Transforming
Borderline Personality Disorder
Into A Healing Experience
online conference transcript

Laura Paxton, counselor and author of "Borderline and Beyond: A Program of Recovery From Borderline Personality Disorder, is our guest. She discusses BPD symptoms and diagnosis, recovery from Borderline Personality Disorder, and her own experiences living with BPD for over 10 years.

David Roberts is the HealthyPlace.com moderator.

The people in green are audience members.

David: Good evening. I'm David Roberts. I'm the moderator for tonight's conference. I want to welcome everyone to HealthyPlace.com. Our topic tonight is "Transforming Borderline Personality Disorder Into A Healing Experience." Our guest is Laura Paxton. Ms. Paxton has a Masters in Psychology and Counseling, and is author of "Borderline and Beyond: A Program of Recovery From Borderline Personality Disorder," which is a workbook she designed based on her own experiences of living with Borderline Personality Disorder (BPD).

Good evening Laura, and welcome to HealthyPlace.com. We appreciate you being our guest tonight. To put what we are going to talk about tonight in context, could you start by sharing your experience with Borderline Personality Disorder? What did it stem from and what BPD symptoms did you experience?

Laura Paxton: I suffered from borderline personality disorder between the ages of 15 and 26. In my case, the disorder manifested as a major disturbance in mood, identity and relationships. Learning to live with the disorder, healing from the wounds and responding to its challenges, has given me incredible strength and has given my life incredible meaning.

Borderline Personality Disorder has a variety of causes, from biological to environmental. In my case, a combination of factors played roles. Most importantly was the failure to bond with a caregiver, as well as childhood abuse. Through my healing process, I learned about trust.

David: And you are how old, now?

Laura Paxton: 32 in two weeks.

David: What was life like living with BPD?

Laura Paxton: Stormy, intense and crazy. It was a roller coaster. My personal experience consisted of eleven hospitalizations over that eleven year period. I self-mutilated at different times and made a serious suicide attempt. I couldn't maintain a non-abusive relationship and I lived literally in hell. All of that time, I struggled to function as a professional and my ability to function unraveled until the healing process began.

David: Some professionals in the medical and psychological community believe that you can control some of the symptoms of Borderline Personality Disorder, but you can never get over it; completely recover. What do you think about that?

Laura Paxton: I know for a fact, based on my personal experience, that that is not true. I believe that since, in my case, I am living a happy, contented life (and without drugs for the past nine months) that more people could recover as I have. I have also worked with clients who are taking back control of their lives and learning to live symptom free. So 
I believe full recovery is possible.

David: I'm wondering if you are the exception to the rule when it comes to recovery, or are you of the belief that everyone with Borderline Personality Disorder has an equal chance of recovery?

Laura Paxton: I don't think there is anything special about me. I have seen recovery in the clients I work with when they begin to accept responsibility for their recovery and practice coping skills daily.

David: We have a few audience questions that I want to get to, then we'll continue with our conversation:

TS: Is Borderline Personality Disorder (BPD) a biochemical disorder or does it stem from trauma, or both?

Laura Paxton: I believe that both are true. Exposure to severe trauma often causes complete biochemical changes. Some cases of BPD have been reported in people with no abuse history, or who have suffered physical trauma only.

weaverwoman: I have both borderline personality disorder and multiple personality disorder. Have you run into this dual diagnosis before?

Laura Paxton: Sometimes these disorders are diagnosed simultaneously.

gracee124: Laura mentioned she has been "without drugs for the past nine months." What kind of drugs? Legal or illegal?

Laura Paxton: I have not taken any psychiatric drugs for nine months. Prior to that, I took Zoloft for about four years, Prozac before that, and Effexor before that.

ELIMAE: When Borderline Personality Disorder runs in your family, how do you know if you have it? I am having the same trouble as my sister, who has been diagnosed with BPD.

Laura Paxton: You need to consult with a mental health professional to receive a reliable diagnosis of BPD. If you are experiencing intense emotional experiences and instability in relationships, self-image and career, then you need to seek the counsel of a mental health professional.

David: Here is the diagnostic criteria for Borderline Personality Disorder.

