Transcript: Personality Disorders, Perdita Felicien | Feb 02, 2004

(music plays)

In animation, against a backdrop of colourful squares in hues of purple, blue and orange, words fly by as clips show people performing different activities: More to Health, More to Education, More to Science, More to Money, More to Family, More to Ontario. Finally, the title of the show reads "More to life."

Mary Ito sits in a studio made of translucent panes that mimic the animated presentation of the show.

Mary is in her late thirties, with short black hair and bangs. She's wearing a black jacket over a pink blouse, and a choker necklace.

Mary says HELLO. I'M MARY ITO. WELCOME TO "MORE TO LIFE." TODAY WE'RE GOING TO LOOK AT PEOPLE STRUGGLING TO OVER COME SOMETHING CALLED PERSONALITY DISORDERS. INDIVIDUALS EXPERIENCING ONE OF THE THESE TEN TYPES OF DISORDERS, EXPERIENCE A RANGE OF SYMPTOMS. SOME PEOPLE SUFFER A PARANOIA. WHILE OTHERS SEE THE WORLD IN EXTREMES AND THEY FIND IT IMPOSSIBLE TO HAVE STABLE RELATIONSHIPS. JUST WHO ARE THESE INDIVIDUALS? AND WHY ARE THEY CONSIDERED THE MOST DIFFICULT TO TREAT? AND ANSWERS FROM OUR MEDICAL PANEL TODAY. "MORE TO LIVE" REGULAR DR. DAVID GOLDBLOOM IS HERE A SCIENTIST AT THE CENTRE OF ADDICTION AND MENTAL HEALTH...

David is in his late fifties, clean-shaven, with short gray hair. He's wearing glasses, a green tweed suit, white shirt and checkered gray tie.

Mary continues HE'S JOINED BY Doctor Shelley McMain, A PSYCHOLOGIST WHO SPECIALIZES IN THE TREATMENT OF PEOPLE WITH BORDERLINE PERSONALITY DISORDER. SHE'S ALSO WITH THE CENTRE...

Shelley is in her late thirties, with shoulder-length straight brown hair. She's wearing a green blazer and a gray shirt.

Mary says WE WOULD LIKE TO HEAR FROM YOU TODAY. IF YOU WOULD LIKE TO KNOW HOW TO TELL IF SOMEONE HAS A PERSONALITY DISORDER OR YOU WOULD LIKE TO SHARE A PERSON STORY WITH US, PLEASE...

A caption reads "416-484-2727. 1-888-411-1234."
Then, it changes to "moretolife@tvo.org"

Mary says HELLO, DAVID AND SHELLY. THANK YOU FOR COMING IN TODAY.

David says HI THERE.

Shelley says HI.

Mary says DAVID, I MENTIONED THAT THERE ARE TEN DIFFERENT PERSONALITY DISORDERS OF THE. CAN WE TALK FIRST OF ALL, WHAT IS IT THAT DISTINGUISHES PERSONALITY DISORDERS FROM OTHER KINDS OF MENTAL ILLNESSES?

David says RIGHT. WELL, YOU HAVE TOUCHED UPON ONE OF THE MOST CONTROVERSIAL AND I THINK LEAST UNDERSTOOD STARTS OF PSYCHIATRY. THE IRONY IS IT'S SO BASIC WHO WHO... TO WHO WE ARE. BECAUSE YOU CAN'T HAVE A PERSONALITY DISORDER WITHOUT HAVING A PERSONALITY TO START WITH. ALL OF US HAVE PERSONALITIES, AS YOU KNOW AND...

Mary says EVERYONE HAS SLIGHT DISORDERS IF THEM... IN THEM.

The caption changes to "Doctor David Goldbloom. Psychiatrist."

David says ABSOLUTELY. THIS IS NO A SITUATION WHERE... SITUATION WHERE THERE'S A CLEAR LINE THAT... THAT SEPARATES WHAT WE WOULD CONSIDER THE NORM. IN PERSONALITY, FROM PEOPLE WHO ARE DIFFICULTY. AND THAT'S WHAT MAKES IT HARD TO THINK ABOUT IT AS A DISEASE OF THE. IN THE WAY THEY THINK ABOUT SOME OTHER ILLNESSES, LIKE SCHIZOPHRENIA. IT'S A VERY DIFFERENT FRAMEWORK FOR UNDERSTANDING. IT'S REALLY ABOUT AN UNDERSTANDING OF THE WAY PEOPLE INTERACT WITH OTHERS. OTHER A SUSTAINED PERIOD OF TIME. AND IN A WAY THAT IS MAL-ADAPTIVE, EITHER FOR THEM OR THE PEOPLE AROUND THEM. SO IT'S HOW WE CONNECT TO THE REST OF THE WORLD. AND THERE ARE, ADMITTEDLY, TEN OF THESE KISS ORDERS... DISORDERS. BUT THEY'RE NOT SO PURE OF THE MUCH IN THE SENSE THAT THERE'S LOTS OF OVERLAP AMONG THESE DIAG DIAGNOSES. AND I'M HOPEFUL OVER THE NEXT TEN YEARS THAT WE'LL HAVE A BETTER MODEL OF UNDERSTANDING THESE.

Mary says I KNOW WHAT YOU MEAN BY PURE. BECAUSE WHEN YOU LOOK AT THE LIST, YOU I THOUGHT, WELL, THESE TERMS WE USE FREQUENTLY IN EVERYDAY CONVERSATION TO DESCRIBE SOMEONE. WHEN I SAY PARANOIA. I MIGHT SAY THAT PERSON IS PARANOID. NOT MEANING THEY HAVE A MENTAL DISORDER BUT EXHIBIT THIS KIND OF TRAIT. OR SAY THAT PERSON CAN BE NARCISSTIC. NOT labeling THEM AS SUCH BUT THEY CAN COULD SHOW THAT CHARACTERISTIC SOMETIMES.

David says THERE YOU USED THE KEY WORD, WHICH IS TRAIT. THAT THESE PEOPLE HAVE A TRAIT. ALL OF US HAVE TRAITS OF VARIOUS TYPES. BUT FOR PEOPLE WHO MEET THE DIAGNOSIS OF PERSONALITY DISORDER, THESE ARE REALLY ENDURING TRAITS IN THEIR BEHAVIOUR THAT... THAT TYPICALLY EMERGE BY ADOLESCENCE OR YOUNG ADULTHOOD. THAT TYPICALLY POSE PROBLEMS FOR THEM OR FOR THE PEOPLE AROUND THEM.

Mary says UM, CAN WE GET AM AM... GET SOME MORE HISTORICAL PERSPECTIVE? I FIND IT INTERESTING. AT ONE TIME, THESE WEREN'T INCLUDED IN YOU SIGH CAN YOU KAI FRIDAY. WHAT IS IT THAT CHANGES THAT? WHAT DO PSYCHIATRISTS AND PSYCHOLOGIST LOOK AT IT AS NOW AS SYMPATHETIC THAT CAN BE TREATED?

David says I THINK MA MORE... THAT MORE RECENTLY, WE HAVE A LOT OF GOOD RESEARCH THAT SUGGESTS THAT THESE, THESE, YOU KNOW, PERVASI PERVASIVE WAYS IN END GAUGEING IN THE WORLD OFTEN CAN BE CHANGED THAT OFTEN TIMES THESE BEHAVIORS OF... THESE PATTERNS OF BEHAVIOUR ARE LEARNED BEHAVIORS AND CAN BE UNLEARNED WITH THE RIGHT TYPE OF TREATMENT. SO I THINK THAT RESEARCH IS NOW HOLD ING HOPE I THINK FOR PEOPLE WHO HAVE A PERSONALITY DISORDER. I THINK THAT AT THIS POINT IN TIME, PEOPLE ARE MUCH MORE OPTIMISTIC ABOUT, UM, ABOUT THE PROGNOSIS FOR PEOPLE WITH THESE INGRAINED WAYS OF BEING.

Mary says HAVE THERE BEEN STRIDES MADE IN TREATING PEOPLE WITH PERSONALITY DISORDERS? GOOD OUT COMES?

The caption changes to "Doctor Shelley McMain. Psychologist."

Shelley says IN PARTICULAR THE MOST PROMISING RESEARCH LIES IN THE AREA OF BORDERLINE PERSONALITY DISORDER. WHERE WE'VE SEEN OVER THE PAST 10, 15 YEARS, RESEARCH COMING OUT ON, UM, ON THE TREATMENT OF THESE INDIVIDUALS WITH A COGNITIVE BEHAVIOUR... NISG, THE DILECTICAL BEHAVIOUR THERAPY.

The caption changes to "Today's topic: Personality disorders."

Mary says WHICH IS WHAT YOU SPECIALIZE IN.

Shelley says IT IS. I'LL PUT IN A PLUG FOR THAT. BUT, NO, BUT WHAT I THINK IS IMPORTANT ABOUT THIS, IS THAT RESEARCH IS A LIGHT AT THE END OF THE DOUBLE IN MANY WAYS, BECAUSE SUDDENLY PEOPLE ARE BEGINNING TO REALIZE THAT WITH THE RIGHT KIND OF TREATMENT, BEHAVIOURS CAN, CAN CHANGE. AND SO I THINK THIS REALLY STIMULATEED A LOT OF INTEREST IN THIS AREA. AND I THINK THE GOOD NEWS IS THAT IT'S STIMULATING OTHER PEOPLE TO BEGIN TO DO RESEARCH IN THIS AREA.

The phone numbers and email reappear briefly.

Mary says OKAY. BEFORE WE GO INTO THE TREATMENT, CAN WE JUST GO BACK A AND WHEN WE TALK ABOUT THE TEN, I KNOW THAT... THAT IT'S DEFINED IN... IN SORT OF THREE MAIN CATEGORIES, RIGHT? CAN YOU TELL WHAT... WHAT THOSE CATEGORIES?

David says SURE. FIRST CLUSTER OF PERFECTSONALITY DISORDERS IS CALLED THE ODD CLUSTER, TO TUESDAY A... TO USE SORT OF LINGO LINGO. WHICH IS... IT INCLUDES PEOPLE THAT MAY BE PARANOID. THEY'RE NOT DELUGSAL OF THE. THEY DON'T HAVE FIXED, FALSE... LE... DELUSIONAL. THEY DON'T HAVE FIXED, FALSE BELIEFS. BUT THEY HAVE A... AN ODD WAY OF DEALING WITH THE WORLD. BY NATURE, THEY'RE TRUSTFUL OF OTHER PEOPLE AND THEN THE SKITS OID PERSONALITY DISORDER. THEY HAVE VERY LITTLE ENGAGEMENT WITH AND A VERY ODD, ALOOF KIND OF EMOTIONALLY COLD WAY OF BEING. AND THE THIRD TYPE CALLED THE S SCHITSO. THAT REFERS TO AM PEOPLE WHO MAY BE HIGHLY ECCENTRIC IN THEIR MILES PER HOUR OF DRESS IN, THEIR BELIEFS. IN THE WAY THEY LEAD THEIR LIVES. BUT NOT FALLING INTO THE CATEGORY OF SCHIZOPHRENIA. AND YOU HEAR FOR THE LAST TWO PERSONALITY DISORDERS YOU I MENTIONED THE WORD SCHIZO IS IN THE NAME. IT'S THOUGHT THAT THERE IS SOME CONNECTION ULTIMATELY BETWEEN THOSE PERSONALITY DISORDERS AND PEOPLE WHO HAVE SCHIZOPHRENIA.

Mary says WHAT'S BELIEVED?

