Psychiatric Interview: BPD (Borderline Personality Disorder) | Part 2 | Analysis with Dr. Choi-Kain
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- Опубликовано: 8 фев 2021
- Dr. Choi-Kain discusses her psychiatric interview of a woman diagnosed with BPD (Borderline Personality Disorder).
You can find Part 1 (the session) here: • Psychiatric Interview:...
And Part 3 (debrief with client) here: • Psychiatric Interview:...
Topics discussed include BPD’s core engine of emotional and interpersonal hypersensitivity, identity fragmentation, emotion dysregulation, genetics vs shaping, inadequate caretaking, troubled sense of self, reasons for hope, the “corrective experience” with the therapist, relationship anguish, impulsive action, the course of BPD as a person ages, loud symptoms vs quiet symptoms, symptomatic remission and avoidance, motivation for change, and the evolutionary benefit of having BPD.
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
Dr. Choi-Kain is a powerhouse in the BPD treatment world. Her short bio:
"Lois W. Choi-Kain, MEd, MD, is the director of the Gunderson Personality Disorders Institute. The institute provides training and supervision for numerous proven treatments, including mentalization-based treatment (MBT), dialectical behavioral therapy for post-traumatic stress disorder (DBT-PTSD), transference focused psychotherapy (TFP), and general psychiatric management (GPM). She works nationally and internationally to expand teaching efforts on borderline personality disorder and its evidence-based treatments and engages in research to study resources for training clinicians who need direction and patients who need access to informed care. With her mentor, John Gunderson, Dr. Choi-Kain developed a training program for GPM and has been expanding its applications.
In 2009, Dr. Choi-Kain developed the Gunderson Residence, a specialized residential program for adult women with severe personality disorders. In 2013, she founded the BPD Training Institute, a major center for proliferating awareness of and evidence-based care for severe personality disorders. Dr. Choi-Kain has also developed training clinics in McLean’s Adult Outpatient Services for treatment approaches such as MBT and DBT-PTSD."
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For more information about BORDERLINE, the feature-length documentary we made about BPD, please visit: borderlinethefilm.com
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-nc.org (877.235.4525), suicidepreventionlifeline.org (800.273.8255), kidshelpphone.ca (800.668.6868).”
WHY is it so hard to find therapists like this...
I can listen to Dr. Choi-Kain All day~~~
Love her. Black hair suits her best.
Yea she’s excellent I was really impressed with the interview
The stuff about quieting down symptoms but "suffering sub-clinically" was reeeeaaaally thought provoking. Wow.
I agree. It seems to me that, during the pandemic, since we can’t be with other people, we need to find other, often self-directed, methods of dealing with symptoms, which can manifest in either self-destructive behaviors or push us toward more introspection and self-healing. Hopefully, we can lean more toward the latter.
@@kgs2280 good observation
@@kgs2280 Yes! It's the last couple of months of Delta and the stress and disappointment of it that had me finding these vids. I have felt myself slipping into habits I had left behind.
As someone who has BPD (but has probably slipped more to the subclinical side Dr Choi-Kain mentioned), I came here out of intellectual curiosity and ended up feeling so seen. Thank you.
Same here
I feel the same. I have not been diagnosed with BPD but I think I have some form of it and have gone to the subclinical side. I can't find a good therapist here to help me work it out. This videos are really good but I need individual help.
@@wordswordswords8203 forget finding a therapist just the simple act of getting diagnosed is terrible. It raises your health insurance rates and if you haven't had the same insurance since childhood they won't cover any treatment because BPD is listed as a pre-existing condition no matter when the diagnosis was given, you can't win. In USA you can't buy any firearms after being diagnosed with BPD as well so that'll be a great way to bring your anxiety up especially if you're a single girl living in a new city or traveling alone. So unless you're an actual ninja who can dodge bullets, now you are denied the right to physically protect yourself from criminals or wild animals for the rest of your life.
@@ImmersionCitizen Wow. I did not know that. Thank you for telling me! That's awful. Total discrimination.
