I was diagnosed with bpd in my 20s (10 years ago). It was later found to be ADHD. Almost every woman i was in group therapy with for bpd has now had their diagnosis changed from BPD to ADHD or autism. Can you make a video about why this misdiagnosis is so common in women? Irs frustrating because it means that we live with the wrong treatment and consideration for so long 😞
I am a man but went through the same thing and think bpd is used to simply label us "untreatable" and wash their hands clean. It made receiving actual help nearly impossible. Turns out i am juat autistic and adhd. Bpd is way off...i dont even like being around people at all lol. It is mwdical violence, imo.
It's being used as a method for some doctors to excuse a badly done job in finding the right medicine(s). It's, as you say, a method to write people off as untreatable. Now imagine if all other working branches in society had a similar get-out-of-jail card to pull when they've done a really poor job. That being said, there are plenty of people who live with the disorder, though there is probably a massive misdiagnosis in many cases. I live with Bipolar disorder, and the doctors wanted to write me as a Borderline patient because they had thrown all their treatment on every other medication than Lithium and Invega, which are the medications that work best for me.@@AaronHendu
I have to comment on that. It is very important to validate the borderline’s behaviour. A good example is self harm. After cutting one thinks of desperate measures to hide new cuts. The mental health care workers come up with no self harm contracts because self harm seems to be so dangerous. I once asked my roommate in hospital why she engages in self harm in order to understand the underlying pain and self loathing. Building a good rapport helps because as a result the borderline dares to share the reason for the incident. I once had a conversation with a borderline about her cutting. I understood her loneliness and seriously traumatic upbringing. She experienced for the first time that someone totally comprehended her situation. A lot of mental health care workers are not very empathetic towards borderlines who actually need the most compassion-including boundary setting otherwise the therapeutic relationship derails
On a short-term basis in a non-clinical setting, I sometimes work with patients with BPD and emotionally unstable personality traits, and I notice these patients are not too receptive discussing healthy coping strategies or setting goals. Many of them just want to be heard and have their experiences validated. I adapt my approach every time. My priority is empowering their autonomy, as long as it doesn't pose an immediate risk to their safety, and if that means them not picking up the phone to talk on that day for whatever reason, so be it. The last thing they want, as one patient told me, is to be treated like a child. I let them know they can reach out when they need to. Maybe I am a strong advocate of the self-determination theory!
This is so helpful, thank you! My mother in law has borderline but wont acknowledge it because its such a harsh diagnosis, she tried getting help once but was sent to ET without concent, she only have horrible experiences with the psychiatric wards so i do understand her.. But at the same time she is hard to handle, huge amounts of trauma from childhood to adulthood, and she have been using her 2 boys as her saving ring since they where born... Resulting in ruining their lives in a way.. They always have to care about mom, her feelings, her mental state, FIRST, nothing else ever comes first! This have made it really hard for both of them to prioritize themselfs and what they want and feel like. My partner has slowly worked himself out of it, he also have some really bad mental health so it was easyer for him to say no when he could back it up with "i am stressed out and need some down time" where as the other brother cant ever say no, he just have to handle everying.. He also isent trying "i cant say no, god knows what will happen if i do".. He finally got a new girlfriend, who have helped him realize that he needs to live his own life, and he is getting better at saying no and putting up boundaries, but this have gone on for 30+ years... Its not just easy to change behaviors and traditions and so on. Your advice here is great! I will teach it to my partner so he knows what to do next time mom is in a really bad mood! (He have already been so great at handeling her, but this is just another tool in the toolbox! We love her very much, we just need to be able to also live our own lives ❤)
I never figured the silences were on purpose but every time they went silent I just went silent too until they tried to get me to speak again. It takes a lot of energy to speak so I enjoy the silence, especially when the subject makes me uncomfortable.
Thank you for your videos. I’ve been in therapy for years and now I’m in ACA after letting my last therapist go. He was not helpful to me. I was in crisis and he hammered me with suggestions. I got angry and expressed it and said that if I could do any of the things he suggested I would not need therapy. He was suggesting things to help me break the depression I was in. I was not willing to go to meet ups, force myself to exercise, do things alone like go on vacation etc. At that time I could barley get out of bed. My only outlet was attending meetings on line. He was not supportive to me going to AA or ACA in person or on line. I got angry and when I did he gave me the option to opt out of therapy and I took it. Not helpful. I felt he was ego driven and after seeing and hearing this video I sense that I was right. Thank you.
i have bpd and i cannot describe how much i love this video. in those moments i already have what i call “borderline rage,” and people trying to give me solutions and tell me what to do makes me even angrier. thank you. ❤
For folks who have had rubbish childhoods, silence is proof that someone is actually listening to them. Someone who is willing to listen, is a rare commodity for some people.
I was diagnosed BPD over 30 years ago... life has been in a good place for quite some time... I'm torn listening to you. You're right, and what you're saying is important. Speak less, listen carefully, and think before speaking is excellent advice. You're very right that the person presenting needs in an ideal world to learn how to come up with answers for themselves. Slowing things down is perfect advice. I love your example of making a cup of tea. They need to learn how to slow down and obtain calm for themselves... BUT... People with BPD can slide sideways, and you really want to be careful the person doesn't turn off their emotions, as you'll effectively be dealing with a sociopath then. You cover it, but I just wanted to underline, it's really important you don't come across as dismissive or disrespectful, and that you remain engaged. The person may also require guidance as there's a lot of fundamental stuff they may just draw a blank on, and it's important they don't feel judged.... As I say, it's solid advice you're giving, but... there's a lot of room there for a therapeutic worker to face plant, and not everyone might be as socially adroit as your good self. You really want to be careful what games you set up with somebody presenting with BPD, as some will relish the opportunity to play. Really. In short... yes, but hmmm careful, yeah. Excellent video, and I love that you're talking about this stuff. I've been watching most of your video with interest. Please keep them coming.
Absolutely agree, I often hate silence and feel like the person isn't listening or doesn't care enough to respond and then It feels like the wave of emotion is mine and mine only. And effectively feeling like I am a problem, I'm overreacting I'm too much. I end up feeling worse within silence.
Thankyou Dr Syl for another insightful video. @CarnaghSidhe your comment resonated with me and I thank you for offering your perspective and lived experience. I agree that there are opportunities for therapists to 'faceplant' with this technique (love the expression). I have been diagnosed with BPD, though I tend to describe my issues using avoidant attachment, CPTSD and PTSD with substance issues. Anyway, I have experienced myself detaching from emotions or just not having any point of reference to continue down a train of thought. The resulting hopeless frame of mind is rarely helpful. The point you made about relishing in game participation.. yes. In crisis I tend towards tactics for self defence by misdirection, paper tigers and circular logic among the many. It's not like I'm in a healthy place at these moments and simply manipulating for attention, rather if I'm aware you are trying to elicit a particular response I'm not prepared to give then yeah game on
I introduced my psychiatrist to your channel, because it’s been so helpful to me while dealing with my younger sister having BPD. It’s incredibly distressing and none of us really know how to manage the way her disorder manifests, and also having an anxiety and depression disorder myself, and I’ve been struggling for many years with the relationship and interactions with my younger sister. Listening to your breakdowns of the reality and motivations behind BPD has helped enormously. Nothing will ever make it easier, but I hope others who see your videos will also gain some comfort and insight into BPD and the reasons and motivations behind their behaviour.