David says THAT'S WHAT'S BELIEVED. IF YOU LOOK AT THE EXTENDED FAMILIES, UM, OF PEOPLE WITH SCHIZOPHRENIA, THEY MAY HAVEL RELATIVES WHO DON'T HAVE SCHIZOPHRENIA, BUT HAVE THESE, THESE PATTERNS OF BEHAVIOUR WHICH KIND OF APPROACH, BUT DO NOT, BE THE LEVEL OF SCHIZOPHRENIA SO MANY THAT'S THE FIRST CLUSTER. THE SECOND CLUSTER, UM, IS... IS THE ONE THAT'S PROBABLY RECEIVED THE MOST CLINICAL ATTENTION. MUCH AND WHAT SHELLY IS, UM, IS RIGHTLY FOCUSED ON IN TERM OF BORDERLINE PERSONALITY DISORDER IS, IS THE PERSONALITY DISORDER FORTUNATE 20TH AND 21ST CENTURY. PROBABLY THE ONE THAT DERIVES THE SINGLE MOST CLINICAL ATTENTION, THE GREATEST AGREE OF INVOLVEMENT WITH THE HEALTH CAN CARE SYSTEM, WITH EMERGENCY ROOM, AND, AND SHELLY CAN PROBABLY GIVE YOU A BETTER DESCRIPTION THAN ME. MUCH OF WHAT'S INVOLVED IN BORDERLINE PERSONALITY DISORDER. BUT CLOSELY RELATED TO THAT CONSTRUCT ARE PEOPLE WITH NARCISSTIC PERSONALITY DISORDER. HYSTRONIC PERSONALITY DISORDER AND ANTI SOCIAL PERFECT SONALITY DISORDER THAT FORMS THE SECOND CLUSTER. THIRD CLUSER IS A GROUP THAT'S OFTEN CHARACTERIZED AS SAD. AND THESE MAY BE PEOPLE WHO ARE HIGHLY ANXIOUS OR HIGHLY DEPENDENT AND WHAT I MEAN BY DEPENDENT IS THAT THEY'LL PUT THEIR NEEDS DOWN IN FAVOUR OF THE NEEDS OF OTHER PEOPLE. SO THAT THEY'LL, THEY'LL, IN SOME WAYS, OTHER PEOPLE FIND THEM VERY HELPFUL. BECAUSE THEY'RE ALWAYS DOING THINGS FOR OTHER PEOPLE. BUT AT A TREMENDOUS COST TO THEMSELVES. BY NOT ACKNOWLEDGING THEIR OWN NEEDS.

Mary says THEY'RE DO GOODERS BUT DON'T...

David says THEY'RE DO GOODERS, BUT MORE THAN THAT. BECAUSE IN THE ABSENCE OF DOING THESE OTHER THINGS... THEY DON'T FEEL A SENSE OF, A VERY CLEAR SENSE OF SELF WORTH.

Mary says WHAT ARE THOSE PEOPLE CALLED?

David says THAT'S DEPENDENT PERSONALITY DISORDER.

Mary says HMM. WELL, LET'S GO BACK TO, YES, THE BORDERLINE. BECAUSE THAT'S YOUR SPECIALTY. OF AND WE HEAR SO MUCH ABOUT IT. FIRST OF ALL, I THINK A LOT OF PEOPLE, MYSELF INCLUDED, WHEN WE DON'T REALLY KNOW TOO MUCH ABOUT IT IT THE NAME ITSELF, UM, GIVES US I THINK A HE VERY FALSE IDEA OF WHAT THIS IS ABOUT. BECAUSE WHEN WE ATTACH BORDERLINE TO OTHER THINGS, OH, LIKE YOU'RE A BORDERLINE DIABETIC OR YOU'RE... YOU'RE ALMOST THERE BUT NOT QUITE SO MANY WE TEND TO THINK OF THIS AS MAYBE SOME MILD SORT OF MENTAL DISORDER. MUCH BUT IT'S NOT.

Shelley says IT'S NOT. IT'S A VERY SEVERE, AND, UM, AND SERIOUS MENTAL HEALTH DISORDER. AND, UM, AND HAS RECEIVED A LOT OF YOU ATTENTION BECAUSE IT'S PROBABLY THE MOST COMMON PERSONALITY DISORDER THAT YOU'RE GOING TO SEE IN A CLINICAL SETTING.

Mary says COMMON? HOW COMMON IS THIS... IS THIS IN SOCIETY?

Shelley says WELL, THE RATE OF PREVALENCE IS AROUND 2 percent IN THE GENERAL POPULATION. WHICH AMOUNTS TO ABOUT 10,000 PEOPLE IN THE GREATER TORONTO AREA ALONE.

Mary says WOW.

Shelley says SO IT'S A VERY SERIOUS PROBLEM. UM, AND... AND THE... THE CONCEPT BORDERLINE ACTUALLY DERIVED FROM PSYCHO ANALYTICAL LITERATURE. THAT CONCEPT WAS WAS... WAS USED TO DESCRIBE PATIENT WHO IS HAD A HARD TIME ADJUSTING IN TREATMENT. IN THE EARLY '1900'S, THESE ARE THE CLIENT THAT DIDN'T DO WELL WITH TREATMENT. THEY TEND TODAY GET WORSE WITH TREATMENT. SO PART OF WHAT , WHAT IT TMD SEEMED WAS GOING ON IS THEY SEEMED TO LAY ON THE BORDER OF BEING THOSE INDIVIDUALS WHO WERE NEUROTIC AND INDIVIDUALS WHO WERE SIGH COTTIC... WERE PSYCHOTIC. OF SO P.M. PEOPLE WHO HAD DIFFICULTY DEALING WITH... SO PEOPLE WHO ARE DIFFICULTY WILLING DEALING WITH STRESS AND ON THE OTHER LINE, PEOPLE WHO LOST TOUCH WITH REALITY AND THAT'S WHERE THE WORD BORDERLINE COMES FROM. THERE'S A LOT OF OF CONTROVERSY ABOUT THAT TERM NOW. MUCH.

Mary says SO IT...

Shelley says THE TERM BORDERLINE PERSONALITY DISORDER, IT WASN'T, WASN'T UNTIL AROUND 1980 THAT IT STARTED BEING USED IN... IN, UM, IN THE DIAGNOSTIC LITERATURE. YOU NOW REALLY WHEN WE TALK ABOUT SOMEONE WITH A BORDERLINE PERSONALITY DISORDER, WE TALK ABOUT SOMEONE WHO HAS ABOUT PERVASIVE PROBLEMS IN A NUMBER OF AREAS. THEY HAVE PROBLEMS IN TERMS OF REGULATING THEIR EMOTIONS.

Mary says HIGHS AND LOWS, YOU MEAN?

Shelley says OFTEN TIMES THEY TENDS TO FLUCTUATE IN THEIR MOOD. THEIR MOOD TENDS TO BE VERY REACTIVE TO SITUATIONS SO MANY THEY NAY ONE MOMENT FEEL DEPRESSED AND SAD IN RESPONSE TO SOMETHING. AND THEN MAY BE HOURS LATER FEEL INCREDIBLY ANXIOUS AND FEARFUL. SO OFTEN THE EXPERIENCE FOR THE INDIVIDUAL IS ONE OF ALMOST BEING ON A ROLLER COASTER, NOT KNOWING WHEN THEIR MOOD WILL BE FROM ONE HOUR TO THE NEXT.

Mary says WHO DOESN'T KNOW? THE PEOPLE AROUND THEM PROBABLY DOESN'T KNOW, RIGHT? DOES THE INDIVIDUAL HIMER IS OR HERSELF KNOW WHAT TRIGGERS THEM? OR THEY DON'T KNOW WHEN THEY'LL FEEL GREAT OR TERRIBLE?

Shelley says I THINK VERY OFTEN WHEN PEOPLE CAN COME INTO TREATMENT, THEY'RE NOT AWARE OF WHAT HE'S... WHAT'S SETTING OFF THE MOOD. THEIR EXPERIENCE IS ONE OF FEELING LIKE THEY'RE ON AL ROLLER COASTER, A BIT OUT OF CONTROL OF THE MUCH AND THE RESULT FOR THEM IS THAT, IS THAT THEY'RE OFTEN, IT'S OFTEN VERY DIFFICULT FOR THEM TO FRICT HOW THEY'LL BEHAVE IN ANY ONE SITUATION. NOT KNOWING WHAT THE MOOD WILL BE LIKE.

Mary says SO DO THEY ACTUALLY KNOW THEIR OVER... THEY'RE OUT OF CONTROL? DO THEY KNOW THEY'RE GOING THROUGH THIS ROLLER COASTER?

Shelley says YOU I THINK DEFINITELY MANY INDIVIDUALS WOULD SAY THAT THEY'RE VERY AWARE OF FEELING THAT THEIR LIVES ARE EXTREMELY PAINFUL. AND THEY'RE IN A LOT OF DISTRESS BECAUSE OF THAT. ACTUALLY, THERE WAS A STUDY DONE BY A PROMINENT RESEARCHER IN THE AREA OF BORDERLINE DISORDERS AND SHE INTERVIEWED P.M. PEOPLE WITH THIS DISORDER. THEY OFTEN DESCRIBED THEMSELVES AS FEELING IN STATES OF YOU CAN RAGE. FEELING THAT THEY'RE INCREDIBLY, UM, OVERCOME BY FEELINGS OF GRIEF. OFTEN FEELING THAT THEY'RE VERY BAD. THAT THERE'S SOMETHING HORRIBLE ABOUT THEM AND THAT NOBODY WANTS TO BE AROUND THEM. SO YOU I THINK THAT THE EXPERIENCE FOR THE INDIVIDUAL IS OFTEN BEING OVER CAN COME BY THE TREMENDOUS SENSE OF SELF...

David says YOU I THINK IT'S IMPORTANT TO AM EMPHASIZE THAT THERE'S A WHOLE RANGE OF BEHAVIORS THAT PEOPLE WITH ABOUT PERSONALITY BORDERLINE DISORDER EXPERIENCE THAT CAN BE CAN BE RISKY FOR OTHERS ARE OR THEMSELVES. THIS COULD BE RECURRENT SUICIDE ATTEMPT.

Mary says IT'S VERY HIGH, ISN'T IT?

David says VERY HIGH. AND ALSO BEYOND SUICIDE ATTEMPTS, SELF HARM, NOT TO CAN KILL ONE'S SELF BUT FOR A WHOLE VARIETY OF EITHER SOOTHING OR DISTRESS RELIEVING PURPOSES. AND SOMETIMES YOU'LL MEET PEOPLE WHO HAVE BORDERLINE PERSONALITY DISORDER WHO WILL TALK ABOUT, FOR INSTANCE, CUTTING THEMSELVES REPEATEDLY. THEY'LL DESCRIBE HOW IT TEERT HELPS THEM TUNE OUT FROM A PROBLEM OR IT... IF THEY'RE WILLING FEELING UNREAL, AND THEY SOMETIMES DO IT IT, DO HAVE A BIT OF A TENT DID I HAVE GRIP ON REALITY, IT... THEY HAVE A TENTATIVE GRIP ON REALITY, IT... IT TREE MIND THEM THAT THEY'RE REAL TO SEE BLOOD AND FEEL ABOUT PAIN A THAT THESE HELP THEM RECORRECT AND... RECONNECT AND RE-INTERGRATE. THAT ROLLER COASTER IS, INED DEED A ROLLER COASTER. WHILE THEY MAY BE AWARE OF IT. THEY EXPERIENCE THE ROLLER COASTER, THEIR PROBLEM IS THEY DON'T HAVE THEIR HANDS ON THE BRAKE AND THEY CAN'T ANTICIPATE THE DIPS. AND THE RISES OF THE SO PART OF THE WORK THAT... THAT PEOPLE LIKE SHELLY DO, ARE TO GIVE AM THEM THE TOOLS TO... TO TRY TO ANTICIPATE OF THE TO LEARN WHAT THOSE TRIGGERS ARE OF THE TO FIND ALTERNATIVE METHODS OF COPING. THAT ARE, THAT ARE NOT AS MAL-ACAPTIVE MUCH BECAUSE THAT'S WHAT REALLY PERSONALITY DISORDER IS. IT'S A SERIES OF MAL-ACAPTIVE WAYS OF COPING WITH THE WORLD.

Mary says YOU I READ, IT WAS IN ONE BOOK ON PERSONALITY DISORDERS THAT... THAT THESE, THIS IS AN EXAGGERATION OF NORMAL PERSONALITY TRAITS. IS THAT CORRECT? TO SAY THAT?

