Psychiatric Interview: BPD (Borderline Personality Disorder) | Part 3 | Analysis with Dr. Jacob
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- Опубликовано: 5 сен 2024
- Dr. Karen Jacob uses a debrief of her interview with a BPD-diagnosed client as a jumping off point for a more general discussion about therapy.
You can find Part 1 (the session) here: • Psychiatric Interview:...
And Part 2 (debrief with client) here: • Psychiatric Interview:...
Topics include: first session strategy, validation, substance use, avoidance, self conflict, motivation for change, readiness for therapy, the pain of therapy, therapist/client match, the Working Alliance Inventory, behavioral change timelines, assessing the effectiveness of therapy, what makes a good Borderline Personality Disorder therapist, difficulties for a therapist treating BPD, and why treating BPD is fulfilling for the therapist.
This video is part of a series of sessions with therapists who work with Borderline Personality Disorder. Playlist of all videos to date is here: • Playlist
For more related material, see John Gunderson’s videos: • Dr. John Gunderson
And Mary Zanarini's videos: • Dr. Mary Zanarini
Dr. Jacob is at the forefront of treatment for people with BPD, including those who experience co-occurring psychiatric conditions such as substance use, eating disorders, depression, or anxiety. Her short bio:
"Karen L. Jacob, PhD, is an expert treater of those with BPD, a Program Director for a Borderline Personality Disorder Treatment Program, and an Instructor of Psychology. She received her PhD in clinical psychology from Clark University and completed her post-doctoral training at Cambridge Health Alliance at Harvard Medical School. Her clinical training has been primarily in cognitive behavior therapy (CBT) for patients struggling with mood, anxiety, and personality disorders, as well as in mindfulness, mentalization, dialectical behavior, and biofeedback therapies.
Dr. Jacob has an extensive research training background, having studied topics including diabetes, adoption, attachment, panic disorder, and psychotherapy outcomes. She has authored numerous papers and presentations and was honored with the Hiatt Scholarship. Her current research interests include understanding the effectiveness of empirically-supported treatments in clinical contexts and in elucidating mechanisms of change in treatment. Dr. Jacob has a particular interest in understanding the relative impact of different components of treatment on outcome, as measured by both symptom and functional improvement."
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For more information about BORDERLINE, the feature-length documentary we made about BPD, please visit: borderlinethefi...
Our archive of videos on mental health is expanding - be sure to subscribe to our channel here: / borderlinernotes
Disclaimer: "Please be advised this video may contain sensitive information. All content found within this publication (VIDEO) is provided for informational purposes only. All cases may differ, and the information provided is a general guide. The content is not intended to be used as a substitute for medical advice, diagnosis, or treatment. If you have specific questions about a medical condition, you should consult your doctor or other qualified medical professional for assistance or questions you have regarding a medical condition. Studio Comma The, LLC and BorderlinerNotes does not recommend any specific course of medical remedy, physicians, products,opinion, or other information.
Studio Comma The, LLC and BorderlinerNotes expressly disclaims responsibility and shall have no liability for any damages, loss, injury, or liability whatsoever suffering as a result of reliance on the information in this publication. If you or someone you know is considering self-harm or suicide, it’s okay to ask for help. 24 hour support is provided by www.hopeline-n... (877.235.4525), suicideprevent... (800.273.8255), kidshelpphone.ca (800.668.6868).”
Dr. Jacob needs her own Podcast. I would love to hear her talk more about therapy.
Thats what im saynnn! Shes gooddddd
I think she is a great listener, wish she was my therapist.
I agree. She’s very easy to listen to.
Definitely
She doesn’t need her own podcast but others would learn so much from her if she chose to engage in podcasts.:)
“Has it ever struck you that life is all memory, except for the one present moment that goes by you so quick you hardly catch it going?”― Tennessee Williams.
BRILLIANT.
So simple, so real, yet so elusive.
👏👏👏
I can't even remember what you trying to forget
So true..
Rebbie please have Dr. Jacob on you show channel again please. I love to listen to her talk about BPD and therapy.
Agree, duly noted, and will see if we can make this happen. Thank you for your feedback!
I love Dr. Jacob. Her tone is so calming, and if she were my therapist, I would feel so safe to open up and be myself. It's something about her that makes me automatically have a feeling of trust in her.
Also, she is so knowledgeable about mental health, and I could watch her videos and not be bored.
The no 1thing that has helped my bpd is not taking life too seriously. And have stress management and take deep breath if we feel stressed or angry. And dont talk until we have calmed down. And dont feed of people's bad energy. If people are being rude they are not thinking about people's feelings. If we ignore drama we will feel calmer. It's best to let things go. Because we will be less stressed if we care less. And these days people are more self focused and less respectful and sympathetic. Its best to keep it polite with people we are not friends with and dont overshare and not expect to much from people. If people show disrespect they lack respect. Think dont sweat the small stuff and it's all small stuff . Be tough life is rough.