My psychiatrist friend has used this with me several times, I only recognised it now after listening to your video. And that moment of silence, of not commenting, was so odd, it had snapped me out of some habitual way my mind was going with suicidal aviation. Love your videos, how succinct and informative and kind they are thank you
I have to say, I was somewhat skeptical about this technique first time I watched this video, but I have to admit: when my thoughts were going 200 km/h and tumbling over each other earlier today, telling myself "There’s time" really helped bring me back to the here and now. I’m not dealing with BPD, but I‘m having trouble implementing grounding techniques to calm anxiety and today I was able to put my thoughts on hold and just focus on the crunching sound of my feet on the pebbles, and actually began to feel a sense of peace and calm. So I guess this could be really good advice for anyone who’s overwhelmed by the thought chaos in their head. Thanks for sharing, doc! 😊
I'm really enjoying your videos! Would you be able to make a video on BPD and ADHD? I originally believed I had BPD and my psych shut it down. I have since been diagnosed with ADHD and emotional dysregulation with dissociative tendencies. My psych said ADHD in women is usually misdiagnosed as BPD. So, it would be really interesting to hear your thoughts, and touch on the similarities and differences between the two which may lead to ADHD being misdiagnosed as BPD in women.
I've heard that too! Also that cluster b disorders are typically genetic and environmental pathologies and unhealed trauma. There is usually comorbidities overlap with other personality disorders and I admit I see strains of that overlap in myself. DBT therapy has changed my life and I am in almost complete remission. 🌹🌹🙏🙏
@@AliciaM5555that's interesting and makes so much sense when it comes to generational trauma, etc. I definitely think my dad has adhd too. My sister also has it but she's a special case as she also has gene deletion - although she was diagnosed as a child and I was only diagnosed with ADHD last year!! Glad to hear DBT has worked for you ❤ I've not had the chance to try it yet.
one notable Borderline Personality Disorder in a relationship is the push-pull cycle. Anecdotally, what I have seen that the romantic partner in the relationship often become the emotional venting outlet & punching bag and it then turns into very toxic relationship dynamic for both partners. *BPD PUSH-PULL CYCLE* -> "Pulling someone into a close relationship and then pushing that person away repeatedly is one of the most well-known symptoms of BPD. It causes the person in question to be confused about where they stand in the relationship"
Brilliant technique dr syl. As you probably already know, it’s called Motivational Interviewing. You sit and listen to sustain talk (helplessness) and pick up on the change talk (hope). It can be really helpful for health care professionals and family to utilise this skill.
Dr. Syl, I'm really impressed with your calming voice. Perfect fit for people within in psychological fields. I have a lovely daughter we were fortunate enough to adopt. She's dealing with BPD now that she's began to work through trauma.
Great video. Such a good point and helpful for patients. Me as a patient, I find it hard to open up to strangers and be vulnerable.... and when I try to explain my issues to Doctors, it often sounds different to my reality because I feel like I'm being more positive and animated as a defense to feeling vulnerable with a stranger! I am more talking about primary care/GP rather than specialists in hospital though.
This was very good, thank you. When individuals with BPD are in a high state of crisis it feels like "fire 🔥 consumes" the thinking process stepping back is like cooling down the fire as an analogy. Not being bombarded with input. It give the individual some time to process everything. Possibly this is were the expression of "burn out" comes with age?
I'm a MH nursing student and this reminds me of one of the principles of motivational interviewing (not directly relevant to EUPD/BPD but can be applied). It talks about how if you argue the case for something (a behaviour change), it automatically places them in the role of arguing against it. You need to leave space for them to occupy that role, or even both, and explore their own reasons. Very interesting video :)
This is really helpful advice. I’m not a doctor, but I work in the Emergency Department as a psych safety tech so I’m listening to them constantly and trying to keep them in a calm state for my shift. I’m not a therapist for them but if they talk I will listen to them and give minimal advice and feedback
Any time a therapist goes and gets me a coffee, I instantly feel more at ease. Because bringing me coffee gives me the signal that I am not being judged and that there is enough time. So for me, yes this sort of approach works (not full BPD but BPD-traits).
This is a great video! It’s interesting to think about the different reasons behind silence in these situations/settings. I always felt like my psychiatrists silence was different to my clinical psychologists silence, but I couldn’t pinpoint why they felt different before now. My clinical psychologist is very comfortable with long silences, but I know during the silence he’s still analyzing my reactions and checking to see if I’m getting activated without realizing it (so he can reign the conversation back and pause it before dissociation kicks in if I’ve been triggered), and I suspect the silence after I say things that might normally get big/negative reactions from other people is to show me that he’s still present and unaffected by whatever I’ve said (i.e. he isn’t going to freak out or get angry etc), so it gives me time to process the idea that he’s able to hold that space for the conversation and that he’s someone safe to disclose things to. I really appreciate his deliberate silence, because it does help to reinforce that he has predictable and safe responses to anything I say or disclose 🙂 In saying that though, he does approach me in that way because I have ptsd/cptsd, and it’d be interesting to know if he approaches patients with BPD differently 🤔 I love the idea you mentioned for the longer video about how/why some people develop BPD and other various things (especially BPD and ptsd/cptsd as a comparison). Looking forward to it, Dr Syl! 😃😁
Oh, I do like the label "emotionally unstable" rather than "borderline" personality disorder. I may have said this in a previous comment, but you give me amazing hope for mental health treatment in Sydney. You are amazing in having compassion, empathy and the ability to communicate and educate
Yes. Silence, validation, creating, and then holding space. I also find it helpful to verbalise that sitting in this space is not a burden to me. There's no shame, and that life feels best when we experience it as a team. On that, I also remind them that they are the boss of their team and they set the rules. It's so humbling.
I always respect your videos and enjoy them but I don't agree with some of this one. I have had suicidal ideation since I was 40. I'm now 68. I was diagnosed with BPD 10 yrs ago. I'm 68 yrs old now and I have never felt I had a reason to live. It's not that I want to die. I want these feelings to stop. I have no friends or family. No support system. I've lost the two therapists over the past years who did help me by listening and making me feel I had a small bit of hope. I'm so tired of feeling the way I do every single day. It's terrible. I've tried so many things and nothing ever changes.Thank u for listening. Your channel is wonderful.
Wonderful information! I have a graduate Psych degree & did graduate work in Clinical but never worked in the field decades ago (DSM III to give you an idea of how long ago.) I wasn't prepared at that age to work with others at the level you need to be & I think my Mom's personality prompted me to be interested in the field. I doubt she has BPD but there are features of it that I see & I have used these techniques & see how helpful they are. It isn't easy but important to see her as a person who is struggling with a side, while not destructive can undermine her ability to know what she really wants & then be satisfied with "it" when she gets it. I have learned to honor her ability to survive up to this point (age 88) & try to remove my ego from helping her when she is stronger than she recognizes.
This is really interesting! I have been acting and performing since I was a child and your video called to mind one of my guiding principles in the art form, basically, the actor who comes incredibly close to tears, but never actually sheds a tear is far more likely to illicit tears from their audience. It's essentially a sympathetic response. You can apply this to any emotion, not just sadness.
