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Speaker 1: Hey, everyone, Josh and Chuck here to remind you that

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Speaker 1: our last three shows of the year. Boy, this is

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Speaker 1: a good show this year are taking place very soon

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Speaker 1: and tickets are still available.

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Speaker 2: Yeah, so get in the saddle and come out and

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Speaker 2: see us partners in Orlando, Atlanta, and Nashville.

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Speaker 1: Just go to stuff youshould know dot com and click

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Speaker 1: on the tour link and you can get all your

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Speaker 1: tickets right there. Welcome to Stuff you Should Know, a

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Speaker 1: production of iHeartRadio.

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Speaker 2: Hey, and welcome to the podcast. I'm Josh and Chuck's

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Speaker 2: here too. It's just the two of us, and that's

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Speaker 2: cool because this is the stuff you should Know.

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Speaker 1: Yeah, Jerry's got the week off and she said press on, dudes. Yeah,

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Speaker 1: party party on Wayne.

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Speaker 2: That was also from Bill and Ted's excellent Adventure. Wasn't

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Speaker 2: it Party On?

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Speaker 3: No? Was it? I think?

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Speaker 2: So I can see George Carlin say it.

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Speaker 4: Yeah, I'm probably wrong.

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Speaker 2: I'm probably wrong. So, Chuck, we're talking today about something

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Speaker 2: we've kind of touched on before. But when we touched

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Speaker 2: on it, we're like, this is something that deserves its

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Speaker 2: own episode for sure.

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Speaker 1: Yeah, we're talking. This is another in our suite on

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Speaker 1: mental health. Conditions, and boy, we've got a lot of them,

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Speaker 1: but we still got more to go. Yeah, we do,

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Speaker 1: you know, and I think these are important shows, and

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Speaker 1: every time we do these, I feel like we get

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Speaker 1: good feedback on people who suffer from these conditions and

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Speaker 1: say thanks for either educating me and or getting the

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Speaker 1: word out to people who may be a little, uh,

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Speaker 1: what's the word ignorant about some of the stuff.

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Speaker 2: As Michael Jackson would have said, you're ignorant about this?

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Speaker 4: What's that from?

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Speaker 2: He just used that word a lot.

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Speaker 4: Oh really, yeah, But.

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Speaker 2: Regardless, that has nothing to do with anything. When you

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Speaker 2: mentioned just now that people like kind of wrote in

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Speaker 2: or write in when we do episodes like this, Well,

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Speaker 2: we did our emotional pain episode and we mentioned a

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Speaker 2: borderline personality disorder. A lot of people wrote in. Well,

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Speaker 2: I don't want to say a lot, but some people

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Speaker 2: wrote in and they said, you know, thank you for

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Speaker 2: treating it compassionately, because when most people talk about it,

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Speaker 2: they talk about it like they despise it, or they

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Speaker 2: despise people with BPD. And the more you look into

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Speaker 2: the more you realize, like, wow, this is maybe one

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Speaker 2: of the hardest mental illnesses that you can possibly have,

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Speaker 2: and I think we kind of said that in the

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Speaker 2: Emotional Pain episode, but if I didn't know it before,

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Speaker 2: I definitely do now after doing this research.

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Speaker 1: Yeah, and it's also clear that it's one that somehow

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Speaker 1: seems to garner the least amount of empathy, right, not

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Speaker 1: only among just people who you know, may or may

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Speaker 1: not know much about it, but even clinicians and therapists

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Speaker 1: as that stuff you sent me like a lot of

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Speaker 1: times try to avoid or severely limit the number of

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Speaker 1: patients that they have that they treat with BPD, which

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Speaker 1: makes it even more sad because it is a really

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Speaker 1: tough one. I guess we'll just define it kind of

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Speaker 1: off the bat, and you know, a lot of this

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Speaker 1: episode will kind of be defining it in different ways

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Speaker 1: because it's fairly complex. But it is a what's known

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Speaker 1: as a cluster B personality disorder, which is in the

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Speaker 1: anti social personality disorder category along with historyonic personality disorder

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Speaker 1: and narcissistic personality.

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Speaker 4: I'm just gonna start saying PD.

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Speaker 2: Yeah, PDS. It will make it sound like, you know,

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Speaker 2: you're talking about.

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Speaker 1: Yet more narcissistic PD, but it seems like a lot

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Speaker 1: of what it can be is sometimes a disorder of perception.

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Speaker 1: And while there are very real things that do that

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Speaker 1: can trigger people with BPD, a lot of times the

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Speaker 1: way things are perceived incorrectly, either about themselves or about

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Speaker 1: other or others actions.

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Speaker 2: Yeah, and I saw a lot of people confuse borderline

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Speaker 2: personality disorder with bipolar, or at least think they're similar.

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Speaker 2: I guess because they got start with bees or something

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Speaker 2: like that. But no, they're not similar. Bipolar has much

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Speaker 2: more of a brain and central nervous system basis, whereas

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Speaker 2: while borderline personality disorder has a component of that, the

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Speaker 2: executive function of the person in their prefrontal cortex either

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Speaker 2: didn't develop in a fully normal way or it's not

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Speaker 2: functioning up to snuff, I guess, more than anything. And

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Speaker 2: the thing that differentiates it from bipolar is it's an

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Speaker 2: assignment of meaning it's psychological as much, if not more

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Speaker 2: than it is physiological.

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Speaker 4: Yeah.

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Speaker 1: And also bipolar is characterized, and we did a good

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Speaker 1: episode on that quite a while ago, but it's characterized

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Speaker 1: by like these highs and lows, and then in between

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Speaker 1: those periods they can be relatively stable, whereas with borderline

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Speaker 1: personality disorder it's sort of always there. This one thing

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Speaker 1: you sent me had to really kind of really nail

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Speaker 1: it on the head at the end. Those with bipolar

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Speaker 1: may have a hair trigger kind of response during an episode,

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Speaker 1: whereas when you have a borderline PD, you have a

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Speaker 1: hair trigger response all of the time. And I can't

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Speaker 1: imagine how sup that must be.

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Speaker 2: Yeah, so that kind of calls out one of the

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Speaker 2: big hallmarks of BPD, which is it's emotional dysregulation. Yeah,

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Speaker 2: things that would affect other people a little bit, maybe

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Speaker 2: not at all. Stuff that most people that roll off

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Speaker 2: of their back right could set somebody with BPD off

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Speaker 2: into a rage that could last days.

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Speaker 3: Potentially.

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Speaker 2: They also might use self harm it's called non suicidal

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Speaker 2: self injury to kind of externalize the pain because the

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Speaker 2: emotional dysregulation is so profound, they don't know what they're feeling.

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Speaker 2: They just know they're feeling everything all at once. And

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Speaker 2: it's kind of like standing in an ocean and a

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Speaker 2: huge wave hits you, and you're just you're as profoundly

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Speaker 2: enveloped by emotion at that moment as you are by

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Speaker 2: a wave when it just completely knocks you off for

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Speaker 2: feet and sweeps you away.

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Speaker 1: Yeah, there was another and we'll talk about her in

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Speaker 1: great detail. Her name is Marcia Lenahan or is it

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Speaker 1: line Han.

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Speaker 2: I'm gonna go with Lenahan.

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Speaker 1: Yeah, she as we'll see as someone who not only

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Speaker 1: suffered from BPD but kind of pioneered the treatment of BPD.

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Speaker 1: But she said, it's like having third degree burns on

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Speaker 1: ninety percent of your body metaphorically, So you're lacking emotional skin,

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Speaker 1: and you feel agony at the slightest touch er movement,

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Speaker 1: and since you did mention self harm, non suicidal self harm.

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Speaker 1: It also people with BPD have a suicide rate of

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Speaker 1: was it like fifty times higher than average in the population.

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Speaker 4: Yeah, so this is this is no joke.

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Speaker 1: This is a very hardcore disorder that bears more empathy

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Speaker 1: and understanding.

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Speaker 2: Yeah, for sure. Let's go back to the beginning, shall we,

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Speaker 2: Because borderline personality disorder is one of those terms that

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Speaker 2: has taken on its own meaning in the general population,

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Speaker 2: but if you stop and think about it, it doesn't

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Speaker 2: really reveal much about what it's describing. It's just one

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Speaker 2: of those not at all frustratingly So, yeah, and that

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Speaker 2: goes back to a jerk named Adolph Stern who really

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Speaker 2: jerked it up back in nineteen thirty eight.

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Speaker 1: Yeah, he was a psychoanalyst, and he basically I mean,

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Speaker 1: if you didn't know what it was, and I didn't

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Speaker 1: even fully know what it was, I always wondered what

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Speaker 1: borderline meant. And it very simply meant and means, this

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Speaker 1: is Stern saying, you're not quite on the psychotic level

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Speaker 1: and you're not quite psycho neeurotic. You're basically on the

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Speaker 1: border between those conditions while encompassing a bit of each.

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Speaker 1: So we're just going to call it borderline.

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Speaker 2: Yeah, and psychosis is what we would still consider psychosis,

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Speaker 2: but under psychoanalysis, psychoneurosis is what we call anxiety depression,

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Speaker 2: those kinds of mental illnesses. So I guess Adolf Stern

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Speaker 2: wasn't really that big of a jerk, because he really

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Speaker 2: kind of did combine him appropriately. It was Auto Kernberg

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Speaker 2: who was the serious jerk in this situation.