👍🏻⚘💋❤
I think with BPD, validation can be much more subtle than hearing “I understand”.
Rather, validation can be about having the rights to your own experience, and having the listener honor that.
In the interview with the other therapist, the client was discussing how she had a trail of broken relationships and memories of doing things that she wish she hadn’t. The therapists response to that was “doesn’t everyone?”. While that is empathizing and an attempt to normalize the guilt/shame that the client is feeling (because yes, most everyone has these types of regrets), in a subtle way this was invalidating.
No, not everyone’s memory bank of their relationships and life events is a proverbial war zone, and that is real. Saying “everyone feels that way” groups BPD (in this instance) into the general population, which is marginalizing the reality of the clients mental health.
In a way it’s telling the client that because they are like everyone else, that they don’t have a right to their feelings, which is often what people with BPD were told when growing up.
Though a little later in the session, the therapist said that while BPD experiences demonstrate common emotional themes of being human, they are more extreme.
But for the fact that that portion of the session, (and what the lady in the red shirt said towards the beginning of this interview), was framed by “everyone feels that way” really shows how challenging it is for mental health professionals to grasp the mechanisms of BPD.
hard to understand how the patient took it. She might have understood the nuance.
I appreciate the distinction you wrote out here. Helped me grasp what you were getting at.
Dr. Jacob calmly and quietly collected her lol
Omg yes exactly, when she said that something in me burned with awkwardness, and that is the same way my
psychology used to treat me, I don't think they understand how hard that kind of comments can hit someone with BPD. Thank you for putting in words this feeling.
for real. I cringed. like look at my life, relationships, typical string of emotions throughout the day, and all my insecurities that I mentally have to face down every second of every day. this isn’t “everyone.” and like if you’re BPD and seeking help, it may have taken some time to get the courage to talk about this stuff, so then it’s brushed off in that way and then you feel like you’re over-explaining when you try to elaborate. ugh
Grrr i hate when they say like “oh everyone think like that, everyone go crazy sometimes” its NOT the same. Bpd is a mental disease and we are different from “normal” people. If therapist don’t understand, how normal people would?
This helps me understand why therapists I've seen before have done nothing for me. I think they have given me validation and supported, but not challenged me. That's what I've always wanted - someone to challenge me to change; to call me on my BS.
Absolutely! I realized that the great success I’ve had with my therapist now it’s because she’s definitely challenged me to the core!
I'm 62 years old and after around 9-10 different therapists/attempts at Psychotherapy since I was 19, I ask myself why in the heck was I unable to find the kind of EXCELLENT therapeutic relationship like the one shown? I gave up over 20 years ago - stopped looking in 1999 around my 40th birthday - gave up entirely - swore off any chance of therapy since then, I was fed up. Until the past few weeks - then I came upon this channel. So much time lost ... at least NOW I know what I am looking for. Don't know if I will find it but I can hope. Looking back - it is incredibly hard to find a good fit. It has been a futile exercise for me thus far.
1. I thought that Dr Jacob was much warmer in the debrief than in the therapy session. But she did explain her working method, which made it understandable.
2. It's very difficult to find a therapist who is able to tolerate conflict with a patient. Unfortunately, those that can tolerate the discomfort and work with the patient tend to charge a lot of money.
true.
It has been my experience with therapists that one gets what one pays for. My current one, my fourth, is a Ph.D., 40 years in practice, $275 per 45 minute session, self-pay, out-of-pocket. After 3.5 years with him, far longer than I thought, I’ve realized I’m actually in long-term psychoanalysis, Jungian style. Some times it’s hard to tell but I’d say it’s been well worth it.
Yeah. This country only sees the privileged as deserving access to proper care.
I'm sure there may be groups of specialists who advocate for universal care, but.... It at least looks and feels like most just perpetuate that imbalance.
@@MrGone-bw6bk 3.5 yrs doesnt sound very worth it
Yeah, it's funny because I saw the part 1 interview with her and Charlotte and I was blown away with her skill but I went into the comment section and people were saying Jacob needs to be schooled by Choi-Kaine. When I saw that interview with Charlotte I thought Choi-Kaine was somebody I'd love to get coffee with but not someone I would choose as a therapist. I'm someone who will never get anywhere with hand-holding. My dream therapist is someone who challenges me but is also quiet and reflective. It just goes to show you how it's (as Charlotte said) a marriage and people are different and need different skill sets at different times.
