phone coaching is one of the essential elements of Dialectical Behavior Therapy (DBT), a very effective form of psychotherapy for BPD.
In DBT, you will be provided with both group skills training (a therapy group in which you will learn basic skills for managing emotions, maintaining relationships, and tolerating distress), and individual psychotherapy with a therapist. In addition to meeting with your therapist in person, individual DBT therapists usually provide phone coaching. In fact, unlike other forms of therapy for BPD, in DBT you are encouraged to call your therapist.
Phone coaching is used when you are in a crisis and in need of some help. The goals of phone contact are to decrease suicide threats and attempts, to help you to apply skills you've learned in DBT to your everyday life, and to help you maintain a healthy relationship with your therapist.
Most DBT therapists do provide some guidelines about the use of phone coaching. For example, if you are calling too frequently or using telephone calls inappropriately (e.g., calling but being unwilling to accept the help your therapist provides), your therapist will likely work with you to change how you are using the phone coaching.
Source:
Linehan, MM. "Cognitive Behavioral Treatment of Borderline Personality Disorder." New York: Guilford Press, 1993.
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Created March 02, 2010
Question: What is Phone Coaching and How Can It Help You?
One important aspect of dialectical behavior therapy (DBT) for borderline personality disorder is phone coaching. What is phone coaching, and how can it help you cope with symptoms?
Answer:
Phone coaching is one of the essential elements of Dialectical Behavior Therapy (DBT), a very effective form of psychotherapy for BPD.
In DBT, you will be provided with both group skills training (a therapy group in which you will learn basic skills for managing emotions, maintaining relationships, and tolerating distress), and individual psychotherapy with a therapist. In addition to meeting with your therapist in person, individual DBT therapists usually provide phone coaching. In fact, unlike other forms of therapy for BPD, in DBT you are encouraged to call your therapist.
Phone coaching is used when you are in a crisis and in need of some help. The goals of phone contact are to decrease suicide threats and attempts, to help you to apply skills you've learned in DBT to your everyday life, and to help you maintain a healthy relationship with your therapist.
Most DBT therapists do provide some guidelines about the use of phone coaching. For example, if you are calling too frequently or using telephone calls inappropriately (e.g., calling but being unwilling to accept the help your therapist provides), your therapist will likely work with you to change how you are using the phone coaching.
Source:
Linehan, MM. "Cognitive Behavioral Treatment of Borderline Personality Disorder." New York: Guilford Press, 1993.
The Cluster B Personality Disorders
The Cluster B Personality Disorders
What Are the Cluster B Personality Disorders?
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Updated January 12, 2010
Appendicitis Symptoms
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) lists borderline personality disorder (BPD) among the Cluster B personality disorders. Personality disorders are psychological conditions that begin in adolescence or early adulthood, continue over many years, and cause a great deal of distress. Personality disorders also can often interfere with a person's ability to enjoy life or achieve fulfillment in relationships, work or school.
What Are the Cluster B Personality Disorders?
There are four Cluster B personality disorders: antisocial, borderline, narcissistic, and histrionic. The DSM-IV views these as a subset of personality disorders that are characterized by dramatic, emotional or erratic behavior. The Cluster B personality disorders are also the most common of the DSM-IV personality disorders.
Antisocial Personality Disorder
According to DSM-IV, antisocial personality disorder is a “pervasive pattern of disregard for, and violation of, the rights of others that begins in early childhood or early adolescence and continues into adulthood.”
People with antisocial personality disorder have been described as lacking empathy (or the ability to “put yourself in someone else’s shoes” to understand their feelings), and they may often be deceitful or break the law. Antisocial personality disorder is also associated with impulsive behavior, aggression (such as repeated physical assaults), disregard for their own or other’s safety, irresponsible behavior, and lack of remorse.
Borderline Personality Disorder
BPD is associated with specific problems in interpersonal relationships, self-image, emotions, behaviors, and thinking. People with BPD tend to have intense relationships characterized by a lot of conflict, arguments and break-ups. They also have difficulties related to the stability of their identity or sense of self. They report many "ups and downs" in how they feel about themselves. Individuals with BPD may say that they feel as if they are on an emotional roller coaster, with very quick shifts in mood (for example, going from feeling OK to feeling extremely down or blue within a few minutes).
BPD is associated with a tendency to engage in risky behaviors, such as going on shopping sprees, drinking excessive amounts of alcohol or abusing drugs, engaging in promiscuous sex, binge eating, or self-harming.
Narcissistic Personality Disorder
Narcissistic personality disorder is characterized by an inflated sense of self-importance. People with narcissistic personality disorder often believe that they are “special,” require excessive attention, take advantage of others, lack empathy, and are described by others as arrogant.
Histrionic Personality Disorder
The central features of histrionic personality disorder are intense expressions of emotion and excessive attention-seeking behavior. People with histrionic personality disorder often seek out attention and are uncomfortable when others are receiving attention. They may often engage in seductive or sexually promiscuous behavior, or use their physical appearance to draw attention to themselves. They also may demonstrate rapidly shifting emotions and express emotion in a very dramatic fashion.
Source:
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR Fourth Edition. American Psychiatric Association: 2000.
What Are the Cluster B Personality Disorders?
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Updated January 12, 2010
Appendicitis Symptoms
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) lists borderline personality disorder (BPD) among the Cluster B personality disorders. Personality disorders are psychological conditions that begin in adolescence or early adulthood, continue over many years, and cause a great deal of distress. Personality disorders also can often interfere with a person's ability to enjoy life or achieve fulfillment in relationships, work or school.
What Are the Cluster B Personality Disorders?
There are four Cluster B personality disorders: antisocial, borderline, narcissistic, and histrionic. The DSM-IV views these as a subset of personality disorders that are characterized by dramatic, emotional or erratic behavior. The Cluster B personality disorders are also the most common of the DSM-IV personality disorders.
Antisocial Personality Disorder
According to DSM-IV, antisocial personality disorder is a “pervasive pattern of disregard for, and violation of, the rights of others that begins in early childhood or early adolescence and continues into adulthood.”
People with antisocial personality disorder have been described as lacking empathy (or the ability to “put yourself in someone else’s shoes” to understand their feelings), and they may often be deceitful or break the law. Antisocial personality disorder is also associated with impulsive behavior, aggression (such as repeated physical assaults), disregard for their own or other’s safety, irresponsible behavior, and lack of remorse.
Borderline Personality Disorder
BPD is associated with specific problems in interpersonal relationships, self-image, emotions, behaviors, and thinking. People with BPD tend to have intense relationships characterized by a lot of conflict, arguments and break-ups. They also have difficulties related to the stability of their identity or sense of self. They report many "ups and downs" in how they feel about themselves. Individuals with BPD may say that they feel as if they are on an emotional roller coaster, with very quick shifts in mood (for example, going from feeling OK to feeling extremely down or blue within a few minutes).
BPD is associated with a tendency to engage in risky behaviors, such as going on shopping sprees, drinking excessive amounts of alcohol or abusing drugs, engaging in promiscuous sex, binge eating, or self-harming.
Narcissistic Personality Disorder
Narcissistic personality disorder is characterized by an inflated sense of self-importance. People with narcissistic personality disorder often believe that they are “special,” require excessive attention, take advantage of others, lack empathy, and are described by others as arrogant.
Histrionic Personality Disorder
The central features of histrionic personality disorder are intense expressions of emotion and excessive attention-seeking behavior. People with histrionic personality disorder often seek out attention and are uncomfortable when others are receiving attention. They may often engage in seductive or sexually promiscuous behavior, or use their physical appearance to draw attention to themselves. They also may demonstrate rapidly shifting emotions and express emotion in a very dramatic fashion.
Source:
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR Fourth Edition. American Psychiatric Association: 2000.
Is There a Link Between Borderline Personality and Violence?
Is There a Link Between Borderline Personality and Violence?
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Created: February 02, 2009
Question: Is There a Link Between Borderline Personality and Violence?
I am in a relationship with a man who has been diagnosed with borderline personality disorder. He is an incredible person, but when he is in a “dark mood,” things can get really bad. He gets so angry it is scary; he throws things and has even threatened to hurt me. He hasn’t ever laid a hand on me, but he seems so out of control that I fear for my safety. Are people with BPD more prone to be violent?
Answer:
Yes, there is research demonstrating that both men and women who have committed violent acts have elevated rates of borderline personality disorder (BPD) compared to the general population. However, it is important to recognize that this does not mean that all people who have BPD are violent; just that the diagnosis is associated with an increased risk of violence. Impulsive behavior, which includes physical aggression, is one of the diagnostic criteria for BPD (although someone can meet criteria for the disorder without demonstrating this symptom).
There are several reasons why people with BPD are more likely to be violent in their relationships. First, people with BPD have often (although not always) been victims of violence themselves (e.g., child abuse). So, many people with BPD may have learned to use aggression to deal with strong emotions because adults modeled that behavior for them when they were young.
In addition, people with BPD often experience an unstable sense of self and difficulty trusting others in interpersonal relationships. They may experience very strong emotions if they believe they are being rejected or abandoned (this is known as rejection sensitivity), which in turn may lead to aggressive behaviors.
Finally, people with BPD often have difficulties with impulsivity; when they are experience the strong emotions that are typical of the disorder, they may do things without thinking about the consequences. If they engage in violence, it is usually not planned; it is an impulsive act in the heat of the moment.
That said, this general information does not help us to predict whether one particular individual with BPD will be violent. If you are feeling threatened, that is important; even if no violence has occurred in your relationship, something is not right. Your best bet is for both you and your partner to seek professional help—- either separately or as a couple. This may help you figure out whether the relationship can be improved, and may prevent violence from happening in the future. Therapy can also help you decide whether this is a relationship worth working on.
Sources:
Stuart GL, Moore TM, Gordon KC, Ramsey SE, Kahler CW. “Psychopathology in Women Arrested for Domestic Violence.” Journal of Interpersonal Violence, 21: 376-389, 2006.
Holtzworth-Munroe A, Stuart GL. “Typologies of Male Batterers: Three Subtypes and the Differences Among Them.” Psychological Bulletin, 116: 476-497, 1994.
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Created: February 02, 2009
Question: Is There a Link Between Borderline Personality and Violence?
I am in a relationship with a man who has been diagnosed with borderline personality disorder. He is an incredible person, but when he is in a “dark mood,” things can get really bad. He gets so angry it is scary; he throws things and has even threatened to hurt me. He hasn’t ever laid a hand on me, but he seems so out of control that I fear for my safety. Are people with BPD more prone to be violent?
Answer:
Yes, there is research demonstrating that both men and women who have committed violent acts have elevated rates of borderline personality disorder (BPD) compared to the general population. However, it is important to recognize that this does not mean that all people who have BPD are violent; just that the diagnosis is associated with an increased risk of violence. Impulsive behavior, which includes physical aggression, is one of the diagnostic criteria for BPD (although someone can meet criteria for the disorder without demonstrating this symptom).
There are several reasons why people with BPD are more likely to be violent in their relationships. First, people with BPD have often (although not always) been victims of violence themselves (e.g., child abuse). So, many people with BPD may have learned to use aggression to deal with strong emotions because adults modeled that behavior for them when they were young.
In addition, people with BPD often experience an unstable sense of self and difficulty trusting others in interpersonal relationships. They may experience very strong emotions if they believe they are being rejected or abandoned (this is known as rejection sensitivity), which in turn may lead to aggressive behaviors.
Finally, people with BPD often have difficulties with impulsivity; when they are experience the strong emotions that are typical of the disorder, they may do things without thinking about the consequences. If they engage in violence, it is usually not planned; it is an impulsive act in the heat of the moment.
That said, this general information does not help us to predict whether one particular individual with BPD will be violent. If you are feeling threatened, that is important; even if no violence has occurred in your relationship, something is not right. Your best bet is for both you and your partner to seek professional help—- either separately or as a couple. This may help you figure out whether the relationship can be improved, and may prevent violence from happening in the future. Therapy can also help you decide whether this is a relationship worth working on.
Sources:
Stuart GL, Moore TM, Gordon KC, Ramsey SE, Kahler CW. “Psychopathology in Women Arrested for Domestic Violence.” Journal of Interpersonal Violence, 21: 376-389, 2006.
Holtzworth-Munroe A, Stuart GL. “Typologies of Male Batterers: Three Subtypes and the Differences Among Them.” Psychological Bulletin, 116: 476-497, 1994.
Sunday, March 14, 2010
Ways of Coping with Anxiety
Ways of Coping with Anxiety
By Matthew Tull, PhD, About.com Guide
Updated May 14, 2009
People with PTSD often struggle with frequent and intense symptoms of anxiety. These strong symptoms of anxiety often lead people with PTSD to rely on unhealthy ways of coping, such as through drug or alcohol use. Fortunately, there are a number of healthy ways of coping with anxiety that may help your anxiety go down in intensity, become less frequent, and/or become more tolerable.
1. Deep Breathing
Deep breathing can be an important coping skill to learn. It may sound silly, but many people do not breathe properly. Natural breathing involves your diaphragm, a large muscle in your abdomen. When you breathe in, your belly should expand. When you breathe out, your belly should fall. Overtime, people forget how to breathe this way and instead use their chest and shoulders. This causes short and shallow breaths, which can increase stress and anxiety. Fortunately, it is not too late to "re-learn" how to breathe and help protect yourself from stress. Practice this simple exercise to improve your breathing and combat anxiety..
