Borderline Personality Disorder and Buddhism (V)

Borderline Personality Disorder and Buddhism (V) September 30, 2008

– talking, learning…
I gave my “warm up” talk on this topic tonight to a group of Vipassana practitioners, a nice, supportive audience before I go before the wolves, the philosophy students, on Thursday.

“What would Hegel say about all this dialectical behavior therapy?”

“‘All is in flux, ‘ Heraclitus told us long ago – what does a borderline person fail to see in this?”

So how did it go? Good. I managed to get in most of what I wanted to say in only 35 minutes, about 10 minutes more than what I’d guessed. For Thursday’s talk I’ll go a full 50 or so. Honestly, with this topic I could go for hours.

The flow of my talk was:

  1. Intro – why is this important (to me and in general); why Buddhism (Zen) is useful here
  2. BPD – behavior, effects, in a relationship
  3. BPD – brain changes/scans, etiology (causes), comorbidities/similar diagnoses
  4. Buddhism – basic ideas, meditation
  5. Buddhism and the Brain – studies, changes, neuroplasticity
  6. “Buddhism” as treatment, dialectical behavior therapy

I didn’t get into BPD relationship stuff (a particularly interesting area for me) or Buddhism’s basic ideas (they all know it already) and it still went pretty long.

What I learned in the process:

  1. Give the caveat on language: psychology speaks its own language and it is easy, after studying it for a bit, to sink into the jargon. “If I use a word that you don’t know, raise your hand immediately and ask me to clarify!” – terms like etiology are common knowledge probably after freshman year in psychology courses, but new to the other 98% of the population. Terms like alexithymia are (obviously) even worse!
  2. Be nice to therapists. I mentioned at one point that a problem with BPD is the slowness of the discipline of psychology/psychiatry to keep upwith new research. Borderline patients often bounce from therapist to psychiatrist to therapist and so on, searching for a decent prognosis and treatment. It is disheartening and tiring – the BPD person has already gone through so much! And now he/she is getting bounced around the health care system like a rag doll…I was pretty hard on the profession for that, saying that therapists that aren’t up to date on the treatment should at leastbe able to refer the client to one who is.But I didn’t note how notoriously difficult and emotionally taxing a “bad” borderline person can be on a therapist. I’m not sure what exactly makes one a “bad” borderline – perhaps you’re in therapy just to “prove” to others (with whom you often fight) that you’re not the problem, or to show that you’re seeking help when you’re really not. But after my talk and our meditation period, when we had open discussion, the woman to my right, a retired therapist, said to me that she had a borderline client once – and then, as she shook her head she simply said, “devastating… to me.”

    Ohhh… Hearing that… It hurt. It brought back memories, personal and from stories I’ve read and been told. Stories of how (seemingly) manipulative a borderline person can be and how much of an emotional roller-coaster his/her loved ones sometimes have to face. I have also read that the borderline person’s apparent manipulation is just a basically primal response to overwhelming emotions on his/her part – but… That doesn’t make it any less painful to the people around them.

This is one of those ‘dualities’ that is important – difficult as it may be – for us all to grasp and understand. On the one hand a person with BPD is a beautiful, warm, caring, intelligent, carefree and happy person just like all of us deep down. On the other hand, due to causes beyond his/her control, the person with BPD may act in ways that are very harmful and painful to those around him/her. So we and s/he must balance: radical acceptance and the need for change. And it is not even really about balance, but dialectic (thesis, antithesis –> synthesis). It is about rising above the duality and being able to say, “I love me and I want to be better.” This is really something all of us needto say – often and with feeling. It works. I’m sure Oprah says it. 🙂

“Even so, Rahula, one should act with body, speech or mind only after first looking at oneself. Before acting with body, speech or mind, one should think: ‘What I am about to do, will it harm me or others?’ If you can answer: ‘Yes, it will,’ then you should not act. But if you can answer: ‘No, it will not,’ then you should act. You should reflect in the same way while acting and after having acted.

Sometimes I wonder if my blogging/talking with people about is helping or harming things. It doesn’t take a genius to dig into ‘who’ might have sparked my interest in BPD, and I’m pretty sure she (hi there) still reads this. What do you say to the lover or friend of one of those stubborn BPDs out there? I have been advised by some to say nothing – simply turn away, move swiftly, say nothing, and move on. (this is the letting go of the “non-BPD puzzle of hope” A.J. Mahari speaks of – not to be confused with the real hope for BPD persons she also knows so well).

Yet in Buddhism there is also something known (I believe) as satyavacana, speaking truth. And the truth-statement is, according to legend, supposed to work miracles. – August 20, 2009 update, the term is actually satyakriya (Pali: sacca-kiriya), or truth-act.

So I, like so many others, find myself in the dialectic: between silence (letting things move on) and speaking out (bringing truth to the present). What is the synthesis? Accepting the past (accepting her), letting it be, and learning. Growth. Toward what, who knows? To know would eliminate the mystery of life, the beauty. So we simply grow – building on the dialectics/syntheses of life, realizing ever-more deeply the true interconnectedness of all things, including ourselves. Realizing the selflessness of reality, the flux and flow of experience. Smiling upon it all – learning to smile and be glad, even when the mood is tumbling downward. We are ‘bigger than’ that mood. We can just watch it. Just as we can – and should – watch our moods go up….

Very good. Three more days ’till the big talk.

Then 3 days in Glacier (backpacking/photography trip). Then another friend from the UK arives in the US for a week of talks, running, and whatnot. Then I’m likely off to Colorado with my mum to see the grandmum and other relatives for a few days. Thus: busy, busy, busy… And now that I am again paying to be in my ph.d. program – I figure I’d best get to work on it.

So… I’ll focus on the BPD/Buddhism topic for a couple more days, and after that… I’ll leave it to YOU out there to do what YOU can to help further the education (of yourself and others) and help in shedding light on this often very dark place(in the words of one wise soul)…

This is part 5 of a series. Click here for part 1part 2part 3, and part 4.

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