Diagnosing BPD in individuals under age 18 used to be controversial, but that's changed. Diagnosis in adolescents was codified in DSM-V.
In case you might find Dr. Marsha Linehan's story of interest, here's a NYTimes article discussing it. https://archive.ph/EbeNI
Traditional psychoanalysis can actually be detrimental with BPD patients.
Short excerpts from a couple articles:
"The patients that Dr. Stern was seeing appeared neurotic – with intact reality testing – on their first interview, but when they were put on the couch they got worse. Their lives unraveled and they became self-destructive as they were unable to grapple with the intense emotions that psychoanalysis brought up."
"So the prescription was classical psychoanalysis, calling for the patient to free associate while lying on the couch. "At first, she was friendly and cooperative, always on time and eager to talk about herself," Oldham recalled. "She engaged in the treatment and seemed to be benefitting from it."
A couple of months into treatment, however, the patient made an announcement. "She said to me, ‘Here I am doing just what I've always done. I blithely rush into a relationship without even thinking about it, and I don't know you at all. How do I know I can trust you?’"
She began to demand of Oldham information about himself and about his training and blamed him for what she perceived as a treatment that wasn't working. "She became convinced I was keeping secrets from her and told me the problem was that I had been trained in a ‘fly-by-night’ school," he said. "In time, she would become absolutely enraged at me, regardless of what I said. And when I didn't give her an answer she wanted, it became proof that once again she had landed in the clutches of someone who was another disappointment and who might actually harm her."
The treatment and what had appeared to be a promising therapeutic relationship ended abruptly when the patient relocated to another part of the country. For Oldham the case remains an object lesson in how not to treat a patient with BPD.
"Under no circumstances would I treat her today with psychoanalysis," Oldham said."
That's part of what I think happened with my ex. The NPD guy she's now seeing initially offered to act as her therapist (though he has absolutely no training as a therapist). They proceeded with free-association psychoanalysis, and she deteriorated. Then they began their affair. Her BPD symptoms are now far worse than in the years we were together. She believes that her "therapy" with this guy uncovered repressed material that had always been there and needed to be worked on, but the reality is that the pseudotherapy really f*cked her up. And she often does recognize that she's pretty psychologically messed up now. I did subsequently manage to engage her into proper DBT therapy (at a center that works predominantly with pwBPD), but she resisted the DBT therapy and wouldn't do the homework, and then dropped out.
I'm curious -- is the treatment for CPTSD similar? Generalized anxiety? Do they approach treatment from a shared perspective or so a distinct difference in how to approach the patient? In case you might find Dr. Marsha Linehan's story of interest, here's a NYTimes article discussing it. https://archive.ph/EbeNI
Traditional psychoanalysis can actually be detrimental with BPD patients.
Short excerpts from a couple articles:
"The patients that Dr. Stern was seeing appeared neurotic – with intact reality testing – on their first interview, but when they were put on the couch they got worse. Their lives unraveled and they became self-destructive as they were unable to grapple with the intense emotions that psychoanalysis brought up."
"So the prescription was classical psychoanalysis, calling for the patient to free associate while lying on the couch. "At first, she was friendly and cooperative, always on time and eager to talk about herself," Oldham recalled. "She engaged in the treatment and seemed to be benefitting from it."
A couple of months into treatment, however, the patient made an announcement. "She said to me, ‘Here I am doing just what I've always done. I blithely rush into a relationship without even thinking about it, and I don't know you at all. How do I know I can trust you?’"
She began to demand of Oldham information about himself and about his training and blamed him for what she perceived as a treatment that wasn't working. "She became convinced I was keeping secrets from her and told me the problem was that I had been trained in a ‘fly-by-night’ school," he said. "In time, she would become absolutely enraged at me, regardless of what I said. And when I didn't give her an answer she wanted, it became proof that once again she had landed in the clutches of someone who was another disappointment and who might actually harm her."
The treatment and what had appeared to be a promising therapeutic relationship ended abruptly when the patient relocated to another part of the country. For Oldham the case remains an object lesson in how not to treat a patient with BPD.
"Under no circumstances would I treat her today with psychoanalysis," Oldham said."
That's part of what I think happened with my ex. The NPD guy she's now seeing initially offered to act as her therapist (though he has absolutely no training as a therapist). They proceeded with free-association psychoanalysis, and she deteriorated. Then they began their affair. Her BPD symptoms are now far worse than in the years we were together. She believes that her "therapy" with this guy uncovered repressed material that had always been there and needed to be worked on, but the reality is that the pseudotherapy really f*cked her up. And she often does recognize that she's pretty psychologically messed up now. I did subsequently manage to engage her into proper DBT therapy (at a center that works predominantly with pwBPD), but she resisted the DBT therapy and wouldn't do the homework, and then dropped out.