What Can't be Fixed

[Guest guest]

Learning so much about BPD AFTER nada's death is sometimes troubling. I had

always wondered why nada didn't " fix herself " with counseling. Then I learned

that personality disorders are " Axis II " in the DSM and are generally not

thought to be treatable. Guess I have to let go of those feelings of blame! One

can't fix what can not be repaired.

Beth

[Guest guest]

Well, keep in mind that the " Axis " definitions have this disturbing

tendency to shift rapidly and without warning. People at TARA have been

advocating strongly for renaming BPD as " Emotional Dysregulation Disorder "

and sticking it on Axis I, because they think it's caused by a neurological

problem. I tend to think they're more wrong than right about that, but the

point is that the Axis labels are not universal truths, they are " our best

guesses at the moment. "

BPD is definitely treatable, but getting the BPD to take part in therapy

long enough and seriously enough for it to start working is a challenge, to

put it mildly. So the question then comes up: If a person has a mental

illness -- biological or not -- and they refuse to get help, are they to

blame or not for the bad stuff they do? Generally our society says that if

a person knows they have a mental illness that causes them to be dangerous

to others, and they refuse to treat it, they are fully responsible for any

damage they do. Paranoid schizophrenics who go off their meds and kill

someone do not get off Scot free, although they may get a reduced sentence

for mitigating factors. But they ARE held responsible -- that is, they are

blamed. Same goes for a bipolar who acts in a reckless fashion during a

manic phase and kills someone through negligence -- he's in big trouble if

he had that manic episode because he decided not to take his meds.

The real issue with mental illness is, that because it's often so hard to

define and " prove " , we have strong social controls in place for forcing

treatment on suspected sufferers. If the problem were biological and

easily diagnosed, this wouldn't be an issue. For example, say a guy is

dragged into the emergency room by cops because he assaulted someone. He's

examined and it's discovered that he's running a terrifically high fever

from bacterial meningitis, and he's delusional and thinks he's been

captured by Al Qaeda and has to fight his way free. Because the doctors

can simply check his temperature and do a spinal tap and go " Yeah, he is

DEFINITELY really sick! " , they are allowed to sedate him, treat him with

antibiotics and try to save his life, even if he fights them at every step.

The doctors can prove that this man literally does not have any idea of

what he's doing -- it's the fever and infection talking. So they can force

treatment on him.

Unfortunately we don't have any easy diagnostic tests for mental illness,

and there's been a ton of grief in human history over classifying someone

as " mentally ill " when in fact the only issue was that someone in power was

irritated with them. People have been subject to a lot of really nasty

stuff -- false imprisonment, horrific " treatments " , forced lobotomies --

because someone else incorrectly identified them as " insane " , and the

victims were usually the vulnerable in society like women and children and

minorities (recent immigrants and blacks especially.) So these days, you

basically have to wait until AFTER someone hurts themselves or others

before you can take real action to force treatment or forcible restraint on

them.

Anyway, people can and do blame those who have mental illnesses for their

bad behavior if they are capable of recognizing that their behavior is bad.

Mental illness is NOT an excuse, although way too many sufferers and

enablers have tried to use it as one. You are " let off the hook " for bad

behavior only if your mental illness is so extreme that you literally do

not know that you did a wrong thing. For example, to take an urban legend

and modify it: If you are hallucinating so severely that you really

believed the baby was a turkey and you cooked it in the oven, you may not

be guilty of murder, because you really thought that was a turkey and you

had no desire or wish to roast the baby or even any awareness that you were

doing so. But you'll definitely end up involuntarily committed for a while.

Maybe a long while.

So the issue of " blame " when mental illness is involved is a contentious

one at best.

I tend to take the attitude of, " I'm sorry your mental illness caused/is

causing you to treat me very badly. I'm going to go away now. If you get

treated such that you can stop the hurtful behavior, I may consider coming

back. Goodbye. " I might leave the phone numbers of some social help

organizations or psychotherapists if I'm feeling generous.

Just because someone is mentally ill does not mean you MUST tolerate abuse.

Period. You can absolve them of blame and still walk away to save yourself.

It's allowed.

-- Jen H.

> **

>

>

> Learning so much about BPD AFTER nada's death is sometimes troubling. I

> had always wondered why nada didn't " fix herself " with counseling. Then I

> learned that personality disorders are " Axis II " in the DSM and are

> generally not thought to be treatable. Guess I have to let go of those

> feelings of blame! One can't fix what can not be repaired.

>

> Beth

>

>

[Guest guest]

Exactly...

[Guest guest]

They can't help it but doesn't mean we have to take it EVER.

On Sat, Dec 1, 2012 at 3:49 PM, Janice Hall janicehalldesigns@...>wrote:

> **

>

>

> Exactly...

>

>

>

[Guest guest]

Along the same lines, though, just because someone with bpd does go in for

treatment it doesn't necessarily mean they're going to get better. My nada

decided to go into psychotherapy, but only because it was a condition Sister

(and I) imposed on her before we'd even consider resuming contact with her. As

it turned out, our ultimatum didn't work at all.

