Brisbane July 2017 Family Connections Leader Training with Dr Alan Fruzzetti of Harvard University

Registrations for the Family Connections Leader Training with Dr Alan Fruzzetti of Harvard University in Brisbane on July 1 and 2 are now open!

Family Connections is a free, evidence based educations, skills training and support program for people with a loved one who experience bpd and bpd symptoms, reducing stress, conflict, depression and feelings of hopelessness; and build the family's support for their loved one with bpd. 

We are looking for health professionals and carers with a loved one with bpd who would like to volunteer to run the Family Connections program in the community with the support of NEA.BPDAust.

The training will be run by Professor Alan Fruzzetti who commenced as Professor of Psychology at Harvard University in June 2016. He was previously Professor of Psychology and Director of the Dialectical Behavior Therapy Program at the University of Nevada, Reno and provides extensive training for DBT in the United States and abroad. rofessor Fruzzetti teaches skills to families in order to reduce stress, conflict, depression and feelings of hopelessness; and build the family’s support for their loved one with BPD.

If you are interested in becoming a volunteer Family Connections Leader, please email: bpdfamilyconnections@gmail.com for more information on how to register

The Sashbear Foundation 'Having a Life Worth Living' Video Series: Blaise Aguirre, MD Mclean Hospital

To conclude the 'Having A Life Worth Living' Series, The Sashbear Foundation released this insightful video from Blaise Aguirre, MD

'Each year The Sashbear Foundation marks International Mindfulness Day by releasing a message of kindness and compassion to commemorate the birthday of Sasha Menu Courey. Sasha suffered from Emotion Dysregulation and died by suicide in 2011. This year Sashbear is sharing a frank and insightful interview with Dr. Blaise Aguirre, Medical Director of McLean 3East in Boston and one of the leading thinkers and practitioners in Emotion Dysregulation. This mindful discussion is of great value in understanding this not-so-understood disorder, Please share. The interview with Dr. Aguirre was part of an extraordinary film ‘HAVING A LIFE WORTH LIVING’ that Sashbear released last year featuring 12 individuals who speaking candidly about what it has been like living with Emotion Dysregulation.' - The Sashbear Foundation 

Check out Borderline Personality Disorder Patient and Family Education Initiative‘s webinar “Borderline Personality Disorder and Comorbidity: Treatment for Individuals with More than One Diagnosis”

You can view the recording of Dr. Gagliardi’s presentation at: https://mcleaneducation.adobeconnect.com/p7ytih2z5cy/

Our next webinar will be on Wednesday, July 13th, from 4-5 PM EST. George Smith, LICSW will discuss “Group Therapy for Borderline Personality Disorder.” For more information and to register for this webinar, please visit: http://tinyurl.com/mcleanbpd10

 

If you are interested in viewing recordings of previous webinars, please visit website: mcleanhospital.org/bpdinitiative

Professor Alan Fruzzetti Coming to Australia for 12-day Comprehensive DBT Clinician Training. Book Now For Early Bird Discount.

Commencing June 19 2016, Professor Alan Fruzzetti will present in four blocks of three days each block, a comprehensive 12-day, plus supervision, comprehensive Clinician DBT training programme including family skills.  For further information, email bpdaust@gmail.com with 'Fruzzetti Training' or book online now by pressing the Early Bird Discount tab at the top of the home page.

Marsha Linehan talks personally

New York Times Article

The Power of Rescuing Others: Marsha Linehan, a therapist and researcher at the University of Washington who suffered from borderline personality disorder, recalls the religious experience that transformed her as a young woman.

By BENEDICT CAREY

Published: June 23, 2011 

Click on the image above or HERE to read the article.

Orygen Youth Health Research Centre Report: Tell Them They're Dreaming

This report addresses disadvantage in employment and education faced by young
people aged 12-25 years with mental illness. It has a specific emphasis on this age
group because mental illness has its peak onset in youth, and as a consequence the
normal process of vocational development is disrupted. Intervening early to address
disrupted vocational development is likely to have significant individual, societal and
economic benefits.

View the report HERE

How to help the mentally ill in a time of shrinking budgets

 How does mental health become a top priority so that help is available to all who need it? This problem has deep roots, and solutions are elusive and complex. 

It is time to stop talking about helping people with psychiatric illness and actually do something to help them lead productive lives. 

