![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 29 to 53 of 71. Go back in thread:
Posted by TofuEmmy on December 12, 2004, at 21:30:48
In reply to Re: That's ok. There's no need for you to get it. » gardenergirl, posted by fires on December 12, 2004, at 21:19:18
It's quite safe to say that not everyone who files a law suit against a T has BPD. It's probably a REALLY safe bet to say that not everyone who has BPD files law suits against their T's. It's also, a REALLY REALLY safe bet, that T's who SHOULD have law suits brought against them often don't.
So, how is it that you know that your highly ethical pdoc had a lawsuit brought against him by a BPD client?? He didn't reveal this information to you, did he??
Posted by Dinah on December 12, 2004, at 21:55:32
In reply to Re: That's ok. There's no need for you to get it. » fires, posted by TofuEmmy on December 12, 2004, at 21:30:48
Hmmm... Good point, Emmy.
And it also brings to mind the long, but hopefully infrequent, tradition in the mental health community of writing off people who complain of misconduct as "borderline" and thereby dismissing what are sometimes valid complaints.
Of course, the fact that mental health practitioners have been known to misuse the borderline diagnosis to cover their own ethical lapses does not in any way mean that this particular pdoc did that.
Just because some mental health practitioners behave very very badly is no reason to make assumptions about others.
Posted by Dinah on December 12, 2004, at 21:59:24
In reply to Re: I don't get it, posted by fires on December 12, 2004, at 20:42:00
I'm sure that's true.
However, this thread seemed to concentrate mainly on logic as far as I can see. Theorems, proofs. Whether if x then y is a valid conclusion. Subsets, extrapolations, etc.
Math, really.
Posted by littleone on December 12, 2004, at 22:16:35
In reply to Re: That's ok. There's no need for you to get it. » gardenergirl, posted by fires on December 12, 2004, at 21:19:18
Fires,
I don't really understand what point you are trying to make. Of course people with BPD (and other people with similar issues) are going to seek treatment and deal with T's and MD's and whatnot.
And of course it's possible that problems will arise from these dealings (eg lawsuits, transference, you name it).
But T's are trained to deal with this (although MD's probably aren't). Are you suggesting that people with BPD should just live out the rest of their lives in a hole somewhere so they won't cause interpersonal problems?
The whole idea of therapy is for the person to go along and have these problems raise their ugly head and to deal with the issues and break the patterns that are prevalent in these people lives.
You mention this lawsuit with an MD you know. This could have just as easily been a lawsuit against a work boss or colleague or teacher or just about anybody. One way to prevent this from happening is for the person to get therapy and address their issues.
And for that to happen, the person in question has to interact with members of the medical/psych community. Regardless of what interpersonal problems this interaction may illicit.
> > > I think it matters because:
> > >
> > > My former MD, a specialist in TRPs, had a bpd patient file a bogus lawsuit against him because he refused to have an affair with her.
> > >
> > > p. 34 "Tuning the Brain"
> >
> > I hardly think that one must have bpd to file a bogus lawsuit.
> >
> > gg
>
> No, but given the following "symptoms", I'm sure it must help:
>
> Diagnostic Criteria
> A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
>
>
>
> frantic efforts to avoid real or imagined abandonment.
>
> Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
>
>
> a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
>
> identity disturbance: markedly and persistently unstable self-image or sense of self
>
>
> impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).
>
>
> Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
>
>
> recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
>
>
> affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
>
> chronic feelings of emptiness
>
>
> inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
>
>
> transient, stress-related paranoid ideation or severe dissociative symptoms
>
>
Posted by fires on December 12, 2004, at 22:44:18
In reply to Re: That's ok. There's no need for you to get it. » fires, posted by TofuEmmy on December 12, 2004, at 21:30:48
> It's quite safe to say that not everyone who files a law suit against a T has BPD. It's probably a REALLY safe bet to say that not everyone who has BPD files law suits against their T's. It's also, a REALLY REALLY safe bet, that T's who SHOULD have law suits brought against them often don't.