Also just as a PS... I'm curious whether you endorse using this method as a friend and family member of someone with BPD? Wouldn't this only/primarily work in a therapeutic setting where the patient is expecting the response to be of a therapeutic nature and are therefore compelled to reflect on the content of their own words and emotions when they receive an answer that might otherwise feel cold? Maybe I'm genuinely missing something though, I just don't see how using such a direct method can be applicable outside of a therapeutic setting
@@natara658 I can give my input as someone with BPD. For me personally, I would find this effective if my loved ones did it too because when people (anyone) try to present solutions to my problem, I feel like they haven’t listened before telling me how to deal with it. It’s easy to feel misunderstood. I think the patience and allowing space is really helpful in coming down from the high intensity emotions :)
@@emilyj2842 Thanks for your input and explaining your experience! That perspective totally makes sense. I have a really hard time establishing boundaries for myself, so I sometimes struggle to see health in communication that involves a lot of individuation.
I agree with @emilyjacob2842. BPD myself too and my mum has employed this technique with me when I've called her up distressed. Her deliberate, calm and non judgmental pauses do help me check my reactions and feel heard
You can not use a handsome doctor in the thumbnail and a cute dog in the intro and expect me NOT to watch. I think we have some similar experiences with BPD and some very different ones as well, and one of the things not talked about enough is using qualitative variables to quantify the seriousness of mental health but BPD in particular. It's hard to get into in a single YT comment adequately. Great video! Cute dog! BEAUTIFUL eyes!!
Sometimes your videos are just so spot-on and hit home that I have to pause and take a moment, especially with the dynamics of letting a client have the support, but be able to also come to their own conclusions. That grants autonomy and can be really empowering as a client. I really appreciate what you share and the compassion you put into your videos. Thank you! ❤
Thank you so much for this I have saved it for my husband. I live with BPD, OCD and depressive disorder and the year 2023 was an amazing learning year for me. The trauma Team in Psychiatry supported me very well, Decider skills right medication and the right support are game changers for me. My life and life of my loved ones improved so much.We can get better or manage our symptoms better if we get the right support and treatment and of course, it has to work both ways. I have good discipline healthy bed hygiene a general lifestyle, little exercise every day healthy diet and the right medication, decider skills are game changers for me I can function in life much better and it reflects on my family too as if I am doing fine we are all in harmony. ❤ Thank you for this
Hi Syl, this is such an interesting strategy! thanks for sharing. Can it work with other mental health conditions too? like if someone is a bit manic or psychotic and they say they're going to do something that probably isn't good for their health. I volunteer at a foodshare program witch has ALL sorts of people come through, and sometimes I can tell they haven't had their meds or are not in a good place. I've become good at talking people through panic attacks and being empathetic with someone who's life is terribly complicated or tragic, but psychosis and mania are trickier to deal with. Thanks in advance Syl
As someone that have been a great deal in therapy. I support this use of silence. It is a place and time for it of course, but this silence can be so important. When you wait for the patient to get to the answer themselfs 🤩 There is nothing like finding your own way. that sounded cheesy. but its true🤪
➡️ please expand on that last sentence! about "it's not their fault, but it's their responsibility". and about cortex development. I think milions of milions of people don't understand it!!!!
I have BPD and CPTSD. It took so long for someone to diagnose the BPD/CPTSD. So many people just kept saying I was depressed and anxious with some PTSD. I felt like my anger was out of control and sometimes professionals are scared to diagnose BPD due to stigma. For me it gave me so many answers and I'm on the road to recovery. I'm Australian also.
As somebody who struggles with BPD-type responses (not diagnosed but I can recognise similarities in myself with this), this is really eye-opening. I'm going to share this with loved ones in my life when I'm feeling intensely hopeless/helpless and see if this changes the outcome of some of those situations. Tysm for creating this video ☺️🫶
@@Maverick_Mad_Moiselle Ahh yeah I see what you mean! I don't think so tho (at least with me) bcos it helps me understand that I've gotta develop my own autonomy and it'll help my loved ones understand that too and try being supportive in a new way. It's just to see if it has different outcomes so we won't know until we try but thx for the reply! 🫶
I am diagnosed and the biggest help was definitely taking a step back and thinking before saying and doing anything. It also helps keeping reminders on your phone about the people in your life of the beautiful and positive moments and a list of what you’re grateful of, even the small things. The little things add up and definitely help the dark thoughts in your head.
I have felt confused for years by the dizzying array of diagnoses that I have been labelled with: From Borderline Personality Disorder/Emotionally Unstable Personality Disorder, to Bipolar Disorder, to CPTSD, until finally being landed with Schizoaffective Disorder. I heard years ago that it is challenging to differentiate between BPD/EUPD and bipolar disorder. But it was news to me to discover that CPTSD can also be easily confused with these diagnoses, and finally, Schizoaffective Disorder was quite another shock to the system!! Where does ~ADHD fit into all of these diagnoses? Is it in fact another diagnosis that is difficult to differentiate from the others? I am particularly interested, as my son was diagnosed with ADHD as a child, and I wonder whether there is a connection between the symptoms?
Ok... I think people who watch this should remeber that this technique should be done ONLY by professionals. Imagine how would this go down at home with someone who has MDD.
I believe this would have been what my counsellor I previously had work with me was doing, even from first day, first session, first time walking in, she'd be quietly welcoming and small smile, small gestures but wouldn't enter into any topic of conversation and would wait for me to start speaking, or not, so there would be quite quiet periods. It was quite a new experience for me. I could see it was an intentional technique, often her responses to things I might say would be general Hmm Mm noises showing she'd heard but not 'yes' or 'no' or 'you're right/what about alternative xyz'; just neutrally sort of holding the space.
These are great suggestions. Done well, it’s really powerful. It sounds like you’re using a TA (transactional analysis) kind of framework; encouraging an adult response instead of a child or parent response.
Nothing worst than people trying to give you hope on and on... But the space part and someone to just listen is almost universal. Almost just being there letting you vent things out enough. We are there because of trauma...
Hmm, this is interesting. I’m a counselling student with lived experience of mental illness so I feel as though I’m sitting on both sides of the couch in terms of my reaction to this video. As students, we are taught from the get go the importance of person centric care, it creates opportunities for clients to experience autonomy, aids in further development of self identity and encourages self determination and self-advocacy. I guess we look at it as wanting to make ourselves as clinicians as redundant in their lives as possible. We also place emphasis on the value of silence in the counselling relationship for many of the reasons that you described. However we are also taught to really focus on the quality of the silence, by which I mean not simply allowing a verbal pause for interjections but displaying open body language and ensuring our facial expressions convey active listening through warm non-judgmental empathy (rather than simply being ‘neutral’). I imagine by watching the videos you make that you naturally do this, however from my perspective on the ‘other couch’, I have experienced this silence in a hospital setting with a psychiatrist that came across as almost hostile or antagonistic (think the classic ‘go on then do it’ scene from a dodgy action movie). I interpreted this through the lens of my own mental state at the time (severely depressed and perhaps a touch paranoid) and environmental cues like closed body language and a facial expression I read as a ‘smirk’. When I left the interaction I felt humiliated for opening up about my feelings and felt his uncomfortable silences as a “confirmation” of my feelings of being burdensome and stupid, a silent approach on this occasion allowed the little part of myself that perhaps still wanted to live enough to have not yet attempted, to think ‘he’s an expert and he’s not objecting, I feel like I am wasting his time and so I must be accurate in my perceptions that death is the best outcome for everyone involved.’ This same doctor was very angry with me afterwards when I did try to take my life as I hadn’t told him my plan (I didn’t want to be stopped and assumed he wanted to protect his license so thought I’d save us both the hassle) and when returned to the unit from ICU a few weeks later he kept saying over and over that I’d ‘nearly died’. As this was my intention I just felt even more guilty and burdensome that it hadn’t worked... But I digress, we look at our roles as providers of “support” not “solutions” (while still offering psycho-education, referrals to appropriate services and encouragement) but sometimes with suicidal ideation particularly when there’s been a history of trauma, in the uncomfortable silences we still need to allow for compassion, holding space and interjecting with the right questions to encourage out the little part still subconsciously trying to live rather than scaring them out “Tell me more about that” “What was that like for you?” “What were you hoping for out of xyz?”
