Watch this video if you are a mom or if you have a mom!!

Natasha Shapiro, ATR-BC, LCAT:

This will make you cry unless you are an alien from outer space! Watch the video. It’s the least you could do….

Originally posted on Seasons Change, and so do I:

My daughter sent me  this link last night and It was moving.  It is about the toughest job in the world that pays no salary.

http://www.wpxi.com/news/news/local/trending-applicants-worlds-toughest-job-offered-no/nfZtS/

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Why I Like the Term “Borderline”

Natasha Shapiro, ATR-BC, LCAT:

This is a great post that can help people understand how diagnosis is useful and therapists need to understand how it feels to finally feel like your pain is understood and explained and that people with Borderline Personality Disorder have a double fight; the fight to educate people who don’t know much about BPD so they can understand it is an illness just like any other and that behaviors do not define a person, especially before they get diagnosed properly. The other part of the fight is to get doctors and therapists to be more educated about BPD and if they work with patients with this illness, they need to be open, not avoid the term Borderline and be in touch with their own inner “Borderline”. I may not have this disorder but I know what it’s like to be extremely emotionally sensitive, to feel abandoned and paranoid and angry and confused, to feel out of control, even to have self destructive urges and fantasies. I also know that DBT, one of the most successful treatments for BPD, is something I practice in myself constantly and it is not easy. Practicing mindfulness most of the time involves a lot if acceptance of not being any good at being mindful. I will share that I had a great DBT workbook I bought to practice the skills myself and with all my patients. Recently I lost the book in a mindless moment. Then I ordered a new different DBT book, but I didn’t do it mindfully or carefully and ended up ordering two copies, probably a “slip” that meant I need two of the same DBT books to really get any good at DBT!

Originally posted on Pride in Madness:

If I must have a label put on me, so far, Borderline has been the best. Many of you will disagree and rightfully so but in all honesty my other labels can work for me and against me as well. Woman, for example, is a label I carry that is historically and presenting oppressed but I still love it and own just the same.

There is a movement to change Borderline Personality Disorder to something else, something less stigmatizing they say (and I guess more accurate as well). Borderline originated because doctors way back when couldn’t figure out where to put the individuals who were displaying symptoms that appeared to be on the “border” of psychosis and neurosis. This is completely wrong, of course, but the name has stuck and developed a nasty reputation. For many, when they hear Borderline Personality Disorder they think of extreme anger, manipulation and soul crushing…

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Short Post: “Thanks for Sharing”

I intend to post a whole series about the phenomenon of the “Selfie”, and started writing a long complicated post. However, I will be out of town next week, so I probably won’t post then unless I find something great to “reblog”.

So this post is about the film, “Thanks for Sharing”, starring Mark Ruffalo and a with a great supporting appearance by the singer/performer Pink who turns out to be a really good actress. Gwyneth Paltrow and Tim Robbins and Joely Richardson. ImDB describes the movie as “A romantic comedy that brings together three disparate characters who are learning to face a challenging and often confusing world as they struggle together against a common demon: sex addiction.”

It’s directed and partly written by Stuart Blumberg who is known for writing the movie, “The Kids Are Alright.”

This movie did not get much attention before, during or after its run in the movie theaters, however, I went to it and actually really liked it and I think it is very under appreciated. I have told many patients to see it as I work with a lot of people who attend 12 Step Meetings of various kinds and for whom the 12 Step Program is a healing and integral part of their lives and recovery.

Anyway, what struck me the most about the movie is that the 12 Step Program, in this case S.A. Sex Addicts Anonymous (there is also SLA, Sex and Love Addicts Anonymous) is the main character portrayed on many levels in the flim.

Well, I just learned something: there are 4 different 12 step programs that address this kind of addiction/compulsionnn, not just the above two:

Sexaholics Anonymous (SA)
Sex Addicts Anonymous (SAA)
Sex and Love Addicts Anonymous (SLAA)
Sexual Compulsives Anonymous (SCA)

FOr a good description of the differences between these, here is the link I found:

http://www.billherring.info/atlanta_counseling/how-different-12-step-meetings-for-sexual-recovery-define-sexual-sobriety

THat’s what I love about blogging. I learn as I write! As the main character, SA links all the characters together, not just the main one played by Mark Ruffalo. In the opening shots the camera goes down streets in NYC, and what I found great was that the cinematographer captured the point of view of people with sex addiction in terms of their having a different brain response to stimuli in the environment, especially visual stimuli. As the camera goes down a crowded day time NY street, it captures how just about anything, not just people, but inanimate objects, can be taken in as a sexual stimuli, and gives you an idea of the brain of a sex addict getting “triggered” by anything, even a fire hydrant or street light, as well as any random person walking down the street of any gender.

