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Ask Dr. DombeckAsk Dr. Dombeck:
Psychotherapy and Mental Health Questions

Is Borderline Personality Disorder a Choice?

Mon, May 5th 2008

I've been diagnosed with Borderline Personality Disorder, along with depression and anxiety. I've accepted the diagnosis and know I have lots of things to work on. My biggest problem is that my emotions are so strong and take over at times and I can't think clearly. It's so automatic for my strong emotions to control me that all reasoning is completely gone.

When I talk about difficult things in therapy my therapist refers to my tears and strong emotions as a choice. I don't see any of this as a choice and I'm confused by this. I so automatically begin to cry, feelings of abandonment, of how awful I am to be this way, and all sort sorts of negative feelings about myself take over. Because of this the words he's saying don't make sense to me and I feel very confused about what he's trying to say.

I swear I'm not purposely being difficult or manipulative or trying to avoid the conversations--those darn emotions just control me. I can be okay one minute and then a certain topic just sweeps me into the sea of emotions and nothing makes sense. I sense my therapist becoming frustrated with me. He seems to view my emotions and reactions as a choice. Where is the choice in all this? I wish my emotions weren't controlling me. I started attending a group for people diagnosed with Borderline but we're only at the very beginning. So I am starting to work on these things but I just can't see it as a choice. How is this a choice?

I've also having trouble with wanting to get better, as silly as it sounds. I've been this way for so long and even though it's miserable, I have trouble with changes and am afraid of change. My therapist thinks I want to stay sick so that I have control of things and no one expects much of me. I think there's some truth to all that. I know I should want my life to be better but I'm so afraid of losing my therapist in the process. Sometimes I feel I have to call to my therapist. The feeling builds and builds until I can't stand it and I call him. That provides so much relief for me--and frustration for my therapist. I don't understand why I need to call him or what I need to say, but somehow just talking to him helps me and I can go on. I don't have an answer as to what it is I really need when I call him. It's confusing to me. Please help. I feel so crazy and lost and confused.

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