I believe the polar opposite of your comment. Being compassionate, yet insightful, and allowing the patient to come to her own conclusions, which Charlotte was so excited about is not handholding. In contrast, under the guise of “challenging “ Dr. J seemed somewhat threatened by Charlotte, and she accused her of lying in order to what? Let the viewers see what a difficult patient Charlotte was, or is she just one of those catty women who plays mind games with certain other women, including patients. She didn’t fool Charlotte either.
Incredible therapist, so much wisdom and insight into mental health issues. From working with acutely unwell patients suffering with BPD I feel like these videos have given me a fresh insight into how I work myself. Great content, from the UK here
I would love Dr. Jacob to have her own Podcast.Just love listening to her .
How about a national Radio/PBS show? She is far too good for that I hope she does not do that LOL.
I think being with the client, showing them respect, having a calm, attending, and knowledgeable therapist is validating their life and helping contain the process. It can be easy to validate with words but that is not really understanding their narrative. Working to understand the story with a patient, can show honor to their struggle. Small smiles, head nods, true listening and tracking can be quite powerful.
Dr Jacob is wonderful lady, she is deeply mindful and interesting in giving peace and health to people. God bless her 🙏
I disagree. I think if you pay attention to her the times she’s with Charlotte, you will see a therapist with a huge ego. I would never be able to trust sharing my feelings or private information with her.
Without validation, there is no trust or openness for change. Many people who have BPD were invalidated and dismissed/neglected in childhood and that triggered the condition.
I think the insistence on validation can be seen as part of the mechanism of the illness, as a demand for those around the patient to remain in their roles of enablers.
I would love to hear Charlotte's perspective regarding the comments. I feel like a lot of people are projecting their own feelings onto the therapy session while not considering how Charlotte might have felt about it.
an interesting dialogue!
Very much agree. I wasn't shocked at all by the therapist attitude, but everyone's sensitivity is different 😊 I used to recommend my therapist to a friend and she had a terrible experience, she found her cold, but I didn't at all.
How about the woman on the left with sweeping generalizations about BPD folks when it is supposed to be about the session. Charlotte would have good reason to feel that was possibly being said about her...commenters don't hold the same power that these overpaid professionals do. Even if Charlotte didn't feel it was being said about her it is so unprofessional to make sweeping generalizations about a group of people particularly when in a video about a session with a specific person.
@@moriah1394 You sound pretty pissed off.
Actually it's quite unethical.As someone made a comment before (which may have been taken down) this therapist with Herald of facial movements and fake tan is going for the next TV therapist show stardom.
Lots of good food for thought here. I really enjoy Dr. Jacob's demeanor and balanced perspective on things. I'm 51 and currently trying to decide if I want to pursue therapy at this point. I had a great therapist in Germany who I felt walked a good balance between validation and challenge, but I was only able to see him for about 5 or 6 months before I moved back to the states last year. I was just beginning to feel like I was making some positive progress, when my whole world got turned upside down again. The thought of trying to find a good fit again at this age feels futile at times honestly, but I've regressed a lot since I moved back. Anyway, thank you for the quality content.
Dont give up
There are many experts on bpd in the usa
Lee you're only 51 plenty of life left in you yet. It's never too late.
OH MY!! Here it is! More of Dr. Jacob! God bless. Thank you. Just heading to watch it - and probably like another 3973 times more after that... hi from Czech republic. :-)
🙌🧡🙌
Hearing about your own vulnerable aspects and sincere centered motivations is very helpful. Thank you both for sharing.
Prior to starting therapy, I envisioned my sessions as the place where I could finally just spill out my entire lifes story and to have someone actually believe and sympathize the hell I went through. The validation is like a trust test almost. Like if you can hear me and my pain then I feel like you're safe. But as hard as it is to admit, validation isn't as lasting and effective as actually doing the more challenging work. Like how a snack can minimize someones hunger but it won't be as nourishing and filling as a whole meal.
True on the valiation part but others including myself felt and (know about this therapist b/c we've had similiar is she dismissed and even outright tested the patient ( Charlotte) to say/prove she wasn't making up stuff i.e.that her boyfriend did cheat on her.)Those kind of comments from a therapist are the kind which cause distrust of the therapist and usually add up to leaving therapy with the therapist.It's quiet usual
like on this thread those type of evaluations of the session which are negative to the therapist are taken down as in real life of the client the clients' truths and anyone believing them are squashed so the rest of the family,the predators and the society as a whole can crawl back in there holes of denial and respectability now that everyone has been trained to be victims b/c they "have to walk on eggshells" as the only alternative to marginalizing and disrespecting people with MI.Times up on that!
that
I relate a lot to lack of motivation and chronic internal and external conflict. I wish Dr Jacob could be my therapist. I was never formally diagnosed with BPD... instead I got bipolar type 2... AND I am convinced that "developmental attachment trauma" or "complex ptsd" would be a far more accurate diagnosis, however, if this were ever accepted into the DSM, most other diagnoses would become obsolete, AND I think the pharmaceutical industry would have a problem.
