Profiles of Borderline Personality Disorder: David O'Garr

After hitting a writer block earlier this week, I spoke to a fellow counselor about my work with DBT and that I specialize and take an interest in Borderline Personality Disorder.  As is often the case, my fellow counselor was stunned that my specialty was the one diagnosis she avoided working with "at all costs."  Being I speak with those with BPD on Twitter daily, I thought a simple way to change the stigma of "Borderlines" would be to do interviews with people with BPD and put a face with the diagnosis.  I was surprised when I put the ABP out and got 6 responses in a few hours.  The interview also took longer than I expected, but I hope to have 2 profiles out a week for the next month or two.

Being Misdiagnosed

Without further ado, I present David O'Garr, male age 29 years old and from Canada.  David is very open and honest in his life, and writes a blog about his struggles with BPD.  David comes from a large blended family, that were invalidating, although he remains close with his mother. Before his BPD diagnosis he felt jerked around by the Mental Health community, "It got to the point that every time I talked to a doctor they just wanted to prescribe me something else, and I kept saying that this isn't working we need to do something else. But instead of referring me to someone, they just kept telling me that the waiting lists for psychiatrists was too long and it wouldn't' help me."  He was diagnosed in March 2011 with BPD, Generalized Anxiety Disorder, Dysthyia and ADHD Inattentive Type. after 17 years of being diagnosed with depression and on a variety of antidepressants, "I was on meds off and on from 11 - 28  none of them worked."  David found out he had Borderline Personality Disorder after knowing something was amiss for years last March, after waiting almost 2 hours to see a Psychiatrist , "he spent 20 minutes with me, told me I had BPD, referred me to a different Psychiatrist and sent me on my merry way.  So I left there, not knowing up from down, not knowing what BPD actually was, basically thought I was being told that I was not a real person pretty much.  That everything I thought was me was a lie...And to top it all off, I felt disrespected, not listened to, and treated like I didn't actually matter."   

The Hardest Part: Romantic Relationships

As David read about the diagnosis he felt unsettled, "Well the first things I were reading was that it was most often diagnosed in women and gay men.  Which made me feel that the diagnosis was actually wrong, that the treatment of it in the medical field was actually sexist and misogynist in nature (I'd say homophobic, but homophobia also has it's roots in misogyny.)  That we were basically being treated for 'hysteria'  I also came across a lot of blog posts by men stigmatizing women with BPD.  Which was a bit heart breaking to read as well."  David is one of only 3 men, I have meet with the Borderline Personality Diagnosis, "I've also been basically written off in discussion and debates, and told well he's a 'borderline' so not worth engaging with.  It's actually those things that have made me really scared of being in a relationship.  That I would be seen as being 'psychotic' 'crazy' and 'clingy' and I have seen how I've been in relationships and it scares me."  David states he struggles with romantic relationships the most, having BPD, "I find love to be the hardest and most difficult emotion to regulate...It's the intimate relationship thing.  I want nothing more then to find a partner, settle down, create a home and a family for myself.  Get a dog, maybe adopt kids.  It's funny I actually wrote a piece about this not too long ago, about dating with BPD after some pretty crappy experiences this summer.  I have actually been really upfront with guys about what I'm like or I try to be before I had my diagnosis I have said like 'I feel things larger then life, it it's difficult for me to dial it back.' After my diagnosis, I explain what my diagnosis is, and what it meant."  "That I have no interest in dating someone, but if you're perusing me you need to know this, because I can't handle someone who is just going to run the first time I get triggered  and fly off the handle about something.  I get a lot of, 'that's okay', 'I'm still interested' 'I like you for you', or we'll work through it.  But then the first time they're confronted with me being angry and pissed off they totally and utterly just cut me off..tell me I'm melodramatic and they don't have time for that."   

"I pretty much hold that Marilyn quote pretty near and dear to my heart after my experiences: “I'm selfish, impatient and a little insecure. I make mistakes, I am out of control and at times hard to handle. But if you can't handle me at my worst, then you sure as hell don't deserve me at my best.”  Actually it's funny because I usually break it to them with that quote. It's like, do you know what this means? Do you know what this actually means? I think a lot of people use that quote because they think it applies to them, but I think that quote applies to people with BPD so much more.  We can totally be out of control and selfish and impatient, but we can also be so completely and utterly selfless and our ability for empathy and compassion I think is amazing too.  That we have bad things and good things, and our good ones really make it worth it.  If you can give us the time to prove that. 

Support

"I have an awesome support system.  My roommate, which I wish I could love romantically because it would make my life simpler.  He's an amazing man, he has his faults too, but when I freak out he just lets me do it and either walks away or goes out, and then when I done I usually apologize to him for having to see that and he just shrugs and we watch TV or a movie, or play video games.  There's also my mother, who's a big PFLAG mom, she's also trying very hard to learn what BPD is all about and doesn't quite get it yet.  And my best friend, who I am able to talk about pretty much anything and everything with.  She's been there for me through a lot of my life, and is really the strongest part of my support network."