@@wordswordswords8203 also just discovered the other night that 50% of people with BPD who committed suicide did it within a year and a half of their diagnosis 😟
I feel incredibly emotional because the insight in to people suffering, as shown by Dr. Choi-Kain, and the kindness and validation expressed, about what it feels like to experience BPD, is profoundly moving.
I find that when I isolate and "suffer sub-clinically" my symptoms are reduced to a point that I can much more easily manage them. I started seeking treatment when I was 19 and for the next 25 years received so many diagnoses, took countless medications, talked to so many therapists, and I never experienced any lasting relief or recovery.
4 years ago I stopped taking medications, stopped going to therapists, removed several things, including people, from my life that exacerbated my symptoms, and just made myself and my cat and dog my priorities. Since then I have felt amazing relief from my symptoms and am taking much better care of myself. I'm healthier physically, mentally, and emotionally.
I'm not "cured" but I am experiencing a little happiness and hope and self-love that had never been possible for me before.
I'm not making any recommendations but this has been my experience thus far.
The “shadow” side of all this clinical stuff is that you’re incessantly “fixing” yourself which doesn’t really coincide with self love. I think self love includes a lot of things, but self acceptance and going in the direction of what feels good for you are definitely high on that list. And it sounds like that’s what you’re doing so it makes sense to me that life would feel a lot better. Good for you. I’m happy for you. Truly.
And for me what’s also been healing is feeling all the painful emotions I never felt, whether it be with friends or a therapist. But I definitely don’t see it as “treatment” as much as it’s respecting my humanness and my sensitivity, therefore embracing who I truly am and accepting who I am. That is how I love myself. My authenticity and integrity trumps people, places, and things. At least, that is the practice I live by.
Much love to you David. Hope life continues to go well for you.❤️
You haven’t gotten better just better at avoiding
I’ve also noticed this. It’s other people who trigger my mood swings, so if I essentially ‘remove’ other people I stabilize myself or at least weaken the intensity of my mood swings so much that I can easily deal with them. When I do interact with the wrong kind of people (in my case meaning men, mostly) the changes are rapid and violent and often drag me down into a deep dark pit of depression. And so far I haven’t figured out how to deal with that.
I do go to a therapist though, but removing other people/men (nothing against them, but … trauma) makes my life a whole lot easier.
Glad I’m not the only one and I really hope this is a good solution for you and maybe me in the long run. Would be nice to get some rest from all this up and down bullshit :)
@@KeiaraEats Or he figured out how to self heal since self love is the only way to recover and if you are around many other people and your sensitive to how they feel about you or how they have bad energy then avoiding them is a healthy thing for him to do. Having all of these triggers out of your life allows you a lot of introspection and self reflection from your innermost soul instead of from therapy 101 books. That solitude allows you to figure out how to express yourself in a way that won't be judged by others. Quitting therapy takes your attention away from fixing yourself and instead you can focus on the passing moments and what's to come, the healing. If he says he is better than maybe he really is better, feels better and is recovering or recovered. Yes maybe the truth is he'd rather suffer in silence and is dealing with self harm etc but I highly doubt that he'd say he's so much better now if he isn't. You're not a therapist and you aren't him so you really don't know. To dismiss what works for one person is dangerous as it can set them back into darker worlds of second guessing themselves and going back to feeling broken and dependent on therapy.
As I understand interpersonal relations, the BPD is the offender. They are the one laying down the eggshells. Being reactive to others emotionally is something else. From what I am reading here and the other replies, it's oversensitivity to others that is not a condition of BPD. There is no question that people are generally nuts. And for those who are sensitive to being let down or disappointed by them, there is no shortage of people who will disappoint us.
Staying clear of people and taking care of yourself is the best medicine. Not depending on someone just to find they will possibly disappoint you, is the way to go for those of us un-equipped emotionally. There are plenty of head shrinkers willing to waste your time with years of non-sense, when it finally comes down to the fact that some things can't be fixed, so we finally make modifications to our life to compensate. David above is about 45 now, going by his numbers, and has by now settled in life. The things we saw as needs but unobtainable when we were younger are no longer of any strong concern. The act of growing older helps a great deal with accepting our lives as we are. I'm happy you've worked it out David.
