Q. I'm a 31 year old male whose been self-harming for almost 2 decades, and while not making any self-diagnosis - I exhibit most of the behavioral criteria for BPD laid out in DSM-IV. I've learnt a great deal through the internet, but still can't seek professional help as I'm unable to feel I'm worthy of help (no hope = no incentive!)

In all the literature I've read so far, not once have I come across the condition of 'anal retention'; this I suffered with for 1 1/2 - 2 years around the age of six/seven after my parents divorced. This coincided with the 2 year period when my two older brothers and I had to live with my father. He was not a loving caregiver and if I suffered any childhood trauma that BPD can stem from it was the beating I received when I couldn't conceal the physical consequences. None of this pain really registered at the time and the physical symptoms ceased some time after my mother (& new stepfather) gained custody of us.

I understand that anal retention is merely the physical 'side-effect' to a psychological problem, but how significant is it in shaping the developing psyche?

  A. Anal retentive is old psychobabble. It does not mean a lot in my way of looking at the world. More importantly, it does not matter even if it is why you are ill. Bottom line is you have a disease, and it needs to be treated. Whether the disease is genetic in origin, trauma induced, socially induced or something else we do not know about is irrelevant. There are ways to treat it biologically which unequivocally work. Use them. There are psycho therapeutic interventions that work. Use them. If you do not, you will stay sick.