I am the middle of five children. We are close in age, with my brother the oldest. I have two younger, and one older sister.

My brother sexually molested each one of us. It was hard to say no when you knew that if not you, then your younger sister. My parents would send us to do chores with him, and if we tried not to go, we were the bad ones. He once turned a tractor over on himself and broke his leg. We got yelled at because he was alone - no thank God none of the little girls were along. He had power over the whole house, treating us and our parents any way he wanted. We watched them hand it over to him. My father is an alcoholic and joined AA 25 years ago. My sisters and I are still waiting for him to make amends to us for not providing us with a safe home, but I guess it's not happening.

I was sexually active at a young age with other boys, and became pregnant at 15. We married a year after my son was born, and went on to have another son, then divorced. My husband was the meanest, scariest man I ever met, and I was lucky to get out alive. We were in therapy together for a short time - when he baled out, I stayed, and became overly attached and dependent on my therapist.

After a year with no car and only able to work part time and not handling matters very well, I let my boys go live with their dad's parents. I had problems during this time with drugs and alcohol but did get that under control long enough to marry again. That marriage didn't work either because he was eastern European and we were too different. I was then alone for several years and again had problems with drugs and alcohol. I moved to another state, and determined to begin a new life. I spent much time soul searching, and eventually built a good reputation here.

I then was able to meet good people, and married an angel who has given me a good life. We have five boys between us and they are all adults now. I have had a good, rewarding job for 10 years. My moods, while fluctuating more than I would have liked, were managable. I had more problems and always have had more problems with my memory of current events in my life and misunderstandings with people in my current life. Several months ago I had major surgery, and suffered some stress from that which seems to have caused a bit of a flare-up. I am feeling good today, and when I feel good, I can't believe I'll ever feel that badly again. Then it comes around again, and I can't believe I'll ever feel good again.

Thanks for the reading.

Well I am the oldest of 7 which is confusing story in its self i was molested at a young age I am not sure for how long or really what age but i was young i was raised thinking my father (bio) father died in Vietnam wrong but ill get to that my adoptive father molested me for however long my mother would say if i did not show my body off that my brothers would have a father and she did not put him in jail because you can't get child support from a man in jail ( my mother logic) anyways during sometime my mother had two girls who came to live with us my mother was very abusive towards us girls. I spent most of my adolescent life in and out of psyche hospitals even spent my 16th birthday in a hospital well 13 years ago on July 16 I had had an abortion after a very violet rape and after coming home from the procedure I may have been home for like an hour when the phone and someone knocking on my door all at the same time turned out my youngest sister had died in the night it slowly came about that the suspected suicide was more to believe of murder a month after her death my mother was arrested for the murder of my sister my mother pretty much hung her self on the stand when she said while I was on the stand that it was supposed to be me she found guilty of 16 charges in like 3 hours of all charges and so I went to drinking and drugs to cope and now I am clean and sober trying to deal with reality and just diagnosed with BPD blow my mind people wonder why I have fears of being abandoned.

My name is Heather Ann Presley and I was born on Dec 9th 1987. My parents are Steven and Tessa Close. When I was 3 months old I got taken by CPS and put in the care of my maternal grandparents. B/c my dad had raped me and my mom. My mom came and lived with us and I grew and when I learned to talk I imitated what I heard calling my grandparents mom and dad. Then when I was 3 my grandpa had a series of heart attacks died twice and was hospitalized for 47 days. Scared the shit outta me. I started elementary school when i was 5 and that started the teasing and the harassment from peers. Years passed by without anything eventful happening till when I was 10. My dad got released on profanation and came to my 10th birthday party that’s when I found out all about my past and what had happened. Then my mom got remarried. I started to not feel very happy anymore but I wasn't really "depressed yet" Then at the end of my 8th grade yr I had to change schools. Plus all of my friends were seniors and they were leaving me. So I became really depressed. I made my first suicide attempt by hanging. Didn’t really work that well. I started my new school and hated it the kids were even more horrible to me everyday I got busted by my counsellor etc. I managed through my freshmen yr. Then that summer my best friend came over to my house and shot and killed herself. She bled to death in my arms. That is what started a chain of suicide attempts and got me hospitalized for 2 month’s realizing I was bipolar had anxiety issues and minor OCD

