alternate ways of treating borderline personality disorder

cardiacRN2006, ADN, RN · Jun 24, 2006

ADDRESS THE SUBJECT NOT THE MEMBER MAKING THE POST. THIS IS TO DISCUSS AND DEBATE THE SUBJECT NOT PUT EACH OTHER DOWN.

Sorry, you can't have it both ways. You can't be so insensitive and over the top, and then critisize US for calling you out on it.

LydiaNN · Jun 25, 2006

warzprayer says they have only seen one bpd helped by traditional therapy. so to mercyteapot - why are unsuccesfull traditional therapies paid for over and over again? why not spend money on something new - that might work? somebody talked about child abuse. if child abuse is the prob then it should be labeled child abuse syndrome - not borderline personality disorder. i think if a patient is labeled as child abuse syndrome they are going to get better help. people naturally want to help somebody suffering from child abuse syndrome. and as far as treating child abuse - remember the movie i think it was called stand by me about a principal in philadelphia who went into a bad school and told the kids you may come from a slum but i'm not going to allow you to behave like you come from one. i'm not joking about africa or the amazon. i came to this conclusion after making several friends from africa. and let me remind people again ADDRESS THE SUBJECT NOT THE MEMBER MAKING THE POST. THIS IS TO DISCUSS AND DEBATE THE SUBJECT NOT PUT EACH OTHER DOWN.

hsieh, you're not a moderator, are you? I'm not sure it is appropriate for you to be telling the rest of us what is and is not acceptable, and the ''shouting'' most certainly is not appreciated. Traditional treatment is paid for over and over because it is not always ineffective. At this time, it is the best that is available to offer to patients with BPD. May I just say that whatever the shortcomings of standard BPD intervention, it certainly makes far more sense than this talk about sending American citizens to countries that often are the subject of travel advisories to ''heal themselves'' or whatever it is that you think your brainchild will accomplish. Not gonna happen, no way, no how.

Thunderwolf, MSN, RN · Jun 25, 2006

Moving forward with thread.

rn/writer, RN · Jun 25, 2006

ADDRESS THE SUBJECT NOT THE MEMBER MAKING THE POST. THIS IS TO DISCUSS AND DEBATE THE SUBJECT NOT PUT EACH OTHER DOWN.

While the above guideline is correct, it is not the place of non-moderators to issue moderating messages. If you see violations taking place, please report the problem posts and leave the moderating to the mods. Thanks.

rn/writer, RN · Jun 25, 2006

Hsieh does have a point about focusing on the issues and not the particular poster.

I'm not sure if I understand what you are trying to say, hsieh, but let me give it a try.

I think you are saying that in other countries, cultures, and circumstances that are, for lack of a better term, less user-friendly, there are fewer resources available for enabling. It's hard to have a power struggle over staying in the day room when, a) there is no day room, and b) there are genuine concerns about having food, clothing, and a roof over one's head.

The survival behaviors needed for anyone to deal with these "distractions" are much closer to borderline traits than behavior that is socially acceptable in tradtional society. Borderlines don't stand out so much when boundaries have already been eroded by poverty and other stressors. In addition, borderlines who find themselves motivated by real issues like getting enough to eat see immediate rewards and consequences for their functional or non-functional behaviors. Street life and raw nature are far less amenable to manipulation or prone to enabling than exhausted relatives and psych wards.

Is this summation anything close to the points you are trying to make?

LydiaNN · Jun 25, 2006

Hsieh does have a point about focusing on the issues and not the particular poster.
I'm not sure if I understand what you are trying to say, hsieh, but let me give it a try.
I think you are saying that in other countries, cultures, and circumstances that are, for lack of a better term, less user-friendly, there are fewer resources available for enabling. It's hard to have a power struggle over staying in the day room when, a) there is no day room, and b) there are genuine concerns about having food, clothing, and a roof over one's head.
The survival behaviors needed for anyone to deal with these "distractions" are much closer to borderline traits than behavior that is socially acceptable in tradtional society. Borderlines don't stand out so much when boundaries have already been eroded by poverty and other stressors. In addition, borderlines who find themselves motivated by real issues like getting enough to eat see immediate rewards and consequences for their functional or non-functional behaviors. Street life and raw nature are far less amenable to manipulation or prone to enabling than exhausted relatives and psych wards.
Is this summation anything close to the points you are trying to make?

That would explain the lack of BPD in the third world. hsieh is taking things a step further, though, and is trying to sell the idea of sending westerners with BPD into these nations for treatment. Shall we also send people with morbid obesity to these nations? After all, there's not much of that in the third world either.

hsieh · Jun 25, 2006

i thought this thread was dedicated to alternate ways of treating borderline personality disorder? i guess my views are shaped by where i work. we get the worst of the worst. we are a waiting room for the state hospital. the state hospital is no picnic. in fact you might say the state hospital is like a made up third world except they are locked up and not free.

