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Hello! Welcome back to another episode of diagnosing a killer.

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This is Dr

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It's been a while since we've done a minty and breaky intro dancey intro songy.

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Songy and dancey.

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Ah, it's late.

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How's everyone doing?

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Doing alright.

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Yes, we always ask that.

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We're excited for the month.

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Yeah.

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January is the best month.

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It's my birthday month.

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It's my half birthday month.

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This episode will actually come out a day after my half birthday.

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Yeah.

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Oh, yeah, the 15th?

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Yep.

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Well, we're happy to be back with you guys and I don't think I have any business except

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for just by our merch and look at our new designs.

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We have some new designs that have come out and they look really great.

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We're really excited about it.

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Check out diagnosingatkiller.com and we're at diagnosingatkiller at every platform except

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for X, which is at Killer Diagnosis.

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I didn't do that last week.

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That's alright.

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Send us an email at diagnosingatkiller.com.

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Yes.

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Alright.

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Are you ready to get into this?

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I am.

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I'm excited.

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Okay, me too.

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This is actually a request by the lovely ladies that host the podcast, Lady You're

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Scaring Us.

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Oh, hey, ladies.

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Hey, ladies.

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And we did take your request.

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So today, we are going to deep dive into Borderline Personality Disorder.

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Oh, my gosh.

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So we've talked about different personality disorders on the mental breakdown.

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We've talked about them on cases.

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We've definitely talked about BPD before, but in passing, we haven't really done a

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deep, deep dive of it.

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Yeah.

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So I decided to bring that today.

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I'm excited.

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So, this is a content warning.

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This episode contains depictions of self-harm, self-sabotage, extreme reactions to particular

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scenarios, talk of suicide, and mention of murder of children.

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If this episode is not for you, we encourage you to find another one of our episodes.

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Remember your mental health is super important to us, and we love you.

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We love you.

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Love you.

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Bye.

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So yeah, content warning is a little bit of a doozy, but it's just because specific

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cases get brought up that people had BPD, and we talk about just a little bit of that.

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Okay.

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Okay.

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So, here's what your dudes, borderline personality disorder, or BPD, is a mental illness that

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severely impacts a person's ability to manage their emotions.

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This loss of emotional control could increase impulsivity, affect how a person feels about

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themselves, and negatively impact their relationships with others.

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The DSM-5 defines BPD as a pervasive pattern of instability of interpersonal relationships,

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self-image and affects, and marked impulsivity, beginning by early adulthood and present in

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a variety of contexts, as indicated by five or more of the following.

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Number one is frantic effort to avoid real or imagined abandonment.

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Number two, a pattern of unstable and intense interpersonal relationships characterized by

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altering between extremes of idealization and devaluation.

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These words are very big.

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I was going to say, good job.

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Thank you.

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Number three, identity disturbance, markedly and persistently unsable self-image or a sense

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of self.

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Number four, impulsivity in at least two areas that are potentially self-damaging, such as

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spending, sex, substance abuse, reckless driving, or binge eating.

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Oh, wow.

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Number five, recurrent suicidal behavior, gestures or threats, or self-mutilating behavior.

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Number six, effective instability due to a marked reactivity of mood, such as intense

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episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely

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more than a few days.

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Number seven, chronic feelings of emptiness.

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Number eight, inappropriate intense anger or difficulty controlling anger, such as frequent

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displays of temper, constant anger, and recurrent physical fights.

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And number nine, transient stress-related paranoid ideation or severe dissociative symptoms.

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It sounds like Chris and Gilbert.

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Oh yeah.

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I mean, just to a T, for sure.

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And we've done a lot of cases, like I said, that this has gotten brought up because there

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is a lot of cases where people do become serial killers and they have, or just killers in

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general, and they're diagnosed.

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That impulsion one is pretty interesting because it's a wide range of other types of, I guess,

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like comorbidities, do you know?

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Yeah, definitely.

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People with BPD may experience intense mood swings and feel uncertainty about how they

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see themselves.

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Their feelings for others can change quickly and swing from extreme closeness to extreme

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dislike.

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These changing feelings can lead to unstable relationships and emotional pain.

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People with BPD can also tend to view things at extremes, like all good or all bad, and

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their interests and values can change quickly, causing them to act impulsively or recklessly

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at times.

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People with BPD tend to be extremely sensitive, with small things affecting them largely,

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and having a difficult time calming themselves down after getting upset.

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That's really interesting.

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I feel like I've absolutely met at least one or two people that I feel have that kind

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of, I don't want to call it like a pendulum swing, but an adverse reaction, something

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that does not equate to the actual issue.

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I've seen it a lot too, and I will say that it's definitely a symptom of drinking, because

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I've seen it a lot at the bar per se or perhaps.

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People can flip on the switch of a flip or whatever, or flip of a switch.

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I think that the alcohol obviously increases the chances of that happening.

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And the impulsivity, like you said.

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And the impulsivity, for sure.

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This is also not to be confused with someone that's having a panic attack.

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Someone that has a panic attack has a hard time calming themselves down.

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Obviously, you're going to have a hard time getting out of that.

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Someone that is maybe not explosively angry, but stays angry for a long time, even if it's

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not really intense anger.

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It's beyond a reasonable measure.

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Exactly.

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Yeah, exactly.

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Other signs and symptoms of VPD include getting panicky or angry when a friend is a few minutes

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late or cancels plans, causing the person to feel abandoned.

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Having a quick temper and lashing out verbally at friends, parents, or family, especially

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when they think someone is not meeting their high demands for support, is also a symptom.

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Don't you think that ironic, though, that this behavior is probably turning a lot of

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people off to wanting to be around you?

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Not that it's something that you're doing.

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This is a disorder.

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For sure.

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But I don't think that people that have VPD can even recognize that that's what they're

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doing is a problem.

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Yeah.

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Not a problem, but something that's going to turn people off.

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Do you think that because of the disorder, the behavior itself is probably very confusing

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for someone that doesn't understand the disorder.

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Yeah.

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So that's the pattern of abandonment that they're experiencing?

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Maybe.

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These symptoms of VPD, they lash out at people and then in turn they get abandoned, but they

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don't recognize that it was their actions that caused that.

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Yeah.

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Which is really hard because, again, you said it's a disorder.

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People are not doing this just to be difficult or to lose friendships or relationships, but

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it's almost like they can't control that because it's an impulsive thing.

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They can't control the explosive anger and the lashing out verbally and stuff, especially

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when someone lets them down, quote unquote.

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Right.

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And again, like you said, one of the criteria is the fear of abandonment or any cost try

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to avoid that feeling.

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Yes.

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So it's just kind of ironic that that's built in with the criteria of the disorder.

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For sure.

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Now, moving forward with these are signs and symptoms of VPD, so shifting their views rapidly,

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like I stated in the criterion, such as going from praising someone to being overly critical

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of that person.

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So praising someone at first and then maybe something happens that's really minuscule

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and then now you have a lot of things to say negatively about that person.

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You're a liar.

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You're whatever.

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You're a thief.

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Yeah.

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Stabotaging themselves when they're about to reach a particular goal, like dropping

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out of college shortly before graduation.

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That's an extreme skill.

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Harming themselves on purpose, such as cutting or burning themselves and creating crises,

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such as an attempted suicide or threatening suicide to keep people from abandoning them.

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Oh, wow.

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I know.

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That's really extreme.

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Although most people that have VPD will not harm themselves to the point of fatality,

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almost one in 10 individuals with VPD will ultimately die from suicide.

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The average population prevalence of VPD is 1.6%, but experts estimate that it could

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be much higher, as high as 5.9%.

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Out of the population that is diagnosed, about 75% are women.

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Eileen Warnos and Kristin Gilbert are examples of people women diagnosed with VPD, but Jeffrey

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Dahmer was also reportedly diagnosed with VPD as well.

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Oh.

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And it's funny that you did all three of those people.

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I did.

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I have a type.

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Yeah.

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VPD can be caused by a couple of different reasons, but the two most likely are genetic

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and stress that occurred during childhood.

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According to the DSM-5, quote, bear with me, because this is a lot of big words, quote,

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there is considerable variability in the course of VPD.

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The most common pattern is one of chronic instability in early adulthood, which episodes

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of serious affecting and impulsive discontrol and high levels of use of health and mental

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health resources.

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The impairment from the disorder and the risk of suicide are greatest in the young adult

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years and gradually wane with advancing age.

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Although the tendency towards intense emotions, impulsivity, and intensity in relationships

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is often lifelong, individuals who engage in the therapeutic intervention often show improvement

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beginning sometime during the first year.

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During their 30s and 40s, the majority of individuals with this disorder attain greater

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ability in the relationships of vocational functioning.

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Some studies of individuals identified throughout patient mental health clinics indicate that

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after about 10 years, as many as half of the individuals no longer have a pattern of behavior

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that meets full criterion for VPD.

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End quote.

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So that is interesting.

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So do you think that in their earlier years, certain behaviors are accepted because you're

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a young adult and nobody's choosing to correct the behavior because they just think that,

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well, maybe it's hormones, maybe it's the frontal lobe, maybe it's these things.

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Yeah, exactly.

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I think we agree.

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But then the older they get, the more they begin to understand what this is like unacceptable

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behavior to anybody.

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Like you should have grown out of that by now, essentially.

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Yeah.

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Yeah.

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VPD is usually diagnosed in late adolescence or early adulthood, but occasionally people

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younger than 18 can be diagnosed.

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This is only possible if their symptoms are recurrent and last for over a year, which

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is kind of like sucks because like you have to be dealing with this for like over a year

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and all the time to be diagnosed before 18.

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Which, you know, I think quite a few of those personality disorders are probably like that

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as well.

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Oh, for sure.

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Right?

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Yeah, definitely.

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VPD commonly occurs comorbidly with other mental disorders such as PTSD.

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Unfortunately, this can make it difficult to diagnose because their symptoms can be linked

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to other disorders.

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Bipolar disorder, anxiety disorders, substance use disorder, and eating disorders are also

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common comorbidities.

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So I'd like to talk about some famous people who have been diagnosed with or suspected

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of having VPD.

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Okay.

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The first is Philip K. Dick.

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He is a science fiction writer whose themes revolve around a shifting sense of consciousness.

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Philip married five separate times with most of his relationships ending tumultuously.

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He had actually had one of his wives admitted to a psychiatric facility and he actually

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drove his car off the road with another girlfriend of his in the passenger seat.