Find the article here:

Interview with Barb Mullen

Barbara Mullen is one of the specialist leaders in Australia’s first Family Connections course

Barbara Mullen is one of the specialist leaders in Australia’s first Family Connections course

Barbara Mullen is one of the specialist leaders in Australia’s first Family Connections course. Family Connections is an evidence-based program developed by the U.S. NEA.BPD organisation. It runs for 12 weeks, is free, and (as the name suggests) is for families and friends of those diagnosed with BPD. Barbara was able to speak with us recently about her experience running the first Family Connections program in Australia.

Why did you decide to become a specialist Family Connections leader?

I think it’s a question of wanting to give back. When I found myself having difficulty coming to grip with the situation with my own daughter [who was diagnosed with BPD], I had good people who guided me through understanding what was going on and what I could do about it. They got me through a very difficult time, and so I want now to give back to others.

You must be able to empathise well with the families partaking in the program then?

Well you can understand absolutely, exactly what they’re going through, but also the difficulty that a family member has in understanding that they have to change. So it’s not just empathy for the situation that they find themselves in, but it’s also empathy in knowing the way that you need to come through.

Was starting the program a daunting experience?

I wouldn’t have said “daunting” so much as “exciting.”

How do you think the students felt at the beginning of the course?

I think that the students in my class… Well, there’s three things they get out of it. There’s learning more about BPD, and that comes from not just learning about the research and the studies and what the experts say, but also means that they learn because they listen to the stories of the other family members in the class. So they’re able to see things and understand the breadth and depth of BPD by the experiences of the family members in the class. Then they also learn skills and techniques to help them come to a place where they are in a position to better improve their relationship with their loved ones. And then the third thing is being with people who understand… Just being in a room with someone who understands is such a relief.

What do you think the participants’ impressions of BPD were at the beginning of the program?

What they know [at the start] is really what their own experience is. Some of them have done some good reading but... I think what they’re able to learn is the very different manifestations of the disorder. There are family members whose children don’t have a diagnosis, for example, and they’re able to find reassurance as a result of the course that, yes, it is BPD. So there’s that. And they’re all very, very different, from those who self-harm to those who don’t self-harm; from those who don’t have contact with their family members to those who are highly attached; you know, a wide variety of manifestations of the illness. So I think that they’re able to appreciate that more.

What sort of changes have you seen in the family members over the course of the program?

They started off as highly anxious, worried and concerned family members/parents… mainly parents, but not just parents. They started off being unable to see beyond the situation that they just thought was terrible. Now I think they have hope- no, I know they have hope; I know they have optimism. They’re able to laugh and they’re able to smile. They are more relaxed, they are more comfortable and they are happier. In particular, Week 3 was very much a turning point, but even right from the beginning they’re able to see improvement in their relationship with their loved ones. In Week 3 it was almost like a case of no going back.

Why do you think these changes are clear during Week 3 specifically?

I think that’s when the skills start to click. Their techniques, and what we’re doing, start to make sense. We would recite the Serenity Prayer [“God grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference”], and the next question that comes after that is… ‘So what can you change?’ And the answer is that there’s only one thing I can change, and that’s myself. When you are a parent of a person with BPD, what you want is for your child to get therapy; for your child to get treatment; for your child to do this; to do that: and they are resistant. And you learn that you can’t change that, you can’t change them. The only person you can change is yourself. So by Week 3, the logic of that has begun.

So, the course is 2 hours weekly. Do the students and families enrolled have to do any practise outside of those 2 hours?

Practise is really essential for them because what [the students are] doing is learning new skills. And it is absolutely critical to practise outside of the class because it’s about changing behaviours and in order to do that you have to practise. So it’s inevitable that for the period of the course in particular you are absolutely immersed in thinking about it. It’s an intensive experience but you know that once the course is over it doesn’t stop; you continue to work and develop, and it becomes a part of your life. But I did also emphasise the importance of writing. I would set what I would call homework – it wasn’t a case of it ever being checked or corrected or ticked off or anything, but… In order to reinforce your learning, it is helpful to put it down in writing, and the act of writing helps us sort out our thoughts. And writing, for example keeping a journal, is a really important part of our own personal journeys. I highly recommend it.

What do you personally think are the strengths of this program?

Oh, I think undoubtedly the theory behind it. I think its other strength is the commitment you have to make to it. 2 hours a week for 12 weeks is a big commitment. But, you know, people in my class are saying it needs to be longer and they want more! And the other thing is that it has to be free; it has to be done voluntarily. The course has integrity because it is the same that is taught across the board.

It must have been a very rewarding experience for you?

Absolutely. I mean, I was almost desperate to do it because I knew the benefits for me! To be able to reinforce my learning by teaching… A really, really good way to learn is to teach.

And it must be rewarding seeing the changes in the students and families as well?

