Q. Do you have any information related to bpd and self mutilation/substance abuse? I am a substance abuse specialist for an intensive outreach program located in New Jersey- any information related to treating clients dealing with these issues would be greatly appreciated.
A. The most important things in my experience are:
1) Stopping the dysphoria!!!! They only do this because it works to stop their pain. The meds are right when and only when parasuicidal behaviors cause real pain (it’s usually quite a shock to the patient when previously “fun” or “pain relieving” behaviors now cause real pain – and they don’t like it).
2) Teach better perspectives and coping skills so the stressors don’t cause dysphoria.
3) Explain that parasuicidal behavior hurts them severely. Everyone knows it’s wrong, including the borderline. It reinforces the idea that they are severely ill, and the erroneous belief that they are. No one can have a “normal” life or expect a loving, kind individual to love and trust him/her if they self – mutilate. Virtually every borderline wants a successful loving relationship, and they absolutely cannot have one with self-mutilation a part of it.