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Speaker 1: Okay, So he was a psychoanalyst in the mid nineteen seventies,

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Speaker 1: so that's you know, like forty something years later, and

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Speaker 1: he described it as an unstable personality and disorganized conception

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Speaker 1: of the cell. And this is just when it was

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Speaker 1: sort of starting to become more and more kind of

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Speaker 1: talked about, and officially I think five years after that

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Speaker 1: was in the DSM version three.

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Speaker 2: Yeah. I mean that's pretty quick for something you just

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Speaker 2: started to identify, and five years later it makes it

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Speaker 2: in the DSM. Because they don't churn those dsms out

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Speaker 2: like you know, every few months. It takes years to

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Speaker 2: put one together. So Kurenberg seemed to have stumbled onto

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Speaker 2: something that was worth looking at, very very very quickly.

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Speaker 4: Yeah.

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Speaker 1: And isn't there a sort of movement or belief now

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Speaker 1: that it's a lot of people think it's something that

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Speaker 1: is like a diagnosis you shouldn't even give, right.

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Speaker 2: Yeah, there's we'll talk about that. I think we can

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Speaker 2: kind of pepper it throughout, you know. Okay, But yes,

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Speaker 2: there is a school of thought that basically says BPD

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Speaker 2: is not a personality disorder. It's not even a mood disorder,

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Speaker 2: although some people say it would better be characterized as

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Speaker 2: a mood disorder. They say it's a cluster of symptoms

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Speaker 2: that overlap with a bunch of different actual disorders, and

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Speaker 2: that the problem with that, you say, who cares? You're

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Speaker 2: identifying people a group of people whose rate of suicide

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Speaker 2: is fifty times a general population, that alone is worth

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Speaker 2: like identifying and helping those people out. But what they're

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Speaker 2: saying is number one, BPD has gotten such a bad

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Speaker 2: name in the general population that you're literally stigmatizing somebody

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Speaker 2: when you give them that diagnosis. It is an enormously

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Speaker 2: heavy weight you put on somebody. We say, I'm a

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Speaker 2: trained psychiatrist, I know what I'm talking about, and you

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Speaker 2: have borderline personality disorder. Everybody step back.

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Speaker 1: Basically, yeah, I mean it's it's almost in line with

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Speaker 1: saying someone as a sociopath. It's different things, but as

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Speaker 1: far as like the stigma goes very much.

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Speaker 2: So, yeah, for sure, that's a great analogy. Actually, so

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Speaker 2: some people are like, Okay, it's stigmatizing, but even more

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Speaker 2: than that, just the science isn't necessarily there, like we're

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Speaker 2: saying it's symptoms rather than an actual disorder. And then

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Speaker 2: apparently the Working Group for Personality Disorders for the DSM

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Speaker 2: five that's the most recent one, they actually said, we're

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Speaker 2: not sure that this should be a categorical disorder, which

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Speaker 2: is the type that you either have it or you don't.

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Speaker 2: They suggested it should be dimensional, which means that it

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Speaker 2: exists on a spectrum, right, so you can have a

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Speaker 2: little bit of BPD, a lot of BPD, or right

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Speaker 2: in the middle or whatever. And that got rejected. And

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Speaker 2: now so it's a categorical diagnosis where if you don't

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Speaker 2: have BPD, you don't have BPD. If you don't fit

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Speaker 2: the criteria. If you do, you got BPD.

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Speaker 1: Right, And we'll talk about the criterion in a second,

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Speaker 1: but we do want to sort of reintroduce Marcia Lenihan, who,

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Speaker 1: like I said, was a real pioneer for her work

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Speaker 1: in the treatment and recognition of BPD. Very late in

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Speaker 1: her life, revealed that she suffered from BPD. After you know,

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Speaker 1: patients and friends encouraged her to come forward and she said, basically,

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Speaker 1: you know, I'm gonna do it. I'm not gonna die

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Speaker 1: a coward, is what she said, but for the longest

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Speaker 1: time was not out with that information. Was born in

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Speaker 1: Oklahoma in I guess the fifties, and in the nineteen

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Speaker 1: sixties in high school, was diagnosed with schizophrenia, drugged up,

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Speaker 1: give an electro shock, hospitalized, was practicing self harm of

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Speaker 1: all kinds, and then had it sounds like a not

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Speaker 1: a moment of clarity, but a pretty profound religious experience.

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Speaker 2: Yeah, the only thing missing was a visit from Saint

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Speaker 2: Michael pretty much.

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Speaker 1: I mean, she's Catholic, and after this religious experience she

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Speaker 1: was able to which you know, had a lot to

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Speaker 1: do with self love. But after this she was able

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Speaker 1: to still have these emotions that she had before, but

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Speaker 1: managed it to the point where she wasn't practicing self harm.

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Speaker 1: And did she come up with the term radical acceptance

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Speaker 1: or did she just buy into that.

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Speaker 2: I don't know if that was a descriptor of hers

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Speaker 2: or not.

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Speaker 4: Okay, I don't think she came up with that.

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Speaker 1: But basically, as you know, radical acceptance is like, hey, listen,

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Speaker 1: this is how things are with me, this is how

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Speaker 1: things are with the world. I accept this, and I'm

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Speaker 1: not going to compare this to what I think the

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Speaker 1: reality should be or what other people think it should be.

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Speaker 2: There's a huge butt that follows that though.

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Speaker 3: But but but.

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Speaker 2: I am going to do what I can to change

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Speaker 2: those things about myself.

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Speaker 4: Right.

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Speaker 2: So that is the basis of a type of cognitive

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Speaker 2: behavioral therapy that she came up with called dialectical behavioral therapy,

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Speaker 2: and it is it's based in radical acceptance and the

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Speaker 2: desire to examine and change how you interact with the

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Speaker 2: world externally, and it's basically the gold standard for treating

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Speaker 2: a borderline personality disorder it right.

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Speaker 1: Now, Yeah, and it seems like it really works. I

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Speaker 1: saw that it was kind of the only proven treatment

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Speaker 1: to reduce suicidal behavior, which is, you know, at the

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Speaker 1: tail end of what a lot of people experience with BPD.

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Speaker 1: And the good news and we'll talk about treatment later,

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Speaker 1: but the good news is if you have VPD or

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Speaker 1: know someone that does, you can get better. And they

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Speaker 1: have proven and shown time and time again now that

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Speaker 1: through the treatments that we'll discuss later, it is absolutely

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Speaker 1: something that someone can get a hold of in most cases, right,

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Speaker 1: which is great.

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Speaker 2: It is great. I mean, like, for as bad of

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Speaker 2: a stigma as BPD has, the idea that like it

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Speaker 2: has a very high success rate of treatment is pretty couraging.

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Speaker 2: So Lenahan's basis of her understanding or her definition of

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Speaker 2: borderline personality disorder is that it's biosocial that people who

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Speaker 2: have BPD are either genetically or biologically predisposed to having BPD,

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Speaker 2: but not everybody who has that predisposition is going to

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Speaker 2: be triggered into developing BPD. It takes basically a biological

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Speaker 2: substrate for BPD. Usually your prefrontal cortex hasn't developed in

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Speaker 2: a certain way, and so your executive function isn't functioning

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Speaker 2: like an executive should. That gets joined together with a trigger,

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Speaker 2: usually mistreatment, whether it's abuse, neglect, invalidation by your parents

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Speaker 2: as a kid, and you put those things together and

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Speaker 2: very often it results in what you be diagnosed with

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Speaker 2: later as BPD.

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Speaker 1: Yeah, and one thing I really took away from this,

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Speaker 1: and this is something that you know, Emily and I

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Speaker 1: and and most parents that I know are way into,

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Speaker 1: is h oh, you got to validate your kids.

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Speaker 2: Yeah, that's new, which is crazy, but it's.

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Speaker 1: It's Yeah, you got to validate their emotions and validate

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Speaker 1: their experiences and their feelings, even if it's something that

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Speaker 1: you don't think is uh, like has the most relevance

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Speaker 1: or whatever, or even if like the kid is wrong

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Speaker 1: about something or like emotionally wrong, like, you still have

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Speaker 1: to validate that and then talk them through it. What

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Speaker 1: you can't do is just discount a kid's feelings, because

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Speaker 1: that's like telling them that their truth isn't real, and

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Speaker 1: that's damaging I know, and.

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Speaker 2: Doing parenting right sounds like a waking nightmare to me

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Speaker 2: doing wise parenting parenting correctly. Yeah. Nah, I can't imagine

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Speaker 2: the exhaustion along combined with the fear of just misstepping

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Speaker 2: once or twice and then there you go, you screwed

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Speaker 2: your kid up for life.

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Speaker 4: Yeah.

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Speaker 1: What you gotta do is, in my experience, is like

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Speaker 1: you can't beat yourself up too much because parenting fails,

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Speaker 1: you can really go down a rabbit hole.

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Speaker 4: Of your own.

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Speaker 1: I'll be depression if you screw up. And you can't

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Speaker 1: do that because kids are resilient and you just got to,

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Speaker 1: like you got to prove to them that you can

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Speaker 1: like pick yourself up and move on and do better,

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Speaker 1: you know.

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Speaker 2: Yeah, And I don't think Lenahan's idea is that it

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Speaker 2: just takes one or two missteps. It takes like a parent,

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Speaker 2: he was a genuinely bad parent. Very frequently they have

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Speaker 2: BPD themselves. Yeah, and that is a real challenge to

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Speaker 2: parenting well in and of itself. But you don't have

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Speaker 2: to have had a parent with BPD to develop BPD.

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Speaker 2: But typically it's a parent that is not at all

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Speaker 2: meeting your needs, especially emotionally. And I say we take

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Speaker 2: a break and we'll come back and talk about how

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Speaker 2: you would be diagnosed with BPD.