What a kind understanding therapist.
This is such a treat, Dr. Choi-Kain is so amazing
And that blouse is on point.
"I find that when you show positive regard, for someone who has these sensitivities they will give you their best shot at interacting with you and when you start to show some cloudiness of what you think about them, then they show a sense of disrupted deregulated and are more incomprehensible." I think Dr Jacob really should watch this video and get some advice from Dr. Choi-Kain if Dr. J wants to keep seeing people with BPD.
Which one is Dr Jacob?
Dr Choi-Kain is a talented clinician
She really is quite brilliant, I wish I could find a therapist like her
Thank you so much for posting these interviews. It is so illuminating and respect to everyone involved in Borderliner Notes.
Some therapists such as this one are so amazing!OMG that is mad. I am that person who is quiet, isolated but suffer alone. I have no friends who care for me. All alone. What do you do when you have nobody.
I love listening to Dr Lois. I rewatch her compassionate intelligent and relaxing way of engaging in these dialogues many times. It helps me feel supported , even though I don’t know her or receive direct treatment from her. I find her therapeutic presence to be very informative and having a healing quality in of itself.
Dr. Koi chain articulates herself so well.
Dr. Choi-Kain has some good insight into BPD, thanks for putting this together
The more I hear Dr. Choi-Kain's speaking, the more I respect her amazing understanding of her field . . . she just knows how to use the right terms and say things so well! I hope to emulate a fraction of her intelligence someday.
I could listen to Dr. Choi talk all day. She’s so compassionate and her voice is so soothing 🥺❤️🩹
I wish you were my therapist. I think you are so calming, clever & completely understand bpd
Before my diagnosis, I lived 54 years without understanding why I am so different. I so appreciate this series and will watch them over and over. Dr. Choi-Kain, thank you for bringing such insight, intelligence, articulation, clarity, and hope to all of us suffering from this ridiculously complex disorder. (I hate the term, but it does fit.) BTW..there are a LOT of males with BPD, as well. It would be interesting to understand the different ways that different genders express this disorder. I have a few anticdotal experiences that lead me to believe that there are many more men with BPD than many professionals think.
My friend is borderline but she is a very loving mother. So no we don't become just like the parent who abused us.
I really enjoyed Dr. Choi Kain. Warm, insightful, thoughtful yet objective and perceptive. Thank u for this.
Wow this gives me new insight on a long-time coworker who is so over-the-top with people pleasing. Not that he’s BPD (necessarily) but what pushes that people-pleasing drive... which I have never had. I think.
I found u guys a few years ago and I loved this channel ever since. I've been studying psychology and it helped me alot to understand BPD on a much deeper level than what I ever heard in university. Thank you for all the information and the heart you guys have put into this. It shows !
❤️🤎🧡. Thx for the props and so so glad it’s been helpful to you!
Identifying with a lot of Charlotte's struggles, I found these videos to be very therapeutic.
I want to agree with other posters here. Your videos are fantastic. I think it is important to understand that we can all learn things from these videos. You don't have to have BPD to get so much about the human condition and the frailty of the human psyche that is illustrated in these videos. Thank you so much for this project. I really enjoy watching these videos.
Feeling so seen right now. Thank you for this debrief interview.
Wow these videos are so amazing and much needed! You guys are really working miracles 🙌 iv been searching for something like this for weeks!! Thank you so much! I really need a therapist like this.
Glad to find this channel, it's really amazing and by far the best of any out there on the subject, super knowledgeable and educational. Thanks for having the courage and determination to put it out here.
My mother may have been BPD, she's dead now, but I'm still looking for clues to what all that was about. It occurred to me watching this video that a lot of BPD "acting out" could also be thought of as "pantomiming" anger the way very small (
these conversations are Gold.
