Anything to Stop the Pain - BPD and Non-BPs

Often I see in the support groups on the Internet (especially the “Welcome to Oz” or WTO groups), people providing the “3 C’s” of understanding your role as a Non-BP. I’ve seen it quoted on BPD support websites too. These “3 C’s” go as follows:

• I didn’t cause it
• I can’t control it
• I can’t cure it

While these statements are generally true, I’d like to take some time to analyze these statements and add a fourth “C.” I’d also like to tell you what you CAN do – rather than what you didn’t or can’t do.

These statements help take the onus off the Non-BP for any responsibility for their loved one’s disorder. I can understand that. In part, they are about blame or, better, non-blame. I’ve seen many people say “when I came to terms with those ‘3 C’s’ I was free from FOG!” (which is fear, obligation and guilt, for those of you who don’t know). I want to write something about FOG specifically, but haven’t had the time.

OK, now let’s look at each of these statements and see how they fit into my way of thinking about being a Non-BP.

I didn’t cause it

Actually, this statement is liberating, especially for parents of BPs. I think that many parents carry around a lot of guilt that they DID cause their child’s disorder. Even psychologist and therapists often blame the disorder on the parents. However, there are growing studies that suggest that there are many biological causes for BPD. In the case of Marsha Linehan, she provides a “biosocial” model, in which each element (biological and social) are required to cause BPD. The environmental part of that analysis is the “invalidating environment.” So, while you (either as a parent or spouse) didn’t cause the disorder, you may have inadvertently contributed to the disorder’s severity. By reacting to a BP in an emotionally invalidating manner, the disorder can get worse. That is why I spend over 30 pages in WHINE discussing emotional validation as a tool for healing. Of course, a parent might say “Well, I have other children. I’ve treated them the exact same way. Why don’t they all have BPD?” Which again is where the biological element enters. My suggestion for parents is to read the article referenced below.

I can’t control it

Why would you want to? No one can completely control another individual. Even parents can’t completely control the actions and behaviors of their own children. No, the only behavior (which is BTW what Non-BPs are so confused and angry about) you can control is your own. That is why I have made several statements clarifying boundaries. Boundaries can’t be used to control other people’s behavior. If you try and imposed rules on another person’s behavior, you get resentment, rebellion and (in the case of BPD) a statement: “You’re trying to control me!” How many times have you heard THAT in your interactions with a BP? I’ve heard it a bunch.

I can’t cure it

Again, this statement is true. Only the BP him/herself can “cure” the disorder (usually with the help of a qualified and knowledgeable professional). It is important that you re-read that statement – you cannot make your loved one “all better.” You can’t save him or her – especially from his or herself. What CAN you do then? You can contribute to an easing of the conditions under which the BPD behavior is severe. You can re-frame your relationship with the BP in such a way that the emotional invalidation that they have learned to expect is gone. You can encourage effective behavior and practice effective behavior yourself. How? I explain this in detail in WHINE – which is why I called it a “how-to” book.

Now, I think I need to contribute a fourth “C” to the mix. I didn’t make this “C” up. In fact I found it here, on A. J. Mahri’s “BPD from the inside out” page about a mother speaking out about the illness. Please read that page! It really helps define the feelings and confusion of a mother who needed to know she “didn’t cause it.” She offers a fourth “C” which is:

All I can do is cope with it.

Bon Dobbs :: Aug.27.2008 :: Blame, WHINE Book, Biology, Parenting, Validation, Borderline Personality Disorder :: No Comments »

When Hope is Not Enough (WHINE) is my “staying” book for Non-BPs. Did you know that it is available as a downloadable eBook? Yes, that’s right, for $7.50 you can get a copy of the book about which one Amazon reviewer said:

I have read the book and it amazes me how so much valuable information can be condensed into such a quick and easy read. It is written in a style that most anyone can understand and it is filled with useful examples on how to use this approach in everyday situations we all face with highly emotional people. Used correctly, the information provided in this book can help you improve your relationship right now… not next year, not next month, TODAY.

On my free email support list for Non-BPs (the ATSTP Google Groups List), a member said this about the downloadable version of WHINE:

It didn’t take me long to figure out that for me, faster progress will be made from
reading Bon’s book WHINE.  I bought the electronic version for $7.50, printed
it out and put it in a little 3-ring binder.  I have now read it once and have
started the second time through after a couple of days letting it sink in.  I had
the pleasure of experiencing one of my BPDW’s “storms” during this sink-in time.
She was the same - I was different.  Kinda surreal experience.