Stigma

David would most like to change people's opinion of the diagnosis, "I wish people would understand the part about how difficult it is for us to deal with just every day.  The ups and downs of our emotions are a roller coaster and a lot of times we can't deal and really just want to get off the ride...That being melodramatic isn't us being vindictive or malicious, but a result of us trying to cope and ride the wave of emotions without having the tools to do it in a way that meets the limitations of acceptable behavior or the 'status-quo' of our pretty backwards society.  That being clingy, is me trying to be connected, and all I need is reassurance that you respect that, that you still care and you do want me.  That once I'm reassured, you can do whatever you want, within limits of course."  Exactly, the funniest thing is that it's that first part of the relationship that's the hardest, because that's when I need the most reassurance once the trust is built, and I know you're not going to leave, is when I know I'm more relaxed, but I can never get to that stage."

Getting Better

David has mostly utilized CBT therapy, although he found DBT group more helpful, "Well did a lot of CBT which I found unhelpful because none of my therapists really seem to understand what I was going through.  And I've had a few.  But still the same methods were applied over and over again, and I got really good at talking around my therapists, to the point where I have finished treatment with multiple therapists with them saying I didn't need anymore treatment...I got so good at telling people what they want to hear, that I just said it because I felt frustrated with them.  Then I have taken a six week DBT crash course and I found that REALLY helpful, and I am now just waiting for the year long treatment."

When asked what David has learned about himself since this journey began for him at age 11, "I have learned a lot.  I have learned not to change myself for other people, because once learning about that as a symptom I started catching myself doing that.  I have found that medications can help if you start taking the right ones.  I have found that I don't always need to be right, and my need and want to be just stemmed from my need and want to be accepted."

Book Contest Winners!

*The e-books were e-mailed out today and the other 2 books were ordered and will arrive shortly*

I am happy to announce the winners, whom  all have been notified.  I received 53 entries and had 12 winners in total- twice as much as November's contest.  Some of you entered here and on twitter and a few daily.  Below are the winners.  If you won Buddha and the Borderline or Gift of Imperfection please e-mail (alicia.paz.ma(at)gmail.com) or DM on twitter your physical address so I can have it shipped to you via Amazon.  I will send the e-books and 2 other books out once I get everyone's e-mail and physical addresses- hopefully Monday.) I abbreviated all names listed below for privacy.

Stop Sabotaging: 31 Day DBT Challenge to Change Your Life

• Stephanie J (Blogger)
• Jennifer C (Blogger)
• Paul K (Twitter)
• Tee B (Twitter/Blogger)
• Befuddled N (Twitter)
• The Guy... (Twitter)
• HeavensP (Blogger)
• Rhonda (Blogger)
• Cass (Blogger
• Dltd (Blogger)

The Buddha and the Borderline

• MsStitch (Twitter)

The Gift of Imperfection

• Stephanie E (Twitter/Blogger)

Dealing with trauma issues with BPD

Although the DSM IV-r criteria for Borderline Personality Disorder does not include trauma, it is often a common thread in those with the disorder.  Often on Twitter I see a tweet started with "TW" (trigger warning) before something that may be triggering, it's a safety boundary for many in the BPD community.  In DBT we strictly enforce the rules about saying things that can be triggers, sometimes those who don't have BPD don't realize how harmful what they say can be, sometimes people try to stir up some drama and some are so disconnected from their trauma they don't understand how someone could be hurt by what they are saying.

Adults with borderline personality disorder (BPD) showed excessive emotional reactions when looking at words with unpleasant meanings compared to healthy people during an emotionally stimulating task, according to NIMH-funded researchers. They also found that people with more severe BPD showed a greater difference in emotional responding compared to people with less severe BPD. The study was published in the August 1, 2007, issue ofBiological Psychiatry. [source]

This week myself and a client came to the conclusion that talking about her trauma only continues to hurt her more than help her.  Creating a boundary became necessary since other clients continue to push her to speak about the horrific trauma thinking that like them she needs to "get it out and give it away." In group she announced this decision and the overall look was puzzled, so we decided to allow questions as this appeared to go against everything they have been taught since being in therapy.  The questions were in 3 categories; 1) doesn't keeping it in, keep us sick? 2) How does talking about it make it worse? 3) So what are you going to talk about then?  The group decided to respect her boundary, although they were skeptical.  I decided to not go into the details of Borderline Personality Disorder since the client had told me she was not comfortable with that.