This was so good! I'm a nurse and will keep using this technique. I have done this unknowingly as my brain just doesn't think that fast :). Great tips with tea, and "do you think that's a good idea?" I need to find that article :)!
Have you heard about the work of another psychiatrist named Jerry Marzinsky in the US? I find his work very interesting and quite groundbreaking in my opinion. He’s a very honest and brave person in my opinion. He actually speaks from his many many years of experience working in the field of psychiatry. I was wondering if you have ever read up on his latest workings and if so what would your thoughts be on them?
My fiancé has straight up told me this is how to handle him when he’s like this. I finally did it and just said “ya maybe you’re right” or I’ll just say “okay” and it’s crazy for true this is
Love this channel! How do you treat people with borderline and alcoholism/addiction where one can suspect that the drinking might be a part of selfharm? And please do the extended episod you talked about in the start of this video! Btw, I would love to see more on the theme addiction, both with and without severe mental illness.
Came upon your channel with the Hi Ren reaction and i am happy i did. Ive been dealing with bipolar that was diagnosed 15 years ago. I just found out about a new diagnosis (borderline personality disorder) that my doctor never told me about. I found out when i requested all my medical files to apply for disability. Although in many ways it helps to understand some things in my past but it still doesn’t help that i am bipolar. Is it common for a doctor to withhold a diagnosis like that from a parient?
could you make a video discussing bipolar disorder and psychosis/psychotic symptoms, as well as one going over the comorbidity of bpd and bipolar disorder (and how symptoms may present)?
Ok, so, in my case (diagnosed with BPD). When you say nothing, it makes me feel worse. It makes my anxiety go up... and it makes me think about how we are wasting time that could be spent working on my problems. I HATE the silence. I just feel horrible.
I was diagnosed with bpd 30 years ago. I have been hospitalised for 2 years with anorexia and have seen numerous psychiatrists and a psychologist but I was to drugged up to benifit from their services. I went on to get married and have two children but this bpd tag has always been stuck to me. I was offered cbt about two years ago but found I couldn't retain what was said and the course work was to taxing. Now I'm out on my own. I have been told that bpd is a tag thats given to people they can't categorise. Is this true??? Could there be something I'm missing??? I am on a lot of pain meds and antidepressants and psychotic meds but I still don't feel like me. 😢
I have been diagnosed with PTSD along with a personality disorder and have been in hospital. I'm curious if after a single interview you could guess what it is and see if it might align with my official diagnosis. It'd be really interesting to see you break it down.
I wish I had that "support group" to be immediate and protective of my life versus awkward silence when I hint that I'm having a hard time coping. I've grown up managing myself (mentally, and learning physically how to splint sprains or broken bones.) I don't think I ever learned how to "scream" for help. I just assume no one can help me, so I have to go it alone and learn outside myself in order to preserve myself. (Which is leading to dissociation more and more the older I get....how do I keep this up?) I feel like I have to do something drastic to get the help I truly need. Edit; I should add, I wouldn't hurt someone else and I'm too dissociated/apathetic to harm myself. So it would likely be a social meltdown at a job and me walking out/walking home to sleep or cry. (Per "something drastic.") I don't have the energy/care to harm myself or others. I just suffer in silence and wait to implode.
One thing I have never understood about BPD is why the "borderline" description... is it literal, as in "almost" a personality disorder, or is it more rooted in psychiatric jargon? What is going on there?
I would built up real tension with a silent therapist to a point of psychosis and violence. I'm almost over bpd but I tell you "uncomfortable silence" is a harming way.
Dr Syl - I believe my mother has BPD and/or HPD and I don't know how to help her. Could you please make a video discussing the similarities and differences between these disorders and the prevalence of comorbidity? Maybe some tips for adult children of parents with these disorders. I have struggled with anxiety because of the volatility of my mother, and CBT has been so helpful, but my mum is so resistant to seeking help which makes it near impossible for myself and my brothers to have a relationship with her. I'd love to hear some advice from you. Thank you.
As you know their are not enough physicians willing to work with individuals who have bpd the stigmatism still exist, hopefully education and knowledge will break the stigma?
WOW !!! Superb!!!! Speak less,.. and increase silence !! Thank you ,.... Empathetic Neutrality ! I have a son with Schizophrenia marked mostly with apathy, cognitive impairment and negative symptoms..... Mostly sleeps and watches movies,... Could this technique help him ??
Agreed, even though I think it was intended as a lighthearted description of how it might feel. Because of all the stigma, it’s far too common to hear language like that. Also people with BPD already feel unbearable shame and low self worth.
@@minimushrooom because for a lot of BPD people they are traumatized over long periods of time by emotional unavailable parents. Silence can build up a lot of tension with us. Specially from people who are specifically "there for you".
@@caddieohm7059 I agree.A doktor should understand this about borderline . Silence can be very triggering . I had a friend who had sucidal ideation and eventually ended up taking his own life bc of this kind of treatment .It's inhumane.
Interesting, my ex who had BPD would normally interpret silence and neutrality as judgement. She would assume if I wasn't actively communicating that I loved her that I was against her. Perhaps that wasn't something inherent to the diagnosis but was her own issue. She was like this to that point that she was constantly gauging the level of emotion on my face. So if I said something supportive but she convinced herself that there was a negative microreaction that appeared on my face for a millisecond I was in trouble. Overall her attitude exhausted me and it felt like I had second hand BPD from all the empathizing I was doing with her. Actually the more I think about it the more I think she had a lot of really toxic characteristics that weren't BPD...
I was diagnosed with bpd in my 20s (10 years ago). It was later found to be ADHD. Almost every woman i was in group therapy with for bpd has now had their diagnosis changed from BPD to ADHD or autism. Can you make a video about why this misdiagnosis is so common in women?
Irs frustrating because it means that we live with the wrong treatment and consideration for so long 😞
I am a man but went through the same thing and think bpd is used to simply label us "untreatable" and wash their hands clean. It made receiving actual help nearly impossible. Turns out i am juat autistic and adhd. Bpd is way off...i dont even like being around people at all lol. It is mwdical violence, imo.