David says AN EXAGGERATION...

Shelley says YOU I THINK IT'S ABSOLUTELY ACCURATE OF THE THAT... I THINK MANY TRAITS THAT YOU WOULD SEE IN NORMAL INDIVIDUALS OF THE. I THINK REALLY WHAT WE'RE TALKING ABOUT IS A CONTINUUM. WHERE YOU SEE A RANGE IN SEVERITY. AND YOU SEE A RANGE IN TERMS OF THOSE PEOPLE THAT WOULD MEET YOU CRY TIER... CRITERIA FOR PERSONALITY DISORDER. YOU HAVE SOME FUNCTIONING, THEY HAVE GOOD JOBS AND GOOD FAMILIES AND GOOD RELATIONSHIPS. AND, AND I WOULD SAY GOOD RELATIONSHIPS, ALTHOUGH, UM, ALTHOUGH OFTEN UM TIMES, MAYBE EXPERIENCED AS INCREDIBLY ECCENTR A C, A LITTLE DIFFICULT TO GET ALONG WITH. THEY MAY MEET CRITERIA FOR ABOUT PERSONALITY DISORDER. AT THE OTHER END OF THE CONTINUUM, YOU MAY HAVE PEOPLE WHO HAVE TREMENDOUS DIFFICULTY FUNCTIONING IN ANY NORMAL SITUATIONS IN LIFE. WHO ARE... HAVE TREMENDOUS DIFFICULTY HOLDING DOWNING A JOB. OR MAINTAINING A RELATIONSHIP.

Mary says IS THAT THE SEPARATION BETWEEN SOMEONE WHO MIGHT BE CONSIDERED DIFFICULTY AND SOMEBODY WHO IS REALLY STRUGGLING WITH DAY-TO-DAY LIFE? BECAUSE WE KNOW DIFFICULT PEOPLE.

Shelley says WELL, I THINK THAT... TYPICALLY, A PERSONALITY DISORDER REFERS TO SOMEBODY WHO'S QUITE EXTREME IN EVERY... IN THEIR BEHAVIOUR. ALTHOUGH EVEN WITHIN IT HAS BEEN, UM, WITHIN THAT... THIS DIAGNOSIS, WHEN YOU TALK ABOUT PERSONALITY DISORDER, YOU TALK ABOUT A RANGE OF SEVERITY ALSO.

Mary says I CAN SEE, IT'S SUCH A JUDGMENT CALL, RIGHT? BECAUSE MAYBE YOU GO AND SEE ONE PSYCHIATRIST AND THEY COULD SAY, THERE'S NOT REALLY A PROBLEM HERE. ANOTHER PSYCHIATRIST COULD SAY, YES, THIS PERSON HAS THIS TYPE OF PERSONALITY DISORDER.

David says ANOTHER PROBLEM, WE TALKED ABOUT PERSONALITY DISORDER AS BEING AN .EN DURING PATTERN OF BEHAVIOUR OF THE THAT GOES OVER REALLY MANY MANY YEARS. STARTS IN ADOLESCENCE, AND MOST EVIDENCE IS THAT THE PERSONALITY IS QUITE STABLE BETWEEN THE AGES OF 18 AND 60. ALL RIGHT? SO... SO THAT, UM SO, THAT THE PROBLEM WHEN YOU'RE DOING A SINGLE ASSESSMENT IS THAT YOU'RE COMING IN AT A 90-DEGREE ANGLE. TO THE TRAJECTORY OF SOMEBODY'S LIFE WHEN YOU MAKE JUDGMENTS ABOUT NOT HOW SOMEBODY HAS BEEN FUNCTIONING FOR THE LAST TWO WEEKS BUT INDEED HOW THEY'VE BEEN FUNGING OVER A NUMBER OF YEARS, IT'S A, A GREATER CHALLENGE AND B, IS MORE DEPENDENT ON THE INFORMATION FROM OTHERS. PEOPLE WHO HAVE BEEN IN THE CONTEXT OF THAT PERSON. BECAUSE THERE'S SOME PEOPLE WITH PERSONALITY DISORDERS THAT WOULD YOU SAY TO YOU, THERE'S NO PROBLEM. UM I'M NOT... I DON'T NEED HELP. I DON'T WANT ANY HELP AND IT'S ALL THE PEOPLE AROUND THEM WHO SAY, THAT PERSON NEEDS HELP.

Mary says YES. I FIND THAT THE MOST, WELL IT, MUST BE THE MOST FRUSTRATING AND MOST INTRIGUING. BECAUSE FOR THOSE PEOPLE, FIRST OF ALL, I DON'T EVEN KNOW HOW YOU GET IN TO SEE HELP F THEY DON'T THINK THEY HAVE A PROBLEM, WHY WOULD THEY COME IN TO SEE YOU, RIGHT?

Shelley says SOME INDIVIDUALS DON'T. AND I THINK THAT WE DON'T REALLY HAVE A GOOD IDEA OF WHAT THE RATE OF PERSONALITY DISORDER IS IN THE GENERAL . PUBLIC IN THAT MANY PEOPLE DON'T PRESENT TO TREATMENT. UM, HOWEVER, MANY PEOPLE ARE EXPERIENCING A LOT OF SUFFERING. HAD WILL PRESENT TO TREATMENT. AND OFTEN TIMES, UNFORTUNATELY, THERE ARE A LOT OF OBSTACLES TO GETTING ACCESS TO TREATMENT. THERE'S A LOT OF STIGMA ASSOCIATED WITH HAVING A ABOUT PERSONALITY DISORDER. UM, AND SOME OF THE OTHER OBSTACLES ARE THAT THERE IS A LACK OF SPECIALIZED TREATMENT PROGRAMS FOR THESE INDIVIDUALS. SO IT'S OFTEN DIFFICULT TO GET TREATMENT, EVEN WHEN YOU THINK THAT YOU NEED THE HELP.

David says THAT BEING SAID, THOUGH, ABOUT P.M. PEOPLE WITH BORDERLINE PERSONALITY DISORDER ARE IN THE... NEED HAD HELP SEEKING. MUCH IN THIS TERMS OF THE HEALTH SYSTEM: WHETHER IT'S, IT'S PEOPLE IN THEIR OFFICES OR EMERGENCY ROOMS, OR HOSPITALS. THERE IS A FAIRLY STEADY TRAFFIC OF PEOPLE WITH THOSE KINDS OF DISORDERS. NOW, WE SEE OTHER PEOPLE WITH, WITH, FOR INSTANCE, N OF ARCIS Z TIC PERSONALITY DISORDERS WHO MAY PRESENT MUCH LATER IN LIFE WHEN THINGS START TO CRUMBLE. WHETHER IT'S THEIR LOOKS OR, OR THEIR SUCCESSES, UM, START TO, UM, START TO FALL APART. THEN THEY MAY, THEY'RE VERY FRAGILE SENSE OF SELF THAT'S BEEN BOLSTERED BY EXTERNAL FEEDBACK, IT MAY START TO FEEL MUCH MORE VULNERABLE AND AT THAT POINT, PEOPLE MAY THEN COME IN AND SEEK TREATMENT.

Mary says IT'S A PASS NAIGT TOPIC MUCH LEACHTS REMIND OUR VIEWERS, IN CASE YOU'RE JUST YOU TUNING IN TODAY, WE'RE TALKING ABOUT PERSONALITY DISORDERS. THERE'S TEN DIFFERENT KINDS OF PERSONALITY DISORDERS. MUCH WE'RE TALKING ABOUT THEM AND ABOUT RESEARCH AND TREATMENT. IF YOU HAVE ANY QUESTIONS AT ALL, OR PERHAPS SOMEONE YOU KNOW IS SUFFERING FROM A PERSONALITY DISORDER, GIVES US A CALL TODAY OR SEND US AN E-MAIL...

The phone numbers and email reappear briefly.

Mary says WE HAVE CARA ONLINE FROM ARE TORONTO. HI. GO AHEAD.

The caller says I HAD A QUESTION ABOUT THE ETHCITCY OF OMEGA-3 FATTY ACIDS IN PERSONALITY DISORDER OR BIPOLAR. MY FIANCE WENT THROUGH MANY MONTH OF PSYCHIATRIC... THEY ORIGINALLY SAID HE'S BORDERLINE AND THE PSYCHIATRIST BELIEVES HE'S BIPOLAR. AND I UNDERSTAND THAT OMEGA-3 HAS SOME... SOME HELP WITH BOTH DISORDERS. IT SOUND LIKE IT DO A POSSIBLE ADDITION TO TREATMENT.

David says WELL, MAYBE I... FIRST, ILLUSTRATE TO... I WANT TO ELIMINATE A FALSE SEPARATION BETWEEN HAVING A PERSONALITY DISORDER AND HAVING ANOTHER PSYCHIATRIC DIAGNOSIS. PEOPLE THINK THAT, WELL, EITHER I HAVE A PERSONALITY DISORDER OR I HAVE DEPRESSION OR I HAVE MANIC DEPRESSIVE ILLNESS OR I HAVE SOME ANXIETY DISORDER PROBLEM OF THE THAT'S NOT THE CASE. SO THAT WE KNOW THAT MANY PEOPLE WHO PRESENT WITH A CLASSICAL DEPRESSION, FOR INSTANCE, OR MANIC DEPRESSIVE ILLNESS OR BIPOLAR DISORDER CAN ALSO HAVE A PERFECT SOFRNALITY DISORDER. IT IS A... ALSO HAVE A PERSONALITY DISORDER. IT IS...

Mary says IS IT ADMONISH?

David says IT'S QUITE COMMON. AT TIMES, IT'S DIFFICULT, PARTICULARLY AS I SAID WHEN YOU COME IN AT THAT 90-DEGREE ANGLE TO TRY AND FIGURE OUT WHICH SYMPTOMS REFLECT LONG-TERM PATTERNS OF FUNCTION I GO. WHICH... WHEN WE GET DEPRESSED, IT BRINGS OUT THE WORSE IN US, RIGHT? IN TERM OF OUR BE JAVIER WITH OTHER PEOPLE. FLIP SO IT'S A REAL CHALLENGE TO TEASE APART THOSE ELEMENTS WHICH REFLECT, UM, A DISCRETE EPISODE OF ILLNESS. LIKE MANIC DEPRESSIVE ILLNESS OR DEPRESSION AND THOSE WHICH REFLECT MORE LONG-TERM FUNCTIONING, LIKE BORDERLINE PERSONALITY DISORDER SO THAT'S THE FIRST POINT I WANTED TO MAKE. REGARDING THE OMEGA-3 FATTY ACIDS. THIS... THIS DID ATTRACT SOME YOU ATTENTION SEVERAL YEARS AGO AS A POSSIBLE TREATMENT FOR MANIC DEPRESSIVE ILLNESS. MUCH I DON'T THINK IT REALLY HAS REACHED THE STAGE IN TERMS OF SCIENTIFIC EVIDENCE THAT... TOED ADVOCATE, UM, FOR ITS REGULAR USE. FOR ITS USE ON ITS OWN. AS A TREATMENT. FOR MAJOR PSYCHIATRIC ILLNESS. IT'S STILL VERY MUCH UNDER INVESTIGATION. BUT I WOULD SAY THAT IT'S, IT TWO NOT BE IN THE MAINSTREAM OF TREATMENTS, CERTAINLY WOULDN'T BE APPROVED BY HEALTH CANADA RIGHT NOW. AS A TREATMENT. FOR MANIC DEPRESSIVE ILLNESS.

Mary says OKAY. WHAT ABOUT FOR BORDERLINE?

