the use of certain medications: antipsychotics to help with depression, anxiety, suicidality, and psychotic symptoms, antidepressants from the class of SSRIs and MAO inhibitors, and lithium to reduce irritability and angry behavior. These drugs are used in combination with psychological treatment. Psychosocial treatment focuses in strengthening the weak ego. This treatment is based on the idea that these individuals suffering from borderline have weak egos and the primary focus of the treatment is on the defense mechanism “splitting.” This treatment is not usually effective and is also very expensive and time-consuming. The most promising hope for borderline patients is a newly developed therapy called dialectical behavior therapy. The central focus of this therapy is to help the patients accept negative affect without responding to it with maladaptive or self-destructive behaviors. This treatment is based on a hierarchy of goals which are clearly explained by clearly by Carson, Butcher, and Mineka (2000): (1) decreasing suicidal behavior; (2) decreasing behaviors that interfere with therapy, such as missing sessions, lying, and getting hospitalized; (3) decreasing escapist behaviors that interfere with a stable lifestyle, such as substance abuse; (4) increasing behavioral skills in order to regulate emotions, to increase interpersonal skills, and to increase tolerance for distress; (5) other goals the patient chooses. This therapy also combines individual with group components. While Susanna was in McLean, she received daily medications and had daily meetings with her therapist as well as with a group. On January 3, 1969, Susanna Kaysen was discharged. She was declared recovered. Her time in McLean and the newfound friendships “cured” her. While drugs, therapists, and daily checks made a contribution to her recovery, I believe that her biggest awakening was the people she ...