Also cptsd is being misdiagnosed as bipolar. I think it's about drug company sales goals. 🤬
It's being used as a method for some doctors to excuse a badly done job in finding the right medicine(s). It's, as you say, a method to write people off as untreatable. Now imagine if all other working branches in society had a similar get-out-of-jail card to pull when they've done a really poor job. That being said, there are plenty of people who live with the disorder, though there is probably a massive misdiagnosis in many cases. I live with Bipolar disorder, and the doctors wanted to write me as a Borderline patient because they had thrown all their treatment on every other medication than Lithium and Invega, which are the medications that work best for me.@@AaronHendu
I went in for hours of testing thinking I had autism, and got diagnosed with adhd and bpd but not autism 😅😂
@@sharonthompson672 yes!! i’ve been given all of these labels 😂
I have to comment on that. It is very important to validate the borderline’s behaviour. A good example is self harm. After cutting one thinks of desperate measures to hide new cuts. The mental health care workers come up with no self harm contracts because self harm seems to be so dangerous. I once asked my roommate in hospital why she engages in self harm in order to understand the underlying pain and self loathing. Building a good rapport helps because as a result the borderline dares to share the reason for the incident. I once had a conversation with a borderline about her cutting. I understood her loneliness and seriously traumatic upbringing. She experienced for the first time that someone totally comprehended her situation. A lot of mental health care workers are not very empathetic towards borderlines who actually need the most compassion-including boundary setting otherwise the therapeutic relationship derails
On a short-term basis in a non-clinical setting, I sometimes work with patients with BPD and emotionally unstable personality traits, and I notice these patients are not too receptive discussing healthy coping strategies or setting goals. Many of them just want to be heard and have their experiences validated. I adapt my approach every time. My priority is empowering their autonomy, as long as it doesn't pose an immediate risk to their safety, and if that means them not picking up the phone to talk on that day for whatever reason, so be it. The last thing they want, as one patient told me, is to be treated like a child. I let them know they can reach out when they need to.
Maybe I am a strong advocate of the self-determination theory!
This is so helpful, thank you!
My mother in law has borderline but wont acknowledge it because its such a harsh diagnosis, she tried getting help once but was sent to ET without concent, she only have horrible experiences with the psychiatric wards so i do understand her..
But at the same time she is hard to handle, huge amounts of trauma from childhood to adulthood, and she have been using her 2 boys as her saving ring since they where born... Resulting in ruining their lives in a way..
They always have to care about mom, her feelings, her mental state, FIRST, nothing else ever comes first!
This have made it really hard for both of them to prioritize themselfs and what they want and feel like.
My partner has slowly worked himself out of it, he also have some really bad mental health so it was easyer for him to say no when he could back it up with "i am stressed out and need some down time" where as the other brother cant ever say no, he just have to handle everying..
He also isent trying "i cant say no, god knows what will happen if i do"..
He finally got a new girlfriend, who have helped him realize that he needs to live his own life, and he is getting better at saying no and putting up boundaries, but this have gone on for 30+ years... Its not just easy to change behaviors and traditions and so on.
Your advice here is great! I will teach it to my partner so he knows what to do next time mom is in a really bad mood!
(He have already been so great at handeling her, but this is just another tool in the toolbox!
We love her very much, we just need to be able to also live our own lives ❤)
I never figured the silences were on purpose but every time they went silent I just went silent too until they tried to get me to speak again. It takes a lot of energy to speak so I enjoy the silence, especially when the subject makes me uncomfortable.
Thank you for your videos. I’ve been in therapy for years and now I’m in ACA after letting my last therapist go. He was not helpful to me. I was in crisis and he hammered me with suggestions. I got angry and expressed it and said that if I could do any of the things he suggested I would not need therapy. He was suggesting things to help me break the depression I was in. I was not willing to go to meet ups, force myself to exercise, do things alone like go on vacation etc. At that time I could barley get out of bed. My only outlet was attending meetings on line. He was not supportive to me going to AA or ACA in person or on line. I got angry and when I did he gave me the option to opt out of therapy and I took it. Not helpful. I felt he was ego driven and after seeing and hearing this video I sense that I was right. Thank you.
i have bpd and i cannot describe how much i love this video. in those moments i already have what i call “borderline rage,” and people trying to give me solutions and tell me what to do makes me even angrier. thank you. ❤
This is very common with autism as well.
For folks who have had rubbish childhoods, silence is proof that someone is actually listening to them. Someone who is willing to listen, is a rare commodity for some people.
I was diagnosed BPD over 30 years ago... life has been in a good place for quite some time... I'm torn listening to you. You're right, and what you're saying is important. Speak less, listen carefully, and think before speaking is excellent advice. You're very right that the person presenting needs in an ideal world to learn how to come up with answers for themselves. Slowing things down is perfect advice. I love your example of making a cup of tea. They need to learn how to slow down and obtain calm for themselves... BUT... People with BPD can slide sideways, and you really want to be careful the person doesn't turn off their emotions, as you'll effectively be dealing with a sociopath then. You cover it, but I just wanted to underline, it's really important you don't come across as dismissive or disrespectful, and that you remain engaged. The person may also require guidance as there's a lot of fundamental stuff they may just draw a blank on, and it's important they don't feel judged.... As I say, it's solid advice you're giving, but... there's a lot of room there for a therapeutic worker to face plant, and not everyone might be as socially adroit as your good self. You really want to be careful what games you set up with somebody presenting with BPD, as some will relish the opportunity to play. Really.
In short... yes, but hmmm careful, yeah.
Excellent video, and I love that you're talking about this stuff. I've been watching most of your video with interest. Please keep them coming.
Absolutely agree, I often hate silence and feel like the person isn't listening or doesn't care enough to respond and then It feels like the wave of emotion is mine and mine only. And effectively feeling like I am a problem, I'm overreacting I'm too much. I end up feeling worse within silence.
Thankyou Dr Syl for another insightful video. @CarnaghSidhe your comment resonated with me and I thank you for offering your perspective and lived experience. I agree that there are opportunities for therapists to 'faceplant' with this technique (love the expression). I have been diagnosed with BPD, though I tend to describe my issues using avoidant attachment, CPTSD and PTSD with substance issues. Anyway, I have experienced myself detaching from emotions or just not having any point of reference to continue down a train of thought. The resulting hopeless frame of mind is rarely helpful. The point you made about relishing in game participation.. yes. In crisis I tend towards tactics for self defence by misdirection, paper tigers and circular logic among the many. It's not like I'm in a healthy place at these moments and simply manipulating for attention, rather if I'm aware you are trying to elicit a particular response I'm not prepared to give then yeah game on
I introduced my psychiatrist to your channel, because it’s been so helpful to me while dealing with my younger sister having BPD. It’s incredibly distressing and none of us really know how to manage the way her disorder manifests, and also having an anxiety and depression disorder myself, and I’ve been struggling for many years with the relationship and interactions with my younger sister. Listening to your breakdowns of the reality and motivations behind BPD has helped enormously. Nothing will ever make it easier, but I hope others who see your videos will also gain some comfort and insight into BPD and the reasons and motivations behind their behaviour.
My psychiatrist friend has used this with me several times, I only recognised it now after listening to your video. And that moment of silence, of not commenting, was so odd, it had snapped me out of some habitual way my mind was going with suicidal aviation. Love your videos, how succinct and informative and kind they are thank you
Thank you for talking about BPD in a respectful and constructive way. Have a nice weekend!
I have to say, I was somewhat skeptical about this technique first time I watched this video, but I have to admit: when my thoughts were going 200 km/h and tumbling over each other earlier today, telling myself "There’s time" really helped bring me back to the here and now. I’m not dealing with BPD, but I‘m having trouble implementing grounding techniques to calm anxiety and today I was able to put my thoughts on hold and just focus on the crunching sound of my feet on the pebbles, and actually began to feel a sense of peace and calm. So I guess this could be really good advice for anyone who’s overwhelmed by the thought chaos in their head. Thanks for sharing, doc! 😊
I'm really enjoying your videos! Would you be able to make a video on BPD and ADHD? I originally believed I had BPD and my psych shut it down. I have since been diagnosed with ADHD and emotional dysregulation with dissociative tendencies.
