Dual Diagnosis in Young Adult Women
By: Kevin Randall, LMFT, Clinical Director
Every one of the young women who come to Fulshear Treatment to Transition arrives with a unique story and obstacles they are facing. The obstacles they face are usually described in terms of diagnosis: Bipolar Disorder, Generalized Anxiety Disorder, Borderline Personality Disorder, Post-Traumatic Stress Disorder, and many others. These diagnoses organize patterns of behaviors and box up a thousand different experiences and label them so that they can be “dealt” with. The obstacle to realizing potential and achieving independence is not the diagnosis or symptoms. There are many treatments out there for these disorders. We use many of them at Fulshear; Cognitive Behavioral Therapy, Dialectical Behavioral Therapy (DBT), Family Systems Theory, etc. These great therapies offer tools and insight to combat the symptoms of the diagnosed disorder.
The real obstacle is deeper than treating a disorder, personality or otherwise. The true obstacle lies in the heart, often behind some thick, very safe and protective walls. A familiar theme arises in the stories that we hear. The pain of the world these women lived in becomes overwhelming. Wanting to live up to the expectations of the world around them they carry the burden of their pain. The pain doesn’t really subside and these young women work to cut off the source of the pain. Relationships suffer. Isolation occurs. Loneliness sets in. All the while the message gets stronger and more deeply rooted within them. The message that they aren’t worth it, they are unlovable, that they are powerless, incapable, or helpless.
At this point even the people they seemed to trust are saying things that reinforce the negative messages. Walls of anger, isolation, manipulation or many others defense mechanisms begin to lock others out. Symptoms of self-harm, substance abuse, or sexually acting out fill the void and (temporarily) numb the pain.
Herein lies the biggest obstacle. The walls that are meant to keep others out and create safety and some sense of stability lock in a secret that even the young woman herself has begun to forget. Walls are about keeping people out but they are also about protecting something precious or sacred. These walls are no different Everyone is focusing on the behaviors, the defenses, the diagnosis, or the symptoms so it is easy to forget what was being protected all these years in the first place.
What is it that is being protected? It is the belief that they are good, that they are worth it, that they are lovable or powerful. Each person has their own unique version of this. For some people by the time they got the walls up most of that belief was destroyed. Sometimes only the very tiniest sliver of that belief is locked up in there. When the time is right and trust is built, the walls come down, the symptoms subside and the belief is nurtured and grows. This is a real lasting change. When the belief is nurtured it creates a strong unmovable foundation and then a person’s unique potential can be realized.