I typically put “BPD” in quotation marks to indicate that I question the meaning of diagnosis. I want to highlight my own skepticism which is rooted in a general questioning of psychiatry and mainstream mental health. Personally, I believe our experiences should not be labelled as a personality disorder. I understand what’s known as BPD to be more aligned with complex post-traumatic stress disorder (cPTSD), or relational trauma. Although this is still disorder language that I don’t hold too tightly to, it helps reframe our experiences — our personalities are not “disordered,” but are often designed around our protective trauma responses that have become rigid.

Somatic Experiencing™ is one of many body-based therapeutic modalities that have come into the mainstream in recent years. The particulars of SE are based on Peter Levine’s teachings.

Sessions with me typically involve a balance between talking and tuning into your body’s sensations and information (I’ve also been told there’s a lot of playfulness involved as well). Of course, this depends on your comfort level with noticing & being in your body, as well as your level of interest in doing body-based work to go along with traditional talk-based support. For those who tend to intellectualize and “stay in their head” about painful things, somatic work can be both challenging and hugely important work.

When I work with people who sometimes want to die, whether it is chronic & passive or sometimes active & involves a plan, I approach this from a place of consent. Allowing information to come through about what your body & mind are trying to tell you though suicidal urges is difficult work, but I believe it’s possible. If you are sometimes suicidal, we can talk about this, and create a plan that works for you around how to manage these experiences. We will discuss together how we can both recognize if you need outside supports, and think through if psychiatry is the safest means.

I also recognize that self-injury is not always connected to plans to end your life. Harm reduction is at the root of much of my work, and I understand self-injury as a strategy you may have used to regulate your internal experience. Until you and I feel confident that you have other, new skills to be with your internal experience, I will not expect you to do away with this strategy. I will, however, work with you to ensure you are safe enough to continue doing this work.