My psych said ADHD in women is usually misdiagnosed as BPD. So, it would be really interesting to hear your thoughts, and touch on the similarities and differences between the two which may lead to ADHD being misdiagnosed as BPD in women.
I've heard that too! Also that cluster b disorders are typically genetic and environmental pathologies and unhealed trauma. There is usually comorbidities overlap with other personality disorders and I admit I see strains of that overlap in myself. DBT therapy has changed my life and I am in almost complete remission. 🌹🌹🙏🙏
@@AliciaM5555that's interesting and makes so much sense when it comes to generational trauma, etc. I definitely think my dad has adhd too. My sister also has it but she's a special case as she also has gene deletion - although she was diagnosed as a child and I was only diagnosed with ADHD last year!!
Glad to hear DBT has worked for you ❤ I've not had the chance to try it yet.
@@bouquettragedy it's crazy how trauma affects your brain chemistry especially when so young and still developing. Thank you so much! ❤️
one notable Borderline Personality Disorder in a relationship is the push-pull cycle. Anecdotally, what I have seen that the romantic partner in the relationship often become the emotional venting outlet & punching bag and it then turns into very toxic relationship dynamic for both partners.
*BPD PUSH-PULL CYCLE* -> "Pulling someone into a close relationship and then pushing that person away repeatedly is one of the most well-known symptoms of BPD. It causes the person in question to be confused about where they stand in the relationship"
Brilliant technique dr syl. As you probably already know, it’s called Motivational Interviewing. You sit and listen to sustain talk (helplessness) and pick up on the change talk (hope). It can be really helpful for health care professionals and family to utilise this skill.
Dr. Syl, I'm really impressed with your calming voice. Perfect fit for people within in psychological fields.
I have a lovely daughter we were fortunate enough to adopt. She's dealing with BPD now that she's began to work through trauma.
Great video. Such a good point and helpful for patients. Me as a patient, I find it hard to open up to strangers and be vulnerable.... and when I try to explain my issues to Doctors, it often sounds different to my reality because I feel like I'm being more positive and animated as a defense to feeling vulnerable with a stranger! I am more talking about primary care/GP rather than specialists in hospital though.
This was very good, thank you. When individuals with BPD are in a high state of crisis it feels like "fire 🔥 consumes" the thinking process stepping back is like cooling down the fire as an analogy. Not being bombarded with input. It give the individual some time to process everything. Possibly this is were the expression of "burn out" comes with age?
I'm a MH nursing student and this reminds me of one of the principles of motivational interviewing (not directly relevant to EUPD/BPD but can be applied). It talks about how if you argue the case for something (a behaviour change), it automatically places them in the role of arguing against it. You need to leave space for them to occupy that role, or even both, and explore their own reasons. Very interesting video :)
This is really helpful advice. I’m not a doctor, but I work in the Emergency Department as a psych safety tech so I’m listening to them constantly and trying to keep them in a calm state for my shift. I’m not a therapist for them but if they talk I will listen to them and give minimal advice and feedback
Everyone needs a Dr Syl in their lives 🦸
Any time a therapist goes and gets me a coffee, I instantly feel more at ease. Because bringing me coffee gives me the signal that I am not being judged and that there is enough time. So for me, yes this sort of approach works (not full BPD but BPD-traits).
This is a great video! It’s interesting to think about the different reasons behind silence in these situations/settings. I always felt like my psychiatrists silence was different to my clinical psychologists silence, but I couldn’t pinpoint why they felt different before now.
My clinical psychologist is very comfortable with long silences, but I know during the silence he’s still analyzing my reactions and checking to see if I’m getting activated without realizing it (so he can reign the conversation back and pause it before dissociation kicks in if I’ve been triggered), and I suspect the silence after I say things that might normally get big/negative reactions from other people is to show me that he’s still present and unaffected by whatever I’ve said (i.e. he isn’t going to freak out or get angry etc), so it gives me time to process the idea that he’s able to hold that space for the conversation and that he’s someone safe to disclose things to. I really appreciate his deliberate silence, because it does help to reinforce that he has predictable and safe responses to anything I say or disclose 🙂
In saying that though, he does approach me in that way because I have ptsd/cptsd, and it’d be interesting to know if he approaches patients with BPD differently 🤔
I love the idea you mentioned for the longer video about how/why some people develop BPD and other various things (especially BPD and ptsd/cptsd as a comparison). Looking forward to it, Dr Syl! 😃😁
Oh, I do like the label "emotionally unstable" rather than "borderline" personality disorder. I may have said this in a previous comment, but you give me amazing hope for mental health treatment in Sydney. You are amazing in having compassion, empathy and the ability to communicate and educate
Yes. Silence, validation, creating, and then holding space. I also find it helpful to verbalise that sitting in this space is not a burden to me. There's no shame, and that life feels best when we experience it as a team. On that, I also remind them that they are the boss of their team and they set the rules. It's so humbling.
I always respect your videos and enjoy them but I don't agree with some of this one. I have had suicidal ideation since I was 40. I'm now 68. I was diagnosed with BPD 10 yrs ago. I'm 68 yrs old now and I have never felt I had a reason to live. It's not that I want to die. I want these feelings to stop. I have no friends or family. No support system. I've lost the two therapists over the past years who did help me by listening and making me feel I had a small bit of hope. I'm so tired of feeling the way I do every single day. It's terrible. I've tried so many things and nothing ever changes.Thank u for listening. Your channel is wonderful.
Wonderful information! I have a graduate Psych degree & did graduate work in Clinical but never worked in the field decades ago (DSM III to give you an idea of how long ago.) I wasn't prepared at that age to work with others at the level you need to be & I think my Mom's personality prompted me to be interested in the field. I doubt she has BPD but there are features of it that I see & I have used these techniques & see how helpful they are. It isn't easy but important to see her as a person who is struggling with a side, while not destructive can undermine her ability to know what she really wants & then be satisfied with "it" when she gets it. I have learned to honor her ability to survive up to this point (age 88) & try to remove my ego from helping her when she is stronger than she recognizes.
This is really interesting! I have been acting and performing since I was a child and your video called to mind one of my guiding principles in the art form, basically, the actor who comes incredibly close to tears, but never actually sheds a tear is far more likely to illicit tears from their audience. It's essentially a sympathetic response. You can apply this to any emotion, not just sadness.
Also just as a PS... I'm curious whether you endorse using this method as a friend and family member of someone with BPD? Wouldn't this only/primarily work in a therapeutic setting where the patient is expecting the response to be of a therapeutic nature and are therefore compelled to reflect on the content of their own words and emotions when they receive an answer that might otherwise feel cold? Maybe I'm genuinely missing something though, I just don't see how using such a direct method can be applicable outside of a therapeutic setting
@@natara658 I can give my input as someone with BPD. For me personally, I would find this effective if my loved ones did it too because when people (anyone) try to present solutions to my problem, I feel like they haven’t listened before telling me how to deal with it. It’s easy to feel misunderstood. I think the patience and allowing space is really helpful in coming down from the high intensity emotions :)
@@emilyj2842 Thanks for your input and explaining your experience! That perspective totally makes sense. I have a really hard time establishing boundaries for myself, so I sometimes struggle to see health in communication that involves a lot of individuation.