I have to rewatch this. It’s great to see what avoidance looks like. Before the therapist mentioned it I already saw massive avoidance in Charlotte hence her problems
Dr. Jacob is wonderful
I’d love Dr.Jacob to have her on Podcast .
Amazing series. An even bigger ongoing contribution than the original movie. Thank you.
Exactly Dr. Jacob! It depends on what you expect. Is it a validation? Or you want to change? If so, the change is painful by definition. As a person diagnosed w/ BPD, I'd choose this shrink.
Every time I watch these videos I'm pretty sure I have whatever they're talking about
I really like Dr Jacob. You will never go to her and two years later find nothing changed. She is going to guide you to do the really hard work and you will see real results. If you don't want to go deep, you won't last. I wish I came across someone like her 30 years ago.
My mother often told me what I was thinking and feeling regardless of the fact that I had a set of my own thoughts and feelings which were way off from her insight, often very lacking. I love these interviews. The best I've come across when talking about borderline personality.
I wish more therapists were informed or understood how to help someone with BPD. Often those with BPD end up becoming more of the therapist and leads while the therapist becomes kind of lost and hopeless in knowing how to help or where to focus. Then the therapy breaks down either through rejection, avoidance. The therapist becomes flaky, scattered and just unhelpful overall and you wonder what's the point of counselling when it's leading on a path to no where.
Dang this sounds familiar
This is HUGE. I was a bit shocked when I read comments complaining that Dr. Jacob was cold and unhelpful. Like you, I've been told what I'm thinking and feeling by others, rather than being allowed the space to feel/think, identify, and express those thoughts and feelings myself. Dr. Jacob is not there to offer her opinion, provide validation, or tell someone what they are thinking or feeling. She is there to seek an understanding of her client and provide a safe space that allows her client to open up. The first session really is a "getting to know you" sesh. I love how she gave Charlotte the space to express herself and just "be".
@@JessyA86 That was my impression too. I was having therapist envy the whole time; I had so many disappointments. A practitioner that won't sacrifice their clear perspective for my comfort is the holy grail of therapists.
Wow my thoughts exactly!!!
@@dreamingrightnow1174 wow. So true!
Very interesting video, as the rest of this serie. It really resonated with me, I mean it touches deep subjects. Validation is something complicated: when people or therapists always say 'I understand you' after every damn sentences, it feels fake, I'm never sure they really do. I find it to be an automatic response just to reassure me. Nobody can be understood from the inside, yet the seek for validation is a trap: you want to be understood, but never 100% will be! In my opinion, validate oneself is the key. Then you feel legitimate to feel legitimate to feel whatever you feel.
Validation is eye contact, holding space for another’s experience, allowing their feelings, not trying to change what they feel, asking appropriate and kind questions...and on and on.
“I understand you” can actually be very invalidating, especially if you know there’s no way they can.
Invalidation in childhood can be a parent ignoring a child. It can be a parent saying “don’t cry” “it’s not that bad”.
Most BPD patients have had ongoing chronic invalidation. From others and then they do it to themselves too. Having a therapist model validating behavior can be of utmost importance. Correct validation is authentic, connecting and creates safety. Imperative to successful therapy.
Yeah, I'm not looking for charm from a therapist, I'm looking for (and paying for) a skill set.
It's all about genuineness and the relationship in therapy. Being genuine isn't reflected in saying "I understand" to "validate" is the same as hearing "have a nice day." Don't mean anything when it is muttered as a mantra.
i really loved how you refrenced someone who only blacks out sometimes to do you consider someone who only cuts themselves SOMETIMES as some one who self harms? It was brilliant and it was a very subtle way of saying hey if you need to be drunk or high or what have you to socialize with your friends then yes this is a problem that should be addressed
Thank you for the comments on validation. Not being a Dr. My opinion doesn't matter much, but if you could maybe say it' a few times for me? It's not very helpful at progressing through what I'm supposed to feel. I always appreciate the attempt at reinforcing a feeling of safety, and just generally not being a dick, but facing reality and the uncomfortable parts of it are what I do in my own time and it helps. Getting help from someone and them calming down on the validation would make me feel like they were people instead of reassuring chairs. Thank you for the videos, information and your investment of time and energy in helping people.
I wish dr Jacob would meet my ex, for years i have struggled with the erratic, bewildering beahaviour. She is so clear and adamant on her patients recovery. Thank you both.