>
> So, how is it that you know that your highly ethical pdoc had a lawsuit brought against him by a BPD client?? He didn't reveal this information to you, did he??
>
>
He mentions the story on p. 34 of one of his books: "Tuning the Brain". He doesn't give the patients name.Also, he never became a psychiatrist, but rather a Family Doc with a renowned expertise in psychopharmacology, treatment resistant patients, and CFS.
He (my retired MD) decided not to become a PDoc because of incidents like the following which he mentions in the above mentioned book: (I'm condensing it)
He was acing as an intern in a children's hosp.. A 13 year old boy was admitted with a movement disorder which had been Dxed as hysterical but had not responded to 4 years of 5x a week psychoanalysis. The boy also had myoclonic jerks and coprolalia. He immediately Dxed the boy with Tourette's and administered a low dose of Haldol (the only pharmalogic treatment available back then), and the boy was essentially symptom free in less than an hour. His parents were amazed and grateful, and their child was discharged the next day.
He was reprimanded by the chief of child psych. the next day. He didn't realize that the parents might be quite angry with their child's analyst.
He then briefly told the chief about Tourette's, and that it couldn't respond to psychoanalysis because it was a neuro. disorder.
"Remember that this era was one when psychiatry was psychoanalysis, which was the appropriate, best, and only treatment for virtually every disorder that even had a trace of psychiatric flavor added to it (even asthma, ulcers, and headaches, as well as schizophrenia and mania)."
The book contains many similar disgusting, yet fascinating stories. (No personal financial interest).
Posted by fires on December 12, 2004, at 22:52:26
In reply to Re: That's ok. There's no need for you to get it. » fires, posted by littleone on December 12, 2004, at 22:16:35
Are you aware of the current prognosis for those with moderate to severe BPD? Yes they deserve treatment, but don't expect a great outcome.
http://health.allrefer.com/health/borderline-personality-disorder-prognosis.html
Posted by TofuEmmy on December 13, 2004, at 2:53:03
In reply to Re: That's ok. There's no need for you to get it. » littleone, posted by fires on December 12, 2004, at 22:52:26
>Are you aware of the current prognosis for those with moderate to severe BPD? Yes they deserve treatment, but don't expect a great outcome.
>http://health.allrefer.com/health/borderline-personality-disorder-prognosis.html
-------------------------------------------
The current treatment for BPD is CBT which has shown very good results and is close to receiving funding in many states as an "evidence based practice".Published in July 2004 in Psychiatric Times:
"Great strides have been made in understanding the etiologies, neurobiology and longitudinal course of BPD. An evidence-based practice guideline has been developed for the disorder, and a growing number of studies demonstrate that carefully planned and administered treatment can be effective for many patients with BPD."
To post that url with one simple sentence saying, "Borderline personality disorder has a poor outlook because noncompliance with treatment is common" sounds to me to be to be very unsupportive of the many posters here with BPD. It's also an outdated perspective in the field of BPD treatment. I feel that your additional comment, "don't expect a great oucome" would certainly be disheartening for a poster with BPD.
The nature of this forum is education and support. I feel your post lacked these components.
Emmy
Posted by Dinah on December 13, 2004, at 5:34:35
In reply to Re: That's ok. There's no need for you to get it. » littleone, posted by fires on December 12, 2004, at 22:52:26
No easy task...
Posted by fallsfall on December 13, 2004, at 7:11:37
In reply to I don't get it, posted by fires on December 12, 2004, at 15:39:01
> I keep reading posts in which people here talk about calling their therapist between visits, worrying about their therapists, being in love with their Ts, ... What are "these people" (or you) in T for?
Perhaps "these people" are in therapy because they tend to establish "unhelpful" relationship patterns and they are seeking to understand how to change that.
>
> Borderline Personality Disorder. I'm baffled as to what else it could be. Thanks.I was diagnosed with BPD, though my current therapist disagrees. I never was a "Typical" BPD patient, anyway. I have a strong attachment (you could call it a "dependency" - others have) to my therapist - probably due to emotional neglect while I was growing up. You say that you are baffled as to what else it could be - If you are interested in an answer as to what else it could be, then I suggest Emotional Neglect.
