Q. I am a classic borderline, meeting all 9 criteria from the DSM-IV. I recently pressed my psychiatrist a little bit (verbally, of course), which resulted in medical retirement from my job; I'll soon start receiving a cushy disability pension. The retirement package recommends that I undergo psychoanalysis, specifically reparenting. After trying Prozac, Paxil, Zoloft, Effexor, Trazodone, Depakote, and Tegretol, I'm told that my BPD is "characterologically based", and that no medication will help. It's true, these meds didn't help me feel better, but I have gained weight and sustained cracked ribs from dizziness-induced falls.
Is there a clinical explanation for why this psychiatrist seems to endorse a confrontational attitude? Is it really possible to have a form of BPD that does not respond to medication? Is the analysis/reparenting combination worth trying? I believe that this DR does not know how to deal with me, and that these treatment suggestions are designed to terminating our clinical relationship. I'd prefer to deteriorate in peace than embark on any more ill conceived treatment plans, especially if it will take years to see results.
Finally, this DR has probably impeded my recovery more than helping; would my objective feedback be appreciated, or should I just worry about the door not hitting me in the butt on the way out of her office? Just thinking about our next session leaves me consumed with anger; I'd almost rather stick my face in a fan than show up as scheduled.
A. I firmly believe the BPD is a medical problem, not a characterological one. It's also commonly found with other diagnoses as well. Psychoanalysis is not considered to be a good choice for individuals with the BPD.
It does appear you are unhappy with your current treatment and professionals, and they may be tired of taking care of you as well.
The person in charge of your recovery is you. Age is not an issue, neither is the suffering you've been through up to this point. You need to get all your diagnoses correctly made, and a medical treatment plan established, and you need to learn how to become a happy, successful individual.