Shelley says NO, I WOULD ADD TO THAT. I THINK IT'S CERTAIN AN AREA OF INTEREST RIGHT NOW. IN FACT, I WAS JUST AT A MEETING WHERE THEY DID A WHOLE PRESENTATION ON OMEGA-3 FATTY ACIDS. THE NATIONAL INSTITUTE OF MENTAL HEALTH IN THE U.S. THERE'S CERTAINLY INTEREST IN LOOKING AT THE RELATIONSHIP BETWEEN OMEGA-3 FATTY ACIDS AND IMPULSIVE BEHAVIOUR. MUCH MORE RESEARCH IS NEED TODAY UNDERSTAND THE LINK BETWEEN THE TWO. BUT IT'S APPEAR AREA THAT... THAT HOLDS PROMISE AND IF ANYTHING, IT DO AN ADJUNCT TO OTHER TREATMENTS. BAUCHS OFTEN TIMES, MULT TELL TREATMENTS I THINK ARE... MULTIPLE TREATMENT ARE NECESSARY.

Mary says IS THERE ANYTHING TO SUGGEST THAT YOU SHOULDN'T BE TAKING SUPPLEMENTS? IS THERE ANY HARM AT THIS POINT?

Shelley says I DON'T KNOW ENOUGH ABOUT IT TO SUGGEST THAT THERE MAY BE HARM TO IT. BUT I THINK THAT PLOBLLY WHAT'S CRITICAL HERE IS JUST THAT, UM, THAT I THINK THAT HAVING SOME BALANCE, HAVING BALANCE IN ONE'S DIET IS GOING TO BE CRITICAL TO REGULATING YOUR MOOD STATE.

Mary says NOW, THIS WHOLE GROUP THAT YOU SPECIALIZE IN, THE BORED ER LINE PERSONALITY DISORDER, UM, WITH THE MEDIA, WE OFTEN HERE SENSATIONAL STORIES ABOUT PEOPLE WHO HAVE THIS ILLNESS. AND THERE IS A PERCEPTION OF HARM OR VIOLENCE, PERHAPS. ASSOCIATED WITH THE DISORDER. CAN YOU, CAN YOU SHED SOME LIGHT ON THAT.

Shelley says IN MANY WAYS, I'M HAPPY THAT THERE'S BEEN A LOT OF YOU ATTENTION IN THE NEED... MEDIA OF THE TOPIC OF BORDERLINE PERFECTSONALITY DISORDER. IT'S AN AREA THAT'S BEEN NEGLECTED IN THE FIELD. I THINK IT'S IMPORTANT THAT THIS ISSUE IS BEING BROUGHT TO THE ATTENTION OF THE PUBLIC. I THINK IT'S IMPORTANT TO CAN KEEP IN MIND THAT SOME OF THE IMAGES, UM, THAT WE READ ABOUT IN THE PAPERS, ABOUT THESE INDIVIDUALS, ARE REALLY EXTREME FORM OF BEHAVIOUR. AND THEY'RE NOT TYPICAL OF ALL PEOPLE WHO MEET CRITERIA FOR BORDERLINE PERSONALITY DISORDER.

Mary says OKAY. BECAUSE THERE'S EVEN ONE ARTICLE, WELL, YOU... YOU WERE FEATURED IN IT MUCH IT WAS A PATIENT GOING TO THROW A CHAIR AT YOU.

Shelley says AGAIN, I MEAN, THESE ARE REALLY EXTREME FORMS OF BEHAVIOUR. IN FACT, MORE OFTEN THAN NOT, PEOPLE WITH BORDERLINE PERSONALITY DISTORTED, THEY HAVE DIFFICULTY EXPRESSING THEIR ANGER. THAT'S MORE OFTEN WHAT WOULD I WOULD SEE IN OUR CLINICAL SETTING.

David says RIGHT. UNFORTUNATELY, I THINK THE C CINEMATIC IMPRINT MOST PEOPLE HAVE IS FROM "FATAL ATTRACTION." YOU KNOW, YOU I THINK THAT SHELLY WOULD AGREE WITH ME THAT... THAT THE VAST, VAST, VAST MAJORITY OF OUR PATIENTS WHO STRUGGLE, AND I UNDER LINE STRUGGLE, UM, WITH PERSONALITY DISORDER ARE NOT BOILING HOUSEHOLD PETS OR, OR WHATEVER ELSE... WHATEVER HAPPENED IN THAT MOVIE OF OF THE.

Mary says WELL, YOU KNOW, THE OTHER THING THAT, UM, THAT THERE WAS... AND I DON'T KNOW IF THIS IS TRUE, BUT YOU HEAR THAT THEY ARE VERY DIFFICULT TO TREAT. AND THAT EVEN SOME PSYCHIATRISTS HESITATE TO TAKE THEM ON ABSENCE PATIENTS. WHY DID YOU DECIDE TO SPECIALIZE IN THIS GROUP?

Shelley says THAT'S A GOOD QUESTION OF THE UM, YOU KNOW, I... IT'S TRUE. THERE IS A LOT OF STIGMA ASSOCIATED WITH BORDERLINE PERSONALITY DISORDER. IN FACT, IT'S PROBABLY THE MOST STIGMA ADVERTISED... STTGMATIZED DISORDER. THEY'RE KNOWN AS MANIPULATIVE AND OTHER THINGS IN THE MEDIA. THERE'S BAD ADJECTIVE INSIDE THIS DISORDER. NOT... THINGS THAT DON'T HELP US FEEL COMPASSIONATE TOWARDS THESE FOLKS. REALLY WHAT HAPPENED, I THINK PART OF THE REASON FOR THAT IS THAT IT'S OFTEN VERY DIFFICULT TO WORK WITH SOMEBODY WHO IS ENGAGING IN HIGHER-RISK BEHAVIORS, SUCH AS SUICIDAL BEHAVIORS. IT'S STRESSFUL FOR CLIN IGSS. PROBABLY ONE OF THE MOST STRESSFUL THINGS TO WORK WITH AS A CLIN IGS.

Mary says WHAT IS THE SUICIDE RATE?

Shelley says IT'S UPWARDS OF 10 percent. WHICH IS EXTREMELY HIGH. AND WE KNOW THAT 75 percent OF PEOPLE WHO MEET THE CAN CRITERIA FOR BORDERLINE PERSONALITY DISORDER HAVE ATTEMPTED SUICIDE IN THEIR LIFE.

Mary says 75 percent.

Shelley says IT'S A VERY HIGH NUMBER STRESSFUL. CLIN IGSS HAVE BEEN OPERATING WITHOUT... CLINGSS HAVE BEEN OPERATING WITHOUT EFFECTIVE AND GOOD TREATMENTS. MUCH SO I THINK THE RESULT IS THAT MANY CLINICIANS FEEL HELPLESS WITH THEIR INABILITY TO HELP. THAT'S WUFT WORTH THINGS THAT A C LINITION WOULD FEEL. TO SEE SOMEBODY ENGAGE IN HIGH-RISK BEHAVIORS AND BE UNABLE TO TO HELP THEM. I THINK THAT WHAT HAPPENED MORE RECENTLY IS WE HAVE SOME GOOD DATA THAT SUGGESTS TREATMENT CAN BE HELPFUL. MUCH BUT CLINITIONS, MUCH THEM, ARE STILL NOT AWARE THAT HAVE LITERATURE. WE'RE HOPING TO EDUCATE C-OF-C... EDUCATE CLINICIANS SO THE VIEW OF BORDERLINE PERSONALITY DISORDER CAN CHANGE. AND THAT PEOPLE FEEL MORE OPTIMISTIC.

David says YOU ASKED SHELLY WHY SHE CHOSE TO WORK WITH PEOPLE IN THIS...

Mary says I DON'T KNOW IF YOU ANSWERED MY QUESTION.

David says SHE REALLY DODGED IT.

Mary says ARE YOU GOING TO ANSWER IT OR WHAT?

Shelley says YOU I LIKE WORKING IN THIS... I FIND IT INCREDIBLY REWARDING.

Mary says YOU'RE A GIRL LIKE THAT WILL... THAT LIKES CHALLENGES.

David says YOU HAVE TO BEAR IN MIND THAT FOR SHELLY'S PATIENTS ANDL SHELLY'S CLIENT, THE FACT THAT THEY'RE... THAT THEY'RE WITH SOMEBODY WHO DOES ENJOY WORKING WITH THESE INDIVIDUALS AND DOES FEEL THAT THERE'S HOPE, THOSE... THAT THERE'S HOPE, THOSE ARE IMPORTANT MESS ANGLES FOR ANYBODY ON THE RECEIVING END OF MENTAL HEALTH SERVICES. THAT THEY FEEL VALUED BY THE PERSON WHO IS TREATING THEM. AND THAT THEY FEEL THAT THERE IS HOPE MUCH MUCH FOR FEELING BETTER. AND NOT ONLY THAT, AS A SCIENTIST, SHELLY IS... HAS BEEN FUNDED BY THE FEDERAL GOVERNMENT TO DO RESEARCH ON SHOWING THE BENEFITS OF THIS PARTICULAR TREATMENT.

Mary says YES.

says THE BEHAVIOUR THERAPY GIVES ALL OF US, IN THE COMMUNITY, HOPE THAT... THAT WE'LL FIND NEW TREATMENTS TO... TO, UM TO, REDUCE THE SUFFERING OF PEOPLE WITH THIS DISORDER.

Mary says LET'S GO TO AN E-MAIL NOW...

Text on screen reads "What's the prevalence of addiction in persons suffering from borderline personality disorder? Also, how many people with borderline personality disorder have been sexually abused? Joan."

Mary says SO LET'S TACKLE THE FIRST ONE ABOUT YOU ADDICTION.

Shelley says WELL, THE RATE OF SUBSTANCE ABUSE PROBLEMS WITH BORDERLINE PERSONALITY DISORDER IS VERY HIGH. UPWARDS OF 60-70 percent OF PEOPLE WHO MEET CRITERIA FOR BORDERLINE PERSONALITY DISORDER WILL HAVE A SUBSTANCE ABUSE PROBLEM OR WILL HAVE HAD A SUBSTANCE ABUSE PROBLEM AT SOMETIME. IN TERMS OF THE RATES OF SEXUAL ABUSE AND HISTORY OF PEOPLE WITH BORDERLINE PERSONALITY DISORDER, THAT'S ALSO EXTREMELY HIGH. WE KNOW THAT UPWARDS OF 70 percent OF PEOPLE WHO MEET CRITERIA FOR THIS DIAGNOSIS REPORT A HISTORY OF SEXUAL ABUSE. OF THE SO, UM SO, THERE'S VERY HIGH RATES FOR BOTH OF THOSE ISSUES.

Mary says WHAT ABOUT... ARE THERE ANY GENDER ISSUES HERE WITH BORDERLINE PERSONALITY DISORDER?

Shelley says THERE'S A MUCH HIGHER RATE OF DIAGNOSIS OF BORDERLINE PERSONALITY DISORDER IN WOMEN, 75 percent OF PEOPLE WHO MEET CRITERIA FOR BORDERLINE PERSONALITY DISORDER ARE WOMEN. WE DON'T REALLY KNOW WHY THAT'S TRUE. ALTHOUGH I THINK THERE'S A NUMBER OF REASONS TO ACCOUNT FOR THAT. I THINK ONE OF THE REASONS IS THAT WOMEN ARE MORE LIKELY TO EXPERIENCE, UM, FORMS OF INVALIDATION IN THEIR LIFE. THERE'S HIGHER RATES OF SEXUAL ABUSE FOR WOMEN. WOMEN, UM, RECEIVE MORE CONFLICTINGING MESSAGES IN SOCIETY. AND, UM, AND... AND MORE MESSAGES THAT... THAT, UM, THAT CONVEY THAT THEIR OPINIONS AREN'T WORTH TAKING SERIOUSLY. AND I THINK THAT THESE THINGS CAN CONTRIBUTE TO... TO, UM, TO THE DEVELOPMENT OF A PERSONALITY DISORDER. WE ALSO KNOW THAT MEN ARE LESS LIKELY TO SEEK HAD HELP FOR PSYCHIATRIC PROBLEMS. UM, AND... AND AS WELL, WE KNOW THAT CLINITIANS HAVE A BIAS TOWARDS DIAGNOSING BORDERLINE PERSONALITY DISORDER IN WOMEN. THEY'VE... WHERE THEY'VE GIVEN... THEY HAVE STUDIES WHERE THEY FIND THAT CLINITIAN ARE ARE FAR MORE LIKELY TO DIAGNOSIS BORDERLINE ABOUT PERSONALITY, IN THE CASES WHERE A WOMAN IS...