The printed version has a retail price of $19.95, although it is being sold by Amazon and Barnes and Noble for $17.95. If you buy the eBook version you can get the same content for only $7.50.

Buy the eBook version of WHINE here.

Bon Dobbs :: Aug.25.2008 :: WHINE Book, Borderline Personality Disorder :: 1 Comment »

My Book, “When Hope is Not Enough,” is now available in Canada via Amazon:

http://www.amazon.ca/When-Hope-Not-Enough-Dobbs/dp/1435719190/

BTW, it has been available in the UK for a while now:

 http://www.amazon.co.uk/When-Hope-Not-Enough-Dobbs/dp/1435719190/

Bon Dobbs :: Aug.15.2008 :: WHINE Book, Borderline Personality Disorder :: No Comments »

I can’t really add much to this review, it is the best review of When Hope is Not Enough… I know this person… she is a member of the ATSTP Google group list… Please read the review, because WHINE can really help you if you want to (or HAVE to - like a parent) stay with a BP…

In Oct 2007, I was at my wits end and ready to walk away from my raging husband after 4 months of marriage. He had been in therapy for over a year, yet still raging almost daily, beating himself half to death, lying to me about the most ridiculous stuff and destroying our home. All this chaos was causing my 2 teenagers to alienate me out of fear of him. As a Project Manager, I had participated in many classes and seminars on effective communication in the workplace through my job, but it seemed that nothing I tried worked with my husband… most of the time, it only seemed to make things worse. I truly felt helpless. I knew I loved him and I fully understood the complexity of this disorder and how my own (natural) reactions to his behavior contributed to the dynamics of our relationship, but I also realized I didn’t have what it took to provide the healthy and supportive home environment I knew he needed in order to heal from his past.

At the urging of my own therapist (whom I had retained for my own sanity), I decided to join an online support group for loved ones of people who suffered from Borderline Personality Disorder. I found a group called Anything To Stop The Pain (ATSTP). As time went by (with me lurking in the group), I realized that the founder of the group (Ben Dobbs, the author of this book) was promoting a very similar approach with group members that my husband’s therapist was using with him during their sessions. I got more involved with the group and learned how to use this approach, at home, with my husband (and, consequently, with other family members also.)

Ten months later, I’m happy to say that my husband’s raging has reduced to, maybe, once every few months and the intensity is nothing like before — despite the fact that he hasn’t been attending therapy on as regular a basis as I had understood was necessary for improving his emotional health. We are finally enjoying the closeness we both wanted in our marriage. My house feels and looks like a home again (rather than a battlefield) and my kids are back to spending more time with us again. He is slowly changing his maladaptive coping methods to more healthy ones… and working out his past by using this same approach with his own family. It feels good to get genuine apologies (versus “FINE! IT’S ALL MY FAULT!!”) and ‘thank you’s’ (versus daily blaming and projecting) for my patience and understanding.

I have read many books on this disorder. I found ‘Stop Walking on Eggshells’ to be quite validating to my feelings as a loved one (a NON) to a borderline. In that sense, it was very healing for me, personally, but it didn’t help me improve my relationship. ‘I Hate You, Don’t Leave Me’, ‘Sometimes I Act Crazy’ and ‘Get Me Out of Here’ were beneficial to me in that they helped remind me that my husband’s erratic behaviors really were not about me at all. From my personal experience, this book is the next progressive step for those who recognize that they cannot FIX their borderline loved one, yet still have a smidgen of hope that there is a way to find peace and harmony with this person IN their life.

I have read the book and it amazes me how so much valuable information can be condensed into such a quick and easy read. It is written in a style that most anyone can understand and it is filled with useful examples on how to use this approach in everyday situations we all face with highly emotional people. Used correctly, the information provided in this book can help you improve your relationship right now… not next year, not next month, TODAY.

I highly recommend it for anyone who truly wants to learn how to effectively communicate with someone (spouse, parent, child, friend, co-worker or boss) who is struggling with an emotional regulation disorder. You don’t have to give up your rights or go without getting your needs met anymore to stay in this relationship! And the nice thing is, it doesn’t require therapy or counseling to be successful. All you need is an open mind and a desire to try something different… something that works!

