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Borderline Personality Disorder:
A View from the Inside
by Anna Warde, with Shannon Huggins, LCSW
Published in Recovery Today January 2008
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| I have been participating in a weekly education and support
group called “Family Connections,” a program designed
for the relatives and loved ones of persons with
Borderline Personality Disorder (BPD), a serious mental
illness characterized by pervasive instability of moods,
interpersonal relationships, self-image, and behavior.
While less known than other mental illnesses, BPD is
much more common, affecting approximately 2% of the
general population which is twice the percentage of
people diagnosed with schizophrenia. There is also a
high rate of self-injury without suicidal intent, as
well as a significant rate of suicide attempts and
completed suicides in severe cases. |
| The Family
Connections program was developed by Perry Hoffman PhD
and Alan Fruzzetti PhD, two clinical psychologists and
researchers, in concert with the National Education
Alliance on Borderline Personality Disorder (NEA-BPD).
The program, based on the 12-week research-based
manualized model used so successfully by the National
Alliance on Mental Illness (NAMI) in its well-known
classes such as “Family-to-Family,” has been available
for many years on the east coast and in other large
cities but is now slowly gaining momentum nationwide.
This is due, in part, to NAMI's recent decision to
include Borderline Personality Disorder in its priority
population, paving the way to greater awareness and
understanding of the illness and its impact on the
family. In Austin, we are especially fortunate to have a
local chapter of NAMI (NAMI Austin) that has stepped up
to fully support and fund the first Family Connections
class. |
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Although
only four sessions into the twelve weeks, I have already
developed a great respect for those who deal with this
disorder as a part of their daily lives. The group
consists of roughly a dozen people – some professionals
who work with this population but mostly parents,
children, and spouses of those with the disorder, called
“consumers” in this context because they are often
consumers of mental health services. Each Tuesday
evening, I witness the tremendous amount of confusion,
love, anger, and pain that relatives of consumers
experience. I understand it in the stories they tell,
hear in their tones of voice, see it in their facial
expressions, and feel in the air as if I could reach out
and touch it. It is real and it is raw.
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First and foremost, what I am struck with is the group members' sincere desire to better understand their loved one's illness and to find tools to cope. There is hope that they can learn to work with the situation as it exists and to know that all involved are doing the best they can yet, they can do better. There is also an impatience, best described as a “been there, tried that, didn't work” attitude. Some individuals are in relatively new relationships while other have lived many decades with their ill relative. Some are hot with anger, others are resentfully resigned and still others are on the verge of walking away. Because the group's level of understanding varies, teaching the basics of BPD is critical to developing a shared knowledge-base but not all want to “wait to get to the good stuff.” Like it or not, these individuals still show up every week, on time and ready for another round. |
| Each class
starts with group members rating their recent level of
coping on a scale of one to ten. It appears that for
many in the group, this is a rare opportunity to relax a
bit and think about themselves. This is a forgotten
luxury in a world where chaos is the norm and
self-preservation, not self-reflection, reigns. The
answers vary from week to week and, as one father
pointed out, coping levels often fluctuate several times
in even one day. As the group facilitators present that
week's topic and the group process moves forward, the
comfort level seems to increase. It would be interesting
to take a follow-up rating at the end of each group to
assess changes in perception and perspective as folks
support one another and come to know that they are not
alone. |
| The
sessions are also packed with information and can be
exhausting but, at the same time, energizing. There is a
collective relief in knowing facts about BPD that
validate what those in the group experience and in
knowing that research on BPD is advancing significantly.
It is also a shock to learn that research on this
disorder is nearly two decades behind research on other
mental illnesses, surprising to know that the term
“borderline” is so stigmatized in the mental health
field, and that an inability to regulate emotions is at
the core of the disorder. All of this helps yet the
group members still shake their heads ruefully, wishing
that these explanations had come sooner. Participants
cope with humor, for example, worrying about the people
from “the little house on the prairie days” who could
have benefited from what we know now. The fact that the
group facilitators are “family members” themselves
helps the participants relate to them - they don't have
all the answers and are in the trenches, too, learning
as they teach. |
| The group
is not even halfway through and already there is a
powerful feeling of connection and camaraderie. I find
myself thinking about the participants throughout the
week and I look forward to seeing them and listening to
them. Inside, I root for them to know that they can move
beyond just surviving. Yet I also identify with their
anger. I wish I could give the evil eye to the BPD
mother who can't speak without yelling. I wish I could
kick the demanding ex-wife who uses her children as a
weapon against their father. I wish I could threaten the
out-of-control BPD daughter: “shape up or ship out!” But
then I remember, the consumers are doing the best they
can and this is what the illness conjures. The task is
no small feat for the people that love them. They must
keep their own feelings and needs in mind and know that
they can do better in how they respond to their loved
one, that they now have access to the best and latest
research, that there are strategies that work and that
they are not alone anymore. Four sessions down and eight
more to go. I can't wait for next week to get here. |
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"For more information on Borderline Personality Disorder and/or
the Family Connections program, please visit the
following websites:
www.borderlinepersonalitydisorder.com (this is the
NEA-BPD website);
www.nami.org;
www.nimh.nih.gov. |
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