The movie captures the essence of the 12 Step Recovery System which is not for everybody as it follows an abstinence sobriety model, not a moderation/balance model. It is highly effective for many people with sex addiction issues though. The main human character in the film has about 5 years “sobriety” which means he has had no sexual activity including masturbation in 5 years. The longer recovered addict played by Tim Robbins is his sponser and the Ruffalo character is sponsoring a newly in recovery, forced to go to 12 steps person who is still out of contol. Pink enters the movie later and is also a sex addict with little recovery time. So the movie does a good job portraying the different challenges of 12 Step Receovery for the long recovered married addict, the 5 year person with the challenge of having to stop avoiding dating and relationships to more fully recover, and the struggling beginning addicts who are stumbling along having a lot of trouble staying sober and “slipping” while still going to meetings. What saves the two early recovery people is that they bond and help each other because they are on the same level. Ruffalo refuses to sponsor the new sponsee because he is not actively doing anything in his recovery and not being truthful in the meetings or with his sponsor.

For the long recovered addict played by Tim Robbins, there is a great portrayal of a split that can happen with 12 Step Recovery. His SA sponsor role model self is very dedicated and he has saved his marriage and developped a kind of father son relationship with his sponsee, thus making progress with SA while in his personal life, he is having a lot of trouble with his son who is also an addict. He does not accept or validate his son and his disagreements with his wife are about the son. So his main conflict involves changing as a father and stopping hiding behind the replacement father role of being a better sponsor to his sponsee than father to his son…

The Ruffalo character has the challenge of starting to date someone and figuring out how to “come out” about his sex addiction without scaring away his potential girlfriend, and being challenged by relapse and the messiness of life that he cannot avoid anywya.

THe movie zeroes in on the special fellowship of the people at this SA meeting and the way it can be a supportive community, but the challenge is to go back out in the world and manage on your own with your sobriety. The movie is complex enough that we see several different kinds of challenges faced by the characters in SA, as well as seeing how they fare trying to explain their addiction and recovery to non addicts. Because the movie takes on the challenge of sex addiction, which is not understood by the mainstream culture very deeply and which has a lot of shame associated with it, it does have a lot of gorund to cover and cannot be extensive, so unfortunately it only shows people identified as heterosexual with these struggles, and would have been a deeper movie if there were characters from the LGBTQ community.

Much more can be said, but I will end with a few important 12 Step phrases that were important in the film and quite helpful to anyone. “CLean your own side of the street” said by a non sex addict, the partner of the Tim Robbins character, about how she has managed to stay in her relationship and be growing in it. She is aware that she has her own work to do on herself and that her husband’s sex addiction is his “Side of the street” and his problem, not hers. “THanks for sharing” is of course the title and based on what people say in meetings in response to someone sharing their struggles. This phrase is actually very meaningful, it covers the attitude of gratefulness for recovery and rebirth and second and third chances as well as a grateful attitude towards everyone who comes to a meeting. All can equally share no matter how much sober time they have. It is the “Sharing” and community that really aids in the healing process and can be true for any kind of therapeutic healing or group. The mere act of sharing and being validated is very powerful for anyone struggling with mental illness and/or addiction. The two minor characters with little experience sober are sharing with each other outside the meeting and it actually works, because the writer knew not to drama things up and have them sleep with each other. Instead they are learning to have a non sexual relationship through SA, which is incredibly healing for them to “share” in the kind of friendship neither has yet experienced.

So I highly recommend this film as a great effort at portraying some aspects of 12 Step Recovery and the humanity of a person who has done the kind of terrible behaviors sex addicts are compelled to do. This is the other side of it, so we can have compassion for all the characters wherever they are in their recovery, and understand the struggles they have due to a probably biological as well as environmentally caused disorder/imbalance.

Skin Picking: The Freedom to Finally Stop by Annette Pasternak

Natasha Shapiro, ATR-BC, LCAT:

This is a great post about a disorder that even many therapists need to learn more about.

