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Think About It... The Borderline and the narcissist. The borderline tends to be dominated mostly by abandonment fears, and the narcissistic person, by fear of the loss of specialness or appreciation.When the promise of that bond is threatened, the borderline responds with blame and attack defenses. The narcissist tends to withdraw, fears a loss of specialness, easily becomes injured or outraged ~Joan Lachkar, Ph.D..
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Author Topic: How do I find a counselor specialized in personality disorders like Borderline?  (Read 3013 times)
O'Maria
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« on: February 17, 2010, 09:43:02 PM »

I am talking to a counselor after my shocking relationship with a man who has 9 out of 10 traits of BPD, comes from a family with a mother hospitalized for mental illness and a grandfather who committed suicide. The counselor said that BPD is less common and thinks it was anger outbursts from a man who lost his job. This sounds like my ex who defended himself saying that he went a little overboard and wouldnt do it again and that it only happened during stress.

Maybe my ex had more than one illness. I read a book about verbally abusive relationships and he happened to look at the list of traits for both BPD and NPD. Then he said he didnt think he was narcissistic, and that he had heard of borderline but didnt want to comment any further. 

I have so many questions although I feel I learn every day. Its hard to explain to the counselor what went on inside our home, all the abuse that I still suffer from. I want to get treated for my nightmares and start over with a normal partner. What if I got damaged by the abuse. How do I find a counselor specialized in personality disorders like Borderline? Why is it not the first choice they think of?   
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LOAnnie
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« Reply #1 on: February 17, 2010, 11:34:43 PM »

According to this excerpt in a sub-article on BPD in the larger article on personality disorder:

"Standardized criteria were developed[87] to distinguish BPD from affective disorders and other Axis I disorders, and BPD became a personality disorder diagnosis in 1980 with the publication of DSM-III.[82] The diagnosis was formulated predominantly in terms of mood and behavior, distinguished from sub-syndromal schizophrenia which was termed "Schizotypal personality disorder."[86]"

Here's the link:
http://en.wikipedia.org/wiki/Borderline_personality_disorder#History

So, its a fairly new category of mental illness, and the way the symptoms are being re-grouped now will mean yet more changes in the way the disorder is categorized and diagnosed in the DSM 5.0.  The way the disorder is even thought of keeps changing.

The way to find a psychiatrist or psychologist who has experience with treating patients with borderline pd, who has training and experience using dialectical behavioral therapy (or the newer schema therapy) to treat BPD and who is willing to take on a new BPD patient...  is to do a lot of phoning and interviewing of those who are within your area.  

You have to hunt for them and interview them.  

From what I've read, there aren't a great number of psychiatrists or psychologists who are willing to treat patients with BPD.  But if you find one who is willing and who is trained in dialectical behavioral therapy and willing to take new patients, then, jackpot!

Here is a link to a site that does list a few therapists who treat BPD patients, organized by state:

http://www.borderlinepersonalitytoday.com/main/BPDlist.htm

Keep in mind that the person whom you suspect might have BPD has to be willing to accept that he or she may have a personality disorder, has to care very much that his or her behaviors are hurting their spouse and/or their kids, has to want to change his or her behaviors very much, and has to be willing to undergo what might be years of therapy.  Its an uphill battle, but it can happen.

-LOAnnie

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O'Maria
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« Reply #2 on: February 18, 2010, 12:04:53 AM »

Its the endless projection which prevents awareness. Also, there seems to be "forgetfulness" once the rage outburst is over, to minimize the need for therapy. How can they not remember what happened even when no alcohol was used? I remember every word that was said.

My experience is that even when the "patient" knows something is wrong there is resistance to treatment. If I start with family therapy its easier to accept but I already know it won't help cause medication alone has not helped. Even if all other family members know its a mental illness the patient "wants to be left alone". Its the fear of rejection of somebody who is sick, and a fear of getting the diagnosis. 
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SeaCliff
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« Reply #3 on: February 18, 2010, 09:52:06 AM »

I agree with this point. I have spoken with numerous therapists (psychologists and psychiatrists) over the past year about BPD, and most of them aren't that familiar with the Borderline behavior. For those who had a brief experience in treating a Borderline patient, they didn't seem all that motivated to try to treat another Borderline.

