hey everyone this week's video is coming
by popular demand borderline personality
disorder eating disorders and self-harm
how do they relate and so stay tuned
towards the end of the video because I'm
going to give you the dirty little
secret about therapy so I know a lot of
you have asked me about borderline
personality disorder or otherwise known
as BPD which is easier for me to say to
be honest because borderline personality
disorders like little I'll probably mess
it up so BPD is something that a lot of
us struggle with we may have been told
by one person that we're diagnosed with
it or we have BPD like symptoms and a
lot of us just wonder what the heck does
that mean and if I do have it why is
every act like it's such a bad thing
right now just to give you a little
background on what borderline
personality disorder is is it's really
in my opinion it's our minds way of
coping with things and I'm going to read
to you a little bit from the DSM so that
you know when someone says you may have
BPD like symptoms or you actually have
BPD what they're really talking about
okay I'll try to make this very clear
and concise because a lot of times
people throw words around that don't
really pertain to us and I want you to I
want to make sure you understand what
BPD really is so the DSM states that we
have to have 5 or more of the following
and this is the older DSM because the
new one isn't quite out yet so when the
new one comes out I'll get it and then
we'll see if there's any changes but I
don't think there is to this so the
first one in the 1 I've talked about
before and another one of my videos is
frantic efforts to avoid real or
imagined abandonment and this was in my
fear of abandonment video and this one's
probably the most common that I see in
borderline patients but like I said you
have to have 5 or more that's only 1 the
second a pattern of unstable or intense
interpersonal relationships
characterized by alternating between
extremes of idealization and devaluation
now in the therapy world we talk about
it people putting us on a pedestal or
throwing us under the bus see you either
of me or you just hate my guts and you
wish I'd go away right it's that extreme
up and down and that's usually what
people will notice first is that because
they're in relationships with you so if
you're hating them and loving them in
two days they're like oh you know and
that can be really hard now the third
one is identity disturbance markedly and
persistently unstable self-image or
sense of self now we're all like Wow
well that applies a lot of people and
that's why you have to have at least
five of these but I think that that one
point is why it's so linked to eating
disorders okay because we don't think
very highly of ourselves we have a very
distorted vision of who we are what
we're about and that can lead to a lot
of other things like like eating
disorders right and then the next one is
impulsivity in at least two areas that
are potentially self damaging this could
be anything from spending habits like
we'll go on spending sprees or it could
be sex where we have sex with a bunch of
different strangers and it's not really
we're not safe about it and we just act
impulsively right it can be any kind of
thing like that I think in here they say
yeah substance abuse reckless driving
binge eating so again connected to
eating disorders right then the next one
the fifth one is recurrent suicidal
behavior gestures or threats or
self-mutilating behavior now this was my
frustration with the new DSM because
self-mutilating behavior or self-harm
doesn't just occur when we have
borderline personality disorder but the
DSM only puts it in here so we'll work
on that right but a lot of us struggle
is suicide and I find with my borderline
patients many of them use suicide and
suicidal ideation as a way to work on
that abandonment because they're afraid
someone's going to run away so then we
act out and we say well I'm going to
commit suicide or I'm hurt myself and
and that gets people back in our lives
right and that makes sense I can see the
connection can't you so that's kind of
how that's used the sixth thing is
affective instability due to a marked
reactivity of mood so this is like
you're intensely irritable or eggs
and it's usually it lasts for a couple
hours so our mood is just unstable all
over the place I might be really happy
one minute and then really mad and sad
the next it's like ah it's all over and
it feels really crazy so that but it
doesn't usually last more than a couple
hours at the most a day if it lasts
longer than that then it might be
bipolar which I'll talk about another
video let's not get distracted okay on
to the next one so number seven is
chronic feelings of emptiness I know
we're all thinking
well [ __ ] Kati I feel like that that's
me oh but remember we have to have five
of these and you may feel like a lot of
these pertain to you and I can really
connect with that and that's why you may
have heard oh I