Health and Mental Health

National Alliance for the Mentally ill

1-800-950-6264

National Mental Health Association Information Centre

1-800-969-6642

Self Harm

Beyond Blue

1-800-3668-288

Alcohol

Alcoholics Anonymous

(212) 870-3400

American council on Alcoholism

1-800-527-5344

National Clearinghouse for Alcohol and drug Information

1-800-729-6686

National drug and Alcohol treatment referral Service

1-800-622-2255

Alcohol and Drug Crisis Line

1-800-234-0420

Violence and abuse

End Abuse Domestic Assault line

1-800-END-ABUSE

National Domestic Violence Hotline

1-800-799-7233

National Child Abuse Hotline

1-800-422-4453

Child Abuse Hotline

1-800-540-4000

Rape Abuse Network

1-800-656-HOPE

Drugs

National Clearinghouse for Alcohol and drug Information

1-800-729-6686

National drug and Alcohol treatment referral Service

1-800-622-2255

Alcohol and Drug Crisis Line

1-800-234-0420

Camelback Helpline

1-800-253-2334

Suicide

Suicide Prevention Centre

(310) 391 11253

The Samaritans

Rhode Island - (401) 272 – 4044
New York - (212) 673-3000
Boston – (617) 274-0220

Teenline

(617) 247-8050 or (800) 252-8336

The Samaritans Suicide Prevention

(518) 689-4673

National Hopeline Network

1-800-784-2433

NONE OF THE LISTED HELPLINES ARE CONNECTED WITH BPDWORLD THEREFORE WE TAKE NO RESPONSABILITY FOR THEM

Health and Mental Health

Mental illness information and referral

1.800.817.569

GROW:

Mutual support and self help groups
9890 9846

Beyond Blue

National Depression Initiative
(03) 9810 6100

Alcohol

Alcohol and Drugs:

Counselling, Information and Referral Service
(03) 9416.1818

Violence and abuse

Child Abuse Prevention Services

1.800.688.009

Child Protection and Family Crisis Service

1-800-066-777

Domestic Violence Service

1-800-656-463

Advocate for Survivors of Child Abuse

1.300.657 .80

Men's Referral Service concerned about their anger or violence

1800.065.973

Women's Domestic Violence Crisis Service of Victoria

1.800.015.188

Drugs

Family Drug Support

1300.368.186

Suicide & Self harm

Crisis Line, Information, Counselling

1.800.622.112

Lifeline

131.114

Care Ring

136.169

Crisis Care Unit

131.611

SANE helpline

1800.688.382

Suicide Prevention

1300.360.980

Lifeline Suicide Helpline

1.300.651.251

Lifeline

(03) 9662.1000

NONE OF THE LISTED HELPLINES ARE CONNECTED WITH BPDWORLD THEREFORE WE TAKE NO RESPONSABILITY FOR THEM

Therapies for BPD

There are relevant therapies to treat Borderline Personality Disorder (BPD), these are:

Cognitive Behaviour Therapy

This can help you to change how think and what you do in everyday situations. Unlike some talking therapies this focuses on the ‘here and now’ problems and things you find hard. It looks at ways of improving your state of mind now, instead of causes of your distress from the past. It breaks down problems into smaller pieces (Thoughts, emotions, physical feelings and actions) and this makes it easier to see how they affect you and how that can be changed overtime. CBT can be done individually (therapist) and sessions will last between 5 and 20 depending the severity of the disorder or with a group of people.

Cognitive Analytical Therapy

This is a time limited therapy which aims and focuses on repeating patterns that were learnt in childhood as a way of coping with emotional difficulties and deprivations. This helps to recognise and change unhelpful patterns in relationships and behaviour. This therapy will last anywhere between 16-20 sessions and lasting around hour each time.

Psychotherapy

This is a long-term talking therapy that aims to find the roots of present feelings and behaviour. It helps the patient understand what helps them feel positive or anxious, as well as accepting their strong and weak points. If people can identify their feelings and ways of thinking they become better at coping with difficult situations.This strongly relies on a strong and trusting relationship between client and therapist. This therapy can last months or even years.

Dialectical behaviour therapy (DBT)

DBT was designed by Marsha Linehan is regarded as the most effective treatment for client’s with borderline personality disorder as it was created specifically to treat those with the disorder. The aim of DBT is to teach the client to take control of their emotions and their lives. It is frequently used through a group therapy setting, although it may not be an ideal treatment for those clients who struggle to learn new concepts.