Will there (here) be more of dr. Jacob? I mean.... we still need much more of her here, right? ☺
Hi Dr.Jacob,i say you very well listening when someone brings their problems,and vent to you,and then you really do well to coming back with very understanding answers to really comfort them with good logical help,and really come across with what they really need,and very through explaining it all,keep up the good help,thank you,love Denny😘🙏
This series is fire 🔥 thank you
i thought you did a great job. Validated enough to have her continue to look at herself and continue. For a first session, it was very deep and therapeutic too!
She’s a great therapist, patients need to be challenged or else there’s no real bridge for a change. I know from my experience, the best insights have definitely been when my therapist gets me out of that comfort zone.
Ahh I like this better. Much more warmth. How interesting 🧐
Also i can’t be the first person to recognize this interviewers indignity to the most troubling thing that we’re doing.
I could listen to her talk for hours 🧐😊
She saw her dad as herself, back after the concert and clapping, and she had seen herself as her mother, based on her unfeeling and undeserved response to him. That's why it was so important to see him again to correct it, to prove she is not her mother. But later after she patched that up, it recurred. She doesn't understand she is not in control, as she things she is, and more control can solve this. Its losing control that is her savior. Where she can be herself.
Hi notice how Karen Jacob has eliminated the word "but" from her vocabulary and use words as "and" or "if" - teriffic technique. Thanks for letting us listen!
She answers things like a politician;not even directly to direct question.
I enjoy watching all of this analytically.
I really thought Dr. Choi-Kain found that happy medium of warmth and validation vs. letting her patient have the floor and noting behaviors that maybe aren't healthy. I've experienced a distant therapist myself, and while I know their intent is to help, it feels cold and like you're under a microscope. Not a place I felt comfortable opening up, especially with trauma and early on.
this content is SO good! i hope you can do more series like this :)
Yes. Holy fuck. She’s on it... that thing about the dysfunctional therapist. God totally resonates!
excellent insight on the part of the therapist.
I must say that a malnourished patient, underweight etc, needs nourishment, vitamins, support focused in that direction.
Use that as an analogy for validation. A chronically invalidated person (BPD), by others, themselves, etc, is STARVING for that. To be validated feels like emotional Ativan, but better. To be validated feels like a switch to the parasympathetic nervous system. To be validated feels like you can exhale. To be validated feels like safety.
So, no, to an chronically invalidated person, validation is not overvalued.
Sure, the malnourished person will eventually need to do more stressing exercise and challenges..,but FIRST, they may get nourished, build a bit of a reserve. Same with a patient who needs validation like a drink of water after days in a desert.
Validation, trust, connection are key for healing.
I stumbled across an interview that you had with a women named Charlotte, her story hit home with mine and I couldnt stop watching your videos .after years of trying to find just a therapist that made me feel comfortable enough I could really open up and try to fight
My demons ,that i just keep pushing deeper and deeper down inside, ultimately land me in a position in which I've just landed in once, again! Losing my home, my job, and we'll the friends that I thought I had. I started accepting that maybe this could be normal in a sense. You made me realize that I'm not ok and I need help.. that I want helps! So I wonder if you could point me in the rite direction of finding one of the good ones, somebody like you!! But in Las Vegas nv. I'm 40 years old single mother in sept. And have been in and out of therapy and on medication sence before I was in high school. I mention my age because for so long I've had this image in my mind that by the time I turned 40 I would feel like I've accomplished something significant, something that would make my son proud that I was his mother! I'm so sorry for rambling( if there is anybody out there that may know of one of the good ones :) in Henderson NV or Las Vegas NV please send me a email or a link to amanda1981manner@ gmail.com it would be so greatly appreciated! and Dr. JACOB'S I CAN'T TELL YOU HOW REFRESHING IT IS TO HEAR FROM SOMBODY LIKE YOURSELF THAT THINGS CAN AND DO GET BETTER! Please keep up all the good work you are doing!!
Very valuble info! In my latest therapy i belive my therapist was too afraid to confront me at times. I also think i wasen't really ready to deal with the things i struggle with. If or when i decide to start therapy again i will be more informed what im looking for in a therapist. I will do some research first. Thank you!
Very thought provoking and interesting insights into therapy. Thank you.
Hmm. I don't suffer extreme abandonment anymore. That's shattered. That's probably not really going on. However, I remind myself a paycheck is going to be there if I take these steps. I would enjoy loving others. I can't always do that and I don't really do any of it now.
What other people say really angers me. It's gotten a lot better. Loving other people is really difficult. I don't love them. That gives me an internal concern. I don't hurt myself physically. I did rip a dumpster door off and had to get the use of right arm back. It took some time and I had to work both jobs then. I was in exceedingly good shape. However, the rage with others had to be taken elsewhere.
