Wednesday, 5 July 2017

The role of the therapist is to reflect the being/accepting self that was never allowed to be in the borderline

A common misconception with mental illness is assuming that because your depressed friend receives this specific treatment to manage his/her depression, that the same will apply to your schizophrenic friend or your friend who suffers from bipolar. While if you have the same diagnosis (for example, people who suffer anxiety receive cognitive behavioural therapy), similar or the same modular of treatment will help you. But please keep in mind, everyone experiences their mental illness differently. A cancer patient will need chemo, and a person with a broken leg would need an xray. The same applies for mental illness, each diagnosis needs a different treatment method in order to get the best possible help required. So today I am going to give you an insight to the treatment I will be receiving for Borderline Personality Disorder and my symptoms of Post Traumatic Stress Disorder. 

The specific treatment needed to manage Borderline Personality Disorder is known as Dialectical Behavioural Therapy. Dialectical Behavioural Therapy (or DBT) is a cognitive behavioural therapy created to treat chronically suicidal individuals diagnosed with Borderline Personality Disorder, and it is now recognized as the immediate go to therapy for people with BPD diagnosis. Research has shown success for DBT in other disorders such as substance dependence, Depression, Post Traumatic Stress Disorder and Eating Disorders. 

DBT includes four sets of skills the individual will learn when starting treatment. Mindfulness- the practice of being fully aware and present in this one moment, Distress Tolerance- how to tolerate pain in difficult situations, not change it, Interpersonal Effectiveness- how to ask for what you want and say no while maintaining self respect and relationships with others and Emotional Regulation- how to change the emotions that you want to change when in moments of distress and pain. For example, one of the biggest challenges I face with my disorder is dissociation. So when I start to feel distressed, I will shut off completely and not be aware of what is happening in that moment in time. Even though I have learnt aspects of mindfulness, I still have to master distress tolerance for my dissociation to not become life threatening when i am triggered. 

The term Dialectical means a synthesis or integration of opposites. The dialect found in DBT is between the opposite strategies of acceptance and change to the ones you have acquired. Therapists accept clients as they are as well as acknowledging that they need a more strong skill set in order to survive. The four set skill module above includes acceptance-oriented skills (mindfulness and distress tolerance), and two sets of change-oriented skills ( interpersonal effectiveness and emotional regulation). 

DBT is an intense process. It includes group therapy, individual therapy and having a consultation therapy team, making sure the individual is receiving the best treatment that they can. Research has shown DBT to be successful, reducing suicidal behaviours, self harm, anger, substance use and improving social and global functions. DBT was invented by Dr Marsha Linehan, an American Psychologist who was diagnosed with Schizophrenia. It was later on she was misdiagnosed and actually was suffering from Borderline Personality Disorder. She went on to continue her studies in Suicide Prevention and Behavioural Modification. During her studies in Psychology, she developed DBT to manage her own illness of Borderline Personality Disorder. 

I hope when I start this treatment I have been waiting to do for the past 11 years of my life, that I can be able to live life to the best of my ability. I know I may be near that mark, but it was discovered last year when I was in Therapy in Melbourne, that there is a gap in  my skill set. I want to be able to wake up every day not feeling chronically suicidal, fragile and numb. I am hoping this treatment will make me feel complete and able me to continue moving forward. Although I am a firm believer in that you never fully recover from a mental illness, you will find ways to manage it better and ease the pain that you feel internally every day. I know how many people I am already helping, and I want to continue to be that small hope in someone else's world of pain. 

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