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Hi there,
I think it's great that your wife is getting DBT. I know there's a stigma with BPD, but I also think there doesn't necessarily have to be. The way I see it, BPD is a collection of thoughts and coping mechanisms that are human to the core--moodiness, impulsivity, anger, feelings of emptiness and hopelessness, thoughts of suicide, negative thinking, avoidance, anxiety, some paranoia, potential substance abuse. I think most people experience intense emotions from time to time, especially under stress. In my opinion, it's just that with BPD, emotions run on the extreme end of the spectrum, and are felt with such frequency and intensity that they act out on the feelings, which adversely affects their life and relationships. It's as if they have a hair-trigger, trauma-like, fight-or-flight response, much of the time. With BPD, when emotions are running high, the logical part of the brain is completely hijacked, and the consequences of acting out won't be considered. Emotional responses seem to be "desperate"--dire, urgent, hopeless, rash, furious, impulsive, extreme. Hence the potential for dysfunction in daily life, and possibly the realization that they need to get some professional help to address it.
The way I see it, DBT doesn't necessarily have to be framed as a treatment for BPD. It could be framed as learning skills to help cope with traumas. That's shorthand for dealing with intense emotions, tolerating distress, overcoming traumatic experiences, improving interpersonal relationships and moving forward. My opinion is that almost everyone could benefit by learning these sort of skills. After all, emotional control is not taught in school, and typically not taught at home, either. It so happens that the pwBPD in my life embraced the notion of getting extra help to overcome past traumas with DBT. You see, it validated her notion that she was traumatized by life, and it was consistent with her general victim perspective.
Anyway, if your spouse is embracing DBT, that's great news in my opinion. It could mean she recognizes there's some dysfunction in her life, and she's taking active steps to address that. That's all very positive. Now, it's true that pwBPD tend to see things in a negative light, and they feel intense shame. That's probably why having a BPD "label" could be extremely upsetting. That could be why some doctors are reluctant to diagnose BPD in the first place. I suspect that most patients don't like receiving the diagnosis, either.
Anyway, DBT is the gold standard for treating BPD. Even better, BPD is treatable with therapy, provided that the patient is committed to making some positive changes. By the way, the pwBPD in my life really turned her life around with therapy. Though she still struggles and hasn't repaired some relationships yet, my guess is that she probably wouldn't strictly qualify for a BPD diagnosis anymore. My guess is that she's in "remission." Sure, she still has intense feelings, but her coping skills look healthier today in my opinion, and her life looks much less dysfunctional.
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