BPDFamily.com

I was meeting with my psychiatrist a few months ago and told him about the pwBPD I had just broken up with. First off, he said it is almost impossible to do therapy with them. They treat therapists the same way they treat us - seductive, fear of abandonment, quitting all contact.

The most profound thing he said to me was, when dealing with pwBPD:

"It's a hardware issue, not a software issue."

Meaning it's intractable. Unlike depression, bipolar, etc. That phrase really stuck with me and reminded of me how deep and intractable their issues can be.

Unfortunately I believe this to be true. My therapist told me the same. As a matter of fact he said "S.D. I admire the fact you got out when and how you did for I have seen much worse damage to the receiver". I said "really" and he said "Yes for sure".  

I've also read many stories of therapists having difficulties in treating BPDs.  I believe my BPD wife's therapist, who she began to see shortly before she left our home, was very inexperienced in treating the illness, and she encouraged my wife to make some very poor choices I feel will come back to haunt her down the road.

That being said, I don't feel that all BPDs are 'lost causes'.  Some really do dedicate themselves to treatment for an extended period of time and are able to make a lot of changes in their lives.  I wouldn't wish their constant turmoil on anyone... .and while I won't ever agree to excusing poor behavior on mental illness, I do really feel for the truly troubled ones (like my wife) who experienced awful trauma as children, leaving them lost in the adult worlds they now inhabit. 

Not a lost cause.  Some people go into therapy. It is a difficult treatment plan tho.  Takes a lot of commitment like any therapy or recovery.  And like any treatment the person has to want it.  

It also helps pwBPD to have a supportive environment where the people around them aren't what is termed "negative advocates", ie enablers or other unhealthy folk that feed that cycle of dysfunction.

Also general talk therapy hasn't been real successful.  Like physical illnesses, each malady has a treatment that works better for it.

Here's an overview on DBT therapy and how it works:

https://bpdfamily.com/message_board/index.php?topic=211849.0

I've thought a similar thing! But I'm not sure "hardware" is the best analogy. A "hardware" problem would be brain-damage, a problem with the actual physical organ of the brain itself.

The way I see it, it's more like a fundamental problem with the "operating system." So not just a problem with individual glitchy or poorly chosen "programs," but not a physical/material problem either.

Yes, there is therapy GreenMango, but the problems with that are exactly what you say: "takes a lot of commitment" and "the person has to want it."

Imagining successful treatment for them is, thus, extremely difficult because the very problem you'd be trying to solve prevents commitment or the sustaining of second-order desires across time! So it's like a problem whose very nature is to subvert or undermine the very sorts of things that could fix it. It's insidious that way.

From what I hear, DBT has success mainly in treating the "danger" symptoms of self-injury, suicidality, compulsive thrill-seeking, raging, etc. It seems to have moderate success in mitigating those more violent coping-strategies that some Borderlines fall into as a response to the frustration and pain of having the condition. But I've seen little evidence that it gets to the heart of the more nebulous intimacy and identity and commitment and attachment issues that are the actual essence of BPD and which are the things most likely to have sabotaged the relationships of those of us here.

BPD is, at heart, the inability to sustain the sort of coherent autobiographical narrative that allows one to sustain second-order desires through the projection of the self into the future. It's an identity issue and an attachment issue like this, and it's much less clear how something like this can be addressed without a difficult and comprehensive break-down and rebuilding of the whole structure of their internal personality.

The only cure I could imagine would probably have to involve intensive institutionalization like that, and the BPD person might think "the cure is worse than the disease" at that point, because it would require, essentially, becoming a new person, handing over oneself to total reconstruction at the hands of coercive authorities (which is not a nice thought for anyone, let alone someone with a fragile self that fears engulfment and outside agencies co-opting them).

But I hope I'm wrong, of course, and there are less invasive treatment modalities possible... .

The majority of members partners here are subclinical.  And present what members like to call high functioning.  Not really candidates for institutionalizing.

