Well I Have Begun a Course of DBT.

After a lot of serious seliberation and discussions witrh my other half I felt it was the right course of action for me now.

At age 59, I come to this treatment much later than most but am desperate for some sense of control over my thoughts, actions and reactions.

NICE guidelines recommend DBT. The NHS offers DBT to sufferers with severe abd enduring symptoms but the waiting list may be long.

DBT is based on the idea that two important factors contribute towards BPD:

• you are particularly emotionally vulnerable – for example, low levels of stress make you feel extremely anxious
• you grew up in an environment where your emotions were dismissed by those around you – for example, a parent may have told you that you had no right to feel sad or you were just “being silly” if you complained of feelings of anxiety or stress

These two factors may cause you to fall into a vicious cycle – you experience intense and upsetting emotions, yet feel guilty and worthless for having these emotions. Because of your upbringing, you think having these emotions makes you a bad person. These thoughts then lead to further upsetting emotions.

The goal of DBT is to break this cycle by introducing two important concepts:

• validation: accepting your emotions are valid, real and acceptable
• dialectics: a school of philosophy that says most things in life are rarely “black or white” and that it’s important to be open to ideas and opinions that contradict your own https://www.nhs.uk/conditions/borderline-personality-disorder/treatment/

I begin by seeing a therapist on a weekly basis for a year and we have been meeting for a month now. My emotions range from hope to utter terror! I remain so fearful of abandonment and worry that this fear will only get worse as I progress through treatment desite reassurances that I will not be left unsupported at the end of this treatment plan.

Three Months On

Well how is it going?

To be honest it has not been easy. My relationship with my therapist has been rocky. For some reason I have this compulsion to destroy anything good or hopeful in my life. I feel the need to push everything and everyone to the limits and way beyond. I am really not quite sure where that comes from except that I have never had anyone who has hung around for long.

My father committed suicide after my mother walked out on him, my younger brother and myself and then was passed from pillar to post.

So I push, push, push in the knowledge that everyone will eventually abandon  me because I am simply not worth the effort and, of course, it becomes a self fulfilling prophecy.

I have a great need for things to go exactly the way i think they should and if reality strays from my intended path the panic and fear is so violent that I lose control of my emotions completely and cannot cope with the situation.

Well Almost 10 Months On!

Aughhhhh!

I have a case conference next week. Do I continue or give up?

I really do not think I can carry on. I am too old to cope with this full on analysis and now I have to enter group treatment if I am to continue with DBT. Everyone will be young enough to be my grandchild and I feel I live in a different world from them. That may sound unfair but, I do think it is fair to reflect on how much harder it is to make behavioural changes as one grows older and more entrenched in patterns of thought and behaviour.

“Clinical presentation of personality disorders in older adults

Both recognising and effectively managing the difficulties associated with personality disorders in older adults is crucially important as personality disorder dimensions have been found to explain the majority of the variance in suicidal ideation amongst older adults.¹¹ This may be partially explained by the finding that older adults with personality disorders, particularly if multiple, tend to have a worse self-perceived quality of life than others within their cohort, including those who may also be known to secondary mental health services themselves. Suicidal ideation itself has been found to be one of the best predictors of completed suicide in this population and it has been hypothesised that maladaptive coping, which is often seen as a feature in personality disorders, significantly predicts this risk also.¹³ The association between borderline personality disorder specifically and the risk of suicide has been well documented and this is the case particularly when comorbid with major depressive disorder, which is common in this age group.” https://www.progressnp.com/article/personality-disorders-older-adults-diagnosis-management/

Well I guess this article was a warning that it would be a tough deal for me. I find myself flipping between feeling positive about the

treatment and adoring my therapist to wishing I had never started and believing he wishes me dead.

I guess that is classic BPD!