(From Quora) Why is there not more help for those with borderline personality disorder, (BPD)? These people hide their diagnoses. My last girlfriend was diagnosed and screamed in denial after reading this site.

That’s a very timely and pertinent question, Rachel. Mental health services are under attack at the fed, state and local level with many mental health centers shuttered as politicians decide that tax revenue needs to be kicked up to those who need it least.

Working with people with extreme emotional disturbances is difficult: there are huge emotional demands; time demands and pressure from mental health clinics and insurance companies to end the treatment as soon as possible and kick the patient loose.

This coupled with a paucity of training, especially for those of us who know psychodynamically oriented psychotherapy with a well trained therapist and, if needed psychiatric back up for periods when medicine support for the patient is indicated, is a very, very effective treatment.

However, short term therapies are usually the only ones most insurance carriers will fund.

It’s also problematic that many people on the extreme edges of madness often don’t have the funds necessary to support intensive treatment.

However, there are some of us in private practice willing to see these people at a reduced fee, often based on a sliding scale. This, however, can be difficult especially during stormy periods during the therapy where the patient is truly captured temporarily by the underlying madness and the stress on the therapist can be extreme. It is then that we wonder what on earth are we doing this most challenging work for less than our usual fee.

That however, if the therapist has been well trained and well “therapied” him or herself and has ongoing consultation and or therapy to help the therapist with his or her normal, and not so normal, anger and desire to retaliate. Maintaining boundaries is also difficult as these patients in their desperation will not be able to end the sessions on time as the separation from the therapist is felt as catastrophic.

In short, working with people dwelling in the near suburbs of madness or living inside its city limits all too often, is very demanding, draining, & often draining & exasperating work.

Yet, those of us who do work in the vicinity of Madness, USA find the work exhilarating, often magical, and an offered journey deep into ourselves as we accompany the citizens of Madness on their journey of rage, fear, annihilation, brushes with suicide and through it all, an emerging emotional contact with the therapist who, for the most part has not given up and withdrawn, nor has s/he lashed out in fear, anger or rage.

But, instead, the patient gradually finds a therapist who can contain all those feelings of the patient until those inflamed emotions cool to warm embers and provide a space to be truly alive and connected to someone else. Maybe still damaged and sometimes fragile, but an expatriate of Madness USA.

About left0089

Columnist at American News Report. Pain care activist. Poet, memoirist.
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3 Responses to (From Quora) Why is there not more help for those with borderline personality disorder, (BPD)? These people hide their diagnoses. My last girlfriend was diagnosed and screamed in denial after reading this site.

  1. Erika Martinez says:

    Hi my name is Erika after taking Suboxone for a while because I was addicted to pain killers for years to be precise I was addicted to Vicodin. And got sick of it I turned to Suboxone but now I am having a lot of teeth pains and cavity problems, I would like to know more about the side effects of Suboxone because I feel like it’s not fair that I was trying to be clean and now I can’t wven chew on hard foods because my teeth are so damaged like they look okay but they hurt.

    • left0089 says:

      Erika, stop taking Suboxone. I had to have what was left of my teeth nearly all removed. I have a few implants, a few bridges, and an entire upper plate.

      Suboxone is simply not worth the pain and the immense expense of trying to take care of your teeth once the decay and calving of your teeth begin.

      The only thing you can really do is drink tons, I mean tons of water.

      Consult with your prescriber on what other meds you might take, but by all means, stop the Suboxone.

    • left0089 says:

      Erika, your post grabbed both my attention and my emotions.

      Let me be clear from the start. Addiction to opiates by pain patients is rather rare, despite the over-adrenalized reports in the media. Can we look at this together a moment?

      Erika, you may, like me, have been “dependent” on opioid medicines for a very long time. This means the following only: as you used opioids there would be times when you either needed to increase the amount you were taking to beat back the pain or switch to another opioid. This is in no way indicative of addiction to these medicines that allowed you some modicum of “normal” behavior.

      Here’s an example of addiction: you would do anything to get your relief: buy drugs illegally off the streets; engage in any and all forms of illegal behavior to support an addicted self to the drugs you so desperately need to function “normally.” This would include using several different providers to gain your meds, doing the same with several pharmacies while lying to loved ones about what you are doing.

      There are slugs out there who want to villainize those like you and me who suffer from intractable pain that has not responded to any treatment protocols save opioid medicines. If we use these meds responsibly and over long periods, why, we must be addicted to opioids.

      What unmitigated horseshit, Erika. I don’t believe that you were ever addicted to these meds unless you can present me sound evidence otherwise.
      that you were addicted to opioid meds. Dependent on them, you bet. But dependency, despite the fevered dreams of those who wish us to suffer, is not, has never been, nor ever will be “addiction.”

      As far as Suboxone is concerned, this one is yet another fevered dream by those opposed to us using opioids for relief. Stop taking this imposter. It will only continue to ruin your mouth and your teeth.

      Unless you can convince me otherwise, Erika, I don’t think you are an addict but I do think you, like all the rest of us, are entitled to thoughtful, adequate and effective care. I hope you find it soon.

      But just the idea of relying on hope in this ghastly problem is a defeat. We need proactively to call for those treatment regimes we know have worked for us or others in the past.

      We need to stand up and tell these misguided dicks to butt the hell out of our lives and leave us free to use those devices we know works for us.

      If not, they need to shut up and leave us free to pursue what we know works for us, regardless of the knuckleheaded concerns that speciously rules their sorry lives.

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