Yesterday I had appointment part 2 at fancy private therapy place. Apparently one assessment wasn’t enough, this was another assessment with the psychologist I saw last time and the therapist who runs the DBT programme. The aim was to see if me and DBT would be compatible and if the therapist would be prepared to work with me.
Other than my complete inability to keep eye contact, it went pretty well. I admitted my cynicism about the whole concept but was reassured that it was normal. In theory, DBT sounds like an exciting approach. It’s aim (as far as I can figure) is to control crazy emotions when required and to enable you to form functional relationships. I had to admit that I couldn’t see anything in my childhood that would have caused this, instead choosing to blame myself entirely, but as the conversation progressed I could see little details that maybe could have had an influence. It starts from the assumption that as a child you were never taught to regulate and express emotions “normally” and now as an adult, those emotions are out of control.
If it works, I should be able to choose when to let my emotions run away from me which would be fab because having strong emotions is part of me, I just don’t want them there all the time so that they interfere with every little thought, decision or action. It doesn’t specifically deal with suicide ideation, suicide is not an option within the programme. If you try to top yourself, you’re out (obviously if you succeded I can’t very well see how you’d be in but anyway…). You can discuss ideas and how you feel as much as you want but you can’t act on them which is fair enough. The theory being that when your emotions and relationships are sorted you won’t want to kill yourself anymore anyway.
It does sound like incredibly hard work. There are two sessions each week – one individual and one group. The idea of group work terrifies me, am not good with people but there’s a small part of me that thinks ‘hang on, these are people that think like me in some ways, at least maybe then I won’t feel so crazy, so alone’. In between there’s also phone coaching (also not good with phones but apparently there are ways to deal with that) and homework to complete and all sorts. I’d do it though, every bit. If there’s even a small chance of success, then I have to take it.
So, conclusions? I definitely meet the criteria for Borderline Personality Disorder. I fit to nigh on all the criteria in DSM IV. Not the sort of diagnosis to make me jump for joy, however it does mean that me and DBT are a match made in heaven. I’m the sort of person for whom it was designed to work.
Yay a solution, or not? DBT doesn’t come cheap – it’s intensive and therefore expensive. There’s no way we’d be able to afford it ourselves. This means convincing the PCT to pay and therein lies the catch. I just can’t see it happening. The NICE guidelines state:
22.214.171.124 For women with borderline personality disorder for whom reducing recurrent self-harm is a priority, consider a comprehensive dialectical behaviour therapy programme.
That’s me. So technically NICE is on my side and the only place within the area that offers any sort of DBT is the private therapy place. However, the NICE guidelines also state that people with BPD should be assessed and managed by the Community Mental Health Team. Apparently we should be working together to develop a comprehensive multidisciplinary care plan. I apologise for reverting to internet slang but LOL.
For now I’m back to playing a waiting game. They’re going to wite a report to the PCT arguing for funding and I’m going to ask my GP to do the same. However, I reckon these reports will vanish into the system never to be seen again and I’ll disappear to the bottom of another eternal waiting list. It’s so frustrating, I have this seemingly excellent solution I’d be happy to work with and that would be happy to work with me, I just can’t get to it. Give it a couple of weeks and I’ll see what happens, I might be requesting you all come and picket the hospital with me until they back down!
On a lighter note, I’m still unique! The therapist said I’m the only person they’ve ever met who sat in the appointment and discussed DSM IV and NICE guidelines with them! Usually people with a diagnosis of BPD see it as a disaster and collapse even further in on themselves. Whereas I see it as the first diagnosis I truly agree with and once I know what I’m fighting against, it doesn’t seem so bad. Giving it a name and an identity has stopped me feeling alone, like I’m battling something that nobody understands. OK, having a personality disorder didn’t exactly top my lifes ambitions when I was younger but now I know, I don’t feel so mad.
And on the double plus side, I’ve still got the cheque for yesterdays appointment in my bag! Do you think they’ll notice?!