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Philip would state about his mentality, quote,

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I experience an invasion of my mind by a transcendently rational mind as if I had been

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insane all my life and suddenly I had become sane, end quote.

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You're probably already aware that craft beers have exploded in popularity over the

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He gaslight himself.

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He did gaslight himself.

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00:12:24,160 --> 00:12:26,720
That's absolutely incredible.

250
00:12:26,720 --> 00:12:30,600
I did not know that he drove a car off with a wife inside.

251
00:12:30,600 --> 00:12:32,600
Off the road with a girlfriend.

252
00:12:32,600 --> 00:12:34,600
Pay attention.

253
00:12:34,600 --> 00:12:36,600
No, she can't.

254
00:12:36,600 --> 00:12:38,800
He drove his wife off a cliff.

255
00:12:38,800 --> 00:12:41,560
His girlfriend off the road.

256
00:12:41,560 --> 00:12:44,600
So number two, like I said earlier, is Jeffrey Dahmer.

257
00:12:44,600 --> 00:12:47,160
If you have not listened to the episode of JD, please go listen.

258
00:12:47,160 --> 00:12:48,240
It's a really in-depth episode.

259
00:12:48,240 --> 00:12:51,880
It's a Patreon only, so you'll have to join tier two or three to listen to it, but Koala

260
00:12:51,880 --> 00:12:52,880
did a great job.

261
00:12:52,880 --> 00:12:53,880
Thanks.

262
00:12:53,880 --> 00:12:57,280
Jeffrey had a terribly unconventional childhood with his parents leaving him to care for himself

263
00:12:57,280 --> 00:13:01,000
at a young age, leaving him with an intense fear of abandonment.

264
00:13:01,000 --> 00:13:05,160
This along with many other things he experienced and engaged in paved the way for Jeffrey Dahmer

265
00:13:05,160 --> 00:13:06,160
to be diagnosed with BPD.

266
00:13:06,160 --> 00:13:08,280
That's all I have to say about that.

267
00:13:08,280 --> 00:13:14,600
Well, yeah, I mean he started, you know, he would keep his victims in his apartment.

268
00:13:14,600 --> 00:13:17,080
He would keep body parts in his apartment.

269
00:13:17,080 --> 00:13:19,000
Remember the shower thing I told you?

270
00:13:19,000 --> 00:13:21,000
That's awful.

271
00:13:21,000 --> 00:13:23,000
That episode was gross.

272
00:13:23,000 --> 00:13:24,000
Yes.

273
00:13:24,000 --> 00:13:26,720
Or that tidbit in that episode rather.

274
00:13:26,720 --> 00:13:31,240
Yeah, and then eventually he would eat people.

275
00:13:31,240 --> 00:13:34,080
Well, don't give everything away if you want to listen to the episode.

276
00:13:34,080 --> 00:13:36,880
That's true, but it all came from that sense of abandonment.

277
00:13:36,880 --> 00:13:38,360
That way this person would never leave.

278
00:13:38,360 --> 00:13:39,360
He would never leave.

279
00:13:39,360 --> 00:13:43,000
He does have a digestive system work, that's fine.

280
00:13:43,000 --> 00:13:46,280
He's also an alcoholic, so he pooped a lot.

281
00:13:46,280 --> 00:13:47,280
Sorry.

282
00:13:47,280 --> 00:13:49,680
Don't give it all away.

283
00:13:49,680 --> 00:13:50,680
Right.

284
00:13:50,680 --> 00:13:51,680
Moving on.

285
00:13:51,680 --> 00:13:52,680
Please.

286
00:13:52,680 --> 00:14:00,120
Number three is HP Lovecraft, he was a science horror writer.

287
00:14:00,120 --> 00:14:03,400
He suffered a number of deaths in the family at a young age, with his father dying when

288
00:14:03,400 --> 00:14:07,360
he was little and his grandmother dying a few years later, sending him spiraling into

289
00:14:07,360 --> 00:14:09,160
a deep depression.

290
00:14:09,160 --> 00:14:13,320
His grandfather would also die suddenly following a business failure, and he would state that

291
00:14:13,320 --> 00:14:19,000
his life changed almost instantly of warmth and death to a poverty and loneliness.

292
00:14:19,000 --> 00:14:20,000
Oh, fuck.

293
00:14:20,000 --> 00:14:24,000
HP would begin writing but was unable to take criticism to the point of sometimes not publishing

294
00:14:24,000 --> 00:14:25,880
his works at all.

295
00:14:25,880 --> 00:14:30,000
His aunt would describe his mental state around this time as, quote, so hideous that he hid

296
00:14:30,000 --> 00:14:33,480
from everyone and did not like to walk upon the streets where people could gaze on him.

297
00:14:33,480 --> 00:14:34,480
End quote.

298
00:14:34,480 --> 00:14:35,480
That is so fucking sad.

299
00:14:35,480 --> 00:14:38,160
I know, it's very, very sad.

300
00:14:38,160 --> 00:14:42,800
Number four is Jodi Arias, who all did an awesome episode on this case as well.

301
00:14:42,800 --> 00:14:43,800
I told you I have a type.

302
00:14:43,800 --> 00:14:47,600
Yes, and a lot of the cases that you've done, yeah, just pop up in this episode.

303
00:14:47,600 --> 00:14:51,160
Jodi murdered her ex-boyfriend by the name of Travis Alexander, and she fit the bill

304
00:14:51,160 --> 00:14:53,240
pretty well for BPD.

305
00:14:53,240 --> 00:14:57,520
Jodi had a strange obsession with Travis and was not fully realistic about the status of

306
00:14:57,520 --> 00:14:59,020
their relationship.

307
00:14:59,020 --> 00:15:01,280
For more info on this, listen to the case, of course.

308
00:15:01,280 --> 00:15:02,600
I don't know if she was ever diagnosed.

309
00:15:02,600 --> 00:15:03,600
I think it was just suspected.

310
00:15:03,600 --> 00:15:07,680
I feel like afterwards, yeah, she did, I think.

311
00:15:07,680 --> 00:15:13,680
Number five, it is thought that Princess Diana could have met the criterion for BPD.

312
00:15:13,680 --> 00:15:17,400
She was just 19 years old when she met Prince Charles, and although their relationship seemed

313
00:15:17,400 --> 00:15:22,160
pretty perfect on the outside, it seems as though there was intense emotions coming from

314
00:15:22,160 --> 00:15:23,440
Diana.

315
00:15:23,440 --> 00:15:26,600
Even though there was never an official diagnosis that we know about, plenty of books about

316
00:15:26,600 --> 00:15:29,840
the princess suggest that she could have been suffering from BPD.

317
00:15:29,840 --> 00:15:31,200
That's interesting to me.

318
00:15:31,200 --> 00:15:37,120
I don't know if that explains the affair, or if that does explain the affair.

319
00:15:37,120 --> 00:15:38,280
You know what I mean?

320
00:15:38,280 --> 00:15:43,880
Maybe she was, because I was just thinking like a bannermint, you know, I don't know

321
00:15:43,880 --> 00:15:49,280
if it's necessarily having to do with one subject or multiple subjects, but you know,

322
00:15:49,280 --> 00:15:54,560
if there's that want of needing to be loved and admired by others, then that might explain

323
00:15:54,560 --> 00:15:55,560
the affair.

324
00:15:55,560 --> 00:15:56,560
Yeah, definitely.

325
00:15:56,560 --> 00:16:00,600
And it's so long ago, honestly, and it's hard to tell, because back then it was like,

326
00:16:00,600 --> 00:16:01,600
what is, even BPD?

327
00:16:01,600 --> 00:16:03,120
You know what, it probably wasn't.

328
00:16:03,120 --> 00:16:04,120
Really a thing.

329
00:16:04,120 --> 00:16:08,640
Number six, number seven, hey!

330
00:16:08,640 --> 00:16:09,640
Edgar Allen Poe.

331
00:16:09,640 --> 00:16:12,480
I love Poe.

332
00:16:12,480 --> 00:16:16,560
This one might not be as closely accurate to the symptoms of BPD, but it has been suspected

333
00:16:16,560 --> 00:16:18,800
that Edgar suffered from the disorder.

334
00:16:18,800 --> 00:16:23,360
When he engaged in risky behaviors after experiencing bad relationship with his foster father, he

335
00:16:23,360 --> 00:16:27,400
has also been thought to have recurring depression and even signs of potential bipolar disorder.

336
00:16:27,400 --> 00:16:29,560
But again, never diagnosed.

337
00:16:29,560 --> 00:16:30,560
Also Edgar Allen Poe.

338
00:16:30,560 --> 00:16:32,280
He just has everything.

339
00:16:32,280 --> 00:16:33,480
Depressy messy is like his thing.

340
00:16:33,480 --> 00:16:34,880
Yeah, for sure.

341
00:16:34,880 --> 00:16:36,400
Number seven, Ernest Hemingway.

342
00:16:36,400 --> 00:16:38,080
Lots of writers.

343
00:16:38,080 --> 00:16:41,760
Yes, similarly to Edgar Allen Poe, Ernest Hemingway has been suspected of meeting the

344
00:16:41,760 --> 00:16:46,640
criterion for BPD, but also had many signs of severe depression, anxiety, and alcohol

345
00:16:46,640 --> 00:16:47,640
abuse.

346
00:16:47,640 --> 00:16:49,120
Lots of writers, lots of killers.

347
00:16:49,120 --> 00:16:50,120
Yeah, for sure.

348
00:16:50,120 --> 00:16:52,400
Well, they put it into their writing.

349
00:16:52,400 --> 00:16:53,400
Yeah, right?

350
00:16:53,400 --> 00:16:56,600
While he had these symptoms, it is thought that he might have had BPD due to the fact

351
00:16:56,600 --> 00:16:59,440
that he engaged in often risky behavior.

352
00:16:59,440 --> 00:17:03,000
Although this was never diagnosed, it's not simple to rule out, especially considering

353
00:17:03,000 --> 00:17:05,240
the way mental health care was looked at back then.

354
00:17:05,240 --> 00:17:08,440
And Hemingway would also commit suicide in 1961.

355
00:17:08,440 --> 00:17:10,320
Same year that Princess Diana was born.

356
00:17:10,320 --> 00:17:12,840
Oh yeah.

357
00:17:12,840 --> 00:17:15,200
Number eight, Van Gogh.

358
00:17:15,200 --> 00:17:16,200
Another artist.

359
00:17:16,200 --> 00:17:19,880
Yes, like the people previously talked about on this list, Van Gogh engaged in very risky

360
00:17:19,880 --> 00:17:21,040
behavior.

