Topic Tuesday// BPD Awareness– Flipping the script with a special guest from Spectrum// Tues 6th October,7 pm-8:30pm AEDT

Thank you everyone for sharing the various factors that could contribute to our own and the public’s perception of different types of treatments for BPD. I enjoyed what you have raised @JulianSpectrum that “ It’s also important to remember that while there is evidence that some treatments can help, none of these treatments have a 100% success rate.” And what @BPDSurvivor had raised about self-stigma!

So, how can we flip the narrative about this ‘ideal’ and golden treatment for BPD?

@Former-Member

Whilst we have a lot of data accumulating that treatment for BPD helps, we don’t have a lot of data to tell us which treatment works best or for whom. As I mentioned, there are a lot of similarities between treatments for BPD and one would hope that an ‘ideal’ treatment might involve some of these. There is a mountain of data that suggests that, despite the many treatments out there, one of the main ingredients of helpful therapies is the relationship with the therapist. In my mind, this is a crucial factor in an ideal treatment. It needs to be a relationship in which you feel heard and understood, and that you and the therapist have a way of understanding and approaching your difficulties in a way that makes sense to you. Ideally, it is also a relationship in which you can raise it with the therapist if you feel misunderstood by them, and work through it together.

Another thing to raise is that there are lots of different perceptions about treatment out there. One of these can be that people can expect that after 18-months of treatment that the person no longer has any BPD symptoms, or any difficulties whatsoever. What comes to mind here is that different people need different lengths of therapy – some shorter, some longer. Often the treatment lengths in study trials are decided by a range of factors, balancing trying to offer a significant benefit to the person whilst also balancing the pressures of public health waitlist demands. Put another way, many people will still need help after a course of DBT or MBT, this is not an indication of the person ‘failing’ treatment and, indeed, they may have made significant gains over the course of the therapy.

To further flip the script, I think there needs to be change on a policy level so that treatment becomes more accessible to all those who need it, for the length that they need it. The evidence is there that treatment works. The evidence is there that it is cheaper and more economical to provide psychotherapeutic treatment than to not. People should not have to wait until they get worse in order to be able to access therapy. There needs to be changes to the Better Access scheme for accessing a private mental health professionals, similar to those changes made for the treatment of eating disorders, which allows for up to 40 sessions per year, rather than 10. We also need to improve our public mental health system as people should not have to have things get worse until they receive an evidence-based treatment from a specialist service, such as Spectrum.

@BlueBay Sorry that this has been your experience, you raise some serious things here. Trusting again after we have had experiences in our lives where we feel trust has been broken is so hard. If you do seek out more therapy, I'd encourage you to raise this experience with the next therapist and to talk about how it's impacted your trust. It may feel hard to do but it also may help the two of you to have a different experience this time.

@JulianSpectrum

40 sessions would be fantastic

I agree @JulianSpectrum about making treatment more readily available. At the moment, BPD discriminates those who can afford it and those who can't. It is not easy to fund 12-18 months of individual and group therapy when Medicare only funds 10 of each!

I did let it out in a conversation I had with my current psychologist last week @JulianSpectrum

@I'm going to tell my psych this week.

Its difficult but I think I need to tell them. It's affecting my fear of abandonment agsin by my professional support people. The fear is huge.

So true @BPDSurvivor @it'a very expensive

something I cannot do again now due to financial stress.

@BlueBayYou deserve appropriate and quality services always. Every therapist and practitioner is different. So, I hope that you will be able to find a therapist that is right for you

@BPDSurvivor Agreed. Let's use our collective voices to advocate for change here!

You deserve appropriate and quality services alway--- I totally agree @Former-Member , @BlueBay

my husband does not want any help -- and it is hard