This therapist is GOLD!! Thanks for sharing her wisdom ❤❤
Im in the isolation situation, that she talks about were i do things that no one sees. Before i did have outbursts, but not anymore. I have had some anger towards my therapist though. But this was hard to hear..maybe i will never feel capable and in some peace.💔
I think her dad was absent in some ways, even though Charlotte has more positive feelings toward him. I know from hearing one of these interviews out of order that her dad was more than 20 years older than her mom and Charlotte does admit having become aware recently that he probably should have intervened in her mother's abuse of her. It's interesting this therapist seemed to pick up on that with almost no information.
I suffer with bpd and i live in England , this is the first person in 25 years that actually has hit the nail on the head and i need help ,this lady actually understands EXACTLY what i go through and yet we dont know eachother , im going to listen again to this interview , ive recently started counciling and after 4 sessions i had a massive meltdown i drank vodka n managed to have my whole street fall out with me due to my behaviour i live in an area where 1 n half years ive kept my head down n now i became an embarrassing spectical i feel i cannot go back my neighnours are gossips and dont have much goingbon i their lives and take pleasure in keeping me awake drilling hammering doing drugs until 5 am n round the clock keepi g me up sleeping all day then starting again , now other neighbours are gossips who when you make eye contact with them they keep you talking and never shut up slaggibg everyone off for hours , always at my door sticking their noses in. Now my meds stopped working n i started sleeping all day due to bieng kept up every night on n off for a 1yr n ahalf , i started getting mentally ill , i explained to my neighbour tgat its makibg me ill so when i blow they report me , its ok for them to do it though , if they dont like the genie , dont rub the lamp !!!
So knowledgeable!! Thank you for this series!👏🏽💖
Truly wonderful to watch!
Really compasionate. Would you have more videos about people who end up self isolating with bpd and suffer in silence? Videos that are in a similar tone, non pathologising, analytical
Can we talk about the overlap with autism?
Really love this psychiatrist, very much clinical/therapy not Rx- Psychodynamic. Very clearly said, her interaction with Charlotte was based on how Charlotte experiences her point view, how Charlotte looks at the world. Choi was not there to give Charolette a treatment plan. I love that Choi was able to point out Charlotte does want to improve her situation and YES, Charlotte was very hopeful she did see an improvement talking to Choi. The top psychiatrists for me are always the clinical/therapy ones!
Active listening is golden...
This analysis has lead to some very deep insightful thoughts to ruminate on for myself. Hearing explanations by Dr Choi-Kain of why Charlotte may do things helps me better understand my actions that I have been doing unconsciously or things that I didn’t even realize were detrimental to my personal journey of self help.
This is so great💯✨
That was a great question he asked at 11:20. I think it was heard from a clinical view rather than a person view. The optimistic thing about people with BPD they feel things deeply so they are typically empathic or overly empathic to others. Probably make great teachers. They have high emotional intelligence. I think they can be great listeners especially knowing how it feels to be unheard or invalidated. They’re typically self aware so they know themselves and their flaws and weaknesses. Some hyper self aware so they tend to push people away due to that deep seeded belief that their existence is a burden to others. Most are genuinely kind sensitive people.
I sure do hope my future therapist is watching and taking notes 😋
As I watch further, I commit to my initial statement. This therapist is in touch & on point in way that really emotes & invokes deep exhalation 🌀
Where do I find this on betterhelp?
Thank you!
I wish this woman was my therapist
do u kno wats worst than havinf BPD ? the people judgements that think we re the worst person only and didnt see our core thats being miserable for very lonf time. and i wish ppl stop to judge us with BPD or other mental conditions. we kno that we re being angry and raging and hurt someone we cared about but wish those ppl can actually understand thats not the real us. just wish someone can truly understand BPD.
another part is other ppl started to think they knew our symptoms like expert after reading about BPD, just reading in less than 2 weeks, and so they can start judging.. which is alot of professional actually still struggling abt BPD for each person are different.
BPD ppl just need someone who can understand them truly. and we re sorry for our rages. when we re saying we don mean that, we MEAN IT. so PLEASE BELIEVE
Very interesting!
I take issue with the word, "disorder." I would rather think of it as a normal reaction to trauma. I, also, wish that the label of this 'disorder' would be changed because it brings additional trauma onto these people who have to live with this diagnosis.