361
00:17:21,040 --> 00:17:24,600
This is an understatement, as we know that he cut off his own ear after a supposed argument.

362
00:17:24,600 --> 00:17:26,600
Sorry, that's not funny.

363
00:17:26,600 --> 00:17:28,600
That's not funny.

364
00:17:28,600 --> 00:17:29,600
That's not funny.

365
00:17:29,600 --> 00:17:33,760
Goh experienced bouts of depression, mood swings, and extreme impulsive acts.

366
00:17:33,760 --> 00:17:37,120
He would ultimately experience psychotic thoughts and behaviors that led him to staying

367
00:17:37,120 --> 00:17:40,280
in an asylum for a number of months.

368
00:17:40,280 --> 00:17:43,720
Van Gogh would fall into a deep depression that led him to shooting himself.

369
00:17:43,720 --> 00:17:47,920
Unfortunately, he would not die instantaneously and would live for a few days following this

370
00:17:47,920 --> 00:17:49,080
incident.

371
00:17:49,080 --> 00:17:52,760
He was noted as stating about this, quote, I shot myself.

372
00:17:52,760 --> 00:17:55,640
I only hope I haven't botched it, end quote.

373
00:17:55,640 --> 00:17:58,080
You like shot himself in the abdomen or something, right?

374
00:17:58,080 --> 00:18:00,560
Yeah, I think his chest area.

375
00:18:00,560 --> 00:18:02,960
That's like, you know.

376
00:18:02,960 --> 00:18:06,360
It's also kind of a conspiracy theory.

377
00:18:06,360 --> 00:18:07,800
People don't think that he committed suicide.

378
00:18:07,800 --> 00:18:08,800
Oh really?

379
00:18:08,800 --> 00:18:12,240
Yeah, almost like a curcumin kind of situation.

380
00:18:12,240 --> 00:18:14,080
Oh, like somebody did it to him?

381
00:18:14,080 --> 00:18:15,080
I don't know the conspiracy.

382
00:18:15,080 --> 00:18:17,080
I just know that people don't believe it.

383
00:18:17,080 --> 00:18:18,560
Just like Courtney Love then too.

384
00:18:18,560 --> 00:18:20,560
Yeah, a lot of people don't know that.

385
00:18:20,560 --> 00:18:23,560
She's an ancient.

386
00:18:23,560 --> 00:18:26,320
Number nine is Susan Smith.

387
00:18:26,320 --> 00:18:28,640
Coelle did a great episode on this case as well.

388
00:18:28,640 --> 00:18:30,640
Oh my gosh, it's like everyone.

389
00:18:30,640 --> 00:18:31,640
I know.

390
00:18:31,640 --> 00:18:34,960
Susan had two suicide attempts that we know about and was desperate to find a wealthy man

391
00:18:34,960 --> 00:18:37,160
whom she could be in a relationship with.

392
00:18:37,160 --> 00:18:41,400
Unfortunately, when she found a man whom she liked, it became clear to Susan that he did

393
00:18:41,400 --> 00:18:42,720
not like children.

394
00:18:42,720 --> 00:18:45,960
This is what investigators believe led her to murdering her two sons.

395
00:18:45,960 --> 00:18:48,760
Susan was diagnosed with BPD.

396
00:18:48,760 --> 00:18:49,760
Number 10.

397
00:18:49,760 --> 00:18:50,760
Number 10.

398
00:18:50,760 --> 00:18:52,320
This is actually the last one on this list.

399
00:18:52,320 --> 00:18:56,880
Eileen Ornos, like I said earlier, and again, Coelle did an episode on this case.

400
00:18:56,880 --> 00:18:58,560
I just have all of them.

401
00:18:58,560 --> 00:19:01,280
Thanks for promoting me so much.

402
00:19:01,280 --> 00:19:05,760
Like many others on this list, Eileen engaged in extremely risky behavior as she was a sex

403
00:19:05,760 --> 00:19:10,720
worker and she used her work to lure men to where she wanted to in order to murder them.

404
00:19:10,720 --> 00:19:14,240
Eileen had a horrible childhood, leading her to go down the path that she did, but she

405
00:19:14,240 --> 00:19:16,560
absolutely fits the bill for BPD as well.

406
00:19:16,560 --> 00:19:17,560
For sure.

407
00:19:17,560 --> 00:19:19,920
A lot of abandonment at an early age for her too.

408
00:19:19,920 --> 00:19:20,920
Definitely.

409
00:19:20,920 --> 00:19:24,840
So there are a number of ways to treat BPD and the different types of treatment depend

410
00:19:24,840 --> 00:19:27,800
on how severe a person's symptoms are.

411
00:19:27,800 --> 00:19:31,800
Psychotherapy, or better known as talk therapy, is the most common form of treatment for BPD

412
00:19:31,800 --> 00:19:35,560
and there are many different types of psychotherapy that can be beneficial.

413
00:19:35,560 --> 00:19:39,680
The goals of psychotherapy are to focus on one's current ability to function, learn to

414
00:19:39,680 --> 00:19:43,800
manage emotions that are uncomfortable, reduce one's impulsiveness by helping them observe

415
00:19:43,800 --> 00:19:48,600
feelings rather than acting on them, work on improving relationships, and learn about

416
00:19:48,600 --> 00:19:49,920
BPD in general.