Originally posted on The Pluviophile Reader:

5/5 stars.
ebook, 148 pages.
Read from January 17 to March 07, 2014.

This book is by far the most comprehensive, supportive and positive guide out there right now for Dermatillomania. I can’t say enough good things about this book!

For those that don’t know, Dermatillomania, orExcoriation disorder, can be defined as:

…an impulse control disorder characterized by the repeated urge to pick at one’s own skin, often to the extent that damage is caused. Research has suggested that the urge to pick is similar to an obsessive compulsive disorder but others have argued that for some the condition is more akin to substance abuse disorder. The two main strategies for treating this condition are pharmacological and behavioral intervention.” - Wikipedia

This is a condition that I have personally struggled with deeply. I can safely say that through my own methods I was able to battle this condition…

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The Harvard Library Owns Books Bound With Human Skin

Natasha Shapiro, ATR-BC, LCAT:

Thursday, time for my weekly blog post, but I just read this post and it’s too “juicy” not to share, even though it verges on the grotesque, I admit I am fascinated with the way in which dead bodies are disposed and things humans do to others’ dead corpses. This has been a fascinatiin for me since childhood, when I actively worried about what would happen if all the cemeteries were full: what would the grown ups do with all the extra dead bodies?

Originally posted on 101 Books:

Some creepy stuff’s going on over at the Harvard Library, or at least it was in 2006 when this article was originally written.

According to The Harvard Crimson Magazine, at least three rare, extremely old books were bound by human skin. Yep. Human skin.

The three books—about medieval law, Roman poetry, and French philosophy, respectively—date back to as early as 1605.

Here’s the skinny on the medieval law book:

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Movie: “Back From the Edge” – Borderline Personality Disorder

Video

I just recently watched this video on Youtube. I highly recommend it to everyone: other clinicians who work with BPD or who want to learn more about it, people with BPD, people with loved ones with BPD, and those who know nothing about it.

The good news is that there is finally scientific evidence that Borderline Personality Disorder is actually a biological even hereditary illness not that different from diabetes or bipolar disorder. Those suffering from it are relieved to find out what is “wrong” with them and that it is not their fault that they suffer so much, that there is a name for and description of what they struggle with and they are not alone with it. I am especially glad to see them cover the whole issue of diagnosis and show how people who find out they have BPD are so relieved and also feel that they are understood and that they now know what is going on with them and because it can be explained very precisely and all their “symptoms” are mentioned and described in a way that they resonate with the whole diagnosis, there is great hope for them to recover fully and lead happier, more satisfying lives and have better relationships and hope for love with others.

I think this is a great example of the usefulness of diagnosis and the DSM 5 (the diagnostic tool for people in the mental health and substance disease field). It argues against people’s beliefs that some diagnoses are not good and make a person feel worse or sentenced or that having BPD and being told you have it means you are “one of those crazy sick people”. It also helps people encountering BPD in themselves and others have more patience and understanding of the terrible self harm behaviors and very extreme amount of suicidal thoughts, wishes and attempts.

In terms of treatment and hopes for recovery, the movie shows how people benefit greatly from the most documented and researched treatment: DBT, Dialectical Behavior Therapy, founded and invented by Dr. Marsha Linehan. There is also brief discussion of other treatments, especially psychodynamic, however, they leave out a newer treatment called “Mentalization”, maybe because it wasn’t well known when the movie was made. I still don’t understand much about Mentalization, except that it was founded by a psychoanalyst but is not psychoanalysis. I believe it focuses on cognition and accessing the reasoning part of the brain to get the patient out of the amygdala, which is the “fight or flight” response; people with BPD have different brain chemistry from people with “normal” brains. The reason they are so highly reactive, sensitive and emotional in response to interactions with others that other people do not react to or receive as hostile and dangerous is that their brains are wired differently and thus, while ill, people with BPD spend a lot more time trapped in the amygdala. With mentalization, I believe there is some emphasis on learning about responses of other people to the patient’s behavior or reactions and learning to look more neutrally at interactions with others.

Anyway the basic principles of DBT therapy are explained and patients describe how it helped them to learn to self regulate and decrease their extreme symptoms. The movie is not an exhaustive description of DBT as it empasizes the experiences of people with BPD, before effective treatment and after as well as their family’s experiences before and after.