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Stop Panic Attacks
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2. Progressive Muscle Relaxation
Using relaxation exercises can be an effective way to reduce your stress and anxiety. One relaxation exercise called progressive muscle relaxation focuses on a person alternating between tensing and relaxing different muscle groups throughout the body. In this way, relaxation is viewed like a pendulum. More complete relaxation of your muscles can be obtained by first going to the other extreme (that is, by tensing your muscles). In addition, by tensing your muscles (a common symptom of anxiety) and immediately relaxing them, the symptom of muscle tension may become a signal to relax over time. You can learn a basic progressive muscle relaxation exercise in this article..
3. Using Mindfulness to Cope with Anxiety
Using mindfulness for anxiety can be very helpful. Mindfulness has been around for ages. However, mental health professionals are beginning to recognize that mindfulness can have many benefits for people suffering from difficulties such as anxiety and depression. In a nutshell, mindfulness is about being in-touch with and aware of the present moment. So often in our lives, we are stuck in our heads, caught up in the anxiety and worries of daily life. This exercise will introduce you to mindfulness and may be helpful getting you "out of your head" and in touch with the present moment..
4. Self-Monitoring
Self-monitoring can be a helpful way of getting a handle on your anxiety symptoms. We are all "creatures of habit." We often go about our day without thinking, being unaware of much that goes on around us. This may be useful in some situations, but other times, this lack of awareness may make us feel as though our thoughts and emotions are completely unpredictable and unmanageable. We cannot really address uncomfortable symptoms of anxiety without first being aware of what situations bring up these feelings. Self-monitoring is a simple way of increasing this awareness..
5. Using Social Support for Anxiety
Over and over again, it has been found that finding support from others can be a major factor in helping people overcome the negative effects of a traumatic event and PTSD. Having someone you trust that you can talk to can be very helpful for working through stressful situations or for emotional validation. However, simply having someone available to talk to may not be enough. There are several important pieces to a supportive relationship that may be particularly beneficial in helping someone manage their anxiety. Learn more about what makes up a good supportive relationship in this article..
6. Self-Soothing Exercises for Anxiety
When you are experiencing anxiety, it is important to have ways of coping with those feelings. For example, seeking out social support can be an excellent way of improving your mood. However, the anxiety associated with symptoms of PTSD can sometimes occur unexpectedly, and social support may not be readily available. Therefore, it is important to learn coping strategies that you can do on your own. Coping strategies focused on improving your mood and reducing anxiety that you can do on your own are sometimes described as self-soothing or self-care coping strategies..
7. Using Expressive Writing for Anxiety
Using journaling to cope with and express your thoughts and feelings (also called expressive writing) can be a good way of coping with anxiety. Expressive writing has been found to improve physical and psychological health. In regard to PTSD in particular, expressive writing has been found to have a number of benefits including improved coping and posttraumatic growth (or the ability to find meaning in and have positive life changes following a traumatic event), as well as reduced PTSD symptoms, tension, and anger..
8. Using Distraction to Cope with Anxiety
Purposeful use of distraction techniques can actually be of benefit in coping with emotions that are strong and feel uncomfortable, such as anxiety and fear. Distraction is anything you do to temporarily take your attention off of a strong emotion. Sometimes, focusing on a strong emotion can make it feel even stronger and more out of control. Therefore, by temporarily distracting yourself, you may give the emotion some time to decrease in intensity, making it easier to manage. Learn some distraction techniques in this article..
9. Behavioral Activation for Anxiety
Anxiety and avoidance go hand-in-hand. While the avoidance of anxiety-provoking situations may help reduce our anxiety in the moment, in the long-term it may prevent us from living a meaningful and rewarding life (especially as this avoidance grows bigger and bigger). Behavioral activation is a great way of increasing your activity level, as well as the extent with which you engage in positive and rewarding activities. Through behavioral activation, you can reduce your depression and anxiety.
By Matthew Tull, PhD, About.com Guide
Updated May 14, 2009
People with PTSD often struggle with frequent and intense symptoms of anxiety. These strong symptoms of anxiety often lead people with PTSD to rely on unhealthy ways of coping, such as through drug or alcohol use. Fortunately, there are a number of healthy ways of coping with anxiety that may help your anxiety go down in intensity, become less frequent, and/or become more tolerable.
1. Deep Breathing
Deep breathing can be an important coping skill to learn. It may sound silly, but many people do not breathe properly. Natural breathing involves your diaphragm, a large muscle in your abdomen. When you breathe in, your belly should expand. When you breathe out, your belly should fall. Overtime, people forget how to breathe this way and instead use their chest and shoulders. This causes short and shallow breaths, which can increase stress and anxiety. Fortunately, it is not too late to "re-learn" how to breathe and help protect yourself from stress. Practice this simple exercise to improve your breathing and combat anxiety..
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Anxiety Relaxation Techniques
Anxiety Tips & Stress Busters For Women. Watch Expert Videos Online.
www.HealthiNation.com/Anxiety
2. Progressive Muscle Relaxation
Using relaxation exercises can be an effective way to reduce your stress and anxiety. One relaxation exercise called progressive muscle relaxation focuses on a person alternating between tensing and relaxing different muscle groups throughout the body. In this way, relaxation is viewed like a pendulum. More complete relaxation of your muscles can be obtained by first going to the other extreme (that is, by tensing your muscles). In addition, by tensing your muscles (a common symptom of anxiety) and immediately relaxing them, the symptom of muscle tension may become a signal to relax over time. You can learn a basic progressive muscle relaxation exercise in this article..
3. Using Mindfulness to Cope with Anxiety
Using mindfulness for anxiety can be very helpful. Mindfulness has been around for ages. However, mental health professionals are beginning to recognize that mindfulness can have many benefits for people suffering from difficulties such as anxiety and depression. In a nutshell, mindfulness is about being in-touch with and aware of the present moment. So often in our lives, we are stuck in our heads, caught up in the anxiety and worries of daily life. This exercise will introduce you to mindfulness and may be helpful getting you "out of your head" and in touch with the present moment..
4. Self-Monitoring
Self-monitoring can be a helpful way of getting a handle on your anxiety symptoms. We are all "creatures of habit." We often go about our day without thinking, being unaware of much that goes on around us. This may be useful in some situations, but other times, this lack of awareness may make us feel as though our thoughts and emotions are completely unpredictable and unmanageable. We cannot really address uncomfortable symptoms of anxiety without first being aware of what situations bring up these feelings. Self-monitoring is a simple way of increasing this awareness..
5. Using Social Support for Anxiety
Over and over again, it has been found that finding support from others can be a major factor in helping people overcome the negative effects of a traumatic event and PTSD. Having someone you trust that you can talk to can be very helpful for working through stressful situations or for emotional validation. However, simply having someone available to talk to may not be enough. There are several important pieces to a supportive relationship that may be particularly beneficial in helping someone manage their anxiety. Learn more about what makes up a good supportive relationship in this article..
6. Self-Soothing Exercises for Anxiety
When you are experiencing anxiety, it is important to have ways of coping with those feelings. For example, seeking out social support can be an excellent way of improving your mood. However, the anxiety associated with symptoms of PTSD can sometimes occur unexpectedly, and social support may not be readily available. Therefore, it is important to learn coping strategies that you can do on your own. Coping strategies focused on improving your mood and reducing anxiety that you can do on your own are sometimes described as self-soothing or self-care coping strategies..
7. Using Expressive Writing for Anxiety
Using journaling to cope with and express your thoughts and feelings (also called expressive writing) can be a good way of coping with anxiety. Expressive writing has been found to improve physical and psychological health. In regard to PTSD in particular, expressive writing has been found to have a number of benefits including improved coping and posttraumatic growth (or the ability to find meaning in and have positive life changes following a traumatic event), as well as reduced PTSD symptoms, tension, and anger..
8. Using Distraction to Cope with Anxiety
Purposeful use of distraction techniques can actually be of benefit in coping with emotions that are strong and feel uncomfortable, such as anxiety and fear. Distraction is anything you do to temporarily take your attention off of a strong emotion. Sometimes, focusing on a strong emotion can make it feel even stronger and more out of control. Therefore, by temporarily distracting yourself, you may give the emotion some time to decrease in intensity, making it easier to manage. Learn some distraction techniques in this article..
9. Behavioral Activation for Anxiety
Anxiety and avoidance go hand-in-hand. While the avoidance of anxiety-provoking situations may help reduce our anxiety in the moment, in the long-term it may prevent us from living a meaningful and rewarding life (especially as this avoidance grows bigger and bigger). Behavioral activation is a great way of increasing your activity level, as well as the extent with which you engage in positive and rewarding activities. Through behavioral activation, you can reduce your depression and anxiety.
Coping with Flashbacks
Coping with Flashbacks
By Matthew Tull, PhD, About.com Guide
Updated: October 29, 2008
Symptoms of PTSD
Many people with PTSD struggle in coping with flashbacks. Flashbacks are considered one of the re-experiencing symptoms of PTSD. In a flashback, a person may feel or act as though a traumatic event is happening again. A flashback may be temporary and some connection with the present moment may be maintained, or a person may lose all awareness of what is going on around him, being taken completely back to their traumatic event. For example, a rape survivor, when triggered, may begin to smell certain scents or feel pain in her body similar to that which was experienced during her assault.
People with PTSD may also experience dissociation. Dissociation is an experience where a person may feel disconnected from himself and/or his surroundings. Similar to flashbacks, dissociation may range from temporarily losing touch with things that are going on around you (kind of like what happens when you daydream) to having no memories for a prolonged period of time and/or feeling as though you are outside of your body.
Both flashbacks and dissociation may occur as a result of encountering triggers, or a reminder of a traumatic event. To the extent that people are not aware of their triggers, flashbacks and dissociation can be incredibly disruptive and unpredictable events that are difficult to manage. However, you can take steps to better manage and prevent flashbacks and dissociation. These are described below.
Know Your Triggers
In coping with flashbacks and dissociation, prevention is key. Flashbacks and dissociation are often triggered or cued by some kind of reminder of a traumatic event (for example, encountering certain people, going to specific places), or some other stressful experience. Therefore, it is important to identify the specific things that trigger flashbacks or dissociation.
By knowing what your triggers are, you can either try to limit your exposure to those triggers, or if that is not possible (which is often the case), you can prepare for them by devising ways to cope with your reaction to those triggers.
In addition to reducing flashbacks and dissociation, knowing your triggers may also help with other symptoms of PTSD, such as intrusive thoughts and memories of a traumatic event.
Identify Early Warning Signs
Flashbacks and dissociation may feel as though they come "out-of-the-blue." That is, they may feel unpredictable and uncontrollable. However, there are often some early signs that a person may be slipping into a flashback or a dissociative state. For example, a person's surroundings may begin to look "fuzzy," or someone may feel as though he is separating from or losing touch with his surroundings, other people, or even himself.
Flashbacks and dissociation are easier to cope with and prevent if you can catch them early on. Therefore, it is important to try to increase your awareness of early symptoms of flashbacks and dissociation. Next time you experience a flashback or dissociation, revisit what you were feeling and thinking just before the flashback or dissociation occurred. Try to identify as many early symptoms as possible. The more early warning signs you can come up with, the better able you will be to prevent future flashbacks or episodes of dissociation.
Learn Grounding Techniques
As the name implies, grounding is a particular way of coping that is designed to "ground" you in the present moment. In doing so, you can retain your connection with the present moment and reduce the likelihood that you slip into a flashback or dissociation. In this way, grounding may be considered to be very similar to mindfulness.
To ground, you want to use the five senses (sound, touch, smell, taste, and sight). To connect with the here and now, you want to do something that will bring all your attention to the present moment. A couple of grounding techniques are described below.
•Sound: Turn on loud music
Loud, jarring music will be hard to ignore. And as a result, your attention will be directed to that noise, bringing you into the present moment.
•Touch: Grip a piece of ice
If you notice that you are slipping into a flashback or a dissociative state, hold onto a piece of ice. It will be difficult to direct your attention away from the extreme coldness of the ice, forcing you to stay in touch with the present moment.
•Smell: Sniff some strong peppermint
When you smell something strong, it is very hard to focus on anything else. In this way, smelling peppermint can bring you into the present moment, slowing down or stopping altogether a flashback or an episode of dissociation.
•Taste: Bite into a lemon
The sourness of a lemon and the strong sensation it produces in your mouth when you bite into it can force you to stay in the present moment.
•Sight: Take an inventory of everything around you
Connect with the present moment by listing everything around you. Identify all the colors you see. Count all the pieces of furniture around you. List off all the noises you hear. Taking an inventory of your immediate environment can directly connect you with the present moment.
Enlist the Help of Others
If you know that you may be at risk for a flashback or dissociation by going into a certain situation, bring along some trusted support. Make sure that the person you bring with you is also aware of your triggers and knows how to tell and what to do when you are entering a flashback or dissociative state.
Seek Treatment
In the end, the best way to prevent flashbacks and dissociation is to seek out treatment for your PTSD. Flashbacks and dissociation may be a sign that you are struggling to confront or cope with the traumatic event you experienced. Treatment can help with this. You can find PTSD treatment providers in your area through the Anxiety Disorder Association of America website, as well as UCompare HealthCare from About.com. The International Society for the Study of Trauma and Dissociation (ISSTD) also provides a wealth of information on the connection between trauma and dissociation, how to cope with dissociation, and provides links to therapists who treat trauma and dissociation.
Source:
Linehan, M.M. (1993). Skills training manual for treating borderline personality disorder. New York: Guilford Press.