Dialectical Behaviour Therapy (DBT) has been defined as:

• “A novel method of therapy specifically designed to meet the needs of patients with Borderline Personality Disorder and their therapists. It directly addresses the problem of keeping these patients in therapy and the difficulty of maintaining therapist motivation and professional well-being. It is based on a clear and potentially testable theory of BPD and encourages a positive and validating attitude to these patients in the light of this theory.
  
  The approach incorporates what is valuable from other forms of therapy, and is based on a clear acknowledgement of the value of a strong relationship between therapist and patient. Therapy is clearly structured in stages and at each stage a clear hierarchy of targets is defined. The method offers a particularly helpful approach to the management of parasuicide with a clearly defined response to such behaviours.
  
  The techniques used in DBT are extensive and varied, addressing essentially every aspect of therapy and they are underpinned by a dialectical philosophy that recommends a balanced, flexible and systemic approach to the work of therapy. Techniques for achieving change are balanced by techniques of acceptance, problem solving is surrounded by validation, confrontation is balanced by understanding.
  
  The patient is helped to understand her problem behaviours and then deal with situations more effectively. She is taught the necessary skills to enable her to do so and helped to deal with any problems that she may have in applying them in her natural environment. Generalisation outside therapy is not assumed but encouraged directly. Advice and support available between sessions and the patient is encouraged and helped to take responsibility for dealing with life's challenges herself. The method is supported by empirical evidence which suggests that it is successful in reducing self-injury and time spent in psychiatric in-patient treatment”.

Stages of DBT

Patients with BPD present multiple problems and this can pose problems for the therapist in deciding what to focus on and when. This problem is directly addressed in DBT. The course of therapy over time is organised into a number of stages and structured in terms of hierarchies of targets at each stage:

• Pre-treatment stage

This focuses on assessment, commitment and orientation to therapy.

• Stage 1

Focuses on suicidal behaviours, therapy interfering behaviours and behaviours that interfere with the quality of life, together with developing the necessary skills to resolve these problems.

• Stage 2

Deals with post-traumatic stress related problems (PTSD)

• Stage 3

Focuses on self-esteem and individual treatment goals.

The targeted behaviours of each stage are brought under control before moving on to the next phase.

DBT Targets

DBT consists of a hierarchy of targets in which the main goal of each is to increase “dialectical thinking”. An example of such a hierarchy would be:

1. Decreasing suicidal behaviours.
2. Decreasing therapy interfering behaviours.
3. Decreasing behaviours that interfere with the quality of life.
4. Increasing behavioural skills.
5. Decreasing behaviours related to post-traumatic stress.
6. Improving self esteem.
7. Individual targets negotiated with the patient.

In an individual DBT session, the targets outlined above should be dealt with in that order. If in between therapy sessions, self harm or any other incidents have occurred these must be dealt with first before the therapist moves on to anything else.

How are DBT sessions structured?

Dialectical Behaviour Therapy is separated into four parts, three of which the client will experience.

1. Individual Therapy:
   In one to one therapy with a DBT therapist you will work on your self-damaging behaviours and work to continually ensure you are following the skills taught by the DBT course.
2. Group Work:
   Group work will help you to work on your social skills but also teach you new skills from the DBT modules and ways of implementing these.
3. Telephone support:
   Should you be feeling suicidal or as if you may be at risk of self-harm then you may contact your therapist or a member of the DBT team to discuss these and work through your thoughts. You will be urged to apply your DBT skills and techniques. You may only call between times agreed between your therapist and yourself.
4. This is for the therapist only:
   This is the consult group. You could also call it group supervision. This group would meet frequently and is made up by all those who have trained to become DBT Therapists. It’s a place to let off some steam and to make sure you are working effectively and efficiently but also keeping to the model of DBT. The group will encourage you to remain non judgemental and validating of the persons thoughts and feelings.

So now you have a feel for the way the therapy works let’s go into the four separate modules, working on increasing the quality of life of the sufferer.

DBT Skills

Mindfulness

Mindfulness is considered the most important part of Linehan’s DBT skill module. The mindfulness skills focus on "what" and "how" skills; "what" the individual needs to do in order to be mindful and "how" to do this. For example, a typical approach to developing the "what" skill would include an intent and attempt to observe, describe and participate in open dialogue. The "how" skill may require non-judgement, one-mindfulness, and collaboratively determining what is effective.

Interpersonal Effectiveness

Interpersonal effectiveness skills that are used in DBT sessions focus on assertiveness in saying no, making a request, and coping with problems. The purpose of the Interpersonal effectiveness skills are to allow the individual to increase the likelihood of goals being met, while maintaining self respect and keeping the relationship.