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Speaker 3: What do you think, let's do it, okay, Chuck.

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Speaker 2: So we said that BPD's in the d S M five.

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Speaker 2: It's a personality disorder. And just to differentiate real quick,

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Speaker 2: a mood disorder describes patterns and feelings, like you have

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Speaker 2: mood swings in that you know highs and lows, and

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Speaker 2: that's pretty reliable that you're going to have it one

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Speaker 2: way or another. Personality disorder focuses more on how you

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Speaker 2: relate to others, and that definitely makes sense to me

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Speaker 2: that you would consider a BPD of personality disorder.

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Speaker 1: Then, yeah, that seems to be a really key thing,

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Speaker 1: is that it's it's it really disturbs your relationships. So

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Speaker 1: to be diagnosed, you fit at least five out of

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Speaker 1: the following nine that we're gonna read for you. Chronic

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Speaker 1: feelings of emptiness and.

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Speaker 2: That's emptiness, feeling like isolated or lonely or hopeless.

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Speaker 1: Sure, emotional instability and reaction to day to day events.

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Speaker 1: That's the thing we were talking about earlier, Like saying

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Speaker 1: mountains out of molehills seems slightly reductive, but that's kind

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Speaker 1: of a basic way to say it. Okay, frantic efforts

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Speaker 1: to avoid abandonment, whether or not they're real or imagined.

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Speaker 1: As Yeah, as we'll see abandonment issues, and this very

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Speaker 1: very much includes emotional abandonment as a really big precursor

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Speaker 1: unstable self image or sense of self.

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Speaker 2: What else, Impulsive behavior is usually a big one, and

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Speaker 2: you have to have impulsive behavior and at least two

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Speaker 2: areas that are harming your day to day life, like

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Speaker 2: an eating disorder and gambling addiction or something like that.

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Speaker 2: Another one is this is based on and so this

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Speaker 2: is where some psychiatrists would be like, see this is

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Speaker 2: not this is a symptom that we're talking about here,

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Speaker 2: but it's unstable and intense interpersonal relationships. I mean, like

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Speaker 2: you're really really close to somebody for you know, a

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Speaker 2: couple of days, and then they do something you don't

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Speaker 2: like and they're the worst person in the world. And

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Speaker 2: it can happen very very quickly with people with BPD,

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Speaker 2: And if you stick around and stay in that person's life,

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Speaker 2: you can find yourself walking on eggshells very quickly because

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Speaker 2: you don't want them to turn on you all of

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Speaker 2: a sudden. So that's a huge one. If you have

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Speaker 2: a lot of unstable, intense relationships with people, that's just

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Speaker 2: kind of the mo that is usually a big giveaway

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Speaker 2: with BPD.

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Speaker 1: Yeah, the last three recurrent suicidal or self harming behaviors.

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Speaker 1: We've talked about that a little bit, stress related, paranoia

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Speaker 1: or dissociative symptoms, feeling like the self of the world

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Speaker 1: isn't real. It feels like that's probably the far end

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Speaker 1: of the spectrum, or the most severe end. And then

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Speaker 1: one we missed earlier was inappropriate and intense anger or

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Speaker 1: difficulty controlling anger.

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Speaker 2: I didn't miss it. That was purposeful, Okay. I wanted

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Speaker 2: to end with that big one.

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Speaker 4: Okay, all right, speak to it.

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Speaker 2: Well, there's a lot of I always hate saying those qualifiers.

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Speaker 2: It's just so easy to say, but I know I

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Speaker 2: think it perks people's ears up, like, oh, this person

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Speaker 2: doesn't know what they're talking about. So let me rephrase that.

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Speaker 2: I have seen that there are schools of thought regarding

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Speaker 2: borderline personality disorder that it is a rage response to trauma. Okay,

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Speaker 2: that that is your response to unresolved trauma. That's how

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Speaker 2: you learn to deal with those feelings and those emotions.

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Speaker 2: Is to rage at people, because rage is as much

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Speaker 2: a hallmark of BPD as fear of abandonment, is right,

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Speaker 2: and that's why so people are critical of including it

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Speaker 2: as a categorical diagnosis in the d s M five.

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Speaker 2: They're saying, you're pathologizing rage. No, you just need to

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Speaker 2: teach people how to identify their emotions and how to

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Speaker 2: express them in a more appropriate, less hostile manner, and

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Speaker 2: then that's how you would treat somebody with BPD, or

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Speaker 2: not even with BPD, somebody with a rage disorder. But

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Speaker 2: some people think that that is what people are mistaking

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Speaker 2: for BPD.

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Speaker 1: Oh I gotcha, okay, interesting, Uh, you're gonna to be diagnosed,

385
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Speaker 1: Like I said, five of those nine, it'll probably be

386
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Speaker 1: you know, like you'll be talking to a psychologist or

387
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Speaker 1: someone in an interview. You might fill out a questionnaire

388
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Speaker 1: or something they're going to make interesting click click click click,

389
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Speaker 1: or they may speak to your family or something like that.

390
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Speaker 1: It can be difficult to diagnose and there, like you said,

391
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Speaker 1: there's there's a lot of overlap between you know, things

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Speaker 1: like anxiety and depression and things like PTSD and eating disorders,

393
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Speaker 1: a lot of comorbidities. So I get why people can

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Speaker 1: have issues with like this diagnosis rather than it's like

395
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Speaker 1: a cluster of symptoms of other things.

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Speaker 4: But I don't know.

397
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Speaker 1: If you group that altogether then it and call it

398
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Speaker 1: its own thing, then I don't know. I'm not sure

399
00:23:17,840 --> 00:23:18,680
Speaker 1: I see the harm in that.

400
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Speaker 2: Again, I think it's the stigma. And then also it

401
00:23:22,280 --> 00:23:26,000
Speaker 2: might be distracting from treating the other underlying.

402
00:23:25,440 --> 00:23:31,520
Speaker 1: Stuff, maybe because there also isn't and we'll talk about pharmaceuticals,

403
00:23:31,520 --> 00:23:35,000
Speaker 1: but there isn't a specific pharmaceutical for VPD.

404
00:23:35,400 --> 00:23:37,920
Speaker 2: That's another clue that some people point to that it's

405
00:23:38,000 --> 00:23:41,280
Speaker 2: not it's it's it's we're mistaking it somehow. And I

406
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Speaker 2: don't want to like overstate the that school of thought.

407
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Speaker 2: It is widely considered like an accepted diagnosis orderline personality

408
00:23:53,200 --> 00:23:55,200
Speaker 2: disorder is, so I don't want to make it seem

409
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Speaker 2: like the cracks are in the facade. It's about a

410
00:23:57,520 --> 00:24:01,600
Speaker 2: chromole any day. Now. My point is people make some

411
00:24:01,600 --> 00:24:06,159
Speaker 2: pretty good points about how well we understand it or

412
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Speaker 2: how well we're defining and we're possibly missing some component

413
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Speaker 2: of it.

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Speaker 1: Yeah, and isn't that stuff debate usually or I guess

415
00:24:15,320 --> 00:24:17,640
Speaker 1: it should be, And I hope it's couched in how

416
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Speaker 1: to best treat people and help people, right, Yes, rather

417
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Speaker 1: than just like poopooing ideas.

418
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Speaker 2: Yeah, no, I think that's exactly right. But I mean, again,

419
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Speaker 2: if we come to this place where even if if

420
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Speaker 2: a BPD is the center of a giant Venn diagram

421
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Speaker 2: of a bunch of different disorders, Yeah yeah, and we're

422
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Speaker 2: mistaking that center overlap of all of them as its

423
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Speaker 2: own thing. If you zero in on that group and

424
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Speaker 2: they have a fifty times higher rate of suicide than

425
00:24:47,920 --> 00:24:51,520
Speaker 2: the general population, again, that is worth zeroing in on,

426
00:24:51,880 --> 00:24:53,960
Speaker 2: you know, as its own thing. And like you said,

427
00:24:54,359 --> 00:25:00,840
Speaker 2: dialectical behavior therapy is focused initially on individual sessions that

428
00:25:00,880 --> 00:25:04,520
Speaker 2: are that are that are aimed to control that that behavior.

429
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Speaker 2: Suicide alalogy, Yeah, yeah, for sure.

430
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Speaker 1: You did mention earlier as far as causes go, that

431
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Speaker 1: sometimes there is a genetic link, but it seems that

432
00:25:14,880 --> 00:25:18,040
Speaker 1: it's not really the disorder that is like maybe passed

433
00:25:18,040 --> 00:25:20,760
Speaker 1: from parent to child, but some of those traits and

434
00:25:20,840 --> 00:25:26,080
Speaker 1: maybe that's because it is sort of a cluster. Sometimes

435
00:25:26,080 --> 00:25:29,440
Speaker 1: you can't you know, you can have BPD and come

436
00:25:29,480 --> 00:25:34,080
Speaker 1: from like a pretty good, you know, stable upbringing, but

437
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Speaker 1: that seems to be the outlier, and it seems to

438
00:25:37,680 --> 00:25:41,240
Speaker 1: be that like most people that end up suffering from

439
00:25:41,280 --> 00:25:43,520
Speaker 1: this had a pretty lousy childhood.

