Published on 12, July, 2020
Following a recent hospital admission, I have had ‘EUPD tendencies’ noted on my medical history. I understand this to refer to Emotionally Unstable Personality Disorder. I have never had this mentioned to me before, nor am I diagnosed with this disorder, so I looked it up online to find out the features of it. Most of what I found did not appear to fit with my experiences, and the features I did have overlap with features of my Asperger’s or depression anyway, which I suppose is why they said I had ‘tendencies’, but then couldn’t I realistically have tendencies of all sorts of conditions? I think it’s important for me to determine if this diagnosis would be something that would fit me or not, because it would directly affect which psychological therapies would likely be of benefit to me, and for the last three years mental health services have failed to identify a suitable treatment plan for me.
I was therefore wondering if any of you have experience of EUPD and could shed some light on what it means for you? I don’t think I understand it properly from online resources, especially not from the viewpoint of someone who is autistic too, so I would appreciate any personal viewpoints on the topic. Also, does anybody know of any links/overlaps between ASD and personality disorders? As you can tell, it’s not an area of my expertise!
I got misdiagnosed with it during therapy and in hospital when I got sectioned. There are some overlaps such as emotional dysregulation and intense emotional reactions but these are also obviously autistic traits. My understanding is that in EUPD the emotional reactions are related directly to relationships whereas in autism from being overwhelmed. Are you a woman by any chance? It seems to be a label that mental health professionals put onto women who present in a more NT way. These professionals seem to view the criteria through a nt lens which is very different to our autistic brains although superficially the presentation can look similar.
One thing that that is common to both is our ability to "mentalitize" i.e. See things from another's perspective. I had psychodynamic therapy for 2 years for the pd I didn't actually have. However, the therapy has helped me hugely in improving relationships with my friends and husband and has reduced my meltdowns that were caused by misunderstandings. It has also helped me to identify more of my emotions and therefore be able to process them easier. It has been the most helpful thing I've ever done.
Btw, you say that you've had a recently had a hospital admission, I assume for mental health issues. I hope that you are feeling a bit better now
Yes, I am a woman. It’s true that ASD women are usually good at passing as NT, so I suppose that could cause confusion for a professional trying to diagnose us. That being said, the fact that I already have an autism diagnosis shouldn’t have been forgotten, but I suppose the consultant who saw me maybe didn’t understand the traits and therefore put them down to EUPD instead. I’m sorry to hear that you have been misdiagnosed with EUPD yourself.
Thank you for mentioning the psychodynamic therapy - I shall have a look into that and ask if it is available in my area. I’m glad to hear that it has helped you so much.
Indeed, I was admitted to hospital for mental health issues. Thank you for your well wishes - I’m still very up and down (hence my delayed response) but no longer in a dangerous crisis at least.
No the autism diagnosis should not have been forgotten, and a lot of clinical staff don't understand the traits. And the autistic people who were misdiagnosed as BPD/EUPD I was thinking of were also all women.
I have to say, I was surprised at gojojo's positive experience of psychodynamic therapy. It was extremely unhelpful and positively harmful for me, both group and individual. I'm guessing that it is the 'mentalisation therapy' that can help understanding of current relationships. The treatment I received wasn't focussed on mentalisation and I didn't have any current relationships.
Good luck with your recovery.
The problems with psychodynamic therapy are a long story. I could go on for ages.
Briefly, I got into it partly because of unresolved grief issues, having lost a parent when I was a child, and that obviously having a big emotional and practical impact on me, and I'm sure being a factor in long-term depression but also why I haven't been able to make more positive use of my autistic strengths. Psychoanalytic/psychodynamic therapy claims expertise in this area, but of course the therapist never actually explains how they might be able to help, and if you happen to be an analytical and introverted person anyway, who doesn't have direct access to their own emotions, you're constantly generating hypotheses about your counterproductive behaviour without any feedback or evidence. The assumption is that if you cry or become distressed you're making progress, even if you're actually feeling worse as a result.
So therapy is like an echo chamber of negative thoughts, a mirrored maze. Some people (I've seen this in groups) realise it's nonsense and just leave after a while, but if you're also curious about whether you might learn something new, it's very hard to escape.
Friends noticed that the therapy made me more 'morose', I was filled with additional self-doubts and realised I just didn't behave the way a therapeutic subject was supposed to, which made me feel more defective until I got the autism diagnosis (unfortunately, I didn't 'realise immediately' like you).
I suppose I mentalise anyway: I'm often trying to resolve disputes by suggesting to one person what the other might be thinking. It does sound like exploring the autism identity for you was useful. My diagnosis happened halfway through the last group therapy and the reaction was of course 'how do you feel about that?'. Well, I don't know, so that's not at all helpful, and it's claimed that the 'treatment' should stay the same.
Glad to hear that you are feeling a bit better nas36609.
Cassandro, I'm interested to hear why psychodynamic therapy was harmful to you. I can understand group therapy not working - I realised immediately that my brain wasn't wired the same as the nt's.
I should have mentioned the caveat of psychodynamic therapy was that it caused me to have a breakdown before they realised that I was autistic. What it helped me with was to take down the "mask", gain a positive identity and self esteem, and to learn to identify my emotions. Mentalisation was really hard work as it challenges you to contextualise and understand relationships from other perspectives by thinking about it. It doesn't have to be current relationships and can be family etc I found the therapy really hard going and I took a leap of faith by doing it because initially I found talking to someone pointless. However in developing a strong bond with my therapist it has given me confidence to allow me to be more myself. This in turn has reduced the emotional fluctuations caused by being overwhelmed and suppressing my autistic traits. It has also enabled me to express my needs more openly e.g. To say I need to leave somewhere due to sensory overload whereas in the past I would have suffered so as not to upset anyone and then paid the price afterwards by having a meltdown at home.