By contrast, Amy – a 30-year-old burlesque performer, writer and musician – has found therapy to be a “godsend”. Amy went through Dialectical Behaviour Therapy, which is similar to CBT but focuses on acceptance of who you are at the same time as attempting to change the way you behave. It was specially formulated to deal with patients experiencing intense emotions, so is often used with BPD patients. “The techniques taught have helped me cope with everyday life in ways I could not dream possible 10 years ago,” Amy enthuses. “It also took me 10 years of fighting to even be accepted on to a programme, unfortunately!”
Dr Kristi Webb is a therapist and DBT practitioner in America. She produces popular YouTube videos which discuss mental health issues including BPD. “Most DBT practitioners are based in the US, because that’s where its creator, Dr Marsha Linehan – a BPD sufferer herself – comes from,” she tells Cosmo. “DBT was devised 30 years ago after Dr Linehan observed that traditional talk therapy – e.g. ‘Tell me about your relationship with your mother’ etc – didn’t seem to work on some patients. A lot of BPD is trauma-related, and simply reliving these traumas with a counsellor seemed to make sufferers worse. DBT is behavioural: ‘You need skills, we are going to teach you skills’. There are four skills modules: distress tolerance, interpersonal effectiveness, emotion regulation and mindfulness.” What makes it different to CBT? “It contains some CBT,” explains Dr Webb, “but rather than just saying ‘You must do better’, as CBT does, it says ‘You’re doing the best you can right now, but you can do better with some help – and how you’re behaving right now is not at all due to histrionics or manipulation on your part, it’s simply due to a lack of skills.'”
Why does she think so many therapists are scared of dealing with BPD patients? “The depth of pain in BPD frightens a lot of clinicians,” she responds. “The suicidal ideation, self harm and impulsive behaviour seem dramatic and alarming to them. Also, the key to working with BPD patients is incremental change and a lot of them don’t have the patience. For my part, I love working with BPD sufferers. I find them incredibly smart and funny – and what therapist wouldn’t want to work with folks like that?”
Borderline Personality Disorder sufferers are often unfairly perceived to be wilfully manipulative, attention seeking and self-centred. Rubbing their hands in glee, the media frequently accuses troubled celebs such as Lindsay Lohan, Britney Spears and Winona Ryder of suffering from the condition – without a hint of sympathy. That kind of stigma means that, yes, this is pretty much the hardest article I’ve ever had to write. It was only the encouragement of BPD-sufferer friends which actually persuaded me to go through with it.
It was time to speak out. So I have.