Can I Be Normal with the BPD?

Written by Dr. Leland Heller

QUESTION:

Dear Dr. Heller,

I have BPD and I am currently quite unhappy. My current therapist practices rational emotive behavioral therapy. I like him very much but I keep getting the sense that he is overwhelmed by me. The other day he admitted that he never really treated someone with BPD as long as he has treated me and that they usually went away. I have intense feelings of attachment to my therapist and I do not want to leave him. At the same time, I feel I really should be seeing someone who specializes in BPD. My BPD has diminished my life from what it could have been.

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I completed a PhD. in neurobiology and I currently work for myself successfully as a consultant and writer, but I can't shake a pervasive feeling that I have completely failed in life. I feel empty and alone. Working for myself is alienating, I want to be with other people but I hate them so much and fear them. Psychotherapy terrifies me and I fear falling into depression or self-destructive behaviors. I feel like I love my therapist, then I hate him, then I love him. I manipulate him and he lets me. He just wants to help. I went to see someone else, a DBT and transference-based psychotherapy specialist. He says I have BPD. Should I see him? What about my other therapist who I completely adore? I can't leave him. The REBT has helped somewhat.

I see that my relationships have gotten better and easier to deal with, but now I love my therapist so much that I feel desperate from the pain. Then he does something to disappoint me from my idealized image of him and I freak out. I really want to be a normal person. Is it possible? I really want to learn to temper this disorder. I suffer so much.

Thank you for your time.

DR. HELLER'S ANSWER:

If you broke your leg you'd need it medically treated and healing before you do the therapy. The same thing is true with a neurological illness like the BPD, which is a form of epilepsy in the brain's "trapped, cornered, wounded animal" response area. It's probably a disease of the brain's support cells ("glial cells") in that area.

Malfunctions in that area cause unprovoked mood swings, chronic anger and/or irritability, emptiness and boredom. Prozac (fluoxetine) at the right dose stops these symptoms completely. None of the other SSRI's work as well.

When stressed or in a bad mood an epileptic seizure develops causing dysphoria (anxiety, rage, depression and despair) and sometimes dissociation. Most self-destructive behavior and relationship manipulation is a result of trying to lessen the severity of dysphoria. As needed medications, and possibly regular use of the epilepsy medication Tegretol (carbamazepine), are what's needed here.

A good therapist can help enormously with the BPD once the medication is right. I'm against therapy that goes over one's past repeatedly. Doing this usually causes dysphoria (anxiety, rage, depression and despair). The most important thing is to heal mind, body, and spirit and move on with life.

Many brilliant people succeed with the BPD in some endeavor, but the chronic and intermittent BPD symptoms make relationships (both personal and professional) extremely painful and usually unsuccessful unless the medication is used properly.

next: What's Making Me Feel So Miserable? ~ back to: Borderline Personality Disorder FAQs Table of Contents