“Ok, NOW you fuckers are going to spend the next four weeks discussing how evil YOU are, how it’s horrible that you made this rash, incorrect and downright punitive judgement about me, then spent the last four weeks attempting to punish me for it. YOU ASSHOLES!”
bobkitty I appreciate your contributions here on so many levels.
And I’m glad you are the way you are–I’m not so outspoken, but Ellis is my hero. It took his New Guide to Rational Living to really wake me up. People like you are invaluable to the profession. It’s also comforting to know other mental health professionals have had their own shit to deal with at some point.
I read the Wiki article on Wurtzel as well as the plot synopsis for *Prozac Nation *but it’s not revealing at all. What did this person do?
Okay, now get behind having Wurtzel in your office or on your hospital unit. You have to find points of empathy and places to identify with her. You have to get in touch with your compassion. Being angry, wanting to slap her, etc. aren’t going to be useful because that’s probably how a lot of people respond to her already, so it’s just confirmatory of her view of people and the world. Your job as therapist is not to fall all over her with love because everyone else hates her–that’s not helpful, either, and is part of the same pattern. Your job is to do something different. It’s also to collaborate with her as well as setting limits, and to be respectful even when you’re keeping those limits. This is hard, and you won’t get thanked most of the time, but it establishes a mutual relationship where you can get some work done. This derives from my experience, YMMV, therapists have different practices, etc. I’d argue, though, that if you can’t find a point of connection, it is less likely to be a good client-therapist fit.
Yep. Am trying 
Been in and out of counseling my whole life, and like you guessed, I used to be a complete asshole – not quite to Wurtzellian levels, I hope, but still – until life, philosophy, and human interaction eventually taught me empathy. Love is a beautiful thing.
I tend to treat others pretty well these days, but at a cost of having to internalize most of my prior angst and anger. I took responsibility for my behavior and learned to hate myself. Now I have to try and find a way to deal with things without either drowning myself in self-disgust or swinging back to the other extreme and blaming the world for everything. The whole concept of balance / moderation / the middle road is lost on me. What do you mean there might be a healthy middle?!
I continue to learn, research, discuss, etc., but it’s not enough. Basically, I can control what I think and what I know, but not what I feel.
Same. Color me (very) surprised – it started slow, and I was expecting no more than the one or two odd replies.
This is a very special board.
I’m not really sure how to explain it. Keep in mind that I’m the kind of person that typically finds it hard to dislike others; I am usually able to find points of compassion even for serial killers – it often happens automatically, in fact.
Something about Wurtzel (or at least Christina Ricci playing her in the movie) just rubbed me the wrong way… very wrong. Part of it is that she acts like she was was born with the right to treat everyone else like shit. No, not just the right… the commandment, and not only that, it’s like she’s proud of it. “I’m a bitch – go me!” I think she wrote a book called “Bitch: In praise of difficult women”, which appears to sum up her self-attitude pretty well.
Don’t get me wrong, I thoroughly enjoy hardheaded, intense, passionate women – I’ve fallen for more than a few Feminazi types – but Wurtzel almost behaves like a feminist who doesn’t care anything about the cause but rather chooses to be difficult just for the sake of being difficult: an egoist without a cause.
You got me thinking though. If she were instead a man possessing the same qualities… you know, I’m not sure how I’d feel about that. Have to think about it.
How do you do it?
How do you therapist-types manage to not go postal more often?
How do you not choke some people outright, or at least bring home their issues with you and take it out by beating family members, etc.?
Lots and lots of peer consultation and, as I said earlier, seeing clients in a context that allows the therapist to work confidently.
A timely Time article (I admit that I skipped a bit of it).
Thanks, Chimera. That was an article well worth reading
Some choice quotes, for those too lazy to read the whole thing:
A brief personal update if any of ya are interested:
After a discussion amongst themselves, my team of medical professionals told me they didn’t think BPD was the right diagnosis.
Then, a few days ago, a combination of Paxil overdoses, alcohol, weed, and stressful life events culminated in a suicide attempt. Then I saw some friends in the hallway, regretted what I did, and begged for help while sobbing my sorry ass off. Talk about impulsiveness. Ended up in the ER and an asylum for about a week altogether. Whoo. Fun times.
Now they’re changing the diagnosis again and they think I’m bipolar, having had those traits finally brought to light by medication.
Or maybe caused by medication. Who knows, anymore? Sometimes I wonder if psychiatry isn’t more akin to shamanism than surgery. Let’s see what they say ten years from now…
Wow, Reply… I’m so sorry to hear this. It’s true that bipolar folks tend to not respond well at all to antidepressants, but I would imagine that even fewer folks respond well to antidepressants plus alcohol and marijuana (both, of course, being depressants). 
IANAD, but I am (obviously) a therapist; if your docs are going to pursue the bipolar route, I would recommend you talk to them about a daily supplement of Ultra Fish Oil. The majority of our bipolar kids here at work are on it (between 1000mg and 3000mg a day), and our nurse and MD swear by it. Above all, have patience with the medication process- sometimes it takes a bit before the right combination is found. Report ANY negative effects immediately, and don’t be afraid to say that something isn’t working for you. I took Zoloft for years, and always insisted that it would have to be pried from my cold, dead hand (bad analogy, that). Unfortunately it had a negative interaction with a new med I was put on, so I had to find something else. Tried one of the newer antidepressants and hated it- within two weeks I was in my MD’s office demanding something else. The replacement was significantly better, and while it’s not quite as good IMO as the Zoloft, it’s good enough.
