Excerpts from comments by

Jim Breiling, Ph.D.

Program Head – Psychopathology, Behavioral Dysregulation, and Measurement Development Program

Adult Psychopathology & Psychosocial Intervention Branch

Division of Adult Translational Research and Treatment Development (DATR)

National Institute of Mental Health (NIMH)

May 9, 2007 -- As the time yesterday approached the 12:30 start of the briefing, Congressional staff began to arrive at the meeting room in the Capitol. Soon my expectation that perhaps 20 staff would attend was fulfilled. I thought that was quite successful for an initial foray into informing Members of Congress and their staffs about the disorder.

More staff came. All the seats filled. This was far beyond my expectations. Still more came. The standing room space in the meeting room filled. And still more came, clustering around the door to the meeting room. I counted more than 60 staff. Incredible!

Both in and outside the room, staff listened attentively. Their good questions demonstrated engagement.

The briefing was rich in information and very powerful in presenting the burden of suffering that the disorder inflicts and other problems relating to the disorder, e.g., not getting diagnosed and then not having access to helpful treatment. (While there are helpful treatments – DBT was singled out for well deserved recognition -, the need for more effective treatments, psychological and biological, is unquestionable.)

Presenters spoke from text or from Power Point and the briefing was video taped, so I'll only touch on some of the high points.

In Perry Hoffman's welcome and orientation to the briefing, a question and the answer set the foundation for me for the elaboration of impacts and needs:

What does borderline mean?

There is nothing borderline about the illness;

the suffering,

the inaccessibility to care,

the gaps in our knowledge,

the need for research,

the impact of the illness on others.

The next presenter was Tami, a consumer of courage, who began her articulate and moving story of the experience and impacts of the serious mental illness that is borderline personality disorder, by engaging staff with the reality that this illness can and does strike within the ranks of staff and their friends and acquaintances.

My name is Tami and I have Borderline Personality Disorder.

Some 20 years ago, I walked these very halls, lobbying and educating Congress. I went on to raise a family and have had a very successful like as a corporate salesperson and business consultant.

My IQ is in the 130s range; I am well-educated and well-spoken and have been very effective in many areas of life. It would be hard to notice that I am SEVERELY impaired in some key areas of brain functioning.

Ironically, while my brain allows me to remain comfortable presenting to Members of Congress, the part of my brain that controls my emotions, and the part that helps with impulse control, do not work.

Imagine if your brain replayed over and over and over again the most horrifying tragedies of your life, the saddest moments, the loneliest times, and they became your reality each and every day. That has been my life.

The next presenter, Stacey, a mother whose younger (now 19 years old) daughter has borderline pd, began by engaging the Congressional staff about the seriousness of borderline personality disorder and the challenges that the manifestations of the disorder present for parents and others:

Some years back I watched a friend’s mother die of Lou Gehrig’s disease. The image of that smart vibrant woman loosing the ability to interact with the world and in essence becoming a fully aware prisoner of her own body affected me profoundly. I thought there could be no worse disease. I was wrong.

My younger daughter suffers from a disease wherein her body functions normally, but her motions hold her prisoner and prevent her from having normal, easy interactions with the world around her. For years no one around her understood the emotional storm raging within her that she struggled to live through and in spite of every day. We did not recognize her struggle for the heroic effort it was; instead we often judged her as self-absorbed, lacking in self control and self discipline and above all a major drama queen.

The concluding presenter, Robert Friedel, M.D., drew upon his wide and deep expert knowledge about borderline personality disorder research and his extensive clinical experience in treating it and in presenting about the disorder, to engage the staff in the science and clinical arenas. His presentation was more than that of a highly competent professional. It was also, as Dr. Friedel said to the group, personal -- he lost a sister to the illness.