David says WHERE THE PERSON IS IDENTIFIED AS A WOMAN AND MORE LIKELY TO GIVE ANTI SOCIAL DISORDER WHERE THE IDENTIFIED PERSON IS A MALE.

Mary says SO... SO THERE'S A HIGHER RATE OF MEN WHO HAVE ANTI SOCIAL PERSONALITY DISORDER.

David says ABSOLUTELY. IT'S ALMOST A MIRROR IMAGE.

Mary says HMM.

David says AND THEY EXIST WITHIN THE SAME CLUSTER OF PERSONALITY DISORDERS. AND THE QUESTION OF WHETHER THESE SPECIFIC DISORDERS REALLY ARE PURER AND DISCRETE IS REALLY UP IN THE AIR. IF WE WERE TO BE GETTING TOGETHER TENORS FROM NOW, UM, TO TALK ABOUT THIS TOPIC AGAIN, UM, AS YOU I HOPE WE WILL, UM, WHAT WE WOULD FINDS IS PROBABLY A WHOLE DIFFERENT WAY OF CLASSIFYING PERSONALITY, NOT SO MUCH AS DISCRETE DISORDERS, BUT LOOKING AT TRAITS OF HUMAN BEHAVIOUR OF. THAT CUT ACROSS THESE VARIOUS DISORDERS. AND UNDERSTANDING TRAITS AND DIMENSIONS, OF HUMAN BEHAVIOUR, RATHER THAN THE SOMEWHAT ARTIFICIAL CATEGORIES.

Mary says RIGHT. NOW, BECAUSE PERSONALITY DISORDERS ARE A GROUP UNTO THEMSELVES, RIGHT? DOES THAT MEAN THAT TREATMENT FOR THIS GROUP GENERALLY DIFFERS FROM OTHER KINDS OF MENTAL DISORDERS? WHAT... WHAT IS TREATMENT INVOLVE?

David says WELL, TREATMENT CAN INVOLVE A VARIETY OF APPROACHES OF THE WHETHER IT'S INDIVIDUAL, PSYCHOLOGICAL TREATMENT, LIKE SHELLY HAS DESCRIBED. SOMETIMES GROUP PSYCHOLOGICAL TREATMENT. FOR AM PEOPLE WITH ABOUT PERFECTSONALITY DISORDERS. ALTHOUGH THE EVIDENCE BASED FOR IT STINT SPECTACULAR. YOU CAN'T SIT ON YOUR THUMBS WAITING FOR ALL THE EVIDENCE TO COMMUNICATE... TO ACCUMULATE WHEN YOU HAVE PEOPLE IN STRESS. YOU HAVE TO FIND A WAY TO HELP THEM MUCH THERE'S A SMALL HISTORY OF MEDICATIONS BEING USED TO HELP P.M. PEOPLE WITH PERSONALITY DISORDERS OF WHAT I WOULD DESCRIBE AS MODEST BENEFITS. THAT THEY MAY HELP SOMEBODY, FOR INSTANCE WITH A PERSONALITY... BORDERLINE PERSONALITY DISORDERS THAT THEY HAVE UNSTABLE MOODS. THERE MAY BE HELP IN THE MEDICATION TO HELP STABLEIZE THE MOODS. BUT THAT HAS BEEN CONSIDERED AGAINST THE LARGER CANVAS THAT HAVE INDIVIDUAL'S LIFE. AND SO THERE'S PROBABLY A NEED MORE MULTIPLE MODEL INTERVENTION.

Shelley says TO ADD TO WHAT YOU'RE SAYING, YOU I THINK THE OTHER THING TO CONSIDER IS JUST THE FACT THAT MANY OF THESE INDIVIDUALS WHO MEET CRITERIA FOR BORDERLINE PERSONALITY DISORDER OR ANTI SOCIAL PERSONALITY DISORDER OFTEN PRESENT WITH OTHER MENTAL HEALTH PROBLEM SO IT'S RARE THAT YOU'RE REALLY JUST TREATING A PERSONALITY DISORDER. YOU KNOW, TYPICALLY SOMEBODY WITH A BORDERLINE PERSONALITY DISORDER ALSO MEETS CRITERIA FOR FOUR OR FIVE MENTAL DISORDERS. LIKE POST TRAUMATIC STRESS DISORDER. MOOD DISORDERS. SUBSTANCE ABUSE DISORDERS. WHAT HAVE YOU, SO...

Mary says THE TREATMENT, THE TREATMENT THAT YOU'RE INVOLVED IN, THAT IS... THAT'S NON-MEDICATION. RIGHT?

Shelley says IT... THERE IS A BIAS TOWARDS TREATING PEOPLE ON AN OUT-PATIENT BASIS WITH THIS TREATMENT. UM, AND IT IS A PSYCHO THERAPEUTIC TREATMENT.

Mary says WHAT'S INVOLVED WITH IT?

Shelley says IT'S AN EXCITING TREATMENT. RELATIVELY NEW TREATMENT. THAT, UM, THAT HAS ONLY BEEN AROUND IN THE PAST 10 YEARS OR SO. IT'S A TREATMENT THAT WAS SPECIFICALLY DESIGNED WITH PEOPLE WITH BORDERLINE PERSONALITY DISORDER AND WHO HAVE PROBLEMS WILL BE CHRONIC SUICIDAL BEHAVIOUR OF. UM, THE TREATMENT... THE TREATMENT IS DEVELOPED BY A CYCLINGOLOGIST , WHO IS IN SEATTLE. AND REALLY WHAT... WHAT SHE DID IS SHE TOOK TRADITIONAL CO COGNITIVE BEHAVIOUR TREATMENT, WHICH IS A TREATMENT THAT FOCUSES ON HOW PEOPLE ANALYZE THEIR BEHAVIORS. HELPING THEM FIND NEW COPING STRATEGIES. REALLY A TREATMENT THAT FOCUSES ON AM PEOPLE HELPING MAKE CHANGES IN THEIR LIFE. IT ENTER GRATES THAT FOCUS ON CHANGE WITH A FOCUS ON ACCEPTANCE. SO WHAT WE'RE TRYING TO DO IS WE'RE TRYING TO BALANCE WITHIN A FRAMEWORK OF CHANGE, WE'RE ALSO TRYING TO HELP PEOPLE ACCEPT THE... THAT THINGS ARE EXACTLY AS THEY SHOULD BE. L REALLY IDEAS DERIVED FROM EASTERN PHILOSOPHY, WHERE, YOU KNOW, THE IDEA IS THAT THE ROOT OF SUFFERING IS ALL ABOUT JUST BEING ATTACHED TO THINGS AS THEY ARE. AND THAT IF YOU WANT ., YOU UM, TO MOVE SOMEBODY TOWARDS HEALTH, YOU HAVE TO FIRST BE ABLE TO ACCEPT THINGS AS THEY ARE. SO THAT THE DIALECTICAL ASPECT OF THE TREATMENT REALLY FINDING A BALANCE BETWEEN A FOCUS ON CHANGE AND THIS FOCUS ON ACCEPTANCE.

Mary says THAT'S VERY INTERESTING. YEAH. THERE'S... I CAN SEE BUDDHIST LEANINGS IN THERE. VERY MUCH. MUCH YEAH, AND YOU'RE RIGHT, IT'S BECAUSE, BECAUSE AT FIRST GLANCE, IT SEEMS CONTRADICTORY, DOESN'T IT? ACCEPTANCE AND CHANGE. BUT THAT'S WHAT YOU YOU'RE TRYING TO DO. THAT'S WHAT'S BEHIND IT ALL?

Shelley says EXACTLY. EXACTLY. SO... SO, YOU KNOW, IT'S A COMPREHENSIVE TREATMENT. UM, WE FOCUS ON TRYING TO TREAT AM PEOPLE ON AN OUT-PAURBT BASIS AND GIVE THEM SUPPORT ON AN OUT-PAURBT BASIS BECAUSE A HOT OF THESE INDIVIDUALS HAVE A LOT OF DIFFICULTY CONTINUING GOING INTO THE MENTAL HEALTH SYSTEM AND GO INTO EMERGENCY ROOM OR HOSPITALS.

Mary says DO YOU FIND IT'S SUCCESSFUL?

Shelley says THE GOOD NEWS IS THAT, THE REASON WE GOT INTO THIS APPROACH IS THAT THERE'S A LOT OF DATA THAT SHOWS THAT THE TREATMENT IS VERY HELPFUL IN TERM OF P.M. PEOPLE REDUCING THE FREQUENCY OF THEIR SELF HARM BEHAVIORS AND IN TERMS OF REDUCING THE NUMBER OF DAYS THAT THEY'RE SPENDING IN THE HOSPITAL. AND ALSO JUST HELPING THEM STAY IN THE TREATMENT. WHICH TENDS TO BE A BIG PROBLEM. BECAUSE A LOT OF THESE INDIVIDUALS DROPOUT.

David says RIGHT.

Mary says LET'S TAKE ANOTHER CALL HERE. JUDY IS ON THE LINE FROM SUDBURY OF THE HI.

The caller says HI.

Mary says HI.

The caller says THANK YOU FOR YOUR SHOW. MUCH I'M WONDERING IF, UM, HOW DOES A PERSON WORK WITH, UM, WORK WITH A BOSS, UM, WHO SEEMS TO BE EXHIBIT ING A LOT OF THESE, UM, BEHAVIORS? AND, UM, AND... AND SOMEHOW, YOU KNOW, YOU'RE DOING RIGHT. AND YOU'RE ALWAYS ACCUSED OF, UM, OF WHATEVER, UM, WHATEVER TEMPERAMENT IS ON HER AGENDA THAT DAY.

Mary says HMM. HOW WOULD YOU HANDLE THAT, DAVID? (LAUGHING) I THOUGHT I WOULD THROW IT OVER TO YOU.

David says I HAVE A DIFFICULT TV SHOW HOST TO DEAL WITH. UM, NO, THIS IS A REAL CHALLENGE. AND I THINK THAT... THAT THE CALLER HAS DESCRIBED SOMETHING THAT...

Mary says TOXIC BOSSES.

David says BUT THE CALLER HAS DESCRIBED SOMETHING THAT MANY, MANY FAMILY MILLIMETER MEMBERS AND FRIENDS OF SOMEBODY WHO HAVE A PERSONALITY... WHO HAS A PERSONALITY DISORDER WOULD ALSO RAISE A QUESTIONS. NOW, OBVIOUSLY, I CAN'T SAY MUCH ABOUT THIS BOSS, UM, AND HIS OR HER PROBLEM. BUT, BUT, UM, BUT THE THING IS THAT THESE ARE NOT PROBLEMS THAT TYPICALLY RESPOND TO, TO SOMEBODY SAYING, WHY DON'T YOU JUST DO THAT DIFFERENTLY? WHY DON'T YOU TRY AND BE NICE FOR A CAN CHANGE? WHY DON'T YOU GIVE ME A BREAK? BECAUSE IF THEY WERE THAT AMENABLE TO CHANGE, THEY WOULD BE GONE, RIGHT? P.M. PEOPLE WITH PERSONALITY DISORDERS MAY GET LOTS OF ABOUTL FEEDBACK FROM THEIR ENVIRONMENT. THAT THEY'RE, THAT THEY'RE MAKING THINGS DIFFICULT FOR OTHER PEOPLE. AND... AND THAT ALONE IS... IS, IS RARELY SUFFICIENT TO... TO, UM TORQUE TRIGGER A CAN CHANGE IN IT IT THE BEHAVIOUR.

Mary says THEY NEED SOMETHING MORE INTENSE.

David says YEAH. AND I THINK THEY... THEY SUFFER FOR IT AS WELL, BECAUSE PEOPLE END UP NOT LIKING THEM. BECAUSE THEY'RE DIFFICULT TO BE WITH.