Laura, I want to address the treatment for Borderline Personality Disorder. What is available today and considered the "first-line" treatment?

Laura Paxton: The most frequently recommended treatment for Borderline Personality Disorder is dialectical behavior therapy (DBT). Some patients have had positive results with Self Psychology. My program, Borderline and Beyond, integrates both approaches as well as some innovations that arose from my own recovery experiences.

David: So everyone knows what you're referring to, can you briefly describe what Dialectical Behavior Therapy (DBT) and Self Psychology are?

Laura Paxton: DBT is a program that focuses very heavily on the development of coping skills and practicing them in and out of a group setting. Self-Psychology deals with healing deficits in psychological development through forming a bond between therapist and patient. That is just a brief synopsis of two very broad approaches.

David: Considering that many who have BPD are suffering from abuse, coping with depression, self-injury, and other disorders, I imagine therapy is very complex and takes some time to reach a point where you notice real improvement.

Laura Paxton: Yes. Recovery is a long and complex process for most people. Generally, great improvement is not seen in the first year. However, there are exceptions. I think the most important factor is the willingness for the individual to take responsibility for her own recovery, to stay committed to that goal and to stick with recovery even when it feels too hard to continue.

David: Here are some more audience questions:

Sweetgirl01: Since biochemical changes occur in people who have experienced severe trauma, does it mean that it will take a lifetime of medication in order to correct that imbalance?

Laura Paxton: I used to believe this was true, and I took medications for a total of six years, thinking I would never be free of them. In my case, I don't need the medications anymore. I counsel everyone to talk to a medical doctor before making a decision to go off medications. They are essential for some people at some critical periods of recovery.

Baziust: Hello, I'm a "Major Object"/Victim. (Mother of a 26 year old 200 lb. BPD son). My husband and I were the victims of BPD rage and dysphoria from our son. When the patient's denial is working against us, are we supposed to just take it and remain victims ?

Laura Paxton: No. Absolutely not. Your role is to set firm, consistent limits but not to react with anger to his anger. People with Borderline Personality Disorder need structure and limit-setting and you should not live in fear of your son. Part of the acting out in dysphoria motivation is to see if you will still love and support him through the rage, but that doesn't mean you should tolerate abusive behavior.

Baziust: Then we handled it well yesterday. When he began to rage at us and abuse us with foul language, both dad and I were firm and said, time out!!! Go take a walk around the block. We insisted and he went. When he came back, he was a different person. I went down and gave him a hug. He seemed to appreciate that.

Laura Paxton: People suffering from BPD can be very dramatic and hurtful toward those closest to them. Baziust, it does sound like you handled the situation well with loving limit setting.

gracee124: The professionals have not been able to convince my daughter that medications will help, along with therapy for Borderline Personality Disorder. Can you suggest a way that will help to convince her? She is 17.

Laura Paxton: You may not be able to convince her they will help, but you might be able to help her to open up to giving them a try, if she is in enough pain to take the risk. You might also try letting her talk to someone else who is successfully taking medications.

David: I have a few audience comments on what's been said so far tonight that I'd like to post, then we'll continue with the questions:

TS: I can relate to being a victim to a son. We had to hold him accountable in court and finally the court could not help as they were afraid to send him anywhere. He continued to manipulate and threaten suicide every time the court ordered him into a juvenile setting. This was even with a psychiatrist's opinion to make him accountable after three visits to the hospital for treatment. We were all victims and now he went to his Dad's and then to a girlfriend's at age 16.

SuzieQ: In this JEALOUS insecure frame of mind, I become a hermit and antisocial to PROTECT myself from these feelings of jealousy and fear of being hurt.

Emma18: I was diagnosed with Borderline Personality Disorder about 3 years ago, when I was 15 and in the hospital for an eating disorder, suicide attempt, and self mutilation. I have read many things about borderline personalities to try to understand the disease but I still am so confused about what it actually is and what causes it and how I can help myself.

deeny: I think the chances of overcoming BPD problems depend on the relationship the sufferer is in or if they're in one. One of my main coping skills to counteract self cutting is to write, write, write!