For those therapists who consider themselves Borderline experts, there still doens't seem to be one DEFINITE way to improve the Borderline behavior. For every positive article or book which I read on DBT, I then read a negative one which notes that many Borderlines don't finish the DBT treatments very often. What are the absolute best and most consistent treatments out there which may overcome the Borderline's layers of defense barriers such as Blaming and complete denial?
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GENERAL ANNOUNCEMENT: Are you on the right board?
This board is for members with failed or failing relationships that want to detach from their relationship and relationship wounds. If you are still analyzing the decision to stay, please post on Undecided: Staying or Leaving
All members living with a pwBPD should learn to use the Stop the Bleeding tools - boundaries, timeouts and other basic tools - to better manage the day to day interactions with your partner. If you have questions on any of the tools, feel free to go over to Staying: Improving a Relationship with a Borderline Partner and ask for help. :-)
LOAnnie
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« Reply #4 on: February 18, 2010, 11:26:23 AM »

Successful therapy seems to be more about tailoring the therapy to the individual patient's needs than it is about relying on one specific form of therapy because BPD (plus frequently present co-morbidities) is such a complicated disorder.

Here's an excerpt from an article discussing treatment of BPD patients:

"Clinical guidelines for psychotherapy for patients with borderline personality disorder."

Psychiatr Clin North Am. 2000 Mar;23(1):193-210, ix.
Stone MH.
Department of Psychiatry, Columbia College of Physicians & Surgeons, New York, New York, USA.

"In planning a course of psychotherapy for borderline patients, clinicians must take into account the heterogeneity of the clinical presentation in the borderline domain. Borderline personality disorder is usually accompanied, for example, by one or several "symptom disorders," such as an eating disorder, depression, posttraumatic stress disorder, premenstrual tension, dissociative disorder, or anxiety disorder--not to mention one or more other personality disorders. The nature of the "comorbidity" in each patient will determine which medications, if any, are applicable. The accompanying personality disorders will have an impact on amenability to psychotherapy. The main forms of therapy currently in use are supportive, cognitive-behavioral (including dialectical behavioral therapy) and psychodynamic (including transference-focused psychotherapy). Group therapy is often used adjunctively with any of these approaches. The main question is no longer, Which of these approaches is best, overall? but rather, Which approach is best for which type of borderline patient? Contemporary research is addressed to this latter question."

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-LOAnnie

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atwittsend
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« Reply #5 on: February 18, 2010, 11:34:29 AM »

Its the endless projection which prevents awareness. Also, there seems to be "forgetfulness" once the rage outburst is over, to minimize the need for therapy. How can they not remember what happened even when no alcohol was used? I remember every word that was said.

they cant remember cause they are dissociating when they rage.  they arent grounded in reality. 
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SeaCliff
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« Reply #6 on: February 18, 2010, 11:41:29 AM »

Thanks, LOAnnie. Is there an experienced BPD (with possible PPD tendencies) specialist in the West Los Angeles region who you may recommend (or anyone else here on this site)? Does the removal of a potential pituitary or adrenal gland growth (typically a benign tumor as suggested by several medical experts familiar with my situation) potentially improve their personality disorder somewhat in the short term prior to the start of any long term BPD therapy?