If the person is functioning and the majority of their problems are interpersonal conflicts ... .And they are okay with it there's likely any reason to change.  The problem then becomes one for the partner - can you accept this person? 

radical acceptance and working on not being a negative advocate. Or making a difficult decision to let go and find someone who may be a better fit - which may be radical acceptance too. 

Actually as far as the "hardware" issue is concerned the fact is they have done intensive brain imaging studies with the various PDIs that fall into the realm of BPD. In fact there are measurable and provable differences in the way electrical information is processed in these individuals. It seems DBT does in fact mitigate some of this "disordered processing". It is a matter of repetition and retraining and actually "burning" or "opening gates" as it were in electrical pathways in the individuals brains and self communication systems. Think of it as a highway that has bypassed on and off ramps as a result of the constant flow of traffic in one direction from a very early age. Or a signal light that has stopped working as a result of neglect or habit. This phenomena is an actual visual and measurable physical actuality.

And it is also true that DBT is a mitigating and effective therapy in the "danger" symptoms as the above poster pointed out. A well versed DBT therapist informed me the frontier goals of her therapy is not the learned ability to sustain complicated intimate romantic relationships but rather the ability to live a productive somewhat "regulated" lives. If the ability to sustain romantic relationships happens to be among the benefits that the patient "earns and learns" that is certainly a bonus but not a primary target goal.  

I myself do DBT therapy and have a workbook at home that I also use in my own time. It is called The Dialectical Behavior Therapy Skills Workbook by New Harbringer Self Help Books. In all actually it is very akin to the Buddhist approach and view of life. It is all about "Mindful Thinking" and "pre-Meditation" which ironically seems to be a rare occurrence and practice in todays hectic and accelerated modern societies of action and stimuli and immediate reaction response. I began this therapy not because I have been diagnosed with a described Personality Disorder but rather as a tool to help me to slow my thinking down and think through the results of my rather compulsive nature and action "before reacting". The very nature that chooses to ignore those all to often talked about "red flags". The very heroic nature that led me down this path and into these fine rooms. This is what I call the gift of the borderline. It led me to a great deal of self realization that perhaps I would not have known had it not been for experience that we all share.

In many ways I do in my heart of hearts have a great deal of compassion for the suffers of Personality Disorders. Not to say that in that compassion I excuse the various bad and impulsive behaviors they manifest, but as a result of my own therapy I can "see" them and I can "feel" for them although I'm NOT going to involve myself with them. The reason I would have to not involve myself with them and now have a much easier time in my present ability in "letting go" is because I have "thought it through". lol

Right, but they SHOULDN'T be okay with it. The fact that they are, or at least find the pain of having the disorder (and they do suffer; dysthymia, angst, and a feeling of emptiness are symptoms even among the high-functioning) to be less than the pain of changing... .is itself dysfunctional and a barrier to their happiness.

Yes, it's not our place to force anyone to change. But these are people who are not going to change on themselves either. So, basically, they're in their own Hell on earth, not merely unable to change, but unable to WANT to change, unable to sustain and implement a self-directed desire to change, at least.

There may be nothing we can do (short of forcing them, and we shouldn't/can't force). But that doesn't mean it isn't a miserable and intractable problem they're facing.

That's fascinating! Really interesting to read.

However, I still think this describes something whose analogy would be more like "operating system" than "broken hardware."

If the hardware were truly broken in itself, the electro-chemical pathways and gateways wouldn't simply be not activating... .they'd be simply incapable of activation, and no amount of trained or guided thinking would be able to activate them.

You can bet your last dime that their lives are a misery. It not as if they "choose" to be the way they are. One must remember it is a disorganized survival response as a result of what ever it was they were subjected to in the formative years of their lives. It must truly be hell on earth. Imagine a life of virtually in some cases hundreds of people in and out of their lives. Or the life of a stripper or street walker or of a porno "star" or self medicating drug addict. The statistics for long term survival and good health do not play well for these people that in many cases are glorified by our present society as "free spirits". I trust this is NOT freedom but rather quite the opposite.  