Mary says RIGHT.

David says SO IN A WORK SITUATION, I THINK IT REALLY IS A CHALLENGE TO FIGURE OUT NOT ONLY WHAT THE DIFFICULTIES ARE, BUT WHAT THEIR STRENGTH ARE. AND WHAT ARE THE THINGS THAT, UM, THAT PROVIDE AVENUES FOR GETTING ALONG WITH SOMEBODY AT WORK? MAKING SURE THAT ALL OF YOUR EGGS AREN'T IN THE SINGLE BASKET. OF YOUR RELATIONSHIP WITH THAT PARTICULAR BOSS. ARE THERE CAN CO-WORKERS WHO WILL AT TIMES VALIDATE YOU? IN A SENSE, SAY, YOU KNOW WHAT? ARE YOU DOING A GOOD JOB. BECAUSE YOU MIGHT BE GETTING GRIEF FROM YOUR BOSS ALL THE TIME THAT YOU'RE DOING A TERRIBLE JOB. AND AFTER A WHILE, YOU MIGHT START EVEN TO BELIEVE IT. QUITE A APART FROM FEELING HURT THAT YOU'RE BEING CRITICIZED REPEATED ARELY OR FEELING LIKE YOU'RE, UM, YOU'RE A VICTIM, UM, OF ANGER THAT'S REALLY DISPLATESED FROM SOMETHING ELSE THAT HAS NOTHING TO DO WITH YOU. YET YOU GET TARGETED. SO THIS IS WHERE THEL ROLE OF COLLEAGUES AND CO-WORKERS CAN BE EXTREMELY HELPFUL. AND SUPPORTIVE.

Mary says IS IT THE CASE WITH PERSONALITY DISORDERS? THAT IT'S REALLY DIFFICULT TO, UM, TO GET ANY BETTER JUST ON YOUR OWN?

David says WELL, THAT'S NOT COMPLETELY THE CASE. WE, WE KNOW THAT PERSONALITY IS RELATIVELY STABLE OVER TIME. LET... LET'S PARK PERSONALITY DISORDERS AND JUST TALK ABOUT PERFECTSONALITY FOR A SECOND. WE KNOW IF YOU WALK INTO A NEWBORN NURSERY IN A HOSPITAL, AND ASK THE NURSES, TELL ME ABOUT THESE DAY OLD NEWBORNS, YOU'VE GOT HERE, THEY'LL TELL YOU ABOUT VERY DIFFERENT BEHAVIORS.

Mary says RIGHT.

David says THAT THOSE KIDS EXHIBIT. AT DAY ONE OF LIFE. SOME OF WHICH ARE PART OF THEIR TEMPERAMENT. THAT CORE THAT DEFINES WHO WE ARE. AND SOME OF THOSE FEATURES WILL BE STABLE OVER MANY, MANY YEARS MANY YEARS. THERE ARE NOW STUDIES THAT GO OUT OVER 30 YEARS, THAT FOLLOW KIDS FROM BIRTH TO AGE 30. AND FIND TREMENDOUS STABILITY OF TEMPERAMENT. SO... SO THERE ARE, UM, THERE ARE PERSONALITY FEATURES TO ALL OF US THAT ARE STABLE OVER TIME. AND THERE ARE PERSONALITY DIS DISORDER FEATURES THAT ARE ALSO STABLE OVER TIME. ONE OF THE AREAS, HOWEVER, THAT DOES SHOW EVIDENCE FOR CHANGE OVER TIME, JUST BY VIRTUE OF TIME, RELATES TO SHELLY'S AREA. IN A IS THE IMPULSIVE NATURE THAT WE SEE IN SOME PEOPLE WITH BORDERLINE PERSONALITY DISORDER. THAT TENDENCY TO ACT IN A VERY, VERY UNTHINKING, IMPULSIVE, SUDDEN WAY. THERE'S SOME EVIDENCE THAT... THAT BY THE... BY THE PEOPLE GET INTO THEIR 40'S AND 50'S, THAT THAT STARTS TO FLAME OUT. AND THAT, THAT IMPULSIVEITY ACTUALLY DIMINISHES OVER TIME.

Mary says REALLY? DOES THAT HAVE ANYTHING TO DO WITH HORMONES?

Shelley says AGAIN, WE'RE NOT REALLY SURE WHY THAT'S TRUE. UM, YOU KNOW, LITERATURE, THEY TALK ABOUT PEOPLE JUST BURNING OUT. UM, BUT I THINK THAT, YOU KNOW, THE GOOD NEWS IS, ACTUAL HAD YOULY THERE WAS A GREAT STUDY THAT JUST CAME OUT VERY RECENTLY LOOKING AT THE LONGITUDIAL COURSE WITH SOMEONE WITH PERSONALITY BORDERLINE DISORDER AND FOUND THAT OVER A SIX-YEAR PERIOD, THREE... 34 percent OF THE PEOPLE NO LONGER MET CAN CRITERIA FOR THE DIAGNOSIS AFTER SIX YEARS. AND THE AREA THAT CHANGED THE MOST WAS IN TERMS OF THEIR IMPULSIVE BEHAVIORS AND IT'S MOST LIKELY THAT WILL CHANGE. THE AREA THAT WAS LEAST LIKELY TO CHANGE WAS IN TERMS OF THE MOOD. SO THAT... THAT TENDS TO LAST A BIT LONGER.

David says AND THAT THE MOOD...

Mary says WHAT...

David says MOODS THAT FLUCTUATE VERY EASILY. THAT FLUCTUATION OF MOODS, WHICH CAN BE QUITE SUDDEN, WHICH COULD BE QUITE SEVERE, UM, CAUSES A LOT OF DISTRESS FOR THE PERSON.

Mary says LET'S TAKE A... TAKE A CALL HERE. FABIAN IS ON THE LINE FROM TORONTO.

The caller says HI. THANK YOU FOR BRINGING UP THE SUBJECT.

Mary says YES. GO AHEAD.

The caller says I WAS WONDERING, I HAVE A PROBLEM WITH MY FRIENDSS... I TEND TO BE NICE TO THEM MOST OF THE TIMES. AND THEY'LL THINK... AND THEY LIKE MY NICENESS AND EVERY TIME THAT I'M ALONE BUT BY ME SELF... MYSELF, I'LL BE... I'LL BE UNSET WITH ME. AND I'VE NEVER BEEN UPSET WITH THEM. AND AT THE SAME TIME, IT HAPPENS WHERE I'LL CUT THEM OFF WITHOUT EXPLANATION. IT'S NOT TO DO... NOTHING TO DO WITH...

Mary says HMM.

David says THAT'S A TOUGH CALL. THAT'S A TOUGH QUESTION. UM, I MEAN, I THINK THE FIRST STEP IS EXAMINING, IF YOU SAY YOU'RE ALWAYS BEING NICE, TO EVERYBODY AROUND YOU, AND THEN AFTERWARDS WHEN YOU'RE ON YOUR OWN, YOU'RE FEELING BADLY, UM, IT MAY BE THAT... THAT YOU'RE BEING NICE MORE THAN YOU ACTUALLY WANT TO BE. OR MORE THAN YOU SHOULD BE. UNDER CERTAIN CIRCUMSTANCES. YOU MIGHT BE SACRIFICEING YOURSELF IN ORDER TO TRY AND CONTINUOUSLY PLEASE OTHER . PEOPLE. AND THAT'S HARD WORK. AND, UM, AND ABOUT PEOPLE NOT UNCOMMONLY, UM, GET PRETTY ANGRY WHEN THEY TAKE A BREAK FROM BEING CONTINUOUSLY NICE TO EVERY SINGLEL PERSON AROUND THEM. CONTINUOUSLY TRYING TO KEEP EVERYBODY ELSE AROUND THEM HAPPY. MUCH I'M NOT SAYING IT'S A BAD THING TO BE NICE TO BE... TO OTHER PEOPLE. OBVIOUSLY. MUCH BUT PEOPLE CAN PUSH IT TO AN EXTREME. WHERE THEY ACTUALLY SACRIFICE THEIR OWN NEEDS.

Mary says RIGHT.

David says IN ORDER FOR JUST... TO JUST KEEP OTHERS HAPPY OF THE SO THAT...

Mary says IF IT WAS A QUESTION FOR HIM, FOR FABIAN, AS TO, AS TO, YOU KNOW, SHOULD I GO SEEK HELP? OR NOT?

David says RIGHT.

Mary says WHAT WOULD YOU SAY TO HIM?

David says WELL, MY OWN APPROACH IS THAT YOU SHOULDN'T SCRATCH WHERE IT DOESN'T ITCH. RIGHT? BUT, BUT CLEARLY THIS IS, THIS IS ITCHY FOR FABIAN AND IT'S BOTHERING HIM. IT'S BOTHERING HIM. WHEN HE'S ON HIS OWN, UM, THAT... THAT SOMETHING'S NOT RIGHT. FROM THE WAY HE'S INTERACTING WITH... WITH HIS, UM, WITH HIS FRIENDS AROUND HIM. AND... AND IT THIEVES HIM TO FEEL BAD ABOUT HIMSELF. WELL, THAT SOUNDS TO ME LIKE A REALLY GOOD REASON TO GO TO TALK TO SOMEBODY. OF THE IT MAY BE SOMETHING STRAIGHT FORWARD. AND IT MAY BE SOMETHING MORE COMPLICATED. IT'S IMPOSSIBLE FOR ME TO KNOW AND IT'S IMPOSSIBLE FOR FABIAN TO KNOW WITHOUT BOUNCEING IT OFF SOMEBODY IN MORE ABOUT DETAIL AND GETTING SOME FEEDBACK.

Mary says I'M WONDERING, DOES THE PERSONAL SENSE WHAT HAVE IS RIGHT AND WRONG HAVE A LOT TO DO WITH HOW SUCCESSFUL THE TREATMENT WILL BE?

David says I DON'T... I DON'T...

Mary says WHAT I MEAN BY THAT IS... UM I'M THINKING, I'M JUST TRYING TO GO... BUT A SOCIAL OWE PATH, RIGHT, YOU I MEAN, WILL ACT REGARDLESS OF HOW ARE OTHER AM PEOPLE FEEL ABOUT IT OF THE MUCH THEY DON'T CARE. THEY CAN BE VIOLENT. AND THEY COULD POSSIBLY MURDER AND CAN COMMIT CRIMES WITH A DISARD... DISREGARD FOR OTHER PEOPLE.

David says A LACK OF EMPATHY FOR OTHER PEOPLE AND A LACK OF REMORSE OVERDOING THINGS THAT ARE WRONG.

Mary says LIKE, THEY DON'T FEEL IT'S WRONG.

David says RIGHT.

Mary says AND THERE ARE OTHER PEOPLE, AS WELL, YOU KNOW, THEY MAY, MAY EXHIBIT ALL KINDS OF PROBLEMATIC BEHAVIOUR, RIGHT. THEY DON'T HAVE AN ISSUE WITH IT T THEY, IN FACT, MAY FEEL THEY'RE JUSTIFIED IN DOING THIS BEHAVIOUR. DOES THAT MAKE THEM HARDER TO TREAT BECAUSE THEY DON'T HAVE A SENSE OF THIS IS WRONG, THIS IS NOT GOOD BEHAVIOUR.

David says IT'S NOT JUST THAT THEY DON'T HAVE A SENSE THAT IT'S WRONG. THEY ALSO DON'T HAVE ANY DISTRESS ABOUT IT. IT'S HARD TO GET YOURSELF INTO TREATMENT...

Mary says THAT'S WHY YOU HAVE DISTRESS, BECAUSE YOU KNOW IT'S WRONG, THE BEHAVIOUR?

David says YEAH, BUT IF YOU'RE SAYING THAT HE DENT... THEY DON'T APPRECIATE THAT IT IS WRONG, RIGHT?

Mary says RIGHT.

David says AND THEY DON'T HAVE... DON'T HAVE YOU ANY DISTRESS ABOUT THE BEHAVIOUR... THEN YOU'VE GOT VERY LITTLE MOTIVATING... MOTIVATION TO BE IN TREATMENT.

