Dialectical Behavior Therapy: Creating Meaningful Lives

...if we have received good things at the hand of God, why should we not receive evil? —Job 2:10

Image by David DaviesAnniversaries are full of meaning.

Today marks ten years since the tragedies that occurred on September 11, 2001 and for many Americans the day will be focused on remembering those who lost their lives.

But it's important to remember that even in great sadness meaning can often be found and that meaning can be a source of healing and personal growth.

Individuals who have been diagnosed with borderline personality disorder have experienced lives of intense emotional suffering. We can respond to this pain by blaming ourselves for our past mistakes, we can point the finger at others, or we can make a choice to do something different.

Psychologist Marsha Linehan even included meaning as a part of the distress tolerance module of Dialectical Behavior Therapy (DBT). It's really that powerful. While finding meaning or purpose can be a life-long challenge, it's far from impossible.

If you are looking for a good book or two that might help you to find meaning in your own life, I can recommend Viktor Frankl's Man's Search for Meaning and another called Wounds Not Healed by Time: The Power of Repentance and Forgiveness by Solomon Schimmel.

Borderline Personality Disorder and Teens

I get unusually excited when applicable research becomes available.

This month it's an article published in the Journal of the Canadian Academy of Child and Adolescent Psychiatry* by Robert Biskin, Joel Paris et al. 31 women who were initially diagnosed with borderline personality disorder as adolescents. These women were subsequently followed for ten years.

The results? Only 11 still met DSM criteria for the disorder after four years. The authors concluded that----

These findings highlight the need to direct BPD patients to specialized treatments at an early age when there is more potential to provide them the skills necessary for improved long-term functioning, particularly in the educational and vocational domains.
Photo by emdot
and that----

Ultimately, clinicians need not be reluctant to diagnose BPD in adolescent patients on the grounds of a negative prognosis. Early diagnosis might lead to timely identification of BPD and access to treatment.

Regretfully, I still often hear stories of mental health professionals who are reluctant to diagnose BPD until after the age of 18 but this and other research points time and time again towards the need for early identification and treatment.

It's clear that the sooner adolescents and young adults receive a correct diagnosis and are able participate in evidenced-based therapies specifically designed to treat BPD, the greater the opportunity to enjoy health and happiness later in life.

Early identification and treatment may make a difference between staying right on track to meet academic and vocational goals in early adulthood and playing "catch up" with peers for years.

* If you'd like to receive a copy of this article, please contact me.

Getting Better All the Time: The Course of BPD

Been diagnosed with borderline personality disorder? What happens now? How long do the symptoms last? Will you have to be in treatment forever? What's the rest of your life going to look like?

We'll attempt to answer these questions and more at 8:00 pm EDT on Thursday, September 8.

This tele-event is specifically geared towards individuals diagnosed with BPD but friends and family members are welcome to participate. If you've been recently diagnosed or would like to share your recovery wisdom with others, this telephone call is for you.

The cost to join us is just $25 per person but you can register until September 1 for $15.

When you register, you'll be given a phone number for this event and several resources about the prognosis of BPD to review prior to the call.

Click here to register today.

Managing Expectations about Recovery

Because borderline individuals have little tolerance for feeling bad, they have difficulties carrying out behavior change action plans that require a "wait-and-see" approach. Rather, they will often engage in the "quick-fix syndrome," which involves setting unreasonably short time limits for relatively complex changes. To put it another way, progress is expected to occur overnight, otherwise, the plan has failed. Once again, emphasizing the gradual nature of behavior change and the need to tolerate some negative affect in the interim should be a major focus of therapists' efforts. —Marsha Linehan

Image by Croqueta de ArrozManaging expectations about recovery is a big issue.

On the one hand, you have people with the disorder who are anxious (and yet fearful) about "getting better" and then you have moms, dads, spouses, and other loved ones who are sometimes unable to tolerate a lot of the emotions that are generated when someone they love is suffering or behaving in a way that confusing or hurtful. Finally, you have well-meaning mental health professionals who also have an emotional stake in their patient's recovery.

It's a lot of pressure on everyone.

Patience is critical but so is understanding how recovery works. Thankfully, researchers like McLean Hospital's Mary Zanarini and her colleagues have looked at how people recover from BPD for over ten years.

Therapeutic approaches that involve promises of immediate relief or treatments that aren't evidence-based are all but destined to fail leaving everyone feeling even more hopeless and confused.

Making careful and informed treatment decisions today mean a greater opportunity for success tomorrow. Clear and consistent communication about what recovery really looks like helps everyone to manage their expectations.  

Of course, a little support and encouragement for everyone along the way doesn't hurt either.



Relationship Repair with Valerie Porr

Please join us on Wednesday, August 17 at 8:00 pm EDT for a teleconference on relationship repair with borderline personality disorder advocate and educator Valerie Porr.

Valerie is the author of Overcoming Borderline Personality Disorder: A Family Guide to Healing and Change (OUP 2010) and has worked with families for the past ten years. She's also the founder of TARA National Association for Personality Disorder Treatment and Research Advancements—a nonprofit organization based in New York City.

This 90-minute teleconference will cover issues surrounding relationship repair, creating and sustaining healthy relationships, and barriers to effective communication. The event is appropriate for both family members and individuals diagnosed with BPD and is limited to just 10 registrants to allow maximum participation.

The cost for this event is $25 but you can register until August 10 for $15. Registration will close on Tuesday, August 16.

You can register here.

Update on Saturday, August 20, 2011 at 10:25AM by Hope for BPD

If you would like an opportunity purchase an MP3 of our August 17th conference call with Valerie Porr, you may do so by clicking on our PayPal link below. The length of the call is 90 minutes and the cost is $10.

Once you have completed your purchase click the "Return to Hope for BPD" link for access to the recording.