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She knows what is true for her, what her values are, and then she sticks to them. She never apologizes for leaving and just >> that's not a good thing. That's not a good thing for someone who's very low in agreeableness >> and just keeps repeating herself, I'm going to keep on dancing. I'm going to keep on dancing. >> Chasing that prey. Keep chasing that prey until they're they're exhausted. They lie down dead and you can just eat them. >> Using that broken record to really stand in self-respect. If I had to guess, I would say that self.
Now, we're going to start on the million-doll question, which is, can the borderline personality be cured? And in which case, how? So people will always talk about the magical DBT therapy, dialectical behavioral therapy. This is still the gold standard of treatment. This was the therapy developed by Marshall Linen which we discussed in the previous video. The most lenient, the most accurate way of looking at DBT is that it it it it's well supported that it will reduce acute risk in the short to medium term. It does uh reduce the risk of self harm. It does reduce this acute stress. Why? It's not for the reasons advertised. And I know this. I've done this therapy myself. I've had a lot of borderline patients and I can tell you I'm going to tell you exactly where they are mistaken and why. It's built on four four pillars. Mindfulness, staying present. distress tolerance, so surviving crisis, emotional regulation, and interpersonal effectiveness. But as I said, DBT conceptualizes the problem wrong. It frames and that that we've talked about this before that it frames emotional dysregulation as a skills deficit, as an inherent problem with the nervous system. >> This is DBT for neurode divergent minds. Welcome or welcome back. My name is Edetta and I'm a licensed trauma therapist who also happens to be neurode divergent. This space is for sensitive, intense, deeply feeling people who've learned to blame themselves for their nervous systems. It completely bypasses what we know that the the these these borderline personalities, they they're making strategic inter interpersonal moves. This isn't something that just it's not they're not just having breakdowns for no reason. What they call dysregulation. It's emotional escalation which they use to move other people into action. >> She's recording me. Tell her to stop. >> And those who are advocating DBT, that's a lot of therapists, right? They see the borderline personality as a victim patient lacking the tools to completely regulate their emotions. The the real difference with DBT is that there's a real intensity to this kind of therapy. Not only do you get a once a week session, in addition to that, you'll get group support and you'll also be allowed to call the therapist when you're in crisis. So that creates a sort of unhealthy dynamic that we'll get back to later, what actually happens there. And I think that's the secret to why they reduce the self harm. But I want to quickly show you exactly what I think is wrong with these skills that they learn with the the the modules themselves. So, I found a therapist for us to look at and she goes through it in quite a disturbing manner. >> In today's episode of DBT Skills in Pop Music, we are talking about Chapel Rowan's Pink Pony Club. I'm Dr. Kiki Failing. I am a licensed psychologist, an expert in dialectical behavior therapy or DBT and I love pop music. And yesterday I was listening to this song and I just got so overwhelmed with joy over how interpersonally effective Chapel Rowan is as she sings this song. In DBT, one of the four primary modules of skills that we teach is in interpersonal effectiveness. And there are three main areas of skills that we teach. assertiveness and getting what you want out of relationships, saying no, setting boundaries, etc. >> We >> pause right there. This is an aggressive female who puts on this excitement as sort of to distract us from her teaching a very cold machavellian dominance strategy. her her facial expressions are exaggerated, wide eyes, constant nodding and over signaling, which is I mean, she's giving me definite histrionic vibes. Like, some of these things are hallmark cluster B traits. She's treating the borderline who is a high antagonist adult as a fragile child with this high-pitched melodic chirping of a kindergarten teacher. We and us and it's this linguistic regression. So this is what I mean with infantilization. So I think a lot of this is when they're teaching a skill, they're modeling a histrionic mask and they are teaching the patient to be better at dominating the room, not to stop dominating the room while all the while looking like this pro-social person. It's it's really quite disturbing. And so she's telling the patient how to get what you want. like that is supposed to be synonymous with health. So here you have a therapist telling a patient that their stability depends on other people complying to their demands. So that's what I mean with reinforcement. You're reinforcing this belief that their internal state is downstream of how others treat them. that if they don't get their way, they're being invalidating, invalidated. So, that's more of this invalidating environment that's supposed that supposedly made them uh into borderliners in the first place. And so, it really prevents them from learning the most vital skill, which is that this internal stability should be independent of external compliance. You don't want to tether their well-being to how well they can manipulate their immediate surroundings. So when I look at her, I think, oh, here we have a predator who's telling another predator how to hunt better. We have skills