WhatNext? · Jun 25, 2006

That would explain the lack of BPD in the third world. hsieh is taking things a step further, though, and is trying to sell the idea of sending westerners with BPD into these nations for treatment. Shall we also send people with morbid obesity to these nations? After all, there's not much of that in the third world either.

Are there studies that show that borderline personality disorder does not occur in third world countries? Does it only occur in industrialized societies? Haven't thought this through.

Throwing anyone into a third world country against their will or better judgement is simply duplicating the experience of violation and abuse. Particularly not beneficial to people with borderline personality disorder.

BTW, I spell it out because BPD means Bi-Polar Disorder in my practice and acronyms are confusing. And they are people with a disorder and are not simply the label!

hsieh · Jun 25, 2006

borderline people are thrown into state hospitals against their will. like i said - state hospitals are like made up third world countries.

LydiaNN · Jun 25, 2006

Are there studies that show that borderline personality disorder does not occur in third world countries? Does it only occur in industrialized societies? Haven't thought this through.
Throwing anyone into a third world country against their will or better judgement is simply duplicating the experience of violation and abuse. Particularly not beneficial to people with borderline personality disorder.
BTW, I spell it out because BPD means Bi-Polar Disorder in my practice and acronyms are confusing. And they are people with a disorder and are not simply the label!

WHATNEXT, I honestly don't know whether there are any such studies or not. What I was meant was that even rnwriter was right about what hseih is saying, her summation went only so far as to account for hseih's contention that borderline doesn't exist in the third world. I didn't mean to imply that I necessarily agree or disagree with that part of hseih's contention. I wanted to point out that even if it is true, the other part of the contention, that therefore, it would be wise to send our borderline patients there, is still impractical at best and inhumane at worst. I hope that makes sense.

LydiaNN · Jun 25, 2006

i thought this thread was dedicated to alternate ways of treating borderline personality disorder? i guess my views are shaped by where i work. we get the worst of the worst. we are a waiting room for the state hospital. the state hospital is no picnic. in fact you might say the state hospital is like a made up third world except they are locked up and not free.

It is a discussion thread. We are discussing your proposed alternative treatment, even though you haven't yet actually told us what the ''treatment'' would be. Yesyes, we understand you want to ship em all off to Africa, but what would happen once there? Just because we are disagreeing with what you propose doesn't mean we aren't following TOS or the rules you seem to feel you have the right to impose. No one is debating you personally- everytime I've responded to your posts, I've addressed your points. Apparently, what needs to happen for you to feel like we're following your rules is that we all agree with you and ignore the laundry list of reasons why your alternative should never and will never be accepted by the psychiatric community.

rn/writer, RN · Jun 25, 2006

I posted a message asking for clarification. I haven't yet stated an opinion of my own because I want to be certain that I have (or don't have) an understanding of the ideas on the table.

What I was meant was that even rnwriter was right about what hseih is saying, her summation went only so far as to account for hseih's contention that borderline doesn't exist in the third world.

I don't know if I am right. That's what I'm trying to find out. Even if that summation is correct, it doesn't state that borderline doesn't exist in third world countries. Only that it might not be as noticeable and that there may be no reason and no means to give a formal diagnosis when there really aren't many treatment options available. I don't know if this is what hsieh was saying and that's part of what I'm trying to clarify.

i thought this thread was dedicated to alternate ways of treating borderline personality disorder?

Once I have a better feel for the thoughts that have already been expressed, I'll be happy to discuss pros and cons. And alternatives to present care, which does NOT have a very good track record.

hsieh, just out of curiosity, are you male or female? I don't have a bias either way. It would just make referring to things that you said a bit easier.

It would be interesting to see if we could put our heads together and look at the essence of what motivates borderline patients toward healthier choices, even if we didn't go so far as to replicate the actual circumstances. Is it fear, structure, urgency, immediate consequences, or something else? Are there practical ways to bring these principles into operation in a therapeutic milieu?

Finally, in the previous thread, hsieh expressed dismay at the way psych staff members often refer to borderline patients negatively and engage in put-downs and derogatory talk about them. I believe this is the result of having to deal with a population that presents with an extremely challenging profile WITHOUT having effective methods to handle them. Frustration builds and it sometimes does result in making the patient (and not the illness) the enemy. This is especially likely in cases where the borderline patient appears to be happy while everyone else is ready to tear their hair out. Awfully difficult to remember, at such times, that the patient may feel very different behind the scenes.

By the time we see them in an inpatient setting, they have often used up family and friends and are begging for some kind of safe boundaries. Unfortunately, we are quite limited in setting those boundaries, even though doing so would benefit everyone.

This is not an easily discussed or changed topic. I hope we can keep going because there are questions that need to be asked and answers that need to be sought, for the sake of all involved.