417
00:19:49,920 --> 00:19:56,600
So I'm going to go through the different types of BPD psychotherapy and treatment options.

418
00:19:56,600 --> 00:20:00,960
So the first one is called mentalization-based therapy, or MBT.

419
00:20:00,960 --> 00:20:04,520
This is a type of talk therapy that helps someone identify their own thoughts and feelings

420
00:20:04,520 --> 00:20:06,160
at any given moment.

421
00:20:06,160 --> 00:20:10,080
This also helps create an alternative perspective on the situation at hand.

422
00:20:10,080 --> 00:20:14,740
This type of therapy essentially emphasizes thinking before reacting.

423
00:20:14,740 --> 00:20:17,960
The second one is called schema-focused therapy.

424
00:20:17,960 --> 00:20:21,960
This can be done individually or in a group setting, and its goal is to help someone identify

425
00:20:21,960 --> 00:20:24,720
unmet needs that led them to negative life patterns.

426
00:20:24,720 --> 00:20:25,720
That's interesting, I like that.

427
00:20:25,720 --> 00:20:28,920
Yeah, these patterns were perhaps beneficial to someone in the past, but now that they

428
00:20:28,920 --> 00:20:31,920
have gotten through that hard time, it is no longer necessary, and I know that we've

429
00:20:31,920 --> 00:20:33,160
talked about that before.

430
00:20:33,160 --> 00:20:38,120
And in fact, now that they've gotten through that, it can be harmful to them.

431
00:20:38,120 --> 00:20:42,120
This type of therapy focuses on helping someone get their needs met in order to promote positive

432
00:20:42,120 --> 00:20:43,120
life patterns.

433
00:20:43,120 --> 00:20:44,120
Number 3!

434
00:20:44,120 --> 00:20:45,120
Number 3!

435
00:20:45,120 --> 00:20:49,040
It is called dialectical behavior therapy, or DBT.

436
00:20:49,040 --> 00:20:52,560
This type of therapy can also be done in an individual or group setting, and this is

437
00:20:52,560 --> 00:20:55,360
a therapy specifically designed to treat BPD.

438
00:20:55,360 --> 00:20:59,680
DBT uses a skills-based approach to teach someone how to manage their emotions, tolerate

439
00:20:59,680 --> 00:21:02,960
distress, and improve their relationships.

440
00:21:02,960 --> 00:21:06,560
Number 4 is called transference-focused psychotherapy, or TFF.

441
00:21:06,560 --> 00:21:08,560
T-P-F- Excuse me, TFP.

442
00:21:08,560 --> 00:21:09,560
Jesus.

443
00:21:09,560 --> 00:21:11,480
I was like, I just said it.

444
00:21:11,480 --> 00:21:14,760
This is also referred to as a psychodynamic psychotherapy.

445
00:21:14,760 --> 00:21:19,680
TFP's goal is to help one understand their emotions and interpersonal difficulties through

446
00:21:19,680 --> 00:21:23,080
the developing relationships between the client and the therapist.

447
00:21:23,080 --> 00:21:26,880
The insights learned in this type of therapy are then encouraged to be utilized in outside

448
00:21:26,880 --> 00:21:28,560
settings.

449
00:21:28,560 --> 00:21:31,520
Number 5 is good psychiatric management.

450
00:21:31,520 --> 00:21:34,920
This type of treatment, not psychotherapy, but it's just a treatment, relies on case

451
00:21:34,920 --> 00:21:39,760
management and anchors treatment and an expectation of work or participation from the client.

452
00:21:39,760 --> 00:21:44,080
It also focuses on emotionally difficult moments by considering the interpersonal context for

453
00:21:44,080 --> 00:21:45,200
feelings.

454
00:21:45,200 --> 00:21:49,240
This type of treatment may also integrate medications, groups, family, education, and

455
00:21:49,240 --> 00:21:50,440
individual therapy as well.

456
00:21:50,440 --> 00:21:53,440
So you can do these both at the same time.

457
00:21:53,440 --> 00:21:57,960
And the last one is called systems training for emotional predictability and problem-solving,

458
00:21:57,960 --> 00:22:00,480
or steps with two P's.

459
00:22:00,480 --> 00:22:04,160
This is a 20-week treatment that involves working in groups that incorporate a client's

460
00:22:04,160 --> 00:22:08,160
family members, caregivers, friends, or significant others into the treatment.

461
00:22:08,160 --> 00:22:11,240
And this would also be combined with a type of psychotherapy that would also benefit the

462
00:22:11,240 --> 00:22:12,240
client.

463
00:22:12,240 --> 00:22:15,360
Yeah, it sounds like a little bit of rehab, but like Alanon too, with the family friends

464
00:22:15,360 --> 00:22:16,360
coming in.

465
00:22:16,360 --> 00:22:18,360
And it kind of sounds like a restart.

466
00:22:18,360 --> 00:22:19,360
Yeah, a reboot.

467
00:22:19,360 --> 00:22:20,360
Definitely.

468
00:22:20,360 --> 00:22:21,360
Steps.

469
00:22:21,360 --> 00:22:25,600
Although there are no medications that are approved by the FDA to treat BPD, someone

470
00:22:25,600 --> 00:22:29,360
can be prescribed medications that can help improve the symptoms that are usually comorbid

471
00:22:29,360 --> 00:22:35,120
with BPD, such as anxiety, depression, impulsiveness, or aggression and irritability.

