Topic Tuesday// Borderline Personality Disorder Awareness Week 2023: Be the Difference // Tuesday 26th September 2023 5:30-7PM AEDT

[TideisTurning]

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@Alex_Spectrum wrote:

Well to start with being involved in forums like this are a great way for clinicians like me to help to challenge stigma and to provide evidence based information. I also agree with what @BPDSurvivor has said in that we need to focus on the person rather than the diagnosis. What we know is that no two people with a BPD diagnosis are the same. There are a multitude of different interactions of symptoms that make up a BPD diagnosis and this means it’s important to focus on an individual’s unique story. For me, providing education to clients about BPD and recovery is important. The fact that BPD is highly treatable is not well understood nor is it promoted enough. Finally, expressing a desire to work with people with a diagnosis of BPD and in fact a desire to work with the person in front of them regardless of diagnosis is also crucial in my mind.

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Having a support professional say this and demonstrate having this kind of mindsetis super powerful. I'm glad there are clinicians like you around @Alex_Spectrum 😊

[amber22]

Now for our next question for our special guests @Alex_Spectrum @BPDSurvivor 

Why is the therapeutic relationship/ working alliance between clinician and the individual so important?  

[Alex_Spectrum]

Hi @rye, thanks so much for your question.

Being a part of the MBT team at Spectrum I have to admit my knowledge of what is offered in the DBT space is limited. What I can do is talk with our DBT team and try to get a more detailed answer for you re RO-DBT and whether it is offered widely in Aus. 

One thing I would say is that it sounds like you have a good understanding of yourself and some of the main challenges you experience. What I wonder is even if you don't find a specific RO-DBT treatment provider if maybe letting the person you are working with know about your history with DBT treatment and your sense of having issues with being ‘overcontrolled’ and ‘internalising’. My sense is that they should be able to work with you around this whether it's from a DBT framework or even in another modality such as MBT, SFT etc. 

I hope this helps and I'll see what else I can find out!

[BPDSurvivor]

For me, having a regular clinician was very helpful. In my life, I had been disappointed by people many times and so it was difficult to learn to trust people again. The therapeutic relationship was vital in re-teaching me the skills needed to be around people again in the real world. The skills of communicating, active listening, mentalizing etc were being transferred through discussion in each session. These individual sessions complemented the group sessions.

For me, the thought was participating in a group session was terrifying. Yet the preparatory work in the pre-treatment sessions were so helpful in easing us into it.

One of the hardest parts of MBT was facing each group session. Fancy having a room of borderlines together? To me, I thought it was a disaster in the making. But lo and behold, the takeaways and the learning from these group sessions was and is indescribable. Yes, it was very difficult, but it had such a profound impact on my recovery. It was as though, growing up, I missed being taught how to think in a healthy way, and to communicate my innermost emotions. So much so that I had to learn these skills as an adult while being carefully guided by trained facilitators.

[Alex_Spectrum]

Firstly, what the research tells us is that the therapeutic alliance is one of the most important factors in whether therapy will be helpful. What’s really important in this research is that this is therapeutic relationship based on the report of the CLIENT rather than the report of the CLINICIAN. It seems that clinicians aren’t always great at accurately assessing the strength of the relationship. This is why it’s important for clinicians to ask how the relationship is going and ideally for clients to let the clinician know if something doesn’t feel right or it feels the clinician misunderstood/missed the mark on something. As we talked about earlier, clients should feel safe, supported and heard within the therapeutic relationship.

A strong working alliance can also help by providing an attachment relationship in which clients can navigate the world and particularly any interpersonal issues. Ideally, the therapeutic relationship can help clients to work through issues in a safe, supportive environment. This in turn should help clients to be able to traverse their personal relationships more effectively.

[rye]

Thanks @Alex_Spectrum - I really appreciate your response, and that’s a helpful perspective.

I do think DBT can be tailored, and I definitely tried to do so during the program, but I am curious about RO-DBT as it seems to be quite new.
Thanks for offering to seek out an answer, that would be great.

I have never looked into MBT either so that could be interesting to investigate too. Cheers!

[Giselle_]

Hi everyone 

I’m new here and have recently been diagnosed with BPD.

I have made progress with my current therapist but would be very interested in group therapy. How do I go about finding groups in my area? 

[amber22]

Onto our next question!

What’s happening for BPD Awareness week? How can I get involved? 

@Alex_Spectrum @BPDSurvivor 

[Alex_Spectrum]

No problems @rye! I'll get back to you asap. 

I think MBT is great and we certainly work with people with some of the challenges you mentioned. But really it's about finding someone who you fit well with which I know can be challenging at times. 

[BPD_Cat]

Hi everyone! I understand stigma first hand, and it sucks. I found out that I have BPD about a month ago, but I was diagnosed by my psychiatrist six years ago and he and my parents hid it from me. It really hurt when I found out, being kept in the dark about my mental health because they didn't want anyone to find out.