Q. Questions for Dr. Heller:
My doctor said that BPD is the label given to patients doctors don't like - like me. He said it is so derogatory that my medical records are not released for me to read. Can you recommend one key article to enlighten him?
If borderline episodes are triggered by threatening stresses, could the negative threats from authority figures, such as doctors or police, damage the patient's recovery?
How is it that BPD's manage to do well in loving, structured support environments, but fall apart under threats? Is this just cowardice?
A. I believe your first question is can threats from authority figures damage the patient's recovery. If so the answer is complicated. The actual answer is no, unless there is some very real threat - such as going to jail for attending an AA meeting, taking prescription medication, seeing a therapist, etc. All stressors make the BPD temporarily worse, the level of worsening depending upon the perception of stress and the baseline functioning level of the individual with the BPD.