Treatment

One of the things I am focusing on is what can be done for factitious disorders. This disorder is typically seen as not being amendable to treatment. Granted, the co-morbid personality disorders that usually accompany FD’s, some really are not. Of the three main ones seen in FD’s, they are Borderline Personality Disorder (BPD), Narcissistic Personality Disorder (NPD) and Antisocial Personality Disorder (APD). Both APD and NPD are not typically associated with change and are not usually considered amendable to treatment. Borderline personality disorder is while serious, one that can be associated with a positive outcome.

Someone’s ability to recover from a FD is going to be determined by seeing something wrong with what they’re doing. Often, many do not “see the error of their ways.” For those people, little can be done until they realize the need and have the desire for change. As serious as these problems are, I don’t believe they are beyond hope. But one has to want change. Some of the possible treatments I feel can be helpful for someone suffering from a FD are (and will be discussed in detail in my book):

  • DBT (Dialectical Behavioral Therapy)
  • Insight oriented therapy to identify how the FD came about and what coping strategies can be helpful if a relapse happens (and this does not stop overnight.
  • STEPPS (Systems Training for Emotional Predictability and Problem Solving)
  • EMDR (Eye Movement and Desensitization Reprocessing)
  • Medical treatment for existing (legitimate) medical problems, including pain (pain will make you mental) but it is my belief that if possible, it be managed without the use of narcotics

There are many conventional therapies that can be of benefit for someone with a FD or even someone who has non-suicidal self-injury (NSSI). But in my mind, the most critical one for factitious disorders is a 12 step program (such as Alcoholics Anonymous, Narcotics Anonymous, or any of the others). For someone who has a basic problem with a lack of honesty-these are all programs of rigorous honesty.

I have had most of the above treatments and while they were helpful, they did not change the underlying problems, the chronic self-pity or the resentments that caused me to use them as an excuse to use or self-harm. For me, AA is what changed all of that.

Try it, it will change your life.

Recovery Directional Sign – 3D Rendering

Stigma and self-harm

There is a huge stigma associated with mental illness. Of living with a diagnosis such as borderline personality disorder. There are a lot of misperceptions.

We have riots and demonstrations when the “n-word” is used and rightfully so. The term is offensive to me and abusive to the recipient. It is the terminology of hate. Which in my mind has no place in today’s society-it comminucates hatred of those who are perceived as being different. Ironic that whites are going to eventually be in the minority. What that is is short-sighted, amongst other things.

However, if you call someone a “psycho” or “mental” no one cares. It is business as usual. Because it is a mental health issue, it is considered socially acceptable. Why else would it continue? With no understandable outrage over it, the message sent when no one reacts serves to reinforce that same stigma. I feel calling someone mental or a psycho is hateful and mean, and just as abusive to the recipient as is the n-word. And it is equally as offensive as the n-word.

The stigma of mental illness is the negative views associated with the terminology of mental health (Mayo Clinic, 2017). And it has far reaching consequences. Some of them include:

Some of the harmful effects of stigma can include:

  • “Reluctance to seek help or treatment
  • Lack of understanding by family, friends, co-workers or others
  • Fewer opportunities for work, school or social activities or trouble finding housing
  • Bullying, physical violence or harassment
  • Health insurance that doesn’t adequately cover your mental illness treatment
  • The belief that you’ll never succeed at certain challenges or that you can’t improve your situation”

(Mayo Clinic, 2017)

And as I recently found out when trying to purchase mortgage protection insurance and life insurance, no one wants to sell you that either.

A FD is a severe form of self-harm. And self-harm has an even greater stigma associated with it. And non-suicidal self-injury (NSSI) can trigger a vicious cycle of negative consequences that include low self-esteem, economic consequences (job loss or not being hired), and social distancing-it is these consequences that cause the individual with NSSI increased stress which puts them at increased risk of using NSSI as a coping mechanism (Burke, Piccinilo, Moore-Berg, Alloy, & Heimberg, 2019). And this stigma can also cause the above consequences, such as making it difficult to seek help when someone has an episode.

I know it kept me from admitting the truth for many years. Which kept me from seeking help and developing coping strategies. I am not convinced that self-harm is completely a conscious decision, as the literature on FD’s states. Why is that? You must make a conscious decision to stop. And even then, it doesn’t happen overnight.

A considerable amount of literature exists that links NSSI to addiction. I know the last time (a year ago) that I had a craving for it, it was so strong I had to do something. It did not feel like a choice. Instead of seeking unnecessary treatment, I called an advice line. Seems stupid when academically, I am qualified to be answering those calls. But it kept me from following through. My addiction to medical treatment extended to procedures (no unnecessary ones for over 5 years), medical testing and seeking unnecessary medications and other treatments.

When I think about it, it seems like the definition of insanity. But I have seen how my own brother looks at what I was doing with disgust. Time heals, right? I’m not so sure. But self-harm feels like a double-whammy as far as stigma goes.

And what is so stupid about the stigma on mental illness? All mental means, is that you are a human being. No reactions to life evens such as death of a loved one, marriage or divorce, being assaulted with depression or anxiety, or other mood symptoms, would be something I would worry about. Having a mental reaction to stress is normal. One should not be denied health coverage for treatment of it if needed or life insurance for that matter for reacting to life as a human being. The message that sends, is my life is less valuable because I have a mental illness. No one is denied health coverage because of race (as far as I know). Sadly, that is not how life works.

Black lives matter. ALL lives matter!!!

REFERENCES

Burke, T.A., Piccirillo, M.L., Moore-Berg, S.L., Alloy, L.B., & Heimberg, R.G. (2019) The stigmatization of non-suicidal self-injury; Journal of Clinical Psychology; 75(3); 481-498; Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6679979/

Mayo Clinic (2017); Mental health: overcoming the stigma of mental illness. Retrieved from: https://www.mayoclinic.org/diseases-conditions/mental-illness/in-depth/mental-health/art-20046477

There is always hope

I had always had some idea about the truth about myself, that I did have a factitious disorder (FD), but admitting it first to myself, then to another person was one of the most difficult things I have ever had to do. When I looked at the treatment for this, I didn’t find much. Which was incredibly discouraging. I felt hopeless, and in my mind, that is a dangerous place to be. One of my goals in building this site is to offer support in the recovery from this serious disorder. Serious as it may be, one thing it is not is a hopeless case. God does not create hopeless cases.

Most of the treatments I will discuss will be part of a book on the subject that I have started writing, and yes, one that will include my own experiences. The honest ones, of course. I do have some great, “no BS” stories that I plan to share.

It does get better and there is always hope.

%d bloggers like this: