Many of the people I work with in therapy have, often since early childhood…
… led unbelievably tragic and painful lives, struggling with many of the devastating symptoms and traits of what are known as personality disorders.
Some have a history of characterlogical or emotion regulation problems, some with a clinical diagnosis of Borderline Personality Disorder (BPD), often diagnosed because of an attempted suicide.
Most of my clients are people who are more emotionally sensitive and vulnerable than others, and when they experience negative emotions — anger, shame, guilt, hurt, fear, sadness, anxiety, hatred — they do so far more intensely than most other people.
Many will have grown up in an environment that was dismissive and invalidating, where they were labelled as "difficult" or "attention seeking" or even "manipulative", and were discouraged from displaying any negative emotion at all.
So, in adulthood, as these memories and emotions surface, they struggle to find the coping skills they need to control and manage them, particularly in stressful or "triggering" situations, and so engage in impulsive behaviours such as self-harm, alcohol or drugs misuse, binge-eating, purging, etc.
A number of those I work with can recall a history of sexual or physical abuse. Some have developed an obsession with suicide, or have indeed attempted to kill themselves, often repeatedly.
Borderline Personality Disorder 'borders on' and often co-occurs with other mood disorders, such as depression, anxiety, PTSD, bipolar, or chemical dependency, prevalent in many of my clients.
Do the following scenarios fit your own situation…?
It's hard for you to accept any separation from those you're closest to, and the prospect of being abandoned can leave you feeling terrified. Sometimes the need for closeness pushes other people's boundaries, pushing them away from you.
There's a need for constant reassurance from partners, resulting in frantic and desperate efforts to avoid being left alone. Relationships get very 'stormy', they shift from love to hate at the drop of a hat, from "my new best friend" and "love of my life" to an all-consuming hatred and loathing.
The mood swings are incredibly intense, emotions up and down: Quick to heat up; slow to cool down. Negative emotions are overwhelming at times, particularly when stressed or frustrated. Feelings of high anxiety, a sense of being filled with pressure, lead to outrage and aggression.
There's a tendency to act impulsively to regulate these emotions and cope with life. Or behave in a very self-destructive way — drug abuse or alcohol, bingeing and purging, suicide threats or actual attempts, self-harming (cutting and burning), impulsive spending, shoplifting, reckless driving, sexual promiscuity, picking fights, or moving home on a whim, even to another country.
Your sense of self and your identity is one that's fragile and shifting. A sudden change, even a good one, can completely destabilise your own self-image, and your sense of where you fit in in the world, who you are, your likes and dislikes, or confidence in your ability to make decisions.
There's a feeling of emptiness and sometimes you can even feel 'cut off' from your own body. There's confusion about your own sexual orientation.
Everything is very 'black-and-white'; grey doesn't really exist and compromise is an impossibility.
Thinking becomes distorted, particularly when under stress or with certain triggers. Everything is simply "either-or"; a very 'black or white' world where grey doesn't really exist and where compromise is an impossibility. There's a tendency to see others as either all-good or all-bad.
It's difficult to see positives, and easy to become overly jealous or suspicious, or overly conscious about perceived threats. Even 'neutral' facial expressions from others are interpreted as being hostile towards you.
Or, perhaps you are a General Practitioner, social worker, Clinical Commissioning Group or Community Mental Health Team, and you're seeking a qualified DBT Therapist, local to Essex or bordering counties, to refer a patient presenting with any or all of these symptoms, or simply looking for information and expertise about effective treatment.
If one or more of these scenarios is true for you, please read on. You're in the right place. There is help for you here
Who is most likely to succeed working with me?
The clients I work with come to me, usually on a weekly or twice-weekly basis for Cognitive Behavioural or Dialectical Behaviour therapy, Schema-focused ('Life-traps') work, or Mindfulness training, at my office and therapy room in Chelmsford. Most, if not all, live or work in Essex, or fairly close by — Kent, Suffolk, Hertfordshire, Cambridgeshire and North-East London; I'm officially 29 miles from central London ('as the crow flies'.)
I work some of the time via Voice Over IP applications, such as Skype (please see the Treatment Strategies section for details.)
While I tend to work mainly, though not exclusively, with clients who are adults, over the age of 18, I also work with adoloescents (ages 13 to 17), often combining DBT with family therapy.
As with most things, what you get out of therapy depends on what you put in. And specialist therapy for personality disorders is going to need a reasonable period of time, especially for Borderline symptoms.
To be clear, behavioural control and learning the skills, outlined in the Treatment Strategies section, could take up to a year; in some cases, a lot more. With mood and personality disorders (such as BPD), the process isn't like mending a broken ankle. At every stage there's hard and still harder work to do.
The people who are more likely to be successful working with me, therefore, are those who have made a clear commitment to doing the very best they can in working towards their therapy goals.
Such commitments include:
- Not dropping out, or threatening to drop out of therapy, not missing or cancelling sessions, for whatever reason, or getting admitted to hospital excessively, or acting suicidal in session, or taking mind-altering substances before coming to sessions;
- Taking on board and practising new behaviours and skills, ones which maybe you've not practised before;
- Continuing to take medication as prescribed by your psychiatrist or GP, as not doing so can be one of the major barriers to staying in therapy;
- Taking on various homework assignments between appointments. Filling out and bringing in Diary Cards to sessions;
- Not looking to seek therapy elsewhere while engaged in therapy with me.
- Gradually exposing yourself to situations you fear, ones that could produce responses you may find very difficult;
- Being willing to commit to see the process through to the end; being an active partner in a collaborative therapeutic process.
If you fit the profile above, you can be successful in tackling the symptoms of Borderline Personality Disorder.
Now that you know the kind of clients I work with, the issues I've helped them resolve and what my clients need to do to ensure their success, tap or click on the panel, below, to learn more about how I work