WE need thousands more therapists in America as good as Drs Choi-Kain and Jacob. Why cant most everyone in the US get that level of quality MH care I just don't get it - we are the US! We should be able to do this.
My ex never understood that her extreme abusive behaviors had 100% everything to do with our destroyed relationship. Instead, I got the blame for abandoning her.
What kind of outcome will Charlotte have? It doesn't look good without a great therapist.
What is Lamaze musical?????
I wish they would interview other people with BPD rather than the exact same person. We can all have the same types of feelings and emotions but regulate differently. I have a completely different type of life and would like to hear from others with different situations. Such as people married with kids and struggling to keep their job.
Working on it. -P
Is there any research that having the therapist accepting the description of the others on face value without there input is the most effective therapeutic approach?
2:25 oh my goodness!!! Right on!!!!!
Most doctors diagnosed me with anxiety and depression (long with anorexia) only recently a doctor said I had BPD or BPD traits. I really don’t understand some of the differences between anxiety and BPD.
the best advice i can give is to keep researching it if u want to understand it more, i went through the same thing. i had never heard of bpd before because most therapists actually shy away from personality disorders until at least hitting your 20s. so as a child and teen my extreme anxiety and depression was directly an effect of my bpd. therapists usually want to see a longer period of time where u are expressing all the symptoms of bpd before diagnosis. it is also commonly misdiagnosed as autism or bipolar in women!!
BPD from my understanding is learned behaviour as a child and sadly this disorder stays with you for life till you die. But, doesn’t not mean you can’t live a fulfilling life. Means you have to work harder to ensure you live the best life you can live. Anxiety is caused by poor coping skills that were never address. The best example is someone who keeps running away from their problems. A person who doesn’t run away from their problem, seeks help like calling a mental helpline or gets therapy to understand why they run, but most importantly “build self awareness” to build strong boundaries to avoid problems all together. Reality, like anyone who wants to get better and work with what they have. Know this, having BPD doesn’t not make you a worthless person, having BPD is a gift for you to understand how you can find your own language to work you and give insight for other people who have what you have. You do have to do this on your own and I cheer you on that you will get through this. Thank you for sharing and know you are never alone.
@@ThatGmoney i wouldn’t necessarily say learned behaviors from childhood is a good description bc it sounds like u act how the people who miss-used u in ur childhood, but definitely would say that bpd stems from behaviors/actions from people in your childhood life! it’s actually usually a case of being raised by a narcissist (maybe not an extreme one, even partial narcissism can be harmful to a childs brain development). you can “cured” from bpd with lots of therapy and medication helps too but youre right, most people live w bpd the rest of their lives. its an extremely hard to understand disorder, took me such a long time to even figure out what my therapist said may be wrong with me
@@ThatGmoney my anxiety i used to have as a child was mainly “fixed” through cbt i went through in adulthood. lots of things i was avoiding fixing and just had no clue how to deal w it bc my mother and father treated me like i was crazy and a problem child instead of teaching me coping mechanisms. they know now that wasnt the case and finally came around to understanding the lectures my doctors would give them on anxiety.
also ive learned to love my bpd(: ive come to terms with the fact that in a lot of my friendships and relationships im always the one that cares more. ive turned it into a positive things and realized i just wanna make others as happy as possible bc it makes me happy to see them like that, if it benefits me or not. its kind of a beautiful thing to want to love so many people despite what ive been through.
@ 10:50 where Dr Choi-Kain speaks of "those that are very isolated..." about prognosis being poor - I'm one of those, and trying to pull out of it and cant imagine others... well - Not everyone who is isolated wants to remain there - it's just hard to find the technique/alliance combo that works - epecially those that have been through the system several times and nothing has worked yet. Just sayin.
Charlotte keeps mentioning that’s he did three of these. Besides Dr Jacob where is the third?
✅ good video
Does BPD go away completely?
