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The Burden of Borderline Personality Disorder - Part 2

Thursday, May 11, 2000 at 9:56 AM

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Borderline Personality Disorder is a strange and powerful mental illness that can all but consume its victims. Patients who suffer from this disease not only fear abandonment but often go so far as to mutilate themselves. In the second part of our series on BPD, 90.3's Lorna Jordan takes a look at various treatment methods.

Lorna Jordan- BPD patients are often full of rage, and sometimes that anger can turn on a therapist. That’s why it’s so difficult to find someone who will accept a Borderline patient. BPD patient Lori Groves says she bounced around in the medical community before finding someone that would help her.

Lori Groves- Before I met my therapist six years ago I was in and out of therapists offices. I’ve seen dozens of therapists so it wasn’t like I started six years ago and that was it. I started 15 years ago seeing therapists, so it takes a long time to find one that’s suitable for you and suitable for your needs.

LJ- Groves says the she wasn’t even told about her diagnosis.

LG- Back when I was in the hospital, several years ago, they didn’t share that information. So I suppose it was probably one of my first diagnosis that I received 15 years ago. They labeled me with several different things. I was manipulative, I was seeking attention, I was uncooperative, I refused treatment, even though I drove myself there to get help. I was uncooperative and refused treatment. That didn’t make sense to me.

LJ- While some psychologists and psychiatrists fear manipulation and anger from these patients and might turn them away, there are some who embrace this population. There are three main treatments; psychotherapy, behavioral therapy and medication. Many experts say that’s one reason therapy can work in tandem with drugs.

Kelly Camlin of Case Western Reserve University has researched new medications that can be used treat certain characteristics of Borderline Personality Disorder. She says the drug trials are over and they show promise. The project at Case looked at the new or atypical anti-psychotic drugs.

Kelly Camlin- So when you’re looking at a disorder like Borderline Personality Disorder where people have extreme mood changes - often have feelings of major depression - to have one medication that can help with thought organization and mood, that’s really what we were looking at. We think the typical psychotics are really the thing.

LJ- Camlin says in many cases more than one medication is needed to fight different problems associated with BPD.

Cognitive therapy has proven to be among the most effective treatments for BPD. Jim Pretzer is a cognitive therapist with Behavioral Health Associates. He focuses on present problems.

Jim Pretzer- Using a practical approach where we have some clear ideas as to what we’re trying to accomplish, and work with the person in concrete terms to accomplish those, is handy when there are a lot of different problems going on. Because it is real easy to get lost in all the different things going on. If we can pick one or two or three problems which are the top priority at the moment and focus on those, it improves our odds of making some progress.

LJ- One type of cognitive therapy for treating Borderline patients was developed by Marsha Linehan at the University of Washington. Her program is called Dialectical Behavioral Therapy. It’s one of the few therapies for BPD that has any empirical evidence showing improvement in patients over a short period of time.

This group is part of the curriculum at the Laurelwood Counseling Center, Westlake, which uses Dialectic Therapy. Clinical Psychologist Ed Lessin says they focus on a balance between acceptance and change…

Ed Lessin- And when the client feels comfortable with acceptance then we will challenge her with something that she needs to do. So we say to people, “Look, we know you’re trying. We know that you want to do better. But at this point, given the way your history is, you haven’t developed the skills. You’re going to have to work a little harder to have a life that truly is worth living.”

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