By Matthew Tull, PhD, About.com Guide
Updated: October 29, 2008
Symptoms of PTSD
Many people with PTSD struggle in coping with flashbacks. Flashbacks are considered one of the re-experiencing symptoms of PTSD. In a flashback, a person may feel or act as though a traumatic event is happening again. A flashback may be temporary and some connection with the present moment may be maintained, or a person may lose all awareness of what is going on around him, being taken completely back to their traumatic event. For example, a rape survivor, when triggered, may begin to smell certain scents or feel pain in her body similar to that which was experienced during her assault.
People with PTSD may also experience dissociation. Dissociation is an experience where a person may feel disconnected from himself and/or his surroundings. Similar to flashbacks, dissociation may range from temporarily losing touch with things that are going on around you (kind of like what happens when you daydream) to having no memories for a prolonged period of time and/or feeling as though you are outside of your body.
Both flashbacks and dissociation may occur as a result of encountering triggers, or a reminder of a traumatic event. To the extent that people are not aware of their triggers, flashbacks and dissociation can be incredibly disruptive and unpredictable events that are difficult to manage. However, you can take steps to better manage and prevent flashbacks and dissociation. These are described below.
Know Your Triggers
In coping with flashbacks and dissociation, prevention is key. Flashbacks and dissociation are often triggered or cued by some kind of reminder of a traumatic event (for example, encountering certain people, going to specific places), or some other stressful experience. Therefore, it is important to identify the specific things that trigger flashbacks or dissociation.
By knowing what your triggers are, you can either try to limit your exposure to those triggers, or if that is not possible (which is often the case), you can prepare for them by devising ways to cope with your reaction to those triggers.
In addition to reducing flashbacks and dissociation, knowing your triggers may also help with other symptoms of PTSD, such as intrusive thoughts and memories of a traumatic event.
Identify Early Warning Signs
Flashbacks and dissociation may feel as though they come "out-of-the-blue." That is, they may feel unpredictable and uncontrollable. However, there are often some early signs that a person may be slipping into a flashback or a dissociative state. For example, a person's surroundings may begin to look "fuzzy," or someone may feel as though he is separating from or losing touch with his surroundings, other people, or even himself.
Flashbacks and dissociation are easier to cope with and prevent if you can catch them early on. Therefore, it is important to try to increase your awareness of early symptoms of flashbacks and dissociation. Next time you experience a flashback or dissociation, revisit what you were feeling and thinking just before the flashback or dissociation occurred. Try to identify as many early symptoms as possible. The more early warning signs you can come up with, the better able you will be to prevent future flashbacks or episodes of dissociation.
Learn Grounding Techniques
As the name implies, grounding is a particular way of coping that is designed to "ground" you in the present moment. In doing so, you can retain your connection with the present moment and reduce the likelihood that you slip into a flashback or dissociation. In this way, grounding may be considered to be very similar to mindfulness.
To ground, you want to use the five senses (sound, touch, smell, taste, and sight). To connect with the here and now, you want to do something that will bring all your attention to the present moment. A couple of grounding techniques are described below.
•Sound: Turn on loud music
Loud, jarring music will be hard to ignore. And as a result, your attention will be directed to that noise, bringing you into the present moment.
•Touch: Grip a piece of ice
If you notice that you are slipping into a flashback or a dissociative state, hold onto a piece of ice. It will be difficult to direct your attention away from the extreme coldness of the ice, forcing you to stay in touch with the present moment.
•Smell: Sniff some strong peppermint
When you smell something strong, it is very hard to focus on anything else. In this way, smelling peppermint can bring you into the present moment, slowing down or stopping altogether a flashback or an episode of dissociation.
•Taste: Bite into a lemon
The sourness of a lemon and the strong sensation it produces in your mouth when you bite into it can force you to stay in the present moment.
•Sight: Take an inventory of everything around you
Connect with the present moment by listing everything around you. Identify all the colors you see. Count all the pieces of furniture around you. List off all the noises you hear. Taking an inventory of your immediate environment can directly connect you with the present moment.
Enlist the Help of Others
If you know that you may be at risk for a flashback or dissociation by going into a certain situation, bring along some trusted support. Make sure that the person you bring with you is also aware of your triggers and knows how to tell and what to do when you are entering a flashback or dissociative state.
Seek Treatment
In the end, the best way to prevent flashbacks and dissociation is to seek out treatment for your PTSD. Flashbacks and dissociation may be a sign that you are struggling to confront or cope with the traumatic event you experienced. Treatment can help with this. You can find PTSD treatment providers in your area through the Anxiety Disorder Association of America website, as well as UCompare HealthCare from About.com. The International Society for the Study of Trauma and Dissociation (ISSTD) also provides a wealth of information on the connection between trauma and dissociation, how to cope with dissociation, and provides links to therapists who treat trauma and dissociation.
Source:
Linehan, M.M. (1993). Skills training manual for treating borderline personality disorder. New York: Guilford Press.
Coping With Your PTSD at Work
Coping With Your PTSD at Work
By Matthew Tull, PhD, About.com Guide
Updated February 26, 2010
Health and Fitness
If you have a diagnosis of PTSD (or even if you are simply experiencing just a few symptoms of PTSD), you may have found that it is incredibly difficulty to manage PTSD at work.
The symptoms of PTSD can be quite debilitating, interfering greatly with many aspects of a person's life. For example, you may feel disconnected or detached from loved ones, and as a result, relationships with friends and family may suffer. You may find that you experience less pleasure when engaging in activities or hobbies that you used to enjoy. You may notice that you become highly anxious and on edge when you are around large crowds, and therefore, you avoid leaving your house. Finally, you may find work to be a particularly stressful experience.
Situations associated with the work environment can be particularly stressful for a person with PTSD. For instance, your work may require you to attend meetings which might make the person with PTSD feel on guard and trapped. A work environment may also have loud, unexpected noises that can trigger a strong startle response in someone with PTSD. You may be forced to interact with people that you feel disconnected or detached from. Finally, the concentration and sleep problems associated with PTSD may make it difficult to be productive and attentive at work.
Although it may be particularly difficult to manage PTSD symptoms while at work, work is a situation that few people can avoid. Therefore, it is very important to come up with ways of coping with your PTSD symptoms while at work. Listed below are just a few tips that may help you in better managing your PTSD symptoms during the work day.
Know Your Symptoms
Regardless of whether you are coping with your PTSD symptoms at work, in relationships, or going shopping, it is very important that you know what PTSD symptoms you are experiencing. Having a good understanding of how you experience your PTSD provides a strong foundation for all other coping skills. It is very difficult to manage symptoms if you cannot recognize them in the first place. Therefore, it can be important to spend some time reading about PTSD and monitoring your experience. By doing this, you can gain an increased awareness of what PTSD symptoms you are experiencing and what they feel like.
Know Your Triggers
Monitoring can also be a very helpful way of increasing awareness of triggers for your PTSD symptoms. For example, are there certain activities, places, or conversations that bring up unpleasant memories or thoughts about a traumatic event? Do crowds activate hyperarousal symptoms for you? Does seeing particular images cause you to have nightmares? Monitor your experience while at work or think about situations that you may encounter at work that could be triggering.
Come Up With a List of Ways to Cope with Triggers
Once you have identified what PTSD symptoms you are experience and what kind of situations trigger those symptoms, plan ahead. List all of the ways that you can cope with those triggers should you encounter them. Write these coping strategies down on a note card and carry this note card with you at all times. Then, when you encounter a trigger and experience PTSD symptoms, go down the list until you find a coping strategy that helps you manage your PTSD symptoms. Remember, the more strategies you have available to you, the better off you will be in managing your triggers.
Practice Your Coping Strategies
As stated above, the more coping strategies you have available to you, the better off you will be in managing your PTSD symptoms. Therefore, it is important to practice a number of coping strategies. Get comfortable with them in a number of different situations. This way, when you need them, it will be easier to enact them.
It is also important to remember that some coping strategies work really well in some situations but not so well in others. For example, expressive writing may be a great coping strategy when you have a good amount of time to sit down and reflect on your experience; however, it may not be the best strategy during a busy work day. Coping strategies that can work really well in a short amount of time are deep breathing, mindfulness, and grounding skills. These coping skills can be done pretty much anywhere, whether you are in a meeting, at lunch, or on your way to work.
Come Up With a Plan for Coping with Unexpected Situations
Even with the best planning, the occurrence of PTSD symptoms can be unpredictable. Therefore, it is important to create a safety plan for coping with them when they occur. For example, it may be helpful to keep a list of supportive people you can call. Make sure you put more than one number on the list in case the first person you call is not available. If you have a therapist and you are able to contact him or her outside of session, you may want his or her name on your list as well. If you are on PRN medication (medication taken as needed), make sure that you have it with you in case you are in a situation where you need it. Make sure you also have your list of coping strategies available. When you are experiencing high levels of stress and anxiety, it can be difficult to come up with a good coping plan. By having the coping strategy list available, you won't have to think on your feet.
Finally, it can be important to come up with some explanations in case you have to excuse yourself from a situation. Plan ahead to what you might say to excuse yourself from the room if your PTSD symptoms are triggered while you are in a meeting or at lunch with co-workers. The goal of this strategy is not avoidance, but instead, giving you the opportunity to be alone so that you can best enact effective coping strategies for your PTSD symptoms.
Coping with your PTSD symptoms at work can be a very difficult thing to do. However, through careful planning and preparation, you can find ways to limit the extent with which PTSD interferes with your life.
By Matthew Tull, PhD, About.com Guide
Updated February 26, 2010
Health and Fitness
If you have a diagnosis of PTSD (or even if you are simply experiencing just a few symptoms of PTSD), you may have found that it is incredibly difficulty to manage PTSD at work.
The symptoms of PTSD can be quite debilitating, interfering greatly with many aspects of a person's life. For example, you may feel disconnected or detached from loved ones, and as a result, relationships with friends and family may suffer. You may find that you experience less pleasure when engaging in activities or hobbies that you used to enjoy. You may notice that you become highly anxious and on edge when you are around large crowds, and therefore, you avoid leaving your house. Finally, you may find work to be a particularly stressful experience.
Situations associated with the work environment can be particularly stressful for a person with PTSD. For instance, your work may require you to attend meetings which might make the person with PTSD feel on guard and trapped. A work environment may also have loud, unexpected noises that can trigger a strong startle response in someone with PTSD. You may be forced to interact with people that you feel disconnected or detached from. Finally, the concentration and sleep problems associated with PTSD may make it difficult to be productive and attentive at work.
Although it may be particularly difficult to manage PTSD symptoms while at work, work is a situation that few people can avoid. Therefore, it is very important to come up with ways of coping with your PTSD symptoms while at work. Listed below are just a few tips that may help you in better managing your PTSD symptoms during the work day.
Know Your Symptoms
Regardless of whether you are coping with your PTSD symptoms at work, in relationships, or going shopping, it is very important that you know what PTSD symptoms you are experiencing. Having a good understanding of how you experience your PTSD provides a strong foundation for all other coping skills. It is very difficult to manage symptoms if you cannot recognize them in the first place. Therefore, it can be important to spend some time reading about PTSD and monitoring your experience. By doing this, you can gain an increased awareness of what PTSD symptoms you are experiencing and what they feel like.
Know Your Triggers
Monitoring can also be a very helpful way of increasing awareness of triggers for your PTSD symptoms. For example, are there certain activities, places, or conversations that bring up unpleasant memories or thoughts about a traumatic event? Do crowds activate hyperarousal symptoms for you? Does seeing particular images cause you to have nightmares? Monitor your experience while at work or think about situations that you may encounter at work that could be triggering.
Come Up With a List of Ways to Cope with Triggers
Once you have identified what PTSD symptoms you are experience and what kind of situations trigger those symptoms, plan ahead. List all of the ways that you can cope with those triggers should you encounter them. Write these coping strategies down on a note card and carry this note card with you at all times. Then, when you encounter a trigger and experience PTSD symptoms, go down the list until you find a coping strategy that helps you manage your PTSD symptoms. Remember, the more strategies you have available to you, the better off you will be in managing your triggers.
Practice Your Coping Strategies
As stated above, the more coping strategies you have available to you, the better off you will be in managing your PTSD symptoms. Therefore, it is important to practice a number of coping strategies. Get comfortable with them in a number of different situations. This way, when you need them, it will be easier to enact them.
It is also important to remember that some coping strategies work really well in some situations but not so well in others. For example, expressive writing may be a great coping strategy when you have a good amount of time to sit down and reflect on your experience; however, it may not be the best strategy during a busy work day. Coping strategies that can work really well in a short amount of time are deep breathing, mindfulness, and grounding skills. These coping skills can be done pretty much anywhere, whether you are in a meeting, at lunch, or on your way to work.
Come Up With a Plan for Coping with Unexpected Situations
Even with the best planning, the occurrence of PTSD symptoms can be unpredictable. Therefore, it is important to create a safety plan for coping with them when they occur. For example, it may be helpful to keep a list of supportive people you can call. Make sure you put more than one number on the list in case the first person you call is not available. If you have a therapist and you are able to contact him or her outside of session, you may want his or her name on your list as well. If you are on PRN medication (medication taken as needed), make sure that you have it with you in case you are in a situation where you need it. Make sure you also have your list of coping strategies available. When you are experiencing high levels of stress and anxiety, it can be difficult to come up with a good coping plan. By having the coping strategy list available, you won't have to think on your feet.