Mr. Kitty, as I’ve mentioned elsewhere, has Cystic Fibrosis. He went un/misdiagnosed for 48 years; now he’s about to turn 50 and the docs have NO CLUE why he’s still alive (I insist it’s because he’s too damn mean to die). He spent over a month in the hospital this past summer, and once he could get around the unit he went to visit the other cystic patients (most of whom were children). His favorite piece of advice: if there is no other choice, then let the disease kill you- NOT the diagnosis. IOW, docs (and families) get really caught up in the terminal nature of the diagnosis, which has a negative effect on the patient whether they intend it to or not. The disease is going to kill you- there’s no doubt about it- but you can choose to go down fighting every second of it, or you can give in once you’ve been “labeled.”
I mention that as a lead-in to this: as humans, we like categories and “pat” answers; that’s why we become so focused on finding a name for something. Whether you’re BPD or bipolar, don’t let the label be the thing that guides you. Let your internal sense of what feels right and what doesn’t be the thing that tells you when the treatment is working.
Keep us posted on how you’re doing, please!
After reading all the stories in this thread, I am left with the impression that the overwhelming majority of people with BPD are female. 
From the DSM: “Borderline Personality Disorder is diagnosed predominantly (about 75%) in females.”
I wonder if some of that may be cultural: think of some of the criteria, and how its appearance would be interpreted differently between the genders. A man who drinks to excess, gambles, and engages in risky sexual practices simply isn’t going to raise the same eyebrows as a woman who does the same. The image of a moody, angry, alternately dismissive/needy man is actually somewhat valued and desired; not so with a woman. I’d think that a lot of male artists are undiagnosed BPD, and “get away with” their behavior because, well, that’s just the artistic personality.
There is a theory that men with BPD tend to be mis-diagnosed with Anti-Social Personality Disorder, since the cultural values of male behavior combined with the BPD symptoms would lead them into legal trouble more often. That may also be one explanation for the gender disparity.
Also true, which is intriguing to me because all the ASPDs I’ve met have been exceptionally charming, whereas the BPDs make me want to run screaming. Think Ted Bundy vs. Criss Angel (NOT saying that CA is a borderline, although- thanks to Supernatural- we now know he is a douchebag; rather that he was the first male “celeb” that I could come up with who was a good example of dramatic-creepy).
Thank you for the stories and thoughts They are appreciated.
Meh. If it was just my internal sense guiding me, I’d say I’m absolutely fine, if a bit lonely and lacking in good friends. At the mental institution, the crisis doc determined that I had low self-worth (ya think? with half the world ignoring me and the other half telling me I’m nuts?) and he prescribed a goal for me to become totally “conceited” before I could be released – perhaps thereby bridging that BPD <-> ASPD gap Kolga hinted at.
I have a belief that they are blindly looking for neurological causes when none may in fact exist; I am unhappy not because my meds aren’t right or because I’m undergoing the wrong subtype of psychotherapy, but because I’m lonely and sick to hell of all the rejections from friends and romantic interests. It’s been this way since 5th grade for me, and that’s not something meds can ever cure. The only reason I have ANY faith left in the psychiatric system is that I’ve come to realize paying for a session means I actually get someone to talk to for 50 minutes, and that would often be the social highlight of my day. Speaking of therapists, in the institution one of them made me write down, as homework, some ways to become more conceited :rolleyes:
Here’s what I wrote in my highly-altered, hyper-anxious state of mind (I should add that I’ve never felt that way before or after the particular drug cocktail they forced on me):
Of everything they put me on and had me do, I think that was the most helpful. I managed to retain some semblance of my individuality, and for that I’m grateful. Over the years I’ve come to realize that DSM diagnoses can sometimes become self-fulfilling prophecies, turning a presumably helpful description of symptoms into a haunting prescription of what the future must be.
I don’t want to subscribe to their bullshit. If it’s impossible to separate the science from the psuedoscience, I’d really rather just go it au naturel and take my chances. Sadly, that’s not really an option at this point – school, folks, and friends would not be happy if I suddenly stopped participating in their holy system.
Anyway. I’m ranting.
The point is that for every male patient caught in the mental health web, there are probably dozens more equally disturbed, but more functional because they’re able and willing to use their differences to their advantages, or in the case of ASPD, to manipulate others to their gain. I am not. Call it silly, but I’ve grown up with a very strong sense of right and wrong and I refuse to hurt others if there’s anything at all I can do to myself first; sadly, this means I internalize every negative situation or emotion. Martyrdom does not seem to play well with the various shades of depressive/personality disorders.
I forgot to say I was one of the lucky ones. I was institutionalized as a kid for almost half a year and learned most of the drills. I got out in only 2 days this time, as opposed to the “6 days to several months” the doc initially threatened.
Start with 1/2 cup of relativelyclearspeech, mix in 2 tablespoons each of whattheywannahear and situationallyappropriatehumor, keep the bowl free of warningflags, liberally sprinkle californiabudgetcuts and bake overnight. Makes 1-2 servings of barelyfunctionalindividuals to unleash upon an unsuspecting society.
The others there… I could sense vague consciousnesses in most of them, begging to come out but drowned by the drugs and isolation that only forced psychotropics and barred windows could bring. It’s… scary and sad. Like the prison system, I get the feeling that mental asylums are more about excommunication/containment than actual healing. Ugh.
::visceral shudder::
yeah, ugh! Thanks for the nightmares! Yeesh!