440
00:25:43,600 --> 00:25:46,960
Speaker 2: Yeah, so they were either neglected or just kind of

441
00:25:48,680 --> 00:25:52,560
Speaker 2: saddled with emotionally unavailable parents who just weren't really there

442
00:25:52,560 --> 00:25:54,720
Speaker 2: for them, didn't go to their dance recital kind of thing,

443
00:25:55,840 --> 00:26:01,320
Speaker 2: never went to a single one. Excessive control. It sounds

444
00:26:01,440 --> 00:26:04,760
Speaker 2: very Freudian, but I saw one classic example as an

445
00:26:04,800 --> 00:26:09,320
Speaker 2: absent father and a domineering mother, and it's like, how

446
00:26:09,320 --> 00:26:11,480
Speaker 2: many times have you guys tritted that one out? But

447
00:26:11,840 --> 00:26:14,840
Speaker 2: apparently it really does have a screwy effect on people

448
00:26:14,960 --> 00:26:18,760
Speaker 2: as a kid. And then also if your parents or

449
00:26:18,920 --> 00:26:25,280
Speaker 2: parent had a mood disordered themselves, or misused substances, that

450
00:26:25,440 --> 00:26:29,400
Speaker 2: would probably have affected their parenting as well.

451
00:26:29,560 --> 00:26:33,159
Speaker 1: Yeah, this also made me think about like parenting of

452
00:26:33,280 --> 00:26:37,639
Speaker 1: old versus parenting now and parents can there are still,

453
00:26:37,960 --> 00:26:42,080
Speaker 1: of course, a huge range of bad parents these days.

454
00:26:42,119 --> 00:26:44,879
Speaker 1: I'm not saying that everyone's doing it right now, but

455
00:26:45,000 --> 00:26:48,679
Speaker 1: it definitely seems like things turned a corner and parents

456
00:26:48,680 --> 00:26:52,200
Speaker 1: are trying a lot harder these days, and like sort

457
00:26:52,200 --> 00:26:54,720
Speaker 1: of the old days of like, oh, you know, kids

458
00:26:54,760 --> 00:26:57,080
Speaker 1: raised themselves and you can ignore them and blah blah blah,

459
00:26:57,119 --> 00:26:59,600
Speaker 1: and like, I'm sure that, I mean, I know that's

460
00:26:59,560 --> 00:27:02,040
Speaker 1: so happen, but it just seems like that happened a

461
00:27:02,080 --> 00:27:05,840
Speaker 1: lot more back in the day. And maybe in the

462
00:27:05,840 --> 00:27:08,760
Speaker 1: future things like this will be less and less.

463
00:27:08,840 --> 00:27:10,240
Speaker 2: Yeah, that's the hope for sure.

464
00:27:11,400 --> 00:27:14,119
Speaker 1: I know that's sort of a basic, sort of an

465
00:27:14,119 --> 00:27:16,280
Speaker 1: elementary way of looking at it, but I just feel

466
00:27:16,280 --> 00:27:19,479
Speaker 1: like parents are more aware of stuff these days, and like,

467
00:27:19,560 --> 00:27:22,280
Speaker 1: you know, people of our generation and certainly the generations

468
00:27:22,320 --> 00:27:25,040
Speaker 1: before that, it was even worse as far as parental

469
00:27:25,040 --> 00:27:28,280
Speaker 1: involvement and parents who either one or the other. You know,

470
00:27:29,320 --> 00:27:31,600
Speaker 1: fathers a lot of times, you know, historically the ones

471
00:27:31,600 --> 00:27:33,480
Speaker 1: that are like, no, we're we're not going to parent

472
00:27:33,520 --> 00:27:35,199
Speaker 1: because we're doing the work and we're gonna bring home

473
00:27:35,240 --> 00:27:38,840
Speaker 1: the paycheck. And so like I had, I've talked about

474
00:27:38,840 --> 00:27:41,600
Speaker 1: it before. I had a dad that wasn't very involved,

475
00:27:41,840 --> 00:27:45,199
Speaker 1: but it wasn't like the kind of thing where I

476
00:27:45,320 --> 00:27:47,800
Speaker 1: ended up with BPD because of it, you know, yeah,

477
00:27:47,840 --> 00:27:49,360
Speaker 1: for sure, if that makes sense.

478
00:27:49,440 --> 00:27:52,800
Speaker 2: You raise a question though, in my mind, I wonder

479
00:27:52,920 --> 00:27:57,760
Speaker 2: what percentage of boomer grandparents are allowed to see their grandchildren.

480
00:27:59,160 --> 00:28:02,560
Speaker 4: I'll bet at hire you think are allowed to or not.

481
00:28:02,960 --> 00:28:06,520
Speaker 2: Allowed to, like just don't have contact with their grandkids.

482
00:28:06,840 --> 00:28:10,719
Speaker 1: Yeah, or it's very limited and supervised. And so actually

483
00:28:10,720 --> 00:28:12,920
Speaker 1: though a lot of those grandparents, all of a sudden,

484
00:28:13,000 --> 00:28:15,639
Speaker 1: are the most doting, and it's kind of like, I

485
00:28:15,680 --> 00:28:18,000
Speaker 1: know some parents are like, oh, okay, well this is great.

486
00:28:18,920 --> 00:28:21,000
Speaker 1: Yeah when I was a kids, right, sure, for sure.

487
00:28:21,119 --> 00:28:24,080
Speaker 2: But also I think in some of the cases that

488
00:28:24,480 --> 00:28:27,880
Speaker 2: the more they dote, they're actually also undermining the parenting

489
00:28:27,960 --> 00:28:28,680
Speaker 2: of their kids.

490
00:28:28,880 --> 00:28:29,080
Speaker 3: Yeah.

491
00:28:30,200 --> 00:28:33,119
Speaker 1: Yes, And imagine it can be very painful for a

492
00:28:33,160 --> 00:28:37,720
Speaker 1: parent who had a unattentive parent to now have that

493
00:28:37,800 --> 00:28:39,480
Speaker 1: parent be a very intentive grandparent.

494
00:28:39,600 --> 00:28:41,640
Speaker 2: You have BPD, I would guess that would be a

495
00:28:41,760 --> 00:28:42,840
Speaker 2: rage inducing trigger.

496
00:28:43,400 --> 00:28:44,400
Speaker 4: I imagine it would be.

497
00:28:44,760 --> 00:28:48,640
Speaker 2: So there are plenty of other ways that you could

498
00:28:48,720 --> 00:28:52,040
Speaker 2: probably develop VPD. Another very classic one is any kind

499
00:28:52,120 --> 00:28:55,400
Speaker 2: of abuse emotional, sexual, physical abuse at the hands of

500
00:28:55,400 --> 00:28:59,680
Speaker 2: your parent or a caregiver. And they say that about

501
00:28:59,720 --> 00:29:03,280
Speaker 2: eighty percent of people with BPD experience some level of

502
00:29:03,520 --> 00:29:08,280
Speaker 2: childhood trauma, whether it was emotional neglect or some sort

503
00:29:08,280 --> 00:29:11,920
Speaker 2: of abuse. It is. It's a huge factor, a huge

504
00:29:12,000 --> 00:29:14,360
Speaker 2: risk factor in developing BPD for sure.

505
00:29:15,080 --> 00:29:19,240
Speaker 1: Yeah, absolutely, And it seems to be exacerbated if you're

506
00:29:19,280 --> 00:29:23,480
Speaker 1: a kid who is maybe you're just innately a little

507
00:29:23,560 --> 00:29:26,400
Speaker 1: more unsure of yourself or a little more vulnerable as

508
00:29:26,440 --> 00:29:31,040
Speaker 1: a person, and then that is reinforced with a parent

509
00:29:31,080 --> 00:29:35,200
Speaker 1: who is not validating your experience and your emotion as

510
00:29:35,240 --> 00:29:38,520
Speaker 1: a kid. So you're already starting back sort of behind

511
00:29:38,520 --> 00:29:40,520
Speaker 1: the eight ball, and then your parents are making it worse,

512
00:29:41,240 --> 00:29:44,880
Speaker 1: and so that can definitely, you know, easy toward that condition.

513
00:29:45,080 --> 00:29:48,000
Speaker 2: Well, it's like that's a chicken or the egg question though,

514
00:29:48,080 --> 00:29:51,080
Speaker 2: like were you like that you know already and your

515
00:29:51,120 --> 00:29:53,720
Speaker 2: parents is reinforcing it, or did you get that kind

516
00:29:53,720 --> 00:29:56,320
Speaker 2: of did you learn to do that because of your parents' behavior.

517
00:29:56,320 --> 00:30:00,160
Speaker 2: It's like a chicken or the egg, parent or the disorder, right,

518
00:30:00,320 --> 00:30:03,680
Speaker 2: you know. But we said earlier that there's also believed

519
00:30:03,680 --> 00:30:06,200
Speaker 2: to be a biological component to it too, that it's

520
00:30:06,280 --> 00:30:10,600
Speaker 2: not all psychological, and it does seem to have something

521
00:30:10,600 --> 00:30:13,320
Speaker 2: to do with executive function in the brain. One of

522
00:30:13,320 --> 00:30:17,360
Speaker 2: the big things that executive functioning does is it helps

523
00:30:17,400 --> 00:30:22,320
Speaker 2: you control your emotions, not just in accepting things and

524
00:30:22,560 --> 00:30:26,200
Speaker 2: dealing with them and moving on, but also your outward

525
00:30:26,280 --> 00:30:30,600
Speaker 2: display of emotions. If you don't have executive function, your

526
00:30:30,600 --> 00:30:36,600
Speaker 2: emotional dysregulation is more likely to include explosions of anger,

527
00:30:37,000 --> 00:30:40,320
Speaker 2: uncontrollable anger. And then one of the things, it's not

528
00:30:40,400 --> 00:30:44,600
Speaker 2: just BPD that has that, there's plenty of other disorders

529
00:30:44,600 --> 00:30:47,280
Speaker 2: that have it. But one of the key traits of

530
00:30:47,360 --> 00:30:50,400
Speaker 2: BPD is it can last a really long time too.