I agree with @emilyjacob2842. BPD myself too and my mum has employed this technique with me when I've called her up distressed. Her deliberate, calm and non judgmental pauses do help me check my reactions and feel heard
You can not use a handsome doctor in the thumbnail and a cute dog in the intro and expect me NOT to watch. I think we have some similar experiences with BPD and some very different ones as well, and one of the things not talked about enough is using qualitative variables to quantify the seriousness of mental health but BPD in particular. It's hard to get into in a single YT comment adequately. Great video! Cute dog! BEAUTIFUL eyes!!
Sometimes your videos are just so spot-on and hit home that I have to pause and take a moment, especially with the dynamics of letting a client have the support, but be able to also come to their own conclusions. That grants autonomy and can be really empowering as a client. I really appreciate what you share and the compassion you put into your videos. Thank you! ❤
I wish you were in my health authority, Dr. Syl. Some of our acute clinicians have ghosted us BPD pts, which is the worst thing.
Thank you so much for this I have saved it for my husband.
I live with BPD, OCD and depressive disorder and the year 2023 was an amazing learning year for me.
The trauma Team in Psychiatry supported me very well, Decider skills right medication and the right support are game changers for me.
My life and life of my loved ones improved so much.We can get better or manage our symptoms better if we get the right support and treatment and of course, it has to work both ways. I have good discipline healthy bed hygiene a general lifestyle, little exercise every day healthy diet and the right medication, decider skills are game changers for me I can function in life much better and it reflects on my family too as if I am doing fine we are all in harmony. ❤
Thank you for this
Hi Syl, this is such an interesting strategy! thanks for sharing. Can it work with other mental health conditions too? like if someone is a bit manic or psychotic and they say they're going to do something that probably isn't good for their health. I volunteer at a foodshare program witch has ALL sorts of people come through, and sometimes I can tell they haven't had their meds or are not in a good place. I've become good at talking people through panic attacks and being empathetic with someone who's life is terribly complicated or tragic, but psychosis and mania are trickier to deal with. Thanks in advance Syl
As someone that have been a great deal in therapy. I support this use of silence. It is a place and time for it of course, but this silence can be so important. When you wait for the patient to get to the answer themselfs 🤩 There is nothing like finding your own way. that sounded cheesy. but its true🤪
➡️ please expand on that last sentence! about "it's not their fault, but it's their responsibility". and about cortex development. I think milions of milions of people don't understand it!!!!
I have BPD and CPTSD. It took so long for someone to diagnose the BPD/CPTSD. So many people just kept saying I was depressed and anxious with some PTSD. I felt like my anger was out of control and sometimes professionals are scared to diagnose BPD due to stigma. For me it gave me so many answers and I'm on the road to recovery. I'm Australian also.
As somebody who struggles with BPD-type responses (not diagnosed but I can recognise similarities in myself with this), this is really eye-opening. I'm going to share this with loved ones in my life when I'm feeling intensely hopeless/helpless and see if this changes the outcome of some of those situations. Tysm for creating this video ☺️🫶
I'd worry that by learning about this trick, they'd realize it and get counterproductive results.
@@Maverick_Mad_Moiselle Ahh yeah I see what you mean! I don't think so tho (at least with me) bcos it helps me understand that I've gotta develop my own autonomy and it'll help my loved ones understand that too and try being supportive in a new way. It's just to see if it has different outcomes so we won't know until we try but thx for the reply! 🫶
I am diagnosed and the biggest help was definitely taking a step back and thinking before saying and doing anything. It also helps keeping reminders on your phone about the people in your life of the beautiful and positive moments and a list of what you’re grateful of, even the small things. The little things add up and definitely help the dark thoughts in your head.
The idea about the tea is fabulous! I understand completely how to have things under control.
I have felt confused for years by the dizzying array of diagnoses that I have been labelled with: From Borderline Personality Disorder/Emotionally Unstable Personality Disorder, to Bipolar Disorder, to CPTSD, until finally being landed with Schizoaffective Disorder. I heard years ago that it is challenging to differentiate between BPD/EUPD and bipolar disorder. But it was news to me to discover that CPTSD can also be easily confused with these diagnoses, and finally, Schizoaffective Disorder was quite another shock to the system!! Where does ~ADHD fit into all of these diagnoses? Is it in fact another diagnosis that is difficult to differentiate from the others? I am particularly interested, as my son was diagnosed with ADHD as a child, and I wonder whether there is a connection between the symptoms?
Yes, interesting points
Ok... I think people who watch this should remeber that this technique should be done ONLY by professionals. Imagine how would this go down at home with someone who has MDD.
I believe this would have been what my counsellor I previously had work with me was doing, even from first day, first session, first time walking in, she'd be quietly welcoming and small smile, small gestures but wouldn't enter into any topic of conversation and would wait for me to start speaking, or not, so there would be quite quiet periods. It was quite a new experience for me. I could see it was an intentional technique, often her responses to things I might say would be general Hmm Mm noises showing she'd heard but not 'yes' or 'no' or 'you're right/what about alternative xyz'; just neutrally sort of holding the space.
These are great suggestions. Done well, it’s really powerful. It sounds like you’re using a TA (transactional analysis) kind of framework; encouraging an adult response instead of a child or parent response.
Nothing worst than people trying to give you hope on and on... But the space part and someone to just listen is almost universal. Almost just being there letting you vent things out enough. We are there because of trauma...
Thank you for talking about this. I always thought the person just didn’t know what to say to me. Lol, now I understand.
Hmm, this is interesting.
I’m a counselling student with lived experience of mental illness so I feel as though I’m sitting on both sides of the couch in terms of my reaction to this video.
As students, we are taught from the get go the importance of person centric care, it creates opportunities for clients to experience autonomy, aids in further development of self identity and encourages self determination and self-advocacy.
I guess we look at it as wanting to make ourselves as clinicians as redundant in their lives as possible.
We also place emphasis on the value of silence in the counselling relationship for many of the reasons that you described. However we are also taught to really focus on the quality of the silence, by which I mean not simply allowing a verbal pause for interjections but displaying open body language and ensuring our facial expressions convey active listening through warm non-judgmental empathy (rather than simply being ‘neutral’).
I imagine by watching the videos you make that you naturally do this, however from my perspective on the ‘other couch’, I have experienced this silence in a hospital setting with a psychiatrist that came across as almost hostile or antagonistic (think the classic ‘go on then do it’ scene from a dodgy action movie).
I interpreted this through the lens of my own mental state at the time (severely depressed and perhaps a touch paranoid) and environmental cues like closed body language and a facial expression I read as a ‘smirk’.
When I left the interaction I felt humiliated for opening up about my feelings and felt his uncomfortable silences as a “confirmation” of my feelings of being burdensome and stupid, a silent approach on this occasion allowed the little part of myself that perhaps still wanted to live enough to have not yet attempted, to think ‘he’s an expert and he’s not objecting, I feel like I am wasting his time and so I must be accurate in my perceptions that death is the best outcome for everyone involved.’
This same doctor was very angry with me afterwards when I did try to take my life as I hadn’t told him my plan (I didn’t want to be stopped and assumed he wanted to protect his license so thought I’d save us both the hassle) and when returned to the unit from ICU a few weeks later he kept saying over and over that I’d ‘nearly died’. As this was my intention I just felt even more guilty and burdensome that it hadn’t worked...