Finally, it can be important to come up with some explanations in case you have to excuse yourself from a situation. Plan ahead to what you might say to excuse yourself from the room if your PTSD symptoms are triggered while you are in a meeting or at lunch with co-workers. The goal of this strategy is not avoidance, but instead, giving you the opportunity to be alone so that you can best enact effective coping strategies for your PTSD symptoms.
Coping with your PTSD symptoms at work can be a very difficult thing to do. However, through careful planning and preparation, you can find ways to limit the extent with which PTSD interferes with your life.
Living With Borderline Personality Disorder Video
Living With Borderline Personality Disorder Video
Lauren | March 14, 2010 at 5:14 pm | Tags: borderline, borderline personality disorder, bpd, creativity, expression, happiness, mental health, mental illness, music, ronald paul corbin, video | Categories: borderline personality disorder | URL: http://wp.me/pNiLP-57
This video was made by Ronald Paul Corbin (a supporter of On The Borderline), also known as MrOntheborder on YouTube. The song in the video is "Happiness," and was written and performed by Ronald Paul Corbin.
http://ontheborderlineblog.wordpress.com/2010/03/14/living-with-borderline-personality-disorder-video/
Lauren | March 14, 2010 at 5:14 pm | Tags: borderline, borderline personality disorder, bpd, creativity, expression, happiness, mental health, mental illness, music, ronald paul corbin, video | Categories: borderline personality disorder | URL: http://wp.me/pNiLP-57
This video was made by Ronald Paul Corbin (a supporter of On The Borderline), also known as MrOntheborder on YouTube. The song in the video is "Happiness," and was written and performed by Ronald Paul Corbin.
http://ontheborderlineblog.wordpress.com/2010/03/14/living-with-borderline-personality-disorder-video/
Saturday, March 13, 2010
Stigma and Borderline Personality Disorder
Stigma and Borderline Personality Disorder
How Stigma Impacts People With BPD
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Updated June 30, 2009
Stigma and borderline personality disorder (BPD) often go hand in hand. But what is stigma, and how can it impact you?
For years, in the United States and abroad, public information campaigns have tried to combat the stigma associated with mental illness. Unfortunately, these campaigns don’t seem to have been successful. In fact, the general public today is as afraid or more afraid of people with mental illness than they were decades ago. And people with BPD are among the most highly stigmatized groups.
How can we combat the stigma faced by people with BPD and other mental illnesses? The first step is to learn more about stigma, its consequences, and how to fight it.
What Is Stigma?
Stigma is a perceived negative attribute that causes someone to devalue or think less of the whole person. People tend to distance themselves from individuals in stigmatized groups, to blame individuals in these groups for the perceived negative attributes, and to discriminate against and diminish the stigmatized individuals.
Many individuals with mental health difficulties are perceived as weak, inhuman, or “less than” because of their psychological symptoms. Of the major mental illnesses, individuals with BPD are perhaps among the most stigmatized. Individuals with BPD are often blamed for their symptoms by both professionals and laypeople.
To give one example of stigma and mental illness, consider public perception of mental illness and violence. Research has shown that the American public is twice a likely to believe that people with mental illness tend to be violent than they were in 1950.
Actually, mental illness alone does not increase the chances that a person will be violent at all. In fact, people with mental illness are actually much more likely to be victims of violence than the general population. Still, the public perception is that people with mental illness are dangerous.
What Are the Consequences of Stigma?
The consequences of stigma are far-reaching. Research has shown that people from stigmatized groups are more likely to distance themselves from others, and they may start to believe what others say about them, thinking of themselves as incompetent, weak, or unreliable. These negative self-beliefs may have worse consequences than the mental illness itself, in some cases.
In addition, people from stigmatized groups may be less likely to seek treatment because of the possible consequences of being labeled with a disorder. Many people will not seek treatment for fear that getting a diagnosis will interfere with their ability to get a job in the future.
Stigma also makes it difficult for people with mental illnesses to find the social support they need to successfully manage their illness. There is evidence that social support is one of the key factors in successful recovery from mental illness, but individuals from stigmatized groups may have trouble finding that social support.
How Can I Fight Stigma?
Perhaps the most important way to fight stigma in your own life is to engage in educating others about BPD. There is evidence that when people learn about the symptoms, causes, and treatments for BPD, their attitudes tend to change. Share your knowledge about BPD with people around you, and you can be a major force for change in their beliefs.
Another way to fight stigma is to volunteer your time for organizations that seek to change public attitudes about mental illness. For example, the National Alliance for Mental Illness StigmaBusters campaign accesses the talents and resources of thousands of volunteers to identity and confront stigma wherever it occurs.
Sources:
Aviram RB, Brodsky BS, Stanley B. “Borderline Personality Disorder, Stigma, and Treatment Implications.” Harvard Review of Psychiatry. 14(5):249-256, 2006.
Dingfelder, S. F. “Stigma: Alive and Well.” APA Monitor on Psychology, 40(6): 56-60, 2009.
Krawitz R. “Borderline Personality Disorder: Attitudinal Change Following Training.” Australian and New Zealand Journal of Psychiatry. 38(7):554-559, 2004.
How Stigma Impacts People With BPD
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Updated June 30, 2009
Stigma and borderline personality disorder (BPD) often go hand in hand. But what is stigma, and how can it impact you?
For years, in the United States and abroad, public information campaigns have tried to combat the stigma associated with mental illness. Unfortunately, these campaigns don’t seem to have been successful. In fact, the general public today is as afraid or more afraid of people with mental illness than they were decades ago. And people with BPD are among the most highly stigmatized groups.
How can we combat the stigma faced by people with BPD and other mental illnesses? The first step is to learn more about stigma, its consequences, and how to fight it.
What Is Stigma?
Stigma is a perceived negative attribute that causes someone to devalue or think less of the whole person. People tend to distance themselves from individuals in stigmatized groups, to blame individuals in these groups for the perceived negative attributes, and to discriminate against and diminish the stigmatized individuals.
Many individuals with mental health difficulties are perceived as weak, inhuman, or “less than” because of their psychological symptoms. Of the major mental illnesses, individuals with BPD are perhaps among the most stigmatized. Individuals with BPD are often blamed for their symptoms by both professionals and laypeople.
To give one example of stigma and mental illness, consider public perception of mental illness and violence. Research has shown that the American public is twice a likely to believe that people with mental illness tend to be violent than they were in 1950.
Actually, mental illness alone does not increase the chances that a person will be violent at all. In fact, people with mental illness are actually much more likely to be victims of violence than the general population. Still, the public perception is that people with mental illness are dangerous.
What Are the Consequences of Stigma?
The consequences of stigma are far-reaching. Research has shown that people from stigmatized groups are more likely to distance themselves from others, and they may start to believe what others say about them, thinking of themselves as incompetent, weak, or unreliable. These negative self-beliefs may have worse consequences than the mental illness itself, in some cases.
In addition, people from stigmatized groups may be less likely to seek treatment because of the possible consequences of being labeled with a disorder. Many people will not seek treatment for fear that getting a diagnosis will interfere with their ability to get a job in the future.
Stigma also makes it difficult for people with mental illnesses to find the social support they need to successfully manage their illness. There is evidence that social support is one of the key factors in successful recovery from mental illness, but individuals from stigmatized groups may have trouble finding that social support.
How Can I Fight Stigma?
Perhaps the most important way to fight stigma in your own life is to engage in educating others about BPD. There is evidence that when people learn about the symptoms, causes, and treatments for BPD, their attitudes tend to change. Share your knowledge about BPD with people around you, and you can be a major force for change in their beliefs.
Another way to fight stigma is to volunteer your time for organizations that seek to change public attitudes about mental illness. For example, the National Alliance for Mental Illness StigmaBusters campaign accesses the talents and resources of thousands of volunteers to identity and confront stigma wherever it occurs.
Sources:
Aviram RB, Brodsky BS, Stanley B. “Borderline Personality Disorder, Stigma, and Treatment Implications.” Harvard Review of Psychiatry. 14(5):249-256, 2006.
Dingfelder, S. F. “Stigma: Alive and Well.” APA Monitor on Psychology, 40(6): 56-60, 2009.
Krawitz R. “Borderline Personality Disorder: Attitudinal Change Following Training.” Australian and New Zealand Journal of Psychiatry. 38(7):554-559, 2004.
Why is it Called Borderline Personality Disorder?
Why is it Called Borderline Personality Disorder?
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Created: October 18, 2009
Question: Why is it Called Borderline Personality Disorder?
Where did the term "borderline" come from, and what does it mean?
Answer:
The term "borderline" was first used by early psychiatrists to describe people who were thought to be on the "border" between diagnoses. At the time, the system for diagnosing mental illness was far less sophisticated than it is today, and "borderline" referred to individuals who did not fit neatly into the two broad categories of mental disorder: psychosis or neurosis.
Today, far more is known about BPD, and it is no longer thought of as being related to psychotic disorders (and the term "neurosis" is no longer used in our diagnostic system). Instead, BPD is recognized as a disorder characterized by intense emotional experiences and instability in relationships and behavior.
Many experts are now calling for BPD to be renamed, because the term "borderline" is outdated and because, unfortunately, the name has been used in a stigmatizing way in the past. Suggestions for the new name have included: "Emotion Dysregulation Disorder," Unstable Personality Disorder," and "Complex Posttraumatic Stress Disorder."
Source:
Bernstein, PhD, David P., Iscan, MD, Cuneyt, Maser, PhD, Jack, Board of Directors, Association for Research in Personality Disorder, & Board of Directors, International Society for the Study of Personality Disorders. "Opinions of personality disorder experts regarding the DSM-IV Personality Disorders classification system." Journal of Personality Disorders, 21: 536-551, October 2007.
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Created: October 18, 2009
Question: Why is it Called Borderline Personality Disorder?
Where did the term "borderline" come from, and what does it mean?
Answer:
The term "borderline" was first used by early psychiatrists to describe people who were thought to be on the "border" between diagnoses. At the time, the system for diagnosing mental illness was far less sophisticated than it is today, and "borderline" referred to individuals who did not fit neatly into the two broad categories of mental disorder: psychosis or neurosis.
Today, far more is known about BPD, and it is no longer thought of as being related to psychotic disorders (and the term "neurosis" is no longer used in our diagnostic system). Instead, BPD is recognized as a disorder characterized by intense emotional experiences and instability in relationships and behavior.
Many experts are now calling for BPD to be renamed, because the term "borderline" is outdated and because, unfortunately, the name has been used in a stigmatizing way in the past. Suggestions for the new name have included: "Emotion Dysregulation Disorder," Unstable Personality Disorder," and "Complex Posttraumatic Stress Disorder."
Source:
Bernstein, PhD, David P., Iscan, MD, Cuneyt, Maser, PhD, Jack, Board of Directors, Association for Research in Personality Disorder, & Board of Directors, International Society for the Study of Personality Disorders. "Opinions of personality disorder experts regarding the DSM-IV Personality Disorders classification system." Journal of Personality Disorders, 21: 536-551, October 2007.
Borderline Personality Disorder Diagnosis
Borderline Personality Disorder Diagnosis
How Is BPD Diagnosed?
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Updated April 04, 2009
If you think you or a loved one may have borderline personality disorder (BPD), it can be very helpful to educate yourself about borderline personality disorder diagnosis. Being armed with some information can help you to take the next important step: making an appointment for an assessment with a mental health professional.
The Diagnostic and Statistical Manual of Mental Disorders (DSM)
The DSM, which is published by the American Psychiatric Association, is the official source of diagnostic information for psychiatric disorders, including BPD and related conditions. For each disorder, the DSM provides a list of symptoms and specifies how many symptoms are needed (and how severe the symptoms must be) to warrant a particular diagnosis.
The current DSM criteria for a BPD diagnosis are summarized below.
The Criteria for a Borderline Personality Disorder Diagnosis
BPD is a pervasive pattern of instability in interpersonal relationships, self-image, and emotion, as well as marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
•Frantic efforts to avoid real or imagined abandonment
•A pattern of unstable and intense interpersonal relationships characterized by extremes between idealization and devaluation (also known as "splitting")
•Identity disturbance: Markedly or persistently unstable self-image or sense of self
•Impulsive behavior in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)
•Recurrent suicidal behavior, gestures, or threats, or self-harming behavior
•Emotional instability in reaction to day-to-day events (e.g., intense episodic sadness, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
•Chronic feelings of emptiness
•Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
•Transient, stress-related paranoid ideation or severe dissociative symptoms
How Were the Criteria for BPD Established?
A team of psychologists and psychiatrists who are considered experts in BPD developed the DSM symptom criteria. Many of the work group members are considered preeminent BPD researchers, and most also work directly with BPD patients.
The symptom criteria were established based on the best research available. However, it is important to keep in mind that the symptom criteria are always being fine-tuned as new research comes out. Currently, the DSM is in its fourth edition, and has undergone a text revision (this is why you will sometimes see it referred to as the DSM-IV-TR). In the next edition of the DSM (DSM-V), the symptom criteria for BPD may be altered to keep up to date with new research.
The Assessment Process
There are a number of psychological disorders and even medical problems that can cause symptoms very similar to those associated with BPD. For this reason, it is very important to see a licensed clinician (for example, a therapist or doctor) who can listen to your concerns, conduct a thorough assessment, and make an accurate diagnosis.