Thanks for your help. I do appreciate it.
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atwittsend
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« Reply #7 on: February 18, 2010, 11:43:34 AM »

http://www.borderlinepersonalitytoday.com/main/states/california.htm

thats where id start Rick...
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SeaCliff
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« Reply #8 on: February 18, 2010, 11:46:16 AM »

Thank you, "Atwittsend". I do appreciate the list of L.A. doctors. Your website name describes my situation exactly due to my absolute shock and complete disbelief in regard to my current relationship situation as I, too, am completely at my "wit's end".
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atwittsend
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« Reply #9 on: February 18, 2010, 11:50:46 AM »

yep when I came here I was a disaster!  that was July 09.  there was no room for my own identity in that relationship!  I just put out fires for the girl 24/7.  it was killing me. 
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LOAnnie
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« Reply #10 on: February 18, 2010, 12:24:51 PM »

I haven't come across any studies at all regarding pituitary gland or adrenal gland tumors in relation to BPD symptoms.
But if I do I'll post the links.   Sorry, but I have no links to psychiatrists who treat BPD other than:
http://www.borderlinepersonalitytoday.com/main/BPDlist.htm
By the way, if you'd care to share, is your BPD ex left-handed, and did she or does she have any dyslexia?  That is a correlation I am curious about (and posted on an earlier thread) as a possible physical marker,  based on my BPD/NPD mother, having to do with the possibility of left-brain damage in BPD.
-LOAnnie

Thanks, LOAnnie. Is there an experienced BPD (with possible PPD tendencies) specialist in the West Los Angeles region who you may recommend (or anyone else here on this site)? Does the removal of a potential pituitary or adrenal gland growth (typically a benign tumor as suggested by several medical experts familiar with my situation) potentially improve their personality disorder somewhat in the short term prior to the start of any long term BPD therapy?

Thanks for your help. I do appreciate it.
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SeaCliff
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« Reply #11 on: February 18, 2010, 12:32:44 PM »

Thanks, LOAnnie. My ex-BPD is right handed, and she is an avid reader herself with no dyslexia problems. She has perfectionist artist traits as that was her backgroud. She has always been too hard on herself. Sadly, I saw more good in her (as did her friends and family) than she did in her own self.

As she was certain that I stopped loving her, she completely "split" as severe as possible. Yet, I keep trying to show my love and support for her if only for the sake of our children at this point.
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O'Maria
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« Reply #12 on: February 18, 2010, 02:25:02 PM »

Very interesting comment about therapists' unwillingness to treat Borderline. I understand now from what I have learned that its a hard illness to treat. Maybe because there are so many tragedies in early childhood that shape the person. My ex didnt even touch the childhood issues before I asked about his constant irritation, anger, instability and jealousy. It was so obvious to me that he needed treatment.

I have not found an expert in central Florida yet. There are several counselors interested in family therapy, trouble with relationships but not too many who are willing to treat any personality disorders. I read that all PDs are hard to treat and from experience I can tell that I didnt even succeed in talking about it, I was accused for being Miss Perfect, or Crazy B, or something similar.

How can a therapist know whats going on between BPs and non-BPs if they don't ask us, the victims? A therapist can easily be mislead to think that a functioning, nice looking, polite (outside home), educated guy has some temporary stress issues.

 

 
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O'Maria
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« Reply #13 on: February 18, 2010, 02:35:31 PM »

What were your experiences with dissociation during rage? How do you treat such a misbehavior?

I was totally confused, never prepared for the sudden anger. It could happen in the middle of an everyday conversation, during a TV program, in the traffic, in the store, in the restaurant. Just one "wrong" look from somebody could trigger impulsive behavior. I still don't understand the sudden adrenaline rush and how you could ever treat such a hormonal imbalance in a guy.
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LOAnnie
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« Reply #14 on: February 18, 2010, 02:42:24 PM »

Here's a link to an article on why a lot of therapists do not choose to treat borderline pd patients.  I get the impression that its because most therapists just aren't prepared for how incredibly difficult, hostile, negative, uncooperative, manipulative, blaming, and irrational BPDs can be. We adult kids of BPDs have been putting up with their crap our whole lives. 
We're used to it; they're not.

http://psychcentral.com/blog/archives/2008/04/02/why-do-therapists-stigmatize-people-with-borderline/

-LOAnnie
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O'Maria
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« Reply #15 on: February 18, 2010, 02:47:52 PM »

LOAnnie,

They are incredibly HOSTILE and behave like monsters, at home.

