POLL: The Mystery of Borderline Personality Disorder - John Cloud (Time Magazine)

[william3]

Here's a good article in TIME magazine on BPD:

Minds on The Edge
By John Cloud/Seattle Thursday, Jan. 08, 2009

Because our knowledge of the mind's afflictions remains so limited, psychologists--even when writing in academic publications--still deploy metaphors to understand difficult disorders. And possibly the most difficult of all to fathom--and thus one of the most creatively named--is the mysterious-sounding borderline personality disorder (BPD). University of Washington psychologist Marsha Linehan, one of the world's leading experts on BPD, describes it this way: "Borderline individuals are the psychological equivalent of third-degree-burn patients. They simply have, so to speak, no emotional skin. Even the slightest touch or movement can create immense suffering."

Borderlines are the patients psychologists fear most. As many as 75% hurt themselves, and approximately 10% commit suicide--an extraordinarily high suicide rate (by comparison, the suicide rate for mood disorders is about 6%). Borderline patients seem to have no internal governor; they are capable of deep love and profound rage almost simultaneously. They are powerfully connected to the people close to them and terrified by the possibility of losing them--yet attack those people so unexpectedly that they often ensure the very abandonment they fear. When they want to hold, they claw instead. Many therapists have no clue how to treat borderlines. And yet diagnosis of the condition appears to be on the rise.

A 2008 study of nearly 35,000 adults in the Journal of Clinical Psychiatry found that 5.9%--which would translate into 18 million Americans--had been given a BPD diagnosis. As recently as 2000, the American Psychiatric Association believed that only 2% had BPD. (In contrast, clinicians diagnose bipolar disorder and schizophrenia in about 1% of the population.) BPD has long been regarded as an illness disproportionately affecting women, but the latest research shows no difference in prevalence rates for men and women. Regardless of gender, people in their 20s are at higher risk for BPD than those older or younger.

The rest is at:
http://www.time.com/time/magazine/article/0,9171,1870491-1,00.html

It mentions Opposite Action, I guess they're talking about this:
http://www.dbtselfhelp.com/html/dbt_video_text.html

I'd really like to see a review on this video. 

I wonder if showing this DVD to my uBPDw would make her more receptive to attending DBT sessions.

[elphaba]

Actually a pretty decent article, thanks for sharing it.

It does seem that BPD has been gaining some ground in the press/media and that is the second time I've seen it refered to as something of the mental illness of our age.  It's interesting that the new figures (2007) are so much higher than previous studies...almost 6% vs. 2%...that is huge and I've talked about that on here before...tripple the number of BPD's and that is only those who are diagnosed...never mind the millions more that don't think there is anything wrong with them.

[Bitzee]

I hadn't realized it was a Cover story.  That's wonderful!  Oh, and they Finally said it is just as prevalent in men as it is in women.

I hope my ex's family reads it...

[Major_Dad]

The headline is

Borderline Personality: The Disorder that Doctors Fear Most


word

[william3]

I hadn't realized it was a cover story (saw it online).

While I'm glad it will increase public awareness, I don't think I'll get this magazine issue for my wife ... I've learned the hard way that offering a diagnosis to her is counterproductive.

It is much better to focus behaviors.  I'd really like to get the DVD if it does not discuss BPD diagnosis anywhere.

They've posted text from the videos, and searching it I find no mention of "BPD" or "borderline".  This is a good thing.
http://www.dbtselfhelp.com/html/part_34.html

Has anyone actually seen this video?

[JoannaK]

My issue, as usual, is that high-functioning bpd people aren't discussed, nor the connection/overlap with aspd or npd.

[lostinspace]

I have to put in my two cents here.  I thought that this was one of the worst articles on BPD I have read.  I understand it is great that BPD is "gaining attention".  At the same time, I thought it hardly scratched the surface.  I was a tiny innocent baby in the hands of a brutal vicious mean sadistic mother for years and years and years... to present boderlines the way the article did... as I have already said, didn't even scratch the surface.  I'm really angry about the article actually.

thanks for hearing me out.

lost

[Sandcastle]

I just found it online, and actually zipped over here to see if folks here had seen it yet.  It bothered me too, because it was very not specific about what it actually was.  Emotional dysfunction.  Okay.  But nothing about symptoms or what borderline actually means (overlapping on NPD, etc.)  And like Major_Dad said, there's no mention of how BPD affects loved ones or how traumatic it is for the nons; it reads more like "pity the BPs and they can be saved!  There's hope, and this is another one of those fad diseases that'll change in the next decade!" There's no real definition of the disease, and only that second paragraph that's quoted gives much info about what it really is.