A complete assessment for BPD may include several components. Your therapist or doctor may ask you to participate in an interview, during which they will ask you questions about your symptoms, physical health, and past and present life situation. He or she may also ask you to fill out a written questionnaire about BPD symptoms. Finally, if you are willing, your clinician may ask to talk to family or loved ones to get complete information on the ways that your symptoms are affecting you.
At the end of the assessment process, your clinician will compile all of the information and make a diagnosis. Then, they will speak with you at length about the diagnosis and treatment options.
What Should I Do if I Think I Have BPD?
If you think you may have BPD, the first step is to find a mental health professional to work with. While they can be hard to find, there are clinicians who are specially trained to treat BPD.
•How to Find a BPD Therapist
•Find a Psychiatrist in Your Area
•Find a Psychologist
If you have health insurance, you may want to talk to the insurance company about clinicians who take your insurance and who have expertise in BPD (you should also ask how many sessions would be covered and how much the co-pay would be). If you do not have insurance, you may qualify for public assistance programs or services through your state or region's department of mental health or social services. You can also ask your primary care physician for a referral, or look into whether medical centers or universities in your area offer psychiatric or psychological services.
In addition to working with a clinician, it may help to educate yourself about the variety of effective treatments available, including medication, psychotherapy, and self-help treatments.
Finally, it is important to know that you are not alone, and that with help, people with BPD lead normal and fulfilling lives.
Sources:
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed, text revision. Washington, DC: Author, 2007.
Oldham, MD, John. "Launching DSM-V." Journal of Psychiatric Practice, 13: 351, November 2007.
How Is BPD Diagnosed?
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Updated April 04, 2009
If you think you or a loved one may have borderline personality disorder (BPD), it can be very helpful to educate yourself about borderline personality disorder diagnosis. Being armed with some information can help you to take the next important step: making an appointment for an assessment with a mental health professional.
The Diagnostic and Statistical Manual of Mental Disorders (DSM)
The DSM, which is published by the American Psychiatric Association, is the official source of diagnostic information for psychiatric disorders, including BPD and related conditions. For each disorder, the DSM provides a list of symptoms and specifies how many symptoms are needed (and how severe the symptoms must be) to warrant a particular diagnosis.
The current DSM criteria for a BPD diagnosis are summarized below.
The Criteria for a Borderline Personality Disorder Diagnosis
BPD is a pervasive pattern of instability in interpersonal relationships, self-image, and emotion, as well as marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
•Frantic efforts to avoid real or imagined abandonment
•A pattern of unstable and intense interpersonal relationships characterized by extremes between idealization and devaluation (also known as "splitting")
•Identity disturbance: Markedly or persistently unstable self-image or sense of self
•Impulsive behavior in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)
•Recurrent suicidal behavior, gestures, or threats, or self-harming behavior
•Emotional instability in reaction to day-to-day events (e.g., intense episodic sadness, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
•Chronic feelings of emptiness
•Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
•Transient, stress-related paranoid ideation or severe dissociative symptoms
How Were the Criteria for BPD Established?
A team of psychologists and psychiatrists who are considered experts in BPD developed the DSM symptom criteria. Many of the work group members are considered preeminent BPD researchers, and most also work directly with BPD patients.
The symptom criteria were established based on the best research available. However, it is important to keep in mind that the symptom criteria are always being fine-tuned as new research comes out. Currently, the DSM is in its fourth edition, and has undergone a text revision (this is why you will sometimes see it referred to as the DSM-IV-TR). In the next edition of the DSM (DSM-V), the symptom criteria for BPD may be altered to keep up to date with new research.
The Assessment Process
There are a number of psychological disorders and even medical problems that can cause symptoms very similar to those associated with BPD. For this reason, it is very important to see a licensed clinician (for example, a therapist or doctor) who can listen to your concerns, conduct a thorough assessment, and make an accurate diagnosis.
A complete assessment for BPD may include several components. Your therapist or doctor may ask you to participate in an interview, during which they will ask you questions about your symptoms, physical health, and past and present life situation. He or she may also ask you to fill out a written questionnaire about BPD symptoms. Finally, if you are willing, your clinician may ask to talk to family or loved ones to get complete information on the ways that your symptoms are affecting you.
At the end of the assessment process, your clinician will compile all of the information and make a diagnosis. Then, they will speak with you at length about the diagnosis and treatment options.
What Should I Do if I Think I Have BPD?
If you think you may have BPD, the first step is to find a mental health professional to work with. While they can be hard to find, there are clinicians who are specially trained to treat BPD.
•How to Find a BPD Therapist
•Find a Psychiatrist in Your Area
•Find a Psychologist
If you have health insurance, you may want to talk to the insurance company about clinicians who take your insurance and who have expertise in BPD (you should also ask how many sessions would be covered and how much the co-pay would be). If you do not have insurance, you may qualify for public assistance programs or services through your state or region's department of mental health or social services. You can also ask your primary care physician for a referral, or look into whether medical centers or universities in your area offer psychiatric or psychological services.
In addition to working with a clinician, it may help to educate yourself about the variety of effective treatments available, including medication, psychotherapy, and self-help treatments.
Finally, it is important to know that you are not alone, and that with help, people with BPD lead normal and fulfilling lives.
Sources:
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed, text revision. Washington, DC: Author, 2007.
Oldham, MD, John. "Launching DSM-V." Journal of Psychiatric Practice, 13: 351, November 2007.
Proposed Revisions to the DSM - Are Big Changes on the Way?
Proposed Revisions to the DSM - Are Big Changes on the Way?
Tuesday February 23, 2010
The American Psychiatric Association (APA) recently posted the proposed changes to the upcoming edition of the Diagnostic and Statistical Manual of Mental Disorders (fifth edition) or DSM-V, scheduled to be published in 2013. While these are only a draft of the revisions, the proposed changes reflect a major change to the way that personality disorders are diagnosed.
You can find the possible changes here. Of note, the APA is proposing that a general diagnosis of "personality disorder" be given to individuals who exhibit extreme deficits in personality functioning. In addition, the APA is advocating that certain subtypes of personality disorders be retained. Borderline personality disorder is reformulated as "borderline type" in this new proposed system.
The potential changes are so sweeping that I haven't fully digested them yet. What are your reactions?
http://glclk.about.com/?zi=8/91QG
Tuesday February 23, 2010
The American Psychiatric Association (APA) recently posted the proposed changes to the upcoming edition of the Diagnostic and Statistical Manual of Mental Disorders (fifth edition) or DSM-V, scheduled to be published in 2013. While these are only a draft of the revisions, the proposed changes reflect a major change to the way that personality disorders are diagnosed.
You can find the possible changes here. Of note, the APA is proposing that a general diagnosis of "personality disorder" be given to individuals who exhibit extreme deficits in personality functioning. In addition, the APA is advocating that certain subtypes of personality disorders be retained. Borderline personality disorder is reformulated as "borderline type" in this new proposed system.
The potential changes are so sweeping that I haven't fully digested them yet. What are your reactions?
http://glclk.about.com/?zi=8/91QG
Bring Mindfulness to Your Everyday Activities
Bring Mindfulness to Your Everyday Activities
By Matthew Tull, PhD, About.com Guide
Created February 24, 2010
Mindfulness is about being completely in touch with the present moment and being open to experiences as they come. Mindfulness has been around for ages. However, mental health professionals are beginning to recognize that mindfulness can have many benefits for people suffering from difficulties such as anxiety and depression.
Practicing mindfulness can be an excellent way of coping with your PTSD symptoms. People with PTSD may sometimes feel as though they have a hard time getting any distance from unpleasant thoughts and memories. They may feel preoccupied with and distracted by these thoughts. As a result, many people with PTSD find that they have a hard time focusing their attention on what matters most in their life, such as relationships with family and friends or other activities that they used to enjoy.
Mindfulness may help people get back in touch with the present moment, as well as reduce the extent with which they feel controlled by unpleasant thoughts and memories. There are many ways of practicing mindfulness. There are exercises for being mindful of your breathing, sounds, thoughts, or your body in general.
Many of these exercises are practiced in a formal manner. That is, they are taught in such a way that people are instructed to put aside a set amount of time during their day so that these exercises can be practiced. Although formal practice is useful to become familiar with certain coping exercises, many people find that they do not have the time to formally practice mindfulness on a regular basis. All is not lost! No matter how busy you are, there are actually many opportunities to informally practice mindfulness during your day. Listed below are some ways that you can bring mindfulness into your everyday activities.
•Practice mindful eating: We often eat "unmindfully," not paying attention to what or how much we're consuimg. Next time you eat a snack or meal, be mindful. Pay attention to all the sensations that are associated with eating, such as smell, sight, touch, taste, and sound. Be mindful with every bite you take. You can even be mindful of the sensations associated with swallowing your food.
•Practice mindfulness while driving: Driving becomes a habit; however, there is a lot that goes into driving. Next time you go for a drive, be mindful of the sights around you, the radio playing, the noise your car makes as you accelerate or decelerate, the way the air conditioner or heater feels against your skin, or any other sensation associated with driving. There are a number of rich experiences associated with driving -- try to discover as many as you can through mindfulness.
•Mindfully wash the dishes: Washing the dishes is a chore that many of us do not like, and oftentimes, we simply try to get it done as quickly as possible. However, washing the dishes is an excellent time to practice mindfulness. There are a number of experiences associated with washing the dishes that we can bring mindfulness to. For example, we can mindful of what each dish feels like in our hands, the temperature of the water against our skin, or the smell of the soap we are using. You might find that practicing mindfulness while you wash dishes completely changes that experience.
These are just a few ways in which we can easily practice mindfulness throughout our day. Here are some more everyday activities that can provide you with the opportunity to practice mindfulness: Taking a shower
•Going for a walk
•Exercising
•Cooking
•Listening to the radio
•Watching the television
•Drinking a cup of coffee
•Waiting in line at the grocery store
By bringing mindfulness to your everyday activities, you may be amazed at all the wonderful experiences that are out there that we often take for granted. Try to see what you can discover by informally practicing mindfulness.
Source:
Hanh, T. N. (1992). Peace is Every Step: The Path of Mindfulness in Everyday Life. New York, NY: Bantam Books.
By Matthew Tull, PhD, About.com Guide
Created February 24, 2010
Mindfulness is about being completely in touch with the present moment and being open to experiences as they come. Mindfulness has been around for ages. However, mental health professionals are beginning to recognize that mindfulness can have many benefits for people suffering from difficulties such as anxiety and depression.
Practicing mindfulness can be an excellent way of coping with your PTSD symptoms. People with PTSD may sometimes feel as though they have a hard time getting any distance from unpleasant thoughts and memories. They may feel preoccupied with and distracted by these thoughts. As a result, many people with PTSD find that they have a hard time focusing their attention on what matters most in their life, such as relationships with family and friends or other activities that they used to enjoy.
Mindfulness may help people get back in touch with the present moment, as well as reduce the extent with which they feel controlled by unpleasant thoughts and memories. There are many ways of practicing mindfulness. There are exercises for being mindful of your breathing, sounds, thoughts, or your body in general.
Many of these exercises are practiced in a formal manner. That is, they are taught in such a way that people are instructed to put aside a set amount of time during their day so that these exercises can be practiced. Although formal practice is useful to become familiar with certain coping exercises, many people find that they do not have the time to formally practice mindfulness on a regular basis. All is not lost! No matter how busy you are, there are actually many opportunities to informally practice mindfulness during your day. Listed below are some ways that you can bring mindfulness into your everyday activities.
•Practice mindful eating: We often eat "unmindfully," not paying attention to what or how much we're consuimg. Next time you eat a snack or meal, be mindful. Pay attention to all the sensations that are associated with eating, such as smell, sight, touch, taste, and sound. Be mindful with every bite you take. You can even be mindful of the sensations associated with swallowing your food.
•Practice mindfulness while driving: Driving becomes a habit; however, there is a lot that goes into driving. Next time you go for a drive, be mindful of the sights around you, the radio playing, the noise your car makes as you accelerate or decelerate, the way the air conditioner or heater feels against your skin, or any other sensation associated with driving. There are a number of rich experiences associated with driving -- try to discover as many as you can through mindfulness.
•Mindfully wash the dishes: Washing the dishes is a chore that many of us do not like, and oftentimes, we simply try to get it done as quickly as possible. However, washing the dishes is an excellent time to practice mindfulness. There are a number of experiences associated with washing the dishes that we can bring mindfulness to. For example, we can mindful of what each dish feels like in our hands, the temperature of the water against our skin, or the smell of the soap we are using. You might find that practicing mindfulness while you wash dishes completely changes that experience.
These are just a few ways in which we can easily practice mindfulness throughout our day. Here are some more everyday activities that can provide you with the opportunity to practice mindfulness: Taking a shower
•Going for a walk
•Exercising
•Cooking
•Listening to the radio
•Watching the television
•Drinking a cup of coffee
•Waiting in line at the grocery store
By bringing mindfulness to your everyday activities, you may be amazed at all the wonderful experiences that are out there that we often take for granted. Try to see what you can discover by informally practicing mindfulness.
Source:
Hanh, T. N. (1992). Peace is Every Step: The Path of Mindfulness in Everyday Life. New York, NY: Bantam Books.
How To Be Mindful of Thoughts
How To Be Mindful of Thoughts
By Matthew Tull, PhD, About.com Guide
Updated December 04, 2008
About.com Health's Disease and Condition content is reviewed by the Medical Review Board
Mindfulness can be a wonderful skill to practice when it comes to coping with your PTSD symptoms; however, it can be difficult to be mindful of thoughts, especially those that usually accompany a PTSD diagnosis.
