Ask An Expert
Email or text (9252649739) us any question you have related to mental health and we'll reply directly to your email or text with our answer. Please include your initials and location in your message**.
Each month, we'll pick one question to post along with our response here on the site for others to benefit.
"How can you defeat someone with borderline personality disorder at their own game?" - CL, UK
Individuals diagnosed with borderline personality disorder grew up in an unpredictably terrifying situation, unclear as to when and how their actual needs would be met even from infancy. No one diagnosed with this personality disorder is ‘playing a game’- their behavior is adaptive within the context they were raised. So there is nothing to ‘defeat’. No one behaves in ways that cause them and others this kind of harm on purpose.
Individuals with this diagnosis can benefit a lot from others being extremely clear and consistent with expectations and boundaries, even if they might lash out when they come up against those boundaries. If you can help their brain find reliable consistency and stability, you can help reduce the need for the behaviors that bother most people.
"What is the best advice to give someone who is the first in their family to go into entrepreneurship?" - KD, AZ, USA
Your success will come only through a willingness to fail.
"Why am I so depressed, but I don’t know why I am depressed?" - JF, CA, USA
It is helpful to think of Depression as nothing other than the mind’s response to helplessness- this is why you’re depressed. When the mind experiences helplessness in resolving anxiety/anger/grief/guilt/shame/regret, it causes what you experience as the symptoms of depression for protective purposes.
The more important question then is what is your stuckness in reaction to? Get that addressed, and the depression response will no longer be needed and will go away by itself.
"What is the most common cause of anosgonosia? How do we evaluate it in people with neurological and psychiatric disorders?" - MVO, KS, USA
Brain damage/trauma. We could- though we often don’t because of stigma and ego- evaluate anasognosia by comparing the presentation and expressed identity of an individual with what has gone on with their lives since the brain damage occurred. If a 45-year-old individual without a home who is frequently admitted to the inpatient psychiatric unit is talking about getting back to complete their semester as a first-year, dorm-dwelling university student that has never had a mental health issue, it may be safe to say they’re experiencing anasognosia.
"Anosognosia, also called "lack of insight," is a symptom of severe mental illness experienced by some that impairs a person's ability to understand and perceive his or her illness. It is the single largest reason why people with schizophrenia or bipolar disorder refuse medications or do not seek treatment."
Taken from www.treatmentadvocacycenter.org
"What does 'waking up' in the metaphorical sense mean and is there such a thing as really waking up?" - IG, CA, USA
We are always dreaming whether we are awake or asleep. Sometimes we are aware of this and sometimes we can even remember some of it. When we are asleep, our senses aren’t providing the feedback that they are when we’re awake, so the dream seems externalized, a world that is occupied in spacio-temporal dimensions. When we are awake and the senses are providing that feedback, our dreams occur internally, in the the abstract dimension of mind. These waking dreams are the sole cause of all suffering, the fruit of the tree of knowledge of good and evil, self-consciousness. We know their activity as anxiety, guilt, shame, regret, pain, anger, fear, grief, exhaustion, dis-ease… every form of suffering.
To ‘wake up’ is to stop having these waking dreams, i.e. to stop believing in them as real or relevant or true or helpful or necessary, in the way that one might treat an episode of Sesame Street in terms of concern for its imminent impact on ones literal survival as an adult, and thus they lose their grip on your mind. To wake up is thus to end all suffering. Nothing changes other than you stop suffering, and when you don’t suffer, you can give of yourself and attach yourself endlessly and easily.
It’s like when you’re engaged in an activity that so absorbs you that ‘time flies’- but always. Life lived un-self-consciously. The importance of being there is a personal thing for each individual.
"How do I stop from feeling bad over an object I accidentally broke? I feel so pathetic for feeling so bad and sad over it because I'm anxious that I cant fix/replace it. I feel stuck in these feelings of guilt and sadness over it and I feel abnormal." - MB, Vancouver, BC
You, like the rest of us, have been using the word ‘should’ incorrectly. ‘Should’ is not synonymous with ‘want’ or ‘prefer’. ‘Should’ is only applicable to describe logical consequences- like if you break your arm, it should hurt- or things it would be good to do- like “you should get off at the next exit so we don’t miss the turn”.
You don’t want to have broken that thing, but to say you shouldn’t have broken it is to deny the Law of Cause and Effect. Given where your attention was at the moment and that you knocked into it/dropped it, you should have broken it.
People should make mistakes. Crappy people should do crappy things- it would be weird if they didn’t! Both good things and bad things should happen. You shouldn’t be better than you are, given that you probably haven’t put much time into taking significant action to actually growing (guilt and shame are very destructive and not in any way helpful!).
Swap your shoulds and your shouldn’ts. It’s more accurate and it eliminates all guilt and shame.
"Can the tempo and rhythm of music trigger psychological episodes such as depression, mania and schizophrenia?" - RT, Fayettesville, NC, USA
Not in the way that it sounds you're thinking. Certain sensory data can trigger/call to being memories and associated emotional data, which can set off an intense response, eg. someone incurred some sort of traumatic experience while hearing a particular song and hadn't yet cleared it, a similarly sounding song could trigger a similar emotional response to what occurred, which- under the right circumstances- can trigger an episode.
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Questions are answered directly by Jordan Boehler, LCSW, Founder of the Institute for the Relief of Suffering and psychotherapist.
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