For those (of us) who have BPD, it is a sign of strength that we have sought therapy for our issues. Since your retired MD did not feel able to deal with these patients, I think it was a good choice for him (and his patients) for him to choose not to pursue a Pdoc career. I also did not choose to pursue a Pdoc career, and I would guess that you made that same choice.
Isn't it wonderful that there are so many kind of people and so many career choices, so that people can choose a career that suits them and that they are well suited for?
Posted by Joslynn on December 13, 2004, at 9:49:15
In reply to I don't get it, posted by fires on December 12, 2004, at 15:39:01
You don't understand why people have transference with their therapsists, yet you have just spent a lot of time and typing discussing your former MD on an internet board.
Do you see the irony in this? Perhaps you relate to us more than you realize. Clearly that doctor had a huge impact on you, since you are now talking about his career, quoting his book, criticizing the types of people he couldn't handle, etc.
I wonder, what is the real problem here? Do you miss him and resent the types of cases that you think drove him away from you?
I think there is more to the story than you are telling us.
Posted by Joslynn on December 13, 2004, at 9:54:24
In reply to I think you DO get it, posted by Joslynn on December 13, 2004, at 9:49:15
Posted by gardenergirl on December 13, 2004, at 10:18:54
In reply to Re: Please be Supportive » fires, posted by TofuEmmy on December 13, 2004, at 2:53:03
Lovely post, Emmy.
You said what I wanted to but couldn't because I found myself much like Dinah after reading the latest.
gg
Posted by fires on December 13, 2004, at 10:40:17
In reply to I am struck dumb. » fires, posted by Dinah on December 13, 2004, at 5:34:35
> No easy task...
I don't "get" your cryptic messages.
Posted by fires on December 13, 2004, at 10:54:24
In reply to Re: I don't get it » fires, posted by fallsfall on December 13, 2004, at 7:11:37
You misunderstood. My Dr. knew more about psychiatry than most psychiatrists. He taught psychopharmacology and other courses to med students at several major universities.
He took on treatment resistant patients. Few Drs. will do that! He was known to say that no Dr. should have more than one BPD patient at a time, unless they can handle the frequent late night/early AM "emergency" phone calls from them.
He married a psychologist.
Posted by fires on December 13, 2004, at 10:59:29
In reply to I think you DO get it, posted by Joslynn on December 13, 2004, at 9:49:15
Your info. is wrong. He had to retire due to an injury. No type of patient drove him away from me.
What gave you that idea?
There is not any more to this story than what I'm telling you, but I doubt if you will beleive me. ;)
Posted by TofuEmmy on December 13, 2004, at 11:05:35
In reply to Re: Please be Supportive » TofuEmmy, posted by gardenergirl on December 13, 2004, at 10:18:54
Except for the typo....CBT should be DBT. But you knew that. D'oh, it was late.
Posted by Joslynn on December 13, 2004, at 12:52:05
In reply to Re: I think you DO get it » Joslynn, posted by fires on December 13, 2004, at 10:59:29
I may have surmised the details incorrectly, but my overall point was, it was ironic to me that you said you didn't get transference to a T, yet you are so interested in your former doctor. You have taken on his opinions, quoted him, supported his side on this board, are still thinking of him even though he is no longer your doc, etc. That could be considered as transference, something you say you do not "get."
Also, it sounds like you have some anger and resentment towards people with BPD (which I don't have, by the way) and it seems like that must come from somewhere.
Unless you really do just want to hurt sensitive people who come on here for support?
Posted by Joslynn on December 13, 2004, at 12:54:35
In reply to Re: I think you DO get it, posted by Joslynn on December 13, 2004, at 12:52:05
I'm just adding to the problem by responding, never mind. I should have just kept scrolling.
Posted by fallsfall on December 13, 2004, at 12:55:12
In reply to Re: I don't get it » fallsfall, posted by fires on December 13, 2004, at 10:54:24
OK... I am easily confused these days.
I did also answer your original question, however, if you would be interested in discussing that...