People with PTSD may struggle with unpleasant thoughts and memories of their traumatic event. These thoughts can take control over a person's life. Mindfulness can be used to take a step back from your thoughts and reduce their power to impact your life. This simple exercise will help you learn how to be mindful of your thoughts.
Difficulty: Average
Time Required: At least 15 minutes
Here's How:
1.Find a comfortable position either lying on you back or sitting. If you are sitting down, make sure that you keep you back straight and release the tension in your shoulders. Let them drop.
2.Close your eyes.
3.Begin by focusing your attention on your breathing. Simply pay attention to what it feels like in your body to slowly breathe in and out. Spend a few minutes focusing your attention on the full experience of breathing. Immerse yourself completely in this experience. Imagine you are "riding the waves" of your own breathing.
4.Once you have spent some time focusing on your breathing, shift your attention to your thoughts. Bring awareness to whatever thoughts enter your mind.
5.Try to view your thoughts as simply thoughts -- only objects in or events of your mind. It may be useful to imagine your thoughts as simply clouds passing through the sky or leaves passing down a stream. Notice them enter your consciousness, develop, and then float away. There is no need to seek out, hold onto, or follow your thoughts. Just let them arise and disappear on their own.
6.Anytime that you notice that you are getting immersed in a thought (this is completely normal), notice what took you away from your "observer stance" and bring your attention back to having awareness of your thoughts.
7.After a few minutes, shift your attention back to your breathing, and when you are ready, open your eyes.
Tips:
1.Before you try this exercise, it may be useful to first practice mindful awareness of your breathing.
2.Make this a habit. Practice everyday.
3.At first, it may be important to practice this exercise with thoughts that are not upsetting. Learn how to first be mindful of thoughts in general, and once you feel comfortable, practice this exercise with other thoughts.
4.You are going to get caught up in your thoughts from time to time. Try not to get discouraged -- this is completely normal, and simply noticing this is being mindful. Whenever you do get caught up in your thoughts, remind yourself that this is natural and then bring your attention back to simply observing your thoughts.
Sources:
Roemer, L., & Orsillo, S. An Acceptance-Based Behavior Therapy for GAD. Unpublished treatment manual.
Hayes, S.C., Strosahl, K.D., & Wilson, K.G. (1999). Acceptance and Commitment Therapy. New York: Guilford Press.
By Matthew Tull, PhD, About.com Guide
Updated December 04, 2008
About.com Health's Disease and Condition content is reviewed by the Medical Review Board
Mindfulness can be a wonderful skill to practice when it comes to coping with your PTSD symptoms; however, it can be difficult to be mindful of thoughts, especially those that usually accompany a PTSD diagnosis.
People with PTSD may struggle with unpleasant thoughts and memories of their traumatic event. These thoughts can take control over a person's life. Mindfulness can be used to take a step back from your thoughts and reduce their power to impact your life. This simple exercise will help you learn how to be mindful of your thoughts.
Difficulty: Average
Time Required: At least 15 minutes
Here's How:
1.Find a comfortable position either lying on you back or sitting. If you are sitting down, make sure that you keep you back straight and release the tension in your shoulders. Let them drop.
2.Close your eyes.
3.Begin by focusing your attention on your breathing. Simply pay attention to what it feels like in your body to slowly breathe in and out. Spend a few minutes focusing your attention on the full experience of breathing. Immerse yourself completely in this experience. Imagine you are "riding the waves" of your own breathing.
4.Once you have spent some time focusing on your breathing, shift your attention to your thoughts. Bring awareness to whatever thoughts enter your mind.
5.Try to view your thoughts as simply thoughts -- only objects in or events of your mind. It may be useful to imagine your thoughts as simply clouds passing through the sky or leaves passing down a stream. Notice them enter your consciousness, develop, and then float away. There is no need to seek out, hold onto, or follow your thoughts. Just let them arise and disappear on their own.
6.Anytime that you notice that you are getting immersed in a thought (this is completely normal), notice what took you away from your "observer stance" and bring your attention back to having awareness of your thoughts.
7.After a few minutes, shift your attention back to your breathing, and when you are ready, open your eyes.
Tips:
1.Before you try this exercise, it may be useful to first practice mindful awareness of your breathing.
2.Make this a habit. Practice everyday.
3.At first, it may be important to practice this exercise with thoughts that are not upsetting. Learn how to first be mindful of thoughts in general, and once you feel comfortable, practice this exercise with other thoughts.
4.You are going to get caught up in your thoughts from time to time. Try not to get discouraged -- this is completely normal, and simply noticing this is being mindful. Whenever you do get caught up in your thoughts, remind yourself that this is natural and then bring your attention back to simply observing your thoughts.
Sources:
Roemer, L., & Orsillo, S. An Acceptance-Based Behavior Therapy for GAD. Unpublished treatment manual.
Hayes, S.C., Strosahl, K.D., & Wilson, K.G. (1999). Acceptance and Commitment Therapy. New York: Guilford Press.
Practicing Mindfulness Throughout Your Day
Practicing Mindfulness Throughout Your Day
By Matthew Tull, PhD, About.com Guide
Updated: March 24, 2009
PTSD
Practicing mindfulness can be an excellent way of coping with your PTSD symptoms. People with PTSD may sometimes feel as though they have a hard time getting any distance from unpleasant thoughts and memories. They may feel preoccupied with and distracted by these thoughts. As a result, many people with PTSD find that they have a hard time focusing their attention on what matters most in their life, such as relationships with family and friends or other activities that they used to enjoy.
Mindfulness may help people get back in touch with the present moment, as well as reduce the extent with which they feel controlled by unpleasant thoughts and memories.
What is Mindfulness?
In a nutshell, mindfulness is about being completely in touch with the present moment and being open to experiences as they come. Mindfulness has been around for ages. However, mental health professionals are beginning to recognize that mindfulness can have many benefits for people suffering from difficulties such as anxiety and depression.
Skills of Mindfulness
Mindfulness is made up of a number of skills, all of which require practice. These skills are briefly described below:
1.Awareness
One skill of mindfulness is learning how to focus your attention on one thing at a time. This includes being aware of and able to recognize all the things that are going on around you (for example, sights and sounds), as well as all the things that are going on inside you (for example, thoughts and feelings).
2.Nonjudgmental/Nonevaluative Observation
This skill is focused on looking at your experiences in a nonjudgmental way. That is, simply looking at things in an objective way as opposed to labeling them as either "good" or "bad." An important part of this skill is self-compassion.
3.Being in the Present Moment
Part of mindfulness is being in touch with the present moment as opposed to being caught up in thoughts about the past (also called rumination) or the future (or worry). An aspect of this skill is being an active participant in experiences instead of just "going through the motions" or "being stuck on auto-pilot."
4.Beginner's Mind
This skill of mindfulness focuses on being open to new possibilities. It also refers to observing or looking at things as they truly are, as opposed to what we think they are or evaluate them to be. For example, going into a situation with a preconceived notion of how things will turn out can color your experience. This can prevent you from getting in touch with the true experience.
Practicing Mindfulness
Mindfulness takes practice. Some people may put aside time to formally practice mindfulness, such as devoting time to practice mindful awareness of their breath or thoughts. However, the good thing about mindfulness is that you can also practice it at any point throughout your day. For example, you can bring mindfulness awareness to a number of activities that we often do without thinking, such as eating, washing dishes, cooking, taking a shower or bath, walking, driving in the car, or listening to music.
As you go about your day, try to find as many opportunities as you can to practice mindfulness. The more you practice, the easier it will become to bring mindful awareness to your life experiences, which in the end may also help you cope with your PTSD symptoms.
Source:
Roemer, L., & Orsillo, S. M. (2008). Mindfulness- and acceptance-based behavioral therapies in practice. New York, NY: Guilford
By Matthew Tull, PhD, About.com Guide
Updated: March 24, 2009
PTSD
Practicing mindfulness can be an excellent way of coping with your PTSD symptoms. People with PTSD may sometimes feel as though they have a hard time getting any distance from unpleasant thoughts and memories. They may feel preoccupied with and distracted by these thoughts. As a result, many people with PTSD find that they have a hard time focusing their attention on what matters most in their life, such as relationships with family and friends or other activities that they used to enjoy.
Mindfulness may help people get back in touch with the present moment, as well as reduce the extent with which they feel controlled by unpleasant thoughts and memories.
What is Mindfulness?
In a nutshell, mindfulness is about being completely in touch with the present moment and being open to experiences as they come. Mindfulness has been around for ages. However, mental health professionals are beginning to recognize that mindfulness can have many benefits for people suffering from difficulties such as anxiety and depression.
Skills of Mindfulness
Mindfulness is made up of a number of skills, all of which require practice. These skills are briefly described below:
1.Awareness
One skill of mindfulness is learning how to focus your attention on one thing at a time. This includes being aware of and able to recognize all the things that are going on around you (for example, sights and sounds), as well as all the things that are going on inside you (for example, thoughts and feelings).
2.Nonjudgmental/Nonevaluative Observation
This skill is focused on looking at your experiences in a nonjudgmental way. That is, simply looking at things in an objective way as opposed to labeling them as either "good" or "bad." An important part of this skill is self-compassion.
3.Being in the Present Moment
Part of mindfulness is being in touch with the present moment as opposed to being caught up in thoughts about the past (also called rumination) or the future (or worry). An aspect of this skill is being an active participant in experiences instead of just "going through the motions" or "being stuck on auto-pilot."
4.Beginner's Mind
This skill of mindfulness focuses on being open to new possibilities. It also refers to observing or looking at things as they truly are, as opposed to what we think they are or evaluate them to be. For example, going into a situation with a preconceived notion of how things will turn out can color your experience. This can prevent you from getting in touch with the true experience.
Practicing Mindfulness
Mindfulness takes practice. Some people may put aside time to formally practice mindfulness, such as devoting time to practice mindful awareness of their breath or thoughts. However, the good thing about mindfulness is that you can also practice it at any point throughout your day. For example, you can bring mindfulness awareness to a number of activities that we often do without thinking, such as eating, washing dishes, cooking, taking a shower or bath, walking, driving in the car, or listening to music.
As you go about your day, try to find as many opportunities as you can to practice mindfulness. The more you practice, the easier it will become to bring mindful awareness to your life experiences, which in the end may also help you cope with your PTSD symptoms.
Source:
Roemer, L., & Orsillo, S. M. (2008). Mindfulness- and acceptance-based behavioral therapies in practice. New York, NY: Guilford
Symptoms of BPD
Symptoms of Borderline Personality Disorder. Personality Disorders
are diagnosed by observing patients and identifying
whether or not clusters of symptoms exist in that person.
If several of the identified symptoms exist, the person is
Said to be suffering from that particular personality
disorder.
This is the list of identified symptoms which professionals
look for to diagnose Borderline Personality Disorder*. A
person is said to have BPD if he or she has 5 or more of these:
=> Frantic efforts to avoid real or imagined abandonment
=> A pattern of intense interpersonal relationships characterized
by alternating between extremes of idealization and
devaluation. This is called "splitting."
=> Identity Disturbance: Markedly and persistently unstable
self-image or sense of self.
=> Impulsivity in at least two areas that are potentially self-
damaging. Examples are spending, sex, substance-abuse,
reckless driving, binge eating.
=> Recurrent suicidal behavior, gestures, or threats, or self-
mutilating behavior.
=> Intense episodes of depression, irritability or anxiety usually
lasting a few hours and rarely more than a few days.
=> Chronic feelings of emptiness.
=> Inappropriate, intense anger or difficulty controlling anger.
=> In severe cases, transient, stress-related paranoid
ideation or severe disassociative symptoms.
*This list of symptoms is adapted from the DSM-IV
Diagnostic Criteria for Borderline Personality Disorder.
If your loved one is displaying these symptoms, please
get them competent medical attention immediately.
Just a word about the odd symptom of "splitting." Borderline
Personality Disorder sufferers may one day regard you as
saintly, even perfect. And the very next day, for no reason
you can identify, your loved one considers you a horrible
person, and maybe even a person who is dangerous to him. Go
to http://www.borderlinecentral.com/report1/ for more information
In the next email, we'll talk about the anger and rage symptoms
which seem to be part of many Borderline Personality Disorder
sufferers disease.
Your friend,
David Oliver
By accepting and reading this, you agree to all of the following: This newsletter, and all the opinions expressed herein, are not intended to replace the assessment, advice or treatment of a physician or therapist, and are not professional advice. You, and you alone, are solely responsible for the use of the ideas, concepts, opinions and content and hold The Leverage Team, LLC. and all members and affiliates harmless in any event or claim. If you are under the age of 18, please go to the link at the end of this email to stop receiving it immediately or send mail to address below.
The Leverage Team, LLC.
90-100 Route 206
Suite 300
Stanhope, NJ 07874
Usa
are diagnosed by observing patients and identifying
whether or not clusters of symptoms exist in that person.
If several of the identified symptoms exist, the person is
Said to be suffering from that particular personality
disorder.
This is the list of identified symptoms which professionals
look for to diagnose Borderline Personality Disorder*. A
person is said to have BPD if he or she has 5 or more of these:
=> Frantic efforts to avoid real or imagined abandonment
=> A pattern of intense interpersonal relationships characterized
by alternating between extremes of idealization and
devaluation. This is called "splitting."
=> Identity Disturbance: Markedly and persistently unstable
self-image or sense of self.
=> Impulsivity in at least two areas that are potentially self-
damaging. Examples are spending, sex, substance-abuse,
reckless driving, binge eating.