Laura Paxton: Emma18 and deeny, yes, writing is an excellent coping skill. So is artwork. One of the key ways to work with this disorder is to channel the destructive urges into a creative direction. Also, deeny, a supportive social network goes a long way in the healing process.

Emma18, also the most important thing to remember is to learn to develop self-love and compassion for yourself to use as medicine in healing your wounds.

David: Here's the link to the HealthyPlace.com Personality Disorders Community. You can click on this link, sign up for the mail list at the top of the page so you can keep up with events like this.

We have an excellent site that deals with Borderline Personality Disorder: "Life on the Border."

We are looking for journalers in the HealthyPlace.com Personality Disorders Community to keep online diaries of their experiences. If you are interested in doing that, here is the signup link.

Here is Ms. Paxton's website.

Here's another audience question:

Skier4444: I have bought your book. Is it possible to use the workbook and get better without the help of a therapist?

Laura Paxton: I have received many letters from people who have stated they made noticeable improvement in their recovery using the workbook alone. I usually suggest that my workbook be used in tandem with therapy or a support group, but it can be used as a stand-alone program as well.

Mensch: What do you think of the skills in DBT?

Laura Paxton: Many of them are critical skills to learn, such as emotional modulation and self comforting. These skills are also stressed in my program. They require consistent daily effort and commitment to make them work. The core of all of the coping skills is developing a deep rooted love for self and willingness to take responsibility for recovery rather than blaming self and others.

species55: I have been recovering for 7 years from PTSD (Post-Traumatic Stress Disorder), with dramatic biochemical changes in the brain along with attachment issues resulting from severe trauma by others. This has resulted in difficulties with trust. How were you able to overcome this hurdle?

Laura Paxton: One of the most important things I have learned is that the only person you ever really trust is yourself. You learn to trust yourself to set limits for you and protect you from harm, so that you can learn who is safe to open up to, but you never really trust another human being. I believe we only learn to trust ourselves. We can learn to do this by taking risks in opening up to safe people, but it has to start with discovering Self. I used to believe you could only find a sense of Self through learning to bond with another. Now, I believe that these two things are not mutually exclusive. I think that in the process of learning to trust ourselves, we learn to trust others and vice-versa.

ELIMAE: Is severe attention seeking a part of this disease?

Laura Paxton: Yes, for many people it is. Borderlines are experts at going to any lengths to get their unmet needs from childhood met, even if this paradoxically results in driving people further away. This is one of the most frustrating parts of the disorder for family and professionals.

Cheryle: How do I get over the feeling that I need to have someone in my life or I am no good?

Laura Paxton: Begin to affirm yourself, giving yourself positive messages even if you don't believe them right away. Also, spend time with yourself focusing on developing a loving relationship with yourself. Spend quiet time breathing deeply and focusing on developing love and compassion for your shortcomings. Love has to come from you. You will never be satisfied if you keep trying to find it outside of yourself. The good news is that if you try long enough to develop self-love, you will develop it.

SuicideGIRL: I have fantasies of cutting myself, but never have. Do you think I will in the future?

Laura Paxton: Only if you believe you will. I suggest consciously putting images in your mind of nurturing and loving yourself instead. If you continue to scare yourself with these images, you may feel compelled to act on them. The choice is always yours. Choose self-love.

mom12989: I personally have had so many traumas in my life, and multiple medical issues as well as mental illnesses. I have been a bulimic, for example, for 15 years. Do you think it is really possible to get completely better?

Laura Paxton: Yes, I absolutely do. I was diagnosed with profound depression as a result of my Borderline Personality Disorder, and my BPD was considered a serious case. I suffered for eleven years. It takes a huge amount of commitment, positive thinking, and daily practice of coping skills to do it, but it is possible.

blondie_punk_girll: Does a person have to experience a bad childhood to be borderline?

Laura Paxton: No. There are cases of people who report no childhood abuse who have been diagnosed with BPD. This is more rare, but possible because Borderline Personality Disorder is complex and has multiple causes.

2sweet2say: I am a case manager, and I want to know the best way to defray an explosive situation and benefit the individual, not just defer the problem?

