Mentalization Therapy Conclusion, cont.

As I have mentioned before, Bateman and Fonagy's research and treatment come the closest to anything I've read that explains BPD, and provides two essential elements to work on as therapy goals:

1) Transference used to create attachment and validation lacking in the BPD person's formation.

2) Teaching and encouraging alternative perspectives/interpretations of events.

However, I feel their approach is just the beginning in treating a person with BPD.  An important element I feel is missing is identity formation.

Their focus appears to be treating two of the underlying conditions present in BPD vis a vis relationships.

If the BPD person can learn to trust one person (the therapist) and be heard, validated; then, perhaps, that trust can be extended to others

If the BPD person can learn to have alternative perspectives and ways of interpreting their world, it may help with misreading human interactions and responding negatively.  Thereby improving relationships.

At the same time, without being able to form a solid core of self (rather than the alien self described in my last posting) how can we with BPD avoid the relationship patterns shown in the graphic diagrams earlier in this segment of the blog?

Is it thought that if we get better at trusting and not jumping to conclusions along the lines of old rigid thought patterns, we will do better in our relationships, and thereby develop a healthy core identity?  I don't know, and wish I could ask the researchers.

For myself, I've always felt like a chameleon.  That I could take on and fit into anyone's life, and often did.  Living my life through others, trying to control things.  Whether that was through over-involvement or detachment.

I've felt like a "site where things happen".  Usually bad things.  Like a catalyst.  I enter a situation and with my crazy energy things start to happen.  Sometimes good things.  But often bad--and that is when I would leave.

Bateman and Fonagy suggest that due to lack of emotional regulation, people with BPD also have problems with attention control.

I can see this in myself.  When things don't "pan out" or something "goes wrong" I'm on to something else.  I don't stay at any one thing for very long.  I discard people and situations like toilet tissue.  I flush them away and start over.

In the end, while I think this therapeutic research team are definitely on to something that will help; they leave me with as many questions as answers.

I believe their ideas constitute a good beginning.  But it seems to me the next steps on the BPD treatment road map are missing.

Individual Factors - Self Concept

Continuing with the book, Growing Up Resilient...

Self-Concept

Self-concept, self-image, self-identity, self-esteem, self-worth--all interrelated awarenesses which can fluctuate over time, and depending on environment.  

As many with BPD, I have suffered from an unstable image of self.  Sometimes I have felt like a chameleon, as though I could fit in anywhere, or take on anyone else's life.  Partially, I think this is due to a distinct lack of boundaries between me and others.

When I left home, I definitely didn't want to be where I was from, or who I was.  I wanted to change my name.  Sometimes, I "made up" parents.  I "made up" a past.

It was only years later, when I started to do genealogy research, I became proud of my name and my family history.  I began to realize, going back in time, there were some incredible stories and much of which to be proud.

Barankin & Khanlou describe children with a positive self-concept as confident, optimistic about the future, realistic about their abilities, self-disciplined, able to cope with criticism and problem-solve.  They feel a sense of belonging to their family and/or community.

Self-esteem, self-worth and identity are tied to our concept of ourselves, and can fluctuate wildly as a child; often dependent on the feedback we get from others in our environment.

The doctors suggest that accepting, loving and appreciating a child for their uniqueness; for the way they are and aspire to be, can strengthen self-worth.  As adults, if we can learn to accept ourselves just as we are at this moment, appreciating our own uniqueness and what we have to offer, we can improve how we feel about ourselves. Mastering a hobby, a sport or a subject area can also help a child to feel more confident.  The same is true for us as adults.

Learning how to accept defeat with grace, and success with modesty, is an important skill for all humans.  I have observed that children who have learned to play team sports, in a healthy manner, get a chance to learn this skill more than those of us who either didn't engage in sports; or excelled in solo performance.

I conjecture that perhaps seeking out opportunities at whatever level, to engage in some sort of team sport/team work, may help in building skills and self-confidence.  I know for me as a loner, it would be hard work to join a group--at any level (e.g bowling) without comparing myself to others and perhaps feeling competitive.  Possibly, this is an area in which I could push myself to grow a little.

Learning to face things, rather than hiding or running away, can help children, and adults, discover that things are often, not as bad as they seem.  Facing our fears provides an opportunity to overcome them.  Makes us stronger.  Makes us feel better about ourselves.

As I have so often cut and ran, it helps a lot to have the professional support I have now, to talk things through, and if necessary, take someone with me to face things I may have been avoiding for years.  Believe me, whether it is money troubles, relationship troubles, or legal troubles, it is much better to face up to it.  Get the professional help you need to help protect you and guide you through the process. 

You'll find, that whatever the problem is, you aren't the first and you won't be the last.  And, I have discovered a) it often turns out to be far easier to handle than I anticipated and b) it is a huge relief not to be carrying whatever it is alone.  Facing things removes an incredible load of guilt and shame=increased self-esteem.  Avoidance diminishes us.  Facing life, with proper supports, builds mastery and moves us towards happiness.

So, esteem yourself!  Value yourself.  Just as you are, flaws and all.

As Leonard Cohen said, "There are cracks in everything; that's how the light gets in."