There is nothing better than knowing what you’re doing is making a person’s life easier and happier. Not just for yourself, and not just for that person, but also for their families. The effects of that are like… It’s like throwing a stone into a pond; you make one little ripple and then the ripple effect goes all the way out.

Have you had anyone attend your classes from interstate?

Not in my class. But I know that there are people who would be screaming out for the program. One of the [problems] is people not knowing about the course. I’m involved in another BPD organisation and we’re doing everything we can to publicise Family Connections because we know the benefits of it. But I think that as people do it, and as the word-of-mouth spreads, I believe that the demand for the program is enormous. If 2% of the population have got BPD…

Are there currently any plans to expand the program here?

They have trained specialist leaders in South Australia, and I think there are a number of programs available there now, as well as Perth, Albury Wodonga and Wollongong in NSW.  I think having good leaders is important for the continued development of the program. But I do know that there’s an extraordinary need. That’s also why it’s so critical that it be freely available.

Thanks for your time, we appreciate it.

A pleasure!

 

Professor Andrew Chanen

Professor Andrew Chanen is the Deputy Director of research at Orygen: The National Centre of Excellence in Youth Mental Health, Board Director of NEA.BPD Australia

Professor Andrew Chanen is the Deputy Director of research at Orygen: The National Centre of Excellence in Youth Mental Health, Board Director of NEA.BPD Australia

Professor Andrew Chanen is the Deputy Director of research at Orygen: The National Centre of Excellence in Youth Mental Health, Board Director of NEA.BPD Australia and the President of ISSPD (International Society for the Study of Personality Disorders).  He is the keynote speaker at the 5th annual National BPD Conference “New Directions - New Opportunities.” He was kind enough to give us some time recently to talk about the role he and Orygen have played in BPD research.


In 1999 Orygen established a program called Helping Young People Early (HYPE). ‘We have a model of care that involves two levels of service,’ Chanen says of the program. ‘One of them is a general model of early intervention, and that involves training people in the rationale for early intervention and includes a service model and general psychiatric care; family involvement; case management… and then we have a second stage of training which trains people in a particular form of individual psychotherapy which is called Cognitive Analytic Therapy, or CAT.’ HYPE was the first program of its kind internationally and received the Australian and New Zealand Mental Health Service Achievement Awards Gold Award in 2010 and The Victorian Premier’s Health Service Awards for Advancing Healthcare in 2012. It has also been exported to centres overseas. ‘I’m heading off to the Netherlands to do some training,’ Chanen says. ‘There’s a HYPE program established in the Netherlands and they’re looking at developing a national program which would involve skilling-up services in other centres in the country.’


HYPE has been a breakthrough program in diagnosing and treating young people with BPD. ‘The main kind of task that we faced originally was actually getting [clinicians] to make the diagnosis in young people because, despite all the scientific evidence, making the diagnosis is still fairly controversial.’ Early diagnosis (or “early intervention” as it is sometimes referred to) in BPD has been a divisive topic in the field for a multitude of complex reasons. ‘People involved in the care of young people are reluctant to give them a diagnosis that might well expose them to stigma and particularly to discrimination in health services,’ Chanen elaborates. ‘We [Orygen] think the diagnosis can be applied in young people around about from the age of twelve; essentially, people from puberty onwards. The cutting edge of research into diagnosis is looking at the features in children, but we think it’s premature to make the diagnosis [then].’


This controversy that surrounds BPD early diagnosis isn’t unique to Australia. ‘In some countries early diagnosis is never made and people are kind of frowned upon if they do make it. In the United States, it’s a highly controversial diagnosis. Partly because the insurance companies don’t cover BPD, and so in order to get care, clinicians will often make substitute diagnoses,’ Chanen explains. ‘Then they’re likely to be started on medications that are actually ineffective, and that risk harming the patient. In other countries… there’s a more positive culture. In the Netherlands, there’s much more of a propensity to make the diagnosis to not discriminate against those patients, so it’s no accident that they’ve taken up the HYPE program without too much controversy. It really varies enormously across the globe. The community tend to stigmatise people with mental health problems in general, but actually the worst forms of stigma for people with BPD come from professionals who should know better. There are isolated pockets around the world of good practice…some countries are better than others, but on the whole, it’s a universal problem.’ 


