Facing My Addiction: How Will BPD Impact My Treatment? (pt. 1)

Good news. I heard from the therapist who treated me in college, Dr. Cynthia Wall. I told her I was ambivalent about paying $115 for treatment I wasn't sure I needed. She wrote "I imagine you know what my bias is, but I will say it anyway. No money is wasted on treatment, particularly that related to an addiction. You are worth it!!!"

I also found that I can get the money together given a little time. So now that the money issue is dealt with, I have one more hurdle to clear: psychiatric clearance. Basically, how will borderline personality disorder (BPD) impact my treatment?

Question One: Where will I go?

As I said in last week's post, dual diagnosis treatment is hard to come by in Indiana. The state hospital which previously featured dual diagnosis treatment has closed the substance abuse unit. The places that offer addiction treatment often focus on substance abuse as the primary problem when often it is a symptom of the problem. This often results in places not being equipped to handle a psychiatric diagnosis, especially a self-destructive one such as BPD.

I've chosen a program which many people with dual diagnoses have used in the past. Harbor Light is run by the Salvation Army and is the most accessible of my limited treatment options. My current therapist, Tanya Thompson, has referred clients to Harbor Light in the past, but we don't know if my BPD will be a problem. Right now, it's up to the program administrators and my psychiatrist if I can go.

Another potential problem is the fact that I take Ativan as needed, and Ativan is a benzodiazepine ("benzo" for short). Benzos are often abused and considered addictive. We expect that Harbor Light will not allow me to take it while I am there. So that leads to the second question: how will I handle my symptoms?

Question Two: How will I handle my symptoms?

BPD is a constant struggle for control. Either you control the symptoms, or the symptoms control you. While medication can be helpful, it's not a magic bullet. That's why a person with BPD needs coping skills, in the event that medication is not available or not working.

Deep breathing exercises are helpful for some people, but painful for others. I don't recommend deep breathing for people with vivid intrusive memories, as the deep breathing can bring those memories to the forefront. For the people it does help, however, it is an invaluable tool.

Exercise is another potential coping skill that works for some but not others. I have found the martial arts helpful. Punching a pillow can work wonders, although some mental health professionals believe that technique reinforces hitting others or hitting oneself. Other helpful exercises include running in place, sit-ups, and push-ups.

Another coping skill is spirituality, which is a core component of Alcoholics Anonymous and Narcotics Anonymous. This is a difficult one for me. Due to a botched exorcism (long story), I carry scars from my religion. It is hard for me to spiritually feel anything. But for a lot of people it works.

Ultimately, you have to decide what coping skills work for you.

Question Three: What will I do to stay safe and sober?

Inpatient treatment eventually ends. That's when the real work begins. What will I do to stay safe (no self-injury) and sober?

Coping skills will be required, so I will have to know what works for me. I will have to use what I learned in treatment. I will have to decide that sobriety and safety are worth the price I must pay for them. Then I must pay that price. I have to work for safety and sobriety in order to maintain safety and sobriety.

Neither one will be easy. But both will be worth it.

Facing My Addiction: How Will BPD Impact My Treatment? (pt. 1)
Facing My Addiction: Overcoming the Past (pt. 2)
Facing My Addiction: Taking the Plunge (pt. 3)
Facing My Addiction: Where To Now? (pt. 4)