Loved ones get the worst treatment.

But I guess seeing the same therapist for a while makes them less shy to act out.
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LOAnnie
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« Reply #16 on: February 18, 2010, 11:05:40 PM »

Here's an excerpt that I think explains really well why it is that those closest to the BPD/NPD get the worst of their behavior:

--- In WTOTransition@yahoogroups.com, "scrambled75" <stujwils@...> wrote:

"I have posted this before but it may be worth saying again. It is something I read in Richard Skerritt's book 'Meaning from Madness'.  Basically, borderlines and narcissists live in great fear of being negatively judged by others so they project an image they feel will be acceptable (i.e. mirroring). But they will only do this so long as you fall outside their definition of 'self'. Once you fall within their definition of 'self' (i.e. through marriage or the like) they are no longer motivated to impress you, but to control you so that you ALSO project that image to those outside. All perceived flaws must be eradicated.

I don't think it is a case of them consciously choosing when to be nice and when to be nasty. In general, they will appear to be nice so long as you are on the outside."

This explanation works for me because my BPD/NPD mother actually told me on more than one occasion that I "had to love her."   So, in her mind, she could do or say anything at all to me, anything she felt like, because I had no choice; I had to love her.   Its that "treating other people like objects or possessions without feelings" thing, that narcissistic component to BPD that is so damned horrid to live with and so incredibly damaging to children.  

Anyone who is suspected of having BPD should really be very thoroughly examined and assessed and monitored closely if she has children; its just unconscionable to allow little kids to be raised by a mother who is incapable of relating to her child as anything more than a possession or an object without feelings.
Its a recipe for tragic emotional damage to the child.

-LOAnnie

LOAnnie,

They are incredibly HOSTILE and behave like monsters, at home.

Loved ones get the worst treatment.

But I guess seeing the same therapist for a while makes them less shy to act out.
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O'Maria
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« Reply #17 on: February 18, 2010, 11:47:26 PM »

Whats dissociative disorder?

I remember my ex in a state of rage, his eyes moving very fast, tense muscles, mouth foamy, yelling - terrible memory. When he calmed down he said he went "a little too far". At the same time I had to leave the house and call the emergency line. He said he didnt realize he raised his voice. Is this dissociation?

Whats the basis for fast marriage and trapping their loved one as soon as possible, it seems to be quite common that they want to make sure youre locked in before the abuse starts. There seems to be a total lack of empathy.
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O'Maria
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« Reply #18 on: February 18, 2010, 11:51:06 PM »

Is the perception of you being theirs also the reason why they don't need to impress? This means they will never work on a relationship and understand the concept of mutually fulfilling.

I heard him say many times: You either hate me or love me. You said you will love me forever.

So he counted on me being there forever even though he treated me like dirt.
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« Reply #19 on: February 19, 2010, 07:13:32 AM »

What you want to find is a therapist that specializes in PTSD. You are in need of a listener that understands the stress you've had to endure. You will spend a fair deal of your time re-living the bad experiences by re-telling them to a therapist. This hopefully sheds off the confusion and doubt that it was your fault and releases the pain. Once you've re-lived most of the bad, the therapist should guide you away from toxic shame, on to anger and then acceptance that this person will not change unless they do their own work. Your work is your work. Your brain has to heal from the emotional trauma. This can only come after you let go of controlling the outcome of the BPD's life.

Stay away from Dialectical Behavior Therapy. It is a business model.  It is social/emotional training for persons suffering from BPD. If you are a non-BPD with a BPD loved one or family member- you can get pulled into a false hope with DBT businesses. Speaking from experience, I wasted 6 years. Dont gear your therapy toward the BPD partner. BPD partners have a laser like precision of falsifying presentations and making you look BPD- which really treats the DBT therapist to a second patient.

Find a therapist that deals with your own emotional trauma and not DBT couples therapy. Google "borderline males" and you'll find a few women therapists online that do phone consultations. Hope this helps.
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