for relationship effectiveness, which is increasing intimacy, easing conflict, and just general I if you've ever met a borderliner, intimacy is not something they have a problem with. They will overshare on the first date. You will know about their abusive father and their abusive ex and they will take you into bed, right? Intimacy is not something they should be learning. in just generally maintaining relationships. And then three, we have skills for selfrespect. In this song, Chapel balances these three areas so perfectly that I had to come on and talk about it. So, let's start. >> Did you Did you should you have >> start with assertiveness skills. These are what we call the dear man skills in DBT. It's an >> So, now she's going through the different models. So the inter the interpersonal effectiveness, that's really where we want to focus with the borderline personalities because they create such chaos around them and drag other people in. But basically what this comes down to is Chapel describes so clearly the situation and what it is that she wants. She explains why it's important to her and then asserts clearly and explicitly so there is no doubt she wants to dance at the Pink Pony Club. Ayay. So justice this this thing that you there you're teaching you're basically teaching children a skill and if you say that this is the problem and you need to learn these skills to fix these deficits then you are framing their rage and their emotional manipulations as the tantrum of of a child and that these they aren't manipulations. they're just expressions of unmet needs. I think that's a problem in itself. All the while, you'll notice the complete absence of um the effect of the damage to anyone else. And so onto this dear man, I'm going to show you here on the cheat sheet the what that stands for. Describe, express, assert, reinforce. Um that's what they're coaching. And this is just I mean this is training a high functioning predator that to handle conflicts better. So instead of feeling the cost of their behavior through how do we do that? How do we ever change our behavior? It's because we feel guilt. We feel shame. We feel others pain. That's what what regulates us. Oh, I'm ashame. I shouldn't have done that. You know, I'm ashamed of myself. I want to do better. and they are taught to bypass that completely because that's an oppressive feeling that doesn't shouldn't belong to them. So they're basically stopping them from developing a conscience. Instead, when they describe, they become this perfect narrator of their own emotional chaos. And that keeps them trapped in this cycle where they learn to talk their way out of any guilt they might feel that could otherwise trigger any change. So, all I see when I what I hear her speaking is how to manipulate more quietly. how to manipulate more effectively. There's nothing about learning how to value the relationships, how to value feelings of other own others only to validate them so that you seem more normal, to validate them so that you can more effectively move them into position. They learn to value the utility of the relationship. And that all that does is further isolate them in their narcissistic bubble. And believe me, they are in a narcissistic bubble. And so their emotional lives are broken into these worksheets, these acronyms, these scripts. And so respons, it's not about responsibility and how you treat others. It's whether you're using the right skill, whether you're getting the the correct reaction from the others. And I mean, for a population that's already prone to externalization, to blaming others, to to uh not seeing their their own faults, this will completely uh delay psychological maturation further because what what encourages ma emotional maturation? It's taking responsibility. It's taking accountability. >> She then even uses the man skills of dear man as well by when people are coming at her with judgments or attacks like when her mom is screaming, "God, what have you done?" Uh, she keeps repeating herself. She uses the technique of a broken record. She stays cool, calm, collected. She doesn't judge back and she just repeats herself. I'm going to keep on dancing. I'm going to keep on dancing. This is this is sociopathy. What they're taught here, if they aren't already in, they're encouraging the patient to this upsets me so much to to simply repeat their demand. If your demand isn't met, just repeat it until the person stops resisting. How sick is that? So, just you're supposed to ignore your mother screaming. If your mother is in pain, you're supposed to just ignore that biological signal of the attachment system and then become more effective at being less human. I mean, it's the very definition of interpersonal predation, just dressed in this staying cool. It's the same as when a predator runs an animal into exhaustion so that they can eventually eat them. And then you're exhausting the mother into submission. So the mother in the song is screaming and the therapist is just smiling and validating and nodding performative skill. So the therapist is effectively gaslighting the observer's distress um by pretending it doesn't warrant a serious response. This is sociopathy a how-to guide. Speaking of those judgments from others, maybe it's worth talking about the give skills. Now, the give skills are an acronym for those relationship skills of improving intimacy and just like making interpersonal effectiveness a little bit smoother with other people. And Chapel nails these skills, too. She stays pretty gentle and non-judgmental. She validates the other people consistently through the song. Like, she even starts the song um with saying, "I know that you wanted me to stay." It's validation. She's