you have borderline tendencies or
borderline like symptoms right because
we don't meet all criteria so that was
the 7th there's two more I'm almost done
now the eighth is inappropriate intense
anger or difficulty controlling anger
now this is that I feel like a lot of
these kind of go hand in hand but with
the eating disorders in self-harm you
know how I just talked about my PTSD
video how we wranger out or where anger
in well this is saying that we have
inappropriate intense anger so we really
don't have a place to put it we don't
really know why it's there but we feel
it and it's bad and blah you know so
that's another way it relates and the
last one is transient stress-related
paranoia or paranoid ideation or severe
dissociative symptoms now that also kind
of goes in line with my PTSD video
because remember how I talked about the
ways that we kind of deal with a
situation and some of us can actually
dissociate like I'm trying to think of
what I even talked my binge I when I
talk about binging and bulimia when
you're kind of an out-of-body experience
like I can't handle this I'm stepping
out well and you like watch yourself
doing stuff that's kind of what
disassociation is because we are too
intense everything is too intense that
we can't even be present like fully
present in the in the moment
okay so that's what borderline
personality disorder is and you can see
how it ties into
our self-harm behaviors and our eating
disorder but remember we have to meet
five of those criteria to be properly
diagnosed and we may go in and out we
may meet some sometimes and some not the
other times but that gives you an idea
of what it is now the dirty little
secret of therapy and kind of something
that I think is really important for you
to know and I I feel like many
therapists might be like well thank God
somebody's finally telling people this
because I know a lot of you tell me all
the time yeah I keep getting passed
around and people will say I don't
really deal with that and and we don't
know what to do
we're like well holy moley I've been
looking for therapy forever and I
finally get to see somebody and then
you're like I don't see you great thanks
for nothing right and it's really
frustrating and that can happen a lot
and that even perpetuates our struggle
with abandonment if we are borderline
right we're like holy moly
so why does it happen why why do we feel
like we're so like the black sheep and
that's really because even in school as
a therapist they tell us how difficult
it is to treat someone with borderline
personality disorder and I almost feel
like yeah they should let us know but
instead of saying that and just making
it like you don't want a lot of
borderline patients they're really hard
to deal with and yeah because you're
volatile your moods all over the place
you feel completely out of control and
you're afraid people are going to hurt
you and you want to hurt yourself I mean
it makes sense right
but as a therapist I'm not afraid of
borderline patients it's really not that
hard to deal with and that's why to be
honest why I tell you I'll get a DBT
workbook join a DBT group
DBT which stands for dialectical and
behavioral therapy is the best thing
it's the saving grace for people who
struggle with borderline because it
helps us get in control of our emotions
a little bit more instead of feeling
like they control us so that extreme
fear of abandonment the mood volatility
the suicidal ideation all of those
characteristics that intense anger can
all be calmed we recognize it coming in
we can feel it we use our mindfulness
there's a lot of techniques that they
use and it can kind of bring us back
down
so that's why people avoid borderline
illan people get a bad stigma and it's
really not so bad we just have to work
together we need to get our DBT workbook
we need to start working on it I know
it's hard and it's intense and you feel
it and ah right but then we're calmer we
feel better and therapist will be more
willing to work with you and I just hate
that it's given such a bad rep but
people don't talk about it they don't
let us know they don't tell you other
than we won't see you anymore I need to
refer you out and that just makes us
feel like [ __ ] right so that's kind of a
little insight into why that happens so
I hope that makes sense and I hope that
that kind of clarifies what BPD is why
it's given a bad rep how we're diagnosed
with it and how we can work on it so hop
online there's a great workbook for
dialectical and behavioral therapy by
Marcia liniment she's the one who did
all of the research on DBT and she's
actually one who I think even coined the
phrase DBT therapy check it out
take time look into it look into D be
true beat bit C DBT groups in your area
we can get a hold of this we can work
together and then we can get the help
that we need right so stay tuned for my
next videos don't forget to subscribe
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healthy mind and a healthy body