Day 18:

The Therapist

Because of the fragility and vulnerability of a borderline, a good therapist is vital. Some can do more harm than good and the therapist's behaviour can be destructive if the patient doesn't feel trust, feels rejected or does not feel safe. Remember, a borderline is constantly scanning another person for signs of rejection so, if a therapist just looks at their watch or a clock on the wall, this can trigger all kinds of emotions within the patient.

BPD patients are said to be one of the most challenging types of patient to treat. It is also emotionally draining for the therapist and they often dread or even refuse to treat someone with BPD. This is because BPD is much deeper in the very being of the person than any other mental illness. Borderlines test the skills of even the most experienced therapists. A BPD patient is almost always in crisis so it is difficult to get to other, deeper issues. Many BPD patients are outwardly angry or agressive which can frighten the therapist. Equally they can be frustrated by someone like me who is quiet and reluctant to talk. You are made to feel you have to prove how sick you are. You feel that the therapist is angry with you, disappointed or even disgusted by you. When a patient doesn't get better despite the therapist's efforts, patients may often be blamed for the lack of progress. If you can't talk, can't "participate", you are blamed. The greatest sin the patient can commit is poor response to treatment. So the therapist may blame the patient rather than admit that the treatment isn't working. Then they may be labelled as difficult, manipulative, a nuisance, dangerous etc etc which can make the patient even more traumatised. Because of all of these factors, patients are often written off with no appropriate treatment which leads to continued deterioration and even suicide.

I must point out that there are probably lots of therapists who are capable, professional and able to provide good treatment and this is just my experience. No therapists were harmed in the making of these statements!!.....