Posted by Adam on May 21, 2002, at 20:56:10
In reply to A Big Question -- about Borderline Personality Dis, posted by Sarahmarie on May 17, 2002, at 22:46:04
Hi, Sarahmarie,
I was once concerned I had a personality disorder (I also have major depression and OCD). I sat down with the DSM-IIIR (didn't have vsn. IV handy), and read the descriptions; of course I found some things that fit, and it made me really worried.
I shared my thoughts with my doctor, and he told me the mere fact that I had such questions and concerns was a strong indicator that I did NOT have a personality disorder. That's not to say I didn't have problems, just that they weren't of that type. He had treated a few individuals with BPD, and he told me that, besides sometimes being a nightmare to work with, they tended to look externally for the source of the trouble: YOU'RE the one with the problem, not ME. He also said they were prone to outbursts of rage when confronted with the reality of their disorder (directed, I gathered, at him on occasion).
I can't say for certain, but I think if you were sitting in front of him, he would tell you the same thing he told me: You don't have a personality disorder. You seem to have a relatively normal level of insight about your own difficulties, and, while doubtful about your therapist's diagnosis, you aren't angrily hurling invective at her as a means of voicing your concerns.
To me, quite frankly, the whole concept of the personality disorder is frought with difficulty. Part of the reason I, and many others (as I have seen on this board) have wondered aloud if they themselves might be so afflicted, is because to some extent we all have a little "personality disorder" to contend with. Since personality disorders are defined largely as an exaggerated form of the "normal" personality, it's not hard for relatively normal people to recognize some aspect of themselves in the definition. Certainly, some of us have more of such problems than others. It seems to me that the bona fide BPD sufferer ought to be pretty easy to identify. Even then, it's a matter of degree, not kind, e.g. you don't just get a little angry, you get totally enraged.
It might be helpful to get a second oppinion from another psychotherapist. You might even hunt around for someone who specializes in personality disorders. I think one practical concern is: Will you recieve a different kind of therapy if you do have BPD, one that is specifically tailored to BPD sufferers, and is thus inappropriate for non-borderline patients? For instance, there are strains of behavioral therapy, like dialectical behavioral therapy, which were developed to treat personality disorders. The dialectical approach may or may not be good for you, regardless of your diagnosis. It really depends on what you need. Some people just use straight cognitive-behavioral therapy to deal with personality disorders, tweaking it as needed to suit the specific concerns. In that case, you might find that all your therapist is doing is treating YOU, the person with a problem, and not using a cookie-cutter approach.
In other words, the diagnosis may or may not be all that important in the end. Just say you go along with the BPD angle. Where would it lead you? Maybe, in the end, the label put on you could be of relatively little importance. Your issues with depression and OCD don't go away whether or not you have BPD, and your treatment may well take account of that fact. Lots of people with personality disorders have comorbid psychiatric disorders, and this has to be addressed when treating them.
Best of luck!
poster:Adam
thread:24005
URL: http://www.dr-bob.org/babble/social/20020517/msgs/24251.html