Though, I liked the numbers mentioned.

I also liked the part about BP's not being coddled, after watching momster and grandmomster being coddled by everyone.  I wish it were that easy to stop them.

Overall, though, hooray for getting it noticed, but it was so general how is anybody really supposed to recognize anyone else, let alone themselves, by the info in that article?

[nowwhat]

http://www.time.com/time/magazine/article/0,9171,1870491-1,00.html

The Time article defines and explains Borderline Personality Disorder.  The article also interviews Marsha Linehan, the mental health professional who developed Cognitive-Behavioral Therapy for BPD and interviews a patient named Lily.  

The article does an adequate job explaining the BPD from a clinical standpoint, but falls short on adequately describing how devastating BPD is to the patient and those around the patient.  It fails to mention or describe how a boarderline will change the facts to fit thier feelings.

The author describes meeting Lily, a woman afflicted with BPD.  Lily was described as "friendly but not terrible expressive, and that she carried an aura of self-protection."  The article explains how it came to be that Lily sought help after cutting herself.  That Lily felt empty and had 'dark emotions.'  It details a half-hearted suicide attempt.

I can't help but feel disappointed in the article.  The author suggests that borderline may be the 'illness of our age,' just as it seemed that other illnesses, such as bi-polar, depression and schizophrenia seemed to be he diagnosis of the day in years past.  The author awknowledges that mental health providers don't like to give the diagnosis of Boardline Personality Disorder because of the grave nature of the diagnosis since it is difficult to treat.  

The author also provides new statistics: that 5.9% of the population have been given the diagnosis of BPD.  Way up from the 2% given in 2000.  Of course that number doesn't include those who are not diagnosed.  The article never mentions that many with BPD don't seek treatment or stick with treatment.

[lostinspace]

Great summary Now and thanks!  I have been posting my feelings/thoughts/etc about the Time article in the "coping with parents et al" section of the boards.  I just posted a draft of a letter I am writing (and hoping to send) to Time.  Would love your comments.

Lost

[Chili]

OMG I love this quote:

"Borderline individuals are the psychological equivalent of third-degree-burn patients. They simply have, so to speak, no emotional skin. Even the slightest touch or movement can create immense suffering."

That description needs to be in our archives somewhere to reference!

I also found this interesting:

BPD has long been regarded as an illness disproportionately affecting women, but the latest research shows no difference in prevalence rates for men and women.

It’s about friggin time I read this somewhere. Every time I hear someone say it’s primarily women and rare in men, I want to SCREAM!

This is a really good article.

Chili

[MarkB]

I agree with nowwhat here that the devastating effect of BPD on
people around the person suffering from the disorder is not presented
in the article. This article does a good job at presenting BPD to the
general public but yet it is not enough.

It was almost two years ago that I had my awakening to the fact
that my stbx was BPD. I then tried to find all of the information
I could about BPD. This article would have fallen into the category
I was seeking. It could see the match with some of the things I
was experiencing but yet there was something missing.

Then a year ago, I stumble upon this site here and I did have a
huge EUREKA moment. I realized that I was a NON and that dealing with
BPD WAS the issue. Not the BPD disorder itself. I assume that
people living with alcoholics face the same dilemma. There is this
person in our life that suffers from a disorder that spills over our
own life. Then you have to decide how you deal with this.
There are many mentai illness that affects people and these plights
will challenge the lives of the people around. I do not
know of something as "invasive" as BPD is to the NONs that have to
suffer it

[StayingAfloat]

I posted this article yesterday in Non Stop (sorry, didn't know it was already here), and thought it was pretty good, after I was halfway through it.  When I finished reading it, I did admit I felt a little hollow somehow.  I didn't really know why, but after reading everyone's responses, I think I see it a little more clearly now.

Even though they called it "the disorder doctors fear most" and called it "the disease of our time" or whatever, they really didn't treat it quite gravely enough.

There was even a comment about how, with treatment, something like 90% of BPDs don't have symptoms 10 years later, and within even 1 year many are improved (oh really?  This must be only DBT.  No other treatment is very successful, as we know.  And that paints a much rosier picture than the reality, because countless BPDs refuse treatment or are undiagnosed, or don't know they have BPD).

Nowhere--not once--is there a mention of the trauma BPD inflicts on loved ones and friends.  Yes, I know I'm biased because it's what this board is about... but even much of the reading out there on BPD now at least mentions, if not focuses on, family members and loved ones. 

I guess without *actually* developing an intimate relationship with a bpd, you'll never be able to provide an insightful story about how it affects anyone.  In fact, I almost felt like the writer was itchin' to put the moves on that BPD girl he was reporting about! 