The end question was then "Ms. Paz, how is she going to work on her trauma issues without talking about it?"  I spoke about working on how the trauma affects you now; relationship issues, boundaries, PTSD symptoms and focusing on coping skills and grounding techniques instead of living in the past.  The group was still unsure about this plan as it goes against what they have (thought) they have known for most their life.  HEre are some ways to work on your trauma without talking about the trauma [source]

1. Tell yourself that you are having a flashback  

2. Remind yourself that the worst is over.  The feelings and sensations you are experiencing are memories of the past.  The actual event has already occurred and you survived. Now it is the time to let out the terror, rage, hurt, and/or panic.  Now is the time to honor your experience.  

3. Get grounded.  This means stamping your feet on the ground to remind yourself that you have feet and can get away now if you need to.  (There may have been times before when you could not get away, now you can.)  Being aware of all five senses can also help you ground yourself.  

4. Breathe.  When we get scared we stop normal breathing.  As a result our body begins to panic from the lack of oxygen.  Lack of oxygen in itself causes a great deal of panic feelings; pounding in the head, tightness, sweating, feeling faint, shakiness, and dizziness.  When we breathe deeply enough, a lot of the panic feeling can decrease.  Breathing deeply means putting your hand on your diaphragm, pushing against your hand, and then exhaling so the diaphragm goes in.  

5. Reorient to the present.  Begin to use your five senses in the present.  Look around and see the colors in the room, the shapes of things, the people near, etc.  Listen to the sounds in the room:  your breathing, traffic, birds, people, cars, etc.  Feel your body and what is touching it: your clothes, your own arms and hands, the chair, or the floor supporting you.  

6. Get in touch with your need for boundaries.  Sometimes when we are having a flashback we lose the sense of where we leave off and the world begins; as if we do not have skin.  Wrap yourself in a blanket, hold a pillow or stuffed animal, go to bed, sit in a closet, any way that you can feel yourself truly protected from the outside.  

7. Get support.  Depending on your situation you may need to be alone or may want someone near you.  In either case it is important that your close ones know about flashbacks so they can help with the process, whether that means letting you be by yourself or being there.  

8. Take the time to recover.  Sometimes flashbacks are very powerful. Give yourself time to make the transition form this powerful experience. Don't expect yourself to jump into adult activities right away.  Take a nap, a warm bath, or some quiet time.  Be kind and gentle with yourself.  Do not beat yourself up for having a flashback.  

9. Honor your experience.  Appreciate yourself for having survived that horrible time.  Respect your body's need to experience a full range of feelings.  

10. Be patient.  It takes time to heal the past.  It takes time to learn appropriate ways of taking care of yourself, of being an adult who has feelings, and developing effective ways of coping in the here and now.

 Stay safe.
AP

Hopelessness and Suicide

At the women's prison I work at they have a new job, essentially life sentenced inmates who have had specialized training are now "observing" other inmates who are in segregation due to suicide (talk of it, paraphernalia or an attempt.)  This is a controversial plan; inmates watching other inmates and when necessary calling for an Officer.  The inmates who have just started this say more than anything it is boring; lots of downtime, odd shift hours- but they get paid for it and these are "mentors," in our program.  I spent part of this week talking to one of these inmates about her shift last night which began at 2am and she told me about the training and what she had learned about suicidal risk factors.  She did not mention the #1 risk factor for suicide, which is hard to assess as an observer- hopelessness.

From this amazing documentary interviewing people who jumped

Hopelessness is the despair you feel when you have abandoned hope of comfort or success.  I often refer to hopelessness of being in a black box and being able to see a way out.  Hopelessness is the #1 indicator of suicide; more than age, gender or even past attempts.  When someone does not see a way out, or things improving they are more likely to hurt themselves.

The Beck Hopelessness Scale is a 20-item self-report inventory developed by Dr. Aaron Beck. It is designed to measure three major aspects of hopelessness: feelings about the future, loss of motivation, and expectations. The test is designed for adults aged 17 – 80.Individuals completing the scale are asked to answer the questionnaire based on their attitudes during the preceding week. It may be administered in written or oral form, and each item is scored with a true/false. Total scores range from 0-20 with higher scores indicating a greater degree of hopelessness. 

Beck’s cognitive model of depression focuses on a “cognitive triad” which includes negative thoughts about self, the world/environment, and the future. Hopelessness is the experience of despair or extreme pessimism about the future. As such, hopelessness is part of the “cognitive triad” of depression, but it also plays an important role in predicting suicide. [source]

Although I typically advise against taking any online quizzes to determine any mental health diagnosis, there is a copy of the "test" here if you are interested to see where you might be at this moment on the scale.  I would advise that if you feel you are at risk for hurting yourself you immediately call your local crisis line or go to the hospital to keep yourself safe.

I always tell client's who are suicidal, that by taking their own life they won't ever know if it gets better; their mood improves naturally, situation at home/relationship change or if new medications will hit the market.  They will never know what their life is going to be like in 2 or 20 years, if they end it right now.