I have been successfully treating Borderline Personality Disorder (BPD) or Post Traumatic Stress Disorder (PTSD) for many years and have found a multivariate approach using multiple therapies i including dialectical cognitive behavioral, psychodynamic, medical, addictive and somatic therapies to be most effective. Essentially this is what we use to call a biopsychosocial situation that calls for a good assessment process, treatment plan, \and caring perspective and case management.
Over the years in treating BPD or PTSD I have observed a syndrome that my fellow clinicians now refer to as the "Bellman Syndrome" a title I modestly (sic) accept. It is simply stated thus; chronic pain and medication addiction are directly associated with Borderline Personality Disorder or Post Traumatic Stress Disorder in a complex interaction.
In treating many patients both in-patient and out-patient over the years, I noticed that many people had become addicted to pain medication for chronic pain, as I treated these clients over time it became clear that;
these were mostly middle class housewives
without a "standard" profile for drug addiction that therapy in most cases disclosed to a BPD-like symptomatology of early child abuse, mood swings, dissociate states etc.
2. successful treatment resulted from a team approach
of easing the pain with meds, acupuncture etc. recovering from addiction and therapy for the abuse, and to address the needs of the client with cognitive and psychodynamic treatment for moods and develop appropriate support systems.
This success with clients confirmed my "person in a situation" training and the importance of case management. But it also sparked my interest in research, so I became a Diplomat in the American Academy of Pain Management, there the research has focused on the ways that pain escalates the need for pain medication and that pain medication then escalates the pain in a vicious interactive cycle, which also changes physiology in the brain, research themes that affords the academy credit.
I believe that the etiology of the initial painful injury goes back to early childhood abuse; that in a state of rage or disassociation the client twisted their back pulling the vacuum cleaner or doing laundry, or so it is often reported although this may be a "doing everything for them" metaphor.
Pain-addiction-emotional trauma thus causes brain and personality change in a complex interaction is the very treatable syndrome.
Eric Bellman LCSW 32129 Lindero Cyn. Rd. #108E Westlake Village, CA 91361 Phone;805-493-2492 email;firstname.lastname@example.org
updated on 2/3/2007
Please note that this was written over a decade ago
and much of the new research focuses on the genetic propensities for developing disorders.
As well as early life caregiving experiences that affect personality developement
and the responses of caregivers interacting with unexpected infant reponses.
These theories expand our understanding of Disorders but still speak to the cycle of abuse
through time and families and the societal values underlying harsh early environements.
Contact Eric Bellman LCSW at: email@example.com Office 32129 lindero Canyon Road Suite 108-E Westlake Village CA. 91361