Laura Paxton: After rage has escalated to explosiveness, the individual needs a huge amount of reassurance that she will not be abandoned and that she can prevent further episodes. What is most critical is to positively teach affective containment within the parameters of what's possible. Too often, professionals react with contempt to an outburst and focus only on getting through the episode safely and do not use it properly as the healing opportunity it truly is.

TS: Is the cutting EVER just for ATTENTION? My son did that. He carved LOSER in his forearm.

Laura Paxton: I don't think anything is EVER just for attention. Attention is as important to a child as food or oxygen. People need to know they exist, that they are valued and loved. Cutting is a way of saying: "I don't value myself, do you?"

David: Here are some more audience comments on what's being said tonight:

deeny: Cutting for me HAS NEVER BEEN FOR ATTENTION.

Baziust: Blondie punk girl - My son had two wonderful parents. His PTSD in grade 4 was the result of how he interpreted a school yard bullying incident. Being extremely sensitive, he interpreted it as a life and death situation and ended up with full blown PTSD. Untreated PTSD, no doubt, contributed to his BPD.

Laura Paxton: Baziust, I believe that, in many cases, all BPD is a chronic, serious form of PTSD.

deeny: Medications help some, but more or less just takes the edge off.

Cheryle: I am taking paxil for panic attacks and it works great for that, but it seems like ever since I have been on it I have been suicidal, self destructive and have no self-confidence. 

gracee124: The therapist has not wanted my daughter to know of her diagnosis. Although she is 17, the therapist thinks she is too immature to understand the diagnosis.

Laura Paxton: Gracee124, it is not necessary to know what the diagnosis is in order to recover. There is so much stigma associated with Borderline Personality Disorder that sometimes it is better not to know.

Cheryle: I am suicidal, an alcoholic, and a pharmaceutical drug addict. Is this caused by the disease?

Laura Paxton: You would need to talk to your doctor about this, Cheryle. This could be serious and needs to be looked at. Impulsive, self-destructive behavior is often a part of BPD, but they do not always indicate BPD in themselves.

serenity33: I have already been through DBT, and I was wondering if your workbook would be an enhancement to the skills I have already learned.

Laura Paxton: Serenity33, I have been told that my book is a perfect complement to DBT training groups. My program focuses on helping you experiment and learn which coping skills work for you.

David: Also, we have hosted personality disorder support groups on our site and support groups for many mental health topics. Here are the details and the schedule of all support groups at HealthyPlace.com

So, everyone knows, there is no charge to join one of the support groups. We have trained hosts who do a great job. And I'm not just saying that; we get about 5-10 emails a day from visitors to the site saying how helpful the groups are to them. So I invite you to stop by and join in.

2thumbs: I want to stop burning myself, yet I'm afraid to let it go.

Laura Paxton: You can learn to use coping skills which will help you let go of the urge to hurt yourself.

David: Also 2thumbs, you might want to visit the HealthyPlace.com Self-Injury Community and click on the sites there and read the conference transcripts..

Thought I was kidding about visitor support for the hosted support groups here? :)

pia: Yes, two thumbs up for the hosts who do the support chat :). Extra plug for the hosts of support chats :) They have been a life saver, and I've learned more in these chats than I did in years of therapy. :)

David: I know it's getting late. Thank you, Laura, for being our guest tonight and for sharing this information with us. And to those in the audience, thank you for coming and participating. I hope you found it helpful. We have a very large and active community here at HealthyPlace.com. You will always find people in the chatrooms and interacting with various sites.

I invite you to stay and chat in any of the other rooms on the site. Also, if you found our site beneficial, I hope you'll pass our URL around to your friends, mail list buddies, and others. http://www.healthyplace.com

Thanks again, Laura.

Laura Paxton: Thank you very much. I have enjoyed being here tonight. Keep in mind that I offer on-line and phone counseling and consulting through my web-site. Thanks again!

David: Good night, everyone.

Disclaimer: We are not recommending or endorsing any of the suggestions of our guest. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment.

We hold topical mental health chat conferences every Wed. and Thurs. nights. The schedule, and transcripts from previous chats, are here.

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