Wednesday, June 17, 2009

A psychological doom notice

In the eighties and early nineties a young woman in her early 20's with a history of volatile relationships and generally desperate and manipulative behavior would be diagnosed as having "borderline personality disorder". There was no WWW to confirm one's desperation...had there been, the landscape at the time would have seemed grim. No treatment, and a lifetime of despair, longing, and loneliness. And addiction, abusive relationships, and suicide.
Marsha Linehan changed all that. She drew significant insights from Buddhist ideas of non-attachment and the nature of suffering, and from the burgeoning field of Cognitive-Behavioral therapy. The untreatable became treatable. It is a huge amount of work demanded of the client, and boring, too. But it works. Life gets better. Linehan also made sure that the approach was designed in such a way that it produced reams of quantifiable data. Dialectical Behavioral Therapy opened up vast regions of help for once impossible clients.
It works for many, many different types of suffering. It works so well that one begins to wonder if the missing link between Borderline Personality, Bi-polar, and other such things (diagnoses that I find to be far less helpful than harmful) is really trauma and abuse.
Here is a refreshing little article from the NY Times (whose mental health coverage has been very, very good over the last few years) on DBT and the Borderline Diagnosis.

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