WHINE (When Hope is Not Enough) is available at Amazon and other Internet retailers.

Bon Dobbs :: Aug.10.2008 :: WHINE Book, Borderline Personality Disorder :: 3 Comments »

Someone forwarded this information to me this morning….

Science, an extraordinarily selective and highly prestigious publication,
includes a report, “The Rupture and Repair of Cooperation in Borderline
Personality Disorder,” by Brooks King-Casas and five collaborators
(including Peter Fonagy) in its August 8th issue. The editors of Science
felt this innovative research was of such potential importance that they
provided almost two full of Science’s limited pages for a commentary, “Trust
Me on This. Borderline personality disorder is associated with abnormal
activity in a brain region associated with monitoring trust in
relationships,” by Andreas Meyer-Lindenberg.

The Brooks King-Casas, et al paper in Science is another indicator of
innovative, significant research with a high potential for traction that can
come from collaborations between an investigator with leading edge methods
and borderline pd investigators, and a reminder of the importance of
reaching out to engage and to fund other investigators for ventures into
borderline pd research. Such engagements and funding represent an important
route to gain more positive attention for borderline pd, to increase the
interest in research concerning the disorder, to open new pathways for
borderline pd research and possibly to grow the number of investigators for
an area of study for which new investigators are vital for maintaining even
a modicum of vigorous research activity.

Abstract of August 8th Science paper:

To sustain or repair cooperation during a social exchange, adaptive
creatures must understanding social gestures and the consequences when
shared expectations about fair exchange are violated by accident or intent.

We recruited 55 individuals afflicted with borderline personality disorder
(BPD) to play a multiround economic exchange game with healthy partners.
Behaviorally, individuals with BPD showed a profound incapacity to maintain
cooperation, and were impaired in their ability to repair broken cooperation
on the basis of a quantitative measures of coaxing. Neurally, activity in
the anterior insula, a region known to respond to norm violations across
affective, interoceptive, economic, and social dimensions, strongly
differentiated healthy participants from individuals with BPD. Healthy
subjects showed a strong linear relation between anterior insula response
and both magnitude of monetary offer received from their partner (input) and
the amount of money repaid to their partner (output). In stark contrast,
activity in the anterior insula of BPD participants was related only to the
magnitude of the repayment sent back to their partner (output), not to the
magnitude of offers received (input). These neural and behavioral data
suggest that norms used in perception of social gestures are pathologically
perturbed or missing altogether among individuals with BPD. This
game-theoretic approach to psychopathology may open doors to new ways of
characterizing and studying a range of mental illnesses.

Bon Dobbs :: Aug.08.2008 :: Biology, Borderline Personality Disorder :: 1 Comment »

Why boundaries and  detaching can make things worse….

I decided to write this post because I have seen many non-BPs frustrated over the fact that when they try to use the tools in certain books with their BP, the tools seem to cause more rage and emotional dysregulation. The two “tools” that I have found that cause the most problems are boundaries and detachment. I’ve already written a LOT about boundaries and where my view of boundaries diverges with some of the other “Non-BP authors.” Today, I’d like to turn to detachment.

“Stop Walking on Eggshells” recommends on page 98, that a Non-BP “detach with love” from a BP and BPD-like behavior. This concept was “borrowed” from Al-Anon as it is made clear in SWOE. I think that “detaching” (whether with or without love) works in some situations and blows up in the Non’s face in others.

What are the differences? In WHINE, I explain that the “engine” of BPD is emotional dysregulation (which is the opposite of regulation). A person with BPD will heat up more quickly and cool down more slowly than someone without the characteristic of emotional dysregulation. One study that I cite in WHINE deals with “neutral” reactions to someone who is dysregulated. The basic evolution of an (as “Tides” calls it on her blog) Emotionally Dysregulated Moment (or EDM) is trigger -> cognition -> emotion -> expression -> behavior. Emotions can spur on other emotions. Anger is IMO the most powerful of the basic emotions and it is easily triggered, especially when a person with BPD is feeling judged. Ok, now back to detachment. On page 39 of WHINE, I explain that:

One of the most interesting findings of a study in which scientists used functional magnetic resonance imagining (fMRI) to measure the emotional reaction (limbic system activation) of patients with BPD is that these people react to neutral faces in the same manner they react to angry faces. In essence, when shown a picture of a person with a neutral expression, people with BPD showed amygdala activation as if the picture was one of a person with an angry expression. These people expect judgment and anger in others towards them and react physically and mentally to neutral situations as if they are threatening. They are likely to find “meaning” that is judgmental or threatening in an event that others would see as meaningless. A member of my list compared this reactivity to neutral faces to neutral feedback on eBay. As a buyer on eBay, you don’t give neutral feedback to a seller when everything about the sale is perfect. You give [neutral] feedback when something is wrong. A person with BPD will interpret a neutral face as “something wrong.”