The physical high intensified the rage. This is good and bad. It's mostly bad. I have two jobs. Although this arrangement is stable, my goals suffer. I don't have anybody who loves me or says anything loving to me. There's someone I'm trying to be around and with whom I'm making strong attempts to be positive. He says nice things. I tolerate whatever he says so he can see a stable friendship. I'm not gay. It's a guy. He's good-natured.
My neighbors are complete assholes who can't keep to themselves. Instead of a splitting process, it's now objectively a game of cat-and-mouse with them. They don't have deep emotion. My co-workers aren't warm people towards me. I'm not human to them. There's no deep emotion. My goals really suffer and that's misery. I still can't attract a member of the opposite sex. That's loneliness. I'd really enjoy navigating that complexity. What you two women talk about is very important. It wasn't about me. That's fine. I'm just reminded how bad it is for me.
Validation for a sake of validation can feel fake pretty fast. I think that would be more harmful because it would create trust issues. And the other thing is that therapy, when you really work on yourself, is full time job that is not fun. It is painful, frustrating, draining and it makes you want to give up on some days because of all that. But it is also journey of discoveries that can really change your life and so worth of doing with all that you can gain from it.
Oh no! This isn't Dr. Jacobs channel???!!! If she makes one ever, tag me, please. 🥰
One of my step brothers been in therapy for years and only gets worse. Always complains they cannot find a good therapist.
Some therapists can be toxic, some can be great. If they aren't looking, you have to wonder.
Some times all therapy can do is be like hospice. A life of trauma can sometimes end up just a matter of acceptance and grief including anticipation that things will get worse, including being isolated; like lepers. Civil rights, poverty and so many other cultural conditions can not be alleviated much in therapy. Life cannot always be reclaimed.
Interesting concept. The point of hospice is comfort...a lot of patients of therapy find the process anything but comforting. How do you reconcile that?
The beginning of therapy for these type of diagnosis is like a constant purge of previous toxic family,relationships; like breaking out of a stone prison.
Poverty can be a state of mind. Creating a repeating pattern.
Validation is what everyone does. I feel u have what it takes to do the best u can. Other therapist suck and just want pay check. Especially older therapist. .
incredible. thank you
How often should i be going to therapy. Im surviving. Im making 6000$ a month and ive been homeless for 6 months now. Ive never lived on my own. Ive seen 50 Dr's, they fall off when i go into rage. I have a hard time keeping any type of professional relationship. I know im alot to handle, but theres gotta be someone that can help me.. so i keep looking. But at 250$ a session its hard to think its genuine help. I digress, once a week therapy or once a month?
Where do you live?
Charlotte has a serious drinking problem. And this is from her presenting it in a most favorable light.
The reason I would go now is because what a family member is doing to me. I have not been to therapy in years, but what my son and his girlfriend are putting me through with basically holding my grandson hostage when he wants to be with me. I can see him but not as much as I should since I practically raised him because my son is such a terrible father.
Interesting about the validation stuff being potentially counterproductive; I've had issues where therapists have tried to be comforting and validating by saying things about how "normal" I come across and that "everyone thinks and feels that way", which made me feel like I wasn't being listened to and responded with the irritated thought of "well why can other people function and I can't, over and over and over" meaning a presumably good faith attempt at connection on the therapists part ended up making me feel misunderstood and alienated from being on the same page with the therapist.
Going through the 7 th gate
I noted Charlotte's discussion with her mom about her dad's time in AA. Given my time in AA myself, I remember people talking about the functioning alcoholic parent. For example was the mother a functioning alcoholic given her mother's anger, rage and resentment as discussed? Why is that important: maybe the mother was an alcoholic and there would have been a direct familial relationship. Although, alcoholism can skip a generation, the adverse effects are inherent in each generation. Just a side note: I know that alcoholism is not the primary issue here.
Mother dry alcoholic? Or co alcoholic? I thought of that. Also Charlotte enjoys drinking anyway and then feels shame and guilt. I notice a lot of shame and guilt
Defeat, my Defeat, my shining sword and shield,
In your eyes I have read
That to be enthroned is to be enslaved,
And to be understood is to be leveled down,
And to be grasped is but to reach one’s fullness
And like a ripe fruit to fall and be consumed.
how do you know when symptoms of one disorder over take another? Which do you consider addressing first?
Who is the other woman?
There’s a fine line between a therapist and it’s client. Pay attention. The client is NOT weird.
"it's" client?