=> Recurrent suicidal behavior, gestures, or threats, or self-
mutilating behavior.
=> Intense episodes of depression, irritability or anxiety usually
lasting a few hours and rarely more than a few days.
=> Chronic feelings of emptiness.
=> Inappropriate, intense anger or difficulty controlling anger.
=> In severe cases, transient, stress-related paranoid
ideation or severe disassociative symptoms.
*This list of symptoms is adapted from the DSM-IV
Diagnostic Criteria for Borderline Personality Disorder.
If your loved one is displaying these symptoms, please
get them competent medical attention immediately.
Just a word about the odd symptom of "splitting." Borderline
Personality Disorder sufferers may one day regard you as
saintly, even perfect. And the very next day, for no reason
you can identify, your loved one considers you a horrible
person, and maybe even a person who is dangerous to him. Go
to http://www.borderlinecentral.com/report1/ for more information
In the next email, we'll talk about the anger and rage symptoms
which seem to be part of many Borderline Personality Disorder
sufferers disease.
Your friend,
David Oliver
By accepting and reading this, you agree to all of the following: This newsletter, and all the opinions expressed herein, are not intended to replace the assessment, advice or treatment of a physician or therapist, and are not professional advice. You, and you alone, are solely responsible for the use of the ideas, concepts, opinions and content and hold The Leverage Team, LLC. and all members and affiliates harmless in any event or claim. If you are under the age of 18, please go to the link at the end of this email to stop receiving it immediately or send mail to address below.
The Leverage Team, LLC.
90-100 Route 206
Suite 300
Stanhope, NJ 07874
Usa
Should I Tell Others I Have BPD?
Should I Tell Others I Have BPD?
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Updated June 30, 2009
About.com Health's Disease and Condition content is reviewed by the Medical Review Board
Question: Should I Tell Others I Have BPD?
I was diagnosed with borderline personality disorder (BPD) by a psychiatrist about 5 years ago, and I have been in some form of treatment ever since. I feel like I am finally making progress and getting more control over my symptoms. I’ve even started seeking out more social connections and recently started dating someone. Now that I am forming new relationships, I am wondering when and if I should tell people about my BPD diagnosis.
Answer:
First, good for you for getting the help you need and for starting to put yourself out there for relationships! You are entering a very important (and sometimes stressful) part of the recovery process — many people with BPD withdraw from relationships because intimacy can trigger so many emotions and symptoms. But, getting back into relationships is a very healthy step.
The choice to disclose your BPD diagnosis depends on a few different variables, including your own need for privacy and comfort with disclosure, your relationship with the other person, and the context of your relationship.
First, there is your personal comfort level. Are you someone who feels comfortable with others’ knowing private details, or do you prefer to keep private information off the table? If you are uncomfortable with disclosure, keep that in mind when making the decision about whether to tell the other person that you have BPD.
Next, consider your relationship with this person. How long have you known them? Are they one of the people you would consider yourself to be very close to? Or are they a more distant friend or relative? Do they need to know about your BPD because they are affected by the symptoms and need an explanation? Or are you motivated to tell them simply because you feel the need to share and get support?
Finally, consider the context of the relationship. For example, it is safer to tell a family friend about your diagnosis than a work colleague.
There is no definitive way to know whether disclosing your diagnosis is a good or bad decision, but if you consider all of the factors above, you may find yourself closer to an answer. The most important thing is that you take the time to think it through and make an intentional decision about whether or not to tell (rather than making a decision in the moment that you may regret later). Take it on a case-by-case basis whenever possible.
If you have a therapist or other professional support person, this is definitely the sort of decision that you may want to consult with them about.
It is important to remember that there is considerable (undeserved) stigma about the BPD diagnosis. So, if you do decide to tell someone that you have BPD, it may make sense to also provide them with some information about the diagnosis, the symptoms, and the prognosis. The “What is BPD?” fact sheet is a good place to start.
Sources:
Aviram RB, Brodsky BS, Stanley B. “Borderline Personality Disorder, Stigma, and Treatment Implications.” Harvard Review of Psychiatry. 14(5):249-256, 2006.
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Updated June 30, 2009
About.com Health's Disease and Condition content is reviewed by the Medical Review Board
Question: Should I Tell Others I Have BPD?
I was diagnosed with borderline personality disorder (BPD) by a psychiatrist about 5 years ago, and I have been in some form of treatment ever since. I feel like I am finally making progress and getting more control over my symptoms. I’ve even started seeking out more social connections and recently started dating someone. Now that I am forming new relationships, I am wondering when and if I should tell people about my BPD diagnosis.
Answer:
First, good for you for getting the help you need and for starting to put yourself out there for relationships! You are entering a very important (and sometimes stressful) part of the recovery process — many people with BPD withdraw from relationships because intimacy can trigger so many emotions and symptoms. But, getting back into relationships is a very healthy step.
The choice to disclose your BPD diagnosis depends on a few different variables, including your own need for privacy and comfort with disclosure, your relationship with the other person, and the context of your relationship.
First, there is your personal comfort level. Are you someone who feels comfortable with others’ knowing private details, or do you prefer to keep private information off the table? If you are uncomfortable with disclosure, keep that in mind when making the decision about whether to tell the other person that you have BPD.
Next, consider your relationship with this person. How long have you known them? Are they one of the people you would consider yourself to be very close to? Or are they a more distant friend or relative? Do they need to know about your BPD because they are affected by the symptoms and need an explanation? Or are you motivated to tell them simply because you feel the need to share and get support?
Finally, consider the context of the relationship. For example, it is safer to tell a family friend about your diagnosis than a work colleague.
There is no definitive way to know whether disclosing your diagnosis is a good or bad decision, but if you consider all of the factors above, you may find yourself closer to an answer. The most important thing is that you take the time to think it through and make an intentional decision about whether or not to tell (rather than making a decision in the moment that you may regret later). Take it on a case-by-case basis whenever possible.
If you have a therapist or other professional support person, this is definitely the sort of decision that you may want to consult with them about.
It is important to remember that there is considerable (undeserved) stigma about the BPD diagnosis. So, if you do decide to tell someone that you have BPD, it may make sense to also provide them with some information about the diagnosis, the symptoms, and the prognosis. The “What is BPD?” fact sheet is a good place to start.
Sources:
Aviram RB, Brodsky BS, Stanley B. “Borderline Personality Disorder, Stigma, and Treatment Implications.” Harvard Review of Psychiatry. 14(5):249-256, 2006.
Living with Borderline Personality Disorder
Living with Borderline Personality Disorder
Learn More About Living with Borderline Personality Disorder
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Updated April 21, 2009
About.com Health's Disease and Condition content is reviewed by the Medical Review Board
Living with borderline personality disorder is not easy. Intense emotional pain, and feelings of emptiness, desperation, anger, hopelessness, and loneliness are common. These symptoms can affect every part of your life. However, despite the suffering that borderline personality disorder (BPD) can cause, many people learn ways to cope with the symptoms and lead normal, fulfilling lives.
How Does Living with Borderline Personality Disorder Affect You?
Relationships
BPD can have a major impact on your relationships. In fact, having difficulties in relationships is one of the primary symptoms of BPD. People with BPD have lots of arguments and conflict with loved ones, or a lot of relationships that break up repeatedly. The way that they feel about their family, friends, or partner can change dramatically from day-to-day or hour-to-hour. These patterns can be very difficult both for the person with BPD and those who care about him or her.
Work
Work, school, or other productive pursuits can give us a sense of purpose in life. Unfortunately, BPD can interfere with success at work or school. Because BPD has such an impact on relationships, people with BPD may find themselves in trouble with co-workers, bosses, teachers, or other authority figures. The intense emotional changes may also impact work or school; people with BPD may have to be absent more often due to emotional concerns or hospitalization. Some of the symptoms of BPD (e.g., dissociation) can also interfere with concentration, making task completion very difficult.
Physical Health
Unfortunately, BPD can also have a major impact on physical health. BPD is associated with a variety of serious health conditions, including chronic pain disorders such as fibromyalgia and chronic fatigue syndrome, arthritis, obesity, diabetes, and serious health problems. BPD is also associated with less healthy lifestyle choices (e.g., smoking, alcohol use, lack of regular exercise).
BPD and the Law
Some of the behaviors associated with BPD can lead to legal problems. The anger associated with BPD can lead to aggression (e.g., assaulting others, throwing objects, or acting out against others' personal property). Impulsive behaviors, such as driving recklessly, abusing substances, shoplifting, or engaging in other illegal acts, can also lead to trouble.
Coping with the Symptoms of BPD
People with BPD do not have to resign themselves to a life of emotional pain. Below are some things you can do that can help. These are just the beginning. Getting help from a licensed mental health professional, and learning more about how to manage the symptoms of BPD, can alleviate the impact of BPD on your life.
Get Help
BPD is a very serious disorder. The intense experiences associated with BPD are not something that one person should face alone. Fortunately, there are a number of effective treatments for BPD. Finding a professional you feel comfortable with is one of the most important steps you can take for your health.
Have a Safety Plan
BPD causes very painful emotions, and as a result, it is not uncommon for mental health emergencies (for example, active suicidality) to arise. For this reason, it is critical you to have a safety plan in place before a crisis happens. If you are in danger of harming yourself or others, what will you do? Can you call 911? Is there a hospital nearby with an emergency room that you can go to? If you have a therapist, counselor, psychiatrist, or social worker, talk this plan over with them. Learn more about what to do in a crisis so that you can keep yourself (and others) safe.
Get Support
Having the support of your family, friends, or partner can be a big help. But, not everyone has someone to turn to when things get difficult. You may need to find ways to connect with others, and to build a support network for yourself. BPD is not an uncommon disorder; it occurs in about 1.4% of the population. That means that there are roughly four million people with BPD in the U.S. alone. Many of those people are looking for support, just like you.
Take Care of Yourself
It is important that individuals with BPD take good care of themselves. Good self-care can reduce emotional pain, increase positive emotions, and help reduce the emotional ups and downs experienced by people with BPD. Good self-care includes eating nutritious and regular meals, practicing good sleep hygiene, getting regular exercise, taking time for relaxation and stress-reduction, and scheduling enjoyable activities.
Learn More
When it comes to your mental health, knowledge is power. Educate yourself about the symptoms, causes, and treatments of BPD. Learn about ways to manage your symptoms. Share what you have learned with the people in your life who are affected by it.
Sources:
Chapman, AL, and Gratz, KL. "The Borderline Personality Disorder Survival Guide." Oakland, CA: New Harbinger, November 2007.
Frankenburg, F, and Zanarini, MC. "The Association Between Borderline Personality Disorder and Chronic Medical Illnesses, Poor Health-Related Lifestyle Choices, and Costly Forms of Health Care Utilization." Journal of Clinical Psychiatry, 65: 1660-1665, December 2004.
Lenzenweger, MF, Lane, MC, Loranger, AW, and Kessler, RC. "DSM-IV Personality Disorders in the National Comorbidity Survey Replication." Biological Psychiatry, 62: 553-654, September 2007.
Linehan, MM. Skills Training Manual for Treating Borderline Personality Disorder. New York: Guilford, 1993.
Learn More About Living with Borderline Personality Disorder
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Updated April 21, 2009
About.com Health's Disease and Condition content is reviewed by the Medical Review Board
Living with borderline personality disorder is not easy. Intense emotional pain, and feelings of emptiness, desperation, anger, hopelessness, and loneliness are common. These symptoms can affect every part of your life. However, despite the suffering that borderline personality disorder (BPD) can cause, many people learn ways to cope with the symptoms and lead normal, fulfilling lives.
How Does Living with Borderline Personality Disorder Affect You?
Relationships
BPD can have a major impact on your relationships. In fact, having difficulties in relationships is one of the primary symptoms of BPD. People with BPD have lots of arguments and conflict with loved ones, or a lot of relationships that break up repeatedly. The way that they feel about their family, friends, or partner can change dramatically from day-to-day or hour-to-hour. These patterns can be very difficult both for the person with BPD and those who care about him or her.
Work
Work, school, or other productive pursuits can give us a sense of purpose in life. Unfortunately, BPD can interfere with success at work or school. Because BPD has such an impact on relationships, people with BPD may find themselves in trouble with co-workers, bosses, teachers, or other authority figures. The intense emotional changes may also impact work or school; people with BPD may have to be absent more often due to emotional concerns or hospitalization. Some of the symptoms of BPD (e.g., dissociation) can also interfere with concentration, making task completion very difficult.
Physical Health
Unfortunately, BPD can also have a major impact on physical health. BPD is associated with a variety of serious health conditions, including chronic pain disorders such as fibromyalgia and chronic fatigue syndrome, arthritis, obesity, diabetes, and serious health problems. BPD is also associated with less healthy lifestyle choices (e.g., smoking, alcohol use, lack of regular exercise).
BPD and the Law
Some of the behaviors associated with BPD can lead to legal problems. The anger associated with BPD can lead to aggression (e.g., assaulting others, throwing objects, or acting out against others' personal property). Impulsive behaviors, such as driving recklessly, abusing substances, shoplifting, or engaging in other illegal acts, can also lead to trouble.
Coping with the Symptoms of BPD
People with BPD do not have to resign themselves to a life of emotional pain. Below are some things you can do that can help. These are just the beginning. Getting help from a licensed mental health professional, and learning more about how to manage the symptoms of BPD, can alleviate the impact of BPD on your life.
