QUESTION:

Dear Dr. Heller,

I am working with a very treatment-savvy 16 year old female. Her physician has her diagnosed with Bipolar Disorder (which she frequently uses as an excuse to misbehave and avoid responsibility). I am suspecting that she has BPD. I wonder if you have any specific techniques that I could use or look into that might help. She has all of the staff infuriated at the residential center where I work .

Thank you - I am a licensed therapist.

DR. HELLER'S ANSWER:

I'm very up front with BPD patients - explaining that the "trapped, cornered animal" response in their brain is broken, and has epilepsy. I then go over the symptoms and explain why they happen. I also tell them it's not their fault they have the diagnosis, but they are 100% responsible for getting it under control. My goal is a successful life in every area of life. I also explain how the medications work. These actions are incredibly important.

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