like, "I hear you. I know what you wanted. I get it. >> I just don't care. I hear you. I just don't care." They don't need help in this. They're very low in agreeableness. Putting themselves first is not a problem for someone with a borderline personality. It's the opposite. You want to teach them to be more agreeable. Oh, I hear you. They're very good at knowing what you feel, right? They're very neurotic, so they're always very attuned to the vibe in the room. They just don't care. And you're making them more justified in not caring. Um, she comes back later in the song consistently to describe that she understands what other people want. And then she expresses warmth saying, "I still love you. I think about you. You're always on my mind." And as I said, all of this is >> it's just not enough. You're always on my mind, just not enough for me not to go to this party. >> Is done in the context of feeling like other people might be judging her. She stays true to herself and maintains those. >> Look at her facial expressions just throughout condescending, smirk, showing the tease. This is an aggressive female >> those relationships by being giving. That probably takes us into >> making an al acrem that means the opposite of what you are doing. There's nothing self-sacrificing here. There's no nothing about what I should contribute to this home I apparently live in. If you are in a situation where your mom is screaming at you not to go to a concert, maybe there are chores you haven't done around the house. I don't know. As a mother, that's what I'm thinking. Maybe there are obligations you need to fulfill before you can go and think about yourself >> to that final area of skillfulness for self-respect. And we think about the fast skills from DBT. This is another acronym. And Chapel practices these amazingly too. So she is super fair. She considers the desires and preferences and opinions of the other people including her mom. But she doesn't forget about her own. In fact, she prioritizes. Shocking. She doesn't forget about her own shocking. So these give skills, gentle, interested, validate, easy manner. This is just to soften the blow. You're still going to do what you want to go and do. It's just about doing it in the right way. And so I think we should understand here what these they're trying to avoid the big rage outbursts, right? That's what they want to reduce the emotional escalation. But we know this is the strategy. So when they get to the point where they're completely outrageous, we're talking uh throwing things around in the middle of a of a of an airplane or or a train with other passengers. They're having a a fit where they're throwing things and screaming at you and you don't know what to do and it's embarrassing. We're talking about those sort of emotional escalations. that's what they want to reduce, but that's the last resort. That's the end of the road. So, they're not going to go there if it's not necessary. And this is just about getting what they want in a different way so they don't have to escalate. It changes nothing for the people in the environment. It changes nothing for that poor boyfriend on the train. So I think this is the most dangerous thing. This is what I call the neuroticism subsidy, right? It teaches the patient that if you mimic warmth, so mimicking effective empathy, the you can use that as a tool to leverage rather than encourage that genuine connection where you are self-sacrificing when you think about the other person. So the therapist will reward the patient for acting gentle to get their way. So they are re reinforcing a very Machavevelian reward circuit. And what does the patient learn? They learn that they don't have to be stable. They just have to perform stability well enough to maintain their host. And that it can be the therapist or the parent or the partner. the subjective stress they feel that's the priority not the observer's distress and that is the priority throughout all of the research as well. It's the subjective suffering this this the lack and this the lack of apology that this unapologetic skill learning that's what gets to me the most. It is the they're shielding the predatory behavior instead of what they should be um receiving is reputational loss. That's what will more effectively deter this kind of behavior. The only thing orizes what she wants more than anything. She says this is where I belong at Pink Pony Club. She knows what is true for her, what her values are, and then she sticks to them. She never apologizes for leaving and just >> that's not a good thing. That's not a good thing for someone who's very low in agreeableness >> and just keeps repeating herself. I'm going to keep on dancing. I'm going to keep on >> chasing that prey. Keep chasing that prey until they're they're exhausted. They lie down dead and you can just >> eat them. Using that broken record to really stand in self-respect. If I had to guess, I would say that self-respect is the area that Chapel is prioritizing among all others. And if you're familiar with DBT, we know that we ask you to rank how important each of these areas are in any given interpersonal situation. All three are always important, but you can't always get what you want. So in this song, Chapel does an absolutely amazing job prioritizing self-respect, probably assertiveness, assertiveness next, but then she does >> that's what you want to prioritize, self-respect and being assertive, getting what you want, >> include the give skills and stays so skillfully balanced between these three areas that it's a great example of interpersonal effectiveness. I'm sorry. I hope this was helpful >> and harmless. And so you can see what I mean. This is infantilizing and it's also