Mary says RIGHT. RIGHT. I HAVE... I WAS THINKING YOU HAVE TO THINK IT'S... THINK IT'S WRONG IN ORDER TO BE DISTRESSED.

David says RIGHT OF THE AND THEIR DISTRESS LEVEL IS LOW, RIGHT?

Mary says RIGHT.

David says THIS IS NOT...

Mary says SO THAT...

David says ABOUT PEOPLE WITH ANTI SOCIAL PERSONALITY ARE RARELY TREATMENT SEEKING.

Mary says SO THEN, IN FACT, ARE THEY THE MOST... THEY MUST BE EXTREMELY DIFFICULTY TO TREAT, THEN, BECAUSE THEY DON'T ANYTHING'S WRONG...

Shelley says GENERALLY A HARDER GROUP TO TREAT. IT DOESN'T MEAN THAT THEY MAY NOT END UP IN TREATMENT. I MEAN, MANY OF THE INDIVIDUALS CAN COULD END UP COMING INTO CONTACT WITH HEALTH PROFESSIONALS BECAUSE THEY END UP IN... IN, UM, IN CORRECTIONAL SETTING. UM, OR BECAUSE THEY HAVE SUBSTANCE PROBLEMS OF THE AND THOSE PROBLEMS ARE, ARE GETTING IN THE WAY OF OTHER THINGS IN THEIR LIFE. SO THAT CAN COULD CERTAINLY LEAD THEM TO GETTING HELP. NOT NECESSARILY BECAUSE THEY'RE SEEKING IT OUT TO THE. BUT BECAUSE SOMEBODY IS UM IMPOSING THEM UPON IT.

Mary says WE'RE ALMOST OUT OF TIME. BUT ARE SOME PEOPLE JUST UNTREATABLE?

David says OF COURSE... THERE'S ALWAYS... FIRSTLY IT, DEPENDS WHAT YOUR GOAL OF TREATMENT IS. IF YOUR GOAL OF TREATMENT WITH SOMEBODY IS WITH A PERFECT SONALITY DISORDER IS TO MAKE THE BEST POSSIBLE... ABOUT PERSONALITY DISORDER IS TO MAKE THE BEST POSSIBLE ADAPTATION TO WHO THEY ARE, THEN MOST ABOUT PEOPLE ARE, INDEED, TREATABLE. IF THAT'S THE GOAL. IF YOUR GOAL IS TO TAKE SOMEBODY WITH PERSONALITY X AND TRY TO INVENT THEM AS PERSSON AMOUNT Y, MOST P.M. PEOPLE ARE... AS ABOUT PERSONALITY Y, MOST PEOPLE ARE UNTREATABLE. BUT GETTING MOST PEOPLE TO ADAPT TO WHO THEY ARE, THAT'S A GOOD...

Mary says IS THERE SOME IDEA OF HARM REDUCTION HERE AS WELL?

David says ABSOLUTELY.

Mary says BECAUSE I WAS THINKING WITH ADDICTION THACHT HARM REDUCTION MODEL. S THAT WHAT YOU'RE LOOKING AT?

David says ABSOLUTELY.

Mary says YEAH.

David says THE TREATMENT OF DIABETES IS HARM REDUCTION. AND NO MATTER HOW PERFECTLY YOU REGULATE SOMEBODY'S BLOOD SUGAR, WITH INSULIN, AND... AND MANAGE THEIR DIET, AT THE NHL... THEY STILL HAVE DIABETES. RIGHT? WHAT YOU HAVE DONE IS REDUCE THE... YOU HAVE NOT ELIMINATED THE ILLNESS, YOU REDUCED THE HARM ASSOCIATED WITH IT THRD OKAY OF THE MUCH WE'RE OUT OF TIME. THANK YOU. IT WAS IT IT WAS A HAS PLAYING... FASCINATING DISCUSSION.

Shelley says THANK YOU.

Mary says DAVID GOLDBLOOM IS A PSYCHIATRIST WITH THE CENTRE OF ADDICTION AND HEJT HEALTH MANY... MENTAL HEALTH IN TORONTO CAN AND WE ALSO A PSYCHOLOGIST IN WITH US OF THE WITH OTHER INFORMATION ON THIS AND OTHER MENTAL HEALTH ISSUES, CHECK OUT...

A slate reads "Centre for Addiction and Mental Health, www.camh.net."

Mary says ALL RIGHT. AND ON AUGUST 27TH OF LAST YEAR, PICKERING IN PERDITA FEL FELICIEN RAN INTO WORLD HEADLINES AND JUMPED NATIONAL HEARTS OF EVERY CANADIAN. SHE WON THE GOLD MEDAL IN THE 100-METER HURLEDS AT THE WORLD TRACK AND CHAMPIONSHIP IN PARIS MUCH SHE'S THE FIRST CAN CANADIAN WOMAN EVER TO WIN A MEDAL AT THIS EVENT AND I SPOKE TO HER EARLIER THIS SEASON.

Perdita is in her twenties, with chin-length straight brown hair. She's wearing a red sweater.

Mary says WE HAVE TO RELIVE E MOMENT, RIGHT? WHAT WAS GOING THROUGH YOUR MIND WHEN YOU... YOU THROUGH YOUR MIND WHEN YOU WON?

The caption changes to "Perdita Felicien. World Champion Hurdler."

Perdita says YOU KNOW, EVERY TIME I SEE THE TAPE NOW, I LOOK BACK, AND I WAS JUST? SHOCK. I WAS IN... I WAS IN AWE THAT I WON AND I PRIDED MYSELF ON BEING THE BEST IN COLLEGE. SO WAS THIS NCAA'S? NO, THIS WAS THE WORLD CHAMPIONSHIP THE BIGGEST FOR THE YEAR. SO MISSED A.

Mary says AND THEN WHAT ABOUT AFTER? WHY... YOU KNOW, AND THEN ALL THE ADULATION AND THE PRESS AND EVERYTHING.

Perdita says RIGHT.

Mary says WERE YOU... I KNOW IT'S HARD TO BE PREPARED FOR THAT.

Perdita says YOU KNOW WHAT? I DIDN'T KNOW WHAT I GOT MYSELF INTO. I DIDN'T KNOW. FOR THE FIRST SIX HOURS, I DID A LOT OF MEDIA. DRUG TESTING, ALL OF THOSE THING. I DIDN'T SEE MY COACH UNTIL PROBABLY I WOULD SAY A GOOD SIX HOURS AFTER THE RACE WAS OVER. THEN I GOT TO TALK TO MY FAMILY FOR A WHILE. BUT I REALLY DIDN'T UNDERSTAND WHAT I DID FOR THE FIRST TIME... FIRST I... I WOULD SAY TWO WEEKS. OF COURSE, ALL THE ATTENTION. I THINK IT'S NOW THAT I REALLY LACKED BACK AND UNDERSTOOD THE MAGNITUDE OF IT AND REALLY APPRECIATED IT.

Mary says NOW YOU SET A RECORD OF THAT...

Perdita says CANADIAN RECORD.

Mary says SO WHAT WAS IT?

Perdita says IT WAS 12.61. MY PERSONAL BEST WAS 12.67 AND I RAN 12.53. SO HUGE, HUGE PR. HUGE PERSONAL BEST.

Mary says AND THE OTHER THING... THERE ARE SO MANY FIRSTS, BUT YOU ARE ALSO THE YOUNGEST CONTENDER, RIGHT? TO EVER WIN A MEDAL AND YOU WERE 23...

Perdita says I WAS 22 AT THE TIME. TWO DAYS BEFORE MY 23RD BIRTHDAY.

Mary says SO WHAT'S THE AVERAGE AGE OF PEOPLE WHO WIN THE GOLD MEDAL AT THIS EVENT?

Perdita says YOU KNOW WHAT? IT'S ANYWHERE FROM PROBABLY 26 TO 29 IS THE PEAK AGE FOR THE EVENT. SO... SO...

Mary says 26 TO 29? OKAY, I DON'T KNOW ABOUT THESE... TO ME, THAT SOUNDS OLD.

Perdita says YEAH, IT IS. IT IS FOR THE SPORT. BUT THAT'S WHAT YOU... WHEN YOU MAKE... WHEN YOU MAKE THE PROGRESSIONS. PRETTY MUCH THE FIVE YEARS AT THE TOP IS ANYWHERE FROM 25-30. SO 22 IS JUST... IT JUST BLEW MY MIND AND EVERYBODY ELSE'S MIND AS WELL.

Mary says THAT'S GREAT. BECAUSE YOU ONLY HAVE UP TO GO.

Perdita says EXACTLY. AND I KEEP SAYING, I HAVE NO... BY MO MEANS REACHED MY GLASS CEILING. THERE IS A... THERE'S A LOT MORE I NEED TO WORK ON. SO IN A WAY I'M SCARED. BECAUSE HOW MUCH FAST ERIKA I... CAN I RUN? BECAUSE IT'S GREAT... BUT IT'S GREAT. BECAUSE I CAN PROBABLY RUN 12.4 IF I TRY AS WELL.

Mary says YOU'RE NOT A BIG PERSON. YOU CAME IN... I DON'T KNOW WHAT I WAS EXPECTING. AND YOU'RE 5,4."

Perdita says UH-HUH.

Mary says IS THAT TYPICAL OF RUNNERS? AS WELL?

Perdita says WELL, FOR HUDDLEERS, IT'S PRETTY MUCH BETTER TO BE SHORTER. THE TALLER THAT YOU ARE THE... THE MORE YOU HAVE TO WORK TO GET OVER THE HULING AREER BECAUSE YOU'RE ONLY ALLOWED TO TAKE THREE STRIDES IN BETWEEN. THE TALLER YOU ARE, THE HARDER IT IS TO MANEUVER.

Mary says RUNNERS, LET'S SAY...

Perdita says A 10 O METER SPRINTER.

Mary says THEY'RE TALLER.

Perdita says THEY COULD BE TALLER. IDEAL FOR THEM TO BE TALLER. THEY DON'T HAVE TO WORK AS HARD. BECAUSE A HUNDRED METER, HOW MANY STEPS YOU WANT TO. BUT IN THE HURDLES, YOU YOU CAN ONLY TAKE THREE AND THEN JUMP. THREE AND THEN JUMP THE HURLING HURLING. SO I HAVE THE PERFECT PHYSIQUE MY COACHES SAID FOR THE EVENT. WHICH IS NICE.

Mary says HURDLE HURDLES.

Perdita says NOT SOMETHING 2 YEARS OLD I WANT TO BE A HUDDLE JUMPER EYE STARTED IN TRACK AND I WAS ALWAYS A SPRINTER AND I DETESTED THE HURDLES. I WOULD GO TO THE MEETS AND BE SO EXCITE TODAY RUN THE 100 AND AVOID THE 100-METER HURDLES AND I DIDN'T WANT TO FALL ON MY FACE. BUT I WAS BETTER AT THE HURDLES THAN THE 100.

Mary says THAT CLINCHED IT?

Perdita says THAT SEALED THE DEAL. YOU KNOW? I WAS BETTER AT IT.

Mary says WHAT ABOUT... YOUR FAMILY? WERE THEY... WERE THEY ALWAYS BEHIND YOU. GREAT. KEEP UP THOSE HURDLES?

Perdita says YEAH, MY MOM AND MY SISTER ARE VERY SUPPORTIVE. MY OLDER SISTER AND MY MOM, CATHY. SHE'S JUST... I STOPPED RUNNING FOR TWO YEARS PROBABLY IN GRADE... GRADE 9 AND GRADE 10. AND I DIDN'T RESTART GETTING SERIOUS UNTIL GRADE 11. BUT THOSE TWO WHOLE YEARS, MY MOM NAGGED ME LITERALLY ALMOST EVERY DAY TO GET BACK INTO THE SPORT.

Mary says SHE NAGGED YOU. THIS IS GOOD TO HEAR. I NAG MY KIDS. DON'T DO THIS AND DO THAT. IT PAYS OFF, DOES IT?