531
00:30:51,920 --> 00:30:54,440
Speaker 1: Can we make a T shirt that has a chicken

532
00:30:56,080 --> 00:30:59,720
Speaker 1: that says parent across the chicken's chest and then next

533
00:30:59,720 --> 00:31:02,600
Speaker 1: to it an egg that says mental disorder? Love it

534
00:31:03,440 --> 00:31:06,080
Speaker 1: and just that's the shirt. No explanation, figure it out

535
00:31:06,240 --> 00:31:06,600
Speaker 1: or don't.

536
00:31:06,760 --> 00:31:09,000
Speaker 2: How about this though, On the back of the shirt,

537
00:31:09,480 --> 00:31:12,760
Speaker 2: Mork is coming out of the egg all right to

538
00:31:12,840 --> 00:31:14,240
Speaker 2: really confuse people.

539
00:31:16,560 --> 00:31:18,360
Speaker 4: Oh wow, that just really changed things.

540
00:31:18,400 --> 00:31:19,080
Speaker 2: I like it, Okay.

541
00:31:19,800 --> 00:31:24,000
Speaker 1: So as far as the number of people who experience BPD,

542
00:31:25,080 --> 00:31:27,120
Speaker 1: it's kind of a wide range, like all this stuff,

543
00:31:27,160 --> 00:31:30,320
Speaker 1: because it's one of those disorders that is a lot

544
00:31:30,320 --> 00:31:32,600
Speaker 1: of people don't admit it or seek treatment, so it's

545
00:31:32,600 --> 00:31:35,960
Speaker 1: really hard to nail it down. But Lyba helped us

546
00:31:35,960 --> 00:31:37,960
Speaker 1: out with this one, and she said zero point five

547
00:31:38,000 --> 00:31:41,400
Speaker 1: percent to six percent, and they find it about four

548
00:31:41,400 --> 00:31:44,400
Speaker 1: times more in women but they've also found other studies

549
00:31:44,400 --> 00:31:46,880
Speaker 1: are like, no, it's the women who are brave enough

550
00:31:46,920 --> 00:31:49,600
Speaker 1: to come forward and seek treatment, and it happens just

551
00:31:49,640 --> 00:31:50,400
Speaker 1: as much in men.

552
00:31:50,520 --> 00:31:53,240
Speaker 2: I also saw that it's a that's an indictment of

553
00:31:53,280 --> 00:31:58,440
Speaker 2: clinicians who basically have to figure out for themselves whether

554
00:31:58,520 --> 00:32:01,360
Speaker 2: the person has BPD, that they're more likely to assign

555
00:32:01,360 --> 00:32:03,760
Speaker 2: it to a woman than a man a male patient.

556
00:32:04,080 --> 00:32:04,760
Speaker 4: Oh interesting.

557
00:32:05,640 --> 00:32:10,000
Speaker 2: So regardless, it is very frequently diagnosed, more than you

558
00:32:10,000 --> 00:32:14,040
Speaker 2: would think. It's one of the more common serious mental illnesses. Apparently,

559
00:32:14,800 --> 00:32:19,400
Speaker 2: people receiving impatient mental health treatment, one in five of

560
00:32:19,440 --> 00:32:23,480
Speaker 2: those people are diagnosed with BPD. So it is very prevalent,

561
00:32:23,520 --> 00:32:27,320
Speaker 2: at least inside the clink.

562
00:32:28,280 --> 00:32:32,560
Speaker 1: Yeah, the mental clink, Yeah, the mental clink. One other

563
00:32:32,680 --> 00:32:37,200
Speaker 1: aspect is a very black and white thinking. You kind

564
00:32:37,200 --> 00:32:42,280
Speaker 1: of talked before about splitting, which is, you know, really

565
00:32:42,320 --> 00:32:46,640
Speaker 1: revering and idolizing somebody and then very quickly despising them.

566
00:32:47,480 --> 00:32:50,760
Speaker 1: And this can happen very very frequently and like several

567
00:32:50,800 --> 00:32:53,760
Speaker 1: times throughout a day even or it can be like

568
00:32:53,960 --> 00:32:57,560
Speaker 1: just a switch that is permanent, like someone you used

569
00:32:57,560 --> 00:33:00,320
Speaker 1: to really like and idolize all of a sudden just

570
00:33:00,440 --> 00:33:02,320
Speaker 1: no more. You despise them, and they're they're on the

571
00:33:02,640 --> 00:33:03,959
Speaker 1: bad person list forever.

572
00:33:04,240 --> 00:33:06,880
Speaker 2: Yeah, and that's that falls under the larger category of

573
00:33:06,920 --> 00:33:09,719
Speaker 2: black and white thinking. It's not just applied to people,

574
00:33:09,800 --> 00:33:15,560
Speaker 2: it's events, things, anything a dandelion can be entirely evil

575
00:33:15,960 --> 00:33:20,080
Speaker 2: or the fully good. And because you see things in

576
00:33:20,120 --> 00:33:23,560
Speaker 2: people and events as entirely one way or the other,

577
00:33:24,200 --> 00:33:27,000
Speaker 2: you set people up for unrealistic expectations. If you're like,

578
00:33:27,280 --> 00:33:31,760
Speaker 2: you're one percent pure and kind person and I love you,

579
00:33:32,040 --> 00:33:34,680
Speaker 2: that person is inevitably going to let you down in

580
00:33:34,680 --> 00:33:37,000
Speaker 2: some way, shape or form. Sure, because no one's one

581
00:33:37,040 --> 00:33:40,040
Speaker 2: hundred percent pure and kind. Similarly, no one's one hundred

582
00:33:40,040 --> 00:33:44,479
Speaker 2: percent evil. And most people that you would label evil

583
00:33:44,560 --> 00:33:46,840
Speaker 2: as if you have VPD, probably aren't evil at all.

584
00:33:46,880 --> 00:33:49,320
Speaker 2: They just did something you really didn't like. But now

585
00:33:49,360 --> 00:33:53,800
Speaker 2: to you, that person is evil, not to be trusted,

586
00:33:54,200 --> 00:33:58,320
Speaker 2: not you know, they did something wrong. At their core,

587
00:33:58,440 --> 00:34:02,360
Speaker 2: they're evil, And that's another huge hallmark of BPD as well.

588
00:34:03,360 --> 00:34:06,880
Speaker 1: Yeah, I mean even Darth Vader was once a young boy, Yeah,

589
00:34:07,440 --> 00:34:08,960
Speaker 1: just trying to learn the ways of the force.

590
00:34:09,400 --> 00:34:11,640
Speaker 2: But boy did he get pale as he aged.

591
00:34:13,600 --> 00:34:14,239
Speaker 4: He sure did.

592
00:34:15,160 --> 00:34:19,680
Speaker 1: This can also this splitting can happen with yourself. You

593
00:34:20,080 --> 00:34:24,719
Speaker 1: may vacillate wildly from feeling like you're you're okay and

594
00:34:24,760 --> 00:34:26,440
Speaker 1: that you feel good about yourself and you have a

595
00:34:26,440 --> 00:34:30,799
Speaker 1: little bit of self confidence to really loathing yourself. And

596
00:34:31,800 --> 00:34:34,480
Speaker 1: that's when like things like you know, self harm can

597
00:34:34,480 --> 00:34:37,839
Speaker 1: come into play. Your sense of your own personality can

598
00:34:37,880 --> 00:34:42,760
Speaker 1: really change your you know, you could very much switch,

599
00:34:42,800 --> 00:34:46,120
Speaker 1: like kind of do these wild switches between your goals

600
00:34:46,160 --> 00:34:48,800
Speaker 1: in life for or how you want to present yourself

601
00:34:48,800 --> 00:34:51,719
Speaker 1: to the world, or like your values and ethics and

602
00:34:51,760 --> 00:34:54,440
Speaker 1: things like that. And this I'm not really sure, but

603
00:34:54,480 --> 00:34:58,759
Speaker 1: it kind of seems like almost like sort of auditioning

604
00:34:59,200 --> 00:35:02,759
Speaker 1: yourself kind of over and over sometimes like let me

605
00:35:03,160 --> 00:35:06,080
Speaker 1: try this new me or whatever, or auditioning or trying

606
00:35:06,120 --> 00:35:08,560
Speaker 1: out a new thing that you think might help.

607
00:35:10,440 --> 00:35:10,759
Speaker 4: Make sense.

608
00:35:10,840 --> 00:35:13,839
Speaker 2: Yeah, no, totally. It's also circumstantial too. They might act

609
00:35:13,840 --> 00:35:16,239
Speaker 2: different ways to different people depending on what they think

610
00:35:16,280 --> 00:35:20,400
Speaker 2: those people want from them, or yes, to impress like

611
00:35:20,680 --> 00:35:23,040
Speaker 2: a friend or a new person or something like that.

612
00:35:23,080 --> 00:35:27,680
Speaker 2: They might adopt that person's like hobbies and interests. But

613
00:35:28,000 --> 00:35:31,080
Speaker 2: I saw it explained as the people who have VPD

614
00:35:31,160 --> 00:35:34,520
Speaker 2: and do that that they don't understand where they end

615
00:35:34,600 --> 00:35:37,600
Speaker 2: or the other person begins, because they have no idea

616
00:35:37,680 --> 00:35:40,720
Speaker 2: what they believe in. They just don't know, so they're

617
00:35:40,840 --> 00:35:44,840
Speaker 2: kind of open for suggestions. Basically interesting.