Emotional detachment from an EDM will trigger more emotional dysregulation within a person with BPD. Instead, an EDM is a time to engage someone with BPD and engage them on an emotional level. Otherwise, if you detach emotionally from the situation, the BP will interpret your “calmness” and detachment as judgment or criticism. Additionally, they will likely consider you untrustworthy to validate their emotional states. What I mean by this is that if they are feeling so much emotional pain that they are dysregulated what they are really trying to do (regardless of the content what they say) is to communicate that pain to you. If they’re “dying in pain” and you’re detaching and calm, they feel they can’t come to you with the problem. On page 95-96 of WHINE, I describe this situation as follows:

The purpose of someone coming to you in an emotionally dysregulated (or close to one) state is to communicate the emotions that she feels. She may have difficulty expressing these emotions and may use other means for expressing them such as blame, sobbing, cutting, raging or other behaviors that are difficult for you to deal with. The underlying point however is one of communication – she is trying to tell you something, but she doesn’t have the language for it. Therefore, if you respond to an emotional communication in either an invalidating fashion (using one of the many, many invalidating phrases above) or in a way that doesn’t match the emotional distress, the BP will feel unable to communicate. She will think “I’m going off the deep end here and you are so calm! You don’t understand anything! You’ll never understand me!”, and not trust you. The tenor of your voice is more effective if you express your emotional identification with emotion in your voice as well, but with slightly less emotion than the BP is feeling. In other words, express distress in the identification, but less emotion than if you are actually in distress yourself.

Bon Dobbs :: Aug.07.2008 :: WHINE Book, Resources, Emotions, Borderline Personality Disorder :: 2 Comments »

I have been looking over the keywords that found my blog in the past few days and have noticed that I’m getting more traffic from people seeking information, self-help, advice and assistance with their borderline personality disordered partner. Here is a (small) sample of of these search terms:

helping someone with bpd
bpd crazymaking
levels of validation
“self-destructive behavior” friend
how to get bpd to go to psychiatrist
bpd communication
bpd and lying
high-functioning borderline
borderline how to convince ex i have changed
are emotions painful for bpd
invalidating environment, boundaries
advice for dealing with someone with a bpd
bpd dealing with love
borderline girlfriend
when she clearly has a personality disorder
bpd google groups
how to deal with a bpd
rejection-sensitivity
borderline rage attack
telling someone they have bpd
mental illness that exhibits rage, blaming
borderlines and lying to hurt their partner
did i give my child bpd

If you found my blog while searching on one of the above or on a similar search term, I would suggest you read my book When Hope is Not Enough (aka WHINE), because it contains answers to all of the above search terms and provides a how-to guide for solving those issues. WHINE is available for sale on Amazon and other Internet retailers. You can also buy an eBook version from Lulu.

I’d also like to respond to  two reviews of WHINE from Amazon - one negative and one positive.

First, the negative review…

Sorry, I didn’t care for this book as much as the others on BPD. The techniques were pretty much the same as recommended in “Stop Walking on Eggshells” but the technical background and reasoning behind the techniques was not as clearly discussed. Perhaps this book could be useful to someone who prefers the “lay” or non-professional approach and needs a book written in simpler terms.

OK, the techniques that I discuss are different than “Stop Walking on Eggshells” (although some of the techniques DO overlap). The main reason that my tools are different than in SWOE has to do with the fact that I present a different view of BPD focusing on three main aspects: emotional dysregulation, impulsiveness and shame. Unlike SWOE, I do not take you on a step-by-step review of the DSM-IV diagnostic criteria and, in this way, I feel that WHINE is more practical as a how-to guide than SWOE. Additionally,  I explain the techniques in DETAIL, that is, HOW to do each one, what to say and what NOT to say, etc. As an example of this surrounds validation techniques. I have flipped through SWOE and found very little on emotional validation of the BP’s emotions. There is 1/2 a page on the “triggers” of invalidation and a how a “I know how you feel” response could trigger rage (that’s on pages 113-114 of my copy of SWOE). There is some additional information that MAY be considered validation on pages 142-145 of SWOE about “Acknowledge Before Disputing;” however, this information is not detailed. In WHINE I spent over 30 pages (of a 185 page book) on emotional validation - why to do it, how to do it, how not to do it, when to do it, etc. Why? Because emotional validation is central to learning how to communicate effectively with someone with BPD.

Where SWOE spends many, many pages on boundaries and limits, the message is inconsistent. In the beginning of the introduction of boundaries SWOE says this:

Personal limits are not about controlling or changing other people’s behavior. In fact, they’re not about other people at all. There about you and what you need to do to take care of yourself. (pages 118-119)

THAT I agree with wholeheartily! However, later in SWOE we get this:

If you want the BP to change, you have to be willing to make some changes yourself if the person does not observe your limits. (page 157)

Alright, I would believe in the first part; however, the second part is what I have a problem with. My understanding of boundaries and limits are that they are for YOU and not about other people’s behavior. A person can’t “violate your boundaries” because only YOU can violate your own boundaries. If they do, your “boundaries” are not about your behavior anymore, they are about ANOTHER person’s behavior and those type of “boundaries” are really rules for the other person’s behavior. On this point (and on the importance of emotional validation) is where my book and SWOE completely diverge. (Another note creating such “boundaries” - that are really rules - is a trigger for BPD rage too).

Finally, the two books were written for two separate reasons. If you look at the subtitles of each you can see where each book has a separate purpose. The subtitle of SWOE is “taking your life back when someone you care about has borderline personality disorder.” The subtitle of WHINE is “a how-to guide for living with and loving someone with borderline personality disorder.” SWOE is written to focus on validation of the non-BP (which has its place, no doubt, I got a LOT of validation out of SWOE when I first read it 3 years ago). WHINE is written as a “how-to” guide for (peacefully) living with a person with BPD. The difference is subtle, but important. A member of my Internet list summed it up rather well this way:

I want to add another thought about this…

I think when Randi [Kreger, the co-author of SWOE] wrote her book, she likely recognized the importance of
validation, but her frame of mind was on healing herself.  So, I would
venture to say that is why there was a strong bent towards validating nons.
In addition, Randi got out of her BP relationship, so she didn’t really know
what to advise those who wanted to stay.  If I was her, I don’t think I’d
even care about any of that “staying stuff”… I’d probably just want to
help the nons move on with their lives (something she was familiar with.)

Bon, on the other hand, it seems had already gotten through the stage of
being able to self-validate, and had decided to stay.  So, his focus was, of
course, on problem solving.  And the only way to be effective at that is
through validation of BPs.

Each of their situations are different, as are their target audiences
(Randi’s being X-Nons and Bon’s being Staying-Nons.)  I think they both did
an excellent job speaking to the feelings of those they could sincerely hope
to reach out to.  The audiences that are getting caught up are the
Undecided-Nons.  Those are the ones who would benefit most by reading both
books in the exact order you advise.

So, as you can see both books have their place in the life-cycle of being a non-BP. I think what you have to do it decide where you are in the life-cycle. My book is aimed at making BP/Non-BP relationships more calm without “walking on eggshells.” SWOE is not really a “staying” book - although Randi Kreger does have a new book due out in the Fall with staying in mind.

Ok, so back to the key words… if you are searching on those types of things and WANT to maintain a relationship with someone with BPD, WHINE is an excellent resource for that. If you’re searching on “i hear demon moaning in husband” or “cutting ties borderline personality disorder” I suspect you should look for a book other than WHINE.

I’ll have to review my “good review” in the next post.

Bon Dobbs :: Aug.07.2008 :: WHINE Book, Validation, Borderline Personality Disorder :: 1 Comment »

I am posting a preview to my book When Hope is Not Enough: a how-to guide for living with and loving someone with Borderline Personality Disorder. You can get the preview here:

When Hope is Not Enough Preview

I “hope” you enjoy it!

I will be posting more information about the book shortly. As of this writing, there is only 1 more copy in stock at Amazon.

Bon Dobbs :: Aug.04.2008 :: WHINE Book, Borderline Personality Disorder :: No Comments »