Posted by littleone on December 13, 2004, at 14:20:40
In reply to Re: That's ok. There's no need for you to get it. » littleone, posted by fires on December 12, 2004, at 22:52:26
> Are you aware of the current prognosis for those with moderate to severe BPD? Yes they deserve treatment, but don't expect a great outcome.
Fires, you made me laugh with this. You've fallen into your own trap of believing everything you read on the internet :)You can have a prognosis in relation to a liver transplant. You can have a prognosis in relation to open heart surgery. It denotes the chances of success or failure.
I think you will find that the website you quoted uses a standard template of symptoms, treatment, prognosis, etc for a very wide range of conditions.
But with psychological problems, there are no successes or failures. There is a continum of growth that continues throughout the individual's lifetime. Therapy is not a cure. It is a tool that can be utilised to assist in this growth journey.
I would hazard a guess that the website was referring to the fact that due to the traits of impulsiveness and vilification that some people with BPD exhibit, there is a high drop out rate from treatment by these people.
However it would be grossly inaccurate to say there is a poor prognosis. In my opinion, with a strong committment from the individual and the assistance of a skilled T, I believe there is an excellent "prognosis" for growth.
Also, you need to remember that even if a person drops out of treatment, it could still be argued that it was successful to a degree. In all likelihood, the person has walked away with an awareness of some of their issues. Even just an awareness can sometimes assist in everyday life.
Posted by fires on December 13, 2004, at 16:15:48
In reply to Re: I think you DO get it, posted by Joslynn on December 13, 2004, at 12:52:05
I don't recall ever using the word transference in a post. Please define what you mean by transference.
I think we might want to concentrate on what is known, rather than what things seem or sound like.
You stated: "Unless you really do just want to hurt sensitive people who come on here for support?"
What? Where did that come from?
Posted by 10derheart on December 13, 2004, at 16:16:01
In reply to Prognosis » fires, posted by littleone on December 13, 2004, at 14:20:40
Posted by fires on December 13, 2004, at 16:52:47
In reply to Prognosis » fires, posted by littleone on December 13, 2004, at 14:20:40
No. Many sites made the same prognostic statement.
If psychotherapy can't offer any more than "growth", I'd sugggest the BPDs take a look at pharmacologic treatments. Here's just one:
Posted by pegasus on December 13, 2004, at 17:04:50
In reply to Re: Prognosis » littleone, posted by fires on December 13, 2004, at 16:52:47
You don't value growth? That would explain a lot.
This is sounding like a false dichotomy to me. A person could surely use pharmacotherapy for relief of symptoms as well as psychotherapy for growth. In fact, that's what I'm doing, and both parts of my treatment are doing wonders. It would be sad to me to miss the growth part of the equation, but of course, everyone gets to choose what their own goals are.
pegasus
Posted by fires on December 13, 2004, at 19:26:21
In reply to Re: Prognosis » fires, posted by pegasus on December 13, 2004, at 17:04:50
> You don't value growth? That would explain a lot.
>
> This is sounding like a false dichotomy to me. A person could surely use pharmacotherapy for relief of symptoms as well as psychotherapy for growth. In fact, that's what I'm doing, and both parts of my treatment are doing wonders. It would be sad to me to miss the growth part of the equation, but of course, everyone gets to choose what their own goals are.
>
> pegasus
>
>
First, I feel that your rhetorical question is quite offensive. I feel that it is a thinly veiled sarcastic putdown.I tried the growth part of the equation and found it akin to malpractice. For a patient to have to endure psychotherapy for physical problems due to a Ts lack of medical knowledge is inexcusable. I'm sure that you are aware that T is continually having to psychologize problems of living because meds have made such a signicant inroad into "emotional" disorders.
In my state, CA, it got so bad a few years back that Ts (non MD types) lobbied to try to get laws to allow them to prescribe!! Wanting for patients? You bet.
Then came Oprah, Dr. Phil, and other pop psych personalities to save the day.
They even have succeeded in getting people to believe that they primarily over-eat for "emotional" reasons - imagine that-- and they are both over weight!
Go forward in thread:
Psycho-Babble Psychology | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.