618
00:35:44,960 --> 00:35:48,000
Speaker 1: Yeah, should we take a break?

619
00:35:48,360 --> 00:35:50,280
Speaker 2: Oh jeez, that came out of left field.

620
00:35:50,640 --> 00:35:53,319
Speaker 1: Sorry, sure, all right, I think it's a good time

621
00:35:53,320 --> 00:35:54,680
Speaker 1: to take a break, and then we're going to come

622
00:35:54,719 --> 00:36:18,719
Speaker 1: back and talk more about personal relationships. All right, we're

623
00:36:18,760 --> 00:36:23,920
Speaker 1: back and talking about borderline personality disorder. And one kind

624
00:36:23,960 --> 00:36:29,960
Speaker 1: of hallmark with someone with BPD is what's called like

625
00:36:30,000 --> 00:36:34,440
Speaker 1: a favorite person, or just a person in their life

626
00:36:34,480 --> 00:36:38,640
Speaker 1: that they have have not necessarily even chosen, who they've

627
00:36:38,640 --> 00:36:40,279
Speaker 1: hooked up with. It could be a spouse, it could

628
00:36:40,280 --> 00:36:43,400
Speaker 1: be a partner, It could be a friend or coworker,

629
00:36:43,520 --> 00:36:48,600
Speaker 1: anyone that you really have latched onto as someone maybe

630
00:36:48,640 --> 00:36:53,600
Speaker 1: the only person that you really really trust with yourself.

631
00:36:53,880 --> 00:36:56,000
Speaker 2: Yeah, and I don't think you even trust that person.

632
00:36:56,080 --> 00:36:58,319
Speaker 2: You just that's the person you've come to find you

633
00:36:58,360 --> 00:37:01,319
Speaker 2: can lean on the most, I think. Okay, but yeah,

634
00:37:01,320 --> 00:37:03,920
Speaker 2: the FP, for those in the know, the favorite person

635
00:37:05,239 --> 00:37:12,840
Speaker 2: is very frequently somebody who is willing to kind of

636
00:37:12,880 --> 00:37:15,080
Speaker 2: go along with this, at least for a while. There's

637
00:37:15,120 --> 00:37:18,160
Speaker 2: a ton of flattery and admiration and praise, and all

638
00:37:18,200 --> 00:37:21,640
Speaker 2: of your greatest points are pointed out all the time.

639
00:37:22,920 --> 00:37:27,720
Speaker 2: But you're also in real danger of letting that person

640
00:37:27,840 --> 00:37:31,399
Speaker 2: down and facing that wrath of rage or anger or hostility.

641
00:37:32,560 --> 00:37:35,120
Speaker 2: And if you come back for more, you're going to

642
00:37:35,160 --> 00:37:38,400
Speaker 2: find that you, as the favorite person, might start altering

643
00:37:38,440 --> 00:37:42,200
Speaker 2: your behavior to fit the person with BPD's behavior, so

644
00:37:42,600 --> 00:37:45,480
Speaker 2: you might start considering them when you're making plans like, oh,

645
00:37:45,520 --> 00:37:49,080
Speaker 2: we can't go out of town this weekend because our

646
00:37:49,120 --> 00:37:51,960
Speaker 2: friend with BPD was going to, you know, wanted us

647
00:37:52,000 --> 00:37:55,520
Speaker 2: to come out for their Sunday picnic or something like that.

648
00:37:55,640 --> 00:37:58,840
Speaker 2: Right like, you would be afraid to not go to

649
00:37:58,880 --> 00:38:02,440
Speaker 2: their picnic, And you generally end up feeling like you're

650
00:38:02,480 --> 00:38:06,400
Speaker 2: walking on eggshells. And it's a codependent relationship that evolves.

651
00:38:07,239 --> 00:38:09,960
Speaker 2: The favorite person seems to be the person who's willing

652
00:38:10,000 --> 00:38:12,319
Speaker 2: to take it the longest or the most, and that

653
00:38:12,400 --> 00:38:16,600
Speaker 2: it's not a permanent thing. Typically people get burned out

654
00:38:16,640 --> 00:38:20,479
Speaker 2: on it and eventually abandon the person with BPD, which

655
00:38:20,520 --> 00:38:23,560
Speaker 2: is again at the root of what they are fearful of.

656
00:38:23,640 --> 00:38:27,920
Speaker 2: They're fearful of rejection or abandonment. The tragedy of the

657
00:38:27,920 --> 00:38:32,759
Speaker 2: whole thing is that their behavior almost inevitably guarantees that

658
00:38:32,840 --> 00:38:35,680
Speaker 2: they will be rejected or abandoned by the people around them.

659
00:38:36,280 --> 00:38:40,839
Speaker 1: Yeah, that sort of self fulfilling feedback loop. Yeah, I mean,

660
00:38:41,520 --> 00:38:45,839
Speaker 1: it's a big burden for an FP. And if you

661
00:38:45,880 --> 00:38:49,040
Speaker 1: are a spouse or partner of someone and you are

662
00:38:49,080 --> 00:38:51,920
Speaker 1: the FP, like, that's a lot to manage, and so

663
00:38:52,320 --> 00:38:54,520
Speaker 1: a lot of empathy goes out to those people as

664
00:38:54,520 --> 00:38:58,320
Speaker 1: well when you're altering your own behaviors, like literally things

665
00:38:58,400 --> 00:39:01,040
Speaker 1: like I saw people or like you know, had to

666
00:39:02,200 --> 00:39:04,520
Speaker 1: I've had to step out of like really important meetings

667
00:39:05,040 --> 00:39:08,440
Speaker 1: just to answer a text within ten minutes because I

668
00:39:08,520 --> 00:39:11,880
Speaker 1: knew that that would set them off. And just little

669
00:39:11,880 --> 00:39:15,160
Speaker 1: things like that can really add up to someone's burden.

670
00:39:16,239 --> 00:39:18,839
Speaker 2: One of the other things that is difficult to deal

671
00:39:18,880 --> 00:39:21,640
Speaker 2: with when you're an FP is that person wants you

672
00:39:21,680 --> 00:39:25,000
Speaker 2: all of themselves. They're yeah, right, and very much by

673
00:39:25,040 --> 00:39:27,680
Speaker 2: other people. So they will try to isolate you from

674
00:39:27,719 --> 00:39:30,360
Speaker 2: your other friends and your family so that they have

675
00:39:30,440 --> 00:39:32,839
Speaker 2: you all of themselves, not just for time, I'm sure

676
00:39:32,880 --> 00:39:34,719
Speaker 2: time is a big part of it, but also to

677
00:39:34,880 --> 00:39:39,960
Speaker 2: cut down on any I guess rational explanation or rational

678
00:39:40,000 --> 00:39:42,200
Speaker 2: points from those other people, like what are you doing?

679
00:39:42,239 --> 00:39:45,439
Speaker 2: Why are you putting up with this? Isolating them would

680
00:39:45,440 --> 00:39:46,680
Speaker 2: help cut down on that too.

681
00:39:47,440 --> 00:39:49,920
Speaker 1: Yeah, and you know, if you're an FP, there's always

682
00:39:50,000 --> 00:39:54,160
Speaker 1: the sort of sad and scary possibility that there could

683
00:39:54,200 --> 00:39:58,440
Speaker 1: be a split incident that all of a sudden you

684
00:39:58,520 --> 00:40:01,800
Speaker 1: go from being the FP to be the most despised person.

685
00:40:03,480 --> 00:40:06,480
Speaker 1: I would imagine that's something that has probably comes over

686
00:40:06,560 --> 00:40:09,200
Speaker 1: time and is not like a quick thing. It can

687
00:40:09,239 --> 00:40:11,759
Speaker 1: be but it can be all right.

688
00:40:11,640 --> 00:40:14,359
Speaker 2: For sure. It can happen, It can turn on a dime.

689
00:40:15,920 --> 00:40:18,640
Speaker 2: And the other problem with it as well, Chuck, is

690
00:40:18,680 --> 00:40:25,640
Speaker 2: that the person with BPD almost invariably immediately regrets doing

691
00:40:25,680 --> 00:40:28,440
Speaker 2: that right, and so they will make every effort to

692
00:40:28,560 --> 00:40:31,360
Speaker 2: try to win the person back, which probably feels pretty

693
00:40:31,360 --> 00:40:34,879
Speaker 2: gross for the FP, and they'll say things like I'll

694
00:40:34,880 --> 00:40:37,319
Speaker 2: never do that again, like they know what they've just

695
00:40:37,520 --> 00:40:40,600
Speaker 2: done is worth regretting, is worth feeling horrible about because

696
00:40:40,600 --> 00:40:43,520
Speaker 2: they've just been abandoned or rejected. They just did it

697
00:40:43,520 --> 00:40:45,600
Speaker 2: to themselves, so now they're trying to fix it or

698
00:40:45,640 --> 00:40:47,840
Speaker 2: mend it. But it's all just kind of built on

699
00:40:48,080 --> 00:40:51,959
Speaker 2: you know, hicky ground because it's it's gonna happen again,

700
00:40:52,040 --> 00:40:54,759
Speaker 2: because it's impossible for that person not to let the

701
00:40:54,760 --> 00:40:56,320
Speaker 2: person with BPD down again.

702
00:40:57,280 --> 00:40:59,400
Speaker 1: Yeah, I mean, I get the impression that people with

703
00:40:59,520 --> 00:41:04,240
Speaker 1: bp D generally don't have any illusions about themselves because

704
00:41:04,239 --> 00:41:05,200
Speaker 1: it is such a struggle.