I feel Dr. Choi is better than Dr. Karen
🙏✨
I wish that I could understand
I believe the best thing she has going for her is KNOWING she wants to be right! And being willing to work on it. lol
8:03 1000% me 😕
When I was six years old my stepmother left me in a doorway with a note saying not wanted
Is charlotte an alter? I’m confused
Is dr choi kain a psychoanalyst? I'm seeing one so just curious
Nvm i just read her info so I'm guessing not
Who has written about the evolutionary benefit to BPD? I'd love to know.
I'm confused, who are they talking about? Who is "she"?
Chatlotte. She had a clinical evaluation/interview with her on this same channel
the real life pickle rick therapist
Upspeak.
10:52
I disagree that she shares different things with different therapist. She shared many many of the same things. Of course its not the exact same conversation because its not supposed to be but the themes and even interpersonal relationship shares were all similar.
성지루 닮았어요~
apologizing & placating I bet is common
Life cannot depend on psych labels or Narc Abuse Recovery. That is not normal everyday living. Unless, of course , one is a severe mental case. Stay safe.
Too bad only the rich can afford this treatment. Not surprising, just sad.
I don't see any benefits to BPD.
What do you mean? Nobody wants to have BPD. It’s an adaptation from childhood abuse or attachment disruption in the the majority of cases.
This lady causes me to feel fear. I feel unsafe. It is not her. It is the listeners.
You focusing on her relation with her mother as the cause of her illness, but Borderline forms before a person is 2 years old. In that time our personality integrates and creates self from ego and inner child. If that doesn't happen a person interacts with the world with ego and inner child directly without self that is normally the intermediate between these two parts and the world.
This is spiritul warfare. its so clear. Only Jesus can heal this kind of thing, all bred ultimately from pain(the demonic can do nothing without the basis of trauma/pain). Bitterness can grow into something incidious. Bitterness takes root from unforgiveness.(Proverbs) Jesus is the key and there is no condemnation with Christ. Truely. He knows all
Is this interviewer allowed to tell stories about this patient?
Yes karen
@@gerhitchman There is confidentiality between patient and therapist. I will assume that the patient signed away ALL information to be discussed between the filmmaker, the therapist and the public.
She would have signed a disclosure agreement for this and so glad as this girl was so brave and strong
@@67cici I am assuming so as well but I took a step back with the interviewer shared information with the therapist. If the therapist did not know than should it have been shared by the interviewer.
I only learned of bpd today through RUclips. From the interviews with this patient, it makes me think that bpd is secret medical lingo for addiction issues. I think she has issues with drinking and medication.
Substance abuse and alcoholism is kind of a hand off symptom from BPD. I have no idea what you’re saying but from how I take it you’re implying BPD isn’t real, and that this woman is just doing drugs that it’s impaired her entire life? Makes no sense.
Addictions or eating disorders are very comorbid with BPD, these behaviours serve the function of avoidance and self soothing. BPD is a very real disorder and the intense emotions felt, feel so awful for the person that they will often do almost anything to avoid this. These actions also serve as a form as a self-destructive action or form of self-harm as people with this disorder can be very self- persercutory due to the shame of acting out or feeling as though they are inadequate and cannot "get better." I have so much empathy with all people who suffer from BPD. A nice analogy I like to use to explain it to my own clients is that it is almost like being a burn victim, someone walking by and brushing across the skin of someone with in tact skin is not a big event, but brushing up against a burn victim who is open and raw feels like hell and triggers a much bigger reaction.
Is this extremely inappropriate?
discussing a client without them? In a public sphere?
An evolutionary benefit to BDP is making others look after you?
No look after yourself and look after others too!
It's not evolutionary.
People need to look after each other and better ourselves, not excuse mental illness.
This is irritating. The girl blasted her foot through a glass window and had a 9 hour surgery? And the therapist laughs it off? Wow. Now that is scary.
Seriously wrong. Yikes
Upspeak? Every single sentence? This therapist...needs a speech therapist?
How does this affect your ability to take in information? Seems sexist
i love this whole team, the therapist bring such insight. the lady asking questions is asking all the right questions( looks super cool too) i love that the crew is so involved. what a cool thing yall are doing. thanks✨🫧