David: Can you define Dialectical Behavior Therapy (DBT)? What is it. Can you describe the DBT process?
Melissa Thornton: Borderlines tend to think of things in terms of black and white. Basically, things are either so good I can conquer the world or so terrible I am lonely and in pain and want to die. Dialectic means holding or relating to two opposing ideas in your mind at the same time. Thus the DBT is behaviorally based and accepts a person where they are but insists on incremental changes to the point of using the skill "tool-box" offered by Linehan's approach. For example, people would learn to see that Winter might be very cold and an isolating time for some, yet it is a natural seasonal change and allows the ground to be fallow, the sap to lower in trees, and thus allowing a time for post-harvest activities such as tilling the land for food, and trees to be transplanted, and, most importantly, for cozy indoor activities and/or fun adventures even for sufferers of SAD (Seasonal affective disorder) to try skiing or skating, etc. So winter is neither good nor bad; it is neutral or both. I like to think of good/bad things or happy/sad things and find not a grey area but the full spectrum of colors - the rainbow inbetween black and white.
David: A few site notes, then we'll continue: You can click on the Personality Disorders Community link and sign up for our weekly newsletter, so you can keep up with events like this.
Dr. Leland Heller's site, Life on the Border, is here. I'm also getting some questions on self-injury. We have several excellent sites that deal with many aspects of self-injury: A Healing Touch and Vanessa's "Blood Red" site.
So what you are saying, Melissa, is that DBT is a therapy that allows the person to see that not everything is black and white, good or bad, but there's a grey area where most people live.
Melissa Thornton: That's it on a very basic level. There are many skills and an outpatient DBT groups session includes homework on honing those that work for a person. The idea is to realize that most if not all things are "both" - even if the "both" sound opposite. Life is good but hard - both are true. Is that more clear?
David: Yes. How long did this therapy take to have an impact in the way you felt and the way you behaved?
Melissa Thornton: I was a pretty sick puppy. I was hospitalized long-term. For me, that was close to one year with many subsequent hospitalizations locally. I had to make a safety plan matching inappropriate emotional states to actions - DBT skills I would use. These were reviewed in Highland prior to release and then made contractual (binding) with my very skilled psychiatrist at home.
David: We have a lot of audience questions. Let's get to some of those:
Filly: I am 7 months into DBT (and very thankful to have found it), but sometimes I have trouble finding the willingness to use my skills. Did you find this, and if so, how did you deal with it?
Melissa Thornton: I really do understand motivational problems. However, we both know how painful BPD can be for us. If we've made it through even one really tough episode and lived to tell the tale we can always say: Hey, I've felt this bad (or worse) before. I can make to the other side - if I use my skills, be it making it out of bed, to that doctor appointment, or calling 911 BEFORE self-harm occurs.
SweetPeasJT2: Melissa, what do you think about psychotherapy to deal with those issues that caused the BPD?
Melissa Thornton: I have found that really important in my recovery. Different things work for different people. That includes medication intake or not.
little1scout: Several questions: Are you on any medications currently? Do you regard DID and Borderline as one and the same? Was inpatient treatment important? What is the hardest part of therapy now?
Melissa Thornton: Yes, I'm on several medications - mostly antidepressants and a brigade of mood-stabilizers (in my case a few anti-seizure medications have worked to help my self-control). Dissociative Identity Disorder is one name for Multiple Personality Disorder - likely because so many MPs have DID in some form. Dissociation is a psychotic episode that can be part of many mental illnesses, including BPD to schizoid personalities, etc.
Can you tell us how you are now, symptom-wise?
Melissa Thornton: Inpatient treatment was imperative for me. I would surely have successfully suicided by now had I not been in such a controlled environment. I'm much much better, thank you. In fact, I am on the books as bipolar (manic-depressive) only. However, I still tend to recognize BPD symptoms, such as lack of appetite, loss of motivation, overspending, and dangerous driving that could be parasuicidal when I feel overwhelmed or under extreme stress. I have been blessed with a baby boy, born in 1, and remained on my medications duirng my pregnancy. He is just perfect. I feel so blessed that my husband and I have that long-awaited pitter patter of little feet.
David:Melissa has a two year old son now. And I want to talk about that in a minute, too.
Psych_01: After dealing with Borderline Personality Disorder myself and in group atmospheres I have found that it appears that an individual must WANT to get better. Do you feel this is a big part of recovery?
Melissa Thornton: The psychologist and psychiatrist on the BPD ward had clinical data that revealed an early committment to life, i.e. will to live, was the best indication of a successful move toward wellness and or productively living with the illness in much less pain. I want to say that if you don't have that, please don't give up. I didn't. The odds toward suicide were stacked against my survival, but I'm so very glad I am here. Even if I hurt more than I feel others might at times and more frequently, I know my mom would be proud to see me now.