472
00:22:35,120 --> 00:22:39,440
So how do you know if you're experiencing symptoms of BPD or just a number of other things

473
00:22:39,440 --> 00:22:40,600
that can mimic the disorder?

474
00:22:40,600 --> 00:22:41,600
I love this.

475
00:22:41,600 --> 00:22:45,400
You can ask yourself the following questions to determine your potential for this disorder.

476
00:22:45,400 --> 00:22:48,440
Of course, you should always see a doctor for any medical information.

477
00:22:48,440 --> 00:22:49,440
Do you want to answer?

478
00:22:49,440 --> 00:22:50,440
Yeah.

479
00:22:50,440 --> 00:22:51,440
Okay.

480
00:22:51,440 --> 00:22:52,440
Although we're not licensed to diagnose.

481
00:22:52,440 --> 00:22:53,440
Of course not.

482
00:22:53,440 --> 00:22:55,000
But I don't think you want to identify with this disorder.

483
00:22:55,000 --> 00:22:56,000
Oh, okay.

484
00:22:56,000 --> 00:22:57,000
Did you find this in Cosmo?

485
00:22:57,000 --> 00:22:58,000
I'm kidding.

486
00:22:58,000 --> 00:22:59,000
No.

487
00:22:59,000 --> 00:23:00,000
Okay.

488
00:23:00,000 --> 00:23:02,080
Do you identify with the following statements?

489
00:23:02,080 --> 00:23:04,000
Number one, I often feel empty.

490
00:23:04,000 --> 00:23:05,000
No.

491
00:23:05,000 --> 00:23:09,360
Number two, my emotions shift very quickly and I often experience extreme sadness, anger,

492
00:23:09,360 --> 00:23:10,360
and anxiety.

493
00:23:10,360 --> 00:23:11,360
No.

494
00:23:11,360 --> 00:23:14,080
Number three, I'm constantly afraid that the people I care about will abandon me or

495
00:23:14,080 --> 00:23:15,080
leave me.

496
00:23:15,080 --> 00:23:16,080
Oh, gosh, that's too real.

497
00:23:16,080 --> 00:23:18,360
Can I a little bit of yes and a little bit of no?

498
00:23:18,360 --> 00:23:19,360
Yeah, for sure.

499
00:23:19,360 --> 00:23:20,360
Yeah.

500
00:23:20,360 --> 00:23:24,240
Number four, I would describe most of my romantic relationships as intense but unstable.

501
00:23:24,240 --> 00:23:25,240
No.

502
00:23:25,240 --> 00:23:28,880
Number five, the way I feel about the people in my life can dramatically change from one

503
00:23:28,880 --> 00:23:31,240
moment to the next and I don't always understand why.

504
00:23:31,240 --> 00:23:32,240
No.

505
00:23:32,240 --> 00:23:36,560
Number six, I often do things I know are dangerous or unhealthy such as driving recklessly, having

506
00:23:36,560 --> 00:23:40,040
unsafe sex, binge drinking, or going on spending sprees.

507
00:23:40,040 --> 00:23:41,880
I mean, I smoke and I drink but that's it.

508
00:23:41,880 --> 00:23:43,680
Yeah, but not bingeing.

509
00:23:43,680 --> 00:23:44,680
Yeah.

510
00:23:44,680 --> 00:23:46,880
I have once or twice recklessly driven.

511
00:23:46,880 --> 00:23:47,880
Really?

512
00:23:47,880 --> 00:23:48,880
Yeah.

513
00:23:48,880 --> 00:23:49,880
Same.

514
00:23:49,880 --> 00:23:52,480
I don't know how that was that funny.

515
00:23:52,480 --> 00:23:55,840
It was just your face, you're like the same.

516
00:23:55,840 --> 00:23:59,080
I just didn't ever but also I did.

517
00:23:59,080 --> 00:24:00,080
I just drive fast.

518
00:24:00,080 --> 00:24:01,080
I really don't drive recklessly.

519
00:24:01,080 --> 00:24:02,080
I just drive fast.

520
00:24:02,080 --> 00:24:05,240
I guess fast is reckless.

521
00:24:05,240 --> 00:24:09,480
And then one more, when I'm feeling insecure in a relationship, I tend to lash out or make

522
00:24:09,480 --> 00:24:12,160
impulsive gestures to keep the other person close.

523
00:24:12,160 --> 00:24:14,720
Probably not an attempt to...

524
00:24:14,720 --> 00:24:15,720
No.

525
00:24:15,720 --> 00:24:16,720
No.

526
00:24:16,720 --> 00:24:17,720
Yeah.

527
00:24:17,720 --> 00:24:18,720
Okay.

528
00:24:18,720 --> 00:24:19,720
Well, there's many more than just that.

529
00:24:19,720 --> 00:24:20,720
Those are just a couple of examples I wanted to bring in.

530
00:24:20,720 --> 00:24:23,720
I feel like I guess there's a little bit of everything.

531
00:24:23,720 --> 00:24:25,120
A little bit of truth.

532
00:24:25,120 --> 00:24:26,120
Yeah, for sure.