So Dr. Jacob Have you thought of starting a pod cast? ;)
I have a question: when you talk about "validation" , are you referring to a sort of "understanding" of the patient's perspective from the therapist point of view ("I understand you"), or a litteral "approval" of the patient behaviour ("I agree with you")? Because from my "inexpert" point of view it seems difficult to balance between trying to deeply understand the roots of one person's story (for example, the origin of a familiar disagreement), even commenting with her the feelings at stake, and letting the patient take his/her own space to retrieve his/her personal memories. What do you think about? Thank you very much, as usual :)
@ante portas yeah, i think it's their job to help us understand ourselves, not take our side
Yes, I personally think that their job is important in the sense that make people in general much more aware of their feelings. And I think this series helps, too 😉
One of the things I was taught is that you can validate peoples' feelings without validating associated (and sometimes very problematic) behavior. "I can see why you feel that way, that makes total sense." That you then went out, based on these feelings and cut yourself or verbally attacked someone... that would not be useful to validate and just because you have feelings that generate the urge to engage the problematic behaviors doesn't mean the behaviors are okay. The feelings, sure. The associated problematic behaviors, not great to validate as you don't want to reinforce them and, frankly, they're destructive to others as well as the person being validated. But I think you put it so beautifully... "trying to deeply understand the roots on one person's story..." I actually think that effort goes beyond and goes deeper than simply validation, but definitely inspires it. Btw... I am not an expert so this is just opinion and therapy experience I'm relying on to comment.
@@BorderlinerNotes Thank you very much for your answer! I think that your opinion is interesting exactly in the sense that you've done many experiences and because of that you're probably aware of your feelings and this delicate (but intriguing!) relationship with the therapist much more than before. So, I understand your point of view and indeed it makes sense that some associated behaviours need to be smoothed without belittling the emotions and the very intimate story behind them. I imagine that it's hard work, it's not a simple task, but I hope that this could turn to be useful in the long run, with the support on the side of a cohesive group of people like this community or some others :)
I think side support / community is CRITICAL. And this community is becoming an amazing source of connection for me.
How many tenses can you use the word validation to make someone that could have used this as motivation turn it into something negative.
Are there other things a person does instead of cutting themselves that acts as the same purpose as cutting? Can someone still be diagnosed with BPD without cutting themselves?
I think she was extremely sure that she is Not an alcoholic. I just think with This Kind of uncertainty she wanted to demonstrate societys scepsis towards her behaviour. And I think it is sad if someone feels Bad because of an abstract expectation...
I’m a little late to these videos but they are so compelling and interesting even though it seems somewhat voyeuristic if that is the right word. But how is putting this on RUclips ethical? I’m not being accusatory, but I’m sincerely interested.
I think bpd is really being a HSP growing up being extremely sensitive. Nobody knowing a damn thing about it or understanding it. And loving with family or parents that are messed up
Therapists validate psychopathology; that doesn’t always feel good to a client.
Pretty sure there's an issue with your interpretation there. No one is trying to validate "psychopathology". Also, that's completely irrelevant to this discussion...
Its reality,they need to confront it and doesn't have to feel good.
Validation is for parking.
Maybe somethings are buried for a reason. My addictive nature made me keep digging.im now nonfunctional with depression and tons of emotion stuck in my chest.
My ability to ignore emotional pain seems to be tremendous,,the dam finally broke.im constantly suicidal but logically I don't want to die.going back to substances seems enevetable.
How do you even begin to cope w these feelings?
Lifespan Integration is a therapy that is helping me after years of traditional therapy (which was useful but didn't get to the body based emotions I still have ). This therapy is based neuro scientific theory of how the brain becomes integrated and how certain adaptations that helped us as children have become stuck as neural pathways that are not integrated into the 'self'. The therapist uses timelines of your life to integrate these.....it's having very quick results for people. See Peggy Pace's RUclips explanation
I think therapists have a tendency to latch onto factors (such as drinking/smoking weed) instead of focusing and working with clients on their actual underlying personality/history/experiences. It's not that it doesn't need to be discussed, but when the use is only occasional and/or the use is not a significant impediment or harming factor in the client's life then it shouldn't be the prime focus of the therapist.
IMO the therapist should have inquired more into the roots of the social anxiety and worked with the client on improving self confidence and techniques to handle anxiety when with people.
What is the difference between"ego distonic" and cognitive dissonance?
I sometimes wonder
OMG!! Saying people with BPD over value validation? Who is that woman on the left? This is supposed to be about that session...I feel bad for the client who put her self out there only to have her sit here and talk about it and making sweeping generalizations. WOw. Way to not respect power dynamic. I'm not a fan of validation unless it is authentic, period. I would have tended toward more insights etc. and Dr. Jacob's point is a good one about the first session being about getting to know someone (though she used the performance and power-struggle based terms "Let them have the floor" LOL)
What is the one word missing from this dialogue: empathy. There is some nibbling around the edges. Talk about support, etc.
