Split Black /#Wattys 2021

Chapter Twenty-four

"Yeah." John walked through into a comfortable office with a desk, another small couch and a chair, crammed bookcases, and framed degrees on the wall. He picked a spot on a chair facing the desk and took out his notebook. "I ran across this term on a homicide I'm assisting with. Can you tell me what 'DBT' is?"

Dr. Rogers took a seat behind her desk. "It's a type of psychotherapy that was developed in the nineties to treat borderline personality disorder. Now it's used for other problems, too, but BPD is what it was originally developed to treat." The clinical terms sounded odd rolling so languorously off of her tongue.

John thought briefly of Tyler Greenhouse, but kept his focus on Julie Samuels. He remembered the phrase "dumb DBT group" and asked, "Is it a group therapy?"

"Partially," said Dr. Rogers. John raised his eyebrows, about to say, "Partially?" but she went on.

Dr. Rogers tucked a strand of hair behind her ear. "For a lot of people with BPD, their lives are in a constant state of crisis. Some seventy-five percent come from dysfunctional families, so they have problems there. Then a lot of them choose unhealthy relationships in friends or spouses, so they have problems there. Many of them have trouble with occupational functioning, so there's problems on their job. Then they get fired, so there's money problems. That kind of thing."

She sat back in her chair and folded her hands across her stomach. "A lot of times it's hard to help them with their core problems because every time they come in, they're dealing with a new crisis. So, in DBT there's a regular weekly therapy session, and then there's a skills training group that's run like a class. It's there to teach a lot of basic skills that most of us learn as we grow up, but that borderlines for various reasons didn't have an opportunity to learn."

John blinked. "Skills like what? Reading, 'riting, and 'rithmetic?"

Dr. Rogers smiled. "A lot more basic than that. A lot of borderlines need help with things like experiencing anger or fear without flying into explosive rages and doing things they might regret. They need support in things like, how to say soothing things to themselves when they're upset to help calm themselves down. Correctly interpreting things that other people do and say. Some of it is like assertiveness training. It's run something like a high school class, and there's assigned homework."

John jotted a couple of notes. "I guess it makes sense that a teenaged girl might feel a little silly having to go to something like that."

"Possibly," said Dr. Rogers.

John thought again of Tyler Greenhouse. "I'm thinking of another case we're waiting to go to court on where the perp was actually diagnosed with this. You said, 'explosive rage'. Would that include things like kicking in windows and threatening to throw your daughter's dog off a sixth-floor balcony?"

"It might," said Dr. Rogers. "It could be consistent with a lot of other things, too, but that sort of extreme behavior is common in borderlines, especially men. It's lifelong unless the person seeks treatment, so that child probably grew up with this kind of behavior."

"Really?" said John. "What other kinds of things do these people do?"

Dr. Rogers looked up at him through her glasses. "Well, a number of behaviors are commonly reported. But borderlines are kind of like snowflakes—no two are exactly alike. You can have two vastly different people with the same diagnosis. One thing that's seen a lot is 'splitting', where a borderline sees a situation or a person as perfect under one set of circumstances, and then something happens, and they completely forget all the good qualities and only see the bad. One day a person can do no wrong, the next day they're the very devil. And they can flip back and forth between these two extremes several times in one day. Other behaviors that are common are fears of abandonment by important people. Lack of confidence in themselves and their ability to handle issues with other people. Borderlines tend a lot to try to handle issues with other people through third parties."