533
00:24:26,120 --> 00:24:29,200
But again, we talk about the fact that everybody has a brain, everybody's capable of these

534
00:24:29,200 --> 00:24:30,880
emotions and feelings, right?

535
00:24:30,880 --> 00:24:31,880
Who wants to...

536
00:24:31,880 --> 00:24:34,000
I mean, some people want to be alone, you know, and that's fine.

537
00:24:34,000 --> 00:24:35,000
There's nothing wrong with that.

538
00:24:35,000 --> 00:24:36,960
But me personally, do I want to be alone?

539
00:24:36,960 --> 00:24:38,920
No, I enjoy being in a relationship.

540
00:24:38,920 --> 00:24:41,720
But am I going to do everything in my power to keep that relationship?

541
00:24:41,720 --> 00:24:42,720
No.

542
00:24:42,720 --> 00:24:43,720
No, exactly.

543
00:24:43,720 --> 00:24:47,480
If you do identify with several of the previous statements, you may meet criteria to be diagnosed

544
00:24:47,480 --> 00:24:48,480
with BPD.

545
00:24:48,480 --> 00:24:52,680
Again, always seek a professional opinion if needed because we are not licensed professionals.

546
00:24:52,680 --> 00:24:57,280
If someone you know is showing signs or symptoms of BPD, it may be difficult to start a conversation

547
00:24:57,280 --> 00:24:58,280
about it.

548
00:24:58,280 --> 00:25:00,880
However, that conversation is extremely important.

549
00:25:00,880 --> 00:25:05,280
There are some suggested ways to talk to someone with BPD or suspected BPD.

550
00:25:05,280 --> 00:25:08,280
Take the time to learn about the illness to understand what your friend or relative is

551
00:25:08,280 --> 00:25:09,760
experiencing.

552
00:25:09,760 --> 00:25:13,800
Offer emotional support, understanding, patience, and encouragement.

553
00:25:13,800 --> 00:25:18,800
Change can be difficult and scary to people with BPD, but things can improve over time.

554
00:25:18,800 --> 00:25:22,580
Encourage your loved one to seek help and seek counseling for yourself if necessary.

555
00:25:22,580 --> 00:25:26,880
If you or someone you know is experiencing a crisis, you can call 988-247 to speak with

556
00:25:26,880 --> 00:25:27,880
someone.

557
00:25:27,880 --> 00:25:30,880
And of course, if it's an emergency, always dial 911.

558
00:25:30,880 --> 00:25:32,040
But that's my mental breakdown.

559
00:25:32,040 --> 00:25:33,960
That's a great topic.

560
00:25:33,960 --> 00:25:35,360
Thank you, lady, for suggesting that.

561
00:25:35,360 --> 00:25:36,600
Yeah, absolutely.

562
00:25:36,600 --> 00:25:41,080
Like you said, we had mentioned many times this disorder, but we never really did a full

563
00:25:41,080 --> 00:25:42,080
on deep dive.

564
00:25:42,080 --> 00:25:43,080
Yeah.

565
00:25:43,080 --> 00:25:44,080
So, yeah.

566
00:25:44,080 --> 00:25:47,280
Well, I think it was good going to the New Year with a suggested case because I think

567
00:25:47,280 --> 00:25:50,120
that, I mean, at least I'm sure you are as well and you have them on your list, but

568
00:25:50,120 --> 00:25:54,240
I'm definitely going to start tackling more requested cases because I know that our listeners

569
00:25:54,240 --> 00:25:55,720
are the reason why we're here.

570
00:25:55,720 --> 00:25:59,360
And so I definitely want to be honoring the requested cases that they're doing, even if

571
00:25:59,360 --> 00:26:01,600
it's a mental breakdown or a regular case.

572
00:26:01,600 --> 00:26:04,200
So yeah, that's all I got today.

573
00:26:04,200 --> 00:26:05,920
Thanks for being on the topic.

574
00:26:05,920 --> 00:26:08,840
Yeah, you guys continue to reach out to us and let us know what you want us to break

575
00:26:08,840 --> 00:26:09,840
down next.

576
00:26:09,840 --> 00:26:13,800
There's only so many diagnoses that we can cover, honestly, unless we do all the obscure

577
00:26:13,800 --> 00:26:19,080
ones for the TSM that are real, not a lot of information on them, but anything, experiment,

578
00:26:19,080 --> 00:26:21,280
event, something that you just think is cool.

579
00:26:21,280 --> 00:26:22,280
Psychological synominal.

580
00:26:22,280 --> 00:26:23,280
Yeah, anything.

581
00:26:23,280 --> 00:26:24,880
Seriously, let us know.

582
00:26:24,880 --> 00:26:28,200
This is our loophole to talk about other things than just your crime where the killer

583
00:26:28,200 --> 00:26:31,400
is, you know who the killer is and you know who did it.

584
00:26:31,400 --> 00:26:34,680
So thank you guys for joining us and we will see you on Thursday.

585
00:26:34,680 --> 00:26:35,680
Yeah, see you on Thursday.

586
00:26:35,680 --> 00:26:36,680
Love you.

587
00:26:36,680 --> 00:26:37,680
Love you.

588
00:26:37,680 --> 00:26:38,680
Bye.

589
00:26:38,680 --> 00:26:39,680
Okay.

590
00:26:39,680 --> 00:26:40,680
Okay.

591
00:26:40,680 --> 00:26:47,120
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