Seattle's Dr. Linehan Taking Questions on NYT's "Consults"

In the wake of the New York Times article on borderline personality disorder, "An Emotional Hair Trigger, Often Misread," in which she's quoted, Dr. Marsha M. Linehan, psychology professor and director of the Behavioral Research and Therapy Clinics at the UW, is answering readers’ questions on the NYT's "Consults" blog. Looks like she's there for two weeks. So far, there are 89 questions.

The NYT's Jane E. Brody describes the disorder thusly: "People with the disorder are said to have a thin emotional skin and often behave like 2-year-olds, throwing tantrums when some innocent word, gesture, facial expression or action by others sets off an emotional storm they cannot control." Research implicates an amygdala with a low threshold before full fight-or-flight response, and not much emotional restraint. It's like Elaine Aron's Highly Sensitive Person on steroids.

Here's Linehan's contribution to the article:

"Some children need more than others in learning to regulate their emotions," said Marsha M. Linehan, a psychologist at the University of Washington who devised the leading treatment for borderline disorder.

"These kids require a lot of effort to keep themselves emotionally regulated," Dr. Linehan said in an interview. "They do best with stability. If the family situation is chaotic or the family is very uptight, teaching children to grin and bear it, that tough kids don’t cry, these children will have a lot of trouble."

Linehan's dialectical behavioral therapy helps the motivated deal with their fly-off-the-handle amygdala and the usual warping of personality that has ensued. Part of its success is due to its acceptance that the person will experience oscillations in their recovery--sometimes they'll be ready to make a leap, sometimes they'll need to take two steps back.