I'm trying to find a residential unit dealing with Borderline Split Personality !


Question:

I'm trying to find a residential unit dealing with Borderline Split Personality Disorder?

My younger brother has been told he has some kind of "problem" since he turned 11. He's been catagourised dozens of times as various different disorders and every psychiatrist has come up with something different regarding his mental welfare. Our adoptive parents disowned him years ago and it fell to me as his gaurdian to take care of him and support him. He is 26 now and homeless as the unit he was living at shut down, and I've been told he has to be found relevant accomodation or he will spend a long time in prison. No one is willing to help me from the government side nor the family side and I'm completely lost. To make things worse they've now rediagnosed him as having Borderline Split Personality disorder which gives me a new thing to start reading up on along with the fact I have no idea about how to find somewhere for him to go. Please please help me as this is starting to send me mad! I need to find somewhere he can live that specialises in Borderline Split Personality.


Answers:

It's a little difficult to answer this since I don't know where you live, but most states have residential facilities available for folks with mental illnesses in order to provide supervision and medication management. I worked for a great place some 20 years ago which was divided into levels of supervision required-level 1 was a group home where meals were provided and people had shared rooms with 24 hour supervision; level 2 was like an apartment building where people shared one of several apartment within the building with a counselor available 24 hours a day on site; level 3 were actually individual apartments in the community with 24 hour access to an off-site counselor. I know of no specific residential facilities that are diagnosis specific however and that probably isn't necessary. The appropriate out-patient treatment is what is necessary and needs to be provided by a specialist if your brother has DID/MPD. (Dissociative Identity Disorder/Multiple Personality Disorder) I question the diagnosis as truthfully there is no such thing as Borderline Split Personality-it is either Borderline Personality Disorder or Multiple Personality/Dissociative Identity Disorder, so check the diagnosis. If he does have a dissociative disorder for certain, there is an excellent Day Treatment attached to a hospital based In-Patient program at Forestview Hospital in Grand Rapids, Michigan that is specific for self-injurers and dissociative disorders and eating disorders. There are others, but this one I have visited and toured and sat in on groups and I can recommend it without hesitation. Masters & Johnson also run in-patient trauma programs in Louisiana, there is a sexual abuse in-patient program in Maryland (The Center) and 2 other in-patient programs like the one in Grand Rapids also under the direction of Colin Ross in Del Amo, California and Dallas? or Houston? Texas.

Since Jacko referenced one of my previous answers (thank you) for info regarding DID and the misdiagnosis with other disorders, I'll repost an excerpt here for your information, but your brother needs a proper evaluation by a professional for accurate diagnosis:

DID is the existence of two or more separate personalities or personality states within one person, with each alter having distinctly different ways of thinking, feeling, behaving and relating to the world and distinctly different memories, each part having amnesia for the other parts' memories. It is born from repeated and severe abuse and involves the defense mechanism of dissociation and generally develops before the age of 10 as children are far more likely to dissociate.
DID is often misdiagnosed and it is very common for a person to have had multiple different psychiatric diagnoses before it is definitively identified as DID. The symptoms frequently overlap with symptoms of schizophrenia, Bipolar Disorder, Depression, Anxiety Disorders (all), PTSD, other Dissociative Disorders and Somatoform Disorders as well as Borderline Personality. It requires extremely careful assessment and a high level of trust by the patient before alters reveal themselves. The diagnosis cannot be finalized before a therapist has actually made contact with another alter and observed the switch between alters.
The hallmark symptom is amnesia, which can be partial or complete depending on the level co-consciousness that exists between alters. Folks with the disorder describe the amnesia as "missing time" or blank periods, often daily or weekly, where they cannot account for their whereabouts or behavior. It is this amnesic barrier between parts that often leads to the most bizarre and distinctive signs and symptoms: not recognizing familiar people; not remembering highly significant events in their lives (like the birth of their first child, for example); finding purchases or articles of clothing/possessions, writings or drawings that they have no recollection of having bought or created. They are frequently accused of lying because they disavow their own behavior which is remembered by one part, while the amnestic part is completely unaware of it. Other unusual symptoms include: an exceptionally high tolerance for physical pain (they split off physical sensation which becomes encapsulated in one or several alters without others feeling it); not recognizing themselves in a mirror; using different names; having dramatically different skills and abilities that seem to be alternately present and then vanish (one alter may be able to drive a car while the sudden emergence of a child alter results in complete loss of this ability until the adult alter re-emerges); completely different opinions and behaviors (leading to the mislabeling of Bipolar or Borderline Personality.
Often communication across between separate alters takes place in the form of hearing voices, hence these folks frequently get misdiagnosed as schizophrenic. The key distinction here is whether the voices are experienced as coming from inside the person's head (DID) or outside one's head (Schizophrenia/Bipolar Disorder).
The separate identities develop in response to traumatic experiences which the child is unable to integrate and so they become "split off" from awareness and begin to take on a life of their own.
Folks with DID often self-injure, frequently a result of internal battles between persecutor alters and weaker alters and there are continual battles for control of the body and "time out" in the body between competing alters.
Symptoms of depression and anxiety are frequent and common and the picture is further complicated by the fact that one alter can meet all clinical criteria for Depression, while another part experiences no symptoms whatsoever. One part can be psychotic and experience no side effects from meds while another non-psychotic part has all the side effects and will stop taking meds. You can imagine that attempting to medicate such a disorder becomes an absolute nightmare.
Other symptoms include flashbacks and nightmares, hence the confusion with PTSD. Sometimes there are fugue states and clients will switch and "come to" in the body and have no idea how they arrived in the situation they are in, not know the people they are with and be completely disoriented. I had one client call me from another state after being away for a few days and having no idea how she got there or how to get home. Depersonalization and trance states are common and hence the overlap with other Dissociative disorders.
Folks with DID frequently experience multiple somatic symptoms for which there is no organic basis. They experience partial body memories of abuse without the actual memory of the event and thus exhibit strange physiological symptoms and are often labeled as Somatoform disorders or hypochondriacs.
I could go on and on, but suffice it to say that virtually any symptom of any disorder can be found at some point in a person with DID. Treatment is almost exclusively through psychotherapy as medication is merely palliative and an adjunct during periods of acute anxiety or depression. Treatment aims at initially contracting against suicidal and self-destructive behavior and attempts to establish safety first. Many DID folks enter treatment in horrendous circumstances where they are frequently in highly abusive relationships or are themselves abusive. Given the multiple alters, they may be both victim and perpetrator both within themselves alone and in the context of their relationships. The second primary goal is establishing communication and negotiation among alters to decrease amnesia and contradictory, self-defeating behavior. Ultimately the goal becomes integration of alters into one cohesive whole which involves sharing of memories and feelings across alters and a merging, where all parts continue to be present, but constant.

Good Luck!




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