Not to discount your hypothesis but this is a "proven" measurable fact. The hardware is dysfunctional. The actual physical properties of the brain. It is working, just not "normally". Perhaps "broken" is too broad of a term. I do believe we can agree on the descriptor "damaged". As a side note one of the researchers likened this brain dysfunction very similar to that seen in long term methamphetamine users for whom one big after effect is dysthymia. In layman's terms long term and often intractable depression and emptiness as a result of serotonin imbalances.  

But computer hardware isn't broken if the circuits are firing wrong. It's broken only if the circuits can't fire at all. If they're firing wrong, it's a problem with operating system. Yes, it can be seen physically, but that doesn't make it brain-damage as if a chemical or electrical or surgical intervention could fix it. Only different thinking is going to fix it. In this case, I think, the physical signs are the result of the psychological dynamic, not the other way around.

Other members have said "there's no such thing as a non".

Would that be a "non" sense?  :)

It's like diabetes... manageable, but not curable - yet.

Well you guys have really run with the computer metaphor; I wanna play.

I say a hardware problem would be an organic brain issue, like BPD was the result of an organic brain abnormality and a person is born with it.  Not true.

A software problem would include a set of disempowering beliefs, which are changeable.  Also not true.

I'm going with firmware problem.  A person is born with a perfectly functional brain, the hardware is fine so to speak, they get traumatized by whatever at a young age, and it affects the way the brain grows and which pathways form where.  It literally gets burned into the brain architecture, so any future beliefs, software, installed must work within that architecture.

Have we beat the metaphor to death yet?  Time for a reboot.

Maybe the actual computer hardware is ok but the windows operating system needs looking at!

The pwPD in my life couldn't pass a Turing test!   :) :)

abuse in general is like a computer virus. some reckless, tortured adult abused the pwBPD and left this virus in them. then the pwBPD go around and abuse others and the virus passes onto to us. the difference being that if we remain healthy and strong enough we can heal and not pass on the virus to others.

I do believe that self awareness can be improved through mindfulness practices like meditation. Helping a person live in the present as opposed to the past or future. I believe this will be the focus on future BPD breakthroughs. The main thing that gets in the way is dissociation. The fact that many are constantly rewriting history in their minds makes creating reality even in the now a mute point since even the now can be convoluted and reconstructed in their minds. It's just nuts, literally.

Wise words, my friend... .

Yes, I think that's a good analogy! I think I was mistakenly calling firmware as "operating system" which is different now that I've looked it up. Or maybe it's somewhere in between the two. But the point is that, while it may not be an organic brain-damage problem... .it is more "fundamental" and "structural" than just their "surface" thoughts or beliefs which can be changed. It is part of the "architecture" of their whole mind.




Right. As I understand it, and in my experience getting to know my guy's psyche inside-out... .it's not so much a problem with "living in the present" (which, really, is ALL they are able to do), but rather a problem with connecting the present to the past and future in a continuous coherent self-narrative that is able to sustain desires and identity and perception across time rather than just identifying with the fragment of the present moment. This is why they have problems with commitment, etc. They can't "weave together" the fragments of each moment into "higher order" desires or senses of continuous selfhood.

Umbrellaboy - I think you are spot on with your last post - spot on! Leading to no consistancy - no deferred gratification ability. No learning from mistakes from the past. Sorry I am being a bit black and white here today on this and generalising horrendously but am a bit emotional myself today so you'll have to excuse me lol... .

I have also read that the physical neurology of peoples brains has actually been found to have been altered by abusive childhoods. (I include myself in this as I have also had a similar background btw) An abusive past can lead the person to lean more heavily (and hence develop more) the emotional and flight or fight responses rather than the higher level thought/logical frontal regions which therefore remain less developed. I found this interesting BPD wise and worrying when I apply this to myself too. Perhaps explains why I have chosen to stay in a BPD r/s that logically is not the best for me.