But educating clinicians in their training is just one part of addressing and correcting this stigma. ‘We know that education can change attitudes but we don’t know whether it changes behaviour,’ Chanen illuminates. ‘One of the important areas of research is to actually develop programs to change the behaviour of [clinicians] because you can get people to change the way they speak about patients, but we don’t know whether any of these training programs actually change the behaviour of people. It’s challenging… it’s like telling people that ‘racism is unacceptable,’ and people can learn that racism/bigotry is unacceptable, but when they’re in the privacy of their own home they still may say those things, you never know. It’s the same: you can get [clinicians] to say what they think you want to hear at the end of the training program, but whether they actually go away and change their behaviour towards patients, well that’s another issue.’


But the future for early diagnosis in BPD in Australia is looking positive. ‘When we began this work it was seen as highly controversial. Now younger clinicians we train don’t seem too fussed about it. If we say ‘this is controversial,’ they often say, ‘well we don’t think it is; we’re happy to make the diagnosis.’ So there’s definitely been a generational change in the time I’ve been doing this work and it’s less controversial making the diagnosis now… But you know that’s really just the first step because then you’ve got to skill-up the workforce to be able to effectively treat it once they’re willing to [diagnose] it.’

Given this positive step forward in early BPD treatment, we asked Professor Chanen what his address at the New Directions conference will focus on. ‘The kinds of things that we need to focus on in the care of people with borderline personality disorder,’ he responds. ‘I’m also going to talk about some of the future challenges, which include making sure that what we measure in terms of the outcomes of treatment focuses much more on things that matter for the people who have the disorder. Like functioning: whether people can manage relationships and have a vocational pathway in life that they value, and more and more asking individuals with BPD what’s important to them in terms of their outcomes…. And the reason for that is that there’s a lot of scientific evidence now to show that these “functional” outcomes are actually the real long-term disability that people with BPD suffer, particularly things like unemployment, social isolation, and lack of supportive and confiding relationships… One of the problems is that people with BPD have been assumed to not know what they want, whereas actually when you ask them they’ll often tell you what they want, and the difficulty is that the mental health system - and the health system more broadly - has not been set up to ask them what they want and need, or help them to get it. Mostly a lot of effort goes into trying to avoid providing services to people with BPD by rejecting them and discriminating against them rather than getting on with the job of actually offering them effective treatment.’


Professor Chanen said he also wants to discuss addressing the common symptoms of BPD. ‘Like depressive symptoms, psychotic symptoms, and physical health problems. People with severe personality disorder have almost a 20 year reduction in life expectancy; they have a suicide rate of around about 8-10%; [have] high rates of smoking; very high rates of obesity (and as a result are at risk of cardiovascular disease); and they also end up on a lot of medications that aren’t very effective, but because people feel desperate they often prescribe them, or patients often ask for them.’ This last point Chanen made links back to his earlier comments on ineffective medication potentially being harmful to patients. Surely early intervention of the disorder is a means to prevent this happening in the future? ‘We have research evidence to show that up to 2 years after they’re diagnosed, that they improve significantly. But we actually don’t have enough research to know whether early intervention leads to long-term, positive outcomes decades down the track. We’ve certainly been trying to get funding to follow-up our patients long-term, but we haven’t succeeded in doing so yet… Then the other thing that I’ll talk about [at New Directions] is how to improve access to treatments; how to increase the variety of available treatments; and also how to develop the workforce that is needed for effective intervention for BPD.’

Given the information Chanen has given us, the future of BPD early diagnosis is one that calls for more public awareness and the eradication of stigma. ‘I think that BPD is unfairly discriminated against, and doesn’t get the attention that it deserves,’ Chanen affirms. ‘It has a high suicide rate; is a stronger predictor of being on the disability pension than either depression or anxiety; it has major adverse outcomes in terms of relationships, work, health… and yet it doesn’t nearly get the attention that it should. And it’s very hard to get my colleagues to prioritise it in their research because of this issue of stigma and discrimination… And I think that at Government level, policy-makers aren’t really that aware of BPD and the effect that it has on individuals in the community.’
‘It’s an important challenge and we think that it’s one that should be a priority for workforce development across Australia and internationally. So that’s why we do the work that we do.’

 

Washington Post Article about Pamela Tusiani and her family's efforts to advocate for BPD research, awareness and treatment.

Pamela Tusiani lost her battle with mental illness in 2002, dying from a severe reaction to an antidepressant prescribed for he borderline personality disorder.

Her mother, Paula, says "September 14th was Pamela's birthday - she would have been 38 years old.   I think she would be pleased on her birthday that her legacy continues.... Thank you all for your support and for making it happen!"

 

https://www.washingtonpost.com/national/health-science/her-brain-tormented-her-and-doctors-could-not-understand-why/2015/09/14/d9d0b788-36c5-11e5-b673-1df005a0fb28_story.html.