705
00:41:05,280 --> 00:41:09,560
Speaker 2: Well, that is a big problem with not only getting treatment,

706
00:41:09,600 --> 00:41:13,600
Speaker 2: but seeking treatment, because when your brain is structured in

707
00:41:13,640 --> 00:41:16,160
Speaker 2: a certain way, and ever since you were a little kid,

708
00:41:16,400 --> 00:41:19,319
Speaker 2: you've just responded a certain way to things. Even if

709
00:41:19,400 --> 00:41:21,759
Speaker 2: people around you are telling you that is messed up

710
00:41:22,120 --> 00:41:25,640
Speaker 2: or that you're being hustle or whatever, to you, that's normal,

711
00:41:25,920 --> 00:41:29,319
Speaker 2: that's natural. So it's really really hard to interrogate your

712
00:41:29,320 --> 00:41:33,240
Speaker 2: own behavior, let alone change it, because it seems normal

713
00:41:33,360 --> 00:41:36,520
Speaker 2: and natural to you. It's not that you need to

714
00:41:36,600 --> 00:41:40,480
Speaker 2: change your behavior because you chase somebody away. It's that

715
00:41:40,480 --> 00:41:42,360
Speaker 2: that person left to you now you need to go

716
00:41:42,400 --> 00:41:45,879
Speaker 2: get them back. So even if you have people around

717
00:41:45,920 --> 00:41:49,600
Speaker 2: you telling you, it's going to take a lot of emphasis, repeated,

718
00:41:50,320 --> 00:41:54,480
Speaker 2: constant emphasis, that what you're doing right now is abnormal

719
00:41:54,760 --> 00:41:57,520
Speaker 2: and harmful and you need to go get help for this.

720
00:41:58,560 --> 00:42:01,279
Speaker 2: That's yeah, that's one of the curses of it. They

721
00:42:01,280 --> 00:42:04,320
Speaker 2: can't see it. They at least if they can see it,

722
00:42:04,480 --> 00:42:06,960
Speaker 2: most of the time they can't well.

723
00:42:07,000 --> 00:42:09,680
Speaker 1: And this is I mean, all the mental health disorders

724
00:42:09,760 --> 00:42:12,759
Speaker 1: require a support system, but this one really seems to

725
00:42:13,400 --> 00:42:14,759
Speaker 1: sort of be at the top of the list of

726
00:42:14,800 --> 00:42:21,640
Speaker 1: needing a really solid, vast support system for treatment. Like

727
00:42:21,680 --> 00:42:25,920
Speaker 1: we said, the good news is that treatment works. They

728
00:42:26,080 --> 00:42:30,680
Speaker 1: used to think that personality disorders were untreatable and that

729
00:42:30,719 --> 00:42:32,080
Speaker 1: you were just kind of stuck with it.

730
00:42:33,120 --> 00:42:36,000
Speaker 4: They have found that about half.

731
00:42:35,800 --> 00:42:39,080
Speaker 1: The people who are treated, who seek treatment and are

732
00:42:39,120 --> 00:42:42,680
Speaker 1: treated no longer meet the criteria after five to ten years.

733
00:42:42,760 --> 00:42:43,160
Speaker 2: Amazing.

734
00:42:43,280 --> 00:42:45,880
Speaker 1: It doesn't mean that they're you know, they're perfect and

735
00:42:45,920 --> 00:42:49,120
Speaker 1: awesome and fixed. It means they can still have some symptoms,

736
00:42:49,120 --> 00:42:51,480
Speaker 1: but they have it under control enough to where they

737
00:42:51,520 --> 00:42:54,640
Speaker 1: don't meet that five out of nine criteria. And that's

738
00:42:54,680 --> 00:42:56,680
Speaker 1: what it's really sort of about, I think, is managing

739
00:42:58,400 --> 00:43:01,560
Speaker 1: something that, like you said, that you might have had

740
00:43:01,560 --> 00:43:05,520
Speaker 1: since you were like a baby, to live a productive,

741
00:43:05,800 --> 00:43:07,040
Speaker 1: you know, healthy life.

742
00:43:07,160 --> 00:43:08,839
Speaker 2: Yeah, and that's kind of what you're going to learn

743
00:43:08,840 --> 00:43:13,720
Speaker 2: in DBT, which again is the gold standard for treating BPD,

744
00:43:14,360 --> 00:43:16,759
Speaker 2: is that you're going to be taught these skills, how

745
00:43:16,800 --> 00:43:21,240
Speaker 2: to deal with disappointment, with being let down, with somebody

746
00:43:21,280 --> 00:43:23,400
Speaker 2: not responding to your text. You're going to learn a

747
00:43:23,440 --> 00:43:25,960
Speaker 2: different set of skills and how to deal with that,

748
00:43:26,360 --> 00:43:29,520
Speaker 2: both internally and externally. And one of the things that

749
00:43:30,840 --> 00:43:34,200
Speaker 2: kind of differentiates DBT from other kinds of behavioral therapy

750
00:43:35,160 --> 00:43:39,160
Speaker 2: is that there's group sessions, but it's not a group

751
00:43:39,200 --> 00:43:42,040
Speaker 2: session that you know, you've seen in a movie like

752
00:43:42,160 --> 00:43:44,400
Speaker 2: My nice Mela was in a movie called No Exit,

753
00:43:44,440 --> 00:43:46,920
Speaker 2: and that featured a couple of group sessions. I think

754
00:43:46,960 --> 00:43:48,600
Speaker 2: you can still see that on Netflix.

755
00:43:49,080 --> 00:43:49,480
Speaker 4: I think so.

756
00:43:49,600 --> 00:43:51,319
Speaker 2: But it's not like that. It's more almost like a

757
00:43:51,320 --> 00:43:55,200
Speaker 2: classroom instead, and then people get up and practice these

758
00:43:55,239 --> 00:43:58,759
Speaker 2: skills in front of others and with others. But it's

759
00:43:58,760 --> 00:44:02,719
Speaker 2: not like a group therapy session in the traditional sense.

760
00:44:02,760 --> 00:44:05,560
Speaker 2: But that's a huge component of it is group work.

761
00:44:06,239 --> 00:44:08,200
Speaker 1: Yeah, And it's you know, if it sounds a little

762
00:44:08,239 --> 00:44:11,400
Speaker 1: bit like cognitive behavioral therapy, it is sort of based

763
00:44:11,440 --> 00:44:14,799
Speaker 1: on that in part because it's a real and I

764
00:44:14,840 --> 00:44:17,000
Speaker 1: get how it works. It seems like a real sort

765
00:44:17,000 --> 00:44:21,799
Speaker 1: of rubber meets the road practical ways of learning new

766
00:44:21,880 --> 00:44:23,200
Speaker 1: behaviors rather than.

767
00:44:24,760 --> 00:44:27,040
Speaker 4: And therapy is a huge part of it.

768
00:44:27,120 --> 00:44:30,359
Speaker 1: But it's not just lets therapy and talk about your

769
00:44:30,480 --> 00:44:33,400
Speaker 1: past until you're blue in the face. It's like, all right,

770
00:44:33,440 --> 00:44:35,640
Speaker 1: we know what's going on, and we think we know

771
00:44:35,680 --> 00:44:38,600
Speaker 1: where it came from. Generally, Now, let's really talk about

772
00:44:39,280 --> 00:44:44,759
Speaker 1: putting this into daily practice, like literally doing things and

773
00:44:44,800 --> 00:44:48,800
Speaker 1: having a checklist and putting stuff into practice, which I

774
00:44:48,840 --> 00:44:51,840
Speaker 1: think is just I mean not only for DBT, but

775
00:44:51,920 --> 00:44:54,560
Speaker 1: stuff like that is so it so speaks to me

776
00:44:54,800 --> 00:44:57,840
Speaker 1: as a good way forward when you have any kinds

777
00:44:57,840 --> 00:45:03,400
Speaker 1: of problems because it's just a practical thing. It's learning

778
00:45:03,480 --> 00:45:04,279
Speaker 1: new behaviors.

779
00:45:04,719 --> 00:45:10,239
Speaker 2: That's another criticism of BPD as its own disorder, that

780
00:45:11,040 --> 00:45:15,160
Speaker 2: DBT can be used to treat all sorts of different

781
00:45:15,200 --> 00:45:17,719
Speaker 2: symptoms of all sorts of different disorders. It just makes

782
00:45:17,719 --> 00:45:21,560
Speaker 2: sense like that, yeah, for sure. But there's also another

783
00:45:21,560 --> 00:45:24,040
Speaker 2: type of therapy that supposedly works really well for DBT

784
00:45:24,160 --> 00:45:28,000
Speaker 2: called psychodynamic therapy, and it is talking about what you

785
00:45:28,040 --> 00:45:29,920
Speaker 2: went through as a child. So you're blue in the face,

786
00:45:30,280 --> 00:45:34,280
Speaker 2: but it's more about relating to relating that to how

787
00:45:34,360 --> 00:45:38,319
Speaker 2: you deal with people in your current life, people in situations.

788
00:45:38,360 --> 00:45:40,920
Speaker 2: It's relating it back to it so that it's not

789
00:45:40,960 --> 00:45:45,080
Speaker 2: just one big confusing blob. You understand your own behavior

790
00:45:45,160 --> 00:45:49,640
Speaker 2: better as a result of interrogating what you went through

791
00:45:49,680 --> 00:45:52,719
Speaker 2: as a kid. And I guess it smells a lot

792
00:45:52,760 --> 00:45:59,520
Speaker 2: like it believes borderline is like a response to trauma

793
00:46:00,160 --> 00:46:02,200
Speaker 2: using a rather than anything else.

