Q. I'm fairly sure I have BPD based upon everything I've read. I'm 39 and about to enter therapy (on other issues) and plan to seek an evaluation from this psychologist. This psychologist is very interested in doing EMDR therapy to alleviate my traumatic memories most of which I can't recall or don't seem really traumatic to me any more; however, I assume they must be because I have a 10 year history of self-injury and a suicide attempt. I'm seeing this doctor to work on my present day parenting skills which are suffering. My question is, do you think EMDR treatment will be sufficient for me if I do in fact have BPD? Will I need medication? Do all persons suffering from BPD need medication for the rest of their lives?

A. I do not know who needs and who does not need medication, just like I do not know who needs and does not need therapy. Both interventions are options available to get patients better. The more credible options you can give someone, the better their chances of getting well. I do not think EMDR works and look at it like laetrile for cancer. That said, other than the cost, it will not hurt you. I have seen no remotely credible data that it helps.

You need to get a medical evaluation, which a psychologist should suggest if they are credible and have read anything in the past ten years on pharmacotherapy of BPD, from a psychiatrist. Any time a treatment of known success (various medications) is not suggested for one that has no data to back it up (EMDR) you are being shorted.