DBT: A Nirvana for BPD Nutters?

“He who makes a beast of himself gets rid of the pain of being a man” – Samuel Johnson, 1809

Next to falling down a rabbit-hole, there isn’t much else that quite compares to being mentally ill; least not for me. I won’t give you a huge backstory about the suicide attempts and the self-harm and the countless nights alone, sobbing, and trembling like a dandelion in a hurricane. That kind of thing is readily available in anecdote after anecdote: just contact your nearest Borderline Personality Disorder sufferer. No; you don’t need to get the whole picture painted for you in glorious technicolour by me. The dawn is drizzling its grey light into the room I’m sitting in right now anyway. No colour today by the look of it in here – or in me. But that’s normal, eh. That’s the default setting. Ghosting your way through life, drifting along from people to people and finding out – if you get lucky – that the problem was never them, it was you. Familiar old emptiness. Friend to no-one, except us: the BPD diagnosed, fully paid up members of the ‘Society of the Inner Void’.

I got diagnosed about ten years ago. And back then the first choice for any Psychiatrist with a full caseload and a bulging morning clinic was always medication. The stronger the better. Sure, I’d been the recipient of ‘warm tea and sympathy’ counselling, and I’d even had a year (extended from six months because I either wouldn’t speak, or spent my sessions engaging in a war of attrition with the therapist) of Psychotherapy. But none of the stuff worked any better than the constant reminder from friends and family that I had ‘changed for the worse’. Eventually, the friends I’d grown up with trickled away down the BPD drain along with a marriage and a career. No, to quote a really bad song, the ‘Drugs DIDN’T work’. Nothing did.

But these things have a funny way of coming to a head, or some sort of messy conclusion, I’ve found. After a decade of complete misery I fell, by default, into the auspices of a different Mental Health Trust – here’s a top tip for changing the treatment lottery: move. So I had yet another assessment by yet another Psychiatrist. Don’t they ever trust each other’s previous diagnosis or simply read casenotes? You’d have to lever mine into a consultation room with a crane. But this time was different. Something was on offer that I’d never heard of before: Dialectical Behavioural Therapy (DBT).

I looked up DBT and tried to avoid all the ‘codswallop’ on the internet, and the sob stories (like this one), and get right to the nut of the thing. Some weird American had invented a system of pseudo-Buddhism crossed with Cognitive Behavioural Therapy to treat BPD. On paper it looked a disaster waiting to happen to anyone with BPD and ten minutes to kill (no pun intended) in a room with someone encouraging them to imagine rocks falling through water in a lake. But what else did I have? Not friends, that was for sure. And not any decent way of getting through life without thinking far too much about hurting the worst monster on earth – myself. Nah…not this time. If DBT was really the evaluated, blue-ribbon treatment for BPD then I owed it to all the people I ever hurt to try and stay alive and make amends for all the sh*t I’d put them through. I signed up – this time not in blood – with mixed hopes.

That was an entire module ago – DBT is run in ‘Modules’. I’ve been on the programme for about four or five months (if you include the pre-treatment psychotherapy). DBT crashed into me like a lifetime rolled into a small ball and thrown through every window in my house at once, in a good way… Nothing could really prepare me for what it feels like to begin to understand exactly how screwed up I am; and that takes a lot of getting over sometimes, believe me. But I’m starting to change. And that’s, ultimately, all I wanted. Yeah, yeah, early days and all that, but I can’t believe I suffered for all this time when there was something out there that could have improved the last twenty years of my life. Instead, I moped around in a prescribed chemical fog, or blasted through life on the back of a mentally ill missile. A beast of a man in every sense.

I’m not sitting here trying to kid you that Nirvana for BPD nutters is really a DBT programme and lots of professionally guided introspection, but I sure as hell wish I’d known a little of what I know now when the symptoms of BPD started to chuck my life down the toilet and reach for the flush. I’ve still got over a year of DBT left. Six months ago I would never have thought I’d stay on something so intense and long-winded, but I can’t see me leaving. I’ve made friends with people on the course (at least I like to think I have) and it is the single most positive experience I’ve had in treatment/life, full stop.

The quote at the top of this article is one that I used to think summed up how I felt about life; like an inevitable outcome of a predictable curse. It meant a lot to me. You could even say it was my motto. But for the last couple of months I’ve begun to think those words might not apply any more. I’m not sure what they’ll be replaced with, or even if they’ll be replaced at all, but something is changing, somewhere, for the better. I can’t give more praise than that, or express a greater sense of hope.

(A 100% free and ungated Dialectical Behaviour Therapy course, for use as self-study or a refresher, can be found at DialecticalBehaviorTherapy.com.)