Making matters worse **TW**

 Just FYI this is probably going to be triggering, but for my own sake I need to get some things out

So I made the brilliant decision after getting my new diagnosis to buy Marsha Linehan's (creator of DBT) Cognitive-Behavioral Treatment of Borderline Personality Disorder. It is very enlightening, but it may be making matters worse at the same time. The book is intended for professionals and not so much for patients. It has a much more detailed and complex description of borderline personality disorder, and she also talks a lot about the tendency with borderline or suicidal patients to blame the victim or view them as manipulative. What she says about that has reminded me of therapists and doctors that I have had in the past. I assumed they were right in that either I wasn't working hard enough at therapy or simply that therapy would never work for me. I like this part

" Even if therapists believe that a particular treatment will be effective in the long run, because it has worked with other patients, helplessness in the face of the borderlines' intense suffering —suffering that causes the therapists reciprocal pain—is the repeated, day-to-day experience of working with these individuals. In the face of this helplessness the therapists may redouble their efforts. When the patients still do not improve, the therapists may begin to say that they are causing their own distress. The patients don't want to improve or change. They are resisting therapy (After all, it works with almost everyone else.) They are playing games. They are too needy."

I wish I could see all this as hopeful.. that maybe I just need to find the right therapist who can handle borderline. Really, it's making me feel hopeless because the likelihood of that is rather limited. I might get into a DBT program, which is terrifying in its own way, or I might not for whatever reason. I am dependent on insurance, transportation, and the fact that if I am honest about how I am doing there is always the risk of just being told I need to be inpatient. There's the risk that if I admit to purging daily, they will insist I need eating disorder treatment first.. and getting insurance to cover that is another nightmare.. and I honestly don't care about stopping right now. If I don't get a good therapist, I am just reminded of all the times therapy has failed in the past. 

But what's really bothering me now is this part in the book where she talks about how the primary goal in DBT is to decrease suicidal behaviors. It gets really triggering there.. 

"The desire to be dead among borderline individuals is often reasonable, in that it is based on lives that are currently unbearable. A basic tenet of DBT is that the problem is rarely one of distorting positive situations into negative situations. Instead, the problem is usually that a patient simply has too many life crises, environmental stressors, problematic interpersonal relationships, difficult employment situations, and/or physical problems to enjoy life or find meaning in it. In addition, the patient's habitual dysfunctional behavior patterns both create their own stress and interfere with any chance of improving the quality of life. In sum, borderline individuals usually have good reasons for wanting to be dead. "

and then

"Whatever the reason, I have at times been convinced by patients that they are right. Not only did I believe that their lives were unlivable, but I myself saw no way out for them. I felt hopeless myself [...]I believe that individuals at times make informed and rational decisions to commit suicide."

I am obviously taking a few parts out of a larger discussion (basically that the therapist must take a non-negotiable position against suicide), but you can see how it might be upsetting. So I really probably should stop reading this book, but it's kind of addictive because it's all so accurate. I have to take occasional breaks to not get totally sucked in since my mind was not in a great place to start with.

So I don't know why I am writing this.. but I just needed to get it out