But I digress, we look at our roles as providers of “support” not “solutions” (while still offering psycho-education, referrals to appropriate services and encouragement) but sometimes with suicidal ideation particularly when there’s been a history of trauma, in the uncomfortable silences we still need to allow for compassion, holding space and interjecting with the right questions to encourage out the little part still subconsciously trying to live rather than scaring them out “Tell me more about that” “What was that like for you?” “What were you hoping for out of xyz?”
This was so good! I'm a nurse and will keep using this technique. I have done this unknowingly as my brain just doesn't think that fast :). Great tips with tea, and "do you think that's a good idea?" I need to find that article :)!
Thank you for sharing all your valuable insight in a succinct & informative way 👍
Have you heard about the work of another psychiatrist named Jerry Marzinsky in the US? I find his work very interesting and quite groundbreaking in my opinion. He’s a very honest and brave person in my opinion. He actually speaks from his many many years of experience working in the field of psychiatry. I was wondering if you have ever read up on his latest workings and if so what would your thoughts be on them?
My fiancé has straight up told me this is how to handle him when he’s like this. I finally did it and just said “ya maybe you’re right” or I’ll just say “okay” and it’s crazy for true this is
Sitting with your feelings can be good and bad
Great! Very good and very real. ❤
Love this channel!
How do you treat people with borderline and alcoholism/addiction where one can suspect that the drinking might be a part of selfharm?
And please do the extended episod you talked about in the start of this video!
Btw, I would love to see more on the theme addiction, both with and without severe mental illness.
I have it. My bf's terrible at this. But he holds me. And that makes me feel better.
This was such a helpful video thank you!❤
How partners react to the BPD person:
"Go Away!"
Thank you for the tips 😊
Please do something similar on Bipolar spectrum. I think some of these are cross used in crisis. The cup of tea on worked for me
Came upon your channel with the Hi Ren reaction and i am happy i did. Ive been dealing with bipolar that was diagnosed 15 years ago. I just found out about a new diagnosis (borderline personality disorder) that my doctor never told me about. I found out when i requested all my medical files to apply for disability. Although in many ways it helps to understand some things in my past but it still doesn’t help that i am bipolar. Is it common for a doctor to withhold a diagnosis like that from a parient?
could you make a video discussing bipolar disorder and psychosis/psychotic symptoms, as well as one going over the comorbidity of bpd and bipolar disorder (and how symptoms may present)?
Ok, so, in my case (diagnosed with BPD). When you say nothing, it makes me feel worse. It makes my anxiety go up... and it makes me think about how we are wasting time that could be spent working on my problems. I HATE the silence. I just feel horrible.
I was diagnosed with bpd 30 years ago. I have been hospitalised for 2 years with anorexia and have seen numerous psychiatrists and a psychologist but I was to drugged up to benifit from their services. I went on to get married and have two children but this bpd tag has always been stuck to me. I was offered cbt about two years ago but found I couldn't retain what was said and the course work was to taxing. Now I'm out on my own. I have been told that bpd is a tag thats given to people they can't categorise. Is this true??? Could there be something I'm missing??? I am on a lot of pain meds and antidepressants and psychotic meds but I still don't feel like me. 😢
can you comment on C-PTSD vs BPD
I have been diagnosed with PTSD along with a personality disorder and have been in hospital. I'm curious if after a single interview you could guess what it is and see if it might align with my official diagnosis. It'd be really interesting to see you break it down.
I wish I had that "support group" to be immediate and protective of my life versus awkward silence when I hint that I'm having a hard time coping.
I've grown up managing myself (mentally, and learning physically how to splint sprains or broken bones.) I don't think I ever learned how to "scream" for help.
I just assume no one can help me, so I have to go it alone and learn outside myself in order to preserve myself. (Which is leading to dissociation more and more the older I get....how do I keep this up?)
I feel like I have to do something drastic to get the help I truly need.
Edit;
I should add, I wouldn't hurt someone else and I'm too dissociated/apathetic to harm myself. So it would likely be a social meltdown at a job and me walking out/walking home to sleep or cry. (Per "something drastic.")
I don't have the energy/care to harm myself or others. I just suffer in silence and wait to implode.
One thing I have never understood about BPD is why the "borderline" description... is it literal, as in "almost" a personality disorder, or is it more rooted in psychiatric jargon? What is going on there?
I would built up real tension with a silent therapist to a point of psychosis and violence. I'm almost over bpd but I tell you "uncomfortable silence" is a harming way.
Dr Syl - I believe my mother has BPD and/or HPD and I don't know how to help her. Could you please make a video discussing the similarities and differences between these disorders and the prevalence of comorbidity? Maybe some tips for adult children of parents with these disorders. I have struggled with anxiety because of the volatility of my mother, and CBT has been so helpful, but my mum is so resistant to seeking help which makes it near impossible for myself and my brothers to have a relationship with her.
I'd love to hear some advice from you. Thank you.
I was diagnosed with quiet BPD years ago, but I'm now thinking it may be ADHD but I don't know
As you know their are not enough physicians willing to work with individuals who have bpd the stigmatism still exist, hopefully education and knowledge will break the stigma?
….thanks.
I wish you could be my doctor. I can't seem to find one willing to fight for my health
Nice lighting.
This kind of reminds me of irreverence or extending from DBT. Are they similar? Is my brain going in the right direction?
Spot on!
Pah! When I say I want to kill myself; people giggle. Or say, "Oh, we don't want that. Bye."
That’s how you explain BPD. Lol Great video.
thanks that is good advice
When the pain is too much,... you want to die... like you wanted to die cause you dont feel hope... losing hope and in pain is worse to be in ....
7:09 great advice
WOW !!! Superb!!!! Speak less,.. and increase silence !!
Thank you ,.... Empathetic Neutrality !
I have a son with Schizophrenia marked mostly with apathy, cognitive impairment and negative symptoms..... Mostly sleeps and watches movies,...
Could this technique help him ??
Maybe don’t call a side of a bpd person evil
Agreed, even though I think it was intended as a lighthearted description of how it might feel. Because of all the stigma, it’s far too common to hear language like that. Also people with BPD already feel unbearable shame and low self worth.
Are upu wearing a Wedding Ring?
You need to be louder
This sounds like harmful advise . 😮
Absolutely! Unbelievable!😮😮😮 is this a doctor at all?????
As a masters level clinician , it makes a lot of sense to me .
I'm curious as to why you think that?
@@minimushrooom because for a lot of BPD people they are traumatized over long periods of time by emotional unavailable parents. Silence can build up a lot of tension with us. Specially from people who are specifically "there for you".
@@caddieohm7059 I agree.A doktor should understand this about borderline . Silence can be very triggering .
I had a friend who had sucidal ideation and eventually ended up taking his own life bc of this kind of treatment .It's inhumane.
Interesting, my ex who had BPD would normally interpret silence and neutrality as judgement. She would assume if I wasn't actively communicating that I loved her that I was against her. Perhaps that wasn't something inherent to the diagnosis but was her own issue. She was like this to that point that she was constantly gauging the level of emotion on my face. So if I said something supportive but she convinced herself that there was a negative microreaction that appeared on my face for a millisecond I was in trouble. Overall her attitude exhausted me and it felt like I had second hand BPD from all the empathizing I was doing with her.
Actually the more I think about it the more I think she had a lot of really toxic characteristics that weren't BPD...
13:00 you've just described my Psychiatrist to a T! He must know what he is doing then ❤️🩹