Distress Tolerance

Distress Tolerance is the skill set for accepting, finding meaning for, and tolerating distress. This area of DBT focuses on learning to bear the emotional pain resulting from distressing circumstances and events in the individual's life. An important focus in Distress Tolerance is the idea of radical acceptance. Linehan describes radical acceptance as a means by which to free oneself from suffering, and requires a choice to let go of fighting with reality. These skills in "letting go" promote acceptance without judgment or evaluation of the self, others or the situation in general. In theory, focusing on the acceptance of reality rather than the approval of reality will foster a clearer understanding of controllable vs. uncontrollable factors and help facilitate manageability of emotional pain.

Emotional Regulation

Emotional regulation assists individuals with reducing their vulnerability to an emotional state of mind. This is accomplished by providing methods to identify and label emotions, finding barriers in changing emotions and applying distress tolerance skills. The other key component of this skill set is to find ways to increase positive emotional events through healthy living and participation in activities that increase self-confidence.

Downfalls of DBT

DBT is an effective treatment for borderline patients but does have its downsides. These include:

the course being very difficult and requires a lot of commitment

It excludes those with alcohol, substance misuse and those with eating disorders, even though these groups account for a high number of those with a diagnosis of personality disorder.

Why Choose a Therapeutic Community?

The services provided to those with Borderline Personality Disorder can often not provide the support these clients need. In some cases weekly therapy may be provided, but the gap between these sessions can often cause clients to feel alone. As those with BPD can struggle with both closeness and being alone, the time between therapy sessions can result in crisis; with clients engaging in both self-harm and suicidal behaviours. In this case in-patient treatment may be provided. However, this can result in a both a loss of control over their everyday lives and privacy, which can therefore lead to further distress. Although in-patient treatment in a psychiatric ward may provide some short-term benefits, in the long run staff do not have the opportunity to work with the client therapeutically and gain a full understanding of them. However, out-patient treatment is also not enough. When this is the case, therapeutic communities, which provide residential and day-care treatment, specifically for those with personality disorders may be considered.

How are Therapeutic Communities structured?

Therapeutic communities offer an intensive programme and vary in length from a daily residential programme to a weekly one-day session. This programme can further vary between lasting a number of weeks, months, years or indefinite period of time. In order for a therapeutic community programme to be effective clients are encouraged to attend on a regular basis, with lateness or non-attendance being challenged as part of the therapy. Within a therapeutic community, sessions are usually group-based although some may also be held on an individual basis as part of the programme. Group sessions usually consist of a small number of people and have an interpersonal and psychodynamic focus. Group sessions may also include friends and family members, depending on the needs of the client.

Therapeutic Community Availability

Despite the growing push for day treatment as opposed to day-care, for some people a residential therapeutic community may be the best option as it provides them with the support they need to manage their feelings in a safe environment and to learn from others who are experiencing similar emotions. The availability of therapeutic communities however, is rather limited. In the UK there are 28 such communities, 2 of these are found within prisons, 17 are voluntary agencies, with only the remaining 9 being run by the NHS.

Within a therapeutic community, the clients themselves take on many staff functions in regards to the day to day running of the community. This includes cooking, cleaning, administration, finances and new admissions into the community. This provides them with a valued and necessary role within the community.

• Affective Instability
• Associations Between Symptoms of Borderline
• Autobiographical memory in BPD and depression
• Bateman Fonagy - Effectiveness of Partial Hospitalisation
• Borderline Personality traits in hysterical neurosis
• BPD - The voice of patients
• Changing Ideas about the treatment of BPD
• Children - BPD
• Children at risk for BPD
• Comparative study of personality disorder associated with deliberate self harm
• Comparison of attachment styles in bpd and ocd
• Couples therapy with BPD individuals
• DBT for women with BPD
• DBT vs Community Treatment
• Depressive experiences of inpatients with BPD
• Differential Diagnosis
• Emotional Responses to Self Injury
• Experience of tension in patients with BPD
• Joel Paris - Borderline Personality Disorder
• Mechanisms of Change
• NICE Guidelines - Antisocial Personality Disorder
• NICE Guidelines - Borderline Personality Disorder
• Psychological Conflict in BPD
• Relationship between depression and BPD
• Social Domain Dysfunction and Disorganisation in BPD
• Subtypes of BPD
• Taxometric Analyses of BPD
• The Borderline Empathy Effect
• Trust as a foundation for intervention