794
00:46:02,960 --> 00:46:05,399
Speaker 1: Yeah, I mean, if you can sort of build out

795
00:46:05,400 --> 00:46:09,680
Speaker 1: your emotional life map, I imagine that's a very helpful

796
00:46:09,680 --> 00:46:10,799
Speaker 1: thing to do, you know.

797
00:46:11,000 --> 00:46:12,880
Speaker 2: Yeah. And then one other thing that really kind of

798
00:46:12,960 --> 00:46:17,840
Speaker 2: underscores how difficult dealing with people with borderline personality disorder

799
00:46:17,920 --> 00:46:22,600
Speaker 2: can be. One of the main components of dialectical behavioral

800
00:46:22,640 --> 00:46:26,920
Speaker 2: therapy is what's called a therapist consultation team, which is

801
00:46:27,000 --> 00:46:31,240
Speaker 2: basically a group of therapists working with patients with BPD

802
00:46:32,440 --> 00:46:37,600
Speaker 2: having like a like a blowoff steam session about them, right,

803
00:46:37,680 --> 00:46:40,279
Speaker 2: and reminding one another like, these are people suffering and

804
00:46:40,320 --> 00:46:42,759
Speaker 2: we need to have empathy for them. That's how hard

805
00:46:42,800 --> 00:46:44,680
Speaker 2: it can be to treat people with BPD.

806
00:46:45,640 --> 00:46:47,640
Speaker 1: Yeah, And like I said at the beginning, there are

807
00:46:47,800 --> 00:46:50,680
Speaker 1: therapists that will refuse treatment because.

808
00:46:52,160 --> 00:46:53,800
Speaker 4: All the reasons that we talked about.

809
00:46:54,239 --> 00:46:57,400
Speaker 1: They say that National Alliance on Mental Health basically says,

810
00:46:57,480 --> 00:47:00,680
Speaker 1: if you have BPD and you wreckon that and you

811
00:47:00,680 --> 00:47:04,560
Speaker 1: want to see treatment, whether it's you know, DBT or

812
00:47:04,560 --> 00:47:07,640
Speaker 1: any other kind you Uh, well, first of all, seek

813
00:47:07,640 --> 00:47:10,840
Speaker 1: out someone that specializes in DVT. But if there's no

814
00:47:10,840 --> 00:47:13,160
Speaker 1: one in your area that does that, then, like you,

815
00:47:13,160 --> 00:47:15,240
Speaker 1: you have a right and this this goes with any

816
00:47:15,600 --> 00:47:18,920
Speaker 1: sort of emotional or mental problems that anyone has that

817
00:47:19,080 --> 00:47:21,200
Speaker 1: they're working for you. So you have the right to

818
00:47:22,120 --> 00:47:25,400
Speaker 1: advocate for yourself and to find somebody who works for

819
00:47:25,520 --> 00:47:30,640
Speaker 1: you and who who will not stigmatize you, and like

820
00:47:30,760 --> 00:47:34,480
Speaker 1: really like it's okay to question them and make sure

821
00:47:34,520 --> 00:47:35,560
Speaker 1: it's a good fit for you.

822
00:47:36,080 --> 00:47:36,919
Speaker 2: Yeah, for sure.

823
00:47:38,360 --> 00:47:40,960
Speaker 1: I think people just I don't know, it's I think

824
00:47:41,000 --> 00:47:42,760
Speaker 1: part of the problems with a lot of these disorders

825
00:47:42,880 --> 00:47:45,480
Speaker 1: is people can't be advocates for themselves, and then that

826
00:47:45,560 --> 00:47:47,120
Speaker 1: might be part of their problems. So they're not going

827
00:47:47,160 --> 00:47:50,319
Speaker 1: to advocate for themselves when receiving treatment, and they'll just

828
00:47:50,360 --> 00:47:53,520
Speaker 1: take whatever they can get. And it's not all therapies

829
00:47:53,520 --> 00:47:55,880
Speaker 1: are created equal, and in therapists are created definitely not.

830
00:47:56,120 --> 00:47:57,799
Speaker 2: I think one of the problems with BPD is that

831
00:47:57,840 --> 00:48:03,520
Speaker 2: they might over advocate for themselves. Else Oh, chaseus off,

832
00:48:03,560 --> 00:48:06,960
Speaker 2: basically right. But the thing is, Chuck is like you said,

833
00:48:07,000 --> 00:48:09,080
Speaker 2: people take what they can get, in part because there's

834
00:48:09,120 --> 00:48:13,840
Speaker 2: a huge shortage of psychiatrists in particular in the United States,

835
00:48:14,480 --> 00:48:17,000
Speaker 2: and people will just take whoever can get them in

836
00:48:17,040 --> 00:48:20,600
Speaker 2: within a year or less. If the waiting lists are crazy,

837
00:48:21,160 --> 00:48:23,560
Speaker 2: it is crazy. Well, if you want to know more

838
00:48:23,560 --> 00:48:27,719
Speaker 2: about BPD, there are a lot of articles and resources

839
00:48:27,760 --> 00:48:31,719
Speaker 2: all over the internet to help you. And since I

840
00:48:31,760 --> 00:48:37,360
Speaker 2: said that it's time for listener mail, I'm going to.

841
00:48:37,400 --> 00:48:42,120
Speaker 4: Call this, uh, well, let's just call it listener mail.

842
00:48:42,239 --> 00:48:44,360
Speaker 1: Hey guys, one day I will write the email that

843
00:48:44,400 --> 00:48:46,680
Speaker 1: I've been formulating in my mind for years, trying to

844
00:48:46,680 --> 00:48:49,000
Speaker 1: put into words, but the show is meant to me.

845
00:48:49,120 --> 00:48:52,160
Speaker 1: I'm tearing up just writing that sentence, which provides you

846
00:48:52,160 --> 00:48:54,200
Speaker 1: with a hint of why that email hasn't been written yet.

847
00:48:55,480 --> 00:48:56,960
Speaker 1: In the meantime, I want to let you know that

848
00:48:57,480 --> 00:49:00,160
Speaker 1: both of your names are listed on my Big Thanks

849
00:49:00,160 --> 00:49:04,560
Speaker 1: to portion of my bachelor thesis. It's customary in my

850
00:49:04,600 --> 00:49:07,319
Speaker 1: country to thank your college coach for their support during

851
00:49:07,360 --> 00:49:08,279
Speaker 1: your graduation year and.

852
00:49:08,280 --> 00:49:09,320
Speaker 4: Your thesis forward.

853
00:49:10,400 --> 00:49:12,719
Speaker 1: I have felt it was only right to also thank

854
00:49:12,719 --> 00:49:15,440
Speaker 1: the other people have supported me to the same extent

855
00:49:15,480 --> 00:49:18,200
Speaker 1: as my coach and this includes you, guys. I don't

856
00:49:18,200 --> 00:49:20,240
Speaker 1: feel the least bit dramatic when I say my thesis

857
00:49:20,280 --> 00:49:22,439
Speaker 1: would not have been written but wasn't for you guys

858
00:49:22,520 --> 00:49:24,879
Speaker 1: keeping me sane. That's what you've done for me over

859
00:49:24,920 --> 00:49:27,200
Speaker 1: the years, but this year I really needed it more

860
00:49:27,239 --> 00:49:33,160
Speaker 1: than ever. So thank you, all caps, double exclamations. I've

861
00:49:33,160 --> 00:49:35,240
Speaker 1: added a picture of my forward where your names are mentioned,

862
00:49:35,239 --> 00:49:37,359
Speaker 1: and since I'm Dutch, I'm afraid it won't make much

863
00:49:37,360 --> 00:49:39,680
Speaker 1: sense to you, but I figured it might bring you

864
00:49:39,719 --> 00:49:40,680
Speaker 1: some joy to see the proof.

865
00:49:40,719 --> 00:49:43,719
Speaker 2: There are some Rando jays scattered throughout those words.

866
00:49:44,080 --> 00:49:47,719
Speaker 1: Yeah, totally, and Chuck has a little null signed through it.

867
00:49:47,719 --> 00:49:49,200
Speaker 4: That's weird unless sure what that means.

868
00:49:49,280 --> 00:49:50,440
Speaker 2: It means your back.

869
00:49:50,880 --> 00:49:51,880
Speaker 4: That means it don't count.

870
00:49:52,440 --> 00:49:56,719
Speaker 1: And that is with much love and immense gratitude from Suzanne. Oh,

871
00:49:56,719 --> 00:50:00,360
Speaker 1: I'm going to do my best to here, Suzanne.

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Speaker 2: Let's hear it again.

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Speaker 4: Chris Silk sick. I like you, I s have you?

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Speaker 4: I JK if you like the second one.

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Speaker 2: Yeah, thank you, Susan. I'm gonna call her Suzanne. Thank

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Speaker 2: you very much. Suzanne. That was very kind of you.

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Speaker 2: Thank you for tearing up. I think you did just

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Speaker 2: write that email. If you ask me, don't you.

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Speaker 4: Chuck, I'm tearing up.

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Speaker 2: If you want to be like Suzanne and let us

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Speaker 2: know what we meant to you. We always love hearing

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Speaker 2: that kind of thing, or you can just write it

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Speaker 2: and say anything you want. We're at stuff Podcasts at

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Speaker 2: iHeartRadio dot com.

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Speaker 4: Stuff you Should Know is a production of iHeartRadio. For

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Speaker 4: more podcasts my heart Radio, visit the iHeartRadio app, Apple Podcasts,

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Speaker 4: or wherever you listen to your favorite shows.