Get Help
BPD is a very serious disorder. The intense experiences associated with BPD are not something that one person should face alone. Fortunately, there are a number of effective treatments for BPD. Finding a professional you feel comfortable with is one of the most important steps you can take for your health.
Have a Safety Plan
BPD causes very painful emotions, and as a result, it is not uncommon for mental health emergencies (for example, active suicidality) to arise. For this reason, it is critical you to have a safety plan in place before a crisis happens. If you are in danger of harming yourself or others, what will you do? Can you call 911? Is there a hospital nearby with an emergency room that you can go to? If you have a therapist, counselor, psychiatrist, or social worker, talk this plan over with them. Learn more about what to do in a crisis so that you can keep yourself (and others) safe.
Get Support
Having the support of your family, friends, or partner can be a big help. But, not everyone has someone to turn to when things get difficult. You may need to find ways to connect with others, and to build a support network for yourself. BPD is not an uncommon disorder; it occurs in about 1.4% of the population. That means that there are roughly four million people with BPD in the U.S. alone. Many of those people are looking for support, just like you.
Take Care of Yourself
It is important that individuals with BPD take good care of themselves. Good self-care can reduce emotional pain, increase positive emotions, and help reduce the emotional ups and downs experienced by people with BPD. Good self-care includes eating nutritious and regular meals, practicing good sleep hygiene, getting regular exercise, taking time for relaxation and stress-reduction, and scheduling enjoyable activities.
Learn More
When it comes to your mental health, knowledge is power. Educate yourself about the symptoms, causes, and treatments of BPD. Learn about ways to manage your symptoms. Share what you have learned with the people in your life who are affected by it.
Sources:
Chapman, AL, and Gratz, KL. "The Borderline Personality Disorder Survival Guide." Oakland, CA: New Harbinger, November 2007.
Frankenburg, F, and Zanarini, MC. "The Association Between Borderline Personality Disorder and Chronic Medical Illnesses, Poor Health-Related Lifestyle Choices, and Costly Forms of Health Care Utilization." Journal of Clinical Psychiatry, 65: 1660-1665, December 2004.
Lenzenweger, MF, Lane, MC, Loranger, AW, and Kessler, RC. "DSM-IV Personality Disorders in the National Comorbidity Survey Replication." Biological Psychiatry, 62: 553-654, September 2007.
Linehan, MM. Skills Training Manual for Treating Borderline Personality Disorder. New York: Guilford, 1993.
Impulsive Behavior and BPD
Impulsive Behavior and BPD
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Updated December 27, 2009
Symptoms of Perimenopause
Are you someone who tends to take action without thinking through the consequences? Do hasty decisions often get you into trouble? Do you often act based on your feelings in the moment rather than on a long-term plan? You may be struggling with impulsive behavior, one of the symptoms of BPD.
Impulsivity can be a very troubling aspect of BPD. Impulsive behavior can lead to problems with relationships, physical health, and finances, as well as legal issues. Learning more about impulsive behavior and treatments that target it can help reduce the impact of impulsivity in your life.
What is Impulsivity?
Impulsivity is a tendency to act quickly without thinking about the consequences of your actions. Impulsive behavior usually occurs in reaction to some event that has caused you to have some kind of emotional response.
For example, imagine you are waiting in line at the bank and someone cuts in front of you. If you were to act on an impulse, you might immediately behave aggressively toward that person (e.g., yelling, or even becoming violent), without thinking about the consequence of this kind of behavior (e.g., being escorted out of the bank or even arrested).
It is important to note that occasional impulsive behavior is not necessarily indicative of a diagnosis of BPD. Everyone acts impulsively from time to time. Only when this type of behavior becomes either frequent or serious (e.g., dangerous), is it considered problematic.
What are Some Examples of Impulsive Behaviors?
Some examples of impulsive behaviors include:
•Going on spending sprees
•Driving recklessly
•Promiscuous sex
•Binge eating
•Yelling, shouting, or screaming at others
•Threatening to harm others
•Destroying property
•Shoplifting
•Getting in physical fights with people
Can Impulsivity Be Treated?
Yes. Many treatments for BPD have components that target impulsivity. For example, Dialectical Behavior Therapy (DBT) focuses on building skills that will help you to reduce your impulsive behaviors.
Mindfulness, which is a skill taught in DBT, can help you to stay more aware of your actions so that you can take time to consider consequences. Mindfulness can help you to make healthier decisions about how to respond to events around you.
Medications may also help with impulsivity, but are probably most effective when used in conjunction with psychotherapy.
If you are struggling with impulsivity, learn more about treatments for BPD that may help you get impulsive behavior under control.
Sources:
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed, text revision. Washington, DC, Author, 2000.
Linehan, MM. "Cognitive-Behavioral Treatment of Borderline Personality Disorder." New York: Guilford, 1993.
Moeller, FG, Barratt, ES, Dougherty, DM, Schmidt, JM, Swann, AC. "Psychiatric Aspects of Impulsivity." American Journal of Psychiatry 158:1783-1793, November 2001.
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Updated December 27, 2009
Symptoms of Perimenopause
Are you someone who tends to take action without thinking through the consequences? Do hasty decisions often get you into trouble? Do you often act based on your feelings in the moment rather than on a long-term plan? You may be struggling with impulsive behavior, one of the symptoms of BPD.
Impulsivity can be a very troubling aspect of BPD. Impulsive behavior can lead to problems with relationships, physical health, and finances, as well as legal issues. Learning more about impulsive behavior and treatments that target it can help reduce the impact of impulsivity in your life.
What is Impulsivity?
Impulsivity is a tendency to act quickly without thinking about the consequences of your actions. Impulsive behavior usually occurs in reaction to some event that has caused you to have some kind of emotional response.
For example, imagine you are waiting in line at the bank and someone cuts in front of you. If you were to act on an impulse, you might immediately behave aggressively toward that person (e.g., yelling, or even becoming violent), without thinking about the consequence of this kind of behavior (e.g., being escorted out of the bank or even arrested).
It is important to note that occasional impulsive behavior is not necessarily indicative of a diagnosis of BPD. Everyone acts impulsively from time to time. Only when this type of behavior becomes either frequent or serious (e.g., dangerous), is it considered problematic.
What are Some Examples of Impulsive Behaviors?
Some examples of impulsive behaviors include:
•Going on spending sprees
•Driving recklessly
•Promiscuous sex
•Binge eating
•Yelling, shouting, or screaming at others
•Threatening to harm others
•Destroying property
•Shoplifting
•Getting in physical fights with people
Can Impulsivity Be Treated?
Yes. Many treatments for BPD have components that target impulsivity. For example, Dialectical Behavior Therapy (DBT) focuses on building skills that will help you to reduce your impulsive behaviors.
Mindfulness, which is a skill taught in DBT, can help you to stay more aware of your actions so that you can take time to consider consequences. Mindfulness can help you to make healthier decisions about how to respond to events around you.
Medications may also help with impulsivity, but are probably most effective when used in conjunction with psychotherapy.
If you are struggling with impulsivity, learn more about treatments for BPD that may help you get impulsive behavior under control.
Sources:
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed, text revision. Washington, DC, Author, 2000.
Linehan, MM. "Cognitive-Behavioral Treatment of Borderline Personality Disorder." New York: Guilford, 1993.
Moeller, FG, Barratt, ES, Dougherty, DM, Schmidt, JM, Swann, AC. "Psychiatric Aspects of Impulsivity." American Journal of Psychiatry 158:1783-1793, November 2001.
BPD and the Law - Legal Issues and BPD
BPD and the Law - Legal Issues and BPD
BPD Symptoms and Legal Woes
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Created March 04, 2010
About.com Health's Disease and Condition content is reviewed by the Medical Review Board
Educate Children
If you have borderline personality disorder (BPD), you are already well-acquainted with the pervasive impact of symptoms in your life. In addition to problems in relationships, work, and physical health, many people with BPD also suffer from legal issues. In fact, about a third of people with BPD will be convicted of a crime in their lifetime.
BPD symptoms can get you in serious trouble with the law, but knowing more about legal issues and BPD can help you make better choices.
Impulsive Behavior and the Law
One source of significant legal troubles is impulsivity. If you have BPD, you may struggle with making decisions without thinking about the consequences, or engaging in behaviors when you are angry or upset that get you into trouble. This is called "impulsive behavior," and it can land many people with BPD in hot water. Reckless driving, shoplifting, and engaging in physical violence are all examples of impulsive behaviors that are also illegal.
BPD and Family Law
In addition to problems with impulsive behaviors, you may have significant difficulties in relationships. Relationships characterized by high conflict are a core feature of BPD. Unfortunately, this means that people with BPD can become entangled in legal battles in the course of divorce. In addition, custody issues can arise when BPD couples separate. Finally, domestic violence can be a serious issue in BPD relationships.
Teens with Legal Issues and BPD
Teenagers with BPD can run into their own set of legal problems. For example, teens struggling with BPD often have very poor school attendance and can run into truancy laws. This can also affect their parents, particularly in places where parents are legally responsible for their child's school attendance and other behavior.
Child Abuse and Neglect
Child abuse and neglect are potential environmental causes of BPD (although, not all people with BPD suffered from childhood maltreatment). But, child abuse can also be an outcome of BPD. Very intense emotions, including borderline rage can drive someone with BPD to abuse their children, or to be so consumed with their own emotions that they are unable to attend to their children adequately.
There are many people with BPD who work hard to be good parents. But there are also many whose symptoms get in the way of effective parenting. Some are so impaired by their symptoms that they engage in criminal abuse and neglect, sometimes leading to arrest and incarceration.
Substance Abuse
In addition to the core symptoms of BPD that can lead to legal issues, some of the conditions that often co-occur with BPD can be their own source of problems. Rates of alcohol and substance abuse in BPD are remarkably high. Addiction to illegal substances, along with illegal behaviors (e.g., stealing) to maintain a substance habit, can lead to arrest.
Sources:
Bouchard S, Sabourin S, Lussier Y, Villeneuve E. "Relationship Quality and Stability in Couples When One Partner Suffers from Borderline Personality Disorder." Journal of Marital and Family Therapy. 35(4):446-455, 2009.
Howard RC, Huband N, Duggan C, Mannion A. "Exploring the Link Between Personality Disorders and Criminality in a Community Sample." Journal of Personality Disorders, 22(6):589-603, 2008.
Stanford MS, Felthous AR. "Introduction to this Issue: Impulsivity and the Law." Behavioral Sciences & the Law, 26(6):671-673, 2008.
BPD Symptoms and Legal Woes
By Kristalyn Salters-Pedneault, PhD, About.com Guide
Created March 04, 2010
About.com Health's Disease and Condition content is reviewed by the Medical Review Board
Educate Children
If you have borderline personality disorder (BPD), you are already well-acquainted with the pervasive impact of symptoms in your life. In addition to problems in relationships, work, and physical health, many people with BPD also suffer from legal issues. In fact, about a third of people with BPD will be convicted of a crime in their lifetime.
BPD symptoms can get you in serious trouble with the law, but knowing more about legal issues and BPD can help you make better choices.
Impulsive Behavior and the Law
One source of significant legal troubles is impulsivity. If you have BPD, you may struggle with making decisions without thinking about the consequences, or engaging in behaviors when you are angry or upset that get you into trouble. This is called "impulsive behavior," and it can land many people with BPD in hot water. Reckless driving, shoplifting, and engaging in physical violence are all examples of impulsive behaviors that are also illegal.
BPD and Family Law
In addition to problems with impulsive behaviors, you may have significant difficulties in relationships. Relationships characterized by high conflict are a core feature of BPD. Unfortunately, this means that people with BPD can become entangled in legal battles in the course of divorce. In addition, custody issues can arise when BPD couples separate. Finally, domestic violence can be a serious issue in BPD relationships.
Teens with Legal Issues and BPD
Teenagers with BPD can run into their own set of legal problems. For example, teens struggling with BPD often have very poor school attendance and can run into truancy laws. This can also affect their parents, particularly in places where parents are legally responsible for their child's school attendance and other behavior.
Child Abuse and Neglect
Child abuse and neglect are potential environmental causes of BPD (although, not all people with BPD suffered from childhood maltreatment). But, child abuse can also be an outcome of BPD. Very intense emotions, including borderline rage can drive someone with BPD to abuse their children, or to be so consumed with their own emotions that they are unable to attend to their children adequately.
There are many people with BPD who work hard to be good parents. But there are also many whose symptoms get in the way of effective parenting. Some are so impaired by their symptoms that they engage in criminal abuse and neglect, sometimes leading to arrest and incarceration.
Substance Abuse
In addition to the core symptoms of BPD that can lead to legal issues, some of the conditions that often co-occur with BPD can be their own source of problems. Rates of alcohol and substance abuse in BPD are remarkably high. Addiction to illegal substances, along with illegal behaviors (e.g., stealing) to maintain a substance habit, can lead to arrest.
Sources:
Bouchard S, Sabourin S, Lussier Y, Villeneuve E. "Relationship Quality and Stability in Couples When One Partner Suffers from Borderline Personality Disorder." Journal of Marital and Family Therapy. 35(4):446-455, 2009.
Howard RC, Huband N, Duggan C, Mannion A. "Exploring the Link Between Personality Disorders and Criminality in a Community Sample." Journal of Personality Disorders, 22(6):589-603, 2008.
Stanford MS, Felthous AR. "Introduction to this Issue: Impulsivity and the Law." Behavioral Sciences & the Law, 26(6):671-673, 2008.
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