reinforcing. And it's because DBT is built on this false assumption that there's a deficit. That brings us to the next why why um why these self the self harm behaviors actually reduce. The the thing that happens is that the therapy becomes uh a supply. The therapist is is drawn into a very unhealthy dynamic with the borderline patient because they agree to be available at any moment. So the patient is is encouraged when they're in a crisis to phone so that you can solve the crisis right then right then and there instead of the next day or two days later uh when things have already happened. So if the patient is in a crisis they will receive immediate engagement and the therapist will sacrifice their own private time their own private lives to play savior. So if the if the patient regulates like a normal person, there's also less reward and the therapist becomes a kind of hostage and you replace the usual hostage which is a partner or a mother or or a sibling. So the people around they'll say, "Oh yeah, I think this this therapy is working." Because they've had someone take their place for a short time. And so the the DBT therapist enters the picture and they are uh most of you know they're female therapists and they have a rescuer complex and so this is exploited. they are, you know, they come in, they're highly validating, uh, available. Um, they're taking the place of another figure and the patient will feed this rescuer complex. And we know that the female therapists, they channel their uh, nurturing void. They're very often childless. And uh, and um, the patients are taking the place of the children they're not having. As you saw, they're very condescending and infantilizing. And the the the it serves both of them. It serves the therapist and it serves the patient. And it creates a very un unhealthy dynamic instead of encouraging psychological transformation, actual change. And this is where the dynamic gets really unhealthy. They get stuck in this game, right? Where they both get something out of it. And then we can look at the self harm in a different way. It's not necessarily a result of internal growth. It is a sort of bargaining chip, a crumb, a payment to keep the therapist engaged. You see, if you weren't on the phone, I would have cut myself. If you weren't on the phone, I would have been hospitalized last night. And and this has happened to me. And so the problem here is that the patient will also punish the therapist if they are not always available. So I came back from my honeymoon and two of my patients were hospitalized. They couldn't deal with me being on vacation for two weeks. Immediate self harm. So they attach to someone who's bound to leave. That's the inherent flaw of I would say any therapist, right? creating this kind of relationship doesn't have to be DBT specific, but the the female therapist, they're bound to get pregnant, to go on vacation, to relocate or burn out. It's inherently flawed. So, I I really would say that the slight decrease in the acute crisis is this payment they have to give to have the therapist stay invested. And if you look at the research that really is the only thing that's decreasing with DBT. So when people say and they'll say this that uh 75 to 80% uh of the borderline patients who've done DBT uh they uh after the treatment they no longer fulfill the criteria for the disorder. This is a huge overstatement. Um I find it very hard to believe and you have to see after to what what they measure is self harm, alcohol consumption, um depressive symptoms. They don't measure are they able to keep a job? Uh are are they staying in a stable marriage and having kids? Those are not the things that they measure. And after treatment means maximum a year after. that they're not saying after treatment and then revisiting these participants 10 years later. And the last thing is if you look at it as at a societal level, right? If you take uh a long view, look just look at the asymmetry and how we conceptualize the behavior, right? If antagonistic traits in non-immigrant men, they are treated with clear consequences and reduction of incentives. But we know that really the only way to fight crime is harsher punishments. Remove the incentives. Uh but the similar patterns in women, they are medicalized and courage. Not only that, but reinforced. Rage is called trauma response. Manipulation is called disregulation. And harmful behavior is vulnerability, being fragile. So I think that this insistence on on pity is it creates a therapeutic environment where accountability is completely removed and consequences are perverted. That's the right word. Perverted. And while it's great that they reduce the immediate risk and they reduce the load on crisis services, they reduce the load on hospitals uh by decreasing hospitalization of these patients. That's that's great also for society. But we cannot claim that DBT or any kind of therapy u changes the societal damage that the that this personality um that this personality causes. That's my that's that's my view on DBT and and my personal experience which does not you know I've done this kind of therapy and when I hear that after it 75% of the patients they don't fulfill the criteria I'm just thinking what are you measuring what are you measuring the only way to really treat this is to reduce societal in incentives to really to change culture And I think we'll get into that more. Psycho bababel will take a little break over Easter, so I won't be posting I think next week. And I hope you enjoy the time with your families. And I hope you have some vacation and some time out. And then I hope to see you when you get back. Thank you so much for supporting. Please like and subscribe and have a nice day.