Nada herself didn't actually believe there was anything wrong with her. Nada

ended up (according to Sister) hating her therapist and stopped going after

about 6 months.

Initially, after a brief period of a seemingly miraculous breakthrough of

personal insight and a new, improved attitude and behaviors, our nada reverting

back to her histrionic, domineering, controlling, raging self after a

spectacular rage-tantrum/meltdown directed at Sister, during which nada claimed

that there was nothing wrong with her, she'd always been the perfect mother to

us, Sister and I were the crazy, hateful ones and we had told lies about her (to

the therapist) and she only went into therapy to learn how to " deal " with us.

Randi Kreger (the owner of this Group), in her articles and books about bpd has

relayed that the statistics indicating that those with bpd respond well to

treatment are based on very young, very low-functioning teen girls with bpd who

are suicidal and in residential treatment centers.

Those are the bpd patients who respond well to dialectical behavioral therapy.

The older, higher-functioning bpds aren't counted in the statistics because they

rarely seek therapy for themselves. They are in an " ego syntonic' state,

meaning that their bpd condition doesn't bother or upset them. They feel

totally justified and entitled to think, feel, and act the way they do. In

their mind they are " just fine, thank you very much, " and its everyone else who

is mean, hateful, ungrateful, insensitive, rude, self-centered and causing all

their problems. " Why should I seek therapy when there's nothing wrong with me? "

is the way " ego syntonic " thinks; they remain in their victim state, never

taking personal responsibility for their own words or deeds, blaming others and

projecting instead of gaining true insight and positive change.

-Annie

>

> > **

> >

> >

> > Learning so much about BPD AFTER nada's death is sometimes troubling. I

> > had always wondered why nada didn't " fix herself " with counseling. Then I

> > learned that personality disorders are " Axis II " in the DSM and are

> > generally not thought to be treatable. Guess I have to let go of those

> > feelings of blame! One can't fix what can not be repaired.

> >

> > Beth

> >

> >

[Guest guest]

Absolutely agreed. It's a message that gets said again and again on this board

but it remains no less true for the number of times it's been said: boundaries

are created (by us) to protect us, and lay out what we will do if they're

crossed. They don't protect us against the inevitable breaking of them by our

BPDs, they just allow us to set the context for how we protect and respect

ourselves regardless of what things others may do. The BPDs in our lives will

cross those boundaries (intentionally or unintentionally) but we do not have to

let that go on, nor do we have to internalize their breaches as our fault.

We can make and keep boundaries that protect us against our BPDs' (sometimes)

unwitting (often more like " deniable " than truly " unwitting " ) attacks.

>

> > **

> >

> >

> > Exactly...

> >

> >

> >

[Guest guest]

Thank you Annie!

This information very much helps me process my current concerns regarding nada.

You are helping me to realize that nothing in this world was going to change

her. I now have even fewer regrats about going NC for self protection.

Beth

Re: What Can't be Fixed

Along the same lines, though, just because someone with bpd does go in for

treatment it doesn't necessarily mean they're going to get better. My nada

decided to go into psychotherapy, but only because it was a condition Sister

(and I) imposed on her before we'd even consider resuming contact with her. As

it turned out, our ultimatum didn't work at all.

Nada herself didn't actually believe there was anything wrong with her. Nada

ended up (according to Sister) hating her therapist and stopped going after

about 6 months.

Initially, after a brief period of a seemingly miraculous breakthrough of

personal insight and a new, improved attitude and behaviors, our nada reverting

back to her histrionic, domineering, controlling, raging self after a

spectacular rage-tantrum/meltdown directed at Sister, during which nada claimed

that there was nothing wrong with her, she'd always been the perfect mother to

us, Sister and I were the crazy, hateful ones and we had told lies about her (to

the therapist) and she only went into therapy to learn how to " deal " with us.

Randi Kreger (the owner of this Group), in her articles and books about bpd

has relayed that the statistics indicating that those with bpd respond well to

treatment are based on very young, very low-functioning teen girls with bpd who

are suicidal and in residential treatment centers.

Those are the bpd patients who respond well to dialectical behavioral therapy.

The older, higher-functioning bpds aren't counted in the statistics because

they rarely seek therapy for themselves. They are in an " ego syntonic' state,

meaning that their bpd condition doesn't bother or upset them. They feel totally

justified and entitled to think, feel, and act the way they do. In their mind

they are " just fine, thank you very much, " and its everyone else who is mean,

hateful, ungrateful, insensitive, rude, self-centered and causing all their

problems. " Why should I seek therapy when there's nothing wrong with me? " is the

way " ego syntonic " thinks; they remain in their victim state, never taking

personal responsibility for their own words or deeds, blaming others and

projecting instead of gaining true insight and positive change.

-Annie

>

> > **

> >

> >

> > Learning so much about BPD AFTER nada's death is sometimes troubling. I

> > had always wondered why nada didn't " fix herself " with counseling. Then I

> > learned that personality disorders are " Axis II " in the DSM and are

> > generally not thought to be treatable. Guess I have to let go of those

> > feelings of blame! One can't fix what can not be repaired.

> >

> > Beth

> >

> >

[Guest guest]

Thank you for these facts and statistics...

Incredibly useful....