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Therapeutic advances have changed the landscape. Since 1991, as Dr. Joel Paris points out in his 2008 book, Treatment of Borderline Personality Disorder, researchers have conducted at least 17 randomized trials of various psychotherapies for borderline illness, and most have shown encouraging results. According to a big Harvard project called the McLean Study of Adult Development, 88% of those who received a diagnosis of BPD no longer meet the criteria for the disorder a decade after starting treatment. Most show some improvement within a year...
Dialectical behavior therapy is so named because at its heart lies the requirement that both patients and therapists find synthesis in various contradictions, or dialectics. For instance, therapists must accept patients just as they are (angry, confrontational, hurting) within the context of trying to teach them how to change. Patients must end the borderline propensity for black-and-white thinking, while realizing that some behaviors are right and some are simply wrong. "The patient's first dilemma," Linehan wrote in her 558-page masterwork, 1993's Cognitive-Behavioral Treatment of Borderline Personality Disorder, "has to do with whom to blame...
Linehan's achievement was to realize that borderlines are, in fact, on the border between various dualities - dualities that they have to learn to accept and reconcile in order to change their lives. That's easy to say but seems impossible to do - until you see it work...
Linehan also taught Lily various skills to regulate her emotions. Among the most important is one Linehan calls the "wise mind" - a kind of calm, Zen state that Linehan insists even the most debilitated patients can achieve. "Generally," she writes, "I have patients follow their breath ... and try to let their focus settle into their physical center, at the bottom of their inhalation. That very centered point is wise mind." Lily remembers this sensation clearly; she came to feel that her dark moods had a physical location in her body - her solar plexus - and when she focused...
...hasten our transition to sustainable energy. For example, instead of letting gasoline prices tumble now only to see them soar again shortly, we could set a floor on prices at the pump and collect the difference between the wholesale and retail prices in federal revenues. Various carbon and gasoline taxes could raise another 1% or so of GDP. The public will also probably accept taxes on health care if they convincingly help save even more in private outlays on health insurance. A well-managed system of public financing of health care can do that and allow...