Perdita says YEAH, THEY'LL APPRECIATE IT DOWN THE LINE. TRUST ME.

Mary says SO REALLY THEN THAT KEPT YOU SORT OF GOING.

Perdita says THAT KEPT ME... RIGHT, THAT KEPT IT IN THE BACK OF MY MINUTE. I WAS UNINTERESTED, BECAUSE, YOU KNOW IN HIGH SCHOOL YOU WANT TO DO YOUR OWN THINGS AND BE WITH YOUR FRIEND AND I WAS INTO SCHOOL AND MY MOM SAID HOW FAR CAN YOU IT GO, AND SEE WHERE IT CAN TAKE YOU AND MOM IT, PAID OFF.

Mary says WAS IT A LOT OF TRAINING?

Perdita says ABOUT IN MY SCHOOL, NOT A LOT OF TRAINING. I TRAINED MAYBE WON OR TWICE A WEEK. MY PEERS TRIP FIVE DAYS A WEEK AND I DIDN'T.

Mary says YOU HAD A GIFT FOR IT?

Perdita says AT THIS LEVEL, NOW IT TAKES THE MOTIVATION AND PSYCHOLOGICAL AS PECTL. IN HIGH SCHOOL WHEN EVERYBODY ELSE IS DABBLING IN IT, YOU IT DON'T NEED TO HAVE...

Mary says WHAT HAPPENS AT THIS LEVEL NOW? YOU'RE IN FULL SCHOLARSHIP AT THE UNIVERSITY OF ILLINOIS. WHAT KIND OF LIFE DO YOU LEAD? WHAT'S THE TRAINING LIKE NOW?

Perdita says VERY STRUCTURED AND STRINGENT. I HAVE TO WATCH THE DIET NOW. I HAVE TO WATCH THOSE THINGS.

Mary says YOU DO? YOU DIDN'T BEFORE?

Perdita says NO.

Mary says YOU WON THE GOLD MEDAL.

Perdita says BUT I'M THINKING... I NEED THE EDGE NOW. ATHENS IS NINE MONTHS AWAY. WHAT CAN GIVE ME THE EDGE?

Mary says IS THAT WHAT ATHLETES LOOK FOR? THE EDGE.

Perdita says THE EDGE. OH, YEAH. BECAUSE ON THIS LEVEL, MARY, EVERYBODY CAN BEAT THE OTHER PERSON ON ANY GIVEN DAY.

Mary says BECAUSE YOU'RE TALKING ABOUT...

Perdita says MILISECOND, SO YOU HAVE TO FIND THAT THING THAT GIVES YOU THE EDGE. IF MY LIFESTYLE ISN'T UP TO PAR WITH THE OTHERS, WHY AM I RUNNING AGAINST THEM? THEY CAN BEAT ME AND PSYCHOLOGICAL... SKILLS, TOO, AS WELL. BELIEVING THAT YOU CAN DO THINGS AND THE CONFIDENCE ALL COME INTO PLAY.

Mary says WHAT ABOUT THE NEGATIVE SIDE? PEOPLE WILL GO TO DESPERATE MEANS TO FIND THAT EDGE. DRUGS.

Perdita says EXACTLY. THEY WILL. AND I THINK THAT THOSE ARE THE PEOPLE THAT DON'T BELIEVE IN THEIR ABILITY. THAT... THAT DON'T BELIEVE IN THE DEDICATION. AND, OF COURSE, I KNEW, I KNOW WHAT IT TAKES NOW TO BE THE TOP. TO BE THE BEST IN THE WORLD. WHAT IT TAKES TO BEAT THE CANADIAN RECORD. I KNEW IT WAS NOTHING BUT HARD WORK AND DEDICATION, OF COURSE, THE GIFT. SO I DON'T HAVE TO RESORT TO THOSE MEAN AND I NEVER WILL. IT'S SOMETHING THAT I PRIDE MYSELF IN DOING THAT CLEANLY. SO...

Mary says WHAT DO YOU THINK AS FAR AS... DO WE STILL SUFFER FROM A BAD REPUTATION? WHAT DO YOU FIN BECAUSE OF...

Perdita says IT'S BEEN 15 YEARS. AND I THINK CANADIANS ARE STILL DEEPLY HURT BY THAT. AND NATURALLY SO. WE WERE SACRIFICED AND A LOT OF THE OTHER COUNTRIES WENT SCOTT FREE. BUT CANADA HAS THE STRICTEST DRUG TESTING SYSTEM, THE CANADIAN CENTRE FOR ETHICS IN SPORTS HAS ONE OF THE STRICTEST SYSTEMS IN THE ENTIRE WORLD... IN THE ENTIRE WORLD SO MANY YOU HAVE TO BELIEVE THAT OUR ATHLETES WHEN THEY'RE COMPETING ARE THERE BECAUSE THEY'RE CLEAN AND THEY, YOU KNOW, ARE HEALTHY. AND...

Mary says SO WHAT DOES THAT MEAN TO YOU, YOU THEN? DOES THAT MEAN THAT EVERY, EVERY EVENT, YOU'RE TESTED? AND... WHAT...

Perdita says YOU KNOW, THE TRUTH IS, YOU I DO GET TESTED A LOT. BUT THAT'S JUST HOW THE CANADIAN SYSTEM IS. THAT WE JUST, YOU KNOW, WE DON'T WANT TO HAVE THAT BLACK EYE ANYMORE. YOU KNOW? OF COURSE, PEOPLE STILL RATHER '88... REMEMBER '88 AND WE DON'T WANT THAT ANYMORE AND I'LL GET ON A PLANE SOMEWHERE AND WALKING SOMEWHERE AND PEOPLE WILL SAY, COME WITH ME AND IT'S VERY INVASIVE. BUT IF THAT'S WHAT I NEED TO DO TO PROVE, YOU KNOW, AND...

Mary says YOU'LL DO IT?

Perdita says I'LL DO IT.

Mary says YOU RECENTLY TURN PROFESSIONAL, RIGHT? WHAT DOES THAT MEAN?

Perdita says YEAH, IT'S A HARD DECISION. I KNOW GOING PRO. UM, I...

Mary says I'M NOT SURE EXACTLY WHAT THAT MEANS?

Perdita says YEAH, JUST BASICALLY BEFORE I... BEFORE I RAN ON THE COLLEGIATE SYSTEM, I WAS AN AMATEUR ATHLETE AND COULDN'T TAKE ANY MONEY OR ENDORSEMENTS AND I DIDN'T KNOW ANYTHING ABOUT THE COMMERCIAL SIDE OF SPORTS.

Mary says MEANING YOU WERE POOR.

Perdita says WFAILLY... BASICALLY. I WAS BROKE. WHICH MOST ATHLETES IN CANADA, SORRY, QUITE FRANKLY, YOU KNOW, WE'RE LIVING AT THE BOTTOM OF THE BARREL. BUT FOR HE ME,... FOR ME, NOW, I MADE THE DECISION BECAUSE ATHENS IS LOOM ING SO CLOSE ON THE HORIZON THAT I REALLY NEEDED TO PREPARE MYSELF AND TAKE IT TO THE NEXT LEVEL.

Mary says OKAY. SO YOU CAN BE PROFESSIONAL AND TAKE ENDORSEMENTS, IS THAT RIGHT? BUT STILL COMPETE AT THE OLYMPICS IN.

Perdita says YEAH, BECAUSE TRACK ISN'T ONE OF THE MAJOR SPORTS LIKE NFL OR NHL. AND IT'S ONE OF THE OLYMPIC... OLYMPIC SPORTS AND...

Mary says NOT ALL ATHLETES CAN TURN PROFESSIONAL?

Perdita says RIGHT I DON'T THINK THE NFL PLAYERS... THINGS LIKE IN A. I DON'T UNDERSTAND HOW IT WORKS.

Mary says WHAT IS HAPPENING? ARE WE GOING TO SEE YOUR FACE PLASTERED ON THE BILLBOARDS?

Perdita says ALL I CAN SAY NOW IS THAT I'M HAVING NEGOTIATIONS, YOU KNOW, AND A FEW THING ARE IN THE WORKS. YOU KNOW, AGAIN, HOPING THAT... THAT THIS GOLD MEDAL WILL OPEN UP A THE DO... A LOT OF DOORS FOR ME AND HOPEFULLY YOU'LL SEE ME ON A COMMERCIAL SOME DAY SOMEWHERE.

Mary says AND I... I HAVE TO ASK YOU YOU THE REALITY. YOU'RE ONLY 23 AT THIS POINT. HOWEVER, UM, ATHLETES GET INJURED. LIKE THAT, RIGHT? AND THEN THE WHOLE CAREER HAS DISAPPEARED BEFORE THEIR EYES. ALSO THE TIME FRAME IS SO SHORT. RIGHT? YOU'RE ONLY YOUNG FOR SO LONG. PLAN "B"?

Perdita says PLAN "B" IS... THAT'S WHY I'M GETTING MY DEGREE NOW AT THE UNIVERSITY OF ILLINOIS. IT WAS FUNNY. IT WAS REPORTED A FEW WEEKS THAT FELICIENE IS DROPPING OUT OF THE SCHOOL TO PREPARE FOR THE OLYMPICS. WHICH MY MOTHER WOULD NOT HAVE THAT. BUT I NEED A BACK-UP PLAN. YOU'RE ONLY A STEP AWAY FROM THE NEXT INJURY. THE... TIME LINE WHERE YOU CAN MAKE ALL OF THIS MONEY AND BE SUCCESSFUL IS... IS ONLY A FEW YEARS. YOU KNOW? FIVE TO EIGHT YEARS. IF YOU'RE BLESSED ENOUGH. AND SO I DO NEED TO HAVE THIS DEGREE IN CASE, YOU KNOW, SOMETHING HAPPENS.

Mary says WE ONLY HAVE ABOUT 30 SECONDS LEFT. BUT I LOVE THE STORY OF HOW YOU GOT YOUR NAME. QUICKLY TELL US HOW YOU GOT YOUR NAME.

Perdita says MY MOM IS A BIG FAN OF THE "PRICE AND RIGHT" AND SAW A CONTEST AN COME DOWN, AND HER NAME WAS PERDITA AND I... SHE SAW THE NAME AND SAID I'LL NAME MY DAUGHTER THIS. IS STILL A FAN NOW. AND STILL WATCHES "THE PRICE IS RIGHT."

Mary says I DIDN'T KNOW IT WAS ON.

Perdita says I HAVE TO TAKE HER A TRIP TO THAT SHOW.

Mary says YOU OWE IT TO HER?

Perdita says I DO.

Mary says DO YOU KNOW ANYONE ELSE NAMED PERDITA.

Perdita says IT'S NOT ME AND HER, WHOEVER SHE IS, THE CONTEST ANT, WE'RE THE ONLY ONES. YOU NEVER KNOW.

Mary says IT WAS A DELIGHT HAVING YOU ON. AND ALL THE BEST AM I KNOW YOU'RE HERE FOR THANKSGIVING.

Perdita says YES.

Mary says RIGHT? BECAUSE IT'S IN THE STATES. GOOD LUCK. YOU'RE HEADING BACK HOME. OR BACK TO SCHOOL.

Perdita says I AM. I HAVE A TEN-PAGE RESEARCH PAPER TO HAND IN.

Mary says THANK YOU. BEST OF LUCK.

Perdita says THANK YOU.

Mary says PERDI... PERDITA FELICIENE WAS THE 100 GOLD MEDAL HURDLEIST AT THE 2003 WORLD CHAMPIONSHIP. NEXT BIG STOP, Athens 2004. Watch for her there and we wish her all the best.

A slate reads "Perdita Felicien, www.athleticscanada.com."

Mary says but that is it for our show today. Thank you for watching, and please join us each weekday, Monday to Friday, for More to Life at 1 o'clock.

A slate reads "The advice given in the preceding program is of a general nature only. Viewers should consult their own medical professional for medical advice specific to their circumstances."

Watch: Personality Disorders, Perdita Felicien