"Hmm, she's VERY pretty... seems recovered... hmmm..."  Let's see him write another story 6 months into the relationship.   

[lostinspace]

I agree!  I also got the yucky feeling that the writer was a bit smitten with the bpd girl in the interview (we all know how "attractive" bpds can be when they choose to turn on the charm    make that a double 

anyway, there is also a long thread about this article in the dealing with parents section of these boards.  And many of us there have chosen to write letters to Time.  fyi

lost

[MarkB]

This is exactly the same experience I had with my stbxUBPDw Flahammerhead.
In my case, since I left last February, I have tried very hard to keep the BPD
discovery for myself since I was certain it would be used against me in court.
Two weeks before we appear in court in december she calls and blast
me for 15 minutes: "I am a borderline and I do not see it". Hello projection!
Knowing my stbx, she probably has studied the in and out of the disorder and
could have a full hour discussion with a therapist and yet she could not
have a hint of a clue to see it in her.

I do not know much about the treatment succes rate of any of the
therapy of BPD. I guess it is possible to make the life ok for those afflicted
with the disorder. I doubt the criteria they use to claim a recovery
could be sufficient to make life  sustainable to a SO. I think BPD should live
alone. They are toxic. It might not be their fault, but the devastation they
create is too much. Self preservation for Nons must come first. I sound
a bit cold and maybe with time I will have more empathy, but I am not
saying this out of a vengeance to stbx. My heart really goes out to the Nons who
have no choice with the ralationship they have with a BPD/NPD: Parent, children
and siblings. A big challlenge awaiting me in rising my two daughters wil be to
teach them to deal with their UBPD mom.

[william3]

Calming effect of sex seems temporary, I've noticed the next day my uBPDw has an even greater rage propensity.

My T told me this has something to do with prolactin levels, but forget the exact explanation.

[Abigail]

I also found this interesting:

BPD has long been regarded as an illness disproportionately affecting women, but the latest research shows no difference in prevalence rates for men and women.

It’s about friggin time I read this somewhere. Every time I hear someone say it’s primarily women and rare in men, I want to SCREAM!

This is a really good article.

Chili

[/quote]

  Although the article left out a lot, at least it had the most recent statistics.  I am glad that the research finally showed what many of us already "knew", that men have the disorder as frequently as women.  Dr. Heller's experience has been about 50/50 for the male/female ratio as well and he believed the rate to be around 6-7% of the population.

   I frequent two forums on ADHD and it is amazing how often I have run into a woman complaining about her husband's "severe" ADHD, as she describes behavior symptoms that are extremely indicative of borderline disorder.  I have sent a few of the women to this site and other BPD sites to research, and I have heard back from several of them stating that their spouse/boyfriend fit the BPD criteria.  Unbelievable how some of their comments seem to come right off the diagnostic criteria for BPD. 

  Abigail

[arjay]

...What is so interesting is that BPDs tend to look at their mates in exaclty the same fashion that the criteria for BPD diagnosis states.  Almost every BPD characteristic my 'ex' told me I had.  It took 2 1/2 years of counseling to realize I was being Gaslighted.  The counselor never used that term, but did tell me it needed to end; that my ex did not think she had much of a problem.  I guess I was not strong enough with boundaries and my convictions to realize what was going on from the beginning.

You know the really scary part is my BPD ex is an LCSW too.  If BPDs are diagnosing nons and BPD, well dang...sort of spooky...

 

[StayingAfloat]

Calming effect of sex seems temporary, I've noticed the next day my uBPDw has an even greater rage propensity.

My T told me this has something to do with prolactin levels, but forget the exact explanation.

I think it totally depends on the particular BPD, too.  Sex is a trigger for many BPDs, especially those with histories of abuse.  While sometimes it can relieve tension and calm them down (doesn't it for everyone?) it can also trigger anxiety, abandonment fears, and a host of other issues.

Probably a topic for another thread, though.   

[Mollyd]

It seems like there was relevant clinical information, infused with sensationalist crap ... at least that's my opinion.

The critique:

Really, the disorder doctors FEAR most is ridiculous.  To have given some real, verifiable stats on treatment protocols and outcomes might have been more useful and real.

And, to say it's the "disease of our time" -  what the heck?

Because there is a name, a set of criteria, and a grouping of treatments, in no way means BPD is a socially constructed condition.

There's no evidence that I know of that bpd is on the rise, and hasn't existed at current prevelance rates forever.  Again, because there is a name and more awareness doesn't mean it exists more now than in the past.  One only needs to look at history to see evidence of pd behavior that was rampant.  That part is misleading, imo.

Otherwise, useful!

m.