People go to a therapist in most cases because they are hurting. And any clinician will tell you that as they feel better they stop going which is the opposite of what they should be doing.
It's hard to be empathetic when you have interaction with a number of client's. I had an elderly psychiatrist tell me he would disassociate when his patients obsessed over death. He was concerned with his own mortality. But whether it was genuine or engineered he still projected empathy. And lonely and hopeless people.felt less lonely and.less helpless.
You can confront and intervene, call people on their avoidance strategies and still give people the empathy they need as an incentive to do the necessary work
Thoroughly disliked this dialogue which began with a review of this first session with Charlotte. It was all mechanics and no soul.
If a therapist told me to come back when I was ready I would feel so rejected and awful about causing someone to reject me.
Is it a problem that the "patient" here has seen two different therapists and had her story made public? Could this harm her?
No she will know later if she doesn't already knows which the other therapist spoke of is that her diagnosis ( BPD) and herself are two separate things.She is not her behaviors.To think so ( which observers of them, who do not suffer w/ MH do all the time) is shaming beliefs which only adds to the shame the client feels already.The difference in other pov w/a spiritual emphasis speak of the Phony False Self and the True Self.
I need therapy.
17:43 How to evaluate the best therapist for you?
How do I book this therapist??
OMG..."There is some utility in that". regarding validation as strategic manipulation...wow. These people are so in their heads can they really help someone get out of theirs? RUclips seems to be becoming a Narcissistic venue and maybe that becoming evident will be its best contribution.
The interviewer moves around so much
The interviewer didnt want to be "seen".. All the agitated movement was shame....basic human stuff...
Don't let them dissect you.
How are people support to endure agony without a team support system? Enduring the pain requires a means to recoup just like a heart surgery patient needs a means of R&R. Our society gives no therapeutic environments except maybe for the rich.
Grrr i hate when they say like “oh everyone think like that, everyone go crazy sometimes” its NOT the same. Bpd is a mental disease and we are different from “normal” people. If therapist don’t understand, how normal people would?
Need email of Dr.
Aren't these two people the same person. Only glasses. Must be some Cluck Kent reverse psychology.
Maybe you're removing yourself from just being with her during the session and listening to what she's saying now and being with her. You can do the analysis later, you won't miss it at any point. It came across strongly in the session that you were emotionally removed and in a different place, I think you lacked a human element to your approach which came across as somewhat cold. I feel she was a subject in an object to you rather than a person.
A therapist's job is not to just be there for a person. That's the job of a good friend. I honestly don't get all the hate. In my opinion she was fantastic at listening to and acknowledging the patient's suffering while keeping enough distance to keep an eye on the big picture. I would love her to be my therapist because unfortunately with my last therapist he wasn't really change oriented but more concerned with making me feel comfortable.
We are in agreement her. She is a remarkable therapist at affecting change for those who can handle the challenge of being challenged. I (Rebbie) spent too many years feeling okay at therapy sessions and watching time recede as my life stayed staid. For the momentary lack of feather-ruffling, a feel-good therapy session for me became entirely NOT worth it.
@Lia N. Gkasouka I'm not a borderline. Its my opinion, if you don't life it or don't agree, no problem, no need to get ratty about it.
i have to agree. A therapist can empathically resonate with a client's pain and also be effective at the same time. I don't think that engaging one precludes the possibility for the other. I don't doubt Dr. Jacob has amazing educational and professional credentials, but the vibe was she was being a "clinician" that was emotionally distant. If i were in charlotte's seat, Dr. Jacob's messages would have come way further and reached me had she shown herself to be a bit more emotionally attuned.
@@lisaj5769 I agree.
My girlfriend has BPD what a total fucking nightmare! God help me!
With the exception of the cutting I don't see any real problem with the patient. Other than an alcohol problem and I think the doctor should prescribe something to calm her down because a Valium is certainly safer than drinking! Especially to the point of blackout.
I have seen the BPD patient Charlotte with 3 therapists now. Dr. Jacob's sessions were by far the worst. I am in private practice and work extensively with women and men of narcissistic parents and/or who have experienced great trauma in childhood. Dr. Jacobs would be great as a "face to the world" in a podcast because she is more focused on educating rather than therapy. She frequently seems out of touch with the patient moment to moment. She lacks deep listening skills, total presence, and the ability to slow way down and go into a place of exploration. She smiles a lot when the patient is showing distress. This is not appropriate. She is not reading/mirroring body language. She does not move intuitively through a session, meeting patients where they are. BPD patients REQUIRE LOVE AND WARMTH. First they must trust that you are genuinely a warm-hearted person. That's where you begin. Further into therapy is where you can bring in challenging them, when rapport and trust are established.